TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID# jqSB^ DATE= ^/l/// U 

ADRESS: 2filV - A) J- i SIREMEDIATION CONTRACTOR: COASTAL ENVIRONMENTAL GROUP Contract: EP-R7-09-06 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

( / Executive Summary 

[j EPA-provided property sketch 

1^ '^ Signed Access Agreement for subject property 

iSTyf Signed Access Agreement (s) for adjacent property 

B Restoration Agreement 

• v l ^ Settlement documents (i.e., for damage or to replace plants, etc.) 

^ I/|lpon^''mation data 

h* ^Photographs SOD 

Pre-Excavation 

Excavation 

As-Built sketch 

Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

Description of areas of areas not meeting ROD cleanup criteria 

Utility clearances 

Property Information from Douglas County Assessor's Office 

D 

t

atiire-/:QASTAL Signature- EPA . NX" 

30262924 °^*^ 

Superfund 
Property Access Checklist 

Property ID: ^ g^^c^ D WORK STARTED ON: / I 

Property Address: D WORKCOMPBLTED ON: I I 

O^vncr: ^v^y^^ ^ VO^V^«^ Rcnten 

Address: Phone: 

Fax: 

Cell/Pager 

Phone: Mf,>. ,Hs\,?AU \ Additional Information: 

Fax: 

Cell/Pager. 

D Notification Letter Sent: / / By: 

'Ql Access Agreement Sipicd; Vt)/^k./>a »>= ViV.W /luLlrV-.,^^ \ 

0 Restoration Agreement Signed; vo /:n3 /^ a By= o.o\ L 1 h<\t\^. , V 

D Topsoil SampUng (if appUcable) 1 1 By: 

D Disposal Samplhig (if applicable) / / By; 

D Garden Sampling (if applicable) / / By: 

D Utility Clearance Called: / / By: 

M Video/Pbotos (Before) On:V5 1 -z&J .. ^ *y* w vt-vt 1 u : (LW. .. I 1 

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

D Video/Pbotos (After) On: / / By: 

D Video/Pbotos (30-Day) On: / 7 By: 

D Property Completion Agreement Signed: / / By: 

D Final Report Issued: / / By: 1 

Air Monitorine (as applicable • 

D Community D Crew On: / / By: 

Results: 

D Community Q Crew On: / / By: 

Results: 

Q Community QCrc w On: / / By: 

Results: 

Omaha Lead Site 
Douglas County Account Intea|tion 

Page 1 of2 

Douglas County, Nebraska Property Record - R2002870000 

Print Reoort 

View Interactive GIS Mao Information is valid as of 2010-8-30 Treasurer's Tax Reoort 

New Feature ^ S> ^ Subdivision Sales Search 

Owner 

WATSON RICHARD W 

ETAL 

2625 MAPLE ST 

OMAHA NE 68111-0000 

Property Informatio n 

Key Numtier: 0287 0000 20 

Account Type: Residential 

Parcel Numtier: 

2002870000 

Parcel Address: 2817 N 27 ST 

OMAHA NE 68111-0000 

Legal Description: PATRICKS -A S- ADD LOT 9 BLOCK 2 S 30 FT LTS 8 & 30 X 102 

Value Informatio n 

Land Improvement Total 

2010 $200.00 $0.00 $200.00 

2009 $200.00 $0.00 $200.00 

2008 $200.00 $0.00 $200.00 

2007 $200.00 $0.00 $200.00 

2006 $200.00 $0.00 $200.00 

2005 $200.00 $0.00 $200.00 

Land Informatio n 

Acres SF Units Deptfi Width Vacant 

0.07 3060.0 0.0 102.0 30.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R200... 9/3/2010 
Douglas County Account I wtion Page 2 of2 

Sacred Heart 

Parish Chli»c^ 

Map data ecOiOOolsle! 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R200... 9/3/2010 
3/31/2011 www.dhon.org/irthinternet/DHONNotic 

Create Another Ticl^et Back tffrth Intemet | c [Send Email 

• YOUR TICKET NUMBER IS 2700073. 

