TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID# : '^<£?U1 Date: l/l 

Address: ^>0 5 Vfe^f f ^ t . 

Remediation Contractor: Coastal Environmental Group_ Year: 2009 

/ 

/ 

7 

-a­

-Bt / 

1/ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 

Executive Summary 

EPA-provided property sketch 

Signed Access Agreement for subject property 

Signed Access Agreement(s) for adjacent property 

Restoration Agreement 

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

Confirmation data 

Photographs \ H ^Cfif]/f\n»^ V V^^C^lPr(\^y[ f i^Ah 

As-built sketch 

Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

Utility clearances 

Property inforaiationsfrom Douglas Coimty Assessor's Office 

Signature 

30217540 

Superfund 
Property Access Checklist 

Property ID: :ss n WORK ST/VRTED ON: _/ /_

Property Address: D WORK COMPELTED ON: / / CM. 

Owner; Renter Se^-tM - Sn^JjHu 

Address: Phone: 

Pa.v: ^5?^mC 

Cell/Pager: 

Phone: C^C^I^C^^IO ^ Additional InlnrmHtion: 

Ft\: 

Cell/Pager. 

D Notincation Letter Sent: / / By: 

y j ^ Access AgrcemcBl Signed:^ / (^/ ^ By: 

1 ^ Restoration Agreement Signed: 4_/^/ ^ By: 

D Topsoil Sampling (if applicuble) / / By: 

Q DisposaJ Sampling (rf applicable) / / By: 

Q Gnrdcn Sfloipliag (if applicable) / / By: 

' ^ Uiility Clearance Called: jl./je/£> 3 

B>= //f/^/o^ 

K Video/Photos (Before) On:JllS/ ^ ^y- O(?\av^o 

• Viileo/Photos (During) On: / / By: 

D Video/Photoi (After) On: / / By: 

D Video/Photos (30-Day) On: / / By: 

D Property Completion Agreemenl Signed: / / By: 

D FinJil Report Issued: / / By: 

Air Monitorine (iU applicable ) 

CD Community Q Crew Oo: / / |By : 

Results: 

CD Community' D Crew On: / / By: 

Results: 

n Community D Crv>y On: / / 1 By: 

Resultj: 

Omaha Lead Site 
Douglas County Account InfqB&ation Page 1 of2 jxa^ i 

Douglas County, Nebraska Property Record - R1416580000 

Print Report 

NEW Feature - Parcel Dimensions avaiiable @ scale 0-50 fi west of 52nd St - VJeW OH Ma p Information is valid as of 2009-10-15 Treasurer's Tax Report 

New Feature ^ •• "• Auto Sales Search 

Owner 

SMITH DOROTHY 

4308 BEDFORD AVE 

OMAHA NE 68111-0000 

Property Informatio n 

Key Number: 1658 0000 14 

Account Type: Residential 

Parcel Number: 1416580000 

Parcel Address: 4308 BEDFORD AV 

OMAHA NE 68111-0000 

Legal Description: INSTITUTE PLACE LOT 15 BLOCK 3 50 X 128 

Value Informatio n 

Land Improvement Total 

2009 

2008 

2007 

2006 

2005 

2004 

$6,400.00 

$6,400.00 

$6,400.00 

$6,400.00 

$6,400.00 

$6,400.00 

$47,700.00 

$47,700.00 

$47,700.00 

$47,700.00 

$31,700.00 

$28,800.00 

$54,100.00 

$54,100.00 

$54,100.00 

$54,100.00 

$38,100.00 

$35,200.00 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.14 6400.0 1.0 128.0 50.0 No 

Improvemen t Informatio n 

Building 1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl... 10/22/2009 
Douglas County Account Infojj|^io )r|^l i n Page 2 of2 

43l»BEDfCRD AV 

MoIBO- First Floor 

3„^ 1020.0 xq ft 

lOtr 

•2r 

Mn 

SWmPitCa*«ii 

RANCH ttittwn ekD£k 8 It 

l ow -1 -,^ 1 

CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 1020.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Fair 

Unit Type: Condition: Average 

Built As: Ranch Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: : 5.0 

Exterior: Masonry Common Brick Units: 1.0 

Interior: Drywall Baths: i 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 1.0 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1924 0 0% 1924 86 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 1020.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Porch End Solid Wail 120.0 

Porch Slab Roof Ceil 36.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl... 10/22/2009 
Page 1 of 1 

"> 

Create Another Ticket. Back to Irth Intemet j | SendEmai[ \ ]C 

• YOUR TICKET NUMBER IS 2410274. 

