# .. .ECC. 

### CONTRACT 

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

# m

us Army Corps

of Engineers 

# 'IV

ECC Certification for Property Closeout
OLSID 25199 Property Address 2414 Indiana St Field Work Started 10/512007 Field Work Completed 10/5/2007 Summary: 

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

## • F1 excavation depth was 13 inches below ground surfaces. 

## • F2 excavation depth was 13 inches below ground surfaces. 

## • B1 excavation depth was 11 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. 

## • Site restoration were conducted in compliance with the specifications and work plans.

Comments: None
ECCQCM 

# () t· 1J:.'l:: 

## '4 Title Date Jeff Hubbard USACE Con Rep Name Title

### '.\ 

# \ 1m 25199 Omaha Lead Site OWner r"/ame:**Gl~IA** JACKSQ!'l:.:.-
_ Site Sketch Address. 2414 INDIANA ST 

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Team' 

# Z42ve OLS 

# ott XRFCode 

## 2775 Quadrant Lead Concentration Fl 

### )3"**~O** ppm 

### F2 13 11 

## .55 ppm Bl 

## 1/1/ 30 ppm B2 ; 

### tf7 ppmjf DZ.
_ _____--1ppm

____....:....-.lppm

_____-1ppm

_____-1ppm ppm 

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# 1Stt CONTRACT # 

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

# 1m]

us Army Corps

of Engineers .Et:t:. 

# ... '

Analytical Results Summary OLS#25199 2414 Indiana St
XRF Results Quadrant Sample Depth Date Collected (ppm) (avg.) Type 40 55 30

SAMPLEID· 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~** FI or F2· front Yard One or Front Yard Two BI 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

## page 1 

## of_ 

## ?-SI9'1 Omaha Lead Site Omaha,NE Residential Yard Soils 

### u.s. Environmental Protection Agency Region VII Environmental Restoration Services 

# ., PROPERTY ACCESS (to be completed by property owner) ;::ia:a re:.:Jlf**€S~Ci ~C!'1'a**  £:;1**£~:i:·"C :;O~**  'ave' 'Jr:'e 81 1-EO·J**22:;<'~:::J** 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 (EGC) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation is requested in giving EPA/USAGE/EGC permission to access your property during the removal/restoration phase. For further information please contact Don Bahnke, EPA Project Manager at (913) 551­

003 or the Office of External Programs, at 1-800-223-0425. Property Access Granted By (Please Print Name)

omments: UTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS (ZIP) 

# o renter



# o No 

# o No (Date)

_____ years Work: 

## -------------11

List Ages: 

## ------------------;1 otal number of occupants:
_ Owners mailing**address:.-J-~_-L~_.....,.::""""""......II._~:-.....:;~_~r'-** _

wner's telephone number -**Home:_l.I;..:o~"J;...-_C....ol:.."""'-.-.._.L.-L-a.oI--''''--_** Resident Name:

__**....:..~** .......**~"""""** .......__.............. _ Residence**Address:-.loi:;;;.......:.......;.-=;L.-..J:.~..:.....L......Io!=----I,,...::;;:.....::..l,..<~"':Y**

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

ge of Home? years How long have you lived here?

. '" l:r-r tL. Hil U 

### 5: as the exteior been painted or covered with siding since 1978? 

## 0 Yes Has the interior been painted or covered since 1978? 

## 0 Yes

he activities to be implemented by EPA under this agreement are pursuant to Section 104 of CERCLA, 42 U.S.C. 9604. EPA's right of access to he property for in Section 104(e) of CERCLA, 42 U.S.C. 9604 (e), which provides entry for. "determining the need for response, or choosing or akin any response action under this title, or otherwise enforcing the ovi_sions of**~his** title," Access Attempts: First: Second: : Third: : _pg._of_ 

# List of Existing Conditions Property Address: 

# dLfJL/ 

# Ind 

# iClOJ 

# 56 DVD 10 # 

# dSlQ 

# 9 Date: 

# qLU /1>7 BVIDIt 

# d51 

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## Owner:

Ref: Photo # 

### Description

Owner Signature 

### ECC Print 

### & Sign Print 

### & Sign

### Contract No. W912DQ-04-D-0017, Task Order 

### DKOI Omaha Lead Site, Omaha, NE Property Closeout Agreement DVID 

### Property Address 

# I rJ.'1/'1 IJJh/I1NA**~.sJ** 

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## i Property Owner Is the Owner the Resident? DYes 

## !LJ-:Nl> (;"UJ 

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### :5:/l<!..kSoJJ 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/USACEIECC 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 Bahnke, EPA Project Manager, at (913) 551-7003 

### or the Office ofExternal Programs at 1-800-223-0425. 

### Additional Comments by USACE and/or ECC:

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

### PROPERTY OWNER SECTION This agreement documents the completion ofremedial/restoration efforts at 

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

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### JV Property Owner's Signature l".7 

### Date; /

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# I

## Property Owner Satisfaction Survey Form Omaha 

### Lead Superfund Site Perfonnance-Based Contracting (PBC) Pilot Project Remediation Contractor:**£I:::::.....!ooC~C** _ 

### Property Identifier Number:
_ Property BVID Number: 

### ;lSI 

### r? Property Address: 

## D2 'fllf ;;J:I./D/ltNA 

### Property Owner's Name: 

## GLOR 

## y 3"'/lCJ(50)./ (above infonnation to be filled out by remediation contractor prior to delivery of fonn to Property Owner) 

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

### lbis fonn is provided to you as a means oftrying to capture your level ofsatisfaction 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 vel)' interested in your opinion regarding the work performed by our contractors. lbis fonn is intended to provide an easy means for you to express your opinion about the work perfonned on your property. Please indicate your level ofsatisfaction 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 

# V 10 5 9 4 8 3 7 2 6 1 

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



### Property Owner's Signature: