TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

l^f) (ia , 'ZS^^K SAID#: '^^ [ f^ Date: 

Address: ^^g^K 0H \ 0 ^ f 

Remediation Contractor: Coastal Environmental Group_ Year: _2010ARRA_ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

7 ^ Video ofproperty (DVD) fc\^ff| \^ f 

0 , Executive Summary 

Q EPA-provided property sketch 

H Signed Access Agreement for subject property 

Signed Access Agreement(s) for adjacent property 

/ Restoration Agreement 

J3 - Settlement documents (i.e., for damage or to replace plants, etc.) 

—B- Confirmation data 

Photographs 

As-built sketch 

7 

/ Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

Utility clearances 

5 / Property information from Douglas Coimty Assessor's Office 

Signature ' Date 

30217652 

Superfund 
Property Access Checklist 

Property ID: ^jl^l^ ^ D WORK STARTED 

n WORKCOMPELTED I Property Address: ^X(^ftou\ n TNT 

Renter: '>^-''- g^tll IIA^QSU - ^'^V^^ ^ ILJ I I I '-'-'V vytvi.Ljyx 

Address: ^/^.,Py^^^^ ^ ^^^ ^ 

Phone: 

Fax: 

Cell/Pager: 

i PhnviA * llJiJ i ii.>i/..j k Phone: l^(^Lj - HZH8> Additional Information: 

Fax: 

Cell/Pager: 

D Notification Letter Sent: / / By: 

^ Access Agreement Signed: H 1 Zl l 10 By: 

^ Restoration Agreement Siened: H iZ-l l IO By: 

Q Topsoil Sampling (if applicable) 1 1 By: 

n Disposal Sampling (if appUcable) 1 1 By: 

O Garden Sampling (if applicable) 1 1 By: 

12 Utility Clearance CaUed:OH

 /»!, / to By= OH/a^/ o LL^Ln/i<^ 

E^ Video/Photos (Before) On: ^ / t1 / 10 By=PrAftt/iO 

D Video/Photos (During) On: / / By: 

n Video/Photos (After) 

On: / / By: 

n Video/Photos (30-Day) 

On: / / By: 

• Property Completion Agreement Signed: / / By: 

D Final Report Issued:

 / / By: 

Air Monitoring (as applicable) 

n Communitv D Crew On: / / By: 

Results: 

n Conmiunity D Crew On: / / By: 

Results: 

O Conununity • Crew On: / / By: 

Results: 

Omaha Lead Site 
Douglas County Accoimt I|^rmatio h ^ r n Page 1 of2 

Douglas County, Nebraska Property Record ­ R0920500000 

Information is valid as of 2010-4-16 

New Feature -^ -* -^

Print Report 

View Interactive GIS IMap 

Treasurer's Tax Reoort 

 Subdivision Sales Search 

Owner 

CITY OF OMAHA 

C/O PLANNING DEPARTMENT 

1819 FARNAM ST #1111 

OMAHA NE 68183-0000 

Property Informatio n 

Key Number: 2050 OOOO 09 

Account Type: Ex Govemment 

Parcel Number: 0920500000 

Parcel Address: 2208 OHIO ST 

OMAHA NE 68110-0000 

Legal Description: DENISES ADD LOT 20 BLOCK 1 50 X 122 

Value Informatio n 

Land Improvement 

2009 $0.00 $0.00 

2008 $0.00 $0.00 

2007 $0.00 $0.00 

2006 $500.00 $0.00 

2005 $500.00 $0.00 

2004 $500.00 $0.00 

Sales Informatio n 

Sales Date: 1993-11-19 

Deed Type: D Sooir: 

Price: $300.00 

Grantor: 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth 

0.14 6098.0 1.0 0.0 

Total 

$0.00 

$0.00 

$0.00 

$500.00 

$500.00 

$500.00 

2171 Page: 634 

Width Vacant 

0.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R09... 4/22/2010 
Douglas County Account b^rmatio b ^ r n Page 2 of2 

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Page 1 of2 

"> 

-L_ 9l'gf%^^SL'gJ-T'g*^gL^ - I Back tpjjth Internet _ _] i[r SendEmail^ I 

• YOUR TICKET NUMBER IS 2473632. 

