TRANSMITTAL of OMAH A LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: 3(P H Date: Xll'gjo ^ 

Address: 1^) ^ (V\iarril' SJ " 

Remediation Contractor: _Coastal Environmental Group_ Year: _2008_ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

\ y Video of property (DVD) 

[[K Executive Summary 

ly EPA-provided property slcetch 

s y Signed Access Agreement for subject property 

/Sjir Signed Access Agreement(s) for adjacent property 

H^ Restoration Agreement 

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

y Confirmation data 

y Photographs ^ce.-ncrfi^)/iinr^ ^ oyr£j)djhoA^ ft rue/ sod 

M As-built sketch 

&^ Satisfactory restoration signed by Property Owner 

y Property close-out check list signed by EPA 

1 ^ Description of areas not meeting ROD cleanup criteria 

y Utility clearances 

Cr Property information from Douglas County Assessor's Office 

^ nh'^y^ . (Lc^.f>ss. Ci^fj-TfjiAD 

Signature Date 
% 

y:0fC^ 

Property Access Checklist 

Propert? lD:fe(^i 4 D N\ORK STARTED ON: / /_ 

n WORKCOMPELTED ON: / / 

Renter: \^--^^y7cy^^ ^?Smw 

: Address: ' 

Phone: 

Fav: 

Ccll/Pa<'cr: 

Phone: .'\dditional information: 

5W^. F:i\: 

Ccll/Paucr: 

I ~1 Notification Letter Sent: 

\ y .\ccess .Agreement 

Si.^ned:H_/2j'QiS! 

0 ' Resloralion Ayreeiiicnl 

Signed: H_/23' ^ AiiCVlOldS. 

I [ Topsoil Siiinplinii (if applicahlei 

1 

"1 ! ! Disposal Samplini; (if ap|)licahle1 ' B 

I i Garden Saniplin*: (if ap|)lical)lc) 

iZl I tilit> Clearance Called: ^ 2 ^ Ol L 1 B 

J5^ I0///o^ 

0 \ ideo'Phdios (Before) P.^yyf/i^eyiy 

I I \idc0'Photos (During On: ,' 

n > ideo/Photos (.After) On: 

1 

LJ V ideo, Phol(»s (3(t-Da.\ i On: 

\ n Proper!} Completion .Agieemeni j Signed: B 

i I Final Report Issued: 

.\ir •Monitorin<; (as applicable) 

* CD Community [Z! Crew On; 

B M 

i Results: 

I I Communit) Q Crc« On: / 

B\: 

i; Results: 

Communit) M Cre« On: Bv: 

Results: 

Omaha Lead Site 
Property 1D# 

Property 

Address: 

Initial Contact: 

Second Contact: 

Final Contact: 

Final Action: 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Coinment (s): 

5 U H 

l^iM 

Date: 

Date: 

Dale: 

% 

CONTACT FORM 

MlCir n I 

Time; Action: 

Time: Action: 

Time: Aclion: 

Transmit lo EPA D Other Action: D 
Douglas Coimty Account Information Page 1 of2 

% 

' Dougla s County , Nebrask a Propert y Recor d - R254482000 0 

Print Report 

NEW Feature - Parcel Dimenstons available @ scale 0-50 ft west of 90th St - Vie w O n Ma p Information is valid as of 2008-9-4 Treasurer's Tax Report 

New Feature -•-•- • Auto Sales Search 

Owne r 

BAILEY PAULETT 

1814 MIAMI ST 

OMAHA NE 68110-0000 

Propert y Informatio n 

Key Number: 4482 0000 25 

Account Type: Residential 

Parcel Number: 2544820000 


Parcel Address: 1814 MIAMI ST 

OMAHA NE 68110-0000 

Legal Description: WRIGHT PLACE LOT 7 BLOCK 0 E 6 FT LT 8 & ALL 36 X 68 5/8 

Valu e Informatio n 

Land Improvement Total 

2008 $3,100.00 $15,500.00 $18,600.00 

2007 $3,100.00 $15,700.00 $18,800.00 

2006 $3,100.00 $15,700.00 $18,800.00 

2005 $3,100.00 $15,700.00 $18,800.00 

2004 $3,100.00 $6,400.00 $9,500.00 

2003 $3,100.00 $6,400.00 $9,500.00 

Lan d Informatio n 

Acres SF Units Depth Width Vacant 

0.05 2484.0 1.0 69.0 36.0 No 

Improvemen t Informatio n 

Building 1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R25... 9/27/2008 
Douglas County Account Information Page 2 of2 

