### CONTRACT # W912DQ-04-D-0017 , T.O . DK0 4 

## !•/! { Environmenta l Chemica l Corporatio n Omah a Lea d Remediation , Omaha , N E u s Arm yCorp s o f Engineer s 

### EC C CertHicatio n fo r Propert v Closeou t OLSI D 3556 7 Propert y Addres s 243 2 Larimor e S t Fiel dWor k Starte d 8/30/200 7 Fiel dWor k Complete d 8/30/200 7 Summary : • Th e excavatio n wa s performe di n complianc e writ h th e work plan s an dspecifications . • B l excavatio n depth was 1 8 inche s belo w groun dsurfaces . • Verificatio n sample s confirme dthat cleanu p standard s wer e met . • Th e sit e wa s backfille dwith materia l whic h meet s th e contrac t specifications . • Th e backfil l was compacte dt o acceptabl e standards . • Sit e restoratio n wa s conducte di n complianc e vdth th e specification s an dwor k

plans .

Comments : Non e -Sco-/- / hjAA l EC C QC M 

# 'A Nam e Title ate Sjfgaatur e , Dat e Jef f Hubbar d USAC E Co n Re p Nam e Title Dat e

3004789 8 Superfun d

## 3556 7 Exterio rPain t Nort hArro w Omah a Lea d Sit e Owne rName : JERRIN E L BURG E • Goo d Sit e Sketc h Address : 243 2 LARIMOR E AV • Poo r W : Phone : ^' • 

# 1 n No l paint TeamRUjgSser v 

### OL S 

### f^ft
- XR FCod e S^^^X Quadran t F l F2 _ Lea dConcentratio n 

## SSLJpm ^ 33 1 ppmaj * Dat e 

## 7-93-0 1 Bl _ B 2 DZ " I'f ! IJMJ ^ MS ^ -^ ^ pp m ppm »

_pp m Lo g Boo k }lhP ^ K / -Oo^o^ ^ pp m pp m pp m c7 ! "X T ?T^T S T ^ J? ^ '

Omah aLea dSit e 4613 0

### Jo . 107 8 P . 3 

### Aug.14 . 200 7 11:57A M EC C Omah a Lea d Sit e 40 2 93 2 146 1 

## pag e 1 of . K«»«'3 8 Omah a Ua d 8lt e Omaha . N E U.S . Environmenta l Protectio n Agenc yRegio n Vl l RMidenUalYarctSdl s Envfronmenta l Roitoratlo n Seiviee a 'ROPFRI Y ACCES S |U.S . Environmdnta i Protaefio n Agenc y(EPA ) ha s contracte d th e U.S . Amt yCop s o f Engineer s (USACE) . Omah a

Xstrtc t t o eonduo l mvironmenta l restoratio n sefvioe s fo rth e Omah a Lea d Site . USAC E Omah a b woffcin g wit h Environmanta l Chemica l Corporatio n (ECC ) t o remov e lea d contamlnete d soi l an d provid e iubaequen t restoratio n arvioes . You rcooperatio n is requeste d in givin g EF^AAJSACE/EC C pennissio n t o aooes s yoi Kpropert ydurin g Ih e tmoval/resioratio n phase . Fo rfurthe rNbmiatto n pleas e contac t Do n Bahnke , EP AProjec t Manage rs t (S13 ) 551 « r00 3 o rth e Offic e o f Externa l Pregrams , a t 1-€00-223-0425 . Propert yAcces s Grantot t B y^/7? , 'f/^' ^ /B ^

A^AA-AV7// 9 (Plta M Print Nsn ^ 

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# Vi^^^^ ^ I f ^ ^ /^oi.,^" ^ i/QTE ; G/ariti n nlssh n DOE S NO TM ^ wa i b e rBtm0itt9 d a f tht o Uitm , Residen t Name : ^A'C-^/O Tl-FT T D owrte rD rente r Residenc e Addntsa : o^Vcf A U^^JAAMI F 