Original Call Date: 4/23/10 Time: 1:13 pm Op: ELIZABETH18790 


Work to Begin Date: 4/27/10 Time: 1:45 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2208 Street: OHIO ST 


Twp: 15N Rng: 13E Sect-Qtr: 09-SE,10-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: (877)662-4211 


: UNSURE IF CORNER LOT. 


Company : COASTAL ENVIRONMENTAL SERVICE 


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


Work Being Done For: COASTAL 


Depth of Excavation: 4 FT Comer Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MAGELLAN MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number UtiUty 

Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MAGELLAN MAGELLAN MIDSTREAM PARTNERS 

LP DEBORAH 

Day: 9185747098 

Alt: 

Emerg: 9185747098 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF GITY OF OMAHA-TRAFFIC.SEWER RICH/TRAFFIC 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 4/23/2010 
Page 2 of2 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT

FT M 

 LOCATING

Day: 4067289343 

^^- 4062071494 

Emerg: 8887289343 

Day: 4067289343 

QLNNEIC QWEST LOCAL NETWORK LOCATING ^^*' 4062071494 

Emerg: 8887289343 

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OLS#:28995 As-Built Drawing ^ Date Excavated: 04/30/2010 

Date USEPA Signed Off: 5/20/2010 COASTA

CNVmONNENTA

L 

L Omaha Lead Superfund Site Area Sodden: 1909 so ft G • O U P . IN C 

3.^^^ ^ 

Omalia Lead Site Date: €-N'0 ^ Nortti Arrow [ 

Address:

Phone: 

 ^Tt ^ O^-O Si - Site SItetch Time: 10: t l t 

TPamSc/Af//^*r.,1 rMfS- ") BVID# 2^'^S' XRF Code ^^ ^ 

Sample Number Lead Concentration Confirmation Sampli 

ppm •f' Yes ^ No 5 ^ 

ppm i^Yes n No g . '^^ ^ p x A - ?!fy?q <>. ^SZg ­ ppm J'Yes a No ^ iz<<rr>s^ p^A --zs^^s 5 / ^ ppm S^Yes a No E3 

ppm Yes C3 No CD 

ppm Yes CD No CD 

ppm Yes • No CD 

Omaha Lead Site 46130 

Legend 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced with Area replaced with 

Sod ' ' Area left bare 
 Rock/Mulch 


Contract #: EP-R7-07-05 Coastal Environmental Group Inc. 

CUovf LL OM/^ ^ a%^^ ^ 

Name:^Jf/J*

Address: 7- ^

Phone: 

 9. I J

 d^'O

 Mih>ffi'>-^ 

 51 

Omaha Lead stte

SKe Sketch

 Date:

 Time:

 C/'^-O V 

 )«'Vf 

North Arrow

f

 \ 

1 

Team'Sf///f//'/^m-l ^.^/i^ ^ ') BVID# g^f7 r XRF Code ^ ^ 

Sample Number Lead Concentration Confirmation Sample 

LCrt ^ov^ W ^ 

-^-zs 

^/C f 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

i^'Yes

I^Yes

5'Yes

Si-Yes

Yes

Yes

Yes

 a 

n 

a 

° 

• 

• 

D 

No

No

No

No

No

No

No

 ^ 

^ 

^ 

 23 

n 

 CD 

• 

Omaha Lead Site 46130 
g^^Qy^ 

luame-.f'loiL .9', E.,/ Mii>,>/f'>'^ Omaha Lead Site Date: €-/^- W Nortti Arrow [• 

Address: ?2£« Ol^.o S/• Site SIcetch Time: I^Vf 

Phone: f 1 

Team S(///i//',ir*>.>i> r^'y^ *) BVID # 2^ffS ' XRF Code -^2 . Sampie Numtwr Lead Concentration Confirmation Sample 

