* 

TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: 2^70 ^ Date: 

Address: l//ol2 Cf.^Yh]^ 5 + 

Remediation Contractor: Coastal Environmental Group_ Year: _2010ARRA_ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

W Video ofproperty (DVD) 

Q^ Executive Summary 

Qy EPA-provided property slcetch 

B— Signed Access Agreement for subject property. 

^^— Signed Access Agreement(s) for adjacent property 

-•^r Restoration Agreement 

"^j^— Settlement documents (i.e., for damage or to replace plants, etc.) 

''^ y Confirmation data 

O ­ Photographs ife ^^Alte* ^ ^ (x(yP(\IPc^(yiA ^ 4(7^ 

\B''^ As-built sketch 

"B" Satisfactory restoration signed by Property Owner 

vQ- Property close-out check list signed by EPA 

•^ ^ Description ofareas not meeting ROD cleanup criteria 

'Q y Utility clearances 

Qy^ Property information from Douglas County Assessor's Office 

D 

30261023 

•III I 

Superfund 
Property Access Checklist 

Property ID: ^'4o ^ 

Property Addresit; )i ' i 2 , CIAJ ^ 'Z^I^ ^ 

D

D

 WORK STARTED 

 WORKCOMPELTED 

ON: 

ON: 

_/

/

 /_ 

/ 

0>vncn

Address: 

 jA^dby^Ht^^^llO'^ ^ 

Plione: 

Fax: 

Cell/Pagen 

,A^Uio ^ 

S^-lisrj 

D Notification Letter 

I^!}^ccess Agreement 

pNRestoration Agreement 

D Topsoil Sampling (if applicable) 

D Disposal Sampling (if applicable) 

Q Garden Sampling (if applicable) 

1 D Utility Clearance 

1 D Video/Photos (Before) 

1 D Video/Photos (During) 

1 D Video/Photos (After) 

D Video/Photos (30-Day) 

D Property Completion Agreement 

D I<'inal Report 

Sent: / / 

Signed: ^/^//£ ) 

si^tA'. jn i i£ l ui> 

1 1 

1 1 

1 1 

Called: / / 

On: / / 

On: / / 

On: / / 

On: / / 

Signed: / / 

Issued: / / 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

Air Monitoring (as applicable) 

Cl Community • Crew

Rcsidts: 

 On / / By: 

n Community

Results: 

Q Crew On: / / By: 

• Community

Results: 

D Crew On: / / By: 

Omaha Lead Site 
Douglas County Accoxint Infoacatio xaaoa n Page 1 of2 : 

Douglas County, Nebraska Property Record - R1744570000 

Print Reoort 

View Interactive GIS Mao Infonnation is valid as of 2010-8-30 Treasurer's Tax Reoort 

New Feature -^ ^ -r^ Subdivision Sales Search 

Owner 

NIKOLAS MICHAEL E 

P 0 BOX 4554 

OMAHA NE 68104-0000 

Property Informatio n 

Key Number: 4457 0000 17 

Account Type: Residential 

Parcel Number: 1744570000 

Parcel Address: 1612 CORBY ST 

OMAHA NE 68110-0000 

Legal Description: MILLARD & CALDWELL'S ADD LOT 20 BLOCK 0 W 50 FT 50 X 86.625 

Value Informatio n 

Land Improvement Total 

2010 $500.00 $0.00 $500.00 

2009 $500.00 $0.00 $500.00 

2008 $500.00 $0.00 $500.00 

2007 $500.00 $0.00 $500.00 

2006 $500.00 $0.00 $500.00 

2005 $500.00 $0.00 $500.00 

Sales Informatio n 

Sales Date: 1999-07-16 

Deed Type: D Boolr: 2133 Page: 347 

Price: $150.00 

Grantor: 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.09 4300.0 0.0 86.0 50.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/acco\mtinfo.jsp?accountno=Rl 7... 9/15/2010 
3/31/2011 www.dhon.org/irthinternet/DHONNotic 

[ Create Another Ticket Back^fft h Intemet '£• Send Email 

• YOUR TICKET NUMBER IS 2700077. 