### 0ASI4/A^ ^ A/ P (OP ) IPrapert yOwne d Bv : COJ^^FFbA l CLfirSl/A L P/^/SPFJ^rf£ ^ Owner s mailir « addreaa ; V/^ ^ ^ ^ £ 1 AFT/J^H/ Yt> F FLbG-'^ ^ ^OFoJ^F^^C/3 . 700tt f Owo«r* 8 telephon e numbe r- Home : ^C ^ * ^/^"^ifit ^ Wori c^_______,.^____^ ^ Ag e o f Home ? /////L ^ yeer s Ho wlon g hav e yo u live d here ? /l//^b > year s Ha s th e exteio rbee n painte d o roovere d wit h Bidin g sino e 1078 7 D Ye s 0 N o la s th e interio rt>ee n pante d o rcowere d sinc e 1978 ? Q Ye s 0 N o •ote t numba ro f ocouBflnt KX//^i ^

Us t Ages ; <^A/ ^ ­ 

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t age s o f occupant s unde re year s ol d wh o pla y in th e yar d fo r5 o rmor « hour s pe rwMk: , 

## jm . Comments : ^UTtiORIT YFO R ENVIftQMMENTA L RESPONS E ACTION S rheadhriilMtobebnplwnmiarfbyEPAundwtMtisresmentMpurMSMtsSedieniOtorC ^ EPA's ilg M at« » ir w propert y ftr i n S«ctle n 104(e ) o

f CERCL A 4 2 U.S. a 9 ^

(e) . wMG h ITCVM M Mfe y tar. Mt^ ^ Minsa ru Acces s Att^^^^^TM^^^^^TM^TM**"""'"^^^^TM""'*"''^TM""^^TMTM'*""^^^"' ^ First - Second : Third: : [ » ]

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# Lis t o f Existin g Condition s Propert yAddress : cQA-Pv^ [rVUTvnQnQ ^

DV D I D # ^Sob l Owner : CUfXnA o 0)rfeeS\ O . Date : '^\\^ \

D l BVID # dfO' P 1 0 ^ Ref : Phot o # 

### Descriptio n 

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### Owne rSignatur e EC C Prin t & Sig n Prin t & Sig nContrac t No . W912DQ-04-l)-00l7 , Tas k Orde r DKO l Omah aLea dSite , Omaha , N E ivp^rt v Ckiieo mAgreemen t BVI D 

# 3^s-i^ 9 Prepcrt y Addres s 

## Jiyj^J . IM/M^/B f Propert y Owne r 

# CdLO^i^ dcuiss/ c I s the Owne r

th e Resident ? D Ye s ^3^ 0 Conpliftikc c Statemeat : U.S . Environincnta l Protectio n Agenc y (EPA ) ha s contracte dth e U.S . Arm y Corp s o f Engineer s (USACE) , Omah aDistric t t o conduc t environmenta l restoratio n service s for th e Omah aLea dShe . USAC E Omah ais , woridn g wit h Hnvirooments l Chemica l Coiporatio n (ECC ) t o remov e lee d contaminate dsoi l an dprovid e subsequen t restoratio n seivices . You r cooperatio n i n givin g EPAAJSACE/EC C permissio n t o acces s you r propert y durin g th e removal/hestoratio n phas e i s sincerel y appreciated . Thi s documen t certifie s tha t al l wor k performe da t thi s propert y wa s complete di n accordanc e wit h th e contrac t specification s an dEP A requirements . I f

yo u hav e question s o r nee dadditiona l infbrmatio n pleas e contac t Do n Bahnlcc ; EP A Projec t Manager , t t

(913 ) SSI-700 3 o r th e Offic e ofExtema ] Program s a t 1-80O-223-O42S . Additiona l Cemmcnt s b y USAC E and/o r ECC :

CONTRACTO RCERTIFICATIO N EC C Projec t Manage r Nam e Titl e Dat e Signatur e 

## PROPERT Y OWNE RSECTIO N Thi s agreemen t documem s th e completio n o f remedial/restoratio n effort s a t th e propert y t o m y satisfhction . -^ ^ Tagre e tha t restoratio n i s complete da t m y property , excep t a s note d Comment s (ifappUcaMe^ : 

