TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: '24?'11'U Date: M 

Address: QAo^ UM^XWi 

Remediation Contractor: _Coastai Environmental Group_ Year; 200i ^ 

SOIL REMEDIATION 

PROPERTY nL E FOLDER DOCUMENTS 

Video of property (DVD) 

Executive Summary 

EPA-provided property sketch 

Signed Access Agreement for subject property 

Signed Access Agreement(s) for adjacent property 

Restoration Agreement 

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

Confirmation data 

Photographs 

As-built sketch 

Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

-& Description of areas not meeting ROD cleanup criteria 

Utility clearances 

/ Property information from Douglas County Assessor's Office 

</l^ 

•^^siiir Dite" 

30054774 

Superfund 
Property Access Checklist 

Property U): 2^)^1l l 

Property Address: 2^0 ^ Pnpp\e,\t^ n 

D

D

 WORK STARTED

 WORK COiVlPELTED

 ON:

 ON:

 /

 /

 /_ 

 /_ 

Ownc Renter 

Address: "oaynrv^ Phone: 

F.L\: 

^•'o"- ?)a. -MW ^ 

Fax: 

Cell/Pager: 

Additional Inl'nrmxtion: 

Cell/Pager. 

D Notification Letter 

15) Access Agreement 

52^ Restoration Agreement 

O Topsoil Sampling (if applicable) 

C3 Disposal Sampling (if applicable) 

O Gnrdcn Sampling (if applicable) 

• Ulility Clearance 

•0 ^ Video/Photos (Before) 

• Video/Photos (During) 

n Video/Photo* (After) 

D Vi(ko/Photo» (30-Day) 

D Property Completion A(;reemeni 

Sent: / / 

Signed: Jl/J|/S l 

S\gt,t6:J_l]\_l(M 

1 1 

1 1 

1 1 

Called: / / 

On:l/LL/0 a 

On: / / 

On: / / 

On: / / 

Sipicd: / / 

By: 

B>= n(i^\i\o 

By: /OMavi n 

By: 

By: 

By: 

By: 

By=0cWiO / SY^aK\ 

By: 

By: 

By: 

By: 

D Final Report Issued: / / By: 

Air Monitoring (aA- applicable) 

O Community d l Crew 

Results: 

Oo: / / By: 

n Communiri'

RMUHS: 

D Crew On: / / By: 

r~l CommunityResulU: 

D Crew On: / / Bv: 

Omaha Lead Site 
CONTACT FORM 

Property ID # 2D 4" ] 1 

Property 

Address: 7-"lQ7) ?o^^\t^ n TW 

Initial Contact: Date: T-fl'O^ Time: |:2^ Action: C^rcj^flwgr 

Second Contact: Date: Time: Action: ^ 

Fina Action: l Contact: Date: Time: 

Final Action: Transmit to EPA D Other Action: D 

Comment: 

Owner 

Comment (s): 

Site 

f o ^c& U^i ^ lt^+ Ca^K f1y.<|- tJ Q-X^y^ Coordinator 

Comment (s): 

\ 
Douglas County Account Informilifi tTaMan i Page 1 of3 

Douglas County/Nebraska Property Record - R1238420000 

Print Report 

NEW Feature - Parcel Dimensions available l® scale 0-50 fl west of 52nd St - Vle W OP Ma p information is valid as of 2009-6-16 Treasurer's Tax Report 

New Feature ••-•- • Auto Sales Search 

Owner 

DYKE NATHAN P 

blAL 

2703 POPPLETON AVE 

OMAHA NE 68105-0000 

Property Informatio n 

Key Number- 3842 0000 12 

Account Type: Residential 

Parcel Number: 1238420000 

Parcel Address: 2703 POPPLETON AV 

OMAHA NE 68105-0000 

Legal Description: HANSCOM PLACE LOT 2 BLOCK 14 E 50 FT LTS 1& 50 X 100 

Value Informatio n 

Land Improvement Total 

2009 $4,400.00 $93,900.00 $98,300.00 

2008 $4,400.00 $93,900.00 $98,300.00 

2007 $4,400.00 $93,900.00 $98,300.00 

2006 $4,400.00 $70,400.00 $74,800.00 

2005 $4,400.00 $70,400.00 $74,800.00 

2004 $4,400.00 $70,400.00 $74,800.00 

Sales Informatio n 

Sales Date: 2007-04-02 

Deed Type: WD BooJIr; 2007 Page: 037579 

Price: $114,000.00 

Grantor: Rogers Michael etal 

Grantee: Dyke Nathan P etal 

Valid/Invalid: Valid 

Exclusion Reason: 

