## TRANSMITTA Lo f OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R
SAI D # : ifS?)^
. IDate : ^ lO^SlCP j Address : 61^( 1 ?^^2?S f RemediationContractor : Coasta l Environmental Group

_Year : _2008
_ SOI LREMEDIATIO N PROPERT YFIL EFOLDERDOCUMENT S G

XVide o o f propert y (DVD ) 4031540 6 ^ Executiv eSun-^ar y 11^1 1 W i H ^ EPA-providedpitipert y sketc hSuperfun d s y Signe dAcces s Agreemen t fo r

subjec t propert y HJrr Signe dAcces s Agreement(s ) fo r adjacen t propert y 53 ^Restoratio nAgreemen t l^tH^Settlemen t document s (i.e. , fo r damag eo r t o replac eplants , etc. ) Q / Confinnationdat a ffl^ Photograph s OT ^- f ^r^i^hJlO A^ OJ^CoMzKyK
. 0As-buil t sketc h WSatisfactor y restoratio nsigne db y Propert y Owne r ^y Propert y close-ou t chec k lis t signe db y EP A fAtp

- Descriptio no f area s no t meetin g RO D cleanu p criteri a WUtilit y clearance s M Propert y informatio nfro mDougla s Count y Assessor' s Offic e


# ^ tsskt u D



# 5^^* ^

### Propert yAcces s Checklis t Property ID ; yf)'^2
. Property Address : 2, ^ 

# 1 't ) ?,>S^ T n D

WOR K STARTE D WORKCOMPELTE D ON : ON : _ / / l_ /


### Owner : S(Loi ^ Address : Saynt . [j^')c,\\ct^ ^ Renter' ' Phone : Fax : 

### Phone : Fax : 

### 3 ^ \­ 5Wlo 2 Cell/Pager : Additional Information : Cell/Pager
. D [ZJ [ ^ D D D NotificationLette r Acces s Agreement Restoratio nAgreement Topsoil Samplin g (if applicable ) Disposa l Samplin g (if applicable ) Garde nSamplin g (if applicable ) Sent : / / Signed : /Q/77/o ^ Signed : JO/22-/i ^ / / / / / / By : By : By : By : By : By : 0 ^ D D D 0 D Utilit y Clearanc e Video/Pliofo s (Before ) Video/Plioto s (During ) Video/Photo s (After) Video/Photo s (30-Day) Property CompletionAgreement Final Report 

### Called: ii/2S/O S On:j0_/22fl2 3 On : / / On : / / On : / / Signed : / / Issued : / / 

### By : iO/Zl/Oh By-MtCLl^lOt? , By : By : By : By : By : Air Monitorin e (a s annlicable ) D Communit y D Crew Results : On : / / By : 

# 1

D Communit) ' Results : D Cre w | On : / / By
. 

# 1

• Communit) ' Results : • Crew On : / / By :

Omah a Lea d Sit e

## CONTAC TFOR M Property I D M 

# l^^2 l Property Address : 

# ^g'l l r ^ 

# ^^^'^ ^ 3 1 Initia l Contact : Date : Time : Action : Secon dContact : Date : Time : Action : Fina l Conlact"
. Dale : Time : Aclion : Fina l Action : Transmi t l o EP AD Olhe r .Aclion : D

Commeni
. Owne r Commen t (s) :

-- J 

## Sit e Coordinato r Cornmen i (s) :

## Dougla s Count y Accoun t Information Pag e 1 of3
Dougla s County , Nebrask a Propert yRecor d - R140967000 0 Prin t Repor t NE WFsatur a - Parce l Dimension s availabl e 6 scal e 0-5 0 f t wes t o fQOt h S t - ViewO H IXla p Informatio n i s vali d a s o f2008-9- 4 Treasurer' s Ta xRepor t Ne wFeatur e ->->- > Aut o Sale s Searc h Owne r WALKE R J R SCOTT ETA L 281 1 8 3 3 S T OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumber : 096 7 000 0 1 4 Accoun t Type : Residentia l Parce l Number : 140967000 0 Parce l Address : 281 1 S 3 3 S T OMAH AN E 68105-000 0 Lega l Description : ILE R AD D LO T1 5 BLOC K3 5 0 X114. 5 Valu e Informatio n Lan d improvemen t Tota l 200 8 $6,000.0 0 $80,900.0 0 $86,900.0 0 200 7 $6,000.0 0 $80,900.0 0 $86,900.0 0 200 6 $6,000.0 0 $79,900.0 0 $85,900.0 0 200 5 $6,000.0 0 $79,900.0 0 $85,900.0 0 200 4 $6,000.0 0 