LOI ^i.\^' ^ 

2Z2: 

-7^ g 

^7 ^ 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

•f'Yes CD 

^^Yes CD 

ilYes n 

«-Yes a 

Yes CD 

Yes CD 

Yes n 

No S ^ 

No 3-

No O / 

No ^ 

No CD 

No CD 

No a 

Omaha Lead Site 46130 
9 • 3.^^^S 

Name:/5/rJ*r 9/, L / Ate>///>^ Omaha Lead Site Date: ^-N-O i NoithAmw 

Address: ^2i « f!^^».•o S^- Site SIcetch Time: /0-Vf 

Phone: f 

TeamS(///f/4*«r) r^/f^ ) BVID#_lg^EL . XRFtDode ^^ ^ 

Sample Number Lead Concentration Confirmation Sample 

ppm ^'Yes ° No 5 ^ 

ppm ^^e s D No 3 ^ 

^,z ppm J'Yes • No O / iZf<r>^p^A-^fi<?^^ . ^ ppm KYes 1=1 No a 

ppm Yes O No O 

ppm Yes n No CD 

ppm Yes • No • 

Omaha Lead Site 46130 
,*^*^>* 

COASTA l iNVItOHniHTAI *•< PROttf- CROU P IR 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: "^v^N^ ^ 7 ^* 7 f C 

Owner's Name: 

u}mM 

Daytime Phone: 

/'/'TV oe o«^H^-tvAddress of Property <S-T. covered by this 2^2-^ ^Hio Agreement: 

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 vi^ith 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 perfomning the work. This access shall 

remain In effect until the work has been satisfactorily completed. The Grantor also 

agrees to: 

Page 1 of 2 
>^*^*'f . 

I 

a) 

COASTA L 

tHViaOHHIfTAl '-«< PftO**' 

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

piles, dog houses, etc; 

c Remove flower bulbs or plants that the Grantor or the Grantor's tenant may wish 

to save; 

c 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 (402) 991-1199 

^ \I grant access to my properties 

D i do not grant access to my properties 

i-yl-l'/a 

Signature 

Signature Date 

D I would like to be present during any sampling that is required. 

Page 2 of 2 
V5 

C O A S T A L • NViaOMMBHTAL O II O U P . IHC . 

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 of the property owner and the United States Enviromnental 

Protection Agency (EPA). 

PropertylD; 2^^^' ^ 

Property Address; 1,X,0 ^ 0H( O '^ -

Owner: QXW ' Of^ OvH^HrtA- fel(( LJJK/ ^ 

Phone; ^^ ^ . ^/2 ^ 

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 responsibUity. 

Hem: 

Mon^ 

Item: 

Kem: 

Item: 

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

Hem: 

f^rwj^ 5YVVoai T^\C/iA:V'S u-^ WeVvvxAfiL-

Kem: 

Item: 

Item: 

Pagel MJ. 
<5 

C OAST A L • MViaONMa H T * L O • O U P . IMC . 

Items to Be Removed By Contractor During 

Kem: 

Shi 

Hem: 

Kem: 

Kem: 

Item 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

trunk diameter 

Number of trees <= 2 inch 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Ntmiber of and size of 

each garden/ flower bed 

area. 

Attach a sketch of relative 

sizes and locations. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

Note this value will be 

used to issue a plant 

voucher to the property 

owner. 

Easement Area, to be 

excavated 

1 

< 

Sot-) 

Quantity 

BZ 

f 

f 

\|ts 

Remediation and Replaced 

Landscape Inventory 

Unit Condition/Type/Species 

Quadrants 

Each 

Each 

Each 

Each 

Square Feet 

$ 

Each (tsu\V^ S^a^^xm^ 

0 

Page 2 of ^ 
C O A S T A L • MViaONMB N T A L a a o u p . INC . 

