TRANSMITTAL of OMAH A LEAD SITE 

SOIL REMEDIATIO N FILE FOLDER 

SAID#: \HlQ'S Date: ^liOJO ^ 

Address: .^1 \ 'S^priAA 3 

O 

Remediation Contractor: Coastal Environmental Group_ Year: 2008 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

y Video of property (DVD) 

Sr Executive Summary 

0 EPA-provided property sketch 

y Signed Access Agreement for subject property 

Isju Signed Access Agreement(s) for adjacent property 

0^ Restoration Agreement 

ji ^ Settlement documents (i.e., for damage or to replace plants, etc.) 

y Confirmation data 

Photographs ye^ J iCCajJaJqOA^ jLX-(laJdJ-LG^. - -t ru l SO<L 

y As-built sketch 

y Satisfactory restoration signed by Property Owner 

B^ Property close-out check list signed by EPA 

/ ^ Description of areas not meeting ROD cleanup criteria 

y Utility clearances 

^ y Property information from Douglas County Assessor's Office 

ly propg^lw. ^tc.jes3 ckeJipL y 

y QjcyauX \(s^\) i ^ 

D 

Signature Date 
4 

iv>;s -

Property Access Checklist 

Propert) ID: \l-:\\t: 5 

Property Address; 

'• 3(^1-1 ^x^^m^i 

D

D

 WORK STARTED 

 WORKCOMPELTED 

ON: 

ON: 

_/

/

 /_ 

/ 

Q^^"^'­^ A^CX^/\ .\mx\rY^\ 

Address: 

Phone: c^^^-5^^a t 

Fax: 

Renter 

Phone: 

Fa.\: 

Cell/Pager: 

Additional Infonnation: 

Ccll/Pager: 

D Notification Letter 

0 ^ Access Agreement 

Q'^Restoration Agreement 

n Topsoil Sampling (if applicable) 

! n Disposal Sampling (if applicable) 

• Garden Sampling (if applicable) 

0 ^ Utility Clearance 

0 Video/Photos (Before) 

n Video/Photos (During) 

n Video/Photos (After) 

D Video/Photos (30-Day) 

n Property Completion Agreement 

D Final Report 

Sent: / / 

Siened: IO/-2/ /CX 

Signed: L^/2i/il)K 

/ / 

/ / 

/ / 

Called: J0/:2i/i::g 

On:^/^/Q / 

On: / / 

On: / / 

On: / / 

Signed: / / 

Issued: / / 

By: 

By: K\.CVIHA ^ 

By=KV^rV\n\/:^ 

By: 

By: 

By: 

B>'=\rJ-7mnS5' 

By:yc/77'0y;cKV\ 

By: 

By: 

By: 

By: 

By: 

Air Monitoring (as applicable) 

' n Community O Crew | 

Results:

On: / / 1 

1 

n Community

Results:

 C] Crew | On: / / By: 1 

i 

1 1 Community'

Results: 

D Crew | On: / / By: 

Omaha Lead Site 
Property ID #

Property 

Address: 

Initial Contact: 

Second Contact: 

Final Contact: 

Final Action; 

Comment: 

Owner 

I Comment (s): 

Site 

Coordinator 

Coinment (s): 

CONTACT FORM 

 jM \C)6 

32n\ ^ priTo 

^ 

Date Time: Action: 

Date Time: Action: 

Dale Time: Action: 

Transmit to EPA D Other .Action: D 

-J 
Douglas County Account Information 

Page I of2 tnatio 

Dougla s County , Nebrask a Propert y Recor d - R232430000 0 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 f) west of 90th St - Vie w o n Map Information is valid as of 2008-9-4 Treasurer^ Tax Report 