Sales Date: 2005-04-22 

Deed Type: WD SooAr; 2005 Page: 047399 

Price: $107,000.00 

Grantor- JOHN L LINCOLN ETAL 

http://douglasne.mapping-online.coin/DouglasCoNe/static/accountinfo.jsp?accountno=R123... 7/7/2009 
Douglas County Account Info: rmgijigr Page 2 of3 

Grantee: MICHAEL RODGERS ETAL 

Valid/Invalid: Valid 

Exclusion Reason: 

Lan d Informatio n 

Acres SF Units Depth Width Vacant 

0.11 5000.0 1.0 100.0 50.0 No 

Improvemen t Informatio n 

Building 1 

fnlP*cr 

itMOir 

Sound Flodr 

: 

4 

*'ja | |i(f HIT i 

..5*tEI!»5JS.J 

PJ!|I I B^ck fl fl 

1 1/2 STORY FINISHED 

CLICK TaENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 1675.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

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

HVAC: Central Air to Air Rooms: 6.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: I 1.0 

Roof Cover: Composition Shingle Bedrooms: ; 3.0 

Roof Type: Gable Stories: ; 1.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1917 0% 1917 91 

Detail Type Detail Description Units 

1040.0 

Appliance Allowance 

Add On Unfinished Attic W/floor 

1.0 

Basement Bsmnt Block 8 ft 

1040.0 

Fixture Base Fixtures 

1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R123... 7/7/2009 
Douglas County Account Informajinn Page 3 of3 irn^^r 

Fixture Bath Full 1.0 

Garage Detached 209.0 

Porch Slab Roof Ceil 184.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accoxmtinfo.jsp?accountno=R123... 7/7/2009 
Page 1 of2 

"> 

Create Another Ticket ] [ Back to irth Internet ] Send Email 

YOUR TICKET NUMBER IS 2332169. 

Original Call Date: 8/03/09 Time: 12:02 pm Op: ELIZABETH18790 

Work to Begin Date: 8/05/09 Time: 12:45 pm 

State: NE County: DOUGLAS Place: OMAHA 

Address: 2703 Street: POPPLETON AVE 

Twp: 15N Rng: 13E Sect-Qtr: 28-NE 

Twp: Rng: Sect-Qtr: 

Legal Given: C 


Type of Work: LEAD REMEDIATION 


Location of Work: INCLUDE ALL EASEMENTS LOCATE ENTIRE PROPERTY 


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


: UNSURE ABOUT CORNER LOT 


Company : COASTAL ENVIRONMENTAL SERVICE 


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


Work Being Done For: COASTAL 


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


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV LEVEL3 MUD02 OMAHACOF 0PPDGPR6 QLNNEIF 


Service Area Contact Phone Nuniber Utility Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 8773668344 

LEVEL3 LEVEL3 COMMUNICATIONS, LLC NA Alt: 

Emerg: 8773668344 

Day: 4025047823 

MUD02 METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047970 

Day: 4024447197 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RON Alt: 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/3/2009 
Page 2 of2 

OPPDGPR6 OMAHA PUBLIC POWER DISTRICT NA

Day:

 Alt:

 4067289343 

 4062071494 

Emerg: 8887289343 

QLNNEIF QWEST LOCAL NETWORK NA

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/3/2009 
As-Built Drawing 

C

ENVIRONnENTA

 OASTA L L Omaha Lead Superfund Site O R O U r , INC . 

Name: 'J'hfxt ^ /. . LSr\e, o I ^ Omalia Lead Site 

Address3s:: -^7^ 3 Popple-fo ^ A tT Site Sketch 

Phone::/Vto2j^6-i5-2- 7 

7fz{Xf~i ', 

Team BVID# zio^n 

Sample Number Lead Concentration 

g.vsscfix" ppm 

ppm 

ppm 

ppm 7.1-O0t^6 ppm 

ppm 

ppm 

Date: North Arrow 

Time: ^ 

^ 

XRF Code /?0(^ 

Confirmation Sample 

F f Yes n No Sl ^ 

/=^AYes CD No 

B f \B s • No 

^2.Yes CD No 

^^.^ s • No » 