AddKlonal Comments / Instructions: 

The city of Omaha ordinances may prohibK you from using dirt or gravel areas on your property 

as driveways or vehicle parking arecis. The Environmental Protection Agency (EPA) may be 

removing and replacing soil underiying 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 cKed by the city If you use a gravel or dirt area 

as a driveway or parking area, not wKhstanding any removal or replacement of soii by the EPA 

If you have any question about legality of a certain driveway or parking area, you may contact 

the cKy of Omaha's Planning Department at (402) 444-5150. 

|~l Please check this box if you understand the information outlined above. 

G 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 of house, including foundation cracks or fissures. 

jree / Q I do not agree 

Owner's Signature Date Contractor's Signature Date 

Page 3 of 
BVID#263i5_ XRF PROPERTY SAMPLE SHEET 

Date ^ -?.--(() Address ll.C^'^ f^VxlO^i; 

Project Omaha Lead ARRA Sample time am/pm 

XRF ID# 1 sample length 30 sec ^^'Ip^f^ 

Shot# Reading Sample area Shot# Reading Sample area 

'TO­ l^'i'^ Up HA /^^ ^ / ^ u^t. IL /:)?>*• / Depth Mmi . 2£^±M Depth 

2 12 I t ^ W/('i- 1'%^ MiO. ch^^ n 

Average [s l L- } ^ Average /^6 ) "^ I i 

Shot# 

H 3 ^ 

±m­ tj^T 

Reading 

i^t^ 

M- %t ^ 

Average ^^ 1 > ^ 

Sample area 

fe^-

Depth 

TV' 

^ 

Shot# 

Average 

Reading Sample area 

Dispth 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

Shot# Reading 

RETEST AREAS 

Sample area Shot# Reading Sample area 

Average 

/

^ - ^ 

/ 

Depth 

Average 

Depth 

Signature 

Print fl4Af<^ IM^T M 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 442 

Mode SOIL 

Time 2010-06-02 08:53 

Duration 90.33 

Sequence Final 

Flags 

AVERAGE 

ADDRESS C-^2 208"Ohid"st i " 

QUADRANT EA 

DEPTH 1" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD ; 7.821 

Zr 455.794 ± 15.289 

Sr 173.633 ± 8.742 

U < LOD : 13.805 

Rb 68.541 ± 6.321 

Th < LOD : 12.131 

X^^.iy.--. ^ :•"• L^Pb— •.r'rrC206^343^ ~U__l:fij3nt 

Se < LOD 5.445 

As < LOD : 24.561 

Hg < LOD : 11.747 

Zn 161.530 ± 21.347 

W < LOD I JQCf^ ^ 

Cu 43.781 ± ^ -"'•'^20^49 

Ni < LOD >7 68^967 

Co < LOD y ^ : ya79.120 

Fe 18746.732 / ± X 383.813 

Mn 530.378/ ^ 95.106 

>7' 

Supe rvised By: v ^— — 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 439 

Mode SOIL 

Time 2010-06-02 08:51 

Duration 30.11 

Sequence Final 

Flags 

BVID 28995 

ADDRESS 2208 Ohio st 

QUADRANT EA 

DEPTH 1" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 7.738 

Zr 466.411 ± 15.458 

Sr 173.371 ± 8.746 

U < LOD : 13.615 

Rb 66.971 ± 6.254 

Th 12.129 ± 8.059 

Pb 197.034 ± 18.364 

Se < LOD 5.920 

As < LOD 24.317 

Hg < LOD 11.681 

Zn 164.691 ± 21.529 

W < LOD 81.258 

Cu < LOD 29.087 

Ni < LOD 71.119 

Co 271.661 ± 122.210 

Fe 18588.803 ± 382.709 

Mn 520.589 ± 94.493 

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 

DEPTH 

TYPE 

INSPECTOR 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

ppm 

< LOD 

446.311 

173.953 

< LOD 

67.560 

12.204 

208.766 

< LOD 

< LOD 

< LOD 

154.093 

< LOD 

41.841 

< LOD 

< LOD 

18596.414 

554.015 

Supervised By: 