% 

1814 Miami 

F©J O 

&•« F r x Floor 

mosq^ t 

MP 1 1/2 Stofy Unfin 

ii v 

.« •* »r 

CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 738.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Fair 

Unit Type: Condition: Good 

Built As: 1 1/2 Story Unfin Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 6.0 

Exterior: Frame Aluminum Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 2.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1903 0% 1903 105 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 672.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Porch End Solid Wall 72.0 

Porch Slab Roof Ceil 16.0 

User Est - Dog 1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R25... 9/27/2008 
Page 1 of2 

% 

"> 

Create Another Ticket Back to irth Internet Send Email 

• YOUR TICKET NUMBER IS 2142607. 

Original Call Date: 9/29/08 Time: 10:28 am Op: ELIZABETH18790 

Work to Begin Date: 10/01/08 Time: 11:00 am 

State: NE County: DOUGLAS Place: OMAHA 

Address: 1814 Street: MIAMI ST 

Twp: 15N Rng: 13E Sect-Qtr: 10-SW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: lead, remidiation 


Location of Work: LOCATE ENTIRE PROPERTY STARTING AT THE HOUSE ALL THE WAY 


: TO THE STREET. 


Remarks: FAX ALL CLEARS TO: (877)662-4211 


: UNSURE OF CORNER LOT 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name: ELIZABETH Phone: (877)662-4210 


Work Being Done For: coastal 


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


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MAGELLAN MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI

Day: 4029340469 

 Alt: 4029340469 

Emerg: 4029329757 

MAGELLAN MAGELLAN MIDSTREAM PARTNERS LP TONYA

Day: 9185747098 

 Alt: 

Emerg: 9185747098 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY

Day: 4025047823 

 Alt: 

Emerg: 4025047946 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RON

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/29/2008 
Page 2 of2 

Day: 4067289343 


OPPDGPR5 OMAHA PUBLIC POWER DISTRICT NA Alt: 8887289343 


Emerg: 4067289343 


Day: 4067289343 


QLNNE 1C QWEST LOCAL NETWORK NA Alt: 


Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoficeCreation/MessageText.asp?ret=<RESULTS... 9/29/2008 
< ^ V As-Built Drawing 

COASTA L Omaha Lead Superfund Site 

Name: Omaha Lead Site - . J ) ) I'-I n^^^ ^ 

Address: {'><H M iCl\AA I Site Sketch y - 11 n-OU£ ) 

Ptione: 

Omaha Lead Site 46904.783-01 

Legend 


Concrete Drip Zone Excavated ^ 
 Quadrants Excavated 

Area replaced with n Area replaced with 

Sod Area left bare Rock/Mulch 

Contrac t #: EP-R7-07-05 Coastal Environmental Group Inc . 
% # scjy 

Name: . , . . . Omaha Lead Site ^^ A\ ^ t--, r^yj J 

Address Site Sketch O - / / n-OU D : /^ W M iQU/ , 

Phone 

Omaha Lead Site 46904.783-01 
% 

Name: 

Omaha Lead Site - , ,} i ^ , ^ r~/^/^ 

Address: l^>H / M .QU A 1 Site Sketch O-^/ / n-O^-i D 

Phone: tDate XRF Code x^,? j A )q^i7/^'\ ^-^{uvvyyi^n^/r* ,-a77 

Sample Number Lead Concentration Confirmation Sample 

1 i?v7/<i^PK^-S7.f^/:y/ b 

»^^^-^^pp m Yes • No ZS­ ^^^ - 3«^ppm Yes • No ^ 

3 /gV^ ^ ^ ^^ ^ • ^ ^ ^»^ CS Q ^^/ ^ ^ ^ ppm Yes • No G3 

4 j^yip^^^^'^ ' f-<^''9 7j^ ^ ^^4 ^ t ? ^ ppm Yes • No cp 

'7^t>' t '/•y ppm Yes • No ca 

RYCSCPLA-5614 J ! K ! / : Xl , 

'-^'^ 551 ppm 

Omaha Lead Site 46904.783-01 
^ 

Name: Omaha Lead Site 

Address: j^'y / M .aU A I Site Sketch 

Phone ! • : 