New Feature -•-•- * Auto Sales Search 

Owne r 

RASHID JEANNE J 

ETAL 

3271 SPRING ST 

OMAHA NE 68105-0000 

Propert y Informatio n 

Key Number: \ 2430 0000 23 

Account Type: Residential 

Parcel Number: 2324300000 

Parcel Address: 3271 SPRING ST 

OMAHA NE 68105-0000 

Legal Description: THOMASON & GOOS ADD LOT 1/2 VAC ALLEY & W 55 E 270 FT OF N 

RESERVE W OF 32 AVE 55 X 87.8 

Valu e Informatio n 

Land Improvement Total 

2008 $5,800.00 $99,800.00 $105,600.00 

2007 $5,800.00 $99,800.00 $105,600.00 

2006 $5,800.00 $85,500.00 $91,300.00 

2005 $5,800.00 $85,500.00 $91,300.00 

2004 $5,800.00 $85,500.00 $91,300.00 

2003 $5,800.00 $65,200.00 $71,000.00 

Sales Informatio n 

Sales Date: 1998-12-10 

Deed Type: Book: 2113 Page: 087 

Price: $87,000.00 

Grantor: 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Lan d Informatio n 

Acres SF Units Depth Width Vacant 

0.11 5225.0 1.0 95.0 55.0 No 

Improvemen t Informatio n 

http://dougIasne.mapping-online.com/DougIasCoNe/static/accountinfo.jsp?accountno=R23... 10/7/2008 
Douglas County Account Informatio rn^ioi n Page 2 of2 

Building 1 

•34 0 -^tt 

r:ir 824(l5l» PI F M Floor 

!» 

»r « f 

M(r 

rtr 

I*W 

M D 2 Story 

•J.M..O.Sg,n.. Bsmrt Block B ft 

CLICK TO ENLARGE IMAGE 

Square Footage: 

Perimeter 

Unit Type: 

Built As: 

HVAC: 

Exterior: 

Interior: 

Roof Cover: 

Roof Type: 

Floorcover: 

Year Built 

1641.0 

0.0 

2 Story 

Central Air to Air 

Frame Vinyl 

Drywall 

Composition Shingle 

Hip 

Allowance 

Year 

Remodeled 

1910 1983 

Detail Type 

Add On 

Appliance 

Basement 

Fixture 

Fixture 

Fixture 

Porch 

Porch 

Percent 

Remodeled 

0% 

Detail Description 

Fence Chain Link 

Allowance 

Bsmnt Block 8 ft 

Base Fixtures 

Bath Full 

Bath Half 

Cvrd Wood Deck 

Wood Deck 

" «2*0Sq Ft 

..»......,« — 1 CLICK TO ENLARGE IMAGE 

Percent Complete: 

Quality: 

Condition: 

Condo Square Footage: 

Rooms: 

Units: 

Baths: 

Bedrooms: 

Stories: 

Foundation:

Sprinkler Square Footage:

Adjusted Year 

100.0% 

Average 

Average 

0.0 

7.0 

1.0 

2.5 

4.0 

2.0 

 Block 

 0.0 

Physical Age Built 

1910 99 

Units 

1.0 

1.0 

624.0 

1.0 

2.0 

1.0 

64.0 

216.0 

http://douglasne.mapping-onIine.com/DouglasCoNe/static/accountinfo.jsp?accountno=R23... 10/7/2008 
Page 1 of2 

% 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 2159953. 

Original Call Date: 10/22/08

Work to Begin Date: 10/24/08

 Time:

 Time:

 2:55 pm

 3:30 pm 

 Op: ELIZABETH18790 

State: NE 

Address: 3271 

County: DOUGLAS 

Street: SPRING ST 

Place: OMAHA 

Twp: 15N

Twp:

 Rng: 13E

 Rng:

 Sect-Qtr: 33-NW 

 Sect-Qtr: 

Legal Given: C 


Type of Work: lead remediation 


Location of Work: LOCATE ENTIRE PROPERTY INCLUDING HOUSE ALL THE WAY TO THE 


: STREET. 


