TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID# 

Date: 1 ni W 

Remediation Contractor: Coastal Environmental Group_ Year: 2001 n 

SOIL REMEDIATION 

PROPERTY nL E FOLDER DOCUMENTS 

Video of property (DVD) 

If Executive Summary 

31' EPA-provided property sketch 

Signed Access Agreement for subject property 

Signed Access Agreement(s) for adjacent property 

a/ Restoration Agreement 

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

Confirmation data 

Photographs 

As-built sketch 

Satisfactory restoration signed by Property Owner 

Property close-out dieck list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

Utility clearances 

c/ 

Property information from Douglas County Assessor's Office 

D 

D 

D 

vhA/ ] / 

30055286 

Superfund 
# • 

Property Access Checklist 

Proper, U): I^L ^ ^ 5 

Property Address: 2m^ 3 hJ L^' p gWF 

D

D

 WORK STARTED

 WORK COMPELTED

 ON. 

 ON: 

_/

/

 /_ 

/ 

o^^'"^- R \o.Wx\rri V^ SrtOOrs 

"'""^"^5amii 

Phonc:|^77-;^{?2/p 

Fav 

Renter. 

Phone: 

F.Lv: 

Cell/Pager: 

Additionul InCnrtnxtion: 

Ccll/Pager. 

D NofifiCiition Utte r 

^Acces s Agreement 

QJ Restomtion Agreement 

O Topsoil Sampling (if applicublc) 

D DisposaJ Sampling (K applicable) 

D Garden Sampling (if applicable) 

G Ulilily Clearance 

St Video/Photos (Before) 

D Video/Pholos (During) 

n Video/Photos (After) 

D Video/Photos (30-Day) 

D Property Complelion Agreemenl 

Sent: / / 

Signed:-!_/13'S^ 

Signed: 2L/i2L/G^ 

/ / 

/ / 

/ / 

Called: / / 

On: JZ/ifl/.23 

On: / / 

On: / / 

On: / / 

Signed: / / 

By: 

By. (J04t5\An 

»yV-ent(j«^\/ 

By: 

By: 

By: 

By: 

ByV-en-fiirx^ 

By. 

By: 

By: 

D Final Report Issued: / / By: 

Air MonitorinK (iU upplicable) 

D Community CD Crew |

Rc&'uJis: 

 On: / / By: 

D Comrounln'

Results: 

D CrcM­ j On: / / Bv: 

D Community

Result): 

D Cruw On: ' / Bv: 1 

Omaha Lead Stte 
Property ID#

Property 

Address: 

Initial Contact:

Second Contact:

Final Contact:

Final Action: 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

CONTACT FORM 

 Vp-^MBS 

Z^U':^ N Hf^ fVy^. 

 Date: 'Jm C^ Time: 6-4^ Action: i^t l fi-V^^ 

 Date: I ^ Time: Action: 

 Date; Time: Action: 

Transmit to EPA D Other Action: D 

f(> MDl M-oWi^, J 1^101 
Douglas County Accoimt Infoi niat^t Page 1 of2 

Douglas County, Nebraska Property Record - R0811190000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - VIe W OH Ma p Information is valid as of 2009-6-16 Treasurer's Tax Report 

New Feature -»••- • Auto Sales Search 

Owner 

PETERSON RICHARD L 

ETAL 

2463 N 45 AVE 

OMAHA NE 68104 

Property Informatio n 

Key Number: 1119 0000 08 

Account Type: Residential 

Parcel Number: 0811190000 

Parcel Address: 

Legal Description: 

2463 N 45 AV 

OMAHA NE 68104-0000 

CLAIRMONT LOT 38 BLOCK 2 50 X 125 

Value Informatio n 

2009 

2008 

2007 

2006 

2005 

2004 

Land 

$6,400.00 

$6,400.00 

$6,400.00 

$6,400.00 

$6,400.00 

$6,400.00 

Improvement 

$65,200.00 

$65,200.00 

$65,200.00 

$65,200.00 

$58,200.00 

$52,900.00 

Total 

$71,600.00 

$71,600.00 

$71,600.00 

$71,600.00 

$64,600.00 

$59,300.00 

Sales Informatio n 

Sales Date: 2000-05-15 

Deed Type: 

Price: 

Grantor: 

$61,000.00 

Book: 2152 Page: 159 

Grantee: 

