^ « 

TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: 1Ao\\ Date: \|^^j\ \ 

'^li^ MIK H f%i Address: 

Remediation Contractor: Coastal Environmental Group_

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 

-J Restoration Agreement 

 Year: _2010ARRA_ 

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

t r Confirmation data 

ij 

Photographs m

As-built sketch 

 b/^t^^[W>^ X tKC^?nilPrTVvA \ ^' ^ 

Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

d 

Description ofareas not meeting ROD cleanup criteria 

Utility clearances 

• 

Propertyjnformation from Douglas County Assessor's Office 

D 

D 

30218080 

Superfund 
k 

t 

^v 

Property Access Checklist 

Property ID: 25ni\ D WORK STARTED ON; / / 

Property Address: 3/j^J^;{^f-^[Q ^ ^ ^ D WORKCOMPELTED ON: / / 

Owner: 

Renter: dcx^ph Wi'^^K 

Address: Phone: 

Fax: 

Cell/Pager: 

Additional Information: 

^L^SEISQl 

Fax: 

Cell/Pager: 

r r~l Notification Letter Sent: / / By; 

I Access Agreement Signed;/_/<3^//Q By: 

^ Restoration Agreement Signed; / /Z H 1^ By; 

Q TopsoU Sampling (if applicable) / / By; 

Q Disposal Sampling (if applicable) / / By; 

Q Garden Sampling (if applicable) / / By; 

liRj Utility Clearance CaUed; 3 / H / Z 7 By: 5/22//^ \ OL>,r.A OH/IU »w a » to 

H Video/Pliotos (Before) Oxi:2-llJ:^llO 

n Video/Photos Paring) On; / / By; 

D Video/Photos (After) On; / / By; 

n Video/Photos (30-Day) On; / / By; 

Q Property Completion Agreement Signed: / / By; 

D Final Report Issued; / / By; 

Air Monitoring (as appUcable) 

• Community QCrew On: / / By: 

Results: 

• Community QCrew On: / / By: 

Results: 

Q Community QCrew On: / / By: 

Results: 

Omaha Lead Site 

\ 
'.V Douglas County Account In^jnatio ^l^ n Page 1 of2 t 

% 

Douglas County, Nebraska Property Record - R1803250000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - Vie w o n Ma p Infomiation is valid as of 2009-11-19 Treasurer's Tax Report 

New Feature -> -> ^ Auto Sales Search 

Owner 

WILSON JOSEPH P 

ETAL 

3119 MYRTLE AVE 

OMAHA NE 68131-0000 

Property Informatio n 

Key Number: 0325 0000 18 

Account Type: Residential 

Parcel Number: 1803250000 

Parcel Address: 3119 MYRTLE AV 

OMAHA NE 68131-0000 

Legal Description: MONTCLAIR ADD LOT 117 BLOCK 0 48 X 121.6 

Value Informatio n 

Land Improvement Total 

2009 $2,500.00 $76,100.00 $78,600.00 

2008 $2,500.00 $76,100.00 $78,600.00 

2007 $2,500.00 $76,100.00 $78,600.00 

2006 $2,500.00 $76,100.00 $78,600.00 

2005 $2,500.00 $76,100.00 $78,600.00 

2004 $2,500.00 $52,100.00 $54,600.00 

Sales Informatio n 

Sales Date: 1995-05-03 

Deed Type: Book: 2006 Page: 668 

Price: $43,500.00 

Grantor: 

Grantee: 

Valld/lnvalld: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.13 5808.0 1.0 121.0 48.0 No 

Improvemen t Informatio n 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl... 11/25/2009 
Douglas County Account InfcBaation Page 2 of2 

% 

Building 1 

1 1/2 Story Fin 3119 Myrtle Av 

^^'•/S^'TDitCiaraoa 

,.. -1 

tmosq ft 

: ^ 0 50 PI 

>c » . . """ fctciScMWM < • » 

aj-*»Biit>9ii nmoSQ PI 

r.,=iNi-^ii,r—i«ii«..»,.i^fi,|,-^f-«.|.-«^i.-..ir i :Ji 

CLICK TO ENLARGEJMAGE r CLICK TO ENLARGE IMAGE 

Square Footage: 1703.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

Built As: 1 1/2 Story Fin Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 7.0 

Exterior: Frame Stucco Units: 1.0 

Interior: Drywall Baths: 2.0 

Roof Cover: CoiTiposition Shingle Bedrooms: 4.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1918 0% 1918 92 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Appliance Fireplace Masonry 1.0 

Basement Bsmnt Block 8 ft 1109.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 2.0 

Garage Detached 552.0 

Porch End Solid Wall 136.0 

Porch Slab w/Steps 28.0 

http://douglasne.mapping-onIine.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl... 11/25/2009 
Page 1 of2 

"> 

Bl^fO •• 9.S-0/I 

Create Another Ticket Back to Irth Internet Send Email _ J 

YOUR TICKET NUMBER IS 2475672. 