Original Call Date: 

Work to Begin Date: 

3/31/11 

4/04/11 

Time: 1:19 pm 

Time: 1:45 pm 

Op: ALFONSO18790 

State: NE 

Address: 2817 

County: 

Street: 

DOUGLAS 

N 27TH ST 

Place: OMAHA 

Twp: 15N Rng: 13E Sect-Qtr: 09-NE-SE 


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: (402)934-2811 


: PLEASE INCLUDE ALL EASEMENTS 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name; ALFONSO Phone: (402)934-2837 


Work Being Done For: Coastal 


Depth of Excavation: 4ft Corner Lot; N Front: Y Rear; 


Involves Tunneling or Horizontal Boring ; N Explosives: N 


CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Nimiber 

Utility 

Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

MUDOl METROPOLIT/y^ UTILITIES 

DISTRICT 

SANDY MUD 

Day: 4025047823 

Ak: 

Emerg: 4025047970 

OMAHACOF 

CITY OF OMAHATRAFFICSEWER 

RICH/TRAFFIC

Day: 4024447197 

 Ah: 4024445161 

Emerg: 4024445160 

0PPDGPR5 

OMAHA PUBLIC POWER 

DISTRICT 

ELM 

LOCATING 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

dhon.org/irthinternet/.../MessageText.as.. 1/2 
3/31/2011

QLNNEIC

 ^^www.dhon.org/irthinternet/DHONNotic 

FTM 

 QWEST LOCAL NETWORK rr^r^ATTxir^

Day:

 Alt:

 4067289343 

 4062071494 

Emerg: 8887289343 

dhon.org/irthinternet/.../MessageText.as... 2/2 
04/01/11 10:01 AM ^^ (111)111-1111, QWEST ^^^ 01/02 

To: COASTAL ENVIRONMESNTAL SERVICE Attn: ALFONSO 

Voice: 4029342837 Fax: 4029342811 

Re: Message from Qwest 

Message from Qwest ^^^ ^ -


Ticket: 2700325 


County: DOUGLAS Place: OMAHA 


Address: 2626 PARKER ST 


QLNNEIC: 


The described dig area of your locate request has been checked and is clear for 


Qwest Communication's Local Network. If you have any cpiestions please call 


Qwest at 1-800-283-4237. 


Ticket: 2700358 


County: DOUGLAS Place: OMAHA 


Address: 2202 FLORENCE BLVD 


QLNNEIC: 


The described dig area of your locate request has been checked and is clear for 


Qwest Communication's Local Network. If you have any questions please call 


Qwest at 1-800-283-4237. 


Ticket: 2700073 


County: DOUGLAS Place: OMAHA 


Address: 2817 N 27TH ST 


QLNmlC: 


The described dig area of your locate request has been checked and is clear for 


Qwest Communication's Local Network. If you have any questions please call 


Qwest at 1-800-283-4237. 


Message from Qwest 

03/31/11 02:37 PM (402)934-0016, Cox Communications
 03/04 

To:- COASTAL ENVIRONMENTAL SERVICE Attn: ALFONSO 

Voice: 4029342837 Fax: 4029342811 

Re: Response to Dig Request 

This is an ittportant message from Cox Cononunications replying to your request 


to locate our underground facilities in an area described on the one call 


center ticket. We do not have any underground facilities in your dig area 


y'=i sB ^ 

Ticket: 2700071 


County: DOUGLAS Place: OMAHA 


Address: 1507 OHIO ST 


CXCATV: 


This is an important message from Cox Communications replying to your request 


to locate our underground facilities in an area described on the one call 


center ticket. We do not have any underground facilities in your dig area. 


If you have any questions, please call our office at 402-934-0469 


Ticket: 2700073 


County: DOUGLAS _ Place: OMAHA 


Address: 2817 N 27TH ST 


CXCATV: 


This is an important message from Cox Communications replying to your request 


to locate our underground facilities in an area described on the one call 


center ticket. We do not have any underground facilities in your dig area. 


If you have any questions, please call our office at 402-934-0469 


Ticket: 2700077 


County: DOUGLAS Place: OMAHA 


Address: 1612 CORBT ST 


CXCATV: 


This is an important message from Cox Communications replying to your request 


to locate our underground facilities in an area described on the one call 


center ticket. We do not have any underground facilities in your dig area. 


