TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#' 1<U\ 

Date 

^^ Ul ll 

Address ^^ K 'jb^t ^ 4 f 

Remediation Conliactor: Coastal Environmental Group Year: _2010ARRA _ 

SOIL REMEDIATION 

PROPERTV FILE FOLDER DOCUMENTS 

i/ 

Video of property (DVD) 

Executive Summary 

EPA-provided properly sketch 

/ 

Signed Access Agreement for subjecl property 

Signed Access Agreement(s) for adjacent property 

Restoration Agreement 

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

Confirmation data 

Photographs \ k ^Cfi(\l(^0 ^ \ QCQ^V^Tl ^ ^ io ^ 

As-buill sketch 

Satisfactory restoration signed by Property Owner 

Property close-oul check lisl signed by EPA 

Descriplion of areas not meeting ROD cleanup criteria 

Utility clearances 

t/ 

Property infonnation from Douglas County Assessor's Office 

Date 

30218933 

II 

Superfund 
vv 

Property Access Checklist 

PropertylD: <^S ? / | 

Property Address: '^^]C:; ­ C^ j S(UJ ^ 

D

D

 WORK STARTED 

 WORK COMPEL IED 

ON:

ON:

 /

 /

 / 

/ 

I Owner: fI' M klyO^ 

Address: 

- ^ 

QyTO/JA^, rr O lgB\\ 

Phone; (o'bO-tO^lt ^ 

Fax: 

Renter: 

Phone: 

Fax: 

CeU/Pager: 

Additional Information: 

CeU/Pager: 

n Notification Letter 

I Access Agreement 

-'Restoration Agreement 

Topsoil SampUng (if appUcable) 

n Disposal Sampling (if applicable) 

Q Garden SampUng (if applicable) 

Q UtiUty Clearance 

mVideo/Photos (Before) 

D Video/Photos (During) 

D Video/Photos (After) 

D Video/Photos (30-Day) 

[~| Property Completion Agreement 

Sent: / / By: 

Signed: M jL^II H °y' ^ V^-cV 

Signed: / O 1 ^ I Q By: w,o«^ 

/ / By: 

/ / By: 

/ / By: 

CaUed: \x / \ / v» By: VV/>>AQ

On: _li2nyi LO By: v^'o*-

On: / / By: 

On: / / By: 

On: / / By: 

Signed: / /. By: 

 v»:>i^>^ 

n Final Report Issued: / By: 

Air MonitoriuK (as appUcable) 

• Conununity • Crew 

Results: 

On: / / By: 1 

• Community

Results: 

• Crew On: / / By: 

• Community

Results: 

O Crew On: / / By: 

Omaha Lead Stte 
Douglas Cotmty Accoimt I; i^j^io n Page 1 of2 n 

Douglas County, Nebraska Property Record - R1641440000 

Print Reoort 

View Interactive GIS Mao Information is valid as of 2010-8-30 Treasurer's Tax Reoort 

New Feature -¥ -* ^ Subdivision Sales Search 

Owner 

HYDE FRED 

3518 CHARLES ST 

OMAHA NE 68111-OOOO 

Property Informatio n 

Key Number: 4144 0000 16 

Account Type: Residential 

Parcel Number: 1641440000 

Parcel Address: 3515 SEWARD ST 

OMAHA NE 68111-0000 

Legal Description: LOWES ADD LOT 4 BLOCK Q W 1/2 30 X 127.5 

Value Informatio n 

Land //nprove/ne/if Total 

2010 $500.00 $0.00 $500.00 

2009 $500.00 $0.00 $500.00 

2008 $500.00 $0.00 $500.00 

2007 $500.00 $0.00 $500.00 

2006 $500.00 $0.00 $500.00 

2005 $500.00 $0.00 $500.00 

Show All Transactions 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.08 3810.0 0.0 127.0 30.0 Yes 

http://douglasne.mapping-online.eom/DouglasCoNe/static/accoimtinfo.j sp?accoimtno=R 164... 9/2/2010 
I

Page 1 of2 

"> 

 Create Another Ticket Back to Irth Intemet [ Send Email 

YOUR TICKET NUMBER IS 2630920. 

