### CONTRACT # 

### W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE US Army Corps of Engineers


### ECC Certification for Property Closeout
OLSID 33919 

### Property Address 4304 N 40 th Av 

### Field Work Started 9/11/2007 

### Field Work Completed 9/12/2007 

### Summary: 

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

# • F1 excavation depth was 3 inches below ground surfaces. 

## • Drip zone excavation depth was 13 inches below ground surfaces. 

## • Drip zone garage excavation depth was 13 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


## s;. 0 

### 0(1**1)v~UAJ** ECCQCM Name Title Jeff Hubbard USACE Con Rep Name Title 

### lO-(}S-C) DateOmaha Lead Site Date:

# Name:~**Add~ss:** Site Sketch Time: Phone: - North Arrow

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Omaha Lead Site 46130

## 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) ?a:a re: blr cstc; fc'''''-'a er**=s;:al~f** ::0: ;a\1O' 13r.12 al**i·CCfoJ·223·':~2S** 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 is requested in giving EPAIUSACEJECC permission to access your property during the removal/restoration phase. For further information please contact Don Bahnke, EPA Project Manager at (913) 551­ 7003 or the Office of External Programs, at 1-800-223-0425. Property Access Granted By (Please Prinl Name)

, , f •• NOTE G t" DOES NOT 

## ., . rt 1/ b ed' ted tth' f -_. ---_ .. -

-- - ...

## _-

------- -- - ----- - . - _.- . - - ) PROPERTY INFORMATION (to be completed by resident and or proper1y owner - Please PrInt) Resident Name: 

# :0/3 M£S I1()O R E UJ...-owner 

# o renter Residence Address: 

## I-fSO't N 

## YO ell (CITY) , (STATE) (ZIP) Property Owned By:

__-"S=.L../lLJML:..!....IE
_ Owners mailing address:
_ Owner's telephone number - Home:
_ Work: 

## -------------41 Age of Home?

______ years How long have you lived here?

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

# o No Has the interior been painted or covered since 1978? DYes 

# o No Irotal number of occupants:
_ list Ages:

## ----------------------41 List ages of occupants under 6 years old who play in the yard for 5 or more hours per week:
_ Comments: AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS The activities to be implemented by EPA under this agreement are pursuanlto Section 104 of CERCLA. 42 U.S.C. 9604. EPA's right of access to he property for in Seclion 104(e) of CERCLA. 42 U.S.C. 9604 (e), which provides entry for. "determining the need for response. Of choosing or aking any response action under this litle, Of otherwise enforcing lhe provisions of this litle." Access Attempts: First Second: : Third: : _pg._of_ 

# list of Existing Conditions
Pro pe rty Add ress:**_---!..'i.=s~O:.........ll(:....__L.:IN:....__J.t..L.lo()~It~VL...-** 

## _ DVD 10 

## #
_ 

## -SOMEs 

## DzOM£ Date: 

## F -cJr-o , BVID# 

## 339/ 

# '1 Ref: 

## Photo # 

### Description 

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### Owner Signature 

### ECC

## {pI~**-3~/.s prin~Sign**  

### Print

# ~~fYl~ J

### Contract No.**W912DQ~04-D-0017,** 

### Task Order DKOI Omaha Lead Site, Omaha, NE Pronerty Closeout Agreement BVID 

### Property Address 

# 1 4

# ~? iiI/ J..fi) 

## Ift/ N Cl 

### NO 

## .... '?-.?rl'i Property Owner Is the Owner the Resident?

# ~s S/fJ\1&;<'**m,/I/1~1C** 

### Compliance Statement: 

## u.s. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps ofEngineers (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 EPA/USACElECC 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. Ifyou have questions or need additional information please contact Don Bahnke, EPA Project Manager, at (913) 551-7003 

### or the Office ofExtemaI 

### Programs at 1-800-223-0425. 

### Additional Comments by 

### USACE and/or ECC:

CONTRACTOR CERTIFICATION ECC Project Manager Name Title Date Signature 

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

.

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

- 

### I 

# X':· 6}£U/1// tJ.;I.

# 1J/?J1~ Pr0fj"iy Owner's Signature Date 

# /j --)1-07

## Property Owner Satisfaction Survey Form Omaha Lead Superfund Site Perfonnance-Oased Contracting (POC) Pilot Project Remediation Contractor:

__**-'-£....:;...::c.~C::::.......** 

### _ Property Identifier Number:
_ Property OVID Number: 

# 33 Cf

## I 

# cr Property Address: 

## '-130 '1 N 

## l./ 0 /} 

## 1/ Property Owner's Name: 

# 38 M 

### €J 

## moo8 

## £ (above information to be filled out by remediation contractor prior to delivery of form to Property Owner) 

### *******.*.***.* •• *•••• ******. .** ** ••• *** •••• ** ••••• ***.******************* Instructions to Property Owner: 

### This fonn is provided to you as a means oftrying to capture your level of satisfaction with the work ofthe 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 ofEngineers (USACE) are very interested in your opinion regarding the work performed by our contractors. This form 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 1 to 10) using the following rating scale, then please sign & 

### date the form and return 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.) 9-10 

### "excellent" 7-8 

### "very good" 5-6 

### "acceptable" 3-4 

### "poor" 1-2 "very poor" Property Owner's Satisfaction Rating regarding Contractor's Work 10 5 9 4 8 3 

# x. 7 

### 2 6 1 

### Additional Comments from Property Owner (optional; continue on back of page ifneeded)

### CONTRACT # 

### W912DQ·04-D-0017, T.O. DK04 Environmental Chemical Corporation 

# m .Ec:C. Omaha Lead Remediation, Omaha, NE us Army Corps of Engineers 

### Analytical Results Summary OLS #33919 4304 N 40 th 

### Av
Quadrant Sample Depth Type 

### DE F1 3 

# I DE 

# I DZ 13 

### II 

## I DE 

# I EA-W 0 

# I 13 

# I DE DZ-G 

### II Date Collected XRF Results (ppm) (avg.) 91712007 30 91712007 179 91712007 46 917/2007 256

SAMPLE 10- SAMPLE ID is a particular residential property ID 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 = During and Post Excavation Quadrant describes the sampling location (with sequential sample number for that location) as follows; Fl or F2 = Front Yard One or Front Yard Two B1 or B2 = Back Yard One or Back Yard Two DZ = Drip Zone GA = Garden PA = Play Area EA = Easement Depth describes the depth from which the sample was collected. ppm parts per million