If you have any questions, please call our office at 402-934-0469 


If you have any questions please contact our local Cox Communications office AT 


934-0469. 

u.3/ji/ii u^:^o fM (1UZ) ^'ii-//^u, Omaha Public Works 06/10 

To: COASTAL ENVIRONMENTAL SERVICE Attn: ALFONSO 

Voice: '4029342837 Fax: 4029342811 

Re: Response to Dig Request 

This is an important message from Omaha Public Works replying to your request 

to locate our underground facilities in an area described on the one call 

center ticket. /-> ^ , 

Ticket: 2700071 


County: DOUGLAS Place: OMAHA 


Address: 1507 OHIO ST 


OMAHACOF (Sewer): 


City of Omaha Sewer- No Conflict per info on the one call ticket 


OMAHACOF (Traffic): 


The City of Omaha Traffic Engineering Division has determined our facility is 


not in conflict with the dig site provided by the one call center. 


Ticket: 2700073 


County: DOUGLAS Place: OMAHA 


Address: 2817 N 27TH ST 


OMAHACOF (Sewer): 


City of Omaha Sewer- No Conflict per info on the one call ticket 


OMAHACOF (Traffic): 


The City of Omaha Traffic Engineering Division has determined our facility is 


not in conflict with the dig site provided by the one call center. 


Ticket: 2700077 


County: DOUGLAS Place: OMAHA 


Address: 1612 CORBI ST 


OMAHACOF (Sewer): 


City of Omaha Sewer- No Conflict per info on the one call ticket 


OMAHACOF (Traffic): 


The City of Omaha Traffic Engineering Division has determined our facility is 


not in conflict with the dig site provided by the one call center. 


If you have any additional questions please contact Omaha Public Works. 

29589 

As-Built Drawing ^ 

C OASTA L Omaha Lead Superfund Site ENVIItONHENTAL C « O U r . IN C 

OLS#: 29589 

Date Excavated: 4/7/2011 

Date USEPA Signed Off: 7/12/2011 

Area Sodden: 4200 so ft 

Owne Omaha Lead Site r Name: RICHARD W WATSON 

Site Sketch Address: 2817 N 27 ST 

Phone: H: W: 

Omaha Lead Site 46130 

Legend 


Concrete V^ Drip Zone Excavated Quadrants Excavated 


Area replaced with Area replaced with 


Area left bare 
 Sod Rock/Mulch 


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

iimiiiiMiiH 29589 

Omaha Exterior Paint North Arrow Lead Site 

O Owner Name: RICHARD VV WATSON ^ Site Sketch • Good 

Address: 2817 N 27 ST • Poor 

|~} Not paint 

Omaha Lead Site 46130 
29589 

Omaha North Arrow Lead Site Exterior Paint Owner Name: RICHARD W WATSON 

Site Sketch • Good Address: 2817 N 27 ST • Poor Phone: H: W: • Not paint 

Omaha Lead Site 46130 
29589 

Omaha Lead Site Exterior Paint Owner Name: RICHARD W WATSON 

Site Sketch • Good Address: 2817 N 27 ST • Poor Phone: H 

Q Not paint 

Omaha Lead Site 46130 
..ePSM , 

COASTA l 

SNVmONHtltlAl 

C K 0 tl r . IN 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: 4->iyic"^xr^ 

Owner's Name 

immi 

Address of Property 

covered by this 

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 with 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 performing the work. This access shall 

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

agrees to: 

Page 1 of 2 
.\*' *> 

COASTA L \y--yf IHVmOMKfKTAl 

6 It O U r IN C 

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 Granlor'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; 

c 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. 

c 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 

Signature Date Signature Date 

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

Page 2 of 2 
COASTA L 

C fl O U P , IN C 

Restoration Agreement 

The purpose of this agreement is to provide a mutual agreement as to conditions of the property prior to 

remediation activities. This will also serve as dociimentation for the purpose of assuring that restoration 

activities are completed to the satisfaction ofthe property owner and the United States Environmental 

Protection Agency (EPA). 