Original Call Date: 4/26/10 Time: 4:47 pm Op: ELIZABETH18790 


Work to Begin Date: 4/28/10 Time: 5:15 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 3119 Street: MYRTLE AVE 


Twp: 15N Rng: 13E Sect-Qtr: 16-NW-SW 


Twp: Rng: 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: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV LEVEL3 MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Plione Number Utility Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 8773668344 

LEVEL3 LEVELS COMMUNICATIONS, LLC NA Alt: 

Emerg: 8773668344 


Day: 4025047823 


MUDOl METROPOLITAN UTILITIES DISTRICT SANDY Alt: 


Emerg: 4025047970 

Day: 4024447197 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RICHA-RAFFIC Alt: 4024445161 

Emerg: 4024445160 

http://vmw.dhon.org/irihinternet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 4/26/2010 
Page 2 of2 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT

Day:

 ELM LOCATING Alt:

 4067289343 

 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK

Day: 4067289343 

 ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 4/26/2010 
OLS#: 25011 

< ^ As-Built Drawing ^ Date Excavated: 4/20/10 

Date USEPA Sianed Off: 5/7/10 

COASTA

ENVIBONHENTA

L 

L Omaha Lead Superfund Site Area Sodden: 2723 sa ft e • O U r , IN C 

1 ­ Name: 

Address:

Phone: 

 >/< ^ fyf.gti S ^ 

Oinaha Lead Site 

Site Sketc h 

Dale: SM. U 2L . 

Time: ?-y 5 fl/t 

North AtTDW

^ 

—I 

Team liliJ'i/(ci4n t.i.i'-. BVID# ^C l I XRFCode 5'^ m 

Sample Number Lead Concentration Confirmation Sample 

pvK.ir/^Y A

RYCSCPVA

RYD acpxA

 - A'irn/y 

 -2Gni l 

­ asn// 

v^. q 

C77,Q^^^.3ppm 

ppm 

ppm 

f • Yes

"Ye s

Ol Yes

G'Yes

•T^Yes

Yes

Yes

 n 

D 

D 

^ 

n 

n 

• 

No

No

No

No

No

No

No

 a 

 K l 

Q 

 " 3 

S 

 CD 

• 

113 PPM @ 10" 

F2 = 101 PPM@6 " 

EA = 193PPM@1 " 

-gr A l f/rr^ £ •» 

Legen d 

Concrete Drip Zone Excavat.ed Quadrants Excavated 

Area replaced

Sod 

 with Area replaced wit:h 

Rock/Mulch Area lef t bare 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group Inc . 
^m 9c/-/ ^cii/ ~ /^/^ye' ^ Aoj} ^ 7.J Ao. f})i' /a ^ Zest's . /AufH/y ^ (2) CVeo^f UL 

F— Name: Omaha Lead Site Date: r/>a^- 3 North Arrow 

Address; >^ /' I rv\^/?li £ ^ Site Sketch Time: ^'•s'5 /1/n 

Phone: 

Team l-f7tJ'S:/^i^/l rcx- BVID # _X£j2ll . XRFCode :55"ir}g 

Sample Number Lead Concentration Confirmation Sample 

RYASCPX A • ^>50/ / f I Yes D No Q 

F?Yes CD No K] 

0( Yes n No C3 RYDSCPX A - <?^o// G'Yes 1^ No H 

g77.Qr^3.J9pp m Op-Yes 1^ No S 

ppm Yes n No • 

ppm Yes D No n 
I— Name: Omaha Lead Site Date: f/>3 ^ », North Arrow 

Address: >/ / *1 ry\^/^7i £ ^ Site Sketch Time: ?'y ? /l/ n 

Phone: 4-

Team liJiJ'i:/^iv i rcK BVID # XS'Cl I XRFCode ^^ m 

Sample Number Lead Concentration Confirmation Sample 

RYASCPXA - 2*50// mo.^ pm *=' Yes D No eg j^ypi.'^r/^y A - py^n/ / -Tl-?!^ tf>3.?. F?Yes 1=1 No K] R Y C SCPV A ' ^50/ / 55Q.HtZS,0 ppm 