Original Call Date: 3/31/11 Time: 1:20 pm Op: ALFONSO18790 

Work to Begin Date: 4/04/11 Time: 1:45 pm 

State: NE County: DOUGLAS Place: OMAHA 

Address: 1612 Street: CORBY ST 

Twp: 15N Rng: 13E Sect-Qtr: 10-SE-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: (402)934-2811 


: PLEASE INCLUDE ALL EASEMENTS 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name: ALFONSO Phone: (402)934-2837 


Work Being Done For: Coastal 


Depth of Excavation: 4ft Corner Lot: N Front: Y Rear; 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number 

Utility 

Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MUDOl METROPOLITAN UTLLITES 

DISTRICT SANDY MUD 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHATRAFFICSEWER RICH/TRAFFIC

Day: 4024447197 

 Ah: 4024445161 

Emerg: 4024445160 

0PPDGPR5 OMAHA PUBLIC POWER 

DISTRICT 

ELM 

LOCATING 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

dhon.org/irthintemet/.../MessageText.as.. 1/2 
3/31/2011 ^ ^ www.dhon.org/irthintemet/DHONNotic..^^ 

W

FTM 

V Day: 4067289343 

QLNNEIC QWEST LOCAL NETWORK rr^r^A-nxT^ Alt: 4062071494 

LOCAIIN U 

Emerg: 8887289343 

dhon.org/irthinternet/.../MessageText.as... 2/2 
As-Built Drawing 

COASTA L Omaha Lead Superfund Site 

OLS#: 29708 

Date Excavated: 4/7/2011 

29708 

Omah Exterior Paint Nortti Antr« Owne a Lead Site r Name: MICHAEL E NIKOLAS 

SH • Good e Sketch Address: 1612 CORBY ST • Poor Phone: " 402-578-1151 W 402-571-9726 r~| Not paint i

Lead Sample Samples Colle Sample Number Concentration Collected LAB Firm: ^ kA U j /' b 

RYASCPXA-29708 F1 D Date ^-l^'. f 

RYBSCPX.V29708 F2 Zll o ppm D Time: io 1^' 

RYCSCPXA-29708 Bl (fH& PPr" or D Samples Analyzed RYDSCPXA-29708 B2 SH 6 ppm D 

RDgOCPXA-eai'OO ~ PP"i 

D D XRF Unit /03 7 Book: /2 ? 

ncascpxA 20708—02- ppm D D Date: I-IZ-OS' 

RPgSCPXA 20708 P2- • " ppm D 

D Time: E m 

Staff: l A Number of Samples = HLegend: Fl = Front Left F2 = Front Right. 81 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from Hte street, facing property 

Legen d 

Concrete Drip Zone Excavated Quadrant:s Excavated 

Area replaced with Area replaced with 

Sod Area lef t bare ' Rock/Mulch 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group Inc . 
29708 

: ^ Owne Omaha Lead Site r Name: MICHAEL E NIKOLAS 

Site Sketch Acidress: 1612.CpRBY ST 

Phone : H: 402-578-1151 W: 402-571-9726 

Sample Number 

RYASCPXA-29708 F1 

RYBSCPX.A-29708 F2 

RYCSCPXA-29708 Bl 

RYDSCPXA-29708 B2 

RDJOCrXA-29700 9? 

nczccnxA ao7oo—G^-

RPZSCPXA 20708 P^ 

Legend: F1 = Front Left, F2 =

Lead 

Concentration 

g 3 7 ppm 

3 7 ^ ppm 

S H O ppm 

ppm 

ppm 

ppm 

Number of Samples 

Sample 

Collected LAB 

D 

[3f D 

D 

D 

D 

D 

n

• 

D D 

Exterior Paint 

• Good 

• Poor 

[~| Not paint 

North Arrow 

i . 

Samples Collected 

Firm: ^kA US/Tb 

Date: IHHEZlZ I 

Time: iQ ' j S 

Samples Analyzed 

XRF Unit: /^3 7 Book: IZ-*) 

Date: ^-tZ-O ^ 

Time: 

Staff: 

r^ 

MA. 

 Front Right, Bl = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

!%..•: f F 'F--1./ A::d'^i 1 i'jii^y.ri.) 