Date XRFCode^^^ ^ ^^n/^ ^ ^-^..vw^^Pl ?y\^neQe w -

^'° ' yh\i r 

Sample Number Lead Concentration Confirmation Sample 

1 f^V^'i ^ /=='K/?' :f<^ / V <?^^> Jfil^^Z^ppm Yes • No 13: 

2 ff//JS^^yy7y - ^<f/*rzys ^ Yes n No ^ 

3 /gy^^ / '^ ^A' ^ • s^^y ^ CSO -^^/ ^ ^- ^ ppm Yes • No 10 

^^^_L2£'ppm Yes • No Cp 

5 ;rie7^:rc:>^»'^- .^^/T - 7z^'7o -;?-3..ot ^ 7 ppm Yes • No m /^pz ^cpx'^' ^^^Y o=>y) I S 

RYCSCPLA-5614 K- ^^-7- ^ • ^ -ie- - ^ 

7- — ) \ Lab 551 ppm ifzf± ^ y\csi

l xl 

x f 4^ 2^^ ^ 

'/- OojdC^ ljlj^ii:xai^ ; ^ 

4^^ ) ;:^I^ yy^y. ^36 'Ci rffi lySfM­ >: ) • 

3<4? ; ^ 

y< y y 

gy­ x v^ 7 

X7^ y^P'^YX 

) ( 

-Id 

yy\ c 

t/^7,y'^5'\ '^£^\±- 3 

\ 

y- - ^ •¥- ^H-^ y 

Cf^iAikM: ^ 

Omaha Lead Site 46904.783-01 
I M ^l# 

COASTA L ENVIKONHENTA l ^ . l^oTt^ C R O U r . IN C 

Consent For Access To Property 

RIGHT OF ENTRY TO PREMISES 

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

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

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

following described premises: 

y7- fJ2-,!r/^y Owner's Name: Daytime Phone:

[yy/y^T/ y/Jy / yy-'9'>/rC ^(0 7 

Address of Property 

covered by this / /yy2yyi7 y -

Agreement: 

y/yyb^yiy. .. n.7'" T^SltO 

PURPOSE OF RESPONSE ACTIVITIES 

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) will be 

excavated to remove contaminated soil. The removed contaminated soil will be 

replaced with clean materials and the area will be restored 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 Grantor 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, 

contractors and subcontractors the right to enter the property, at all 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 
y^i:^>. M COASTA L *^ , . ^ ENVIRONMENTftl 

^ l PROt* C • O U r INC . 

Remove obstructions including boats, trailers, vehicles, playscape items, wood • 

piles, dog houses, etc; 

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; 

• 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. 

• Allow videotaping and/or photographing of the property. 

AGREEMENT 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 (712) 352-0188 

Q^grant access to my properties D I do not grant access to my properties 

yy^-,y^.jy/ ^0/y 

Signature yOate Signature Date 

O i would like to be present during any sampling that is required. 
COASTA L • :' tNOMMSMTAi a « o w p tM C 

Restoration Agreement 

The purpose ofthis agreement is to provide a mutual agreement as to conditions ofthe property prior to 

remediation activities. This will also serve as documentation for the purpose of assuring that restoration 

activities are completed to the satisfaction ofthe property owner and the United States Environmental 

Protection Agency (EPA). 

Property ID: f^l^ l 

Property Address: /// / Mlc^.y^ l Sr 

Owner 

Phone: Q'^y^\ ^ 

On the attached diagram(s) indicate area(s) to excavated and depth of excavation, location of all known 

utilities, subsurface features, surface structures and landscaping features, access location(s) to be used by 

contractor, and the direction of North. Indicate distances, depths, material types, etc. Indicate digital photos 

by referencing the photo-log number with an arrow indicating direction of view. 