0* Yes O No C3 

RYD SCPXA - aso/ / scc.dt^ae.o ppm G^Yes ^ No Q ppm 

OP-Ye s 1=> No S (oJT.O - 23,3 ppm Yes n No tZI 

ppm Yes • No • 

ppm 
Name: _ Omaha Lead Site 

Address: :?//1 ^-i/^i u ^ Site Sketch 

Phone: _ 

Team J^/JZ/^MISJ^:—— BviD# Arc/ / 

Sampie Number Lead Concentration 

RYASCPXA ' 2*50// 

f?vr3CPVA ' ^sn/ / 

RYDSCPXA -asm / 

G77.Q i23, 3 ppm 

ppm 

ppm 

Date: r/o^/ n North Arrow 

Time: ?.'yf /4/»v 

XRF Code SSO Z 

Confinnation Sample 

^1 Yes O No CS 

F?Yes C No IS 

01 Yes n No C3 

G^Yes CD No Q 

D^Yes CD No E] 

Yes CD No Q 

Yes n No CD 
I 

>*^"!!r^''<r 

COASTA l CNVIIOMHIkTAl 

C R 0 tl r IH 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: D sT) / f 

Owner's Name: / « .^^ ... Daytime Phone: (^Z ^ S^Zi^O i 

Address of Property 3([ ^ i\ALi^n^/^^ j 

covered by this 

Agreement: 

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) wili 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 t>eing 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 vtnitten 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 also 

agrees to: 

Page 1 of 2 
i 

,*^*!r''*i 

'if.yiy*^.!^* COASTA L 

CHTIIIONKfKTAl 

CROU P IM C 

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

piles, dog houses, etc; 

e Remove flower bulbs or plants that the Grantor or the Grantor's tenant may wish 

to save; 

c 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 NOT TO 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 

grant access to my properties 

D i do not grant access to my properties 

S^iiature ^at e Signature 

Date 

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

Page 2 of 2 
COA S T A L 

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: ^^501 ( 

Property Address; 3((<^ P^UV^Tij ^ /^ V 

Owner: 

Phone: f U02^^^Z>(9(3 

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, hidicate 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 befbre Start of Remediation: 

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

Item: 

i^H$JM^ / ^ liUi^'^^^yr^ f Hw^U.Xr ^ p/dMO^e J 

Kem: 

Kem: 

Kem: 

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

Kem: 

J^LD6)6r ^<rus *n, ^/ j f^z,. Kem: 

Kem:

Kem: 

Page 1of y 

 1 
COA S T A L • MVI nOMMa NTAL a • o u p . IM C 

Items to Be Removed By Contractor During Remediation and Replaced 

Kem: 

^ \ t 90^ - Fl X l .A)2^,h] 

item: 

Kem: 

Kem: 

Item 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

trunk diameter 

Number of trees <= 2 inch 

trunk diameter 

Nimiber of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Number of and size of 

each garden/ flower bed 

area. 

Attach a sketch of relative 

sizes and locations. 

Agreed upon value of plant 

materials not to be 

replaced by contractor. 

Note this value will be 

used to issue a plant 

voucher to the property 

owner. 

Quantity 

'l3\ 

^ 

5 

. y 

3 

/ 

Landscape Inventory 

Untt Condition/Type/Species 

Quadrants 

Each 

Each 

Each 

Each 

Square Feet 

$ 

Easement Area, to be Each y^w y (2.^$^!-^ excavated 4i} 

Page 2 of ^y 
t 

COA S T A L 

O • O U P , INC . 

AddKional Comments / Instructions: 

The city of Omaha ordinances may prohibK 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. If this is the case, you should understand that this 

removing and replacing of soil 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 removai 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 cKy of Omaha's Planning Department at (402) 444-5150. 

[ ^ Please check this box if you understand the information outlined above. 

•/ 

i z i)fi.-/ A^+'<^ ^^"- ^ ^'"^^ • 

D 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. 