Original Call Date: 11/19/09 Time: 1:35 pm Op: ELIZABETH18790 


Work to Begin Date: 11/23/09 Time: 2:15 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 4308 Street: BEDFORD AVE 


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


Twp: 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 


: RESENT DUE TO WORK EXTENDING. PLEASE REFRESH PAINT AND FLAGS 


Company : COASTAL ENVIRONMENTAL SERVICE 


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


Work Being Done For: Coastal Environmental Group 


Depth of Excavation: 4 feet Corner Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Serviee Area Contact Phone Number Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFIC.SEWER Ricnn-RAFFIC

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

QLNNElC QWEST LOCAL NETWORK NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 11/19/2009 
OLS#:30627 As-Built Drawing Date Excavated: 11/13/09 

Date USEPA Sianed Off: 2/3/10 

C

ENVIRONMENTA

 OAST A L 

L Omaha Lead Superfund Site Area Sodden: 4590 sa ft CROUP . IN C 

30627 

Exterior Paint Morth Arrow Omaha Lead Site Q Good Site Sketch 

Sampling Address: 4308 BEDFORD AV • Nfdrpatnt" \ 

Sample Number Lead 

Concentration 

Sample 

Collected \jt& Samples Collected 

Firm: 7£ T,.c. 06T ) 

RYASCPXA-30627

RYBSCPXA-30627

 F1 

 F2 2-^1 

ppm 

ppm cr 

D 

D 

Date: i^, I ]:-ilo& 

Time: ^:0 O PI'i 

RYCSCPXA-30627

RYDSCPXA-30627

 B1 

 B2 

HO I 

in 

ppm 

ppm 

D 

D Samples Analyzed 

RDZSCPXA-30627 DZ 11 \ ppm D XRF Unit: Co^HO Book: 2<X> 

RQgGCPXA-30G27

RPZGCrXA-30027

 62-

 P2­

ppm 

ppm 

D 

D 

D 

D 

Date:

Time:

 I-OR,-OP, 

 AM 

Number of Samples [Z] Staff: AiSvJ 

Legend: Fl = 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, facing property 

Legen d 

Concrete Dri p Zone Excavate d Quadrants Excavate d 

Area replaced with Are a replace d wit h 

Are a lef t bar e Sod ' ' Rock/Mulch 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group Inc . 
• • • • 

30627 

/^/M ^ 

IL iU-i y 

Omaha Lead Site 

Site Sketch 

Sampling Address: 4306 BEDFORD AV 

Sampl Lead Sample e Number LAB Concentration Collected 

RYASCPXA-30627 Fl ll''2. . ppm BT n 

RYBSCPXA-30627 _ F2 . ppm -iiL ur D 

RYCSCPXA-30627 "B T :asx ppm D

RYI^CPXA-aeMB? B2 ppm

ROZSCPXA-30627 DZ 

i\'\ . ppm n JILL 

nOZOCrXA-30027 GZ- , ppm D D 

RPZSCPXA-300g7 P2- , ppm D

n E

D 

Number of Samples • 

Legend: F1 = Front Left, •• Front Right, Bl = Back 

All quadrants 

:f)OH N rrtnlaf; Zft-Tch-OS 

Exterior Paint Nonfi Arrow 

Q] Good 

H'Poor f 

Samples Collected 

Firm; p£ Inr. P6' 0 

Dale: '., i i:'./tffe 

Time: ^:DO pl" 