# X'-hf.y ^ ^ /i ^

i^in . Properl y Owner' s Signatar e Dat e

e d «PJ0 Wll! S deZi' W lOlioe a 1-588'19 9 ZO f

## Propert y Owne r Satbfiictioi i Surve y For m Omah aLea dSuperfim dSit e Perfbrmanca-Base dCbatractin g (PBC ) Plla t Projec l Remediatia B Contradar : CC>C ~ Propert y Idantifia r Number : ; PraperlyBVIDNiunbe n ^S'St^* } Propert y Address : A*t?J . LA^lM^fi f PropertyOmier'sName : CCUki^ dCLASSI C PA^A/PFATIF S Cabo»cinIbnttrthwtoliegUBdoutbywm»<lkHiwtcottbwWpCMrtpd<iivqyoffa»t»P ^ 

### /[aatTMttiaa t t g PrWHHl Y QffTOC % Ihi s formi s provide dt o yo u a s amean s o f tiyin g t o captur e your lev do f sstisfacbo n wit h th e worl c ofth e above-identifiedRemedialion Contrsctor , a s applicabl B t o th asoil cleanu p aciio aa t your property . Ih e US . Envinmmenta l Protection Agenc y (EPA ) an dth e U.S . Anny Corp s o f Bngineei B (USACE ) ar e ve^ r interestedi n 3rou r opinio alegaidin g di e woik peifermed b

y ou r oonttacton . Thi s for mi s inlendedt o provide s n eas y mean s foryo u t o expres s yoa r opinion abou t th e wor k

peifocme do n your propertjr . Pleas e indicat e you r level o f satisfoction wit h di e Contractor' s worl c fay selecting a numerica l rating (ranging from 1 to 10) using tb e following rating scale ; tiien pleas e sip i A dat e th e forman dletu mI t t o USAC E i n di e attachedsetf-addrRse dft stampedaavdop a(Additiona l comments ma y als o b e providedi n th e spac e provided , a t th e optic o o f di e propert y owner. ) 9-1 0 '^Bxcellen r 7- 8 "ver y good' ^ 5- 6 "acceptaUe " 3-4 "pool " 1-

2 'Veiypoor " yirfT"^"-"rr* 1 ffi^fflflhrl^BatiBarwanifaacontractor' s Wa m 1 0 ^ 5 9 4 8 3 7 2 6 1 AddittenaLCammemsfnMnPniBerftrQinitrfatienal:eantlnaeanbaekofna«i f

Properl y Owner' s Sigiature : ^ j^^.^^^!g^?,/x^>^afe< . Daia t y^-^^-z/ 7 3( j Le99ts5Z( » 8JJU0 W m a dKWZO/loe a• ECC B 

### CONTRACT * W912DQ-04-D-0017 , T.O . DK0 4 llil i 

### Environmenta l Chemica l Corporatio n Omah a Lea d Remediation , Omaha , N E u s Arm yCorp s o rEngineer s 

### Analytica l Result s Summar y OL S #3556 7 243 2 Larimor e S t Quadran t Sampl e Dept h XRFResult s Date Collecte d Typ e (ppm ) (avg. ) D

E B 1 1 8 8/28/200 7 4 8 D

E EA- N 0 8/28/200 7 10 6 

# 1 1 1 1 1

SAMPL E ID SAMPL E I D i s aparticular residential property I D fromwhic h th e sampl e i s collected . Th e sampl e typ e identifie r (with sequentia l sampl e numbe r for tha t location ) a s follows ; P X = Pre-Excavatio n XRFsampl e D E = Durin g an dPos t Excavatio n Quadran t describe s th e samplin g locatio n (with sequentia l sampl e numbe r fo

r that location ) a s follows ; F l o r F 2 = Fron t YardOn e o r Fron t Yar dTwo B 1 o r B 2 = Bac k YardOn e o r Bac k YardTwo D Z = Dri p Zon e O A = Garde n P A = Play Are a E A = Easemen t Depth describe s th e dept h fromwhic h th e sampl e wa s collected . pp m= part s pe r millio n