Remarks: FAX ALL CLEARS TO: (877)662-4211 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name: ELIZABETH Phone: (877)662-4210 


Work Being Done For: coastal 


Depth of Excavation: 4ft Comer Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUD02 OMAHACOF 0PPDGPR6 QLNNEIF QWEST2 

Service Area Contact Phone Number UtiUty Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 4025047823 

MUD02 METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047946 

Day: 4024447197 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RON Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

OPPDGPR6 OMAHA PUBLIC POWER DISTRICT NA Ah: 8887289343 

Emerg: 4067289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 10/22/2008 
Page 2 of2 

% 

QLNNE 1F QWEST LOCAL NETWORK NA

Day: 

 Alt: 

Emerg 

4067289343 

8887289343 

QWEST2 QWEST LONG DISTANCE SARA

Day: 

 Alt: 

Emerg" 

8002834237 

3039921926 

8002834237 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 10/22/2008 
As-Built Drawing A 

COASTA L Omaha Lead Superfund Mte 

Name:^S^iq,!eA^M t Omaha Lead Site Date: Cf^ (CI/QS North Arrow 

Address: ^7^ 1 -T^^I/U^T SKe Sketch Time- , 

Phone: :^^U7 - UV/c Z 

m^ 

Teamf>MiustleAi^(ns BviD# IHK K XRF Code S^^O ^ , 

Sample Number Lead Concentration Confirmation Sample 

f i Yes n No £35 

f 2 Yes a No ^ 

g, 1 Yes • No ^ 

S2Yes ° No ^ 

PDrTiCPkA - /»'/Qtf 'fV.3 - c / ppm 02Jes ° No g A?/>yacPXA - /^/Q ^ /<SO ^/.9 ppm V^e s • No 03 

ppm Yes • No • 

_ ^ 

OLSfe.lldflS i- — t .1-. 1 

Pate Excavated: 11/^/08 

..P.at^-US.EPASjqn^dOff:=12/5/0g i i 

Area iSbdded 3790 s^q ft 

Omaha Lead Site 46130 

Quadrants Excavated 


Are a replace d wit h Area replaced with D Area left bare 
 S o d Rock/Mulch 

Contract #: EP-R7-07-05 Coastal Environmental Group Inc. 
Name:'S^gllOj^^ ^ Omaha Lead Site Date : O^/^/q? North Arrow 

Address^23L^^iE SKe Sketch Time r 

Phone: :-?U7 - UyToZ U:CO - ^ 

W^ 

Team f:SMja|.W(ns BviD# i<4i(K XRF Code S^^G ^

Sample Number Lead Concentration Confirmation Sample 

VVg—L£Q ppm f I Yes a No ^ 

QYS,<10P)(7i ~ /^JQ. ^ f 2 Yes a No ^ 

RvnyjoPXA - P^y(^^ g, 1 Yes O No g l^YDaOPXTl - /t//o£ « 2 Yes 1^ No ^ 

PDL.^CP)(A ' /»/Q{f yy«i?—-€/^ ppm r>2Jes Q No g 

ppyacPXA - /u/Q£ /<gO ^/>9 ppm <lpYes n No f a 

ppm Yes • No ID 

(S) 

y=><^<2yFi.7^. 

4^ 

Omaha Lead Site 46130 
% 

Name:'S^l|OJW^ Omaha Lead Site Date : 0iyQ^ North Arrow 

Address^l^L^teE : Site Sketch Time' 

Phone: r^U7_- UV/o Z U:GO ^ 

f ^ 

Team i<ihMlds|.kn^(ns BVID# I^K K XRF Code 5'^Q ^ 

Sample Numt>er Lead Concentration Confirmation Sample 

PYM,<ioPx^ ­ p/yo ^ yy g

/y3T

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 nnm 

f I Yes

172 Yes

 n 

n 

No J33" 