Samples Analyzed 

XRF Unit: fo^H O Book: 2CB _ 

Date 7-Ofl-Qfl 

Time Jil. Staff rl5u/ 

Drip Zone. GZ = Garden, PZ = Play 

•X_40if~^Myif-i..y>. 
l l \ll l % 

30627 

Omaha Lead Site Exterior Paint Norttl Arrow 

Site Sketch • Good 

Q^Poor Sampling Address: 4308 BEDFORD AV • Nferpatnt~ ^ 

Sample Number 

RYASCPXA-30627

RYBSCPXA-30627

RYCSCPXA-30627

RYDSCPXA-30627

RDZSCPXA-30627

ROZGCPXA-30027

f^rZOCrXA-30C27 

 F1 

 F2 

 81 

 B2 

 DZ 

 GZ­

-PZLead Sample 

Concentration Collected 

litJL­ ppm BA 

-23J .ppm 

HOT . ppm 

-119. ppm 

-IL L . ppm 

, ppm D . ppm D 

Number of Samples = | g |

LAB 

D 

D 

D 

n 

D 

D 

D 

 | Q | 

Samples Collected 

Firm: 7E Tnc. O&A ) 

Date: '.^hiilo& 

Time: ^•on pr'i 

Samples Analyzed 

XRF Unit: fo^HO Book; 

Date: 1-Ofi-OR, 

Time: Ai^ 

Staff: nsiJ 

2<?B 

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

All quadrants are as viewed from trie street, facing property 

^X-^z^f.—MXg:^ -> . • > — ^ , >r ,-- x n- * 
30627 

Omaha Lead Site 

Sampling Address: 4308 BEDFORD AV 

Sample Number 

RYASCPXA-30627 F1 

RYBSCPXA-30627 F2 

RYCSCPXA-30627 B1 

RYDSCPXA-30627 B2 

RD2SCPXA-30627 DZ 

nozsopxA-oooe?—ezRPi!QCPXA-30027 PZLegend: F1 = Front Left, F2 =

.p,>JTT5'F?F.T) 

Ml 23 20G9 

Kcv2008.N Cimcd: 2(>-Fe)MM 

Lead 

Concentration 

liOLiL ppm 

__2il__PPm 

H O I ppm 

__Ill9__ppm 

1 \ \ ppm 

~ ppm 

Site Sketch 

Sample LAB Collected 

or 

D 

D 

Numl)er of Samples = | g |

D 

D 

D 

D 

D 

D 

D 

[ Q | 

Exterior Paint tkxth Arrow 

• Good 

H^oor 

• wrpalnt 

, / ^ 

Samples Collected 

Firm: PE Tnr. 0&r. \ 

Date: u/irt/of e 

Time: ^:0 n ?V\ 

XRF Unit:

Date:

Time:

Staff:

Samples Analyzed 

 CoSHO Book: 2<3f l 

 l-OB-O R 

 AM 

 MSUI 

 Front Right, Bl = Back Left, B2 <° Back Right DZ = Drip Zone, GZ = Garden, PZ= Play 

All quadrants are as vitwed from the atraat. ladng property 

• • > * i *t- i X r—*- T 

HOI nifi 'W .61. 

I 

J- PZ. 

PzOl l 

..H5.QB.... BeACfri Av 
ftfi^'re. 

-f xf COASTA l 

•"'PHO'* cou r 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: Ai ^ ^ 

yiOlp^ZAA^ 

Owner's Name: Daytime Phone: 

H5\-Qzi^ 5 ^ 

Address of Property 

covered by this 

Agreement: HrbO^ fi^lfr^n 

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 viffitten 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 worit. This access shall 

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

agrees to: 

Page 1 of 2 
COASTA L r. -t - INVmOMHfKTAl 

^ i PRQl* C KO U r t H C 

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

piles, dog houses, etc; 

c 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. 

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 wori( 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 

Environmerital Group, at (402) 991-1199 

nt access to my properties D I do not grant access to my properties 

P, ^/AJ IH'6f 

Dat Datee // Signature

 Date 

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

Page 2 of2 
COASTA L 

Restoration Agreement 

The puipose of this agreement is to provide a tnutuBl agreement as to conditions ofthe property prior to 

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

activities are completed to the satisfaction of the property ovmer and the United Stales Environmental 

Protection Agency (EPA). 