Valid/Invalid: 

Exclusion Reason: 

Valid 

Land Informatio n 

Acres 

0.14 

SF 

6250.0 

Units 

1.0 

Depth 

125.0 

Width 

50.0 

Vacant 

No 

Improvemen t Informatio n 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R081... 7/7/2009 
Douglas County Account Infona||k)n Page 2 of2 nu||^r 

Building 1 

! I 'J 0 « T : 

Rrjt Floor 

728.0 «q. t­

»» i L.iut.j 

2 STORY 

«wtirt 5*^4- ft t 

CLICK J O ENLARGE IMAGE 

Square Footage: 1456.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Fair 

Built As: 2 Story Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 6.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 1.5 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Hip Stories: 2.0 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1923 0% 1923 86 

Detail Type Detail Description Units 

Add On Fence Chain Link 1.0 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 728.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Fixture Bath Half 1.0 

Garage Detached 260.0 

Porch End Screen 80.0 

Porch End Screen 112.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R081... 7/7/2009 
"> 

Page 1 of 1 

Create Another Ticket Back to Irth Intemet [ Send Email ] ][ 

• YOUR TICKET NUMBER IS 2328269. 

Original Call Date: 7/28/09 Time: 4:01 pm Op: ELIZABETH18790 

Work to Begin Date: 7/30/09 Time: 4:45 pm 

State: NE County: DOUGLAS Place: OMAHA 

Address: 2463 Street: N 4STH AVE 

Twp: 15N Rng: 13E Sect-Qtr: 08-SW 

Tv»p: Rng: Sect-Qtr: 

Legal Given: C 


Type of Work: lead remediation 


Location of Work: INCLUDE ALL EASEMENTS LOCATE ENTIRE PROPERTY 


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


: UNSURE OF CORNER LOT 


Company : COASTAL ENVIRONMENTAL SERVICE 


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


Work Being Done For: coastal 


Depth of Excavation: 4 ft. Corner Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Nuinber Utility Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047970 

Day: 4024447197 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RON Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT NA Alt: 4062071494 

Emerg: 8887289343 

Day: 4067289343 

QLNNEIC QWEST LOCAL NETWORK NA Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 7/28/2009 
As-Built Drawing 

COASTA L Omaha Lead Superfund Site 

63485 

Omaha Exterior Paint North Arrow Lead Site 

Sit [~| Good e Sl<etcti 

H^Poo r 

Samplin g Address : 2463 N 45 AV I I Not paint 

Sampl Lead Sample 

Samples Collected e Number LAB Concentration Collected Firm: P E <^-e . E-K--

RYASCPXA-6348 5 F1 . ^ :^' ^ ppm Date: 9-30-0^ " 

RYBSCPXA-6348 5 F2 f^ 3 f ppm Time: \'-Ot j p.»«A.. 

• RYC6CPX A 63486 B4 - • ~ ppm D n 

Samples Analyzed RYDSCPXA-6348 5 B2 ^ f o ( o ppm n 

RDZSCPXA-6348 5 DZ '2.00 S~ ppm §^ n X R F Unit fr^6'r/t 7 Book: 

RGZSCPYuft, 63485 152­ p pm D n Date I O • /0-C & 

nPZSCPX A 63486 -P2 - ~ ppm n n Time: 

Ltrz. L a b RYBSCPLA-3348 5 „ ^ , o , r m I—T l Staff; 

nn^L) „ ,. . _ Numbe r of Samples = -4 / Result Minnn m

 I •—I I '-—1 810 ppm 

Front Right, B1 = Back Left. B2 = Back Right DZ = Drip Zone. GZ = Garden. PZ = Pla; 

All quadrants are as viewed from the street, facing property 

OLS#:63485 

Date Excavated:8/6/09 

:<>»R Civat«<i ;7-.\in[J.'« 

Legend 

Concret e 'YA Dri p Zone Excavate d Quadrants Excavate d 

Are a replace d wit:h Area replace d wit;h 

Area lef t bar e Sod 

Rook/Mulch 

Contrac t #: EP-R7-07-05 Coastal Environmental Group Inc . 
63485 

# 

Omaha Exterior Paint North Arrow Lead Site 

Site • Good Sketch 

[g^Poor 

Sampling Address: 2463 N 45 AV 

n Not paint 

Sampl Lead Sample Samples Collected e Number LAB Concentration Collected Finn: 