Property ID: r:^q^^ ^ 

Property Address: ppg^] 7 t\ l oi l 7 ^ 

Owner: R(OyO . \hr\r^(~A 

Phone: 

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 return of these items is the Owner's responsibility. 

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

Item: 

UmJ^y —' yyyz^^ 

Item: ,.——" ^ 

Item: ^^^^^ ^ 

Item: 

y ^ 

Page 1 of. 
C O A S T A L CNVIHOMMtNTA L 

G • O U P . IM C 

Items to Be Removed By Contractor During Remediation and Replaced 

ttem: 

£»// fa, &I 

ttem: 

f ^ -P^ A l 

ttem: 

ttem: 

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 tlie 

.sprinkler layout. 

Number of and size of 

each garden/ flower bed 

area. 

Atlacii a skeicli ot relaiiNC 

sizes and locations. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

Note this \alue will he 

usfd ((» issue a plant 

%(»iiclier IO the propcrl} 

owner. 

Easement Area, to be 

excavated 

P>-^ 

^ 

Landscape Inventory 

Quantity Unit Condition/Type/Species 

f9- Quadrants V^S^IULQ. 

^y Each 

Each 

^ 

Each 

^ 

Each 

Square Feet 

Each 

Page 2 of. 
COASTA L 

C K O U P , INC . 

Additionai Comments / Instructions: 

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

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

removing and replacing soil underlying a gravel or dirt area on your property that you may be 

using as a driveway or vehicie 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 cited by the city if you use a gravel or dirt area 

as a driveway or parking area, not withstanding any removal or replacement of soil by the EPA. 

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

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

VPIPieas . e check this box if you understand the information outlined above. 

'Check the box if Owner does not want CEG to document Interior foundation walls and possible 

fe-existing damage. By checking this box CEG Is not responsible for any damage done to the 

Interior of house, including foundation cracks or fissures. 

MlI agree n I do not agree ! 

Tyj^^y'^/ ./9pyA>z:^. 77) -^i, y/) 

Owner's Signature Date 

Page 3 of. 
BVID # 9^S8° i 

XRF PROPERTY SAMPLE SHEET 

Date ^/- ? ' V 

Project Omaha Lead ARRA 

XRF ID# szoe^i 

Shot# Reading Sample area 

HU ?sZ(^'^\nXlAl\ F:A 

m B?.9 S2+ Z5,r^-:? Depth 

H^ 2^l^.?<^-t23.Ui. I" 

Average -^\ U \R- ^ 2^.?. D 

Shot# Reading Sample area 

s^ •2iq.5t2?> \^ 67 

3":) 711^.1 t 7.7.5^ Depth 

?>io g7M.m IxWn?. i^ . 

Average 2^ 2 ^ H t 2?^.M 4 

Shot# Reading Sample area 

Depth 

Average 

Address 

Sample time 

sample length 

Shot# 

MD 

m 

M l 

Average

Shot# 

•2^ 

2<\ 

-^n 

Average

Shot# 

Average 

RETEST AREAS 

Shot# Reading Sample area Shot# 

Depth 

Average Average 

Signature 4^ ^ 1 ^ 

Print_JULLM tVv 

a^\ ^ >o ;:i ^ ^ ^ 

am/pm 

30 sec 

Reading Sample area 

nR';^*!^^!')^.^ F2 

2\^ ni t ?n.7 Depth 

nc^M^\t^?i,a M« 

 1^1. U A- \ q P S 

Reading Sample area 

7S?sS^i2^(V . R\ 

2bi/5.^ t 7.^ .^n Depth 

2l^,-|l- V i^y,!, M" 

 7ip U • 2 t X 3 . m 

Reading Sample area 

Depth 

Reading Sample area 

Depth 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 49 

Mode SOIL 

Time 2011-04-07 21 :42 

Duration 90.50 

Sequence Final 

Flags 

AVERAGE Avg of 46-48 

ADDRESS 2817 N 27 ST 

QUADRANT EA 

DEPHT 1" 