[

Property ID: P, 

Proper^ Address: ^&^3Ea ^ z ^ ­

^*^«^-XAncn^fMy -^mi-Ho 

|Phone:L46\-CtZI<^ 

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

access Iocation(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 before Start of Remediation: 

The renoval. stora.qe. disposal, and/or return of t^^es& itoms is the Owner's responsibility. 

item: 

Item: 

Item: 

Items to be Removed by the Contractor During Remediation and Wot Replaced 

Item: 

f\m ^(YTJH piaAih JPH hfJiinJ 

Item: 

item: 

Item: 

Pagel of. 
COASTA L 

C h | i o « 

Hems to Be Removed By Confractor During Remediation and Replaced^ 

! Item: 

f^\l ani^^<r)d'(b\ ft? ,P^ 

item: 

Kem: 

Kem: J 

Landscape Inventory 

Item Quantity Unit Condition/Type/Species 

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

is covwed with gass. - ^ P^ 

Number of trees > 2 inch ^i(\ Each 

trunk diameter 

Number of trees <= 2 inch M'R Each 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Each Ttma^, Heads, etc 

^y 

vrrirkli,'! I;;y',iii; 

Number of and size of 

each garden/ flowo- bed Each 

area. Square Feet ^ Aiiitih ;i sketch 1)1 relitiivc 

>i/i'S nnd loc;ilinti\ 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

ACIr l!-|i' \Hltic v\ill hi 

i;sri.' 10 IS; Ul .i filun; is? 

»oiii-iU'r Id the i;rapcrl\ 

yii ner. 

'MAJB' Easement Area, to be Each ^tndina 

excavated 

Page 2 of. 
* Additional Comments / Instructions: 

Q Check the box rf Owner does not want CEG to document interkir foundation walls and possible 

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

interior of house. Including foundation cracks or fissures. pC65( u C GA A QjAQjSiJC^ 

r~] I do not agree agree 

A 

re Date /T Contractor's Signatnrr 

Page 3 of. 
BVID#_ji^4^_? 

XRF PROPERTY SAMPLE SHEET 


Date fl^^-i-O ^ Address V W BedjinJ- Project Omaha Lead ARRA Sample time am/pm 

XRF ID# Vo^ a sample length 30 sec 

Shot# Reading Sample area Shot# Reading Sample area 

lf^ 3 )?)Sl,l?)-L IL-OS- <r^ IfS^ /y>f-:^:t i3.fU B( 

U^f lSb-o^-L/0-9^^ Depth ns^ :ycA^/d 13-^2. Depth 

U"!^ lfA^.92-t i:^ef / " n n ^rl^-oj-^ IY'S3 —la— 

Average )Hlr-l>^'± fU-^?^ Average ^-6^ 0 ^ /3-rf^ / 

Shot# Reading Sample area Shot# Reading Sample area 

// ^ 

i m 

SH.^L>i I9;.l3i 

I^S-L!^± 12^0 

r?>2L 

Depth 

KSl 

(irz 

?,<^g-qq-L ^5:^3 

?)SU=i^ ^i. r 

DTh 

Depth 

U^ l 9^.^ ± /^.SV L " II3?> ^?)^.S^^^CAI /3' ' 

Average "T^-^ S ^ I'b-h^L Average ^oL^lo l J ^9-1 1 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

Shot# Reading 

RETEST AREAS 

Sample area Shot# Reading Sample area 

Depth Depth 

Average 

SignaturePrA'^S i ^ mj^ 

l-%iMfi(^^Pi^ 

Average 
Thernno 

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 

ppm 

Pb ^147.373 

Supervised By: 

Certificate of Verification 

1196 

SOIL 

2009-11­

91.72 

Final 

23 17:26 

Avg of 1193-1195 

4308 bedford 

em 

1" 

R. VENTRY 

clearence 

ngnc 

± Error 

± 16.867 
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 132.128 

Supervised By: 

Certificate of Verification 

1193 

SOIL 

2009-11-23 17:25 

30.55 

Final 

30627 

4308 bedford 

em 

1" 

R. VENTRY 

clearence 

ngnc 

± Error 

± 16.050 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 1194 

Mode SOIL 

Time 2009-11-23 17:25 

Duration 30.60 

Sequence Final 

Flags 

BVID 30627 

ADDRESS 4308 bedford 

QUADRANT em 

DEPHT 1" 

XRF TECH R. VENTRY 

MISC clearence 

NOTE ngnc 

Error ppm 

Pb ± 16.738 150.073 

Supervised By: 
Thernno 

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 159.920 

Supervised By: 

Certificate of Verification 

1195 

SOIL 

2009-11-23 17:26 

30.57 

Final 

30627 

4308 bedford 

em 

1" 