Certificate of Verification 

440 

SOIL 

2010-06-02 08:52 

30.11 

Final 

28995 

2208 Ohio st 

EA 

1" 

CONFIRMATION 

N. LOPEZ 

Error 

J 7.858 

± 15.106 

± 8.721 

: 13.963 

± 6.288 

± 8.125 

± 18.736 

5.510 

24.662 

11.641 

± 20.840 

: 79.174 

± 20.325 

I 68.303 

: 176.337 

± 381.048 

± 95.769 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPTH 

TYPE 

INSPECTOR 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

ppm 

< LOD 

454.660 

173.574 

< LOD 

71.091 

< LOD 

213.228 

< LOD 

< LOD 

< LOD 

165.805 

< LOD 

62.649 

< LOD 

< LOD 

19054.980 

516.531 

Supervised By: 

Certificate of Verification 

441 

SOIL 

2010-06-02 08:53 

30.11 

Final 

28995 

2208 Ohio st 

EA 

1" 

CONFIRMATION 

N. LOPEZ 

Error 

: 7.867 

±. 15.302 

± 8.760 

; 13.836 

± 6.422 

: 12.117 

± 18.960 

'. 4.906 

'. 24.703 

• 11.919 

± 21.671 

: 81.322 

± 21.931 

i 67.479 

: 177.709 

± 387.682 

± 95.056 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 438 

Mode SOIL 

Time 2010-06-02 08:49 

Duration 90.35 

Sequence Final 

Flags : " 

AVERAGE ^,„-VWg;o^35^437'^" 

ADDRESS <-'^0 8 Ohio st 

QUADRANT B2 

DEPTH 13" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 

Zr 500.350 

Sr 150.079 

U < LOD 

Rb 73.118 

Th < LOD 

<Pb^^^=:::==S3::^450^e^^^'^^ 

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 

XL3t-32089 

Reading No 435 

Mode SOIL 

Time 2010-06-02 08:48 

Duration 30.11 

Sequence Final 

Flags 

BVID 28995 

ADDRESS 2208 Ohio st 

QUADRANT B2 

DEPTH 13" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 8.142 

Zr 500.449 ± 16.326 

Sr 152.834 ± 8.478 

U < LOD 14.582 

Rb 76.294 ± 6.828 

Th 16.883 ± 10.578 

Pb 452.442 ± 27.768 

Se < LOD 5.736 

As < LOD 36.441 

Hg < LOD 12.181 

Zn 143.855 ± 20.855 

W < LOD 80.703 

Cu < LOD 30.669 

Ni < LOD 73.589 

Co < LOD 183.888 

Fe 19331.547 ± 400.444 

Mn 615.226 ± 102.466 

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 

DEPTH 

TYPE 

INSPECTOR 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

ppm 

< LOD 

501.873 

144.815 

< LOD 

71.678 

< LOD 

443.547 

< LOD 

< LOD 

< LOD 

140.034 

< LOD 

39.205 

< LOD 

< LOD 

19232.346 

584.619 

Supervised By: 

Certificate of Verification 

436 

SOIL 

2010-06-02 08:49 

30.12 

Final 

28995 

2208 Ohio st 

B2 

13" 

CONFIRMATION 

N. LOPEZ 

Error 

: 8.133 

± 16.267 

± 8.250 

I 14.150 

± 6.614 

; 14.531 

± 27.440 

I 6.215 

: 36.022 

', 12.299 

•± ­ 20.684 

; 83.206 

± 21.135 

: 72.544 

: 181.615 

± 398.654 

± 100.657 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPTH 

TYPE 

INSPECTOR 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

ppm 

< LOD 

498.728 

152.587 

< LOD 

71.383 

< LOD 

456.172 

< LOD 

< LOD 

< LOD 

128.738 

< LOD 

51.858 

< LOD 

< LOD 

19249.162 

555.063 

Supervised By: 

