## TRANSMITTALof OMAHALEAD SIT E SOI LREMEDIATIO NFIL EFOLDE R
SAID# : 

# H % Date : 

# 1 h \ ^ Address : "^^^ ^ f^lfPlieil ^ \JU/I ^ Remediatio nContractor : Coasta l Environmeiita l Group
_ Year : 200 9 SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S 

# A Vide o o f property (DVD ) Executiv e Stmimar y 

# A EPA-provide dpropert y sketc h Signe dAcces s Agreemen t for subjec t propert y Signe dAcces s Agreement(s ) for adjacent property Restoratio nAgreemen t Settlemen t doctmient s (i.e. , for damag e o r t o replac e plants , etc. ) Confinnatio ndat a 

# A Photograph s \\i t^lBHk?^/^ V ^gftVfr-Kg* ^ 4 7 ^ As-built sketc h Satisfactory restoratio nsigne db y Property 0>^e r 

# A Property close-ou t chec k lis t signe db y EPA Descriptio no f area s no t meetin g RO D cleanu p criteri a Utility clearance s Propertyinfi^atio nfromDougla s Coimt y Assessor' s Offic e 

# XT *

3021754 1 

# ill i Superfun d

# Propert y Acces s Checklis t PropertylD : S4-TC>« S D WOW C STARTE D ON : / D WORKCOMPELTE D ON : l _

# J 1 . Propert y Addres, : ^Q5 g for.-h'T^ f \l f ^ ^ 

### O^'-"^'- ' ]eu « Address : Z)Curvvi L 

### Ha^rcKC ^
Pfaonc:57y-q'5qi ' Fax : Cell/Page r D Notificatio nLette r 1 ^ 0 ^ D D D D E l O D D ^ tJ Acces s Agreemen t Restoratio nAgreemen t Topsoll Samplin g (i f applicable ) Disposal Samplhi g O f applicable ) Garde nSamplin g (if applicable ) Utility Clearanc e Video/Photo s (Before ) Video/Photo s (During ) Video/Photo s (After ) Video/Photo s (30-Day ) Propert y Completio nAgreemen t

Final Repor t Ai r Monitorin e (a s anDlicable ) nCommunit y QCrc w | Results : On : /
D Commnnit y Results ; D Cre w On : /
D Commnnit y Results : OCrc w | On : / 

### Renter : Phone : Fax : Ceil/Pager
. AddMonal biformfttion :

Sent : / / Signed : ii_/3D/_0 2 Signed : iL/.2ii/IS
. / / / / / / Called : / / 

### On:l2/J_/ M On : / / On : / / On : / / Slgncd:^/ii/^ f Issued : / /
/ By :
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### By :
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### By : By : By : By : By : Gii o /OdaN/^r ^ 

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Omah a Ljead Sit e I

### Dougla s County Accoun t Info ; Pag e 1 of 2 

# w Dougla s County , Nebrask a Propert yRecor d - R240197000 0 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t o f52n d S t - ViewO P Ma p Informatio n i s vali d a s o f2009-1 1 -1 9 Treasurer' s Ta xRepor t Ne wFeatur e - > - •r » Aut o Sate s Searc h Owne r MARASC O LOUI S R 295 8 FONTENELL E BLV D OMAH AN E 68104-000 0 Propert yInformatio n Ke yNumber : 

### 019 7 000 0 2 4 Accoun t Type : Residentia l Parce l Number : 240197000 0 Parce l Address : 295 8 FONTENELL E B D OMAH AN E 68104-000 0 Lega l Description : VINELAN D LO T1 BLOC K1 N 1/ 2 L T2 & AL L 6 0 X 12 5 Valu e Informatio n Lan d Improvemen t Tota l 

### 200 9 $6,900.0 0 $67,600.0 0 $74,500.0 0 200 8 $6,900:0 0 $89,900.0 0 $96,800.0 0 200 7 $6,900.0 0 $89,900.0 0 $96,800.0 0 200 6 $6,900.0 0 $89,900.0 0 $96,800.0 0 200 5 $6,900.0 0 $59,100.0 0 $66,000.0 0 200 4 $6,900.0 0 $53,700.0 0 $60,600.0 0 Sale s Informatio n Sale s Date : 2008-09-1 8 Dee d Type : W D Booiir : 200 8 Page : 09579 1 