R. VENTRY 

clearence 

ngnc 

± Error 

± 17.812 
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 

ppm 

Pb 76.747 

Supervised By: 

Certificate of Verification 

1192 

SOIL 

2009-11-23 17:24 

91.15 

Final 

Avg of 1189-1191 

4308 bedford 

B2 

6" 

R. VENTRY 

clearence 

ngnc 

± Error 

± 13.616 
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 84.758 

Supervised By: 

Certificate of Verification 

1189 

SOIL 

2009-11-23 17:23 

30.17 

Final 

30627 

4308 bedford 

B2 

6" 

R. VENTRY 

clearence 

ngnc 

± Error 

± 15.118 
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 65.650 

Supervised By: 

Certificate of Verification 

1190 

SOIL 

2009-11-23 17:23 

30.46 

Final 

30627 

4308 bedford 

B2 

6" 

R. VENTRY 

clearence 

ngnc 

± Error 

± 12.396 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 1191 

Mode SOIL 

Time 2009-11-23 17:24 

Duration 30.52 

Sequence Final 

Flags 

BVID 30627 

ADDRESS 4308 bedford 

QUADRANT B2 

DEPHT 6" 

XRF TECH R. VENTRY 

MISC clearence 

NOTE ngnc 

ppm ± Error 

Pb 79.834 ± 13.335 

Supervised By: 
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 

Pb 

Supervised By 

Certificate of Verification 

1188 

SOIL 

2009-11-23 17:21 

91.93 

Final 

Avg of 1185-1187 

4308 bedford 

Bl 

6" 

R. VENTRY 

clearence 

ngnc 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 1185 

Mode SOIL 

Time 2009-11-23 17:20 

Duration 30.79 

Sequence Final 

Flags 

BVID 30627 

ADDRESS 4308 bedford 

QUADRANT B l 

DEPHT 6" 

XRF TECH R. VENTRY 

MISC clearence 

NOTE ngnc 

ppm Error 

Pb 68.314 ± 13.161 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 1186 

Mode SOIL 

Time 2009-11-23 17:21 

Duration 30.54 

Sequence Final 

Flags 

BVID 30627 

ADDRESS 4308 bedford 

QUADRANT Bl 

DEPHT 6" 

XRF TECH R. VENTRY 

MISC clearence 

NOTE ngnc 

ppm ± Error 

Pb 78.610 ± 13.818 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 1187 

Mode SOIL 

Time 2009-11-23 17:21 

Duration 30.60 

Sequence Final 

Flags 

BVID 30627 

ADDRESS 4308 bedford 

QUADRANT B l 

DEPHT 6" 

XRF TECH R. VENTRY 

MISC clearence 

NOTE ngnc 

ppm ± Error 

Pb 92.068 ± 14.530 

Supervised By: 
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 

ppm 

Pb 406.607 

Supervised By: 

Certificate of Verification 

1184 

SOIL 

2009-11-23 17:19 

91.94 

Final 

Avg of 1181-1183 

4308 bedford 

DZ 

13" 

R. VENTRY 

clearence 

ngnc 

± Error 

± 27.113 
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 398.440 

Supervised By: 

Certificate of Verification 

1181 

SOIL 

2009-11-23 17:18 

30.98 

Final 

30627 

4308 bedford 

DZ 

13" 

R. VENTRY 

clearence 

ngnc 

± Error 

± 25.630 
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 386.866 

Supervised By: 

Certificate of Verification 

1182 

SOIL 

2009-11-23 17:18 

30.30 

Final 

30627 

4308 bedford 

DZ 

13" 

R. VENTRY 

clearence 

ngnc 

± Error 

± 28.669 
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 434.516 

Supervised By: 

Certificate of Verification 

1183 

SOIL 

2009-11-23 17:19 

30.66 

Final 

30627 

4308 bedford 

DZ 

13" 

R. VENTRY 

clearence 

ngnc 

± Error 

± 27.040 
# # 

iy^JL\ Omaha Lead Site—Fixed Price EP-R7-07-05 

^f^Sm ^ Coastal Environmental Group inc. 