^ Yes cn No Q 

Yes • No • 

Legend 

Concretie Drip Zone Excavated Quadrants Excavated 

Area replaced wit:h 

Sod 

Area replaced with 

Rock/Mulch Area left bare 

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

^Xl^ ^ ^ ' 

Name: V~i>^n L . ^'/ ] «^o/ ^ Omaha Lead Site 

AddressT~i,7o3 ^ppleio ^ A* r Site Sketch 

Phor\eX*/oys</(, ­ JTST " 

y^S(^^ 

Team/g.^/y^^/j/c?<A/«g ^ BVID# 30^/7-2-

Sample Number Lead Concentralion 

/^YASOPXA - 2.0 U1 2 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

L._^ L/^f^il ^ fe:^ 

Dale: _2, North Arrow 

Time; H 

4-

XRF Code /yptf 

Confinmafion Sample 

^^Ye s n No ^ 

f^^yes O No 

«^Yes O No 

^2Yes CD No 

^^ s n No IS 

/? Yes n No D 

Yes D No n 

\v^*f 

\ \n^ IX 

61 ': t'^-yx ^ 

Lfe.vi(pv(gi j o /i j j 

S(i»o 

±h<i \ \ I 1 1 * 1 I « 

ay„^ 

.1 

4 
^ zt+io'L-V>^JOsaA

s 3|dLue N jsqiun n pea O uojiBJiuaouG

a #aiA X db 0 3PO

J /JIOl I ' c /L/^o

-

v ssajpp C ZoL' j uo^f?lddo V y«

Q BMBiu i pee S 8M N /vsojJVMyO ^ <^ojhi

i 
I 

Name: 7 ^ An L . Line n I'y Omaha Lead Stte Date: ijlijo p NorthArrow 

Address: XnC^ Popplttio^ A • Stte Sketch Time: XSISE^' ^ 

Phone:/Vb2)^4 - iVJ n 

'Tf ^ 

Team /^llc^f^jdl^^' 7 BVID # 30^/72 — xRF Code ^fo ^ 

Sample Number Lead Concentration Confimnation Sample 

ppm /^r Yes !=• No ^ 

ppm /^i-Yes n No •3»otT7. BiYeis CD No 

ppm ^^Ve s I^^ No 

ppm ^ ^ s 1=1 No B 

l*m ISM. 

ppm f>Yes Cl No n 

ppm Yes D No • 

ppm 

;;g==^<P7^Ey r 

==?: 

^ ^ 

^i 

^ pf^' V^ i?? 

6*' •^ttZ^5 ^^^ 1 61 t ^ o 

^1i^ TTtF 3 IJV 

7<b*n5»^ E IE-= ; :

i 

K^ DZ 2X0 o%V6 

?)^ J'" 

JC Jc f<^ 

- 1 ^ 

-ii 

•^: ' 

Jr I 

^ ' k 26 4-1 P-H S^ di ^61?13^ 

?-f^g*/.<>CH^-* 

/'<:>/>ptbr<p)t/ kx/ 
^^'^r^ 

COASTA L fii>iteiiitiiiTtt t • e w p, I H 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: ^ , ^ 

Owner's Name: ' Daytime Phone: 

/ V \Xei. 

Address of Property 

27o3 fovrL^^"^ 

covered by this 

AQreement; 

PURPOSE OF RESPONSE AcTiVmEs 

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($) 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 perfonned 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 vtnll 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 sut>confra€tors the right to enter the property, at all reasonable times 

and with prior notice, for the sole purpose of performing the woric. This access shall 

remain in effect unlU the work has been satrsfactority connpleted. The Grantor also 

agrees f o: 

Pagie 1 iA2 
COASTA L 

• 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 s^ve; 

• 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 worit. 

• Allow videotaping and/or photographing of the property. 

/AGREEMENT NOT TO INTERFERE i 

The Grantor agrees not to Interfere or tamper with any ofthe work activities, or with any 

of the work done, or v^th 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 

Go I grant access to my properties Q I do not grant access to my properties 

JMLI A / Date Signature

 Date plgrpdute 

Q I wouid like to be presettt during any sampling that is required. 
C \^ * S T ^ L 

RestoratlOFt Agreement 

The purpose of this 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 Environmental 

Protection Agency CEPA). 

Property ID: ^2jl^7'2 . 