Items To Be Removed By Owner Before Start Of Remediation: 

(Use additional sheets as necessary) 

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

Item: 

Item: t' ^ 

r-rrfll 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 1 of 
< ^ ^ 

COASTA L 

a n o V r . IN C 

Items To Be Removed By Contractor Durinq Remediation And Not Replaced 

(Use additional sheets as necessary) 

Item: 

3 V^\( y 0 \ cc/TT 5 ^ ^4 - kcV'^wA ^lAol 

Item: 

W'l y> J/ J<rc^^ d i^fy^^ 7 

Item: 

/

ny ui \/^'ui /*€ cj/i co^r d CKS Ku^ \ 7 

Item: / 

Item: / 

Item: / 

Item:

Item:

/ 

/ 

/ 

Item: / 

Item: / 

Item: / 

Item: 

Item:

/ 

/ 

/ 

Item: / 

Item: 

/ 

Page 2 of /_ 7 
• ^ 

C O A S T A L 

c « o u r IM C 

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Hem: 

Item: 

Item: 

Item: 

Item: 

> ^ M -V y J F ; -6 I - DZ^- ? 

7 

Page 3 of ( ^ 
COASTA L • ••'vinONnt M TAL 

C M O U P t N C 

Item 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

trunl< diameter 

Number of trees <= 2 inch 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Number of and size of 

each garden/ flower bed 

area. 

Attach a sketch of relative 

sizes and locations. 

Landscape Inventory 

(Use additional sheets as necessary) 

Quantity Unit Condition/Type/Species 

Qt-y Square feet 

y Each 

•­

r\ ^ Each 

Each y 

y 

/y Each 

Square Feet 

Page 4of ..^ 
COASTA L 

Item Quantity Uriit Condition/Type/Species 

Agreed upon value of 

Diant materials not to be 

renlaced bv contractor. 

Note this value will be 

used to issue a plant 

voucher to the property 

owner. 

y $ 

\ 

Agreed upon list of plant 

materials that will be 

replaced by contractor. Be 

very specific and detailed. 

Include a sketch of were 

each plant will be placed 

by the contractor. 

y Each 

Agreed upon area of 

property to be replaced 

with grass sod. 

Include a sketch of the 

area(s) to be replaced with 

grass sod. 

f)xy SF 1 

1 

Area ofCity or County 

property to be landscaped 

per their requirements. 

Include a sketch of the 

ai^ea (s) y 

y 

SF 

Easement Area, to be 

excavated 

t 

/ 

SF 

/ 

Page 5 of / 
C O A S T A I. « <* e w r . INC . 

Additional Comment lemss // Instruction instrucaonss: f. . • 

Zl0-0 ^. o 

4;,v^ lUr- yc ^ ^y-'^ ^^c^^yc 

cn Check the box if Owner does rrat want CEG to document interior foundation wails and possible 

pre-existing damage. By checking this box CEG is not responsible for any damage done to the 

interior of house, induding foundation cracks or fissures. 

y Q I do not agree agree 

yrag i 

Owoer's Signatur ignaturee t>atc Contractor's Sffinatore Date 

Page 6 of. 
Date 

Project 

XRFID# 

Shot# 

KlU 

K K 

KIU 

K H 

Average 

Shot# 

H^ ^ 

K i ^ 

Kic 

K2-1 

Average 

Shot# 

Average 

Shot# 

Average 

lab sample # 

^C.(4 BVID# 

XRF PROPERTY SAMPLE SHEET 

\? (1 ^ I (^'(' 

Omaha lead FP 2ncl year option 

YLcpM 

Reading Sample area 

-^Mi.mt u.ii<i 

^'Xi.-Mit it-^\ u 

'yvi"^'i+ 'z^.'z.i Depth 

-i'i<<;U 1". ^ ^ ' 

1M. Q.I %o.^^ 

Reading Sample area 

K^.OZt K-lv 

'Z^<-.1^t \\.0\. P^ 

n^.'^'^ r [Cj.ci^ Depth 

^^C.'l-.t lit' i \v. 

Uo-lL^r \^.8L 

Reading Sample area 

Depth 

RETEST AREAS 

Reading Sample area 

Depth 

Shot# 

Jli3_ 

\ ^ 1 

Average 

Shot# 

l^-^-) 

\^^^ 

\^yi 

\<,^^ 

Average 

Shot# 

Average 

Shot# 

Average 

Lab result Sample area XRF Avg. 

Signature 

Print 

Address \l\\ ^ P\\fi^\ y 

Sample time 11-. H L anfpf^ 

sample length 30 sec 

Reading 

^o.'Wt nur^ 

VW^'^ \\-\\ 2-31. ^1 \ I'l.'tS 

^C1- l^t -zJ^i 

Sample area 

^ 

Depth 

y.x\x v\.^\ 

Reading Sample area 

J\.~[^Z W.l l 

lAi,.<i^ t li?.(A fe 

-V'%.<\0 t ^f-if<- Depth 

nuSn + n.i^ bl­

^^sigj^ n-1 -z. 