Original Call Date: 11/01/10

Work to Begin Date: 11/03/10

 Time: 10:58 am 

 Time: 11:30 am 

Op: ELIZABETH18790 

State: NE 

Address: 3515 

County: DOUGLAS 

Street: SEWARD ST 

Place: OMAHA 

Twp:

Twp:

 15N Rng: 13E

 Rng:

 Sect-Qtr: 16-NW,17-NE 

 Sect-Qtr: 

Legal Given: C 


Type of Work: LEAD REMEDIATION 


Location of Work: LOCATE ENTIRE PROPERTY, ALL EASEMENTS AND TO THE PEDESTAL 


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


: UNSURE IF CORNER LOT. 


Company : COASTAL ENVIRONMENTAL SERVICE 


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


Work Being Done For: COASTAL 


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


Involves Tionneling or Horizontal Boring : N Explosives: N 


CXCATV LEVEL3 MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number UtiUty Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Ah: 4029340469 

Emerg: 4029329757 

LEVELS LEVEL3 COMMUNICATIONS, LLC NA 

Day: 8773668344 

Alt: 

Emerg: 8773668344 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Ah: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RICHA'RAFFIC 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 11/1/2010 
Page 2 of2 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING 

Ah: 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK

Day:

 ELM LOCATING AU:

 4067289343 

 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 11/1/2010 
25811 

As-Built Drawing 

COASTA

ENVIRONHENTA

L 

L Omaha Lead Superfund Site GROUP , IN C 

OLS#: 25811 

Date Excavated: 11/4/2010 

Date USEPA Signed Off: 11/30/20r 

Area Sodden: 740 sa ft 

Omah Extenor Paint a Lead Site inn«rr 

Stt • Good e Sketch • Poor 

Sampling Address: 351S SEWARD ST Q^o t paint 

Lead Sample Samples Collected Sample Number LAB Concentration Collected Firm: PE T«- DT, CI. 

RYASCPXA-25811 Fl 2.85" ppm n Date: nllfilo i 

RYBSCPXA-25ei1 F2 332 . oom or n Time: l-.on PM 

RYCSCPXA-25811 B1 4>«j3 oom ar D Samples Analyzed RYDSCPXA-25811 B2 _2Si£_PPm s' D 

nOZeOPXA 26811 BZ pom D D XRF Unit: 6SV<J Book: 21 3 

R026CPXA 26811 6 2 ppm D n Date: 8/^/a A 

nPZSGPXA 26811 PZ — ppm D Time: /Q ^ 

Staff: Number of Samples = | ^ \ | Q . A^ 

Legend: Fl = Front Left, F2 = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewad from the street, facing properw ALLE V 

Legend 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced with 

Sod 

Area replaced with 

Rock/Mulch Area left bare 

Contract #: EP-R7-07-05 Coastal Environmental Group Inc. 

\ . V 

25811 

r \'^h rie e\

Omah Exterior Paint North Arrow a Lead Site 

Site • Good Sketch • Poor 

Sampling Address: 3515 SEWARD ST g3^ot paint \ 

Sample Number Lead Sample 

Samples Collected L^B Concentration Collected Firm: PE TAC^ Dfi cr. 

RYASCPXA-25811 Fl 2-^ 5 ppm 

D Date: ->/lg)o8 

RYBSCPXA-25811 F2 33 Z ppm a Time: XQCl PTJ 

RYCSCPXA.25S11 Bl ^*< 3 ppm ET D Samples Anaiyzed RYDSCPXA-25811 B2 25 ^ ppm 

RDZCOPXA J5011 B3 " ppm D D XRF Unit: 6SV ^ Book: 21 3 

nOZGCDCA 26011 GZ ~ ppm D D 

Date: _ S/S/OFi 

RPZSCPXA 26811 Pg — ppm D n 

Time: /V ^ 

Staff: Numt)er of Samples 

AA. Legend: Fl = Front Left, F2 = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip LGarden, PZ = Play 

All quadrants are as viewed from the street, facing proper^ A l I F V 

i . .•.;• »'-• J "jfN "J.: * S'..'. V 'f .1^.K.G!Riy| t 

JUL 3 0 2008 : 