Property Address: 7-7^2 ^ FOpr^tLrrO^N j /^s/ € 

Owner; 

On the attached diagram(s) indicate area(s) to excavate, surface structures and landscaping features and 

access locatioii(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 befbre Start of Remediation: 

1 ttem: 

--<Ji^- ^ V 

% ^ ( ^inUs

ttem: "^ / 

ttem: 

ttem: 

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

item: 

i!u..Q.w^l( FLm,ts W-TT (!>eJ^.,,-h 

ttem: r 

Item:: / J 

Item: 

Page 1 of 7 
C *J J4 S T M L rNVinONM I MTAI . 

C h O U ' IM C 

Items to Be Removed By Contractor During Remediation and Replaced 

Item 

Pre-existing property area, 

that will be excavated, that 

is cov^ed 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 n sketch ul the 

vpr!;iklcr I;VNCUI. 

Number of and size of 

each garden/ flower bed 

area. 

Attach a sketch of relative 

sizes and locaiiiniN. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

r-Jotc I'll.', S!\liie niii hv 

•jsr*c' '.c issue H j)l«n< 

>oin.'i;ei id \',\e prcpcr:^ 

o« ntr. 

Easement Area, to be 

excavated 

Quantity 

^ 

K y ^ 

i 

i^:> 

Landscape Inventory 

Unit 

Quadrants 

Each 

Each 

Each 

Each 

Square Feet 

$ 

Conditionrrype/Species 

Each P^x ^ ^CJW ^ 

Page 2 . y 
C *- A S 1 /- L I MVIHOMniNTA L 

O H O U r . IM C 

Addttional Comments / instructions: 

. 2- 3 t>^ s Mcn-ia (Sepo^e trtA^^T. 

I 

Q 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. 

^ I agree Q I do not agree 

7% ^ ^^^ ^ ^^^'^^ Eei^^^c2^ 7//)/m 

^wnA-'s Signature / Date Contractor's Signature Date 

Paoe 3 of / 
Date 

Project 

XRFID# 

Shot# 

'Ti^^ 

QXL 

^ ai. 

\?i.t^^ 

Average

Shot# 

SQL 

33Q1­

3-70 M 

Average

Shot# 

SSfll 

3 c ^ 

;?\/^ft 

3v<°l<\ 

Average

Shot# 

Tni?^ 

•2.-HM 

:^n«^ 

3111/ 

Average

lab sample # 

BVID M Zomz . XRF PROPERTY SAMPLE SHEET 


?)l2.i\6A Address Znci-^ B^yii»-h^ ^f ^ 

Omaha lead FP 2nd year opUon Sample time am/pm 

32Q«aC| sample length 30 sec 

Reading Sample area Shot # Reading Sample area 

^\^T9.H,n7^ ^^j i \'5ltf.Vi>Lir\Hn2 

t3ft.?m^)ftA %V 3ufil. 3\ft.%<\^u.'sq> Di 

f?0Viy.\.^i^7.a.S5 Depth V^,ft^^\Sn^ Depth 

M7M.^^7m Turn 3Qg\.-s*\-fc.lA.u( Io: 

 ^O j .' ^ ^ 1S . ^' A Average 1^ 1 .^.^> ^ \^.U l 

Reading Sample area Shol# Reading Sample area 

lU.tqt \%.V/>L ««^ 3u^ \ aft.\v»t\7.o\ 

e.o» ri \mvM^ VHna 

' 

:^i-ft2 fw.situno ^a^.M2Mvta& Depth 31/83 iw.3l/i\V<A Depth 

IM^HiAkii X .•^ItfS^ nT^.^i^M-i^S u 

 \*=S<4.9-^^ \S-2 5 Average QA.\ ^ \Z.\ Z 

Reading Sample area Shot# Reading Sample area 

<\v..?>H^nft\ 

M -flM^ \^v5^ ?^ 

^ n.32>\l.\oA Depth Depth 

^VXAoS^lZST. IH 

 l(V>.aii l \1..9A Average 

RETEST AREAS 

Reading Sample area Shot# Reading Sample area 

\'Sa.ftl*\S.v/& S^ iw.i^tft^zv? 

?An.Vi.li:\\.'\S Depth Depth 

u>5.'^'^^inn^ 8 ^ 1 

 \Cks>th'^ ^ VLA \ Average 

Lab result Sample area XRF Avg. 

