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

Environmental Chemical Corporation 

Omaha Lead Remediation, Omaha, NE 

[[I]] 

us Army Corps 

of Engineers 

.EI::C. 

"iiiP' 

ECC Certification for Property Closeout 

OLSID 27940 Property Address 2211 N 2th 8t 

Field Work Started 8/112007 Field Work Completed 819/2007 

Summary: 

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

• B1 excavation depth was 13 inches below ground surfaces. 

• Drip zone excavation depth was 13 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. 

• Sod placement and site restoration were conducted in compliance with the specifications and 

work plans. 

Comments: None 

$c cd\- D.J'v,J i ()/ Itl () +-- ,.,. ECCOCM ~~ Name Title Date 

Jeff Hubbard USACE Con Rep JNu/ID 

Name Title Date Signature 
_....-- -~-~--_.

27940
 

Omaha Exterior Paint North Afrr1N

Owner Name: JP INVESTMENTS INC Lead Site

'---'­ o Good Site Sketch Address:~~!.'!..-N27 SL... _ IS2("Poor
 Phone:..l!.... .._ W: 402-342-0992
 n Notpaint

" 

F ('2..,...,.", - \ OLS FD A~50"'19+£S XRFCode 

Lead Concentration	 Date 

ppm	 a.

Jz 

,

€A5E(V)eNt 

DZ 

BI

B2

Quadrant

F2

FI

Team

I?> 

I~ tNo-I 

IJJCJi 

191 

JBLl ~~:

ppm
 

ppm
 

LogBook

Izatt­~L

/85	 ppm 

ppm 

ppm 

ppm w~ ... . ._..... - - • . . • • • _ • _• _ • • • • • • . • . . • • . • :~I1.quadrants are as viewed from the street, facing property . 

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 • • • • • • • • . • 046141.012: 
Page I of _ 

Omaha Lead Site 

Omaha, NE 

U.S. Environmental Protection Agency Region vn 

Residential Yard Soils 

Environmental Restoration 

Services 

I'I{( il'l I{ I Y \ClTSS (lll hl' Clllllpktl'd 11: I'Illj1l'rl: OIL Ill'll 

1'.II,lll'c'lhll l'l.1 Illllll.ll"I,.lli"II)(1I·';l\lll tI~lll1l' ,II I-X[)O-=2~-(l-L>

Grantor (the property owner), consents to and authorizes the United Sates Environmental Protection Agency (USEPA) 

or its authorized representatives (or its contractors), the Grantee, to enter and perform certain environmental response 

activities upon the following described premises. For further infonnati:~ :tact EPA at 1-800-223-0425. 

Property Access Granted By '1 :..eo. c J- L..t Jl,../VP 

(Please Print Name) 

(Date) 

Residence Address: "2. '2.J' tJ :z. -=1- -s.T 

(CITY) (STATE) (ZIP) 

Property owned by: -:-­ _ 

Owners mailing address:-'~:z::....:4~.:2~IJL--"""7)JL.Jf£.Lru....w£L..;I't~I----'Sk:R=.;.~)..;.(J~f-~---------

Owner's telephone number-Home: _ Work: ------------

Age of Home? __________years How long have you lived here? years 

Has the exterior been painted or covered with siding since 1978 

Has the interior been painted or covered since 1978? 

DYES 

DYES 

o NO 

o NO 

Total number ofoccupants: _ List Ages: _ 

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

Comments: - _ 

AUTHORITY FOR ENVIORNMENTAL RESPONSE ACTIONS 

The activities to be implemented by EPA under lhis agreement are pursuant to Section 104 ofCERClA, 42 U.S.C 9604. EPA's right of access to the 

property for in Section 100(e) ofCERCLA. 42 U.S.C. 9604 (e), which provides entry for. "determining the need for response, or choosing or takmg 

any response action under this litle, or otherwise enforcmg the provisions ofthis title." 

Access Attempts: 

First: Second: Third: _ 
---------

List of existing Conditions pg.-LofL 

Property Address: _------'-22/J I\J · \ 2.-' T-'--+~ ~-r _ 

Owner: Date: =;-/ J'(b 1-- OLSID #: "2 -:+ 1'16 

Description: 

- JJD <-oN c:..~~N ­

-v~c....4","\ ­

.. 'l'-1"'~~ '--.!!II1JP~~ASW Associates Inc. 