Certificate of Verification 

437 

SOIL 

2010-06-02 08:49 

30.12 

Final 

28995 

2208 Ohio st 

B2 

13" 

CONFIRMATION 

N. LOPEZ 

Error 

: 8.094 

± 16.194 

± 8.419 

\ 15.309 

± 6.706 

; 15.436 

± 27.686 

: 5.771 

: 35.995 

: 12.804 

± 20.054 

: 85.352 

± 21.860 

: 70.535 

: 185.125 

± 397.074 

± 98.680 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 13 

Mode SOIL 

Time 2010-04-30 10:55 

Duration 90.33 

Sequence Final 

Flags 

AVERAGE r-5ya5£io-i2-^ 

ADDRESS 2208 Ohio st 

QUADRANT EA 

DEPTH 1 " 

TYPE iNsrrus 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD \ 7.081 

Zr 318.302 ± 12.448 

Sr 120.830 ± 7.060 

u < LOD : 12.045 

Rb 48.857 ± 5.238 

Th < Lor> 10.67-7 

rp b 1A1 09S —± tfi-fiQQ 

Se < LOD 4.908 

As < LOD : 22.220 

Hg < LOD : 10.048 

Zn 147.116 ± ^,.-^44 9 

w < LOD • v ^ "^ 70.067 

Cu 36.917 /18.72 6 

Ni < LOD / : / 64.047 

Co < LOD 149.248 

/ • / Fe 13821.727 / _315.975 

Mn 327.701 f V / 74.892 

/ " 

Supervised By: y ^ ' / 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 10 

Mode SOIL 

Time 2010-04-30 10 53 

Duration 30.11 

Sequence Final 

Flags 

BVID 28995 

ADDRESS 2208 Ohio st 

QUADRANT EA 

DEPTH 1" 

TYPE iNsrrus 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 7.116 

Zr 314.359 ± 12.316 

Sr 109.112 ± 6.726 

u < LOD : 12.039 

Rb 50.269 ± • 5.284 

Th < LOD 10.166 • 

Pb 173.630 ± 16.418 

Se < LOD : 4.325 

As < LOD : 21.533 

Hg < LOD '. 10.122 

Zn 150.617 db 19.666 

w < LOD : 72.344 

Cu 36.063 ± 18.726 

Ni < LOD I 65.158 

Co < LOD J 140.428 

Fe 12633.854 ± 301.841 

Mn 297.379 ± 71.948 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 11 

Mode SOIL 

Time 2010-04-30 10:54 

Duration 30.11 

Sequence Final 

Flags 

BVID 28995 

ADDRESS 2208 Ohio st 

QUADRANT EA 

DEPTH 1" 

TYPE iNsrrus 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 7.049 

Zr 328.598 ± 12.659 

Sr 124.120 ± 7.168 

u < LOD J 11.688 

Rb 50.069 ± 5.248 

Th 13.878 ± 7.137 

Pb 123.341 ± 14.313 

Se < LOD I 5.343 

As 19.967 ± 12.821 

Hg < LOD : 9.744 

Zn 127.332 ± 18.281 

w < LOD : 66.066 

Cu 32.899 ± 18.505 

Ni < LOD I 65.393 

Co < LOD : 149.889 

Fe 13905.447 ± 317.762 

Mn 288.572 ± 72.430 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 12 

Mode SOIL 

Time 2010-04-30 10:55 

Duration 30.11 

Sequence Final 

Flags 

BVID 28995 

ADDRESS 2208 Ohio st 

QUADRANT EA 

DEPTH 1" 