1^1 agree O I do not agree 

iL-K-pS^ 

tbwner's Signature Da Contractor's Signature Date 

Pages of J 
• • • • 

BVID# <^^/ l 

am/pm 

30 sec 

Reading Sample area 

/^V -^ f.<r 

Depth 

U± 

/ / / 7* -^ / ^ 

Reading Sample area 

;; 1 d: / r D ^ 

M_ Depth JSA 

10"^ t /.sr- // ^ 

/ / ^ - ^ is „ / 

Reading Sample area 

Depth 

* 

Reading Sample area 

Depth 

Date 

Project 

XRF ID# 

Shot# 


'^^S 

- 2 ^ 

-z^T^ 

Average

Shot# ^sa 

^ g 

^MI 

Average

Shot# 

S P ^ 

: 2 ^ 

3<P?-

Average

Shot# 

Average 

Signature 

XRF PROPERTY SAMPLE SHEET 


'=>-?rlO 

Omaha Lead ARRA 

•6Z<PR^ 

Reading 

U r lo ^ 3? >^ fo 

^r- t IO 

 "5 P"J^ / O 

Reading 

/gr-± I'f 

-f /9^ 

/^y 1^ f f 

 /£) / -3^ / V 

Reading 

/c?1 :?- / ^ 

^ ^ :J^ /-^ 

/ ^ ^ :t />^ 

 I <^ 3-t ^ /. ^ 

Reading 

^"" ^ 

Print m( n \k^t(^ 

Sample area 

£L 

Depth 

j f n 

J 

Sample area 

Pz^ 

Depth 

/ 

Sample area 

Depth 

i »( 

/ 

Address 

Sample time 

sample length 

Shot# 

^ 2 L 

23. ^^

s 

r 

Average

Shot# 

3^^ 

3g?2­

'hP'b 

Average 

Shot# 

Average 

RETEST AREAS 

Sample area Shot# 

Depth 

Average 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Biilerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 308 

Mode SOIL 

Time 2010-05-03 10:36 

Duration 90.64 

Sequence Final 

Flags 

AVEE^GE Avg:QtJ^^50T 

ADDRESS ^^=^^2fll9 Myrt:le ave 

QUADRANT EA 

DEPTH 1" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 

Zr 366.408 

Sr 167.225 

U < LOD 

Rb 58.507 

Th 12.454 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Biilerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 305 

Mode SOIL 

Time 2010-05-03 10:35 

Duration 30.11 

Sequence Final 

Flags 

BVID 25011 

ADDRESS 3119 Myrtle ave 

QUADRANT EA 

DEPTH 1" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD ; 7.527 

Zr 367.143 ± 13.888 

Sr 165.199 ± 8.504 

U < LOD I 13.638 

Rb 59.033 ± 5.947 

Th < LOD : 11.622 

Pb 188.755 ± 17.864 

Se < LOD I 5.561 

As 44.965 ± 16.587 

Hg < LOD : 12.369 

Zn 180.764 ± 22.402 

W < LOD : 84.667 

Cu 43.815 ± 20.557 

Nl < LOD 67.392 

Co < LOD ; 165.587 

Fe 16536.813 ± 359.278 

Mn 403.387 ± 85.363 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Biilerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 306 

Mode SOIL 

Time 2010-05-03 10:36 

Duration 30.43 

Sequence Final 

Flags 

BVID 25011 

ADDRESS 3119 Myrtle ave 

QUADRANT EA 

DEPTH 1" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 7.685 

Zr 366.084 ± 13.947 

Sr 167.956 ± 8.606 

U < LOD 13.949 

Rb 61.443 ± 6.088 

Th 13.808 ± 8.208 

Pb 204.085 ± 18.626 

Se < LOD 5.730 

As < LOD 24.728 

Hg < LOD 11.859 

Zn 184.119 ± 22.534 

W < LOD 81.267 

Cu 35.222 ± 20.068 

Ni < LOD 69.166 

Co < LOD 164.099 

Fe 16390.885 ± 359.244 

Mn 481.027 ± 90.023 

Cr < LOD 653.212 

V < LOD 2138.748 

Ti < LOD 6645.938 

Sc < LOD 655.909 

Ca < LOD 11696.620 

K < LOD 26206.189 

S < LOD 601.461 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 307 

Mode SOIL 

Time 2010-05-03 10:36 

Duration 30.10 

Sequence Final 

Flags 

BVID 25011 

ADDRESS 3119 Myrtle ave 

QUADRANT EA 

DEPTH 1" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD ; 7.710 

Zr 365.997 ± 13.952 

Sr 168.521 ± 8.626 

U < LOD : 13.583 

Rb 55.045 ± 5.812 

Th 13.259 ± 8.003 

Pb 187.313 ± 17.975 

Se < LOD 6.034 

As 36.455 ± 16.373 

Hg < LOD 11.107 

Zn 185.248 ± 22.401 

W < LOD 73.674 

Cu 34.101 ± 20.005 

Ni < LOD 72.616 

Co 193.258 ± 113.420 

Fe 16295.806 ± 358.303 

Mn 384.889 ± 84.815 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 304 

Mode SOIL 

Time 2010-05-03 10:34 

Duration 90.35 

Sequence Final 

Flags 

AVERAGE ^--Avg-nf'-wrtrwn . 

