# 4fIIbCONTRACT 

### # W912DQ-04-D-0017, T.O. DK04


# . Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE 

# m

us Army Corps

of Engineers 

### .ECC • 

# ..,

ECC Certification for Property Closeout


### OLSID 32073 

### Property Address 3611 N 30th 

### St 

### Field Work Started 9/24/2007 

### Field Work Completed 9/26/2007 

### Summary: 

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

# • F2 excavation depth was 3 inches below ground surfaces. 

# • B2 excavation depth was 3 inches below ground surfaces. 

# • Verification samples confirmed that cleanup standards were met. 

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

# • The backfill was compacted to acceptable standards. 

# • Sod placement and site restoration were conducted in compliance with the specifications and work plans.



### Comments: None. 

# .5&..914 Name 

### bJJJrJ ECCQCM Title Jeff Hubbard Name USACE Con Rep Title 

### Ie 

# I z

# i 

# /0':/ F4 

### Date

## 32073 EXlarlor Paint Owner Name: KEITH A BATES 

### Omaha Lead Site 

# o Good Add r-ess: 3611 N 30 ST 

### Site Sketch 

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# o Nolpa' t 

### Team 

### C. C I 

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### XRF Code_......**2=;7.!...!~~i/** 

## __ Date . Quadrant Lead 

### Concentration F 1.

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# 9lzz/dZ**__-=-~,...---.Ippm** F2 

## 3 u 

## 2'12 ppm B 1_--:.=-r.
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### B2 

## .3 }/ 17'1 ppm 

### LogBook DZ.
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## 277. ppm

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# . Omaha lead Site Omaha,NE Residential Yard Soils U.S. Environmental Protection Agency Region VII Environmental Restoration Services PROPERTY ACCESS (to be completed by property owner)**~ara** re::,bJr es:a**!r:::~--;"'a** en £s;::a;'Hj :::0:**~avcf 31i~e**  al i·eC Io J·223<'425 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. USACE Omaha is working with Environmental Chemical Corporation (ECG) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation is requested in giving EPAlUSACElECC permission to access your property during the removal/restoration phase. For further information please contact Don Bahnke. EPA Project Manager at (913) 551­

. 7003 or the Office of External Programs, at 1-800-223-0425. Property Access Granted By

1 . NOTE G 

## r DOES NOT rt 'lib eJ,' 

### t d tlh' f

_.**~__** __ _. _ _ • ' , J PROPERTY INFORMATION (to be completed by reSident and or property owner· Please Pnnt) Resident Name:

__

# ---lo.oY1:~....Io**:..-I-i=~---_------­ ~owner**  

# o renter Residence Address: 

# 3b 

# 1/ 

# '11« lJ) 

# '"'Ii 

# :s+ ' Property Owned By:

# 1}i?1(+~ It 

# £utc=s Owners mailing address: 

# 1« 0 I 

# ti 0 

# X' 

# /I 1, fJht 

# itA #; 

# IVE /I/)- 

# bOY) ( Owner's telephone number - Home: 

# I/D 

# ¥t(5 2- S 

# tfy:,-< Work:

ge of Home? years How long have you lived here? years 

# c/J 'r 

# -+-
Has the exteior been painted or covered with siding since 1978? 

## 0 Yes 

# .?( No Has the interior been painted or covered since 1978? 

## 0 Yes 

# J&f No

otal number of occupants:+ list Ages:

# ~~ Ust ages of occupants under 6 years old who play in the yard for 5 or more hours per week:

__

## -40~-+- _ Comments:

UTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS he activities to be implemented by EPA under this agreement are pursuant to Section 104 of CERCLA. 42 U.S.C. 9604. EPA's right of access to he property for in Section 104(e) of CERCLA. 42 U.S.C. 9604 (e). which provides entry for. "determining the need for response. Of' choosing or aking any response action under this tiUe. or otherwise enforcing the provisions of this title." _11

Access Attempts: First: Second: : Third: :

### pg._of_ 

# List of Existing Conditions Property Address: 

# .3 

# u I J 

# tJ. 80 5+ ovo 10 #

# ~Ot 

# oJ "3 Owner: 

# .!5e i 

# lli {6o:te:, Date:

# qJ/~D7 BVID# 

# 3J.OJO

Ref: Photo # 

### Description

Owner Signature 

### ECC Print 

## & Sign Print & Sign

### Contract No. W912DQ·04-D-0017, Task Order DK01 Omaha Lead Site, Omaha, NE Property Closeout Allreement BVID 

# -.? dO 

# f)s Property Address 

# I 5&/1' 

# AJ 

# so 

# 5, Property Owner 

# k e "TII &ftTrs Is the Owner the Resident? DYes 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/USACE/ECe 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 of External Programs at 1-800-223-0425. Additional Comments by USACE and/or ECC:

CONTRACTOR CERTIFICATION ECe Project Manager Name Title Date Signature 

## PROPERTY OWNER SECTION This agreement documents the completion of remediallrestoration efforts at the property to my sati sfaction .

. dL--ragree that restoration is completed at my property, except as noted Comments (if applicable):

## /~-;J./--()~

# 'X"'~~4Ad:b Pro 

### erty Owner's Signature**Dat~**

## Property Owner Satisfaction Survey Form Omaha Lead Superfund Site Performance-Based Contracting (PBC) Pilot Project Remediation Contractor:

__

### ~e~c~C=="","" 

# _ Property Identifier Number:
_ Property BVID Number: 

# S j.t? 

# '7 ? Property Address: 

# S(t, II Ii SO S 

## r Property Owner's Name: 

## _=-k;..=e;..l'u.T .....**H.&...-.-'lJiw..&.<ll..LLF..r-...:S"'~** _ (above infonnation to be filled out by remediation contractor prior to delivery of form to Property Owner) 

# ••••••••••••••••••••••••••••••••• *•••••••••••••• *•••• ** •••••••••••••••• ** ••••• Instnactions 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) 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 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 & 

### 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" Property Owner's Satisfaction Rating regarding Contractor's Work 10 

### 5 9 

### 4 8 

# z 3 7 2 6 1 

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

### needed)



### Property Owner'. 

### Signature:!\2 Date: 

# IJ ..J-I-() 

# 2

# 4i&-
. • ECC. 

### CONTRACT 

### #**W912DQ~04~D~0017,** 

### T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE 

# m

us Army Corps

of Engineers 

# ...
Analytical Results Summary OLS#32073 3611 N 30 th 

## St

# [~ad~nt 

# I Sample Type Depth Date Collected XRF Results (ppm) (avg.) 242 DE F2 

### 3 9/22/2007 DE 82 

### 3 9/22/2 17


# I II I

SAMPLE 10- 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 XR.F 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 B 1 or B2 '"' 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