XRF TECH M. MATEUS 

MISC CLEARANCE 

NOTE CLEAR 

ppm Error 

Mo < LOD 7.815 

Zr 307.371 ± 13.712 

Sr 193.308 ± 9.663 

U < LOD : 14.063 

Rb 66.607 ± 6.531 

Th < LOD 14.098 

Pb 316.181 ± 24.301 

Se < LOD 6.332 

As < LOD : 32.069 

Hg < LOD \ 13.268 

Zn 379.646 ± 32.471 

W < LOD 92.653 

Cu 55.617 ± 23.707 

Ni < LOD : 78.163 

Co < LOD 1 214.217 

Fe 24220.172 ± 452.294 

Mn 687.423 ± 119.072 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 46 

Mode SOIL 

Time 2011-04-07 21:41 

Duration 30.17 

Sequence Final 

Flags 

BVID 29589 

ADDRESS 2817 N 27 ST 

QUADRANT EA 

DEPHT 1" 

XRF TECH M. MATEUS 

MISC CLEARANCE 

NOTE CLEAR 

ppm Error 

Mo < LOD 7.589 

Zr 294.705 ± 13.205 

Sr 201.245 ± 9.632 

U < LOD : 13.281 

Rb 65.465 ± 6.295 

Th < LOD 13.567 

Pb 329.362 ± 24.214 

Se < LOD : 6.228 

As < LOD 31.970 

Hg < LOD 13.163 

Zn 370.764 ± 31.507 

W < LOD : 93.530 

Cu 67.189 ± 23.807 

Ni < LOD 76.423 

Co < LOD 201.959 

Fe 22879.713 ± 430.066 

Mn 770.824 ± 120.629 

Supe rvised 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 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Mo < LOD 

Zr 313.340 

Sr 188.372 

U < LOD 

Rb 64.199 

Th < LOD 

Pb 332.324 

Se < LOD 

As < LOD 

Hg < LOD 

Zn 427.843 

W < LOD 

Cu 52.265 

Ni < LOD 

Co < LOD 

Fe 25762.971 

Mn 587.483 

Supervised By: 

Certificate of Verification 

47 

SOIL 

2011-04-07 21:42 

30.16 

Final 

29589 

2817 N 27 ST 

EA 

1" 

M. MATEUS 

CLEARANCE 

CLEAR 

Error 

: 7.829 

± 13.876 

± 9.601 

14.949 

± 6.557 

: 14.548 

± 25.028 

6.531 

32.604 

: 13.755 

± 34.519 

\ 93.630 

± 23.743 

81.443 

223.052 

± 468.680 

± 113.825 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Mo < LOD 

Zr 314.069 

Sr 190.308 

U < LOD 

Rb 70.157 

Th < LOD 

Pb 286.857 

Se < LOD 

As < LOD 

Hq < LOD 

Zn 340.330 

W < LOD 

Cu 47.397 

Ni < LOD 

Co < LOD 

Fe 24017.830 

Mn 703.963 

Supervised By: 

Certificate of Verification 

48 

SOIL 

2011-04-07 21:42 

30.17 

Final 

29589 

2817 N 27 ST 

EA 

1" 

M. MATEUS 

CLEARANCE 

CLEAR 

Error 

: 8.027 

± 14.055 

± 9.755 

13.960 

± 6.739 

: 14.178 

± 

23.661 

: 6.237 

31.632 

12.886 

± 31.388 

1 90.798 

± 23.569 

76.623 

217.641 

± 458.138 

± 122.761 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

Supervised 

ppm 

< LOD 

407.175 

186.842 

< LOD 

67.736 

14.589 

^87.693 

< LOD 

< LOD 

< LOD 

206.763 

< LOD 

42.890 

< LOD 

< LOD 

19992.924 

564.953 

By: 

Certificate of Verification 

43 

SOIL 

2011-04-07 21:38 

90.50 

Final 

Avg of 40-42 

2817 N 27 ST 

F2 

4" 

M. MATEUS 

CLEARANCE 

CLEAR 

Error 

7.884 

± 15.170 

± 9.399 

15.216 

± 6.627 

± 8.625 

± 19.057 

5.959 

24.872 

12.509 

± 24.467 

\ 90.066 

± 22.320 

75.387 

: 193.065 

± 406.466 

± 108.792 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

40 

SOIL 

2011-04-07 21:37 

30.16 

Final 

29589 

2817 N 27 ST 

F2 

4" 