• '•:••-yy^-CS^ . 

iM. 

] Z 37: ^^J^l^ O f 

V / Mkvf-////VTyy Rev 4' taiLei.. ir. 046U1,012.1 
\y, 

!\\> \ ii ill 29708 

Omah Exterior Paint North Arrow Owne a Lead Site r Name: MICHAEL E NIKOLAS 

Site • Good Sketch Address: 1612 CORBY ST • Poor Phone: H: 402-578-1151 W: 402-571-9726 

[~~| Not paint i

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Firm: _ 

Samples Collected 

n 

RYASCPXA-29708 Fl 2.3 7 ppm D Date: _ RYBSCPX.A-29708 F2 37 ^ ppm D Time: JQ i5 l 

RYCSCPXA-29708

RYDSCPXA-29708

 B1 

 B2 

6V ^

SH d

 ppm 

 ppm 

D 

D Samples Analyzed 

RDZOCrXA-207Q0 9 i ppm n n XRF Unit: 7^3 7 Book: IZ ^ 

RGZSCPXA 20708

RPZSCPXA 20708

 Gi-

 P^ —

ppm 

 ppm 

a 

D 

D 

D 

Date: _ 

Time: _ 

^-/Z-g>S~ 

r^ 

Numbe Staff: MA. r of Samples = 

Legend: F1 = Front Left, F2 = Front Right, Bl = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 
lilii 29708 

Exterior Paint Nortti AncTH Owner Name: MICHAEL E NIKOLAS Omaha Lead Site • Good Address: 1612 CORBY ST Site Sketch • Poor Phone: »- 402-578-1151 W: 402-571-9726 i • Not paint 

Sample Number Lead

Concentration

 Sample

 Collected 

 . . „ 

Firm: 

Samples Collected 

RYASCPXA-29708 F1 g? 7 ppm ef D Date: 9i-\^-< ' 

RYBSCPX.A-29708 F2 37 ^ ppm Q^ • Time: lo­ IS: 

RYCSCPXA-29708

RYDSCPXA-29708

 B1 

 B2 

^^ ^

SM -

 ppm

 ppm

 Q^

 (3^

 D 

D Samples Analyzed 

RDZOOP)(A"20700 9 * 

nc2GCPXJ^ D0700—es­ "

"

 ppm

 ppm

 n

 D

 n 

D 

XRF Unit:

Date:

 /^3 7 Book:

 ^-/Z-C ^ 

 IZ ^ 

RPZSCPXA. 20708 P2­ "• ppm D D Time: Fnn 

Numtter of Samples = . ^ : "" Staff: LA 

Legend: Fl = Front Left. F2 = Front Right, Bl = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

'"5;-T-1^ !!!?'• Tr'fiT •31-1. •I •f 

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^ 

MZ. U^ . ^r 

6.V.^ 

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237 

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UAUf-

Revi toii^i. ix_ 046141.0123 
COASTA l IHVItONHItcTA t 

c i o u r. -\ ti c 

Consent fof Access. To Pr-op^rtf 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner) consents to and authorizes the United States 

Environmental Protection Agency (EPA) or its authorized reprissentatives, collectively 

the Grantee, to enter and perform certain environmental response activities upon the 

following described priemises: "^J^^^floSy^ 

Owner's Name: Daytime Phone: V\vcWV )JlVx6W5 G'y^-ii^l 

Address of Property 

covered by this 

Agreement: l(o\^f^rl v$^ 

PURPOSE OF RESPONSE ACTIVrriES 

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 restoried to its original condition. This 

work is being performed under the Omaha Lead Superfund Site remediation program. 

A representative of Coastal Environmental Group, contracted by USEPA, will contact 

the Graritor 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 written 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, 

confractors and subcontractors the right to enter the property, at ali 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 
..*^*°"'v. w^ 

COASTA L 

•"< BflO^V'^ C ft O U r IM C 

e Remove obstaictions 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; 

« Water and maintain replacement vegetation, including fertilizer application, as 

necessary subsequent to an initial watering period by EPA; 

c 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. 

e Allow videotaping and/or photographing of the properly. 