RYASCPXA-63485 F1 

ppm Date: 

RYBSCPXA-63485 F2 SJ-L ppm Time: 1-Ou p-i ^ 

-nYCCCrXA6348 S &» - ppm n D r4 Samples Analyzed RYDSCPXA-63485 B2 ^toL , ppm D 

RDZSCPXA-63485 DZ 20 0 S" ppm % D XRF Unit: /^^V/ ^ Book; 22J Q 

- RCZSCPXA ea-igi 62 - " " ppm u D Dale: 10 • fO'0 & 

• RPZSCPXA 63486 PZ- ~~ ppm n D Time: Am. .Lab RYBSCPLAr63485 Staff: Number of Samples = | J-{ | | / | JThU. _? Result 810 ppm 

L „ Front Right, B1 = Back Lett, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Pla< 

Al quadrants are as viewed from ttie street, lacing property 

0CTQ9 

^ 

VK. 

t^. b'Z.= 2P9r A •'.V, 

PUT B^*^ / 6: 

^ ^ 

C> Rei.-:0il8 Craned; I7-/\UB-(« t 

^i 

4< 

^ 
63485 

Omaha Lead Site Exterior Paint North Antw 

Site Sketch • Good 

[3^Poor 

Sampling Address: 2463 N 45 AV Q Not paint 

Sample Number 

RYASCPXA-63485

RYBSCPXA-63485

••nYOeOPXA 68486

RYDSCPXA-63485

 F1 

 F2 

B4 -

 B2 

Lead 

Concentration 

ft5/ 

/r//,/i. 

ppm 

ppm 

ppm 

ppm 

Sample 

Collected 

1 

LAB 

g- D 

D 

Firm: 

Date: 

Time: 

Samples Collected 

PE q^e. e.K.­

V-0\* ^' ^ 

Samples Analyzed 

RDZSCPXA-63485 DZ 'S.OOS^ ppm D XRF Unit: f^6Ht ) Book: .22 ^ 

-RCZSCPXA 83481 CZ - ppm D D Date: IOl(i-0 & 

-RPZSCPXA 68486 PS- — ppm D D Time: R m 

6 Lab 

i Result 

RYBSCPLA-d3485 

810 ppm Number of Samples =|i£ j | / | Staff: /yhl.) 

Front Right, Bl = Back Left, B2 = Back Right DZ = Drip Zone. GZ = Garden, PZ • Plai 

All quadrarte ars as viewedftom the (traat, tackle fop ^ 

•y f—-?*—n—) F 

.M.*I5..A/ R«\-20i« Creolftl. 27-AMg-<i8 
COASTA L INVIIIONNtHTA i 

• • O W P . IM 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: 

Owner's Name Daytime Phone: [fj^ l^^j . (jip^^ ^ ^6iZi2^^'xto^^^ 

Address of Property 

covered by this 39{ J j / f^^^- Agreement: 

PURPOSE OF RESPONSE AcTivmEs 

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 vwth 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; 
'« 

COASTA L CHVItOftHmiAl 

B I 0 u r, I It c 

« 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; 

e 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. 

e Allow videotaping and/or photographing of the property. 

AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to Interfere or tamper with any of the work activities, or with any 

of the work done, or vwth 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 

EnvinDnmental Group, at (712) 352-0188 

^ I grant access to my properties Q I do not grant access to my properties 

CMc.mP.'in^l-ti-o^ 

Signature Date Signature Date 

Q i would like to be present during any sampling that is required. 
,*>"'"'*>* Kc^^ ^r ny^ 

COASTA l INVIItOHHIHTAI H^^h^^ C It 0 U r . IN C 

Consent for Access To Property 

RIGHT OF ENTRY TO PREMISES i>^< ^ 

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: 

Owner's Name: Daytime Phone: 

Address of Property 

covered by this 

Agreement: 

l^b'^ U M:5fti/e 

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 

wori( is being performed underthe 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 perfonned, the Grantor will have an 

opportunity to review and approve the planned soil removal, and restoration wori( 

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

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 perfomning the work. This access shall 

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

agrees to: 

Page 1 of 2 
V^^^"^^ /

 COASTAl •AJ ,r ^

 tNri>0>IKIKT>L 

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

piles, dog houses, etc; 

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

to save; 

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

necessary subsequent to an initial watering period by EPA; 

c 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. 

fi' Allow videotaping and/or photographing of the property. 