### Price : $75,000.0 0 Grantor : Whit e Rosali e M Eta l Grantee : Marasc o Loui s Rober t Valld/lnvalld : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 

### 0.1 7 7500. 0 

### 1.0 125. 0 60. 0 N o Improvemen t Informatio n 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R2.
. . 11/24/200 9

### Dougla s County Accoun t Inf«jj^^o n Pag e 2 of 2 t(^j|3^ ^
Buildin g 1

EmtStiw n 2»«F0MTENeLLEB 0 J S ­ tie r
JDE T rr rti n Rrs t Boo r Secon d Ftoo r nSB.OS Q ft
. C D 078. 0 m 1 r p B U m r 1 V 2 STOR Y 12 1 j I I t rI4 a BsffrtsiBateft 170 WOCKivcmn m

CLIC KT O ENLARG E IMAG E CLIC KTO ENLARG E IMAG E Squar e Footage : 1470. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e 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 : 7. 0 Exterior : Fram e Viny l Units : 1. 0 Interior : Drywal l Batiis : 1. 0 Roo fCover : Compositio n Shingl e Bedrooms : 3. 0

Roo fType : ; Gabl e Stories : 1. 5 Floorcover : 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 0 0 % 192 0 9 0 DefafV Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Applianc e Fireplac e Masonr y 1. 0 Basemen t Bsmn t Bloc k 8 f t 1152. 0 Basemen t Minima l Finis h 400. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Garag e Detache d 288. 0 Porc h En d Scree n 96. 0 Porc h Kne e Wal l 24. 0 Use r ML S UPDAT E 1. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R2..
. 11/24/200 9

# i » Pag e 1 o f 1

" > [ Creat e Anothe rTjcke t ][ , Bac k t o Irt h Internet ^ J iL.-Sgndprnaj l : |



### • YOU RTICKE T NUMBE RI S 2415350 . Origina l Cal l Date : 12/01/0 9 Time : 12:0 8 pm Op : ELIZABETH1879 0 Wor k t o Begi n Date : 12/03/0 9 Time : 12:4 5 pm State : N E County : DOUGLA S Place : OMAH A Address: . 295 8 Street : FONTENELL E BLV D Twp : 15 NRng : 13 E Sect-Qtr : 08-NW-S W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : LEA D REMEDIATION Locatio n o f Work : INCLUD E AL L EASEMEN T LOCAT E ENTIR E PROPERTY Remarks : PA X AL L CLEAR S TO : (877)662-421 1 : tnJSUR E O F CORNE R LO T Compan y: COASTAL ENVIRONMENTA L SERVIC E Contac t Name : ELIZABET H Phone : (877)662-421 0 Wor k Being Don e For : COASTAL Dept h o f Excavation : 4 F T Corne r Lot : N Front : Y Rear : Y Involve s Tunnelin g o r Horizonta l Boring : N Explosives : N CXCAT V MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C
Servic e Are a Contac t Plion e Numbe r Utilit y Typ e CXCAT V CO X COMMUNICATIONS , IN C HEIDI 

### Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7
MUDO l METROPOLITA NUTILITIES DISTRICT SAND Y 

### Day : 402504782 3 Alt : 

### Emerg : 402504797 0
OMAHACO FCIT Y OFOMAHA-TRAFFIC,SEWE R 

### RICH/TRAFFI C Day : 402444719 7



### Alt : 402444516 1

Emerg : 4024445160
OPPDGPR 5 OMAH APUBLI C POWE RDISTRICT N A 

### Day : 406728934 3 Alt : 4062071494 Emerg : 888728934 3 QLNNEI C QWES T LOCA LNETWOR K N A 

### Day : 406728934 3 Alt : 4062071494 Emerg : 888728934 3
http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 12/1/200 9OLS# : 8470 5 