AGREEf^ENT 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 

©ig I gran r t access to my properties D I do not grant access to my properties 

^ y ^ ^ ^ 

Signature Datl Signature Date 

n I would iike to be present during any sampling thst is required. 

Page 2 of 2 
COASTA L 

CROUP , IMC . 

Restoration Agreement 

The purpose of this agreement is to provide a mutual agreement as to conditions of the 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:^^^; ^ 

Property Address: /^/ ^ Cs>r^y 

O^vner: \\,^ K JJU^^ s 

Phone: 

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. Indicate 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 before Start of Remediation: 

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

Item: 

y y ^ 

Kem: 

Item: 

Item: 

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

Item: 

/L y i^t^tyy 

Item: 

Item: 

Item: 

Page 1 of. 
& . 

< ^ 

COASTA L • NVIMONMS M T A L 

GROUP . INC . 

Items to Be Removed By Contractor During Remediation and Replaced 

Item: 

yyc ^ 

Item: 

Item: 

Item: 

Landscape Inventory 

Item Quantity Unit Condition/Type/Species 

Pre-existing property area, Quadrants that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch b Each i 

trunk diameter 

Number of trees <= 2 inch Each -h-^ 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, Each Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Number of and size of 

each garden/ flower bed Each 

area. Square Feet 

Attach a sketch of relative 

sizes and locations. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

Note this vaiue will be 

used to issue a plant 

voucher to the property 

owner. 

Easement Area, to be Each 

excavated 

ud_^ani^_ 

Page 2 of. 
COASTA L ENVI RONMC NTAL CROUP , INC . 

Additional Comments / Instructions: 

The city of Omaha ordinances may prohibit 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 underlying 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 withstanding any removal 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 city of Omaha's Planning Department at (402) 444-5150. 

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

^ 

• 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 qf'house, including foundation cracks or fissures. 

n I do not agree 

fKX^^ [vh io £^C^€<M^^fOJl(/ f^\ 

Owner's Signature Date Contractor's Signature Date 

Page 3 of. 
BviD# m^ z 

XRF PROPERTY SAMPLE SHEET 


\lpl7_ Cof m sY 

am/pm 

30 sec 

Reading Sample area 

7.1^.Ky Z\1l R\ 

742.U-t 2\ ^ Depth 

^ a S^O.qi 21 2 

 9_-S-|.i ^ ^ 2.?..l^2 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Date 

Project 

XRF ID# 

Shot# 

1 ^ 

11 

- 1^ 

Average

Shot# 

lo?; 

\ . ^ 

-in 

Average

Shot# 

Average 

Shot# 

Average 

Signature. 

V//?/^^/ l 

Omaha Lead ARRA 

3ZoR^ / 

Reading Sample area 

n?.\s^ 1 A ,^-2 

m5.ctl\?>,L^2 Depth 

llnl^-^ . V^.Vol ^ ' ' 

 \Vr2.n ^ 1 H. I 

Reading 

7A{n.[n^ 23 U 

?SO,2. i ?0, 5 

'^i-Ao T 2^,- ^ 

 11 1 1..-^,

Reading 

Reading 

^-^^^

Sample area 

FTA 

Depth 

\'^ 

21. ^ 

Sample area 

Depth 

Address 

Sample time 

sample length 

Shot# 

1 2 

1 ^ 

1 4 

Average

Shot# 

Average 

Shot# 

Average 

RETEST AREAS 

Sample area Shot# 

y Depth 

x " y 

Average 

Prinnt^^f\f t ^ Mfq-^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 79 

Mode SOIL 

Time 2011-04-08 11:13 

Duration 109.38 

Sequence Final 

Flags 

AVERAGE Avg of 76-78 

ADDRESS 1612 CORBY §T 

QUADRANT B2 

DEPHT 4" 

XRF TECH C.PADILLA 

MISC CONFIRMATION 

NOTE CLEAR 

ppm Error 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

Supervised By; 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

w 

Cu 

Ni 

Co 

Fe 

Mn 

Supervised 

ppm 

< LOD 

469.155 

184.709 

< LOD 

64.942 

< LOD 

172.180 

< LOD 

< LOD 

< LOD 

190.199 

< LOD 

37.836 

< LOD 

< LOD 

18161.215 

748.694 

By: 

