### CONTRACT 

## # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE US Army Corps of Engineers



### ECC Certification for Property Closeout

OLSID 29212 Property Address 1810 Ohio St Field Work Started 8/7/2007 Field Work Completed 8/9/2007 Summary: 

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

# • F2 excavation depth was 12 inches below ground surfaces. 

# • B1 excavation depth was 7 inches below ground surfaces. 

# • B2 excavation depth was 8 inches below ground surfaces

.. 

# • Verification samples confirmed 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: Owners requests: None 

# M-/k-.- ECCOCM Title Jeff Hubbard USACE Con Rep 

# Jo/p//f) Name Title Date Signature

### CONTRACT 

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

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Analytical Results Summary Sample ID # 

## 29212 1810 Ohio St

Sample

Type Quadrant 

# I Depth 

# I Date Collected XRF Results (ppm) (avg.) 

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## II 0 

## II 8/3/2007 228 II=======D=E======l11=

### ==F2==== 12 ==8==/4:=/2==:0==07=====ll====1==36=====U 1F====D=E===lF==B=2==

### 8/4/2007=~F===26=9======l1 DE B1 248

Sample IDSample ID is a particular residential property ID from which the sample is collected. The sample type identifier (with sequential 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; Fl or F2 Front Yard One or Front Yard Two BI or 82'" 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

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### Omaha Lead Site 46130Omaha Lead Site Omaha, NE U.S. Environmental Protection Agency Region VII Residential Yard Soils Environmental Restoration SelVices !'RCJ!'f RTY ,\CCf.S\ It,) h..: t:Pll1pkkd b: 1'lop":l"1: (J\llh'l)**IJ,II~llc,,'ihll c"t~1**  f,'II11,1 C"I',1I"1I)1 P\)I' f,\I()1 il:lll1c'**~d 1"~(JlI-2:;:;-()-l2~**  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 information please contact EPA at**1~800-223-0425.** 

### Property Access Granted By 

# J '"**i?",.~** (Please Print Name) (Date) NOTE: 

### Granting permission DOES NOT necessarily imply your property will be remediated at this time.

(ZIP) Residence Address: 

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## aMlllH AlR :".. (CITY) (STATE) 

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## CelJrr~ Property owned by:

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### /11 Owners mailing**address:_-J~~~-'.2l1~~~~=­ .u~I1I.¥J1~~~_---'.~~~'!.­**  

# __**J.-/).~(** 

### N f91{ oS 

# r 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 DYES 

# o NO Has the interior been painted or covered since 1978? DYES 

# 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 tmder this agreement are pursuant to Section 104 ofCERCLA, 42 V,S.c. 9604. EPA's right of access to the property for in Section 104(e) ofCERCLA. 42 U.S ,C. 9604 (e), which provides entry for, "determining the need for response. or choosing or taking any response action under this title, or otherwise enforcing the provisions of this title," Access Attempts: First: Second: Third:

_

### pg._of_ 

# List of Existing Conditions Property Address: 

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Owner: 

# Q600", Date: 

# ;;jaY/o7 BVID# 

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Ref: Photo # 

## Description

Owner Signature ECC Print & 

## Sign Print & 

## Sign

### Contract No. W912DQ·04-D w 

### 0017, 

### Task Order DKOI 

### Omaha Lead Site, Omaha, NE Pronertv Closeout Agreement Property Address BVID 

# I L8"/O Ofllo S/- 

# c)9JJJ f1.W)- Property Owner Is the Owner the Resident? DYes 

## CITY. OF 

# o J'vJ1? 

# /111 Compliance Statement: U.S. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps ofEngineers (USACE). Omaha District to conduct environmental restoration selVices for the Omaha Lead Site. USACE Omaha is, working with Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration selVices. Your cooperation in giving EPA1USACElECC 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 remedial/restoration efforts at the property to my satisfaction

.

.

# ~agree that restoration is completed at my property, except as noted Comments (if 

### applicable):



# IX··· L 

# /1 

# >u**J'l.-17/~** 7 /' II 

### Pr¢ty' Owner's Signature Datt

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

Remediation Contractor:

## -_..::£:::::;..::ce~--------------- Property Identifier Number:

_ Property BVID Number:

### _---.:et-"--'CJ...:::~~/L..I~.Ao..... 

# __ Property Address:**---- J/L...:l~/..III:IJ_=()..L.:'M..Lt={)_..r.::....rt.._**  

## _ Property Owner's Name:**_~C....::...t./~tY-I--......lI'O~F_-=O:;.&!Jl1.;...:IJ.J?.u.JfJ4.1...:-.** 

## _ (above infonnation to 

### be filled out by remediation contractor prior to delivery of fonn to Property Owner) 

## ••••••••••••••••••••••••••••••••••••••••••••••  .**  ••••• ****** •••••••••••••• Instructions to Property Owner: 

### This form is provided to you as a means oftrying 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. Army 

### 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 of satisfaction with the Contractor's work by selecting a numerical rating (ranging from 1 to 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.) 9-10 "excellent" 7-8 

### "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 if needed)

Property Owner's Signature: 

# lL, 

# k Dale: 

## I 

# '-L 7 

# J d7