### CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE 

# [[I]]

us Army Corps

of Engineers .EI::C. 

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ECC Certification for Property Closeout
OLSID 27940 

### Property Address 2211 N 2t h 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
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# ~~ Name Title Date Jeff Hubbard USACE Con Rep 

# JNu/ID Name Title Date Signature

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## 27940 North Afrr1N Exterior Paint Omaha Lead Site Owner Name: JP INVESTMENTS INC 

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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 

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Residence Address: 

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# -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 of occupants: _ 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 of this title." Access Attempts: First: Second: Third:
_

# --------- List of existing Conditions pg.-LofL 

# · \ 2.-'**+~ ~-r**  Property Address: _------'- 

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_ Owner: Date: 

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# 'l'-1"'~~**'--.!!II1JP~~ASW** Associates Inc
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### Contract No.**W912DQ~04~D-0017,** 

### Task Order 

### DKOI Omaha Lead Site, Omaha, NE PronertI Closeout Agreement BVID Property Address 

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### Property Owner Is the Owner the Resident? DYes**~o** 

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### "'All"" Compliance Statement: U.S. Environmental Protection Agency (EPA) has contracted the 

## u.s. Army Corps of Engineers (USACE). Omaha District to conduct environmental restoration services for the Omaha Lead Site. USACE Omaha is working with Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation in giving EP A1USACE/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 of External 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. /'" 

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# r agree that restoration is completed at my property, except as noted Comments (if applicable): 

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## i-**/~--Io-o~** Prifperty 

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

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

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## _ Property Identifier Number:
_ Property BVID Number:**_-:::~~?-l.q_'i:....:{):::....-** 

## __ Property Address:**J.~Jk.l./** 

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## _ 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 of trying to capture your level of satisfaction with the work of the 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 of Engineers (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 of satisfaction with the Contractor's work by selecting a numerical rating (ranging from 1 10 

### 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) =====_:::: Date: 

## /d'"'/r-t> 

# 7 

# 0

### CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation 

# m .ECC.



# ., Omaha Lead Remediation, Omaha, NE us 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