Pv 

...$|5.VKW Rev 2008 Cre.iled: 0.1-May-08 044701.01.2.1 
% 

25811 

Omaha Lead Site 

Site Slcetch 

Sampling Address: 3515 SEWARD ST 

Sample Number 

RYASCPXA-25811 Fl 

RYBSCPXA-25811 F2 

RYCSCPXA-25811 B1 

RYDSCPXA-25811 B2 

nozccpxA 25611—ez 

RGZSCPXA 26811 6 2 

nPZSCPXA 26811 P i 

Lead Sample 

Concentration Coilected 

2185 " ppm 

332 . ppm 

ppm 

D 

U 

_= ppm D 

Number of Samples = [ *-j | |

LAB 

D 

D 

D 

n 

D 

D 

D 

Q 

XRF Unit: 

Date: 

Time: 

Staff: 

Legend: Fl = Front Left, F2 = Front Right, Bl = Back Left, B2 = Back Right DZ = Drip 

Exterior Paint NorthArrow 

• Good 

• Poor 

Q^o t paint 

I 

Samples Collected 

Firm: PE T/>,^ HTS tr. 

Date: l/lfjlQg 

Time: 'i'.on P M 

Samples Analyzed 

65Vd3 Book: 2t 3 

P/71 

AA. 

.Garden, PZ = Play 

All quadrants are as viewed from the street, facing propert^ ALLE V 

^ - -> . - »t - "i-*.: <•« .-ia'' ? ^ 

JUL 3 0 2008 

Rev 2008 Created: O.1-May-08 

p 044701.01.2.1 . V 
25811 

Omaha Lead Site Exterior Paint NorthArrow 

Site Sketch • Good 

• Poor 

Samolina Address: 3515 SEWARD ST E3^ot paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB Samples Collected 

Firm: PE TAL. DTS tt . 

RYASCPXA-25811 Fl Z.&S ' ppm D Date: l/|g|Q 8 

RYBSCPXA-25811 F2 332 . oom or D Time: 0;/Vt P M 

RYCSCPXA-25811

RYDSCPXA-25811

 Bl 

 B2 

^^ 3 Dom 

2Sii _ ppm E^ 

D 

n Samples Analyzed 

nDZCOPXA 26811 9 i ppm D n XRF Unit: 65^ 0 Book: 21 3 

nOZOOPXA 26011 G i - ppm D D Date: _ 

nPZCGPXA 26811 PZ — ppm 

Number of Samples = |

D 

^ \ \

D 

Q 

Time: 

Staff: 

/=w 

AA. Legend: F1 = Front Left, F2 = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, fedng properW kX \ P y 

. ... ^ ^. . i i . . A 

JUL 3 p 2003 

Vf^% .PR»yf. 

&i 

GHS. 

BI 

ZS' \ 

n 

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WALK 

.$RVAf^Q SV.. Rev 2008 Crealed: 03-May-08 044701 01 2.1 Pv 
J^^t"'-* , 

COASTA I 

IMTItONMINTAI 

C I 0 U P > H C 

Consent for Access To Propefty 

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 / 

Owner's Daytime Phone: ^30-^OS7 ^ Name: f-^^^ f Hi^dt , 

Address of Property 55V5 ^ ^^of d y^^ covered by this 

Agreement: 

PURPOSE OF RESPONSE ACTIVITIES 

The EPA is requesting access to c:ollect 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 wili 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 aiso 

agrees to: 

Page 1 of 2 
V^^-< ^

 COASTAL 

« 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. 

c^ Allow videotaping and/or photographing of the property. 

AGREEMENT NOTT O 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 

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

.^y,>^,^ ^ «>'<1-<0 ^ 

Signature ^ ^=;*^^ '^ Date Signature Date 

Q I would like to be present during any sampling that Is required. 

Page 2 of 2 
^ 

COA S T A L 

GROUP , 

Restoration Agreement 

The purpose ofthis 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). 

Property ID: Z-S'^H 

Property Address: ^S'^IS' ^^:^o<?<c<r " ^ 

Owner: fre.A 

Phone: Alo, ^ ^ 

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

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

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

necessary. 

Items to be Removed by the Owner before Start of Remediation: 

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

Item: 

. yUot^_ 

Hem: 

Kem: 

Hem: 

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

Hem: M ^ ^ 

Hem: 

Hem: 

Item: 

Pagel •^J-
k^ 

COA S T A L • NVinONHI N T * L O n O U P , IN C 

Items to Be Removed By Contractor During Remediation and Replaced 

Hem: 

- S ^ 

Item: 

S ^ 

Hem: 

Hem: 

Landscape Inventory 

Item Quantity Unit ConditionH'ype/Species 

Pre-existing property area, B( Quadrants tbiat will be excavated, that 

is covered with grass. 

