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 29560 Property Address 3836 Maple St 

Field Work Started 8/28/2007 Field Work Completed 8/28/2007 

Summary: 

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

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

• B2 excavation depth was 12 inches below ground surfaces. 

• Drip zone excavation depth was 6 inches below ground surfaces. 

• Drip zone garage excavation depth was 6 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. 

• Sod placement and site restoration were conducted in compliance with the specifications and 

work plans. 

Comments: None 

.:5< -.,..j.f j) J,1I...I ECCOCM 10 

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/t7• Name Title Date Jo-~.. 

19na ~ 

~ 0- Jeff Hubbard USACE Con Reg 112 -)'S-Q 

Name Title Date Si~n!te 
. . . " 

. 

29560 11110 II III ~IIIM ~ III' 

Owner Name: SERT' ttJo~ ftiiCCARREt 

Address: 3836 MAPLE ST 

0 .............. . \01. w. 

Omaha Lead Site 

Site Sketch 

El<terior Paint 

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Quadrant

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B1'--';3--'i,,-c;--:"h--

B2 {2 Itrch 

DZ "iltC h 

p% 6AfA6& "/;, ,I, 

.. .... . . .... . · , . 

Lead Concentration 

2 '10 ppmAt 

'21/8 ppm;fE 

252. ppm 

325 ppm 

7Z ppm

tile ppm 

____-lppm 

____---'ppm 

ppm 

Date 

ff/Z//oZ 

LogBook

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Omaha Lead Site 46130 
Page 1 of __________ 

Omaha Lead Site 

Omaha, NE 

u.s. Environmental Protection Agency Region VII 

Residential Yard Soils 

Environmental Restoration 

Services 

I)I~( lIl] R I ') \( (I \ .... {{(1 l~,- lllll1piLh.. d h\ [J]UPl'll) (l\\ 111..1 \ 

[\u,\ 1lll l'll l,t.] 1\11111.1 l,,)l.llllli )llli I,l\l)] Ildllll' .11 1-~rJI) =2~ (J 1'=" 

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 information please contact EPA at 1-800-223-0425. 

Property Access Granted By boIS C VI) -:SO 

(Please Print Name) 

(Date) 

NOTE: Granting permission DOES NOT necessarily imply your property will be remediated at this time. 

I'I(()I'I I{ 11 1,\1 olnl \ II()'\ 

(Ill hl llllll)lkll'd I') ll',,[(klll ,lilt! tll plllpl'J1) U\\lll'J Pk,he [J tll ll) 

Resident Name: _-"La"l.l.JI"":.s"---_-"C"-'(J."""'/):....:::~'_"O'___ ___ ~wner o Renter 

Residence Address: --"s"--"li':-'"~'-'b"-_t1LL'-'M:.J...Lu:::.!...._-'.s:.:.{__ Om/uto . !JR. (CITY) , (STATE) (ZIP) 

Property owned by: _....:::s~/lf1,'--'--'''1e-= ______________________ 


Owners mailing address: ___________________________________________________________ 


Owner's telephone number- Home: ____________________ Work: 35/- <;~91 

Age of Home? ________________ 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 ofoccupants: _____________ 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 WIder this agreemeru are pursuant to Section 104 ofCERCLA, 42 U.S.c. 9604. EPA's right ofaccess to the 

property for in Section I04(e) ofCERCLA, 42 U.S.c. 9604 (e), which provides entry for, "detennining the need for response. or choosing or taking 

any response action under this title, or otherwise enforcing the proviSions ofthis title." 

Access Attempts: 


First: ______________________ Second: _______________ Third: ___________________ 

pg._of_ 

List of Existing Conditions 


Property Address: ,J>l?3& MftfU= sr 011111111 DVD 10 # _____ 

Owner: LOI.s CUI> -S-o Date: e-0,3 - 0 ? BVID# J. 'lS/eO 

Ref: 


Photo 


# 

Description 

N~IJ£ 

Owner Signature 

Print & Sign 
Contract No. W912DQ-04-D-0017, Task Order DKOI 


Omaha Lead Site, Omaha, NE 


Property Closeout Agreement 


Property Address I DVID ;;21s 00 ,?y..) 6 mn-pu sr

Property Owner Is the Owner the Resident? [l..-Yes 0 No LO/~ CUD"S(J 

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 EP AlUSACElECC 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 ofExtemal 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 ofremediallrestoration efforts at the property to my 

satisfaction. 

[1J./I agree that restoration is completed at my property, except as noted 

Comments (if applicable): 

(M~ ])~ 

1\ /J 

0~i\ Vt:~ Pr~7er's""Sign8fiire() L/ 

I/-OJ -O ? 

Date 
•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 

Property Owner Satisfaction Survey Form 

Omaha Lead Superfund Site 

Perfonnance-Based Contracting (PBC) Pilot Project 

Remediation Contractor: __-'£,a,C"'C"=-_______________ 

Property Identifier Number: ________ 

Property BVID Number: c2 is~O 

Property Address: -38'S'b mML£ &" r 

Property Owner's Name: -'t-<J="'I...S'_---"C"'-"U""'DL.;3" .......... O"-­___________ 


(above infonnation to be filled out by remediation contractor prior to delivery of fonn to Property Owner) 

Instructions to Property Owner: 

Ibis fonn is provided to you as a means of ttying to capture your level ofsatisfaction 

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 perfonned 

by our contractors. Ibis fonn is intended to provide an easy means for you to express your 

opinion about the work perfonned 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 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.) 

9-10 "excellent~ 

7-8 "very good" 

5-6 "acceptable" 

3-4 "poor" 

1-2 "very poor" 

Property Owner's Satisfaction Rating regarding Contractor's Work 

C}2--­ 5 

4 

8 3 

7 2 

6 1 

Additional Comments from Property Owner (optional; continue on back ofpage ifneeded) 

O;~G to ;h~t iAdt~~ 

Property Owner's Signature: Date: 
CONTRACT # W912DQ-04-D-0017, T.O. DK04 


Environmental Chemical Corporation 


Omaha Lead Remediation, Omaha, NE US Army Corps 

of Engineers 

Analytical Results Summary 

OLS # 29560 

3836 Maple St 

XRF Results IQuadrant I Date Collected Sample I Depth I Type 
 (ppm) (avg.) 

I DE II B1 II 3 II 8/21/2007 
 I 252

DE B2 12 8/21/2007 I 325 I II II II 

DE DZ 6 8/21/2007 72 I II II I

t=glII 

DZ-G 6 8/21/2007 148 II II 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: 

Fl or F2 "" Front Yard One or Front Yard Two 

B1 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