### CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE us Anny Corps of Engineers


### ECC Certification for Property Closeout
OLSID 40194 Property Address 2444 Newport Ave Field Work Started 10 /

4

/ 2007 

### Field Work Completed 10/ 1112007 Summary: 

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

# • FI excavation depth was 

### 3 inches below ground surfaces. 

## • B I 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 

## S f <-I 

## + D, ) . .,t>I ECCQCM Name Title Date iUre 

# j leffHubbard USACE Con Rep jI- 6(.

- 07

## f!4i~ Name Title Date Signature

### 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 # 

### 40194 2444 Newport Ave.
Sample

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

### I DE 

### II F1 

### II 3 

### II 10/4/2007 

### I 166 

### I DE 

### II 81 

### II 3 

### II 10/4/2007 

### I 240 DE EA-S 0 10/412007 

### 96 

### I II I I II I I II I

SAMPLE IDSAMPLE 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 descri bes the sampling location (with sequential sample number for that location) as follows ; Fl or F2 · Front Yard One or Front Yard Two B I 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

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# mlru mUlIlWll1**fM II~**  40194 Owner**Name: AES** **~** STlJ BBS JR Omaha Lead Site Address: Z444 N EWPO RT AV Site Sketch

Phon¥.iC 402·934-88

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### Quadrant FI 3;/ F2 

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### IP**-':'~~~_-1p pm**  56 ppm¥­ 

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# I Ithe exteior been painted or covered with siding since 1978? the interior been painted or covered since 1978?

number of occupants:

under I 

## page 1 

## of_ 

## 4dler'l Omaha Lead Site Omaha.NE Residential Yard Soils Environmental Restoration Services U.S. Environmental Protection Agency Region VII



# . PROPERTY ACCESS (to be completed by property owner) ;::J ("**~ ,**  1 1**_s~,** "**~O'** 'cue "t. J ,, :: _'- .**~-** Environmental Protection Agency (EPA) has contracted the U.S. Army Corps of Engineers (USACE). Omaha IDistrict to conduct environmental restoration services for the Omaha Lead Site. USACE Omaha is working with IElnviror.mlental Chemical Corporation (ECC) to ""move lead contaminated soil and provide subsequent restoration Your cooperation is requested in giving EPAIUSACEJECC permission to access your property during the Ireme.vail/re,sto,ration phase. For further information please contact Don Bahnke. EPA Project Manager at (913) 551­ or the Office of External Programs. at 1-800-223-0425.

(Please Print Name)

lZI...<wner 

# o renter UResident Name: 

## 7S/tltl'($ 5TUfi**~** URes,idence Address: 

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# «flU PtJKT Ifv IPrcmerlv Owned By: 

## SliME II01Nniersmailing address :

____________________________ _____**nO~,"el"s** telephone number - Home: 

### CT,j (
- 

## l?f'/f Work: --'--'--'--==-'----11

______ years How long have you lived here? _ _ __ years DYes 

# o No DYes 

# o No

_ _ _ _ _ List Ages:

_________ __________

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

_______

activities to be implemented by EPA under this agreement are pursuant to Section 104 of C E RCLA, 42 U
. S
. C
. 9604
. EPA's right of access property for in Section 104(e) of CERCLA. 42 U
. S.C
. 9604 (e) , which provides entry for. "determining the need for response, or choosing or of this title
. "
F i rst:
__________ Second::
___________ Third::

___________

## List of existing Conditions pg._of_
Property Address:

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### _ ___**-= :...** **'f !...!** **'I !oL<C:** **.!.....!C..** 

### ___ _ DVII> 

### Owner:

### 7:ft/'ll~S 

### sTVe8s Date:

____**~#:** 

### i O/'l'f Description:



# d-)**J) ~**  N OT 

# M ct s s 0)( DR ! !I f W!f 

# is

Owner Signature: AS;; ,dO ' 

### z Inc. Print & 

### Sign Print & 

### SignContract No. W912DQ-04-D-0017, Task Order DKOI Omaha Lead Site, Omaha, NE Property Closeout Agreement DVID 

## LfCJI 

# tty Property Address 

# I /).1/ I{I{**AJfv)P ()** **~r** J}-v Property Owner "S"ffro,l/!<:;' 

## STVJ?gS Is the Owner the Resident?

### ~s 

## 0 No 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. USACE Omaha is working with Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation in giving EPA1USACElECC 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 (9\3) 551-7003 or the Office of External Programs at 1-800-223-0425. Additional Comments 

### by USACE and/or ECC:

CONTRACTOR CERTIFICATION Prashant Khanna or Charles "Skip"Milton ECC Project Manager Name Title Date Signature 

## PROPERTY OWNER SECTION This agreement documents the completion ofremedial/restoration efforts at the property to my satisfaction. 

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



## /J /\ 

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### /,**~** 

## /f/'L-<I :/1 ;;:­

### 1!-~?**-tJ 7** **~erty** Owner's Signature Date 

# f/

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

__**....JPJ!:::..L.C.::lC~** ______________ Property Identifier Number:

________ Property BVID Number: I{ 

## 0/ 

## '1 'i Property Address: 

## J'i'i'f 

## NeW 

# foAr ltV Property Owner's Name: 

## XAM£.s. STU,iPS (above infonnation to be filled out by remediation cootnlCtor prior to delivery of form to Property Owner) Instruc:tions to Property Owner: 

### lIDs 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 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 form and retum it to US ACE 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 Ratin!! mardlng Contractor's Work 

### 10 9 

# -A-­ 5 4 

### 8 3 7 2 6 1 Additional Comments from Property Owner (optional; c:ontinue on back of PRe If needed)

Property Owner's Signature: Date: 

## 11-& 

## 'l-tJ?