AGREEMENT NOT To INTERFERE 

The Grantor agrees not to interfere or tamper with any of the 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 (402) 991-1199 

grant access to my properties D i do not grant access to my properties 

^ 

SigDMur ligimuree Dat Datee Signature Date 

D I would lihe to be present during any sampling that is required. 

Page 2 of 2 
rr 

,v,V • •'i ^ 

COASTA L t NvmONM I M'A L 

C II O U P I t. C 

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 of the property owner and the United States Environmental 

Protection Agency (EPA). 

^i^rr 

I Property Address: Z. H G 1> M H T ~ /^^/g » 

I Owner: 

Phone: 

On the attached diagram(s) indicate area(s) to excavate, surface stmctures and landscaping features and 

access location(s) to be used by the contractors. Indicate distances, depths, material types, etc. 

Photographically and Videographically document the existing conditions ofthe property and the basement if 

necessary. 

items to be Removed by the Owner befoire Start of Remediation: 

The rerrioval. storsfie, dispusel, and/or fe>Lrn of these itams is thf> Qy/ner s '•esponsii.iiifty. 

Kem: 

Item: 

Items to be Removed by the Contractor During Remediation and Not Reyjiaced 

Hem: 

J ^ fr-r 

.o K hronn- c^T -hhc. l\^o9e^ W 

Item: 

Item: 

L 

- ^ 

Page 1 of . 
•r.--' 

COASTA L 

Stems to Be Removed By Contractor During Remedeation and Replaced 

item: 

;^-.( 9\-^Z-^z-\) ^ 

Kem: 

< . i Fl-(^^-B^'P^-- Kem: 

Item: 

Landscape Inventory 

Item Quantity Unit Condition/Type/Species 

Pre-existing property area, Quadrants that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch Each ' ^ 

trunk diameter 

Number of trees <= 2 inch Each z. trunk diameter 

Number of Sprinkler 

Zones, Control Valves, Each Timers, Heads, etc. J ^ 

Atl.T.h n sketch of the 

spiM'klc i li'.\',Hi;. 

Number of and size of 

each garden/ flower bed Each 

area. Square Feet 

Annth il skcicli ol' FL-'.-itivL' ^ 

M7.es and loc;llillll.^. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. $ >'o'< ilii" \nluc ^ul! tiL 

^ •jsrt io i^^'u; <•. ••,\-<'.\;\ 

0 « 1 "^l . 

Easement Area, to be Each excavated k \^L\tr^'''^^ 

Page 2 o, ^ 
COASTA L • MVIHOMMLNTA l O N O U P , IN C 

Additional Comments / Instructions: 

' Q 0 Wiof compadL. 

n Check the box If Owner does not 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, including foundation cracks or fissures. 

\% I agree Q I do not agree 

Owner's Signature Date Contractor's Signature Date 

Page 3 of 7 
Date 

Project 

XRFID# 

Shor# 

mi 

2T73. 

217? 