No ^ 

py/iaoPXA ­ /t//o£ ' (T—IJJLL— ppm g, ! Yes

5 2 Yes

 • 

D 

No

No

 ^ 

^ 

Jiii3.—-^T ppm No ^ 

ppy7iCPX/i ­ /^/o ^ /&o t/.q ppm 

ppm 

^e s

Yes

 • 

• 

No

No

 ^ 

• 

Omaha Lead Site 46130 
Name:'S^[ilDJ^ ^ Omaha Lead Site Date : a^.ya? North Arrow 

A66resl^n { ^^^{MC n Site Sketch TimePhone: r^. - UVfo Z U:00 - ^ 

Team f^NfMistlenl^dfis BviD# ILJKK XRF Code S^O ^ 

Sample Numt)er Lead Concentration Confirmation Sample 

RYD6QPXA

ppyacPX A

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­

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 /^/o £ 

f r V

HS

/r y

yy.5

/& o

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 t/. q ppm 

ppm 

f 1 Yes

PZ Yes

5 1 Yes

52 Yes

Yes

 n 

n 

• 

° 

• 

No J ^ 

No ^ 

No ^ 

No ^ 

No g No fSI 

No • 

^ 

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Omaha Lead Site 46130 
-.:.tBSt4t 

COASTA L 

ENVIRONMENTA L 

C * O U P . IN C 

Consent For Access To Property 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner) consents to and authorizes the United States 

Environmental Protection Agency (EPA) or its authorized representatives, collectively 

the Grantee, to enter and perform certain environmental response activities upon the 

following described premises: 

i/yz. ^^ \ ^¥^S ^ 

Owner's Name: ^1^^^ ^ M^/H I 0 Daytime Phone: 

Address of Property 

covered by this 

Agreement: y)^UA^^, Ky y ^ 

PURPOSE OF RESPONSE ACTIVITIES 

The EPA Is requesting access to collect soil samples and remove soil that contains 

elevated concentrations of lead and may pose a health hazard. The area(s) will be 

excavated to remove contaminated soil. The removed contaminated soil will be 

replaced with clean materials and the area will be restored to its original condition. 

This work is being performed under the Omaha Lead Superfund Site remediation 

program. 

A representative of Coastal Environmental Group, contracted by USEPA, will contact 

the Grantor in-person to discuss the work to be performed, the Grantor will have an 

opportunity to review and approve the planned soil removal, and restoration work 

before it begins. Once the work is finished, the Grantor will be asked to review the 

work and confirm that it is complete and meets with the Grantor's approval. Upon 

completion, the Grantor will receive written documentation from EPA that the property 

has been remediated. 

ENVIRONMENTAL RESPONSE ACTIONS 

By signing this Access Agreement, the Grantor is granting the EPA, its employees, 

contractors and subcontractors the right to enter the property, at all reasonable times 

and with prior notice, for the sole purpose of performing the work. This access shall 

remain in effect until the work has been satisfactorily completed. The Grantor also 

agrees to: 

Page 1 of 2 
•*»•* % 

I ^ < # 

I M^ COASTA L ENVIRONMENTAL 

C • O U P . IN C \!!y 

• Remove obstructions including boats, trailers, vehicles, playscape items, wood 

piles, dog houses, etc; 

• Remove flower bulbs or plants that the Grantor or the Grantor's tenant may wish 

to save; 

• Water and maintain replacement vegetation, including fertilizer application, as 

necessary subsequent to an initial watering period by EPA; 

• Abide by health and safety guidance provided by EPA; 

• If the property is rented, assist EPA in obtaining tenant approval for access to 

the property to perform the work. 

• Allow videotaping and/or photographing of the property. 

AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to interfere or tamper with any ofthe work activities, or with any 

of the work done, or with the equipment used on his property, or to undertake any 

actions regarding the use of said property which would tend to endanger the health or 

welfare of the Grantees or the environment, or to allow others to use the property in 

such a manner. 

