.' 

### CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE 

# 1m

us Army Corps

of Engineers 

### .ECC: • 

# ..

ECC Certification for Property Closeout
OLSID 29288 

### Property Address 1410 Ohio St 

### Field Work Started 10/412007 

### Field Work Completed 10/4/2007 

### Summary: 

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

# • F1 excavation depth was 5 inches below ground surfaces. 

# • F2 excavation depth was 5 inches below ground surfaces. 

# • BI excavation depth was 7 inches below ground surfaces. 

# • B2 excavation depth was 7 inches below ground surfaces. 

# • Verification samples confinned that cleanup standards were met. 

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

# • The backfill was compacted to acceptable standards. 

# • Site restoration were conducted in compliance with the specifications and work plans.



### Comments: None



# S'- o1-\-

## DJ,v~ ECCQCM 

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## 13<)/01- Ii 

### Name Title Date Jeff Hubbard USACE Con Rep I 

# I;) /67 

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# ~ture...p.t:::.=Il-_- Name Title Date

# etiih CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE 

# mJ

us Army Corps

of Engineers 

### .ECC. 

# 'IF

Analytical Results Summary OLS # 29288 1410 Ohio St

XRF Results Sample Quadrant Depth Date Collected (ppm) (avg.)

Type



### DE F1 5 9/27/2007 67 

### DE F2 5 9/27/2007 63 7 

# I 9/27/2007 64 

# I DE B1 

### DE 

# I 82 7 

### II 9/27/2007 54 

# I DE 

# I EA-S 

### II 0 

### II 9/27/2007 

### 111 

# " 

# I I II 

# I I II 

## ij 

# I

SAMPLEID. SAMPLE ID is a particular residential property ID from which the sample is collected. The sample type identifier (with sequential sample number for that location) as follows; PX = Pre-Excavation XRF sample DE = During and Post Excavation Quadrant describes the sampling location (with sequential sample number for that location) as follows; FI or F2= Front Yard One or Front Yard Two 81 or 82" Back Yard One or Back Yard Two DZ '" Drip Zone GA"'Garden PA" Play Area EA = Easement Depth describes the depth from which the sample was collected. ppm = parts per million

# 1r:-~~---:-**--=--~:--::-:-:-_-.;:::~~~~.-:2=9.:28::8** NQr1h /Irrow Exterior Paint Owner Name: BIl:.!:£.MCCORI'tICK 

### Omaha Lead Site, 

# o Good Addf'ess: 1410 OHIO_.2 T 

# .o-...-.____ Site Sketch 

## n Poor Phone: i't**_I.f~** 1. 

# e-. W: XRF Code 

## ;!7?5 OLS

### r~1I Team 

## %Lt>ve Lead Concentration Date 

# 1;, Quadrant 11 

# 67 ppm

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## 5 ppm F2 

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# ---------------------------------- Page lof
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### 2~z82:> Omaha Lead Site Omaha, NE U.S. Environmental Protection Agency Region VII Residential Yard Soils Environmental Restoration Services PROI'I· R I Y \CCf S', {1,1**b~'** COll1pk-lc'd b: Plopell: OIl**1l~'1** )**1'~11** ,I Il'l'lbll**l',I~1** t'll! 1l1,1 L"I ' :llilll!1l11 ':1\ ('I rI:lll1l' :11**I-S(J('-::~~-()-I::'~** Grantor (the property owner), consents to and authorizes the United Sates Environmental Protection Agency (USEPA) or its authorized representatives (or its contractors), the Grantee, to enter and perform certain environmental response activities upon the following described premises. For further infonnation please contact EPA at )·800-223-0425. /J 

## crt L 

### /ht.-C/,"**~~** 

### ..... l/ Property Access Granted By**1":>~** _ '-oJ
....**UoA-~** (Please Print Name) (Property Owner Signature) (Dale) NOTE: Granting permission DOES NOT necessarily imply your property will be remediated at this time. I'ROI'I 1\ I Y 1\1 OI\\I,\TIO\: (hi bl' cLlll1pkted h: IC'llkl11 :Jill! (lJ prUpl'rt: llllilr:r-Pk:bc l'llllt) Resident Name: 