^^^ ^ 

Average

Shot# 

ELd . iai£Z^ 

13ki 

e"i<^M 

Average

Shot# 

T J ^ 

iiig n 

3TU& 

2-1<^ ^ 

Average

Shot# 

2fit2L 

Laa^ 

2 ^ ^ 

^?>?>S 

Average

lab sample it 

BviD^iosyas. XRF PROPERTY SAMPLE SHEET 


9.iy)cPi Address 2m«,. ^ M^5A^ / 

Omahe lead FP 2nd year opllon Sample time am/pm 

sample length 30 sec 

Reading Sample area Shot # Reading Sample area 

UUU«yVt 15^.33 n<\u 11.3Wi:-i.*iS 

Trt-^V^ilt-^S e-c^s^ ^ 5V«.%<^i^lft.U9 Fl non 

3fl\i..ni2^\ ? Depth Mft.\24-AAM Depth nqft 

:V?a.3k"'*'»^ 1 nq q U05th.'^V(> U 

^1.Q5 " - l^-S S Average Ul- U t qnV g 

Reading Sample area Shot# Reading Sample area 

^ft.^ l <^.'bv» 3V..^atp..9><^ laoL ^ ^ 2ftf? Fz i ^^.^m^q.o i 

Depth 2^l:£S). 25•^Alpj-ft.?,^ Depth 

m.-!>1-b<^.'b2> :£i: gftQH D^S^rt a.r>I 3^ 

 fSl .H^ ^ SC) M' S Average ,30.M^ ^ S.S4-

Reading Sample area Shot# Reading Sample area 

1AJO,^^7AA 1 P^ I.'\??.l<^i^aV5 

^li^.m^lL Depth Depth I 

!>^.^l-ic7.^A^ I IL. ?!)aM.Vflft^ ll"l 3 Average 

RETEST AREAS 

Reading Sample area Shot# Reading Sample area 

5M.g>3^\ft,cn^ ^tW'' ^ 

S ^ 

Depth Depth 

[•Sr^AVJbq.^lT. 

 5l.^\-: ^ ^.^ 3 Average 

Lab result Sample area XRF Avg. 

Signature 

Print PWk|yHN 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2836 

Mode SOIL 

Time 2009-08-06 15:25 

Duration 121.76 

Sequence Final 

Flags 

AVERAGE J

*R?^Sgfof'2832-2835 .-£ 

ADDRESS 2463 N 45 ave ' 

QUAD/ZONE easement 

INSPECTOR Nicolas 

DEPTH 6 

SAMPLE TYPE RblhST 

NOTE 

ppm ± Error 

Pb i . \ ± i^.93 2 / 

Supervised By; .m wm 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 54.834 

Supervised By: 

Certificate of Verification 

2832 

SOIL 

2009-08-06 15:23 

30.47 

Final 

63485 

2463 N 45 ave 

easement 

Nicolas 

6 

RETEST 

± Error 

10.015 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 53.336 

Supervised By: 

Certificate of Verification 

2833 

SOIL 

2009-08-06 15:24 

30.57 

Final 

63485 

2463 N 45 ave 

easement 

Nicolas 

6 

RETEST 

± Error 

9.999 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2834 

Mode SOIL 

Time 2009-08-06 15:24 

Duration 30.54 

Sequence Final 

Flags 

BVID # 63485 

ADDRESS 2463 N 45 ave 

QUAD/ZONE easement 

INSPECTOR Nicolas 

DEPTH 6 

SAMPLE TYPE RETEST 

NOTE 

ppm ± Error 

Pb 48.144 ± 9.799 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2835 

Mode SOIL 

Time 2009-08-06 15:25 

Duration 30.18 

Sequence Final 

Flags 

BVID # 63485 

ADDRESS 2463 N 45 ave 

QUAD/ZONE easement 

INSPECTOR Nicolas 

DEPTH 6 

SAMPLE TYPE RETEST 

NOTE 

ppm ± Error 

Pb 50.909 ± 9.917 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2775 

Mode SOIL 

Time 2009-08-06 09:42 

Duration 121.62 

Sequence Final 

Flags 

AVERAGE ltAvi.iiL2Zzil2Z74] ADDRESS 2463 N 45 ave 

QUAD/ZONE easement 

INSPECTOR Nicolas 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb L392JD5ai 

Supervised 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 444.532 

Supervised By: 

Certificate of Verification 

2771 

SOIL 

2009-08-06 09:39 

30.30 

Final 

63485 

2463 N 45 ave 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 25.334 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 375.153 

Supervised By: 

Certificate of Verification 

2772 

SOIL 

2009-08-06 09:40 

30.29 

Final 

63485 

2463 N 45 ave 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 22.945 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 396.172 

Supervised By: 

Certificate of Verification 

2773 

SOIL 

2009-08-06 09:41 

30.71 

Final 

63485 

2463 N 45 ave 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 23.152 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 372.355 

Supervised By: 

Certificate of Verification 

2774 

SOIL 

2009-08-06 09:42 

30.32 

Final 

63485 

2463 N 45 ave 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 22.761 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2765 

Mode SOIL 

Time 2009-08-06 09:35 

Duration 121.39 

Sequence Final 

Flags 

AVERAGE fA^.g*of€*7&l-2764 3 

ADDRESS 

QUAD/ZONE B2 

INSPECTOR Nicolas 

DEPTH 8 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 57:;44r ± Tra.44s 8 

Supervised By= ^^l^ ^£J^2d i ­
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2761 

Mode SOIL 

Time 2009-08-06 09:33 

Duration 30.56 

Sequence Final 

Flags 

BVID# 63485 

ADDRESS 2463 N 45 ave 

QUAD/ZONE B2 

INSPECTOR Nicolas 

DEPTH 8 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 48.860 ± 9.859 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 69.120 