M. MATEUS 

CLEARANCE 

CLEAR 

Error 

: 7.795 

± 15.180 

± 9.364 

15.572 

± 6.802 

± 8.811 

± 18.802 

6.380 

24.277 

12.191 

± 24.630 

88.625 

± 23.267 

77.465 

196.606 

± 407.955 

± 105.612 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

ppm 

< LOD 

403.808 

183.667 

< LOD 

70.924 

17.121 

178.552 

< LOD 

< LOD 

< LOD 

208.217 

< LOD 

53.204 

< LOD 

< LOD 

19956.420 

504.947 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 41 

Mode SOIL 

Time 2011-04-07 21:37 

Duration 30.17 

Sequence Final 

Flags 

BVID 29589 

ADDRESS 2817 N 27 ST 

QUADRANT F2 

DEPHT 4" 

XRF TECH M. MATEUS 

MISC CLEARANCE 

NOTE CLEAR 

ppm Error 

Mo < LOD 8.116 

Zr 400.162 ± 15.127 

Sr 186.570 ± 9.436 

U < LOD \ 15.144 

Rb 70.067 ± 6.724 

Th 14.654 ± 8.902 

Pb 214.079 ± 20.242 

Se < LOD 5.550 

As < LOD 26.865 

Hg < LOD 13.151 

Zn 236.552 ± 26.125 

W < LOD 92.230 

Cu 39.303 ± 22.197 

Ni < LOD 76.262 

Co < LOD 201.830 

Fe 21562.064 ± 423.982 

Mn 665.231 ± 116.455 

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 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Mo < LOD 

Zr 417.553 

Sr 190.289 

U < LOD 

Rb 62.218 

Th < LOD 

Pb 170.446 

Se < LOD 

As < LOD 

Hg < LOD 

Zn 175.519 

W < LOD 

Cu 36.162 

Ni < LOD 

Co < LOD 

Fe 18460.287 

Mn 524.681 

Supervised By: 

Certificate of Verification 

42 

SOIL 

2011-04-07 21:38 

30.17 

Final 

29589 

2817 N 27 ST 

F2 

4" 

M. MATEUS 

CLEARANCE 

CLEAR 

Error 

7.740 

± 15.201 

± 9.398 

* 14.933 

± 6.355 

12.244 

± 

18.128 

\ 5.948 

23.474 

12.184 

± 22.647 

; 89.343 

± 21.495 

• 72.433 

J 180.760 

± 387.463 

± 104.310 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

37 

SOIL 

2011-04-07 21:34 

90.50 

Final 

Avg of 34-36 

2817 N 27 ST 

B2 

4" 

M. MATEUS 

CLEARANCE 

CLEAR 

Error 

\ 7.988 

± 15.178 

± 9.906 

14.873 

± 6.612 

13.917 

± 23.440 

: 6.054 

30.991 

12.194 

± 28.340 

89.366 

± 22.514 

1 76.032 

: 199.611 

± 418.790 

± 108.566 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

W 

Cu 

Nl 

Co 

Fe 

Mn 

ppm 

< LOD 

393.968 

204.949 

< LOD 

66.615 

< LOD 

^92.57 5 

< LOD 

< LOD 

< LOD 

283.696 

< LOD 

41.234 

< LOD 

< LOD 

20789.881 

539.026 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 34 

Mode SOIL 

Time 2011-04-07 21:32 

Duration 30.17 

Sequence Final 

Flags 

BVID 29589 

ADDRESS 2817 N 27 ST 

QUADRANT B2 

DEPHT 4" 

XRF TECH M. MATEUS 

MISC CLEARANCE 

NOTE CLEAR 

ppm Error 

Mo < LOD 7.997 

Zr 387.658 i 15.082 

Sr 170.255 :t 9.166 

U < LOD 15.111 

Rb 67.792 i 6.716 

Th < LOD 13.687 

Pb 279.496 ± 23.131 

Se < LOD 5.978 

As < LOD 30.650 

Hg < LOD 13.236 

Zn 267.471 i 27.910 

W < LOD 92.762 

Cu < LOD 32.256 

Ni < LOD 79.120 

Co < LOD 197.290 

Fe 20294.758 i 417.101 

Mn 523.512 ± 108.087 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

35 

SOIL 

2011-04-07 21 :33 

30.17 

Final 

29589 

2817 N 27 ST 

B2 

4" 