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_**~Owner** 

## o Renter Residence Address:

### ~~/-=O~4..;O~fh;o~,---"",, 

## _ 

## OmAf:t4-=------,/l (CITY) (STATE) (ZIP) Property owned by:**....;~:.JO'_~~(L'"""---<--==~=.....t.=..** _ Owners mailing address:-tl
... 1-::I""'D"'---==...:.::;,....;,,::..=,,"'-"<.--".::;......_-'--
_ Work:

_ • Owner's telephone**number-Hom_"'=---I-f~-+-_L.!:...~----'-'<..I:-"'-'oa.**

Age of Home?**---"l-6~~rr:4_** years How long have you lived here? years Has the exterior been painted or covered with siding since 1978 DYES 

## o NO Has the interior been painted or covered since 1978? DYES 

## o NO Total number of occupants:
_ List Ages:
_ List ages of occupants under 6 years old who play in the yard for 5 or more hours per week:
_ Comments: AUTHORITY FOR ENVIORNMENTAL RESPONSE ACTIONS The activities to be implemented by EPA under this agreement are pursuant to Section 104 ofCERCLA. 42 USc. 9604. EPA's right of access to the property for in Section 104(e) ofCERCLA, 42 U.S,c. 9604 (e), which provides entry for. "determining the need for response, or choosing or taking any response action under this tille, or otherwise enforcing the provisions of this title," Access Attempts: First: Second: Third:
_

### pg._of_ 

# List of Existing Conditions Property Address: 

# 1 

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## DVD ID # 

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# 88' Owner:**~:JtL /YlCu)~**  

## Date:**1-~/** 

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Ref: Photo # 

### Description 

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Owner Signature ECC Print & Sign

## prinQ&~**tv~** 

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### Contract No. W912DQ-O
.... D M 

### 0017, Task Order DKOl Omaha Lead Site, Omaha, NE Property Closeout Agreement Property Address DVID 

# I /110 ell/ltl 

# sr**~q61~f** Property Owner Is the Owner the Resident? DYes

### ~o 1")lLL/Am

### MrJ~tLJt1~ Compliance Statement: U.S. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps of Engineers (USACE), Omaha District to conduct environmental restoration services for the Omaha Lead Site. US ACE Omaha is working with Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation in giving EP A/USACElECC permission to access your property during the removal/restoration phase is sincerely appreciated. This document**ce~ifies** 

### 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 ofExtemal Programs at 1-800-223-0425. 

### Additional Comments by USACE and/or ECC:

CONTRACTOR CERTIFICATION



## - PraJames D, Garcia ECC Project Manager Ch:



### - Na Superintendant Date
v..

# I?~ure 

# P---C fJ PROPERTY OWNER SECTION This agreement documents the completion of remedial/restoration efforts at the property to my satisfaction. 

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


# j O' 

# d,5· 

# °7

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# /f/ 

# AtL Property Owner's Signature Date

### Propert~ 

## Owner Satisfaction Survey Form Omaha Lead Superfund Site Perfonnance-Based Contracting (PBC) Pilot**Proj~t** 

### Remediation Contractor:

__ 

# -I:g=-C=..:L
_ Property Identifier Number:
_ Property BVID Number:

### _-.:;l~Zu;;;:.i~8'~K'---- Property Address:

__**~/** 

### ...... 

### 't

.... 

### IO"__

__ O'_"'_'H'"""/""''I2-S::....l.r-·

_ Property Owner's Name: 

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.......

### e"""CA~;.f..l'R~M~/C"""""""k....._------ 

### ........ I'-='L:..r.J...;:,t/u.ewLl",,;.j'----L-J\1 (above infonnation to be filled out by remediation contractor prior to delivery of fonn to Property Owner) 

### •••••••• ********* ••••• ************************** •• ************ ••• ************* Instructions to Property Owner: This fonn 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) and the U.S. Army Corps of Engineers (USACE) are very interested in your opinion regarding the work performed by our 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 I to 10) using the following rating scale, then please sign 

### & date the form and return 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.) 9-10 "excellent" 7-8 "very good" 5-6 "acceptable" 3-4 "poor" 1-2 "very poor" 

### r'sWork PrnJlerty Owner's SatisfattioD 

### Rating ReDding Co 10 5 9 

### 4 8 3 

### 7 2 

### 6 1 

### Additional Comments from Property Owner (optional; continue on back of page if needed)



### Property Owner's Signature: 

# K 

# t1J;i, ;Ii:£' Date: ) 

### O· r;) t;. 0 

# 7