Reading Sample area 

Depth 

Reading Sample area 

Depth ^^.-^ 

y y 

^Af-07 M>n ^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 1518 

Mode SOIL 

Time 2008-10-16 12:48 

Duration 120.85 

Sequence Final 

Flags 

AVERAGE jAvg of 1514-JLS12. 

ADDRESS 1814 miami 

QUAD/ZONE 

INSPECTOR Ventry 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 242.411 

Supervised By: 

Certificate of Verification 

1514 

SOIL 

2008-10-16 12:46 

30.27 

Final 

5614 

1814 miami 

Fl 

Ventry 

6 

CLEARANCE 

± Error 

± 18.894 
Tliermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 1515 

Mode SOIL 

Time 2008-10-16 12:47 

Duration 30.27 

Sequence Final 

Flags 

BVID # 5614 

ADDRESS 1814 miami 

QUAD/ZONE Fl 

INSPECTOR Ventry 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 236.418 ± 18.515 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 339.848 

Supervised By: 

Certificate of Verification 

1516 

SOIL 

2008-10-16 12:47 

30.03 

Final 

5614 

1814 miami 

Fl 

Ventry 

6 

CLEARANCE 

± Error 

± 22.273 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 295.589 

Supervised By: 

Certificate of Verification 

1517 

SOIL 

2008-10-16 12:48 

30.28 

Final 

5614 

1814 miami 

Fl 

Ventry 

6 

CLEARANCE 

± Error 

± 20.502 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

Supervised By: 

Certificate of Verification 

1523 

SOIL 

2008-10-16 12:54 

121.15 

Final 

Avg of 1519-1522 

1814 miami 

Bl 

Ventry 

6 

CLEARANCE 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 490.447 

Supervised By: 

Certificate of Verification 

1519 

SOIL 

2008-10-16 12:50 

30.39 

Final 

5614 

1814 miami 

Bl 

Ventry 

6 

CLEARANCE 

± Error 

± 26.740 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 237.460 

Supervised By: 

Certificate of Verification 

1520 

SOIL 

2008-10-16 12:53 

30.26 

Final 

5614 

1814 miami 

Bl 

Ventry 

6 

CLEARANCE 

± Error 

± 18.817 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 239.672 

Supervised By: 

Certificate of Verification 

1521 

SOIL 

2008-10-16 12:53 

30.23 

Final 

5614 

1814 miami 

Bl 

Ventry 

6 

CLEARANCE 

± Error 

± 19.290 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 257.107 

Supervised By: 

Certificate of Verification 

1522 

SOIL 

2008-10-16 12:54 

30.27 

Final 

5614 

1814 miami 

Bl 

Ventry 

6 

CLEARANCE 

± Error 

± 20.402 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

Supervised By: 

Certificate of Verification 

1528 

SOIL 

2008-10-16 12:58 

121.15 

Final 

4Avg of 1524-1527 

1814 miami 

.(fez • 

Ventry 

.13 

iCLEARANCE 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 155.027 

Supervised By: 

Certificate of Verification 

1524 

SOIL 

2008-10-16 12:55 

30.27 

Final 

5614 

1814 miami 

DZ 

Ventry 

13 

CLEARANCE 

± Error 

± 15.164 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 226.768 

Supervised By: 

Certificate of Verification 

1525 

SOIL 

2008-10-16 12:56 

30.30 

Final 

5614 

1814 miami 

DZ 

Ventry 

13 

CLEARANCE 

± Error 

± 18.069 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 274.342 

Supervised By: 

Certificate of Verification 

1526 

SOIL 

2008-10-16 12:57 

30.30 

Final 

5614 

1814 miami 

DZ 

Ventry 

13 

CLEARANCE 

± Error 

± 19.922 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 226.938 

Supervised By: 

Certificate of Verification 

1527 

SOIL 

2008-10-16 12:58 

30.28 

Final 

5614 

1814 miami 

DZ 

Ventry 

13 

CLEARANCE 

± Error 

± 18.292 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

Supervised By 

Certificate of Verification 

1537 

SOIL 

2008-10-16 13:10 

121.08 

Final 

l^v g of 1533-153^ 

1814 miami 

WZ 

Ventry 

"^6 

CLEARANCE * 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 74.767 

Supervised By: 