ADDRESS 3119 Myrtle ave 

QUADRANT DZ 

DEPTH 10 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 8.031 

Zr 419.915 ± 15.368 

Sr 183.198 ± 9.302 

U < LOD 14.726 

Rb 63.541 ± 6.414 

Th 14.968 ± 7.848 

t^t3:3M ^54;895=7 

Se < LOD 5.597 

As < LOD 19.373 

Hg < LOD 12.327 

Zn 98.295 18.343 

W < LOD 87.206 

Cu < LOD 30.363 

Ni < LOD 74.937 

Co < LOD 181.982 

Fe 18380.998 394.339 

Mn 231.90 75.941 

Supervised By: 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Biilerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 301 

Mode SOIL 

Time 2010-05-03 10:32 

Duration 30.11 

Sequence Final 

Flags 

BVID 25011 

ADDRESS 3119 Myrtle ave 

QUADRANT DZ 

DEPTH 10 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 7.983 

Zr 427.539 i 15.408 

Sr 172.178 ± 9.010 

U < LOD 14.951 

Rb 71.395 ± 6.710 

Th 15.794 ± 7.919 

Pb 111.044 i 14.767 

Se < LOD 5.796 

As < LOD 19.440 

Hg < LOD 11.875 

Zn 101.870 ± 18.444 

W < LOD 84.643 

Cu < LOD 30.697 

Ni < LOD 76.606 

Co < LOD 183.445 

Fe 18434.586 ± 393.739 

Mn 211.206 ± 74.429 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 302 

Mode SOIL 

Time 2010-05-03 10:33 

Duration 30.12 

Sequence Final 

Flags 

BVID 25011 

ADDRESS 3119 Myrtle ave 

QUADRANT DZ 

DEPTH 10 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm 

Mo < LOD 

Zr 420.084 

Sr 183.450 

U < LOD 

Rb 59.340 

Th 16.128 

Pb 120.431 

Se < LOD 

As < LOD 

Hg < LOD 

Zn 107.763 

W < LOD 

Cu < LOD 

Ni < LOD 

Co < LOD 

Fe 18486.389 

Mn 269.170 

Supervised By: 

Error 

8.022 

± 15.385 

± 9.320 

14.621 

± 6.252 

i 8.003 

± 15.334 

5.816 

19.925 

12.359 

± 18.910 

84.310 

29.832 

73.063 

181.067 

± 395.773 

± 78.666 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Biilerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 303 

Mode SOIL 

Time 2010-05-03 10:34 

Duration 30.12 

Sequence Final 

Flags 

BVID 25011 

ADDRESS 3119 Myrtle ave 

QUADRANT DZ 

DEPTH 10 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 8.088 

Zr 412.120 ± 15.311 

Sr 193.965 ± 9.577 

U < LOD 14.605 

Rb 59.888 ± 6.280 

Th 12.981 ± 7.623 

Pb 108.679 ± 14.583 

Se < LOD 5.180 

As < LOD 18.756 

Hg < LOD 12.746 

Zn 85.253 ± 17.676 

W < LOD 92.664 

Cu < LOD 30.561 

Ni < LOD 75.141 

Co < LOD 181.434 

Fe 18222.021 ± 393.506 

Mn 215.328 i 74.728 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Biilerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 296 

Mode SOIL 

Time 2010-05-03 10:29 

Duration 90.34 

Sequence Final 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPTH 

TYPE 

INSPECTOR 

ppm Error 

Mo < LOD 

Zr 445.480 

Sr 182.357 

U < LOD 

Rb 71.431 

Th < LOD 

<ebz d^t? 

Se < LOD 

As 31.486 

Hg < LOD 

Zn 118.548 

W < LOD 

Cu 38.149 

Ni < LOD 

Co < LOD 

Fe 18385.205 

Mn 271.729 

Supervised By: 
TllieFm® 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 293 