Signature 

Print \Af^07 |1/1/)1^( 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3695 

Mode SOIL 

Time 2009-08-21 13:20 

Duration 122.01 

Sequence Final 

Flags 

AVERAGE (A^£gl691^69 4 ) 

ADDRESS ^70 3 poppleton ave 

QUAD/ZONE B2 

INSPECTOR Ventry 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb [399.354] ± f23JB36j 

Supen^ised By: (gCMfiJ(?Ji A 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 338.033 

Supervised By: 

Ceitlficate of Verification 

3691 

SOIL 

2009-08-21 13:18 

30.39 

Final 

20472 

2703 poppleton ave 

B2 

Ventry 

6 

CLEARANCE 

± Error 

± 22.362 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 238.344 

Supervised By: 

Certificate of Verification 

3692 

SOIL 

2009-08-21 13:19 

30.65 

Final 

20472 

2703 poppleton ave 

B2 

Ventry 

6 

CLEARANCE 

± Error 

± 18.903 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 596.646 

Supervised By: 

Certificate of Verification 

3693 

SOIL 

2009-08-21 13:20 

30.31 

Final 

20472 

2703 poppleton ave 

B2 

Ventry 

6 

CLEARANCE 

± Error 

± 29.550 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 424.394 

Supervised By: 

Certificate of Verification 

3694 

SOIL 

2009-08-21 13:20 

30.66 

Final 

20472 

2703 poppleton ave 

B2 

Ventry 

6 

CLEARANCE 

± Error 

± 24.529 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3705 

Mode SOIL 

Time 2009-08-21 13:28 

Duration 121.73 

Sequence Final 

Flags 

AVERAGE 

ADDRESS po^'()iet6h' 'av 

QUAD/ZONE easement 

INSPECTOR Ventry 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb JS4.P77. 3 L15-2481 

Supervised By: FpQAJl^S^OJ S 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 116.143 

Supervised By: 

Certificate of Verification 

3701 

SOIL 

2009-08-21 13:26 

30.55 

Final 

20472 

2703 poppleton ave 

easement 

Ventry 

1 

CLEARANCE 

± Error 

± 13.617 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 138.138 

Supervised By: 

Certificate of Verification 

3702 

SOIL 

2009-08-21 13:27 

30.59 

Final 

20472 

2703 poppleton ave 

easement 

Ventry 

1 

CLEARANCE 

± Error 

± 14.780 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 182.421 

Supervised By; 

Certificate of Verification 

3703 

SOIL 

2009-08-21 13:27 

30.30 

Final 

20472 

2703 poppleton ave 

easement 

Ventry 

1 

CLEARANCE 

± Error 

± 16.283 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 180.205 

Supervised By: 

Ceitlficate of Verification 

3704 

SOIL 

2009-08-21 13:28 

30.29 

Final 

20472 

2703 poppleton ave 

easement 

Ventry 

1 

CLEARANCE 

± Error 

± 16.312 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3700 

Mode SOIL 

Time 2009-08-21 13:24 

Duration 122.18 

Sequence Final 

Flags 

AVERAGE ^mm§^^99-x 

ADDRESS ^0 3 poppleton ave QUAD/ZONE PZ INSPECTOR Ventry DEPTH 6 SAMPLE TYPE CLEARANCE NOTE 

ppm ± Error 

Pb 

Supervised By: (^C^^p^j?/^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3696 

Mode SOIL 

Time 2009-08-21 13:22 

Duration 30.55 

Sequence Final 

Flags 

BVID # 20472 

ADDRESS 2703 poppleton ave 

QUAD/ZONE PZ 

INSPECTOR Ventry 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 96.844 ± 12.808 

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 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 114.836 

Supervised By: 

Certificate of Verification 

3697 

SOIL 

2009-08-21 13:23 

30.59 

Final 

20472 

2703 poppleton ave 

PZ 

Ventry 

6 

CLEARANCE 

± Error 

± 13.538 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 97.318 

Supervised By: 

Certificate of Verification 

3698 

SOIL 

2009-08-21 13:23 

30.54 

Final 

20472 

2703 poppleton ave 

PZ 

Ventry 

6 

CLEARANCE 

± Error 

± 12.691 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Ceitlficate of Verification 

XL3t-32089 

Reading No 3699 

Mode SOIL 

Time 2009-08-21 13:24 

Duration 30.50 

Sequence Final 

Flags 

BVID # 20472 

ADDRESS 2703 poppleton ave 

QUAD/ZONE PZ 

INSPECTOR Ventry 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb ± 94.654 12.520 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3690 