Should you have any questions about this program, please contact Coastal 

Environmental Group, at (712) 352-0188 

U^ I grant access to my properties 

• I do not grant access to my properties 

m4 

Signature Date Signature 

Date 

Q I would like to be present during any sampling that is required. 
COASTA L 

Restoration Agreement 

The purpose of this agreement is to provide a mutual agreement as to conditions ofthe property prior to 

remediation activities. This will also serve as documentation for the purpose of assuring that restoration 

activities are completed to the satisfaction ofthe propert>' owner and the United States Environmental 

Protection Agency (EPA). 

Property ID: 11T3T 

Property Address: 

Owner: / ^ UA t \ CK y V\ i O 

Phone: 

On the attached diagram(s) indicate area(s) to excavated and depth of excavation, location of all known 

utilities, subsurface features, syrface structures and landscaping features, access location(s) to be used by 

contractor, and the direction of North. Indicate distances, depths, material types, etc. Indicate digital photos 

by referencing the photo-log number with an arrow indicating direction of view. 

Items To Be Removed By Owner Before Start Of Remediation: 

(Use additionai sheets as necessary) 

The removal, storage, disposal, and/or return of these items is the Owner's responsibility. 

Item: 

yo y ^ 

Item: ^ 

Item: 

/ 

item: 7 

y 

Item: 

y Item: y 

y 

Item: 

y Item: 

/ 

Page I o f P 
1 ^ 

C O A j T A L 

Items To Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

Item: 

— ­ / > c l {•I y 

Item: | 

Item: / 

Item: / 

Item: 

Item: / 

Item: / 

Item: 

Item: 

7 

Item: 

Item: 

Item: 

Item: 

/ 

Item: 

/ 

Item: /

/ 

Page 2 of ^ 

i 
COASTA L 

C H O U r IN C 

Items To Be Removed By Contractor Durinq Remediation And Replaced 

(Use additional sheets as necessary) 

j Item: 

S y > ( f x 0 ^ 

Item: 

Item: 

< ; y fl f z / 

/ 

Item: 

/ 

Item: 

/ • 

Item: 

Item: / 

Item: 

/ 

Item: 

/ 

Item: 

/ 

Item: 

/ 

Item: 

/ 

Item: 

/ I 

Item: 

/ 

Item: 

/ 

I 

Page 3 y 
— o 

C O A 5 T A L KM •IKOMMtNTA L a M O U r IM C 

Landscape Inventory 

(Use additional sheets as necessary) 

Item 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

trunk diameter 

Number of trees <= 2 inch 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Number of and size of 

each garden/ flower bed 

area. 

Attach a sketch of relative 

sizes and locations. 

Quantity 

9 ^ 

y 

, ^ 

y 

y 

Unit 

Square feet 

Condition/Type/Species 

Each 

•^ 

Each 

Each 

Each 

Square Feet 

Page 4 of 6^ 
COASTA L 

(MVIMOMMtMTA l C *> O U r tM C 

Item 

Agreed upon value of 

Diant materials not to be 

renlaced bv contractor. 

Note this value will be 

used to issue a plant 

voucher to the property 

owner. 

Agreed upon list of plant 

materials that will be 

replaced by contractor. Be 

very specific and detailed. 

Include a sketch of were 

each plant will be placed 

by the contractor. 

Agreed upon area of 

property to be replaced 

with grass sod. 

Include a sketch of the 

area(s) to be replaced with 

grass sod. 

Area of City or County 

property to be landscaped 

per their requirements. 

Include a sketch of the 

area (s) 

Easement Area, to be 

excavated 

Quantity 

^ ' 

Unit 

s 

Condition/Type/Species 

^ 

Each 

y SF ^y^'"^'^ 

^ SF 

y SF 

Page 5 of. 0 
C O A S T A 1. • M V « h e I'M t «t T* I. 

Additk>na] Comments / Instructions: 

^cyc.p^ ^-^'^^ ^"""^ ^ ^ 

/loi/ ry fd ^ 

G Check the box if Owner does riot want CEG to document interior foundation walls and possible 

pre-existing damage. By checking this box CEG is not responsible for any damage done to the 

interior of house, indudingfoundation cracks or fissures. 