Certificate of Verification 

76 

SOIL 

2011-04-08 11:: 10 

30.51 

Final 

29708 

1612 CORBY ST 

B2 

4" 

C.PADILLA 

CONFIRMATION 

CLEAR 

Error 

i 8.509 

± 16.732 

± 9.733 

: 14.676 

± 6.661 

12.077 

± 19.076 

I 5.991 

25.844 

13.310 

± 24.576 

: 92.206 

± 23.483 

: 78.317 

190.595 

± 403.696 

± 124.460 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Mo < LOD 

Zr 493.825 

Sr 183.907 

U < LOD 

Rb 61.057 

Th < LOD 

Pb 145.980 

Se < LOD 

As 26.295 

Hg < LOD 

Zn 171.416 

w < LOD 

Cu < LOD 

Ni < LOD 

Co < LOD 

Fe 16515.523 

Mn 592.896 

Supervised By: 

Certificate of Verification 

77 

SOIL 

2011-04-08 11:: 11 

48.35 

Final 

29708 

1612 CORBY ST 

B2 

4" 

C.PADILLA 

CONFIRMATION 

CLEAR 

Error 

1 6.463 

± 13.073 

± 7.425 

11.685 

± 5.025 

\ 8.922 

± 13.621 

4.806 

± 12.426 

: 10.219 

± 17.973 

1 71.401 

24.915 

61.366 

140.388 

± 294.332 

± 86.522 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Mo < LOD 

Zr 487.150 

Sr 192.453 

U < LOD 

Rb 61.528 

Th 15.226 

Pb 167.989 

Se < LOD 

As < LOD 

Hg < LOD 

Zn 157.771 

w < LOD 

Cu < LOD 

Ni < LOD 

Co < LOD 

Fe 15705.023 

Mn 768.725 

Supervised By: 

Certificate of Verification 

78 

SOIL 

2011-04-08 11:13 

30.52 

Final 

29708 

1612 CORBY ST 

B2 

4" 

C.PADILLA 

CONFIRMATION 

CLEAR 

Error 

8.270 

± 16.756 

± 9.756 

14.899 

± 6.469 

± 8.682 

± 18.620 

5.923 

24.514 

12.246 

± 22.116 

83.131 

33.292 

74.211 

171.151 

± 369.332 

± 122.479 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

w 

Cu 

Ni 

Co 

Fe 

Mn 

Superv 

sed By: \ y 

Certificate of Verification 

75 

SOIL 

2011-04-08 11:08 

91.55 

Final 

«Avg of 72-74 

1612 CORBY ST 

Bl 

4" 

C.PADILLA 

CONFIRMATION 

CLEAR 

ppm 

< LOD 

503.696 ± 

179.639 

± 

< LOD 

65.688 ± 

15.526 ± 

287.669 ± 

< LOD 

< LOD 

< LOD 

155.389 

± 

< LOD 

< LOD • ^ < LOD / : < LOD y : 

17046.881/ ±

y ^ 

Error 

8.376 

17.109 

9.520 

15.293 

6.726 

9.775 

23.620 

6.152 

30.927 

12.317 

22.248 

^,--88:263-^ 

33.492^ 

79r^ 3 

/^5.10 9 

/-"^ 387.409 

^ 110.022 

^ ^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Mo < LOD 

Zr 485.021 

Sr 180.344 

U < LOD 

Rb 67.079 

Th 23.560 

Pb 229.655 

Se < LOD 

As < LOD 

Hg < LOD 

Zn 167.272 

W < LOD 

Cu < LOD 

Ni < LOD 

Co < LOD 

Fe 17868.938 

Mn 506.250 

Supervised By: 


Certificate of Verification 

72 

SOIL 

2011-04-08 11:06 

30.51 

Final 

29708 

1612 CORBY ST 

Bl 

4" 