Mode SOIL 

Time 2010-05-03 10:27 

Duration 30.11 

Sequence Final 

Flags 

BVID 25011 

ADDRESS 3119 Myrtle ave 

QUADRANT B l 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 7.837 

Zr 441.405 ± 15.356 

Sr 180.263 ± 9.055 

U < LOD 141612 

Rb 70.446 ± 6.551 

Th < LOD 10.433 

Pb 123.759 ± 15.147 

Se < LOD 5.773 

As 34.664 ± 14.187 

Hg < LOD 12.170 

Zn 113.742 ± 18.973 

W < LOD 84.163 

Cu 33.531 ± 20.465 

Ni < LOD 72.006 

Co < LOD 179.220 

Fe 18461.197 ± 387.481 

Mn 253.318 ± 76.244 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 294 

Mode SOIL 

Time 2010-05-03 10:28 

Duration 30.11 

Sequence Final 

Flags 

BVID 25011 

ADDRESS 3119 Myrtle ave 

QUADRANT B l 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 7.804 

Zr 441.348 ± 15.350 

Sr 179.253 ± 9.027 

U < LOD I 15.582 

Rb 75.874 ± 6.830 

Th 11.291 ± 7.461 

Pb 116.996 ± 14.802 

Se < LOD 5.348 

As 25.839 ± 13.555 

Hg < LOD 11.585 

Zn 125.980 ± 19.484 

W < LOD 76.434 

Cu 57.787 ± 22.304 

Ni 90.858 ± 51.395 

Co < LOD : 179.633 

Fe 18352.164 ± 385.927 

Mn 247.822 ± 75.829 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 295 

Mode SOIL 

Time 2010-05-03 10:29 

Duration 30.12 

Sequence Final 

Flags 

BVID 25011 

ADDRESS 3119 Myrtle ave 

QUADRANT B l 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 7.924 

Zr 453.687 ± 15.603 

Sr 187.554 ± 9.240 

U < LOD 15.594 

Rb 67.974 ± 6.588 

Th 13.062 ± 7.549 

Pb 110.515 ± 14.504 

Se < LOD 5.906 

As 33.956 ± 13.649 

Hg < LOD 11.912 

Zn 115.922 ± 19.218 

W < LOD 87.402 

Cu < LOD 29.565 

Nl < LOD 71.063 

Co < LOD 178.150 

Fe 18342.260 ± 387.049 

Mn 314.047 ± 81.633 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 292 

Mode SOIL 

Time 2010-05-03 10:26 

Duration 90.33 

Sequence Final 

Flags 

AVERAGE i^5$^fi89=2S 

ADDRESS 3119 Myrtle ave 

QUADRANT F2 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD ; 8.140 

Zr 428.557 ± 15.463 

Sr 176.182 ± 9.136 

U < LOD : 14.639 

Rb 67.480 ± 6.545 

Th < LOD : 10.927 

i Ws ' • '10n.94H ± . -. 1^1-31-

Se < LOD J 5.350 

As 35.597 ± 13.521 

Hg < LOD \ 12.775 

Zn 97.384 ± 18.293 

W < LOD : g6.661 

Cu 40.977 ± ^ 21.^ 9 

Ni < LOD y ^ 7i(B34 

Co < LOD /y : 190.436 

Fe 19661.709/ ± y^l.1^ 1 

Mn 349.206/ 85.994 

^ < 7 ^- ^ 

Supervised By: y ^y^^ y^^^^^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Biilerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 289 