M. MATEUS 

CLEARANCE 

CLEAR 

Error 

7.961 

± 14.684 

± 9.812 

] 14.217 

± 6.465 

: 13.686 

± 22.555 

I 5.997 

: 29.381 

11.129 

± 26.278 

82.533 

± 22.303 

1 72.566 

194.450 

± 404.120 

± 103.859 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hq 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

ppm 

< LOD 

371.837 

204.043 

< LOD 

65.776 

< LOD 

273.780 

< LOD 

< LOD 

< LOD 

246.284 

< LOD 

44.603 

< LOD 

< LOD 

19714.623 

488.796 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

36 

SOIL 

2011-04-07 21:34 

30.16 

Final 

29589 

2817 N 27 ST 

B2 

4" 

M. MATEUS 

CLEARANCE 

CLEAR 

Error 

8.005 

± 15.768 

± 10.740 

15.291 

± 6.655 

14.379 

± 24.633 

6.185 

:t 21.961 

: 12.218 

± 30.832 

92.801 

± 23.735 

76.412 

207.092 

± 435.149 

± 113.751 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

ppm 

< LOD 

422.409 

240.549 

< LOD 

66.277 

< LOD 

324.449 

< LOD 

33.141 

< LOD 

337.334 

< LOD 

56.437 

< LOD 

< LOD 

22360.260 

604.771 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Mo < LOD 

Zr 370.031 

Sr 199.523 

U < LOD 

Rb 72.838 

Th 16.621 

Pb £66.208 

Se < LOD 

As < LOD 

Hg < LOD 

Zn 460.096 

W < LOD 

Cu 59.203 

Ni < LOD 

Co < LOD 

Fe 37080.563 

Mn 856.230 

Supe •vised By: 

Certificate of Verification 

31 

SOIL 

2011-04-07 21:29 

90.86 

Final 

Avg of 28-30 

2817 N 27 ST 

Bl 

4" 

M. MATEUS 

CLEARANCE 

CLEAR 

Error 

: 8.445 

± 15.416 

± 10.215 

16.164 

± 7.189 

± 9.954 

± 23.427 

6.401 

31.439 

14.169 

± 37.044 

100.589 

± 25.544 

85.969 

: 273.350 

± 581.777 

± 139.478 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Mo < LOD 

Zr 372.277 

Sr 201.534 

U < LOD 

Rb 76.712 

Th 22.764 

Pb 258.546 

Se < LOD 

As 38.623 

Hg < LOD 

Zn 468.178 

W < LOD 

Cu 60.207 

Ni < LOD 

Co < LOD 

Fe 36645.816 

Mn 903.632 

Supervised By: 

Certificate of Verification 

28 

SOIL 

2011-04-07 21:27 

30.17 

Final 

29589 

2817 N 27 ST 

Bl 

4" 

M. MATEUS 

CLEARANCE 

CLEAR 

Error 

8.432 

± 15.444 

± 10.244 

16.251 

± 7.328 

± 10.365 

± 23.022 

\ 5.343 

± 20.900 

14.331 

± 37.310 

102.038 

± 25.514 

: 85.441 

1 272.052 

± 577.330 

± 142.158 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

29 

SOIL 

2011-04-07 21:28 

30.17 

Final 

29589 

2817 N 27 ST 

Bl 

4" 

M. MATEUS 

CLEARANCE 

CLEAR 

Error 

8.339 

± 15.228 

± 10.253 

15.662 

± 7.083 

14.319 

± 23.374 

: 6.187 

30.924 

13.715 

± 35.840 

94.223 

± 25.352 

: 82.897 

262.822 

± 570.261 

± 134.876 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRFTECH 

MISC 

NOTE 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

ppm 

< LOD 

360.738 

201.575 

< LOD 

71.726 

< LOD 

266.301 

< LOD 

< LOD 

< LOD 

432.418 

< LOD 

59.221 

< LOD 

< LOD 

35719.832 

788.212 

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 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Mo < LOD 