\^^^ ^ www.coa8taihazmat.com 

^^tpnoit ^ COASTA L tNVIIOIIHEIITAL 

Clo u r, IM C 

EXECUTIVE SUMMARY: 

BVID #30627-(4308 BEDFORD AVE) 

~x\ No Issues or Concerns Q Issues/Concerns 

Detail Explanation: 
4

# 

EPA Property Close Out Form 7^(^^1 

Property #; 

,, <4m&J>AJ(Uu Property Address: 

Date/Time; 

Owner's Name:. n 

Quads Excavated; ^^ ^ f^^ r jy ^ ^ ^ Contractor Group (_^^ , 

Excavation GenenI 

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

2. If necessary, were the correct areas ofdrip zone excavaied aod restored? 

GradlDC Sod and VcRetatioB 

1. 

Does the grading around the perimeier ofthe house in excavaied areas generally slope away 

from the house? 

2. 

Has sod been laid bi all areas that were excavated? 

3. 

Does tte 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 property graded such that water will not pool on the property'' t 

7. 

Was damage to landscaping or plant materials avoided? 

Gates, Fences and Retainioc Walls 

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

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

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

4. Was damage to retambg walls avoided? (Ifapplicablc) 

Foundation, SidioK and Gatlers 

t. Was damage to the siding or trim avoided? 

2. Was damage to the foundation avoided? 

3. Was damage to windows avoided? 

Was damage to windows or door screens avoided? 

5. Was damage to downspouts or downspoul extensions avoided? 

Sidewallts and Drheways (Concrete) 

1. Wes damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 

Yts No 

/ 

A 

Yes No 

/ 

A 

A 

A 

y 

y 

y 

Yes No 

y 

A 

A _ 

y 

Yes No 

y 

y 

A 

y 

y 

Yes No 

y 

y 
Ort'Dcrs comnients: 

nn.«!pection notes: ^ 

. y V 

Removal and resloralion aclivates complele including the 30-day sod warranry: 

EPA Representative ^o^ jyv Date: \Vl\*» 
I 

Property Completion Agreement 

rins agreement documenls the complclion of remedial aclivilies perloimed on my properly My signalure 

will designate Ihal I am satisfied wilh lhe resloralion ofmy propeily. and ihal no items are in queslions. 

now, or al any lime in the future, excepl those ilems listed below, ifany 

PropertylD: 3^}/^ ^ 

Property Address: l\p ^ Y)^A^ A OlJUe., 

Owner: Q^^yQ^^ g C'SYV I tH \ 

Phone: M<c\- cir\»> 

Restoration Items in Question: 

j item: 

Item: 

Item: 

Item: 

item: 

Item: 

I Additional Comments: 

y^ 1 ayrcc restoration i.« completed, oxccpl as noted 

IKT 1 ayri 

[_J I rio not ai;rtc restoration i<t completed 

^ - /J^-19"A>9 (^{y^'*'^^ r^^^ w 

Owner's Signat/n-p ? Date I Contrarfor's Signature Dale ' 
Property Owner Satisfaction Survey 

Omaha Lead SuperfuncJ Sit 

2008 JAM 0 4 2011) 

Remediation Contractor: Coastal Environmental Group 

Property IdentiFier Number:^ SUPERFUND DIVISION 

Property Address:M riAjT) 

Property Owner's Name 

(above information to be filled remediation contractor prior to delivery of (orm lo Property Owner) 

instructions to Property Owner: 

This form is provided to you as a means of trying to capture your level of satisfaction with the 

work of the above-identified remediation contractor, as applicable to the soil cleanup action at your 

property. The U.S. Environmental Protection Agency (EPA) is very interested in your opinion regarding 

the work performed by its contractors. This form is intended to provide an 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 1 to 10) using the following rating scale, then please sign and date the form and 

return it to the USEPA in the attached self-addressed & stamped envelope, (additional comments may 

also be provided in the space below, at the option of the property owner.) 

9-10 "excellent" 

7-8 "very good" 

5-6 "acceptable" 

I' .......t l 

3-4 poor 

1-2 "very poor" 

Property Ovi^ner's Satisfaction Rating Regarding Contractor's Work 

5 ( ^ 

4 

8 3 

7 2 

6 1 

Additional Comments from Property Owner (optional; continue to bactt of page if needed) 

Property Owner's Signatun JhiM~ Date .r?^ ^f^f