# As-Buil t Drawin g " Dat e Excavated : 12/4/0 9 Dat e USEP ASiane d Off : 1/19/1 0 COASTA L 

# Omah aLea dSuperfun dSit e Are a Sodden : 126 0 s a f t


### 14705 Exleno rPain t Omah a Lea d Sit e Q^Goo d Sit e Sketc h •Roo t Samplin g Address : 295 8 FONTENELL E B D n Not pain t Lea d Sampl e Sample s Collecte d Sampl e Numbe r LA B Concentratio n Collecte d Firm : P-£ - Q.d ^ £< • RYASCPXA-8470 5 F l 

## 3(s 2 pp m 

### D Date : t : -g-rt ^ RYBSCPXA-8470 5 F 2 pp m 

### D 

### 3 ? l Time : ^:0 5 P > •< ^ RYCSCPXA-8470 5 B 1 

### D Sample s Analyze d RYDSCPXA-8470 5 B 2 582
. pp m 

### D RDZSCPXA-8470 5 D Z 

### ^i25JL_PP m 

# I D XR F Unit : JOBUT
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- pp m ~ 

# n D Date : 'r-2.7-0' ) RPZSCPXA847 M -P2 - ~ pp m 

### D D Time : A m Staff : M j y Numbe ro fSample s = | S | | Q | Legend : F l = Fron t Left , F 2 = Fron t Right , B 1 = Bac k Left , B 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , P Z = Pla ; slfronth e s AH quadrant s ar e a s viewe d fro n th e stree t facin g propert y i i y i ¥-

CnAi i iJi>.S.iv-. «


### Legen d Concret e Dri p Zon e Excavate d Quadrant s Excavate d Are a replace d wit h So d' ' Are areplace dwit h Rock/Mulc h Are alef t bar e 

### Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc .

## 1 7

8470 5 Exterio rPain t Omah a Lea d Sit e [3^Goo d Sit e Sketci i •Poor SmnfUWtfAadnm : 29S B FONTENELL E B D [| ] No t paint Sampl e Numbe r Lea d Sampl e LA B Sample s Collecte d Concentraflo r Coilecle d Firm : P-£ •C
. •d - £•< • RYASCPXA-8470 5 F l JJCo Z pp m 

### D Date : < -g-t f RYBSCPXA-8470 5 F 2 3 3 I pp m 

### D Time : ^.Q. ^ f \
. i ^ RYCSCPXA-8470 5 B 1 I j T pp m 

### D Sample s Analyze d RYDoCPXA^a4.70 5 8 2 ^82
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### D ROZSCPXA-M70 S OZ 

### D 

# I
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. Book : Z3 S -RCZ6CPX A8470 S 62 - ~ pp m 

### D Dat e ^^-•^7•o' ^ • aP^SCPX A8470 6 Pi - ~ pp m 

### D 

# a Tim e 

### D Staff : <«iiu ^ Numbe ro fSample s = | S \ \ Q | Legend : F 1 = Fron t Left , F2 Fron t Right , 8 1 = Bac k Lefl , B2 = Bac k Righ t DZ = Dri p Zone , G Z = Garden
. PZ = Pla ; M quadrant s ars a s viewe d ffo m tti e street , fadn g propoty t



# Sc- A

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8470 5 Omah a Lea d Sit e Exterio rPaint Sit e Sketc h g^Goo d •Poor Samplin g Address : 2958 FONTENELLE BD [ ] No t pain t Sampl e Numbe r Lea d Sampl e Sample s Collecte d 

# I LA B Concentratio n Collecte d Fir m p . £ •r..d
. £.«: • RYASCPXA-8470 5 F l 

# • pp m Dat e RYBSCPXA-8470 5 F 2 

## Jil l pp m 

### D Tim e q-.Q 3 ft-^ RYCSCPXA-8470 5 8 1 ^ 1 pp m 

### D Sample s Analyze d RYDSCPXA-8470 5 8 2 382 , pp m 

### D RDZSCPXA-8470 5 D Z pp m 

### D XR F Unit : /fiff^l
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### D D Date : <--.2 7 0< ? RPZSCPXA8470 6 PZ - pp m 

### D Time : 

### D Ar y Staff : 

### i*is y Numbe ro fSample s = | S \ \ Q | Legend : F 1 = Fron t Left , F 2 = Fron t Right , B l = Bac k Lefl , B 2 = Bac k Righ t DZ = Dri p Zone , G Z = Garten
. PZ = Pla ; A B quadrant s ar e a s viewe d fro m th e ^^eet , fadn g propert y



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### 84705 Exterio rPain t Nort h Am w Omah a Lea d Sit e H^Goo d Sit e Sketc h •Poo r Samplin g Addreas : 295 8 FONTENELL E BD , •Not pain t Sampl e Numbe r"-ea d Concenlratio n Sampl e Collecte d ^. ^ '^

^ Fim, : Sample s Collecte d P.£
. C C £.K
. RYASCPXA-84705 Fl .^ 6i 2 po m \ ^ H Date : C-g-fP l RYBSCPXA-84705 F2 33 1 po m tT fH Time : <^:0 3 t\.t ^ RYCSCPXA-84705 Bl I<^ 1 Pom fTfH RYDSCPXA-84705 B2 S6 2 a m M p Sample s Analyze d RDZSCPXA-84705DZ 31^ 1 txtt n IT TH XR F Unit : JPgbi
. Book : 23 S Date : <--i7-O l Time : A m Numbe r ofSample s = S O Staff : **J^« / Legend : Fl = Fron t Left , F2 " Fron t Right , Bl - Bac k Left , B2 = Bac k Righ tOZ - Dri p Zone , GZ " Garden , PZ = Pla ; ^^

AKyadranl s amaavtawedjw n th e great , teeing propaity 

# ' ' ENTERED : HAY 1 2 208 9



### fib <^i::r:::c?: 3 

## fl 

# © szsic : f:o.»jVeM*l U S p ReviJO S Cruift l i^Nrtv-f «.*>^*L'^*v , COASTA l EHVIttONHIttTA l CROUP
. IN C 

### Consen t fo rAcces s T o Propsrtj ' RIGH TO F ENTR YT O PREMISE S 

### Granto r(th e propert yowner ) consent s t o an d authorize s th e Unite d State s Environmenta l Protectio n Agenc y(EPA ) o rit s authorize d representatives , collectivel y th e Grantee , t o ente ran d perfornr i certai n environmenta l respons e activitie s upo n th e followin g describe d premises : ^ ^

Owner' s Name : ^ Daytim e Phone : 

# LtM 6 M^y^iJ b 

# Ao^^yo^'7392 . Addres s o fPropert y covere d b ythi s 

# f f5 S fOAe^K^OL E^i > Agreement :
PURPOS E O F RESPONS E ACTIVITIE S 

### Th e EP Ai s requestin g acces s t o collec t soi l sample s an d remov e soi l tha t contain s elevate d concentration s o flea d an d ma ypos 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 it s 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 , wil l contac t th e Granto rin-perso n t o discus s th e wor k t o b e perfonmed , th e Granto rwil l hav e a n opportunit yt o revie wan d approv e th e planne d soi l removal , an d restoratio n wor k befor e 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 wor k an d confin n 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 EP Atha t th e propert y ha s bee n remediated
. ENVIRONMENTA L RESPONS E ACTION S 

### B ysignin g thi s Acces s Agreement , th e Granto ri s grantin g th e EPA , it s employees , contractor s an d subcontractor s 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 effec t unti l th e wor k ha s bee n satisfactoril ycompleted
. Th e Granto rals o agree s to :
Pag e 1 of2

## y*^ \
COASTA L INTINOHHIKTA l C ft 0 U rIM C 

## Ki^c y

« Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; cRemov 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 ; cWate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , a s necessar ysubsequen t t o a n initia l waterin g perio d b yEPA ; eAbid 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 perfor m th e work
. /feT ) 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 wor k activities , o rwit h an y o fth e wor k done , o rwit h th e equipmen t use d o n hi s property , o rt o undertak e an y action 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 ) 991-119 9
^

I gran t acces s t o mypropertie s D i d o no t gran t access t o mypropertie s

signature Signature Date

DI woul d lik e t o b e presen t durin g an ysampiin s tha t i s required
.

Page 2 o f2Coasta l Environmenta l Grou p wa s awarde d a contrac t fro m th e EP At o remov e Lea d impacte d soi l fro m residentia l propertie s withi n th e Omah a Area
. Pe rthi s contrac t Sundaywor k activitie s ca n onl yb e performe d wit h writte n consen t o fth e neighborin g residents
. B ysignin g thi s for m i acknowledg e tha t I understan d tha t excavatio n an d backfil l wor k wil l b e performe d a t th e adjoinin g addres s liste d o n SundayDecembe r6,2009
. Addres s 2-^f?- ^ feyOrrg<^l^^^^-£rgg/ p Propert yOwne r Signatur e ^ 

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. aCi'yfy COASTA L 

## Restoratio n Agreemen t Th e purpos e o f thi s agreemen t i s t o provid e amutua l agreemen t a s t o condition s ofth e propert y prio r to remediatio nactivities
. Thi s wil l als o serv e a s documentatio nfo r th e purpos e o f assurin g tha t restoratio n activitie s ar e complete dt o th e satisfactio nofth e property owne r an dth e Unite dState s Environmenta l Protectio nAgenc y (EPA) .

Propert y ID : 

# (ZJ ^ PropertyAddress : y p f.^ ^

T^^i^^AA^/?<
. / Z fc~ ^A ) Owner ; L(pLC/ S AUf'heAlS/j o 

### Phone ; /;/ZPZ^J^^ H ^ 3 <?-2
- O nth e attache ddiagram(s ) indicat e aiiea(s ) tb excavate , surfac e structure s andlandscapin g feature s and acces s location(s ) t o b e use db y th e contractors . Indicat e distances , depths , material types , etc . Photographicall y an dVideographicall y documen t th e existin g condition s ofth e property an dth e basemen t i f necessary . 

### Item s t o b e Remove d b yth e Owne rbefor e Star t o fRemediation : Th e renoval
. storage , disposal , and/o rretur n ofthes e Itom s I s th e Owner' s responsibilrty
. ttem: 

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### item s t o b e Remove d b yth e Contracto rDurin g Remediatio n an d Wot Replace d ttem: A^ 

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### Ite m Pre-existin g propert y area , tha t wil l b e excavated , tha t i s covere dwit hgrass . Numbe r o f tree s > 2 inc h trun k diamete r Numbe r o f tree s < = 2 inc h trun k diamete r Numbe r o f Sprinkle r Zones , Contro l Valves , Timers , Heads , etc . Atiat h! i skficl i o l \\\ i sprirklc i l;iyoLi i Numbe r o f an dsiz e o f eac hgarden / flower be d area . All;tt h; i sketc hol ri.-!;tliv f jizc s midloc;llilMl ^ Agree dupo nvalu e o f plan t material s no t t o b e replace db v contractor . \cl c l!ii ' \HIII C «il l nv usro ' I U li ! U ( . 1 iiluit ! >oiie;ii.' : Il l (h e liriipcr n OMnt;i-
. Easemen t Area , t o b e excavate d 

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tPr ^ 

# y

Landscap e Inventor y 

### Quantit y Unit Condition/Type/Specie s Quadrant s 

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I Addttiona i Comment s / Instructions : 

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IS J chec k th e bo xi f Owne 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 thi s bo xCE G I s no t responsibl e fo ran ydamag e don e t o th e interio ro f house , includin g foundatio n crack s o rfissures
.
] [ agre e Q I do no t agre e

Owner' s Signatur e Dat e Cbntractor' s Signatur e ' Dat e Pag e 3 o f• •
BVID # /VT^RS " 

### XR F PROPERT Y SAMPL E SHEE T Dat e 

# loJ^i ^ Addres s Projec t Omah a Lea d ARR A Sampl e tim e XR F ID # sampl e lengt h

Shot # Readin g Sampl e are a Shot # 

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RETES TAREA S Shot # Readin g Sampl e are a Shot # Dept h Averag e Averag e Signatur e 

# ^(jMrn/ ) Prin t ?JunMhCAyQilflOl ^ <^^S S Fit.Uc^4!£Afe^t^ am/p m 3 0 se c Readin g Sampl e are a / / / 

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# m^ i S /3 ' I3^ f"i - Iff , Readin g Sampi e are a Dept h

Readin g Sampl e are a Dept h

Readin g Sampl e are a Dept h

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1 

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 29 7 Mod e SOI L Tim e 2009-12-0 5 08:0 7 Duratio n 91.3 5 Sequenc e Fina l Flag s AVERAG E Av g o f294-29 6 ADDRES S 295 8 fontenell e QUADRAN T e m DEPH T 1 XR F TEC H R
. VENTRY MIS C clearenc e NOT E ngn c
pp m Erro r P b 142.00 6 17.13 0 Supervise d By : 

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

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pp m P b 136.06 4 Supervise d By : 

## Certificat e o fVerificatio n

29 4 SOI L 2009-12-0 5 08:0 6 30.5 2 Fina l 8470 5 295 8 fontenell e e m 1 R
. VENTR Y clearenc e ngn c

± Erro r ± 16.13 7

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

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 153.80 0 Supervise d By : 

## Certificat e o fVerificatio n

29 5 SOI L 2009-12-0 5 08:0 7 30.2 9 Fina l 8470 5 295 8 fontenell e e m 1 R
. VENTR Y clearenc e ngn c

± Erro r ± 18.95 2

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

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E
pp m P b 136.15 3 Supervise d By : 

## Certificat e o fVerificatio n

29 6 SOI L 2009-12-0 5 08:0 7 30.5 4 Fina l 8470 5 295 8 fdntenell e e m 1 R
. VENTRY clearenc e ngn c

± Erro r ± 16.30 3

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

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 29 3 Mod e SOI L Tim e 2009-12-0 5 08:0 4 Duratio n 91.5 6 Sequenc e Fina l Flag s AVERAG E Av g o f290-29 2 ADDRES S 295 8 fontenell e QUADRAN T B 2 DEPH T 6 " XR F TEC H R
. VENTRY MIS C clearenc e NOT E ngn c
pp m Erro r P i 37.07 3 10.66 9 Supervise d By : (J}CCU*iVDj ^

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

## Certificat e o f Verificatio n XL3t-3902 2 Readin g N o 29 0 Mod e SOI L Tim e 2009-12-0 5 08:0 3 Duratio n 30.6 6 Sequenc e Fina l Flag s BVI D 8470 5 ADDRES S 295 8 fontenell e QUADRAN T B 2 DEPH T 6 " XR F TEC H R
. VENTR Y MIS C clearenc e NOT E ngn c
pp m ±Erro r Pb 39.08 9 ±10.63 8 Supervise d By :

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

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRANT DEPH T XR F TEC H MIS C NOTE

pp m P

b 28.96 0 Supervise d By : 

## Certificat e o fVerificatio n

29 1 SOIL 2009-12-0 5 08:0 4 30.3 7 Fina l 8470 5 295 8 fontenell e B

2 6 " R
. VENTR Y clearenc e ngn c

± Erro r ± 10.20 5

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

XL3t-3902 2 Readin g N o Mode Tim e Duratio n Sequence Flag s BVI D ADDRES S QUADRANT DEPH T XR F TEC H MIS C NOTE

pp m Pb 43.17 1 Supervise d By : 

## Certificat e of Verificatio n

29 2 SOIL 2009-12-0 5 08:0 4 30.5 3 Fina l 8470 5 295 8 fontenell e B2 6 " R
. VENTR Y clearenc e ngn c

± Erro r ± 11.16 4

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

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 30 1 Mod e SOI L Tim e 2009-12-0 5 08:1 0 Duratio n 91.2 6 Sequenc e Fina l Flag s AVERAG E Av g o f298-30 0 ADDRES S 295 8 fontenell e QUADRAN T D Z DEPH T 13 " XR F TEC H R
. VENTRY MIS C clearenc e NOT E ngn c
pp m ± Erro r 

### P

b 121.25 5 ± 16.48 0 Supervise d B y 

## •.^^:MM LSCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 110.68 3 Supervise d By : 

## Certificat e o fVerificatio n

29 8 SOI L 2009-12-0 5 08:0 8 30.5 1 Fina l 8470 5 295 8 fontenell e D Z 13 " R
. VENTRY clearenc e ngn c

± Erro r ± 15.31 7

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

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 119.41 2 Supervise d By : 

## Certificat e o fVerificatio n

29 9 SOIL 2009-12-0 5 08:0 9 30.5 6 Fina l 8470 5 295 8 fontenell e D Z 13 " R
. VENTR Y clearenc e ngn c

± Erro r 15.74 2y ^
.

— 

# Therm o

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

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 133.67 0 Supervise d By : 

## Certificat e o fVerificatio n

30 0 SOI L 2009-12-0 5 08:1 0 30.1 9 Fina l 8470 5 295 8 fontenell e D Z 13 " R
. VENTR Y clearenc e ngn c

± Erro r ± 18.38 2# # 

### .^mA^ o iAOL \ ST^^y ^ ^ K ^^tpfioTt ^ 

### i
. .. . _. ._ Omali a a Lea d Site—Fixe d Pric e EP-R7-07-0 5 Coasta l Environmenta l Grou p inc
. www.coastalhazmat.co www.coasiainazmat.co m m 

# EXECUTIV ESUMMARY : BVID #84705-(295 8 FONTENELL EBLVD ) No Issue s or Concern s Issues/Concern s Detai l Explanation : V -"^^- ^ COASTA L EHVItONHENTA L C • 0 U P, IN C• • ^ 

## EP APropert y Clos e Ou t For m Propert y # : _.'.... , Propert y Address : /fy^^ ^ JtO>^sS ^ Daten-lme : Owner' s N.me : fi--^^^^ ^ fyA:^^^^== ^ Quad s Excavated : g,^, , I ^ ^ f^ M Contracto r Grou p C:^^'of ^ ^ Ye s No Excavatio nGenera l 1 . I f necessary , wer eth ecorrec t quadrant(s ) excavate dan drestored ? 2 . I f necessary , wer eth ecorrec t area s ofdri p zon eexcavate dan drestored ? y Gradin g So dan dVcgetalio B Ye s N o IDoe s th egradin g aroun dth eperimete r ofth ehous einexcavaie darea s generall y slop eaway fromth ehouse ? 2 . Ha s so dbee nlai di nal l area s that wer eexcavated ? 

## y S . Doe s th eso dappea r t o b egenerall y health y an dgrowing ? (Onl y evaluat ei f inspecte da t a3 0 

## y da y tim eperiod ) 4 . Ansodde darea s generaU y fir man devenl y graded ? 5 Ar edi ejoint s betwee nth eso dstrips generall y tight ? (Onl y evaluat eif inspecte da t a3 0 da y 

# y tim eperiod ) ] ________. . 

# r 6 . Wa s th epropert y grade dsuc hthat wate r wil l no l poo l o nth e propertv'" ' 

# y I7 . Wa s damag et o landscapin g o r plant material s avoided ? 

## y Gates . Fence aan dRetainin g Wait t Ye s 

# r 1 D o gate s ope nan dclos efreely? (Ifapplicable ) 2 . Wer eal l gate s o r fence s take ndow ndurin g restoratio nactivitie s reinsulled ? (If applicable ! 

## y 3 . Wa s damag et o gate s o r fence s avoided ? (Ifapplicable ) 

### y

' 1 Wa s damag et o retainin g wall s avoided ? (Ifapplicable ) 1 Foundation , Sidin g an dGatler s Ye s N o IWa s damag et o th esidin g o r tri mavoided ? 

## y 2 . Wa s damag et o th efoundatio navoided ? 

### y Wa s damag et o window s avoided' ' 

### J A 4 Wa s damag et o window s or doo r screen s avoided ? 

# y i 5 Wa s damag et o downspout s o r downspou l extension s avoided' ' 

## y Sidewalk s an dDriveway s (Concreie ) Vc s N o 1 . Wa s damag et o drivewa y surface s avoided ? 

### y 2 , Wa. < damag et o walkwa y surface s avoided " 

## y

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_

# • • OM'ner s comments :

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## Removal andresloralio nactivate s complel e includin g the 30-da y sodwarranty : EP ARepresentittiv e B^-^^a nDate : ,|ii(f o• • • •



## Propert yCompletio n Agreemen t I hi s agieemen i documenls
. lh e complclio no l remedia l aclivme s perloime do nm y propert y M y signatur e will designat e Ihal 1 amsatisfie dwit hlh e restoratio nofm y properly , an dIha l n o item s ar e i nquestions , now , o r a l an y tim e i nth e fxiluie
. excep l thos e item s liste dbelow , ifan y 

### PropertylD : g Lj' ^ Q ^ Property Addres.

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# ^oD^lfK-'\^c( x Restoratio nItem s inQuestion :

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

1 ^ 1 ajjrc c I c.<itortilio ni s completed , excep t a s noler i [_ J I rto no t ayie c restoratio ni s complele d

wncr' s Signatiii f Dat e [ Con^iarlor' s Signatur e Dal e

### # •

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### BVID. : g^^ ^ 

### Nam e o f PO : ^ U i S ynf^r^Z S C C ) 

## Date: I S i I l b lo ^ Address : fl^ ^ fl9r]^^eM ^ 

# dfS9r-i39A l Description : 

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# ^^' ^ ^•"'^ ^ UlniAJ Alfk£
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### PiF P '^ 9 220 9 = ropeil vOv-'ne rSetisfaciiyr i Survey^"- ^ O^ahauac^superfunds:
. gUPERFUN D DIVISIO N Remediatio n Contractor ; Coasta l Enviror^menta l Grou p Propert YIdentifie rMumber : 9^ M "?r > f T Propert yAf<rir.^s. : ^c^^S'^ N FvS>0-k'j>V>/)[3 ^ BlV ^ Propert yOv^ner' s IMamc : ^r^V yI S M^f/ ) S rQ (abov e informatio n t o be fille d ou t b yremediatio n contracto rprio rt o deliver yoffor m l o Propert yOwner)
Instruction s t o Propert yOwner : Thi s for m i s provide d t o yo u a s a mean s o ftryin g t o captur e you rleve l o fsatisfactio n wit h th e wor k o fth e above-identifie d remediatio n contractor , as applicabl e t o th e soi l cleanu p actio n at you r property
. Th e U.S
. Environmenta l Protectio n Agenc y(EPA) i s ver yintereste d i n you ropinio n regardin g th e wor k performe d b yit s contractors
. Thi s for m i s intende d t o provid e a n eas ymean s fo ryo u t o expres s you ropinio n abou t th e wort < performe d o n you rproperty
. Pleas e indicat e you rleve l o fsatisfactio n wit h th e contractor' s wor k b yselectin g a numerica l ratin g (rangin g fro m 1 t o 10 ) usin g th e followin g ratin g scale , the n pleas e sig n an d dat e th e for m an d retur n i t t o th e USEPAi n th e attache d self-addresse d & stampe d envelope , (additiona l comment s ma y als o b e provide d i n th e spac e below , a t th e optio n o fth e propert yowner. )
^•'^ ' 9-lo}y ^ "excellent " '^ ~ -T-' B "verygood " 5- 6 "acceptable " 3- 4 "poor " 1-2 "ver ypoor " Propert yOwner' s Satisfactio n Ratin g Regardin g Contractor' s Wor k 5 9 4 8 3 7 2 6 1 Additiona l Comment s fro m Propert yOwne r(optionai ; continu e t o bac k o fpag e i f needed )

Prnpprt yOu/ner' s SignatureT^W ^ N^-^' ^ V"^>-r^ TDate : J^^jA^ZlQil
.