TYPE iNsrrus 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 7.078 

Zr 311.950 ± 12.370 

Sr 129.259 ± 7.286 

U < LOD 12.410 

Rb 46.233 ± 5.181 

Th < LOD 11.158 

Pb 246.314 ± 19.366 

Se < LOD 5.055 

As 30.409 ± 17.264 

Hg < LOD 10.278 

Zn 163.400 ± 20.399 

W < LOD 71.790 

Cu 41.789 ± 18.946 

Ni < LOD 61.591 

Co 218.354 ± 104.953 

Fe 14925.880 ± 328.323 

Mn 397.153 ± 80.299 

Supervised By: 
i^fjQL\ Omaha Lead Site—Fixed Price EP-R7-07-05 

I ^^^^ ^ I Coastal Environmental Group Inc. ^'^g^p ­

\7^~Js f www.coastalhazmatcom '' ^ 

%PROrtJ^ COASTA L 

IN*tlONHIIIT*l C 10 U P. IN C 

EXECUTIVE SUMMARY: 

BVID #28995-(2208 OHIO ST) 

No Issues or Concerns [^ Issues/Concerns 

Detail Explanation: 

DAN GARVEY WALKED THE PROPERTY ON 5/20/10 
4

s ^ 

EPA Property Close Out Form 

Date/Time; Owner's Name:,i^>V>\y.^W'_ri.Vft itrV , • ^ — 

Quads Excavated: Contractor Croop CrOL^ciX 

Excavation Yes No Generai 

I. If necessaiy, were the correct quadiant(s) excavated and restored? / 

2. If necessary, were the correct areas ofdrip zone excavaied and restored? / 

Gradlnv Sad and VMetafion Yes No 

I. Does the graduig around the perimeter 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 

^ day time period) 

4, Are sodded areas generally llrm and evenly graded? / 

5. Are the Joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day y time period) 

6. Was the property graded such that water will not pool on the property' / 

7. Was danuge to landscaping or plant materials avoided? / 

Gates, Fences and RetaiDlns Walls Yes No 

1. Do gates open and close finely? (if applicable) / 

2. Were all gates or fences taken down during restoration activities reinstalled? (If applicable) • 

/ 3. Was damage to gates or Tences avoided? (tfapplicable) 

4. Was damage to retaining walls avoided? (If applicable) • 

Foundation, SidioK and Gntters Yes No 

t. Was damage 10 the siding or trim avoided? »/ 

2. Was damage to the foundation avoided? y 

3. Was damage to windows avoided? • ^ 

^ Was damage to windows or door screens avoided? 

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

Sidewalks and Driveways (Concrete) Yes No 

1. Was damage to driveway surfaces avoided? 0 ^ 

2, Was damage to walkway surfaces avoided? ^ 
Ort'oers commenfs: 

_^ 

jlnspection notes: 

Removal and resloration activates complele including the 30-day sod warranty: 

EPA Represerjlaiive $cm }( ^ Dale: t/i»/tt> 
• • # • 

Property Completion Agreement 

Ihis agreemenl documenls the complclion ol remedial aclivities perionned on my properly My signature 

will designate that I am satisfied with the restoration of my propeity, and that no items are in questions, 

now, or al any time in the future, except those items listed below, if any 

PropertylD: 28^<^5 ~ 

Property Address: •2.2.0<g> 0\\\ 0 S V 

Owner: 5 ; ^ LuKcL^V x di^ A O ^ PMAHf i 

Phone: UU^ - MZ,H 6 

Restoration Items in Question: 

item: 

Item: 

Item; 

item: 

Item: 

Item: 

AddHionai Comments: 

i Dgrec restoraiion is completed, except as noted 

[ J I do nol a|>rtc restoration is completed 

Conti arlor's Signatnre Date 
(2i\ 

^^CEIVED 

^^'f 2 4 2010 

Property OwEner Asgessment of F£ir|M"m£BiCe F©rm 

American Recovery anci Reinvestment ^^i'^SSi^/y/^ ni\/IQir\ 

Omaha Lea(i Superfund Site " ^'^'^iUN 

2009/2010 

Remedistion Contractor: Coastal EnviroBmental Group - EP-R7-Q9-06 

Property Identifier NuBmber: 2fV^^f5^ 

Property Address: '^iLr>9\ <DW\0 f?T ^__. ^ 

Piroperty Owaer's Name; WW LvAVXtSyN C \\\A r^QiUAW\y^ 

Instructions to the Propertv Owner; 