Q I agree --^ j • I do not agree 

^yy y y y 'frmvois'"y.ir^ 

Owner's statur e -^ Date Contractor's Signature T)ate 

Page 6 of. 
Date 

Project 

XRFID# 

Shot# 

yiio.n ^ 

ytun ^ 

^GzHU ' 

c^i^n ^ 

Average

Shot# 

Average 

Shot# 

Average 

Shot# 

Average 

lab sample # 

BVID#'\mCS" 

XRF PROPERTY SAMPLE SHEET 

\\-Lo-OP> Address ^"~^ \ "y y rxCK S ^ 

Omaha lead FP 2ncl year option Sample time ^ am/pm 

3Qoeq sample length 30 sec 

Reading Sample area Shot# Reading Sample area 

ioa.QS!:\3.-i 8 ZiU^iS (y.?.Z^\t)-i A 

-g-i oQ-t -\.iJ,c^ f\ c3(.?^ 8&B\i'\ \ 1.R ibt 

.Qf..H«tn.q \ Depth .-Q(o3l 99-131 ^.u q Depth 

VTO •J.ot: UsM'T ( C r^t^ a Aa.u.t n.u^ / ^ 

fif"^. f^U^ ^ l\.0 \ Average ^fi,:q(ot : 4.?,' o 

Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average 

Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average 

RETEST AREAS 

Reading Sample area Shot# Reading Sample area 

Depth ^..-" ^ Depth 

y y 

Average 

Lab result Sample area XRF Avg. 

Signature_ 

Print MfH ^ Ufcrjys 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 102.249 

Supervised By: 

Certificate of Verification 

2674 

SOIL 

2008-11-06 15:31 

30.90 

Final 

14105 

3271 spring st 

Fl 

Ventry 

6 

CLEARANCE 

± Error 

± 12.778 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2675 

Mode SOIL 

Time 2008-11-06 15:32 

Duration 30.44 

Sequence Final 

Flags 

BVID # 14105 

ADDRESS 3271 spring st 

QUAD/ZONE Fl 

INSPECTOR Ventry 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 25.020 ± 7.687 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 25.884 

Supervised By: 

Certificate of Verification 

2676 

SOIL 

2008-11-06 15:32 

31.16 

Final 

14105 

3271 spring st 

Fl 

Ventry 

6 

CLEARANCE 

± Error 

± 7.912 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 170.303 

Supervised By: 

Certificate of Verification 

2677 

SOIL 

2008-11-06 15:33 

30.92 

Final 

14105 

3271 spring st 

Fl 

Ventry 

6 

CLEARANCE 

± Error 

± 16.469 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2678 

Mode SOIL 

Time 2008-11-06 15:33 

Duration 123.42 

Sequence Final 

Flags 

AVERAGE Avg of 2674-2677 

ADDRESS 3271 spring st 

QUAD/ZONE Fl 

INSPECTOR Ventry 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 80.864 ± 11.211 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 64.331 

Supervised By: 

Certificate of Verification 

2679 

SOIL 

2008-11-06 15:34 

31.19 

Final 

14105 

3271 spring st 

DZ 

Ventry 

13 

CLEARANCE 

± Error 

± 10.711 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2680 

Mode SOIL 

Time 2008-11-06 15:35 

Duration 31.28 

Sequence Final 

Flags 

BVID # 14105 

ADDRESS 3271 spring st 

QUAD/ZONE DZ 

INSPECTOR Ventry 

DEPTH 13 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 83.808 ± 11.781 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 22.733 

Supervised By: 

Certificate of Verification 

2681 

SOIL 

2008-11-06 15:36 

30.97 

Final 

14105 

3271 spring st 

DZ 

Ventry 

13 

CLEARANCE 

± Error 

7.489 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 22.160 

Supervised By: 