Supervised By: 

Certificate of Verification 

2762 

SOIL 

2009-08-06 09:33 

30.21 

Final 

63485 

2463 N 45 ave 

B2 

Nicolas 

8 

CLEARANCE 

± Error 

± 11.127 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2763 

Mode SOIL 

Time 2009-08-06 09:34 

Duration 30.11 

Sequence Final 

Flags 

BVID # 63485 

ADDRESS 2463 N 45 ave 

QUAD/ZONE B2 

INSPECTOR Nicolas 

DEPTH 8 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 64.444 ± 10.978 

Supervised By: 
f 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2764 

Mode SOIL 

Time 2009-08-06 09:35 

Duration 30.51 

Sequence Final 

Flags 

BVID # 63485 

ADDRESS 2463 N 45 ave 

QUAD/ZONE B2 

INSPECTOR Nicolas 

DEPTH 8 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 47.373 ± 9.827 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2770 

Mode SOIL 

Time 2009-08-06 09:38 

Duration 121.30 

Sequence Final 

Flags 

AVERAGE rAvg~bl- 2/bb-2J69] 

ADDRESS ^-2463-N-45-ave 

QUAD/ZONE DZ 

INSPECTOR Nicolas 

DEPTH 12 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 304.678^ ± L^;^ ^ 

Supervised By: QOAj^j/r^js^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 260.562 

Supervised By: 

Certificate of Verification 

2766 

SOIL 

2009-08-06 09:36 

30.28 

Final 

63485 

2463 N 45 ave 

DZ 

Nicolas 

12 

CLEARANCE 

± Error 

± 20.165 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 295.752 

Supervised By: 

Certificate of Verification 

2767 

SOIL 

2009-08-06 09:37 

30.32 

Final 

63485 

2463 N 45 ave 

DZ 

Nicolas 

12 

CLEARANCE 

± Error 

± 21.347 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 326.178 

Supervised By: 

Certificate of Verification 

2768 

SOIL 

2009-08-06 09:37 

30.69 

Final 

63485 

2463 N 45 ave 

DZ 

Nicolas 

12 

CLEARANCE 

± Error 

± 22.792 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 336.221 

Supervised By: 

Certificate of Verification 

2769 

SOIL 

2009-08-06 09:38 

30.01 

Final 

63485 

2463 N 45 ave 

DZ 

Nicolas 

12 

CLEARANCE 

± Error 

22.625 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2800 

Mode SOIL 

Time 2009-08-06 14:23 

Duration 121.06 

Sequence Final 

Flags 

AVERAGE LAvgj)ii7S[^ES]~7 

ADDRESS 2463 N 45 ave~~~ ^ 

QUAD/ZONE Fl 

INSPECTOR Nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb i 47.i06 / ± [_ 9.7^0'J 

Supervised By: (^/^J?/P^^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 22.358 

Supervised By: 

Certificate of Verification 

2796 

SOIL 

2009-08-06 14:21 

30.31 

Final 

63485 

2463 N 45 ave 

Fl 

Nicolas 

6 

CLEARANCE 

± Error 

± 7.753 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 56.891 

Supervised By: 

Certificate of Verification 

2797 

SOIL 

2009-08-06 14:22 

30.14 

Final 

63485 

2463 N 45 ave 

Fl 

Nicolas 

6 

CLEARANCE 

± Error 

± 10.481 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 48.120 

Supervised By: 

Certificate of Verification 

2798 

SOIL 

2009-08-06 14:22 

30.47 

Final 

63485 

2463 N 45 ave 

Fl 

Nicolas 

6 

CLEARANCE 

± Error 

± 9.943 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2799 

Mode SOIL 

Time 2009-08-06 14:23 

Duration 30.14 

Sequence Final 

Flags 

BVID # 63485 

ADDRESS 2463 N 45 ave 

QUAD/ZONE Fl 

INSPECTOR Nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 61.053 ± 10.863 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2805 

Mode SOIL 

Time 2009-08-06 14:26 

Duration 121.03 

Sequence Final 

Flags 

AVERAGE ^g^i£giOf2801-2||4 

ADDRESS 2463 N 45 ave 

QUAD/ZONE F2 

INSPECTOR Nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 30.486 ± 8.568 

Supervised By •• f^C0& M 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billferlca, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2801 