Mode SOIL 

Time 2009-08-21 13:17 

Duration 121.53 

Sequence Final 

Flags 

AVERAGE rAvg^.3j68^-3609 

ADDRESS '-2703 poppleton ave 

QUAD/ZONE DZ 

INSPECTOR Ventry 

DEPTH 12 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb f"231.23r~7 

Supervised By : ^CaBJ(?Q6 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 136.616 

Supervised By: 

Certificate of Verification 

3686 

SOIL 

2009-08-21 13:15 

30.28 

Final 

20472 

2703 poppleton ave 

DZ 

Ventry 

12 

CLEARANCE 

± Error 

± 14.716 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 318.890 

Supervised By: 

Certificate of Verification 

3687 

SOIL 

2009-08-21 13:15 

30.32 

Final 

20472 

2703 poppleton ave 

DZ 

Ventry 

12 

CLEARANCE 

± Error 

± 21.576 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 159.826 

Supervised By: 

Certificate of Verification 

3688 

SOIL 

2009-08-21 13:16 

30.64 

Final 

20472 

2703 poppleton ave 

DZ 

Ventry 

12 

CLEARANCE 

± Error 

± 15.754 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 309.591 

Supervised By: 

Certificate of Verification 

3689 

SOIL 

2009-08-21 13:17 

30.29 

Final 

20472 

2703 poppleton ave 

DZ 

Ventry 

12 

CLEARANCE 

± Error 

± 21.611 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3685 

Mode SOIL 

Time 2009-08-21 13:13 

Duration 121.97 

Sequence Final 

Flags 

AVERAGE /Wofi6Sl'-.36.84/ 

ADDRESS 2703 poppleton ave 

QUAD/ZONE Fl 

INSPECTOR Ventry 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb ^M.IOOJ' ± & ! ^ 

Supervised Bv: r/IO A MVQ^ A 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 88.158 

Supervised By: 

Certificate of Verification 

3681 

SOIL 

2009-08-21 13:11 

30.56 

Final 

20472 

2703 poppleton ave 

Fl 

Ventry 

6 

CLEARANCE 

± Error 

± 12.005 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3682 

Mode SOIL 

Time 2009-08-21 13:12 

Duration 30.31 

Sequence Final 

Flags 

BVID # 20472 

ADDRESS 2703 poppleton ave 

QUAD/ZONE Fl 

INSPECTOR Ventry 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 80.506 ± 11.701 

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 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 114.363 

Supervised By: 

Certificate of Verification 

3683 

SOIL 

2009-08-21 13:12 

30.51 

Final 

20472 

2703 poppleton ave 

Fl 

Ventry 

6 

CLEARANCE 

± Error 

± 13.506 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3684 

Mode SOIL 

Time 2009-08-21 13:13 

Duration 30.59 

Sequence Final 

Flags 

BVID # 20472 

ADDRESS 2703 poppleton ave 

QUAD/ZONE Fl 

INSPECTOR Ventry 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb 73.372 ± 11.251 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3717 

Mode SOIL 

Time 2009-08-21 13:45 

Duration 122.51 

Sequence Final 

Flags 

AVERAGE feycLgL371f3'^37t6,y 

ADDRESS 2703 poppleton ave 

QUAD/ZONE B2 

INSPECTOR Ventry 

DEPTH 8 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb ± /T2.91;3 >.j 

Supervised By: /^(ih^lo/ ^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 159.866 

Supervised By: 

Certificate of Verification 

3713 

SOIL 

2009-08-21 13:43 

30.95 

Final 

20472 

2703 poppleton ave 

B2 

Ventry 

8 

CLEARANCE 

± Error 

± 15.675 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 111.686 

Supervised By: 

Certificate of Verification 

3714 

SOIL 

2009-08-21 13:44 

30.56 

Final 

20472 

2703 poppleton ave 

B2 

Ventry 

8 

CLEARANCE 

± Error 

± 13.264 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3715 

Mode SOIL 

Time 2009-08-21 13:45 

Duration 30.46 

Sequence Final 

Flags 

BVID # 20472 

ADDRESS 2703 poppleton ave 

QUAD/ZONE B2 

INSPECTOR Ventry 

DEPTH 8 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 86.614 ± 11.927 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3716 

Mode SOIL 

Time 2009-08-21 13:45 

Duration 30.54 

Sequence Final 

Flags 

BVID # 20472 

ADDRESS 2703 poppleton ave 

QUAD/ZONE B2 

INSPECTOR Ventry 

DEPTH 8 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 65.994 ± 10.785 

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

I ^^^ ^ I Coastal Environmental Group inc. 