Certificate of Verification 

2682 

SOIL 

2008-11-06 15:36 

31.19 

Final 

14105 

3271 spring st 

DZ 

Ventry 

13 

CLEARANCE 

± Error 

± 7.430 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2683 

Mode SOIL 

Time 2008-11-06 15:36 

Duration 124.63 

Sequence Final 

Flags 

AVERAGE Avg of 2679-2682 

ADDRESS 3271 spring st 

QUAD/ZONE DZ 

INSPECTOR Ventry 

DEPTH 13 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 48.258 ± 9.353 

Supervised By: 
Omaha Lead Site—Fixed Price EP-R7-07-05 

Coastal Environmental Group Inc. (Ml www.coastal hazmat.com 

COASTA L 

[NVItONHENTAL 

C II 0 U f . INC . 

EXECUTIVE SUMMARY: 

BVID # 14105 - (3271 SPRING ST) 

I I No Issues or Concerns X Issues/Concerns 

Detail Explanation: 
^^EPA 

EPA Property Close Out Form 

Property ff:

Date/Tine: 

 /^./.D/S^ Property Address-.­ '3.^7 ( 7^ ^ ^ 

Owner's Name:. /j^..,,,- -^^ . ._ .j . MX". i i Z • . 

Quads Excavated: F 7 P ^ Contractor Group 

Excavation General 

Yes No 

1. If necessary, were the correct quadrant{s) excavated and restored? 

y 

2. If necessary, were the correcl areas ofdrip zone excavaied and restored? y 

Grading Sod and Vegetation 

Yes No 

1. Does the grading around the perimeier ofthe house in excavaied areas generally slope away y from the house? 

2. Has sod been laid in all areas that were excavated? y 

3. Docs the sod appear to be generally healdiy and growing? (Only evaluate if inspected at a 30 

day time period) 

4. Are sodded areas generally firm and evenly graded? 

5 Are the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day 

time period) 

6. Was the property graded such that water will nol pool on the property? y 

7 Was damage to landscaping or plant materials avoided? y 

Gates, Fences and ReUining Walls 

Yes No 

1. Do gates open and close freely? (Ifapplicable) y 

2. Were all gates or fences taken down during restoration acliviiies reinstalled? (Ifapplicable) y 

3. Was damage to gates or fences avoided? (Ifapplicable) y 

A. Was damage to retaining walls avoided? (Ifapplicable) 

y 

Foundation, Siding and Gutters 

1. Was damage to die siding or trim avoided? 

2. Was damage to the foundation avoided? 

3. Was damage to windows avoided? 

Yes 

y 

y 

y 

No 

4 Was damage to windows or door screens avoided? •^ 

5. Was damage to downspouts or downspoul extensions avoided? y 

Sidewalks and Driveways (Concrete) 

1 Was damage to driveway surfaces avoided? 

Yes

y 

 No 

2. Was damage to walkway surfaces avoided? y 
Oviners comments: 

Inspection notes: 

Removal and resloration activates complete including the 30-day sod warranty: 

EPA Representaliv^^^^?:^!^^ .^^ ^ Dale: /y/y/of 
Property Completion Agreement 

This agieemeni documents the completion ot remedial activities performed on my properly My signalure 

will designate that i am satisfied with the restoration of my property, and thai no items are in questions, 

now, or al any time in the future, except those items listed below, ifany 

Property ID: 'A\<y 

Property Address: ^ ^ I S^n ^ r^C^_ St ^ 

Q""^"Uo^V^\c^ ^ . g.CA>-oy\ 

Phone: SBv-s^uQ 

Restoration Items in Question: 

Item: / 

>^^vj/-fr»/*/^i<a Sao A 'r^.^c^L..t/'ifrf Spnritf . J U ' ' -1 

Item: 

Item: 

Item: 

Item: 

Item: 

vee re.<itoralion iv complcled, cxccpl as noled 

 I I rio nol aijrec restoration \s completed 

yyyyy K n hir 

OWiici^ Sig Contractor's Signature Date ^-- ^ Dale 

I