Mode SOIL 

Time 2009-08-06 14:24 

Duration 30.20 

Sequence Final 

Flags 

BVID # 63485 

ADDRESS 2463 N 45 ave 

QUAD/ZONE F2 

INSPECTOR Nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 36.579 ± 8.890 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 33.336 

Supervised By: 

Certificate of Verification 

2802 

SOIL 

2009-08-06 14:25 

30.15 

Final 

63485 

2463 N 45 ave 

F2 

Nicolas 

6 

CLEARANCE 

± Error 

± 9.021 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 25.460 

Supervised By: 

Certificate of Verification 

2803 

SOIL 

2009-08-06 14:25 

30.05 

Final 

63485 

2463 N 45 ave 

F2 

Nicolas 

6 

CLEARANCE 

± Error 

± 8.339 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2804 

Mode SOIL 

Time 2009-08-06 14:26 

Duration 30.63 

Sequence Final 

Flags 

BVID# 63485 

ADDRESS 2463 N 45 ave 

QUAD/ZONE F2 

INSPECTOR Nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 26.570 ± 8.022 

Supervised By: 
Iii ^ 

> — **. / Jfk^ \ Omaha Lead Site—Fixed Price EP-R7-07-05 

I

ST^^^ ^

 Coastal Environmental Group Inc.

 www.coastalhazmat.com 

 vl 

^^ ^ 

%p„o*< ^ COASTA L ENTIIOMHIIITAl 

C lO U r, IN C 

EXECUTIVE SUMMARY: 

BVID #63485-(2463 N 45 AVE) 

No Issues or Concerns [^ Issues/Concerns 

Detail Explanation: 
I^EPA m 

EPA Property Close Out Form 

Pn.p,rty Addr,,s:J^M(r?^^aH, 5 Uf , . ^ Property #:_i^[^HSS L 

Datc/Tlne: 

Owner's Nane:. .j^r ^rVyjlGrV, \oS- Quads Excavated: P ^ f^^ %1 - Q l 

Contractor CronpCjptV^rJ l jiici::jr\T*^fl^ 

Excavatioii General 

Yes No 

1. If necessuy, were the correct quadrant(s) excavated and restored? 

2. If necessary, were the correct areas ofdrip zone excavated and restored? 

Grading Sod and Vegetatton 

Yes No 

I. Does the grading around the perimeter ofthe house in excavaled areas generally slope away 

from the house? 

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

3. Does the sod appear to be generally healthy 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 17" 

time period) 

/ 6.

 Was the property graded such that water will not pool on the property*] C^' 

7. Was damage to landscaping or plant materials avoided? 

Gates, Fences and Retaining Walb 

Yes Jio 

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

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

3. Was danuge to gates or fences avoided? (Ifapplicable) u - ^ 

4. Was danuge to retaining walls avoided? (Ifapplicable) 1?^ 

Foundation, Siding and Gutters 

Yes No 

I. Was danuge to tlie siding or trim avoided? 1 ^ ^ 

2. Was damage to the foundation avoided? i^" 

3. Was damage to windows avoided? ly' 

4. Was damage to windows or door screens avoided? l^ ^ 

5. Was damage to downspouts or downspoul extensions avoided? T-^ 

Sidewalks and Driveways (Concrete) 

Yes No 

1. Was damage to driveway surfaces avoided? U^. 2.

 Was damage to walkway surfaces avoided? 
Owners comments: 

Inspection notes: 

^A/Q^^ JUqi 

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

EPA Representative LJ(J ^ IjkJlJL ^ Date: ^ 2Qj 
Property Compietion Agreement 

f his agreemenl documents the completion of remedial acliviiies perCormcd on my properly My signature 

will designate ihal I am satisfied with the re.<;toralion of my propeiiy. and Ihal no items are in questions, 

now, or at any lime in the future, except those items listed below, ifany 

Property ID: l/]6 ^ 

Property Address: 'Z-^f^'h i j A^O ^'^ ^ 

Owner: ^anc(^t ^ ^JJ^Fd^O ^ 

Phone: (yT7 • yblM) 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

«3AJ i )i(,'rcr mtoration M completed, except «$ nateri 

[_j I do nol a|>rec re$toratuin is compleled 

?\\^\o\ 

OwncV's Sicnatiirf Contrarlor's Signature Date