\!^^^ ^ www.coastalhazmat.com 

'^tPHOtt^ COASTA L 

HKIIONHINTAl C lO U P. IN C 

EXECUTIVE SUMMARY: 

BVID #20472-(2703 POPPLETON AVE) 

No Issues or Concerns Q Issues/Concerns 

Detail Explanation: 
I ,St«t 

EPA Property Close Out Form 

27£3^ X>or/>C^T<^ ^" ^ Property #: 20^.72 ^ 

Property Addrcsr. ^^ ^ 

'«gH^ Datc/Tlmc: 

Owner's Name:. ^ ^^ E 

Quads Excavated: 

Contractor Group. 

Excavation Yes No General 

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

( / ' 

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

Grading Sod and Vegetation 

Yes No 

1. I>oes the grading around the perimeter ofthe house in excavated areas generally slope away 

Grom the house? 

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

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

day time period) ^__ 

4. Are sodded areas generally firm and evenly graded? tX^ 

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

time period) • 

6, Was the property graded such that waier will not pool on ihe property'? 

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

Gates, Fences and Retaining Walb 

Yes No 

I. Do gates open and close freely? (Ifappiicable) 

2. Were all gates or fences taken down during restoration acliviiies reinstalled? (If applicable) 1 ^ ' 

3. Was damage to gates or fences avoided? (Ifappiicable) t ^ " 

4. Was damage to retaining walls avoided? (Ifappiicable) 

Foundation, Siding and Gutters 

Yes No 

I. Was damage to the siding or trim avoided? i / " 

2. Was damage to the foundation avoided? 

tX ' 

Was damage lo windows avoided? 

4. Was damage to windows or door screens avoided? 1 ^ ^ 

5. Was damage lo downspouls or downspout extensions avoided? 

^ ^ 

Sidcwallts and DrKcways (Concrete) 

Yes No 

1. Was damage lo driveway surfaces avoided? 

\^ ' 

2. Was damage to walkway surfaces avoided? < ^ ' 
0>»'ncrs comments: 

inspection notes: 

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

EPA Represenlalive i^& K lJi[/ k A ^ Date: T/^// 
Property Completion Agreement 

riiis agrecincnl documenis the compielion of remedial activities perCormeci on my properly. My signature 

wil] desijjnalc Ihal I am .salislled with the restoration of my properly, and Ihal no items are in questions, 

now. or at any time in the future, except those ilems lisied below, ifany. 

Properly II): 2/i*'l7^ 

Property Address: ^^ j I? ^l^.fp>^ 4^ . 

Phone 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

[ J ^ I acrcc re.sfoi/irion i.s completed, except as nofe<l 

|_ | I do not acicc rcslomtion is completed 

liA^ ?//-i^ 

C)^vna('s- SiRnadirc ? Date 

U
Water Bill Settlement 

Property ID 20472 

Property Address 2703 Poppleton Ave 

Tenant Nathan Dylce 

I have received from the contractor, Coastal Environmental Group Inc. (Coastal), the sum of $ 103.86 for 

water usage required to maintain the sod. 

Checic Number 1828 

Value of Checic $ 103.86 

Made Out To Nathan Dyke 

Description of Settlement 

To reimburse tenant for estimated water charges on their MUD monthly invoices. 

My signature below is acltnowledgement of the receipt of the sum listed above, which i further 

aclcnowledge to be fair compensation and full payment for the above, and release Coastal 

Environmentai Group inc. from further obligations or liability. 

^ Signature ( Date Q>ntractor's Signature * ' Date 

•^"i. 'gr*""^^«y'j --•.- "• •w'-'^"?'t^.^'-js^ass5g!^v*>/^^-^iy:''''4v 

COASTAL ENVIRONMENTAL QROUP INC. 1828 

2411 MAm>IA STREET 27-5/1040 003 

OMAHA, NE 68105 6247372904 

\\\\\ ^ DATE 

PAY TO T 

ORDER O.^!lia±han_buk F 

^ $\05' .tk 

QyuVuAmcUcd tWST Q^^d ^ m. -DOLUVRS fi SSn 

WWIiF!w9oBinli,NA 

Nibmk i 

wilifit9u,ijum 

•: 101*00005ai: E.EU73?2qoitii* oiasa Hartand CUirka