Mode SOIL 

Time 2010-05-03 10:25 

Duration 30.11 

Sequence Final 

Flags 

BVID 25011 

ADDRESS 3119 Myrtle ave 

QUADRANT F2 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD ; 8.085 

Zr 429.007 ± 15.449 

Sr 174.703 ± 9.094 

U < LOD : 14.524 

Rb 66.575 ± 6.497 

Th < LOD \ 10.563 

Pb 104.900 ± 14.350 

Se < LOD I 5.482 

As 35.004 ± 13.662 

Hg < LOD : 12.718 

Zn 89.247 ± 17.728 

W < LOD ; 86.564 

Cu 34.701 ± 21.265 

Ni < LOD : 76.877 

Co < LOD : 190.828 

Fe 19447.551 ± 405.369 

Mn 373.323 ± 87.220 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 290 

Mode SOIL 

Time 2010-05-03 10:25 

Duration 30.11 

Sequence Final 

Flags 

BVID 25011 

ADDRESS 3119 Myrtle ave 

QUADRANT F2 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 8.187 

Zr 425.023 ± 15.381 

Sr 174.163 ± 9.068 

U < LOD 14.838 

Rb 68.358 ± 6.595 

Th 10.965 ± 7.308 

Pb 94.409 ± 13.759 

Se < LOD 5.812 

As 46.168 ± 13.668 

Hg < LOD 12.644 

Zn 82.869 ± 17.373 

W < LOD 90.487 

Cu < LOD 31.256 

Ni < LOD 76.761 

Co < LOD 188.265 

Fe 19738.531 ± 407.961 

Mn 349.547 ± 85.807 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 291 

Mode SOIL 

Time 2010-05-03 10:26 

Duration 30.11 

Sequence Final 

Flags 

BVID 25011 

ADDRESS 3119 Myrtle ave 

QUADRANT F2 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 8.148 

Zr 431.643 ± 15.558 

Sr 179.681 ± 9.246 

U < LOD I 14.554 

Rb 67.509 ± 6.543 

Th 11.830 ± 7.504 

Pb 103.534 ± 14.285 

Se < LOD : 4.754 

As 25.620 ± 13.234 

Hg < LOD : 12.963 

Zn 120.036 ± 19.778 

W < LOD : 82.931 

Cu 59.456 ± 22.994 

Ni < LOD J 73.863 

Co < LOD \ 192.215 

Fe 19799.047 ± 410.031 

Mn 324.749 ± 84.953 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 288 

Mode SOIL 

Time 2010-05-03 10:23 

Duration 90.35 

Sequence Final 

AVERAGE cr:$5Z|PoP2S5^587——^^^ 

ADDRESS 3119 Myrtle ave 

QUADRANT Fl 

DEPTH 4 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 8.192 

Zr 435.084 ± 15.727 

Sr 181.755 ± 9.353 

U < LOD 14.624 

Rb 66.607 ± 6.558 

Th 12.705 ± 6.981 

crEb •-=• c^arit5fi=r: ^ J ^y.oy4— 

Se < LOD 5.477 

As 30.694 i 10.221 

Hg < LOD 12.638 

Zn 61.224 ± 15.872 

W < LOD ^,SQiQ2S 

Cu < LOD ....--"•'^ioB 

Ni < LOD 78:830 

Co < LOD y ^/l88.65 6 

Fe 19619.223/ ± y ^ 411.092 

Mn 227.846 

-y^'^'^^^ ^ 

^ ^rii^^"^" ^ Supervised By: . y 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Biilerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 285 

Mode SOIL 

Time 2010-05-03 10:22 

Duration 30.11 

Sequence Final 

Flags 

BVID 25011 

ADDRESS 3119 Myrtle ave 

QUADRANT Fl 

DEPTH 4 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm 

Mo < LOD 

Zr 428.476 

Sr 178.189 

U < LOD 

Rb 69.499 

Th 13.111 

Pb 41.332 

Se < LOD 

As 28.844 

Hg < LOD 

Zn 55.229 

W < LOD 

Cu < LOD 

Ni < LOD 

Co < LOD 

Fe 19893.953 

Mn 261.129 

Supervised By: 

Error 

8.316 

15.610 

9.261 

15.141 

6.716 

7.070 

10.191 

5.750 

10.299 

12.377 

15.311 

88.366 

30.676 

75.442 

188.708 

± 413.761 

± 79.844 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 286 

Mode SOIL 

Time 2010-05-03 10:23 

Duration 30.12 

Sequence Final 

Flags 

BVID 25011 

ADDRESS 3119 Myrtle ave 

QUADRANT Fl 

DEPTH 4 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 8.159 

Zr 445.922 ± 15.964 

Sr 184.542 ± 9.457 

U < LOD 14.886 

Rb 62.018 ± 6.434 

Th 14.731 ±­ 7.178 

Pb 36.924 ± 9.759 

Se < LOD : 5.166 

As 31.051 ± 10.178 

Hg < LOD : 13.109 

Zn 76.769 ± 17.232 

W < LOD : 92.156 

Cu 34.092 ± 21.675 

Ni < LOD : 76.905 

Co < LOD : 190.540 

Fe 19677.717 ± 413.227 

Mn 210.256 ± 76.360 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 287 

Mode SOIL 

Time 2010-05-03 10:23 

Duration 30.12 

Sequence Final 

Flags 

BVID 25011 

ADDRESS 3119 Myrtle ave 

QUADRANT Fl 

DEPTH 4 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 8.102 

Zr 430.853 ± 15.608 

Sr 182.535 ± 9.340 

U < LOD ; 13.845 

Rb 68.304 ± 6.523 

Th 10.275 ± 6.694 

Pb 37.117 ± 9.732 

Se < LOD : 5.516 

As 32.188 ± 10.185 

Hg < LOD : 12.429 

Zn 51.676 ± 15.073 

W < LOD : 89.551 

Cu 37.891 ± 21.686 

Ni < LOD : 75.142 

Co < LOD : 186.719 

Fe 19285.998 ± 406.287 

Mn 212.159 ± 75.338 

Supervised By: 
ijQL\ Omaha Lead Site—Fixed Price EP-R7-07-05 

I ^^^ ^ I Coastal Environmental Group Inc. 

\^^^j ^ www.coastalhazmatcom 

^"iPBOTt ^ COASTA L ENVIIONNENTAl 

Ciour , IN C 

EXECUTIVE SUMMARY: 

BVID #25011-(3119 MYRTLE AVE) 

~x| No Issues or Concerns []] Issues/Concerns 

Detail Explanation 
EPA Property Close Out Form 

PropertyU: 7f50 ) 1 . . 