Number of trees > 2 inch Each 

trunk diameter ; 

Nimiber of trees <= 2 inch £r Each 

trunk diameter 

Number of Sprinkler 

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

Attach a sketch erf the / ^ sprinkler layout. 

Number of and size of 

each garden/ flower bed Each 

area. Square Feet 

Attach a sketch of relative P 

sizes and locations. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. $ Not

used

e

 t

 thi

o issu

s valu

e a

e will

 plan

 be 

t 0

voucher to the property 

owner. 

Easement Aiea, to be 

excavated ^O^x 

Each DenJt^ /S-fe^^^ 

Page 2 of. 1 
COASTA L 

GROUP , IN C 

AddKional Comments / Instructions: 

The city of Omaha ordinances may prohibH you from using dirt or gravel areas on your property 

as driveways or vehicle parking areas. The Environmental Protection Agency (EPA) may be 

removing and replacing soil underiying a gravel or dirt area on your property that you may be 

using as a driveway or vehicle parking area, tf this is the case, you should understand that this 

removing and replacing of soii does not mean that any Illegal driveway or parking area on your 

property is made legal. To the contrary, you may be cited by the city if you use a gravel or dirt area 

as a driveway or parking area, not wKhstanding any removal or replacement of soil by the EPA 

If you have any question about legality of a certain driveway or parking area, you may contact 

the cHy of Omaha's Planning Department at (402) 444-5150. 

O Please check this box if you underetand the infonnation outlined above. 

' ^ Q^u t 2^7 A V- y^^^'^ ce^ 

G 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. 

[Eia n I do not agree I agree 

' D^t«^ "Contractor' • "• s Signature Date 

Page 3 •^3. 
BVID# Z5811 

XRF PROPERTY SAMPLE SHEET 


Date /-<2:5 ­ ^.OH Address 3S l 5 Seu/>«M 

Project Omaha Lead ARRA Sample time am/pm 

XRF ID# 3'^OZX, sample length 30 sec 

Shot# 

^ 0 

"^i 

^ t 

Reading 

/63 i n 

HI t (8 

/1 ^ i 18 

Sample area 

£ A 

Depth 

/ " 

Shot# Reading Sample area 

Depth 

Average /g( t- /I / Average 

Shot# 

86 

8A 

8S 

Reading 

30S ­t L l 

3Zg i Zjb 

33 ^ '­ Z^ 

Sample area 

B 

Depth 

^ u 

Shot# Reading Sampie area 

Depth 

Average 3^0 i^ ZSI / Average 

Shot# Reading Sample area Shot# Reading Samplearea 

Depth Depth 

Average Average 

Shot# Reading 

RETEST AREAS 

Sample area Shot# Reading Sample area 

Average 

/"" ^ ^ 

-­,

^ 

 Depth 

Average 

Depth 

Signature 

Pnnt IVli^ M^Wi 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Supervised By: 

93 

SOIL 

2011-01­

90.62 

Final 

Certificate of Verification 

25 14:49 

Avg of 90-92 

3515 SEWARD 

EA 

1" 

C.PADILU 

CONFIRMATION 

CLEAR 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 163.404 

Supervised By: 

Certificate of Verification 

90 

SOIL 

2011-01-25 14:47 

30.21 

Final 

25811 

3515 SEWARD 

EA 

1" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 19.534 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 141.780 

Supervised By: 

Certificate of Verification 

91 

SOIL 

2011-01-25 14:48 

30.22 

Final 

25811 

3515 SEWARD 

EA 

1" 

C.PADILU 

CONFIRMATION 

CLEAR 

± Error 

± 18.584 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 149.648 

Supervised By: 

Certificate of Verification 

92 

SOIL 

2011-01-25 14:49 

30.19 

Final 

25811 

3515 SEWARD 

EA 

1" 

C.PADILU 

CONFIRMATION 

CLEAR 

± Error 

± 18.993 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Supervised By 

Certificate of Verification 

89 

SOIL 

2011-01-25 14:46 

90.77 

Final 

Avg of 86-88 

3515 SEWARD 

Bl 

4" 

