### CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE us Army Corps of Engineers


### ECC Certification for Property Closeout
OLSID 40299 Property Address 2445 Mary St Field Work Started 10 /6/2007 Field Work Completed 10110 / 2007 

### Summary: 

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

## • FI excavation depth was 3 inches below ground surfaces. 

# • F2 excavation depth was 2 inches below ground surfaces. 

## • B I excavation depth was 3 inches below ground surfaces. 

## • B2 excavation depth was 3 inches below ground s urfaces. 

## • Drip zone excavation depth was 13 inches below ground surfaces
. 

## • Verification samples confirmed that cleanup standards were met. 

## • The site was backfilled with material which meets the contract specifica tions. 

## • The backfill was compacted to acceptab le standards
. 

# • Sod placement and site restoration were conducted in compliance with the specifications and work plans .
Comments: Per owners ' request: Flowers (LIPI, 2' x 5 ' ,**57ppm~** 

### were left inplace.



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### Name Title Date

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## G 7 Name Title Date Signature

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# 19
Name : Omaha Lead Site Date : 

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# : Site Sketch Time :

# dd**ess~ ~~~~~**  L Phone :**---':jb.!;....::...;~~** XRF Code 

### t:775 OLS 

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### Dat~27 Lead CpJcentration Quadrant //7/

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# :Jb 7( ppm F2 '1!II B1 ;, II B2 

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# 11**~~:** 1-7 ppm 

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# 57 ppm 

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### page 1 of_ 

# l/oC).Cftj Omaha Lead Site Omaha,NE Residential Yard Soils Environmental Restoration Services U.S. Environmental Protection Agency Region VII


### • PROPERTY ACCESS (to be completed by property owner)

_ • _ ,_ • _ • _ • ,r _ " : .:.::.. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps of Engineers (USACE), Omaha 1 0istrict to conduct environmental restoration services for the Omaha Lead Site. USACE Omaha is working with IElnviror.m1ent.al Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration Your cooperation is requested in giving EPAlUSACElECC permission to access your property during the**Iremc'vail/re,sto~ation** phase. For further information please contact Oon Bahnke, EPA Project Manager at (913) 551· or the Office of External Programs, at 1·800-223·0425. Property Access Granted By

OResident Name: 

## S" dEeR:;: bt21.L IResidE!nce Address: 

# J INS' (n it /? 

## If oS 

## r (Please Prinl Name)

Itl--ner 

# o renler
IIPr<)per1y Owned By :

___**=.. fl** **CLL..< "-<..o** **F..** 

### _________________ ____**IIn".'n'Q'~** mailing ad,dre'ss :

__________________**~.,."r+- _:=_;_;,;c-....,_ro;_=:o__**  HOvme,r's telephone number· Home: 

### Lj 

### SS
- 

## cl**r4~**

______ years How long have you lived here? the exteior been painted or covered with siding since 1978? the interior been painted or covered since 1978? 

# o Yes 

# o Yes _____ years 

# o No 

# o No number of occupants:

_____ List Ages:.

______________ ____

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

activities to be implemented by EPA under this agreement are pursuant 10 Section 104 of CERCLA. 42 U. S
.C
. 9604
. EPA's right of access for in Section 104(e) of CERCLA. 42 U
. S
. C
. 9604 (e), which provides entry for . "determin ing the need for response, or choosing or

F i rs t:

___________ Second::
__________ Third: :

__________

## List of existing Conditions pg._of_
Property Address: ;) 

## '-I 

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Owner: 

## S/tEM:x D ol..L Date:**9-~8"-t:'2** 

### OLSID# : _ _ _ Description:



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## RE-S£T IN**F~t1AIT** 

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Print & 

### Sign

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# ECC OWNER CHANGE**R~QUEST** 

# FORM PROPERTY ADDRESS

# ~1 O "\f\/ 7 OWNERNAME

________-------------------- CHANGES REQUESTED:



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OWNER**SIGNATUR r;;;"'7** **.a J,..,,:** **"""'-" L:.** **~~~-:&= 1.!..-** **--** 

### ACTION TAKEN:

SUPERVISOR INITIAL --12.4Contract No. W912DQ-04-D-0017, Task Order DKOI Omaha Lead Site, Omaha, NE Prooertv aoseout Agreement DVID Property Address 

# I SIf£JeK[:. 

## baLit{() 

## J.. 'l''l Property Owner Is the Owner the Resident? lLJ....>res 

## 0 No 

### .;11{I{

## S- fnl#·R
. '1 57 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 EPAlUSACElECC 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 ECC 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. 

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

,,--..,. A 

## • 

# l)V{A 1/- 08- 0') 

# xX ,f>ro'p{rty Owner's Signature Date

## •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• Property Owner Satisfaction Survey Form Omaha Lead Superfund Site Perfonnance-Dased ContractinE (PDC) Pilot Project Remediation Contractor:

__

## ....,,{3'--c.=C
............_____________ Property Identifier Number:

________ Property DVID Number: 

# t.t()cA l' Cf Property Address: J.I{I{ 

# S maR I( 

### S 

# r Property Owner's Name: 

### S 

## tfugr DoLL (above infonnation to be filled out by remediation contractor prior to delivery of form to Property Owner) Instructions to Property Owner; 

### This fonn is provided to you as a means oftJying to capture your level of satisfaction 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. Anny 

### Corps of Engineers (USACE) are 

### very interested in your opinion regarding the work performed by our contractors. This form is intended to provide lin 

### easy means for you to express your opinion about the work performed on your property . Please indicate your level of satisfaction with the Contractor's work by 

### selecting a numerical rating (ranging from \ to \ 0) 

### using the following rating scale, then please sign & 

### date the fonn and retum 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-\ 0 

### "excellent" 7-8 

### "very good" 5-6 "acceptable" 3-4 "poor" \-2 "very poor" Property Owner's Satisfaction RatinE mardlnE Contractor's Work \0

# ~ 5 9 4 8 3 7 2 6 \ Additional Comments from Property Owner (optional; continue on back of pm if

## needed)

Date: 

# //-O¥"-cJ'l

### CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation US Army Corps 

### Omaha Lead Remediation, Omaha, NE of Engineers 

### Analytical Results Summary OLS #40299 2445 Mary St Quadrant Sample Type Depth Date Collected XRF Results (ppm) (•• g.) 

### DE F1 3 10/9/2007 40 

### DE F2 2 10/9/2007 4 

### DE B1 3 10/9/2007 46 

### DE 82 3 10/9/2007 97 

### DE OZ 13 10/9/2007 27 

### DE LlP1 0 10/9/2007 57

SAMPLE 10· SAMPLE ID is a particular residential property ID from which the sample is collected. The sample type Identifier (with sequential sample number (or tlUlI location) as follows ; J>X = Pre-Excavation XRF sample DE
- During and Post Excavation Quadrant describes the sampling location (with sequenllal sample number for that location) as follows, FI or F2 = Front Yard One or Front Yard Two D I or B2 - Back Yard One or Rock Yard Two DZ
- Drip Zone GA · Garden PA - Play Area EA = Easement Depth describes the depth from which the sample was collecte(j ppm - parts pcr million