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# ." CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE 

# m

us Army Corps

of Engineers


### ECC Certification for Property Closeout
OLSID 33317 Property Address 3923 N 26th Av Field Work Started 8 / 17 / 2007 

### Field Work Completed 8 / 18 / 2007 

### Summary: 

## • The excavation was performed in compliance with the work plans and specifications
. 

## • B I excavation depth was 12 inches below ground surfaces. 

# • Verification samples confirmed that cleanup standards were met. 

## • The site was backfilled with material which meets the contract specifications
. 

# • The backfill was compacted to acceptable standards. 

# • Sod placement and site restoration were conducted in compliance with the specifications and work plans.

Comments: None 

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## . . Owner Name: LESTER SAND ER S Address: 3923 N 26 AV 

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### ... . .**~** Omaha Lead Si t. 46130

### CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha , NE US Army C orps of E n gi n eers 

### Analytical Results Summary OLS # 

### 33317 3923 N26Av Quadrant Sample Type Depth Da te Collected XRF Results (ppm) (avg.) 

### PX EA·W 0 B/17/2007 70 DE B1 12 B/1B/2007 125

SAMPLE 10- SAMPLE ID is a particular residentiaJ property JO from which the sample is collected. The sample type identifier (with sequential sample number for that location) as follows; PX
- Pre-Excavation XRF sample DE ,.. Durmg and Post Excavation Quadrant describes the sampling location (with sequen tial sample number for that location) as follows ; FI or F2 = Front Yard One or Front Yard Two BI or 82 " Back Yard One or Back Yard Two 02 Drip Zone GA

- Garden PA

- Play Area EA =- Easement Depth describes the depth from which the sample was collected ppm = parts per mill i on-- 

### page 1 

### of_**~ ~~** **~~~ ~~~~~~** **~~~--.-** 

# . Omaha lead Site Omaha, NE Residential Yard Soils Environmental Restoration Services U.S
. Environmental Protection Agency Region VII**~~~-.~ ~~~-~~~**  PROPERTY ACCESS (to be completed by property owner) Para 'c::; ,:'I , es'a fe. 1'Cl,:r1 e;;:" ,"l,J1**::o~** 'aver IIJr,;:; 31 '·8::0-2 2: J.2:J Environmental Protection Agency (EPA) has contracted the U.S. Army Corps of Engineers (USACE), Omaha IIDist,ict to conduct environmental restoration services for the Omaha lead Site. USACE Omaha is working with IIEnviro"menllal Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration IIs.,rvi(;els
. Your cooperation is requested in giving EPNUSACElECC permission to access your property during the IIrem()valirelst(lralion phase. For further information please (;OOtact Don 8ahnke, EPA Project Manager at (913) 551­ or the Office of External Programs, at 1-800-223-0425. Property Access Granted By (Please Print Name)

I!ResidentName: 

### /..E.$TEf? SItNDgS

- 

## VJ1CJJAJi t.o71:iJ...<w'ner 

# o renter IIResidelnce Address : , 

## ?'1d3 N 

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### /tV Owned**By ~~S..L.L.8uM=..oE~**  

### _ __**~~~** 

### _ _ _______**~~ _** **11f"~n.o** .. mailing**address :~~~~~~** **~~~**____________**~~ _~** __**~~~~ ~_**  1I0'NnE"'S telephone number -**Home :_--'** **'f,.p....s;:.lJSo.l -..J.~'''~:..:I{,L/'-**  ___ Work : --------- --11

______ years How long have you lived here?

_____ years the exteior been painted or covered with siding since 1978? the interior been painted or covered since 1978? DYes DYes 

# o No 

# o No number of**occupants:. _~**  __ list Ages:

___________________ -il ages of occupants under 6 years old who play in the yard for 5 or more hours per week:

___ ___

activities to be implemented by EPA under this agreement ate pursuant 10 Section 104 of CERCLA. 42 U
. S
. C
. 9604
. EPA's right of acce •• loll for in Section t04(e) of CERCLA , 42 U
. S
. C
. 9604 (e)
. which provides entry for • "determining lhe need for response, or choosing or action under this i . or otherwise the of this title , "
First:
___________ Second : : ___________ Third: :

___________pg._of_ 

# List of Existing Conditions Property Address: Owner : 

# I

# ~-\-f£ 

# 6m c\v1o Date:

# ~\ 

# I1JW BVID#

## 33~ 

# 1"1

Ref: 

### Photo # 

### Description

Owner Signature ECC 

### Print & 

### Sign Print & 

### SignContract No. W912DQ-04-D-0017, Task Order DKOI Omaba Lead Site, Omaha, NE Property Qoseout Agreement DVID Property Address 

# I , ? <t ."l,

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### /1-11 

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## 2 SSJ? Property Owner Is the Owner the Resident? DYes 

# El..-No**Lf-~n** 

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]) [t.}" Compliance Statement: U.S
. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps of Engineers (USACE) , Omaha District to conduct environmental restoration services for the Omaha Lead Site. USACE Omaha is working with Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation in giving EP AJUSACEJECC permission to access your property during the removal/restoration phase is sincerely appreciated
. This document certifies that all work performed at this property was completed in accordance with the contract specifications and EPA requirements
. If you have questions or need additional information please contact Don Dahnke , EPA Project Manager , at (913) 551-7003 or the Office ofExtemal Programs at 1-800-223-0425
. Additional Comments by USACE and/or ECC:

CONTRACTOR CERTIFICATION Prashant Khanna or ECC Project Manager Charles "Skip " Milton Name Title Date Signature 

### PROPERTY OWNER SECTION This agreement documents the completion of remedial/restoration efforts at the property to my satisfaction.

## ~ I agree that restoration is completed at my property, except as noted Comments (if applicable): 

# 8 '

# ~**fk+~~ ~**  

# y-f d CYl <l- 

### [) f 1';/­ 

## // -() ? -o") Property Owner's Signature Date

## Property Owner Satisfaction Survey Form Omaha 

### Lead Superfund Site Perfonnance-Dased Contradine (PDC) Pilot Project Remediation Contractor:

___.... 

### £C-=-Y"'

________________ Property Identifier Number:

________ Property DViD Number: _--,- I 

### ?

......... 

### ?
.....



## ?

.... 

# I...,i.?-_- Property Address: , 

## f'lJ- 5' 

### tJ 

## cJ-b A-V Property Owner's Name: 

## /...t$Tftf 5Mb£l< (" (above infonnation to be filled out by remediation contractor prior to delivery of fonn to Property Owner) 

### ••••• * •••••• ***** ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• Instructions to 

### Property 

## Owner: This fonn is provided to you as a means of trying to capture 

### your level of satisfaction with the work of the above·identified Remediation Contractor, as applicable to the soil cleanup action at your property. The U,S. Environmental Protection Agency (EPA) and the U.S. Army 

### Corps of Engineers (US ACE) are very interested in your opinion regarding the work perfonned by our contractors . This fonn is intended to provide an easy means for you to express your opinion about the work performed on your property. Please indicate your level of satisfaction with the Contractor's work by 

### selecting a numerical rating (ranging from) to )0) using the 

### following rating scale, then please sign & 

### date the fonn and retum it to USACE in the attached self·addressed & 

### stamped envelope. (Additional comments may also be provided in the space provided, at the option of the property owner.) 9· \0 

### "excellent" 

### 7·8 5-6 

### )·2 "very poor" Property Owner's Satisfaction Rating regarding Contractor's Work 10 

# & 9 8 7 

# 6J

# (~ 4 3 2 ) 

### Additional Comments from Property Owner(optional; continue on back ohm ifneede4)

Property Owner's Signature: