# TRANSMITTALo f

OMAHALEAD SIT E SOILREMEDIATIO NFIL EFOLDER
SAID# : _351k^_

_Date : A'xfi H

. ^Q U Address : MC^ ^ K J M6 > " ^ Remediatio nContractor : Coasta l Environmenta l Group

_Year : _2010ARRA

_
SOI LREMEDIATIO N PROPERT YFIL EFOLDE RDOCUMENT S !JVide o ofpropert y (DVD ) D Executiv eSummar y D EPA-provide dproperty sketc h 0 Signe dAcces s Agreemen t fo r

subjec t property • USigne dAcces s Agreement(s ) fo r

adjacent property D Restoratio nAgreement D Settlement document s (i.e. , fo r

damag e or to replac e plants ; etc. ) D Confirmatio ndat a D Photograph s D As-buil t sketc h D Satisfactory restoratio nsigne db y Property Owner D Property close-ou t check lis t signe db y EPA
nDescriptionofareasno t meetin g RO D cleanu p criteri a D Utility clearance s

• Property informatio nfro mDougla s County Assessor' s Offic e D D ^ '_ D

3021769 6 

# INHI i Superfun d

# v v Propert yAcces s Checklis t Property ID : 3^ 1 U ^ Property Address ; HQ;^^: ^ M^ S 5 T 

### n nWORK STARTE D WOR K COMPELTED ON : __/__/

_ ON : __/__/

_
Owner : /^ AIrrt l Address : 

# Sam e Phone: q,<^S'

- Fax : ftuft^ *



# ROCL ^ Renter : Phone : Fax : Cell/Pager : Additional Information : Cell/Pager :

nNotificationLette r K l Acces s Agreement [jS^Kestoratio nAgreement D Topso USamplin g (if applicable ) Q Disposa l Sampling (if applicable ) D Garde nSampling (if applicable ) S Utilit y Clearanc e IZ

l Video/Photo s (Before) D Video/Photo s (During )
nVideo/Photo s (After) D Video/Photo s (30-Day ) Sent : / / 

# Signed : (2_//ci// Q Siened : 3 / ^ Il O II 1 I 1 I CaUed:0H/3m/\ 0



## On : 7 lU_ll O On : / / On : / / On : / / By : By : 

# By : OcmV/ o By : By : By : By=OH^/i o UJtrrlv j By:/yVc/ < By : By : By : Q Property Completio nAgreement Siened : / / By : nFinal Report Issued : / / By : Air Monitorin e (a s applicable ) C

D Communit y D Cre w Results : On : / / 

## By : " I

O Communit y Results : D Cre w On : / / 

## By : 1
Q Communit y Results : D Cre w On : / / By :

Omah a Lea d Sit e

### DtSugla s Count y Accoun t Info : Pag e 1 of 2

Dougla s CountY / Nebrask a Propert yRecor d - R I 12910000 0 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-5 0 ft wes t o f52n d S t - VIe WO H Ma p 

### Informatio n i s vali d a s o f2009-1 1 -1 9 Treasurer' s Ta xRepor t Ne wFeatur e ••"•"•Aut o Sale s Searc h 

### Owne r BYER S TIMOTH YW ETA L 402 3 N 4 5 S T OMAH AN E 68104-000 0 Propert yInformatio n Ke yNumber : 

### 291 0 000 0 1 1 Accoun t Type : Residentia l Parce l Number : 112910000 0 Parce l Address : 402 3 N 4 5 S T OMAH AN E 68104-000 0 Lega l Description : FONTENELL E PAR KLOT26 7 BLOC K0 1/ 2 VA C ALLE YAD J & Valu e Informatio n

200 9 200 8 200 7 

### 200 6 200 5 200 4 Lan d 

### $4,200.0 0 $4,200.0 0 $4,200.0 0 $4,200.0 0 $4,200.0 0 $4,200.0 0 Improvemen t 

### $55,300.0 0 $55,300.0 0 $55,300.0 0 $55,300.0 0 $25,600.0 0 $23,200.0 0 Tota l 

### $59,500.0 0 $59,500.0 0 $59,500.0 0 $59,500.0 0 $29,800.0 0 $27,400.0 0 Lan d Informatio n Acre s 0. 1 S F 

### 4680. 0 U nit s 

### 1.0 Dept h 117. 0 Widt h 40. 0 Vacan t N o Improvemen t Informatio n Buildin g 1



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl.

. . 11/24/200 9

## < • Dougla s County Accoun t Info : na^^n Pag e2 of 2

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CLIC KT O ENLARG E IMAG E Squar e Footage : 

### 1369. 0 Percen t Complete : 

### 100.0 % Perimete r 0. 0 Quality : Fai r Uni t Type : Condition : Averag e

Buil t As : 1 1/ 2 Stor yFi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 6. 0 Exterior : Fram e Sidin g Units : 

### 1. 0 Interior : Drywal l Baths : 

### 1. 0 Roo fCover : Compositio n Shingl e Bedrooms : 3. 0

Roo fType : Gabl e Stories : 1. 5 Fioorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 Yea r Percen t Adjuste d Yea r Yea rBuil t Physica l Ag e Remodele d Remodele d Buil t 192 2 192 2 8 7 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Fenc e Chai n Lin k 1. 0 Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 816. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Porc h En d Scree n 

### 160. 0 Use r Atti c1/ 2 Finis h 

### 163. 0



## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl.

. . 11/24/200 9

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## Pag e 1 o f 1

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## YOU R TICKE T NUMBE R I S 2496418
. Origina l Cal l Date : 5/18/1 0 Time : 5:0 1 pmOp : ELIZABETH1879 0 Wor k t o Begi n Date : 5/20/1 0 Time : 5:3 0 pm State : N E County : DOUGLA S Place : OMAH A Address : 4 02 3 Street : N45T H S T Twp : 15 NRng : 13 E Sect-Qtr : 05-S W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : LEA D REMEDIATION Locatio n o f Work : LOCAT E ENTIR E PROPERTY , AL L EASEMENT S AND T O TH E PEDESTA L Remarks : FA X AL L CLEAR S TO : (877)662-421 1 : UNSUR E I F CORNE R LOT . Compan y: COASTAL ENVIRONMENTA L SERVIC E Contac t Name : ELIZABETH Phone : (877)662-421 0 Wor k Being Don e For : COASTA L Dept ho f Excavation : 4 F T Corne r Lot : NFront : Y Rear : Y Involve s Tunneling o r Horizonta l Boring : NExplosives : N CXCAT V

MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C

Servic e Are a Contac t Phon e Numbe r Utilit y Typ e 

## Day : 402934046 9 CXCAT V CO XCOMMUNICATIONS , IN C HEID I 

## Alt : 402934046 9 Emerg : 402932975 7 Day : 402504782 3 MUDO l METROPOLITA NUTILITIE S DISTRIC TSAND Y 

## Alt : Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCITYO FOMAHA-TRAFFICSEWE RRICH/TRAFFI C Alt : 402444516 1 

## Emerg : 4024445160 Day : 406728934 3 OPPDGPR 5 OMAH APUBLI C POWE RDISTRIC TELM LOCATIN GAlt : 406207149 4 

## Emerg : 888728934 3 Day : 406728934 3 QLNNEl C QWES TLOCA LNETWOR K EL M LOCATIN GAlt : 406207149 4 Emerg : 888728934 3



## http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.

. . 5/18/201 0" > 

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• YOU RTICKE TNUMBE RI S 2474022

. Origina l Cal l Date : 4/24/1 0 Time : 3:2 9 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 4/28/1 0 Time : 7:1 5 a m State : N E County : DOUGLA S Place : OMAH A Address : 402 3 Street : N45T H S T Twp : 15 NRng : 13 E Sect-Qtr : 05-S W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : LEA D REMEDIATIO N Locatio n o f Work : LOCAT E ENTIR E PROPERTY , AL L EASEMENT S AN D T O TH E PEDESTA L Remarks : FA X AL L CLEAR S TO : (877)662-421 1 : UNSUR E I F CORNE R LOT . Compan y: COASTA L ENVIRONMENTA L SERVIC E Contac t Name : ELIZABET H Phone : (877)662-421 0
Wor k Bein g Don e For : COASTA L Dept ho f Excavation : 4 F T Corne r Lot : N Front : Y Rear : Y Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C

Servic e Are a Contac t Phon e Number Utilit yTyp e 

## Day : 4029340469 CXCAT V CO XCOMMUNICATIONS , IN C HEID I 

## Alt : 4029340469 Emerg : 402932975 7 Day : 402504782 3 MUDO l METROPOLITA NUTILITIES DISTRICTSAND Y 

## Alt : Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFIC.SEWE R RICH/TRAFFI C Alt : 402444516 1 Emerg : 402444516 0 Day : 406728934 3 OPPDGPR 5 OMAH APUBLI C POWE RDISTRICT EL M LOCATIN G Alt : 406207149 4 Emerg : 888728934 3 Day : 406728934 3 QLNNEI C QWES T LOCA LNETWOR K 

## EL M LOCATIN GAlt : 4062071494 Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.

. . 4/24/201 0

# As-Buil t Drawin g COASTA L 

# Omah aLea dSuperfun dSit e CMVIRONMENTA L C •O U P

. IN C OLS# : 3316 8 Dat e Excavated : 5/17/201 0 Dat e USEP ASigne d Off : 6/24/201 0 Are a Sodden : 153 9 s a f t
rName : ///>i^//y>i3^^,r S Omah a Lea d Sit e Date : NoithAmi w

Address : V^9^ ^ A " V.5 ^ -T? ' Stt e Sketc h Time : 

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## Consen t fo rAcces s T o Propert y RIGH TO F ENTR YT O PREMISE S 

## Granto r(th e propertyowner) consent s t o an d authorize s th e Unite d State s Environmenta l Protectio n Agenc y(EPA ) o rits authorize d representatives , collectivel y th e Grantee , t o ente ran d perfor m certai n environmenta l respons e activitie s upo n th e followin g describe d premises : "^-^ / / cy
Daytim e Phone : owner' s Name : (^Hol^yJilZ S 

# •^^)A-4S^> P 9 3

Addres s o fPropert y covere d b ythi s Agreement :
PURPOS E O F RESPONS E ACTIVITIE S 

## Th e EPAi s requestin g acces s t o collect soi l sample s an d remove soi l tha t contain s elevate d concentration s o flea d an d maypos e a healt h hazard

. Th e area(s ) wil l b e excavate d t o remov e contaminate d soil

. Th e remove d contaminate d soi l wil l b e replace d wit h clea n material s an d th e are a wil l b e restore d t o its origina l condition

. Thi s wor k i s bein g performe d unde rth e Omah a Lea d Superfun d Sit e remediatio n program
. Arepresentativ e o fCoasta l Environmenta l Group , contracte d b yUSEPA , v/il l contact th e Granto rin-perso n t o discus s th e wor k t o b e performed , th e Granto rwil l hav e a n opportunityt o revie wan d approv e th e planne d soi l removal , an d restoratio n wor k before i t begins

. Onc e th e wor k i s finished , th e Granto rwil l b e aske d t o revie wth e wori t an d confir m tha t i t i s complet e an d meet s wit h th e Grantor' s approval

. Upo n completion , th e Granto rwil l receiv e writte n documentatio n fro m EPAtha t th e property has bee n remediated

.
ENVIRONMENTA LRESPONS E ACTION S 

## Bysignin g thi s Acces s Agreement , th e Granto ri s grantin g th e EPA , its employees , contractors an d subcontractors th e righ t t o ente rth e property , a t al l reasonabl e time s an d wit h prio rnotice , fo rth e sol e purpos e o fperformin g th e work

. Thi s acces s shal l remai n i n effect unti l th e wor k ha s bee n satisfactoril ycompleted

. Th e Granto rals o agree s to :

Pag e 1 o f2

### '• i COASTA L (IIVI«eilH(KT> t C « 0 U rIK C 

# '*

r

y ( Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; e Remov e flowe rbulb s o rplant s tha t th e Granto ro rth e Grantor' s tenan t ma ywis h t o save ; ( Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , a s necessar ysubsequen t t o a n initia l waterinj g perio d b yEPA ; t Abid e b yhealt h an d safet yguidanc e provide d b yEPA ; < I fth e propert yi s rented , assis t EP Ai n obtainin g tenan t approva l fo racces s t o th e propert yt o perfon n th e work

. » Allo wvideotapin g and/o rphotographin g o fth e property

.
AGREEMEN TNO TT O INTERFER E 

### Th e Granto ragree s no t t o interfer e o rtampe rwit h an yo fth e wort t activities , o rwit h an y o fth e wor k done , o rwit h th e equipmen t lise d o n hi s property , o rt o undertak e an y acftion s regardin g th e us e o fsai d propert ywhic h woul d ten d t o endange rth e healt h o r welfar e o fth e Grantee s o rth e environment , o rt o allo wother s t o us e th e propert yi n suc h a manner
. Shoul d yo u hav e an yquestion s abou t thi s program , pleas e contac t Coasta l Environmenta l Group , a t (402 ) 99 1 -119 9



# i
J gran t acces s t o mypropertie s D i d o no t gran t acces s t o mypropertie s

Signature Signature Date

D i woul d lik e t o b e presen t durin g an ysamplin g tha t i s requiried

.

Page 2 o f2C OASTA L
•NVinONMIMTA L O II O U » , INC

. 

# Restoratio n Agreemen t The purpos e of thi s agreemen t is to provide amutua l agreemen t as to condition s ofth e propert y prior to remediationactivities

. Thi s will als o serve as documentationfo r the purpos e of assuring tha t restoration activitie s ar e completed to thesatisfaction of the propert y owne r an dthe UnitedState s Environmenta l ProtectionAgency (EPA)

.

Propert y m: :^a,^af t Propert y Address L\Q2J? > Ll(\Tf , Nl M S S V 'Address : Owner : 

# <!orfl l ftjarsPhone : Onthe attacheddiagram(s ) indicat earea(s ) to excavate , surface structure s an dlandscapin g feature s an d acces s location(s ) tobeused by thecontractors
. Indicat e distances , depths , materia l types , etc
. Photographicall y an dVideographicall y documen t the existing condition s ofth e propert y an dthe basemen t if necessary . Item s to be Remo v re d byth e Ow i le rbefor e Star t ofRemediation : Th e remova l storage , disp o sal , and/o rretu m ofthes e item s is th e Owner' s responsibility

. Hem : 

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Item s to be Remove d by th e Contracto r Durin g Remediatio n an d No t Reolace d Hem : 

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## Item s t o B e Remove d B L 

## Contracto r Durin g Remediatio n an d Reolace d Kem :
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## Ite m Pre-existing propert y area , tha t wil l b e excavated , tha t i s coveredwit hgrass . Numbe r of tree s > 2 inc h tiiui k

diamete r Numbe r of tree s <= 2 inc h trun k

diamete r Numbe r of Sprinkle r Zones , Control Valves , Timers , Heads , etc
. Attac hasketc ho f th e sprinkle r layout

. Nimibe r of an dsi2 e of eac hgarden / flower bed area . Attac hasketc ho f relative size s an dlocations

. Agree duponvalue of plan t material s not to b e replacedb v contractor
. Not e thi s valu e wil l b e usedto issue aplan t voucher to th e property owner . Easemen t Area, to b e excavated 

## Quantit y 

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### AddKiona l Comment s / Instructions : Th e cit yo fOmah a ordinance s ma yprohib Kyo u fro m usin g dir t o rgrave l area s o n you rpropert y a s driveway s o rvehicl e parkin g areas
. Th e Environmenta l Protectio n Agenc y(EPA ) ma yb e removin g an d repiacin g soi i underlyin g a grave i o rdir t are a o n you rpropert ytha t yo u ma yb e usin g a s a drivewa yo rvehicl e parkin g area
. I fthi s i s th e case , yo u shoul d understan d tha t thi s removin g an d repiacin g o fsoi l doe s no t mea n tha t an yillega l drivewa yo rparkin g are a o n you r propert yi s mad e legal

. T o th e contrary , yo u ma yb e cKe d b yth e cKyi fyo u us e a grave i o rdir t are a a s a drivewa yo rparkin g area , no t wKhstandin g an yremova l o rreplacemen t o fsoi l b yth e EP A I fyo u hav e an yquestio n abou t legalKyo fa certai n drivewa yo rparkin g area , yo u ma ycontac t th e cKyo fOmaha' s Plannin g Departmen t a t (402 ) 444-5150

. Q Pleas e chec k thi s bo xi fyo u understan d th e informatio n outline d above

. 

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D Chec k th e bo xi fOwne rdoe s no t wan t CE G t o documen t interio rfoundatio n wall s an d possibl e pre-existin g damage

. B ycheckin g th| s bo xCE G i s no t responsibl e fo ran ydamag e don e t o th e interiorjs fhouse , includin g foundatio n crack s o rfissures

. 

## nId o no t agre e 

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# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n
XL3t-3208 9 Readin g N o 4 4 Mod e SOI L Tim e 2010-06-0 5 10:2 5 Duratio n 90.3 3 Sequenc e Fina l Flag s AVERAG E ^•L^^'^.'^^S^^W ^ ADDRES S 40^ 3 N 4 b S t QUADRAN T F l DEPT H 6 " TYP E CONFIRMATIO N INSPECTO R N

. LOPE Z

pp m Erro r M o < LO D : 8.15 7 Z r 446.52 7 ± 15.89 3 S r 144.67 4 ± 8.46 1 U < LO D : 14.75 0 R b 72.31 4 ± 6.81 9 T h 14.03 2 ± 8.39 9 (Pb/ S e 166.79 6 < LO D ± , : . 

# : ip M 5.95 1 A s 26.45 5 ± 16.11 6 H g < LO D : 13.08 7 Z n 221.98 1 ± 25.82 2 

# w C u < LO D 53.28 5 : ± 90.42 8 23.25 6 N i < LO D \ 79.43 3 C o < LO D : 201.03 6 Fe 21775.61 1 ± 435.87 8 M n 680.510> o ± 110.85 2 

# U b Ui d Supervise d By : C- K

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPT H TYP E INSPECTO R

M o Z r S r U R b T h P b S e A s H g Z n 

## w C u N i C o F e M n pp m
< LO D 452.04 1 145.07 8

< LO D 70.65 5 14.79 6 165.20 7

< LO D 24.39 6 < LO D 237.71 9

< LO D 52.22 0 < LO D < LO D 21660.02 7 803.12 6 Supervise d By : 

## Certificat e o fVerificatio n

4 1 SOI L 2010-06-0 5 10:2 3 30.1 1 Fina l 3316 8 402 3 N 4 5 s t F l 6 " CONFIRMATIO N N

. LOPE Z

Erro r
: 8.21 8 ± 16.00 4 ± 8.48 9

; 14.79 3 ± 6.76 7 ± 8.46 5 ± 17.85 6

: 5.80 2 ± 16.00 3

: 13.92 8 ± 26.69 8 92.37 6 ± 23.24 6

I 79.76 3 : 201.84 4 ± 435.53 0 ± 118.42 2

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n
XL3t-3208 9 Readin g N o 4 2 Mod e SOI L Tim e 2010-06-0 5 10:2 4 Duratio n 30.1 0 Sequenc e Fina l Flag s BVI D 3316 8 ADDRES S 402 3 N 4 5 s t QUADRAN T F l DEPT H 6 " TYP E CONFIRMATIO N INSPECTO R N

. LOPE Z

pp m Erro r M o < LO D : 8.11 6 Z r 452.16 9 ± 15.98 7 S r 144.02 6 ± 8.45 1 U < LO D 14.43 6 R b 73.39 4 ± 6.83 7 T h < LO D 11.93 1 P b 170.68 8 ± 18.13 5 S e < LO D 6.25 3 A s 24.74 8 ± 16.22 4 H g < LO D 12.03 6 Z n 206.48 4 ± 24.99 8 

## w < LO D 87.57 2 C u 56.52 5 ± 23.52 1 N i < LO D 79.91 1 C o < LO D 203.26 3 Fe 22046.58 2 ± 439.14 7 M n 624.89 9 ± 107.67 6 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPT H TYP E INSPECTO R

M o Z r S r U R b T h P b S e A s H g Z n 

## w C u N i C o Fe M n pp m
< LO D 435.37 1 144.91 7

< LO D 72.89 1 18.94 5 164.49 4

< LO D 30.22 1 < LO D 221.74 0

< LO D 51.10 9 < LO D < LO D 21620.22 7 613.50 5 Supervise d By : 

## Certificat e o fVerificatio n

4 3 SOI L 2010-06-0 5 10:2 5 30.1 2 Fina l 3316 8 402 3 N 4 5 s t F l 6 " CONFIRMATIO N N

. LOPE Z

Erro r
: 8.13 7 ± 15.68 8 ± 8.44 3

; 15.02 2 ± 6.85 2 ± 8.77 7 ± 17.76 3

: 5.79 7 ± 16.12 1

: 13.29 6 ± 25.77 1 * 91.33 8 ± 23.00 2

* 78.62 5 : 198.00 2 ± 432.95 6

•± 106.45 8

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s AVERAG E ADDRES S QUADRAN T DEPT H TYP E INSPECTO R

M o Z r S r U R b T h 

# CH : 

# -. '

S e A s H g Z n 

## w C u N i C o F e M n C r T i S c C a K S Supervise d By : O f< % 

# Certificat e o fVerificatio n

4 8 SOI L 2010-06-0 5 10:2 8 90.6 5 Fina l 

# ^mm^s^^ x ^02 3 N 45sr ^ B l 6 " CONFIRMATIO N N

. LOPE Z

pp m
< LO D 476.57 7 152.73 3

< LO D 73.75 6 17.17 5 3/3.64 / ,

< LO D < LO D < LO D 225.43 4

< LO D 40.91 7 < LO D < LO D 22795.31 3 677.90 4

< LO D < LO D < LO D < LO D < LO D < LO D < LO D ± ±
± i i 

## :

±
it

.

± ± Erro r 8.22 4 16.25 4 8.61 5 15.35 9 6.90 5 lOJO ? 

## T559k- ^ 6.26 0 33.72 5 13.45 4 25.82 8 91.43 6 21.97 7 76.92 9 204.24 2 441.94 2 109.59 9 237.00 5 527.51 0 2120.37 1

171.21 5 3837.75 5 8049.60 3

188.83 2 

# VW/ ? v

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n
XL3t-3208 9 Readin g N o 4 5 Mod e SOI L Tim e 

### 2010-06-0 5 10:2 6 Duratio n 

### 30.1 1 Sequenc e Fina l Flag s BVI D 

### 3316 8 ADDRES S 

### 402 3 N4 5 s t QUADRAN T 

### B l DEPT H 

### 6 " TYP E CONFIRMATIO N INSPECTO R N

. LOPE Z

pp m 

### Erro r M o 

### < LO D 8.34 3 Z r 

### 485.21 9 ± 16.37 4 S r 

### 148.58 5 8.50 7 U < LO D 

### 15.18 9 R b 72.48 7 

### ± 6.84 0 T h 22.32 3 

### ± 10.50 3 P b 

### 364.45 5 25.50 6 S e < LO D 

### 6.18 2 A s 41.62 2 

### 22.65 1 H g < LO D 

### 13.52 9 Z n 225.16 2 

### ± 25.75 2 W < LO D 

### 88.21 4 C u 43.54 6 

### d t 22.06 2 N i < LO D 

### 75.14 1 C o < LO D 

### 204.97 4 F e 22832.75 0 

### ± 442.18 4 M n 

### 678.08 1 109.69 8 Supervise dBy :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPT H TYP E INSPECTO R

M o Z r S r U R b T h P b S e A s H g Z n 

## w C u N i C o F e M n pp m
< LO D 475.80 0 149.78 1

< LO D 75.37 7 < LO D 372.35 1

< LO D < LO D < LO D 217.14 1

< LO D 34.46 1 < LO D < LO D 22920.87 9 644.26 8 Supervise d By : 

## Certificat e o fVerificatio n

4 6 SOI L 2010-06-0 5 10:2 7 30.1 2 Fina l 3316 8 402 3 N 4 5 s t B l 6 " CONFIRMATIO N N

. LOPE Z

Erro r
: 8.05 7 ± 16.11 4 ± 8.48 7

• 14.87 6 ± 6.87 9

: 13.78 9 ± 25.52 3

I 5.67 7 : 33.63 8 : 13.46 9 ± 25.33 4

: 93.69 4 ± 21.39 6

: 78.01 8 \ 204.26 8 ± 440.70 5 ± 107.38 9

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n
XL3t-3208 9 Readin g N o 4 7 Mod e SOI L Tim e 2010-06-0 5 10:2 8 Duratio n 30.4 2 Sequenc e Fina l Flag s BVI D 3316 8 ADDRES S 402 3 N 4 5 s t QUADRAN T B l DEPT H 6 " TYP E CONFIRMATIO N INSPECTO R N

. LOPE Z



### pp m Erro r M o < LO D 8.27 1 Z r 468.71 2 i 16.27 3 S r 159.83 3 ± 8.85 0 U < LO D 16.01 2 R b 73.40 3 ± 6.99 7 T h 25.25 4 ± 10.90 9 P b 384.13 6 ± 26.35 8 S e < LO D 6.92 2 A s < LO D 33.56 1 H g < LO D 13.36 3 Z n 234.00 0 ± 26.39 9 

## w C u < LO D 44.74 3 ± 92.40 0 22.47 2 N i < LO D 77.62 9 C o < LO D 203.48 5 Fe 22632.30 7 ± 442.93 8 M n 711.36 2 ± 111.71 1 C r < LO D 711.01 6 

## v < LO D 1582.53 0 T i < LO D 6361.11 2 S c < LO D 513.64 5 C a < LO D 11513.26 5 K < LO D 24148.80 9 S < LO D 566.49 7 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n
XL3t-3208 9 Readin g N o 5 2 Mod e SOI L Tim e 2010-06-0 5 10:3 1 Duratio n 90.3 3 Sequenc e Fina l Flag s AVERAG E 

# 0m^^i£ J ADDRES S ^02 3 N 4 5 s t QUADRAN T D Z DEPT H 13 " TYP E CONFIRMATIO N INSPECTO R N

. LOPE Z

pp m Erro r M o < LO D ; 8.35 5 Z r 455.50 8 ± 16.19 6 S r 161.25 2 ± 8.96 2 U < LO D ; 15.50 6 R b 78.35 5 ± 7.14 8 T h 13.11 9 ± 8.22 9 I48;u/ y ~ ± ITrt m 

# my:- - S e < LO D b.U/ 9 A s < LO D 22.26 6 H g < LO D 13.51 2 Z n 261.88 0 ± 28.06 9 < LO D : 97.57 9 

## w C u 39.14 9 ± 22.51 1 N i < LO D 80.18 0 C o < LO D 209.90 2 • F e 23590.81 4 ± 457.00 7 M n 838.75 7 ± 120.86 5 Supervise d By : (-C^ i 

# '.:M i ^

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n
XL3t-3208 9 Readin g N o 4 9 Mod e SOI L Tim e 2010-06-0 5 10:2 9 Duratio n 30.1 1 Sequenc e Fina l Flag s BVI D 3316 8 ADDRES S 402 3 N 4 5 s t QUADRAN T D Z DEPT H 13 " TYP E CONFIRMATIO N INSPECTO R N

. LOPE Z

pp m Erro r M o < LO D ; 8.29 5 Z r 444.19 1 ± 15.94 4 S r 162.56 1 ± 8.96 0 U < LO D : 14.65 7 R b 76.00 7 ± 6.95 6 T h < LO D 10.90 5 P b 142.16 7 d b 16.66 2 S e < LO D : 5.80 3 A s < LO D : 21.92 0 H g < LO D ; 13.41 5 Z n 266.36 2 ±' 28.17 5 

## w < LO D ; 97.44 2 C u 35.28 6 ± 22.07 9 N i < LO D : 78.76 9 C o < LO D ; 209.65 6 F e 23678.63 9 ± 456.14 7 M n 856.73 5 ± 121.56 4 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPT H TYP E INSPECTO R

pp m M o < LO D Z r 461.85 2 S r 154.60 1 U < LO D R b 78.42 3 T h 22.25 1 P b 150.15 6 S e < LO D A s < LO D H g < LO D Z n 263.92 0 < LO D 

## w C u 56.54 1 N i < LO D C o < LO D F e 23213.96 9 M n 852.19 2 Supervise d By : 

## Certificat e o fVerificatio n

5 0 SOI L 2010-06-0 5 10:3 0 30.1 1 Fina l 3316 8 402 3 N 4 5 s t D Z 13 " CONFIRMATIO N N

. LOPE Z

Erro r
: 

### %.T n ± 16.24 8 ± 8.76 4

: 15.40 7 ± 7.12 9 ± 9.02 8 ± 17.18 3 5.79 7 22.61 5 13.76 8 ± 28.17 4

: 99.64 4 ± 23.71 0

: 79.71 2 : 210.06 2 ± 452.16 9 ± 121.17 6

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n
XL3t-3208 9 Readin g N o 5 1 Mod e SOI L Tim e 2010-06-0 5 10:3 1 Duratio n 30.1 1 Sequenc e Fina l Flag s BVI D 3316 8 ADDRES S 402 3 N 4 5 s t QUADRAN T D Z DEPT H 13 " TYP E CONFIRMATIO N INSPECTO R N

. LOPE Z

pp m Erro r M o < LO D 8.49 4 Z r 460.48 1 : t 16.39 6 S r 166.59 5 i 9.16 2 U < LO D 16.45 5 R b 80.63 6 i 7.36 0 T h 13.32 4 i 8.39 0 P b 151.91 5 i 17.48 8 S e < LO D 6.63 8 A s < LO D 22.26 3 H g < LO D 13.35 4 Z n 255.35 7 i 27.85 7 

## w < LO D 95.65 2 C u < LO D 32.61 6 N i < LO D 82.06 1 C o < LO D 209.98 8 F e 23879.83 6 ± 462.70 5 M n 807.34 3 ± 119.85 6 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n
XL3t-3208 9 Readin g N o 5 6 Mod e SOI L Tim e 2010-06-0 5 10:3 3 Duratio n 90.3 4 Sequenc e Fina l Flag s AVERAG E l»V.ti»orft5,3a5 E ADDRES S 402 3 N 4Vs t QUADRAN T E A DEPT H 1 " TYP E CONFIRMATIO N INSPECTO R N

. LOPE Z

M o Z r S r U R b T h ) e A s H g Z n W C u N i C o Fe M n pp m
< LO D 252.21 4 186.36 7

< LO D 57.69 5 < LO D .,A'i0V04 5

< LO D < LO D < LO D 230.51 5

< LO D 36.70 1 < LO D < LO D 14021.80 5

378.26 4
Supervise d By : 

### ± ± ±

±
± Erro r 7.26 6 11.84 7

8.85 5 13.63 3

5.82 1 10.20 8 -137822--; )

4:yu i 17.72 4 11.18 4 24.28 7 79.73 5 19.63 4 68.63 0 149.46 9 326.08 7

80.72 2

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n
XL3t-3208 9 Readin g N o 5 3 Mod e SOI L Tim e 2010-06-0 5 10:3 2 Duratio n 30.1 2 Sequenc e Fina l Flag s BVI D 3316 8 ADDRES S 4023N45st QUADRAN T EA DEPT H 1 " TYP E CONFIRMATIO N INSPECTO R N

. LOPE Z

pp m Erro r M o < LO D 7.25 2 Z r 253.00 0 ± 11.86 6 S r 185.69 9 ± 8.85 2 U < LO D 13.86 7 R b 61.26 1 ± 5.97 1 T h < LO D 10.16 9 P b 105.17 6 ± 13.58 6 S e < LO D 4.95 3 A s < LO D 17.46 3 H g < LO D 11.73 8 Z n 249.19 7 ± 25.12 2 

## w < LO D 79.11 6 C u < LO D 28.00 9 N i < LO D 69.47 2 C o < LO D 147.56 8 F e 13909.61 6 ± 325.10 5 M n 438.77 7 i 85.39 1 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPT H TYP E INSPECTO R

M o Z r S r U R b T h P b S e A s H g Z n 

## w C u N i C o F e M n pp m
< LO D 254.26 3 182.05 5

< LO D 55.87 8 < LO D 112.61 7

< LO D < LO D < LO D 218.61 8

< LO D 45.79 9 < LO D < LO D 14114.99 4

328.79 6 Supervise d By : 

## Certificat e o fVerificatio n

5 4 SOI L 2010-06-0 5 10:3 2 30.1 1 Fina l 3316 8 402 3 N 4 5 s t E A 1 " CONFIRMATIO N N

. LOPE Z

Erro r
: 7.27 1 ± 11.88 9 ± 8.77 6

: 13.16 3 ± 5.71 6

I 9.98 7 ± 13.95 8

', 4.93 7 ; 17.99 6 : 11.68 9 ± 23.95 0 85.63 0 ± 20.42 0

; 69.02 1 : 150.60 2 ± 327.84 3 ± 76.84 0

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPT H TYP E INSPECTO R

M o Z r S r U R b T h P b S e A s H g Z n 

## w C u N i C o Fe M n pp m
< LO D 249.37 8 191.34 7

< LO D 55.94 7 11.06 9 112.34 3

< LO D < LO D < LO D 223.73 0

< LO D 41.39 2 < LO D < LO D 14040.80 2

367.21 7 Supervise d By : 

## Certificat e o fVerificatio n

5 5 SOI L 2010-06-0 5 10:3 3 30.1 1 Fina l 3316 8 402 3 N 4 5 s t E A 1 " CONFIRMATIO N N

. LOPE Z

Erro r
: 7.27 6 ± 11.78 5 ± 8.93 9

: 13.86 8 ± 5.77 5 ± 6.97 9 ± 13.92 2 4.81 3 17.71 3 10.12 4 ± 23.79 0

: 74.46 0 ± 19.80 8

: 67.39 7 \ 150.23 7 ± 325.31 3 ± 79.93 6

## /^QAOmah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 § ^^^ ^

I Coasta l Environmenta l Grou p Inc

. %y^^ ^

www.coa8talhazmat.co m '^tPHOT*' ^ COASTA L INVIIOIINIIITA l 6 1 0 U r , IM C 

# EXECUTIV ESUMMARY : BVID #33168-(402 3 N4 5 ST )
No Issue s o r Concern s Q Issues/Concern s
Detail Explanation :

- DA NGARVE YWALKE D TH EPROPERT YO N6/24/1 0

### $ ^ 

# EP APropert y Clos e Ou t For m Proptny# : 3 3 /^ ^ DBtc/Tlmc : Quad s Excavated : Contracto r Grou p
Ye s No Excavatio nGeaera l 1

. I f necessaiy , wer eth ecorrec t quadi3nt(s ) excavate dan drestored ? 

### ^ 2

. I f necessary , wer eth e correc t area s o f dri p zon eexcavale dan drestored ? 