Print & Sign '::, --i"rint & Sign 

t 

.,.. 
Contract No. W912DQ~04~D-0017, Task Order DKOI
 

Omaha Lead Site, Omaha, NE
 

PronertI Closeout Agreement 

BVID :J. 7 q L.j () Property Address 1~.) II AI rJ. ') sr

Property Owner Is the Owner the Resident? DYes ~o ;rP rAJ tlFSiIYl "'All""
 

Compliance Statement:
 

U.S. Environmental Protection Agency (EPA) has contracted the u.s. Army 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 EPA1USACE/ECC permission to access your property during the 

removal/restoration phase is sincerely appreciated. This document certifies that all work performed at 

this property was completed in accordance with the contract specifications and EPA requirements. 

If you have questions or need additional information please contact Don Bahnke, EPA Project Manager, 

at (913) 551-7003 or the Office ofExternal Programs at 1-800-223-0425. 

Additional Comments by USACE and/or ECC: 

CONTRACTOR CERTIFICATION
 

ECC Project Manager
 

Name Title Date Signature 

PROPERTY OWNER SECTION 

This agreement documents the completion of remediallrestoration efforts at the property to my
 

satisfaction.
 

/'" 

.[iJ/' ragree that restoration is completed at my property, except as noted
 

Comments (if applicable):
 

._-"'\ , , 

IX" ,;( /~/tj~- JL· If~::' 42J;/; i- /~--Io-o~

Prifperty O"-'ne'r's Sign,ture Datt 

il 
Property Owner Satisfaction Survey Form 

Omaha Lead Superfund Site 

Perfonnance-Based Contracting (PBC) Pilot Project 

Remediation Contractor: __....;£-.::C~C _ 

Property Identifier Number: _ 

Property BVID Number: _-:::~~?-l.q_'i:....:{):::....-__ 

Property Address: J.~Jk.l./..(_,.;.N~.-.::J~?I--S~r _ 

Property Owner's Name: _3'-=..,jPL-_.Z:~N:....I/~£:.;.;S~T-,M~e-~AI;.Lr-,:S _ 

(above information to be filled out by remediation contractor prior to delivery of form to Property Owner) 

***********************.************•••*•••*.**.***.*.**••***•••••*•••**•••**. 

Instrnctions to Property Owner: 

This form is provided to you as a means oftrying to capture your level ofsatisfaction 

with the work ofthe above-identified Remediation Contractor, as applicable to the soil cleanup 

action at your property. The u.s. Environmental Protection Agency (EPA) and the U.S. Anny 

Corps ofEngineers (USACE) are very interested in your opinion regarding the work performed 

by our contractors. This form is intended to provide an easy means for you to express your 

opinion about the work performed on your property. 

Please indicate your level ofsatisfaction with the Contractor's work by selecting a 

numerical rating (ranging from 110 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 of the property owner.) 

"excellent" 

C1:V "very good"
 

5-6 "acceptable"
 

3-4 "poor"
 

1-2 "very poor"
 

Property Owner's Satisfaction Rating regarding Contractor's Work 

10 5 

9 4 

8 3
 

7 2
 

6 1
 

Additional Comments from Property Owner (optional; continue on back of page ifneeded) 

·· . (-:~. JI~o/~ Property Owner's Signature: "'7\4) 0 =====_::::Date: /d'"'/r-t> 7
CONTRACT # W912DQ-04-D-0017, T.O. DK04 

., 

.ECC.

Omaha 

Environmental 

Lead Remediation, 

Chemical Corporation 

Omaha, NE us 

m

Army Corps 

of Engineers 

Analytical Results Summary 

Sample ID # 27940 

2211 N 27 St 

Sample 

Type 

DE 

PX 

DE 

Quadrant 

B1 

EA 

DZ 

Depth 

0 

14 

Date Collected 

8/2/2007 

8/2/2007 

XRF Results 

(ppm) (avg.) 

191 

185 

184 

Sample IDSample ID is a particular residential property ID from which the sample is collected. 

The sample type identifier (with sequenlla[ sample number for that location) as follows~
 

PX = Pre-Excavation XRF sample
 

PE Pre-Excavation laboratory sample
 

DE • During and Post Excavation
 

Quadrant describes the sampling location (with sequential sample number for that location) as follows; 

FI or F2 c Front Yard One or Front Yard Two 

BI or 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 million