Certificate of Verification 

1533 

SOIL 

2008-10-16 13:07 

30.19 

Final 

5614 

1814 miami 

PZ 

Ventry 

6 

CLEARANCE 

± Error 

± 11.228 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 294.874 

Supervised By: 

Certificate of Verification 

1534 

SOIL 

2008-10-16 13:09 

30.29 

Final 

5614 

1814 miami 

PZ 

Ventry 

6 

CLEARANCE 

± Error 

± 20.694 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 328.906 

Supervised By: 

Certificate of Verification 

1535 

SOIL 

2008-10-16 13:10 

30.28 

Final 

5614 

1814 miami 

PZ 

Ventry 

6 

CLEARANCE 

± Error 

± 21.852 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 196.572 

Supervised By: 

Certificate of Verification 

1536 

SOIL 

2008-10-16 13:10 

30.32 

Final 

5614 

1814 miami 

PZ 

Ventry 

6 

CLEARANCE 

± Error 

± 17.125 
^*-^*% 

ir>A^\ Omaha Lead Site—Fixed Price EP-R7-07-05 (fiflQ« 

% ^^^ 7 S Coastal Environmental Group Inc. ' V^^ ^ 

V^^^T ^ www.coastalhazmat.com 

^^ip^y COASTA L ENVIRONMENTAL 

CROUP . INC . 

EXECUTIVE SUMMARY: 

BVID # 5614 - (1814 MIAMI ST) 

'xl No Issues or Concerns | ^ Issues/Concerns 

Detail Explanation: 
Property Completion Agreement 

Tliis agreemeni docuinenls the completion oi" remedial activities perlbrmecl on my property. My .signature 

will designale Ihal 1 am satisfied wilh the restoralion of my properly, and that no items are in qucstion.s, 

now. or al any time in the fiiUire, except those ilems listed below, ilany. 

Properly ID: ^^/ / 

Property Addre.ss: 'i4^r)i <-J/ 

Owner: P^J- e ^S^'7 ^ ' 

Phone: vz)z^- f 3 ^ yyy ^ .. Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

X I I aj;rc4' restoration i.\ coni|tlr(c(l, cxccpl as noted 

I I <lo not Wttee rcslorHtiun i.v completed 

yuyyyy^ l^'Zi'or \A'^'^ (py\y\ Y 

Owner's Si]>na(iirc Dale riinlractor's Signature Date 

I
7

4

f*!L EPA 

EPA Property Close Out Form 

Property #: ^M l Property Addr». - llj'^j^l' ^ ^^ -

Datcrrtinc: ' ' [ OwVer's Name;.fe.. t^'^grT. . . (^^ ^ 

Quads Excavated: '(^l -<' f 3^ ^ Vk \- ^ I Contractor Croup ^ft^TVyV 

Excavation Yes No General 

1. If necessary, were the correct quadrant(s) excavated and restored? 

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

Grading Sod and Vegetation 

Yes No 

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

from the house? 

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

3. Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 

y day time period)

 __ ^ 

4. Are sodded areas generally firm and evenly graded? y 

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

time period) 

6. Was the property graded such that water will nol pool on the property? y^ 

 Was damage to landscaping or plant materials avoided? t y 

Gates, Fences and RcUining Walls 

Ves No 

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

2. Were all gates or fences laken down during restoration acliviiies reinstalled? (Ifapplicable) .^ 

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

4. Was damage to retaining walls avoided? (Ifapplicable) A , ^ 

Foundation, SidioK and Gutters Yes No 

I. Was damage lo the sidmg or trim avoided? y 

2. Was damage to the foundation avoided? y 

3. Was damage to windows avoided? y 

 Was damage to windows or door screens avoided? -^ 

5. Was damage to downspouts or downspoul extensions avoided? y 

Sidewalks and Driveways (Concrete) Yes No 

1. Was damage to driveway surfaces avoided? 

y 

2. Was damage to walkway surfaces avoided? 

y 
0>*'Dcrs comments: 

Inspection notes: 

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

EPA Represenlaii'^t-yycy77i7^^ y^/icyy r Date: 7^ / y /)//) ^