## y Ye s N o IDoe s th e gradin g aroun dth eperimete r ofth e hous eiii excavale darea s generall y slop e away fromth e house ? •. Gradin g So daa dVcwtetio B

2

. Ha s so dbeenlai di nal l area s that wer eexcavated ? 3

. Doe s th eso dappea r t o b e generall y health y an dgrowing ? (Onl y evaluat e if inspecte dat a3 0 

## y da y tun eperiod ) 4

. Ar esodde darea s generall y firman devenl y graded ? 

## y 5

. Ar eth ejoint s betwee nth eso dstrip s generall y tight ? (Onl y evaluat e i f inspecte da t a3 0 da y 

## y tim eperiod ) •__. . 6

. Wa s th eproperty grade dsuc hthat wate r wil l not poo l onih epropeny' ' 

# y 

# r 7

. Wa s damag et o landscapin g o r plan t material s avoided ? 

# y
Gates , Fence s an d Retainlo s Wall s V « N o 1

.

D o gates ope n an d cioii e finely? (Ifappiicable ) 

## y y 2

. Wer e al l gate s o rfences take n dow n durin g restoratio n activilie s reinsulled ? (I fapplicable ) 3

. Wa s demtg e t o gates o rfences avoided ? (Ifappiicable ) 

### • 4

. Was damage t o retainin g wall s avoided ? (Ifappiicable ) 

### ^ Foundation , SidiB Rao dGutter s 

### Ye a 

### N o 1

. Wa s damag et o th esidin g o r tri mavoided ? 

## y 2

. Wa s damag et o th e foundatio navoided ? 

### y ?

. Wa s damag e t o window s avoided ? 

### y 4 Wa s damag et o window s o r doo r screen s avoided ? 

# y 5

. Wa s damag el o downspout s o r downspou l extension s avoided ? 

### y Sidewalk s an dDriveway s (Concrete ) Ye s N o 1

. Wa s damag el o drivewa y surface s avoided ? 2

. Wa s damag e t o walkwa y surface s avoided ? 

# y

# Ort'oer s comments :

\ 

### _, 

# piinspectio nnotes :

Remova l an drestorationactivale s complet eincludin g th e30-da y so dwarranty : EP ARepresentativejB ^ A y Date : fAvA )

# L Propert yCompletio n Agreemen t
Thi s agreemen t documenl s th e complclio n o t remedia l acliviiie s perioime d o n mypropertyM ysignature wil l designat e iha l I a m satisfie d wit h (li e restoratio n o fm ypropeily

. an d tha i n o item s ar e i n questions , now , o ra t an ylim e i n th e future , except Ihos e ilem s lisle d below , i fan y PropcifyfP : -^-Z,\Q, % Propert yAddress : H^'Zl > M •^ f j fj)-
­ Owncr^^r-Q|

_ JZ,sJp^c 6 

### Phone : 

# H55'
- ^0^- ? ^ Restoratio n Item s i n Question :

Item : Item : Item : Item : Item : Item :
Additiona l Comments :

1

^ I ii|;rc crestoralio n i s completed , excep t a s note d [ I I rio no t a(;re crestoratin n i » complete d



### ^ 

# ^AV/^

Date .ontiac'ioi' s Signatur e

# ® /


# Propert y Owne r Assessmen t of Performanc < America nRecover y an dReinvestment Act (ARRA f OmahaLea dSuperfundSit e 2009/201 0 JU N 2 1 201 0 Remediatio nContractor : Coasta l Environmenta l Grou n- EP-R7-09-0tf^UPERFUN D DI V 1S10 N Propert y Identifie r Number : 3^lLuft Propert y Address : ^<^^ 5 U Q ^ SJ

Propert y Owner' s Name ; ('!^?r(O Jfti6»^
Instruction s t o th ePropert v Owner : Thi s for mserve s to recor dth e Propert y Owner' s assessment o f perfonnanc e (Incentive 1

- Qualit y Assuranc eSurveillanc ePlan ) involvin g th e liste dremediationcontractor , a s applicable t o th e Omah aLea dSite

. Thi s for mdocument s th e timelines s of punchlis t resolution , busines s relations , complaint resolutio nandth e overal l qualit y o f work

. I f needbe , th e Propert y Owne r may utiliz e thi s for mto recor dproblem s and/o r issue s no t specifically tie dto a nassigne d address , for example , busines s relation s that generally don' t follo w the guideline s set fort hi nthe Poformanc eWor k

Statement

. Th ePropert y Owne r will indicate his/her assessment o f perfomianc e wit hth e contractor' s wor k

b y checkin g anumerica l ratin g onth e tabl e belo w usin g th e numerica l definition s firo m th e ratin g scal ebelow , thensign& date th e form

. 9-1 0 "exceUent " 7- 8 "ver y good " 5- 6 "acceptable " 3- 4 "poor " 1-

2 "ver y poor " Propert v Owner' s Assessment o f Performanc e Regardin g th e Contractor' s Wor k 1 0 y5 9 y4 

## 8 3 7 2 6 1 

## Propert v Owne r Additiona l Comment s fro m(optional ; continu e o nbac k pag e if needed )

Propert yOwne rSignature : ( jJjLAyyyji^id y^Date : ^/^st/yO

. 

# ^•4y//J/^

.