C.PADILU 

CONFIRMATION 

CLEAR 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 305.972 

Supervised By: 

Certificate of Verification 

86 

SOIL 

2011-01-25 14:45 

30.22 

Finai 

25811 

3515 SEWARD 

Bl 

4" 

C.PADILU 

CONFIRMATION 

CLEAR 

± Error 

± 26.247 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 328.028 

Supervised By: 

Certificate of Verification 

87 

SOIL 

2011-01- 25 14:46 

30.25 

Final 

25811 

3515 SEWARD 

Bl 

4" 

C.PADILU 

CONFIRMATION 

CLEAR 

± Error 

± 26.986 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 387.478 

Supervised By: 

Certificate of Verification 

88 

SOIL 

2011-01-25 14:46 

30.30 

Final 

25811 

3515 SEWARD 

Bl 

4" 

C.PADILU 

CONFIRMATION 

CLEAR 

± Error 

± 29.282 
^^ jOk >&\ Omah Omahaa Lea I .. d Site—Fixed Price EP-R7-07-0 . .. ._ 5

Coastal Environmental Group Inc. ^ 

V j f www.coastaihazmat.com ' ^ 

%Pi.ote6 COASTA L INVItONMIHTAl 

C 1 0 U r, IN C 

EXECUTIVE SUMMARY: 

BVID #25811-(3515 Seward St) 

No Issues or Concerns | ^ Issues/Concerns 

Detail Explanation: 

-DAN GARVEY WALKED THE PROPERTY ON 11/30/10 
EPA Property Close Out Form 

5r/5^ 3^ujctd<^r 

Proptrty #: ^^11 

Property Address:* • 

Date/Time: Owner's Name;. /4. 

Quads Excavated; ^ | Contractor Group 

Excavation General 

1. If necessaiy, were the correct quadrant(s) excavated and reslored? 

2. If necessary, were the correcl areas ofdrip zone excavated aod restored? 

Gradlns Sod and Vcffetatloa 

1 Does the grading around the perimeter ofthe house in excavated areas generally slope away 

from the house? 

2. 

Has sod been laid in all areas that were excavated? 

3. 

Docs 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 

time period) 

6. 

Was the propeity graded such that water will not pool on the property? 

7. 

Was damage to landscaping or plant maierials avoided? 

Gates, Fences and RcuhilDs Walls 

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

2, Were all gates or fences taken down during restoralion aclivilies reinsialied? (If applicable) 

3. Was damage to gates or fences avoided? (1 f applicable) 

4 Was damage to retaining walls avoided? (1 f applicable) 

Foundation, Sidingand Gattt n 

t. Was damage to the siding or trim avoided? 

2. Was damage to the foundation avoided? 

3. Was damage to windows avoided? 

4 Was damage to windows or door screens avoided? 

5. Was damage to downspouts or downspoui extensions avoided' 

Sidewalks and Driveways (Concrete) 

1. Was dannge to driveway surfaces avoided? 

2, Was damage to walkway surfaces avoided? 

Yes No 

^ 

/ 

Yes No 

/ 

/ 

/ 

y 

/ 

/ 

J 

Ves No 

/ 

/ 

J 

y 

Yes No 

/ 

/ 

/ 

y 

/ 1 

Yes No 
Ort'oers comments: 

1 _^^_ ^ . _ _^_ _ 

n!n.*!pection notes: 

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

EPA Representative ^ J ^ Date: uhojio 
Property Completion Agreement 

This agreement documenls the compiclion of remedial aclivmes perloimed on my pioperiy My signaluie 

will designate Ihat I am satisfied wilh the restoration of my properly, and lha( no items are in questions, 

now, or al any lime in the fuluie, excepl those ilems listed below, if any 

Property ID: ^ ^ / | 

Property Address: ^5~[< ^ SeoQC^ ^ ^ 

Owner: f=7Ml 

Phone: /^ ^Q- ^ ^^^' f L J 

Restoration items in Question: 

Item: 

Item: 

• •••unU^w a I • Wll . UUJI. 

Item: 

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Additional Comments: 

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Iwncr's Date CoiTtt artoi '$ Signature Date