Dntc/Timc: • Owner's Naine;, fejQ.^iTl. Ui>)?Xy\ — 

Quads Excavated: Contractor Croup Q?f3T^<Oi] 

Excavation Yes No General 

1. If necessaiy, were the correct qtiadrant(s) excavated and restored? / 

2. ir necessary, were the correci areas ofdrip zone excavaled aod restored? / 

Grading Sod and VegeUtion 

Yes No 

1. Does the grading around ihe perimeier of the house in excavaled areas generally slope away / from tht house? 

2. Has sod been laid in all areas thai were excavated? y^ 

3. Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 

day time period) y 

4. A R sodded areas generally firm and evenly graded? y 

5. Are the joints betweeti the sod strips generally tight? (Only evaluate if inspected at a 30 day 

time period) y

6. Was tbe property graded such that water will not pool on the property'' 

_ / 

7. Was damage to landscaping or plant materials avoided? 

/ 

Gates. Fences and RcUtaing Walls • 

1. Do gates open and clo.se freely? (If applicable) 

Ves 

y 

No 

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

3. Was danuge to gates or fences avoided? (Ifappiicable) 

A. Was damage to retaining walls avoided? (If applicable) 

y 

J 

Foundation, SidiOR and Gntlers 

t. Was danuge to the siding or nnm avoided? 

Yes 

/ 

No 

2. Was danuge to the foundation avoided? 

?. Was damage to windows avoided? 

4 Was danuge to windows or door screens avoided? 

S. Was damage to downspouts or downspout extensions avoided? 

/ 

/ 

/ 

/ 

1 

Sidewalks nnd Driveways (Concrete) Yes No 

1. Was dannge lo driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 

y 

/ 
OM'tiers comments: 

jln.spection noies: 

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

EPA Representative /9 ^ J3c^ Date: s/r/io 
# 

Property Completion Agreement 

Dili agreement documenli. the complclion of remedial acliviiies perloimed on my properly My signaluie 

will designale that I am satisfied with lhe resloralion of my properly, and lhat no ilems are in questions, 

now, or at any lime in the fuiure, except Ihose ilems listed below, if any 

Pioperty fP: 2f^ \ \ 

Property Addrc.ss:^2,( I q MuftiP , f\\l ^ 

^^""Ah^p^ \AlilSnyi 

"""f^cPg) 3^.?.- \^o\ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

uQ I Rgrcc restoralion rt completed, excepl as noleri 

[_| I rio nol «)>rec resiorntion is completed 

r 

Vc^U^.^^'^tyry ^

^)wncr',<: Signatnre

 ,r-/S

 Date

 ^ 10 3C(hMyn y

 Conti arior's Signature 

^ ^

Dale 

 -f h 
Property Owner Assessment of Performance Form 

American Recovery and Reinvestment Act CAR^)p- ^ p„ 

Omaha Lead Superfund Site ^ t L# F" 

2009/2010 *^ 

'^^^ 12 'im 

Remediation Contractor: Coastal Environmental Group - EP-R7-Q9-06 

Property Identifier Number; ^4Y)/,/ ^^ERFL/M n Hiwio. ^ 

Property Address; ,^l i q Mv/H ^ hl f ^^^'^^ J DiViSlON 

Property Owner's Namc;' L VY>fiJ)V) \k\ i \'>rY\ 

Instructions to the Propertv Owner: 

This form serves to record the Property Owner's assessment of perfonnance (Incentive 1 

- Quality Assurance Surveillance Plan) involving the listed remediation contractor, as applicable 

to the Omaha Lead Site. This fonn documents the timeliness of punch list resolution, business 

relations, complaint resolution and the overall quality of work. If need be, the Property Owner 

may utilize this form to record problems and/or issues not specifically tied to an assigned 

address, for example, business relations that generally don't follow the guidelines set forth in the 

Performance Work Statement. 

The Property Owner will indicate his/her assessment of performance with the contractor's 

work by checking a nnmerical rating on the table below using the numerical defuiitions firom 

the rating scale below, then sign & date the forni. 

9-10 "excellent" 

7-8 "very good" 

5-6 "acceptable" 

3-4 "poor" 

1-2 "very poor" 

Propertv Owner's Assessment of Performance Regarding the Contractor's Work 

10 _XJJ 5 

9 4 

8 3 

7 2 

6 1 

Propert Ttyy Owne Owner Comments from (optional; continue on back page if needed) r Additiona Additional

l Con 

^ aW^ vy^'\^ 

Property Owner Signature: .^^ ^ Ui / iLJLt-^Y\ Date: S~ - ^ -/ ^