Zr 377.079 

Sr 195.460 

U < LOD 

Rb 70.075 

Th 15.363 

Pb 273.777 

Se < LOD 

As 32.221 

Hg < LOD 

Zn 479.691 

W < LOD 

Cu 58.180 

Ni < LOD 

Co 304.138 

Fe 38876.039 

Mn 876.844 

Supervised Eiy: 

Certificate of Verification 

30 

SOIL 

2011-04-07 21:29 

30.52 

Final 

29589 

2817 N 27 ST 

Bl 

4" 

M. MATEUS 

CLEARANCE 

CLEAR 

± 

± 

± 

: 

± 

± 

± 

± 

± 

± 

± 

± 

± 

Error 

8.563 

15.574 

10.149 

16.580 

7.155 

9.951 

23.886 

7.674 

21.362 

14.462 

37.983 

105.506 

25.765 

89.569 

190.118 

597.741 

141.399 
Property Compietion Agreenfient 

J hii agieemeni documenis. Ihe complclion ol remedial acliviiies perroimed on my properly My signalure 

will designate llial I am satisfied with Ihe restoralion of my properly, and Ihal no ilems are in queslions. 

now, or al any inne in the fuluie, excepl ihose ilems listed below, if any 

Property ID: ^c^^^^c y 

Property Address: >^^ ^ ^ ^ ^ ^ ^ 

Q""'='^ ^-.cWr A VO^V^cr^-

Phone: ^^ ^ ^ UK*3\.^0,V, V 

Restoratiort Items in Question: 

Item: 

Item: 

Item; 

Item: 

Item: 

item: 

\j6 l ayrcc restoralion i< complcltd, rxccpl as nnleri 

[ I I rio not ii|;rec rcfioratinn is conipieleri 

7^,..oy.M/^ ^ 7^-v?^// L^ ^ -?-'8y 

Owner's Signatnrf Date Conti arlor's Signadiie Date 
^ 1 

EPA Property Close Out Form 

Propert _aSii2s__u_^2^:i^ Property»: Q?Vt>'£;P\.. y Addrwji^-g^ Addi " ^ ^— ^ » •aPiTN Date/Time: Owiicr*s Name:. /^XV^.rf)! . Wpv^: 

Quads Excavated: _ Contraclor Croup 

Excavatio Yes No n General 

I. Ifnecessuy, were thc correct quadrant(s) excavated and restored? 

y 

2. Ifnccessary, were the correcl areas ofdrip zone excavaled and restored? 

y 

Grading Sod and Venetatioii Yes No 

1 Does Ihe grading around the perimeter ofthe house in cKcavsled areas generally slope away y from the house?

 __ ^ 

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

y 

i. Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 y day time period) 

4. Are sodded areas generally firm and evenly graded? 

-y 

5 Are thejoinis berween the sod strips generally tight? (Only evaluate if inspected at 2 30 day 

_ time period) y 

6. Was the property graded such that water will nol pool on the propeny'' 

I 7. Was damage to landscaping or plant materials avoided? A 

Gates, Fences and Retaining Walls Yes No 

r 1. Do gates open and close freely? (Ifapplicable) ~y 

2. Were all gates or fences taken down during restoration activiiies reinstalled? (If applicable) -y 

3. Was damage to gates or fences avoided? (I f appiicable) 

y 

4. Was dainage to rciaining walls avoided? (If applicable) 71 

Foupdation, Sidiog and GnMers Yes No 

I Was damage to the siding or trim avoided? y J 

2. Was damage to the foundation avoided? - — 

.*. Was damage to windows avoided? y 1 

4 Was dainage to windows or door screens avoided? 

y 

Was damage lo downspouts or downspoui extensions avoided? y

Sidewalks and Driveways (Concrete) Ves^ No 

1 Was damage to driveway surfaces avoided? 

- y 

2. Was damage to walkway surTaces avoided? 
Ort-ncrs comments: 

I 

j Inspection notes: 

Removal and resloration aclivales complete including the 30-day sod warranry; 

EPA Representative 9»" ^ ^ Date: 7lit)n