C.PADILLA 

CONFIRMATION 

CLEAR 

Error 

8.522 

± 17.010 

± 9.627 

15.514 

± 6.846 

± 10.056 

21.712 

6.005 

29.096 

13.067 

23.247 

93.086 

33.135 

83.200 

189.971 

± 400.227 

± 107.347 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Mo < LOD 

Zr 521.318 

Sr 185.958 

U < LOD 

Rb 62.207 

Th < LOD 

Pb 242.397 

Se < LOD 

As < LOD 

Hg < LOD 

Zn 140.515 

w < LOD 

Cu 42.594 

Ni < LOD 

Co < LOD 

Fe 16140.316 

Mn 647.799 

Supervised By: 

Certificate of Verification 

73 

SOIL 

2011-04-08 11:07 

30.52 

Final 

29708 

1612 CORBY ST 

Bl 

4" 

C.PADILLA 

CONFIRMATION 

CLEAR 

Error 

8.373 

± 17.245 

± 9.613 

: 15.082 

± 6.528 

13.019 

± 21.850 

: 6.397 

: 28.030 

: 13.034 

± 21.359 

91.307 

± 23.231 

77.090 

: 179.393 

± 374.686 

± 115.596 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Mo < LOD 

Zr 504.750 

Sr 172.615 

U < LOD 

Rb 67.777 

Th < LOD 

Pb 390.954 

Se < LOD 

As < LOD 

Hg < LOD 

Zn 158.380 

w < LOD 

Cu < LOD 

Ni < LOD 

Co < LOD 

Fe 17131.385 

Mn 507.486 

Supervised By: 

Certificate of Verification 

74 

SOIL 

2011-04-08 11:08 

30.52 

Final 

29708 

1612 CORBY ST 

Bl 

4" 

C.PADILLA 

CONFIRMATION 

CLEAR 

Error 

8.234 

db 17.072 

d 9.321 

15.282 

± 6.804 

15.883 

± 27.298 

6.054 

35.654 

10.850 

± 22.140 

80.396 

32.223 

78.398 

185.964 

± 387.313 

± 107.124 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 71 

Mode SOIL 

Time 2011-04-08 11:05 

Duration 91.57 

Sequence Final 

Flags 

AVERAGE Avg of 68-70 

ADDRESS 1612 CORBY ST 

QUADRANT EA 

DEPHT 1" 

XRF TECH C.PADILU\ 

MISC CONFIRMATION 

NOTE CLEAR 

ppm Error 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

68 

SOIL 

2011-04-08 11:03 

30.53 

Final 

29708 

1612 CORBY ST 

EA 

1" 

C.PADILLA 

CONFIRMATION 

CLEAR 

Error 

8.014 

± 15.195 

± 9.118 

: 14.632 

± 6.682 

± 9.641 

± 23.667 

5.950 

31.118 

12.047 

± 30.014 

* 92.639 

± 23.797 

* 74.319 

194.287 

± 403.912 

± 100.296 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hq 

Zn 

w 

Cu 

Ni 

Co 

Fe 

Mn 

ppm 

< LOD 

398.125 

170.354 

< LOD 

68.540 

14.714 

296.615 

< LOD 

< LOD 

< LOD 

317.026 

< LOD 

55.917 

< LOD 

< LOD 

19209.143 

426.778 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Mo < LOD 

Zr 376.597 

Sr 198.316 

U < LOD 

Rb 64.209 

Th < LOD 

Pb 230.205 

Se < LOD 

As < LOD 

Hg < LOD 

Zn 250.021 

w < LOD 

Cu 33.237 

Ni < LOD 

Co < LOD 

Fe 18307.354 

Mn 399.034 

Supervised By: 

Certificate of Verification 

69 

SOIL 

2011-04-08 11:04 

30.53 

Final 

29708 

1612 CORBY ST 

EA 

1" 

C.PADILLA 

CONFIRMATION 

CLEAR 

Error 

7.578 

± 14.548 

± 9.561 

14.523 

± 6.366 

12.850 

± 20.574 

5.529 

; 26.648 

12.304 

± 26.198 

* 85.407 

± 21.245 

73.763 

J 182.625 

± 384.545 

± 94.845 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 70 

Mode SOIL 

Time 2011-04-08 11:05 

Duration 30.51 

Sequence Final 

Flags 

BVID 29708 

ADDRESS 1612 CORBY ST 

QUADRANT EA 

DEPHT 1" 

