CONTRACT # W912DQ-04-D-0017, T

### .0. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE



### ECC Certification for Property Closeout US Army Corps of Engineers



### OLSID 00671 

### Property Address 2557 Fowler Ave 

### Field Work Started 9/27/2007 

### Field Work Completed 10/19/2007 

### Summary: 

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

# • Fl excavation depth was 4 inches below ground surfaces. 

# • B1 excavation depth was 5 inches below ground surfaces. 

# • F1 VIC 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 was conducted in compliance with the specifications and work plans.



### Comments: None

ECCQCM Ow NoJo') ;.-..-... Name Title Date S 

# aturewJ

JeffHubbard VSACE Con Rep 

# 11- ;'-07 S. 

# »if Name Title Date Ignature

# .4St.. CONTRACT 

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

# II!!)] .ECC:. 

### Environmental Chemical Corporation 

## ,." Omaha Lead Remediation, Omaha, NE us Army Corps of Engineers 

### Analytical Results Summary OLS#00671 2557 Fowler Ave

Sample 

# I Quadrant

# I Depth 

# I Date Collected XRF Results Type (ppm) (avg.) 

# I DE 

### II F1 

### II 4 

### II 10/12/2007 

### II 225 

### I 

# I DE 

### II 81 

# I 5 10/12/2007 

# I 269 

### I 

# I DE 

### II EA-N 

# I 0 10/12/2007 

# I 109 

### I I DE 

### II F1U/C 

### I 7 10/1212007 

# I 128 

### I 

# I I 

# I I

SAMPLEIDSAMPLE ID is aparticular 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 BIor 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 million1111[1111[111111111111111 

### 671

OLS 

### EPA 

# t North Arrow Exterior Paint 

# o Good 

# o Poor 

# o Not paint XRFCode 

### 2775 Omaha Lead Site Site Sketch Owner Name: 

### IX Vel# "'ILJ..f/tl!1$ Address: 2557**FOW.:....:.=LE:;:...:R:.:...:A~V** _**Phone:H:~~3~-J~J~~~r~w~;~** 

### __

Quadrant Fl**~ll** F2. -.--

_ Bl 5/ 1 B2

_ DZ

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### £ll-N 0 1 / Lead Concentration 7-25 ppm

_ -Ippm

___..,....-_-Ippm 

### 26 

### q ppm

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### {oq ppm 

### r;?8 ppm

_____....lppm ppm Date 

### 10/ 

### /2/07 LogBook 

### Z

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ev4 G46141.0123Omaha lead Site Omaha, NE Residential Yard Soils Environmental Restoration Services 

### u.s. Environmental Protection Agency Region VII 

### page 

### 1 of_ 

# &7

• PROPERTY ACCESS (to be completed by property owner)

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### 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

ervices. Your cooperation is requested in giving EPAIUSACElECC permission to access your property during the removal/restoration phase. For further information please contact Don Bahnke, EPA Project Manager at (913) 551-

003 or the Office of External Programs. at 1-800-223-0425. PropertyAccess GrantedBy

Resident**Name:_--4.:~~~:--_~e...r:~[.J..L.~!....-** _ (Please Print Name)



# o renter Residence**Address:_--Ioil::";::~::;""-!-,"""",_-=-':""=_-I...J'...,;V~-** (STATE) (ZIP) Property Owned By:

__**S.;;;;...;.A.:;..;IYt~E_· ~--------**  _ Owners mailing address:

_ Owner's telephone number
-**Home:_..l..,;:'O:":"O:"_.....:.::;...J;,O:;;;':;~** _ Work: 

## -----------11

geofHome?

______years How long have you lived here?

_____years Has the exteior been painted or**cove~ed** with siding since 1978? Has the interior been painted or covered since 1978? DYes DYes 

# o No 

# o No otal number of occupants:

_ list Ages:

## ·_-----------------11 list ages of occupants under 6 years old who play in the yard for 5 or more hours per week:

_ Comments:

UTHORITY FOR ENVIRONMENTAL RESPONE 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). wtlich provides entry for. "determining the need for response, or choosing or '

kin. an,. response action under thiS tiue. or otherwise enforcing the provisions of this title." Access Attempts: First

_ Second: :

_ Third: ;

_pg._of_ 

# list ofExisting Conditions Property Address: 

## c?SS')**hJ4J&E"~** 

# 11=(/ DVD ID #



## ----- Owner: 

### RV!?/J.I WILI

...Jj}MS 

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# 2 BVID#

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### Descri ption 

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Owner Signature

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

__ E:.;CI",..<:;....looC",--

_ Property IdentifierNumber:

_ Property BVID Number: 

## _-=fo'--'7..:......:..../

_ Property Address: 

## .2SS2 

# ErJ

# wL£(( 

## It tI Property Owner's Name: 

# RU..gIII WILL-111M S (above infonnation to be filled outby remediation contractorpriorto delivery ofform to Property Owner) 

### ****************************************************************************** Instnlctions to Property Owner: 

### This form is provided to you as a means oftrying to captureyour level ofsatisfaction with the work ofthe above-identified Remediation Contractor, as applicable to the soil cleanup action atyour property. The U.S. Environmental Protection Agency (EPA) and the U.S. Army 

### Corps ofEngineers (USACE) are very interested in youropinion regarding the work performed by our contractors. This form is intended to provide an easy means foryou to express your opinion about the work performed onyourproperty. Please indicateyour level ofsatisfaction 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 ofthe 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 9 8 7 6 5 4 3 2 1 Additional Comments from Property Owner (optional; continue on backofpage ifneededl



### PropertyOwner'.Signature:

# ~£.J1c/~ Date:

# /1-;9--0 

# 7Contract No. W912DQ-04-D-0017, Task Order DKOI Omaha Lead Site, Omaba, NE Property Closeout Agreement DVID 

### (P7/ Property Address 

# I .:2.SS? 

## f7Jl.tJ

## l£(( Property Owner 

## Rug/II iU/LLIItM

## > Is the Owner the Resident? 

## 0 No Compliance Statement: U.S. Environmental Protection Agency (EPA) has contracted the U.S. Anny 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 EPA1USACEIECC 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. Ifyou 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 ofremedial/restoration efforts at the property to my satisfaction.

### ~gree that restoration is completed at my property. except as noted 

### Comments (if

### applicable): 

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