This form serves to record the Property Owner's assessment of performance (Incentive 1 

- Quality Assurance Surveillance Plan) involving the listed remediation contractor, as applicable 

to the Omaha Lead Site. This foinnn documents the timeliness of punch list resolution, business 

relations, complaint resolution and the overall quality of work. If need be, the Property Owner 

may utilize this form to record problems and/or issues not specifically tied to an assigned 

address, for example, business relations that generally don't follow the guidelines set forth in the 

Performance Work Statement.. 

The Property Owner will indicate his/her assessment of performance with the contractor's 

woric by checking a numerical reting on tiie tsbie beiow using the numerical definitions from 

the rating scale below, then sign & date the form. 

9-10 "excellent" 

7-8 "very good" 

5-6 "acceptable" 

3-4 "poor" 

1-2 "very poor" 

Propertv Owner's Assessment of Performance Regardine the Contractor's Work 

10 5 

9 A 

8

7 ¥

V

 __!_

 3 

2 

6 1 

Property Owner AdditionaE Comments from (optional; continiue on back page if needed) 

Property Owner Signature: v^l//f/^X//^ /AAA ^ ^Date: _lJ_J^yHZs^/0 
EPA Assessment of Performance Form 

American Recovery and Reinvestment Act (ARRA) 

Omaha Lead Superfimd Site 

2009/2010 

Remediation Contractor: Coastal Environmental Group - EP-R7-09-06 

Property Identifier Number: Q?R<^APS 

Property Address: 2£OP> OU\n STT 

Property Owner's Name: ^AV \ ^i..VCri.^V\ P:ih^ ^S-nrYVlV\CN 

(Above information to befilled out by the remediation contractor prior to utilization by the EPA COR) 

Instructions to EPA COR: 

This form serves to record the COR's assessment of perfonnance (Incentive 1 - Quality 

Assxirance Svirveillance Plan) involving the listed remediation contractor, as applicable to the 

Omaha Lead Site. This form docmnents the timeliness of punch list resoliition, business 

relations, complaint resolution and the overall qiiality of work. If need be, EPA may utilize this 

form to record problems and/or issues not specifically tied to an assigned address, for example, 

business relations that generally don't follow the guidelines set forth in the Performance Work 

Statement. 

The COR will indicate his/her assessment of performance with the contractor's work by 

checking a numerical rating on the table below using the niunerical definitionsfix)m the 

rating scale below, then sign & date the form. 

9-10 "excellent" 

7-8 'Very good" 

5-6 "acceptable" 

3-4 "poor" 

1-2 "very poor" 

EPA's Assessment of Performance Regarding the Contractor's Work 

10 / 5 

9 -^^^ ­ 4 

8 • 3 

7 2 

6 1 

Additional Comments from EPA COR (optional; continue on back page if needed) 

EPA COR Signature: fliiM A . Date: ,\*» " 
28995 

m 

NOTES 

RE: 2208 OHIO ST 

2204 OHIO ST 

JULY 17, 2010 

- WE RECEIVED INFORMATION FROM TODD (TODD'S SOD) STATING THAT HE SAW A BULLDOZER 

ON THE SOD, ON PROPERTY 2208 OHIO ST. 

July 19, 2010 

-ONE OF OUR SITE COORDINATORS WENT TO THE HOUSE TO INSPECT THE CLAIM AND NOTICED 

THAT THE GROUND HAD BARE SOIL,WAS LEVELED, AND ALL THE SOD WAS REMOVED, FROM 

PROPERTY 2208 OHIO ST AND ALSO FROM THE NEIGHBORING PROPERTY, 2204 OHIO ST, WHICH 

IS ANOTHER PROPERTY THAT COASTAL DID THE LEAD REMEDIATION FOR. 

"SUPERVISORS WERE NOTIFIED IMMEDIATELY*