XRF TECH C.PADILLA 

MISC CONFIRMATION 

NOTE CLEAR 

ppm Error 

Mo < LOD l 8.044 

Zr 376.781 ± 15.076 

Sr 180.596 ± 9.503 

U < LOD : 15.834 

Rb 63.328 ± 6.678 

Th < LOD \ 14.394 

Pb 306.002 ± 24.329 

Se < LOD 6.362 

As < LOD ; 32.542 

Hg < LOD : 13.355 

Zn 336.798 ± 31.306 

w < LOD 96.057 

Cu 41.061 ± 23.171 

Ni < LOD 77.262 

Co 245.641 ± 145.115 

Fe 23347.225 ± 450.844 

Mn 479.112 ± 107.065 

Supervised By: 
X 

f^QL'\ Omaha Lead Site—Fixed Price EP-R7-07-05 , J^^^ ' I Coastal Environmental Group Inc. 

^^^^p * www.coastalhazmat.com 

"^"iPHOi*^ COASTA L ENVIlONnENTAL 

C R 0 U f . IM C 

EXECUTIVE SUMMARY: 

BVID #29708-(1612 CORBY ST) 

No Issues or Concerns [^ Issues/Concerns 

Detail Explanation: 

-DAN GARVEY WALKED THE PROPERTY ON 04-21-11 
Property Completion Agreement 

This agreemenl documenis lhe complclion of remedial acliviiies peribiinedon my properly. My signaiure 

will designale ihai I am satisfied wilh the re.'itoralion of my properly, and thai no ilems are in questions, 

now. or 31 any lime in the future, excepi ihose items listed below, ifany 

Property ID: f^<^^ P 

Propcrfy Address: \ (o \ y 

Owner: ^C^^QjJ j |/^ 

Phone: ^^-IIS~ \ 

Restoration Items in Question: 

Item: 

Ilem: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

rn-l xfircc ic.^foralion i.s completed, except as noted 

[ I I tio not ai;rec restoration i> complcied 

Owner's Signatiirf- Dati^ ^^ itrarlor's Signature 
^ 1 

EPA Property Close Out Form 

Property #: d^9^S^

 Propert Property Address: Addrt^:-^;^ ' • ^ 

Datc/Tlne: Owner's Name:, / ^ '/, ^^-2y -

Quails Excavated: Contractor Group (". 

Excavation General 

Yes No 

1. If neccssBiy, were thc correci quadrant{s) excavated and restored? / 

2. If necessary, were the correct areas ofdrip zone excavated and restored? y 

1 

GradloK Sod and Vcgetalion Yes No 

1 Does the grading around the perimeter ofthe house in excavated areas generally slope away 

y from the house? 

2. Has sod been laid in all areas that were excavated? y_ 

3. Does lhe sod appear lo be generally healthy and growing? (Only evaluate if inspected al a 30 ~y day time period) 

4. Are sodded areas genetally firm and evenly graded? 'Z 

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

time period) y 

6. Was the property graded such that water will not pool on the properry? y 

7. Was damage to landscaping or plant materials avoided? y 

Gates. Fepces and Retaining Walb Ves .Nu 

I 1. Do gates open and close freely? (If applicable) / 

2. Were ali gates or fences taken down during restoration activilies reinsialled? (If applicable) / 

3. Was damage to gates or fences avoided? (Ifapplicable) / 

1. Was damage to retaining walls avoided? (Ifapplicable) y 

Foundation, SidiiiK and Gutters 

Yes No 

1. Was damage to the siding or trim avoided? / 

2. Was damage to the foundation avoided? / 

5. Was damage to windows avoided? / 

4 Was damage to windows or door screens avoided? 

/ 

5. Was damage to downspouts or downspout extensions avoided? / 

Sidewalks and Driveways (Concrete) 

Y c t W / No 

1. Was damage to driveway surfaces avoided? 

2. Was damage lo walkway surfaces avoided? ~f 
Ort'tiers comments: 

I ^ ^ 

j Jn.spection no<es: 

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

EPA Represenlalive Qo^^^ Date: I'^iL'L