### $79,900.0 0 $85,900.0 0 200 3 $6,000.0 0 $79,900.0 0 $85,900.0 0 Sale s Informatio n Sale s Date : 1998-10-0 1 Oeec fType : Book : 210 3 Page : 62 8

Price : $83,500.0 0 Grantor : Grantee : Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 1997-05-2 8 Deec fType : Book : 

### 206 1 Page : 48 3

Price : $ 67,000.0 0 Grantor :


## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R14..
. 10/7/200 8

### Dougla s County Accoun t Infonnatio n Pag e 2 o f 3

Grantee : Valid/invalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 3 5700. 0 1. 0 114. 0 50. 0 N o Improvemen t Informatio n Buildin g 1



### TW O STORY

, t T 1 3 [ T 1 2 C i f

TKOSf l = : JJOOS f ^ 1 1

X t t

M ! 3 TJ d 0 S F CLIC KTO ENLARG E IMAG E CLIC KT O ENLARG E MAG E Squar e Footage : 1456. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 2 Stor y Cond o Squar e Footage : 0. 0

HVAC : Force d Ai r Rooms : 7. 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 : 2. 0 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 191 0 0 0 % 191 0 9 8 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 ft 720. 0 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R14.
. . 10/7/200 8

## Dougla s Count y Accovm t Information Pag e 3 of3

Fixtur e Fixtur e Fixture Garag e Porc h Porc h Porc h Porc h Additiona l Fixture s Bas e Fixture s Bat h Ful l Detache d En d Scree n Sla b RoofCei l Sla b RoofCei l Woo d Dec k 1. 0 1. 0 1. 0 240. 0

24. 0 160. 0

24. 0 216. 0



## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R14..
. 10/7/200 8

### Pag e 1 of 2

" > Creat e Anothe rTicke t Bac k t o Irt h Interne t Sen d Emai l


### YOU RTICKE TNUMBE RI S 2160937
. Origina l Cal l Date : 10/23/0 8 Time : 5:3 6 p mOp : ELIZABETH1879 0 Wor k t o Begi n Date : 10/27/0 8 Time : 6:0 0 p m State : N E County : DOUGLA S Place : OMAH A Address : 281 1 Street : S 33R D S T Twp : 15 NRng : 13 E Sect-Qtr : 28-SW,33-N 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 PROPERT Y INCLUDIN G HOUS E AL L TH E WA Y T O TH E : STREET . Remarks : FAX AL L CLEAR S TO : (877)662-421 1 Compan y: COASTA L ENVIRONMENTA L SERVIC E Contact Name : ELIZABET H Phone : (877)662-421 0 Wor k Bein g Don e For : coasta l Dept ho f Excavation : 4f t Corne r Lot : N Front : Y Rear : Y Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V LEVEL 3 MUD0 2 OMAHACO F 0PPDGPR 6 QLNNEI F QWEST 2



### Service Area Contact Phon e Numbe r UtiUt y Type Day : 402934046 9 CXCAT V CO XCOMMUNICATIONS , IN C 

### HEID IAlt : 402934046 9 Emerg : 402932975 7 Day : 877366834 4 LEVEL S LEVEL S COMMUNICATIONS , LL C 

### N AAlt : Emerg : 877366834 4 Day : 402504782 3 MUD0 2 

### METROPOLITA NUTILITIE S DISTRIC TSAND YAlt : Emerg : 402504794 6 Day : 402444719 7 OMAHACO FCIT YO FOMAHA-TRAFFICSEWE RRO NAlt : 402444516 1 Emerg : 402444516 0

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT.
. . 10/23/200 8

## Pag e 2 of2

0PPDGPR 6 OMAH APUBLI C POWE RDISTRIC TN A 

## Day : 406728934 3 Alt : 888728934 3 Emerg : 406728934 3
QLNNEI FQWES TLOCALNETWOR K 

### N A 

### Day : Alt : Emerg : 406728934 3
; 888728934 3
QWEST 2 QWES TLON GDISTANC E SARA 

### Day : Alt : Emerg : 800283423 7 303992192 6 800283423 7



## http://wv^'w.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT..
. 10/23/200 8

# As-Buil t Drawin g COASTA L 

# Omah aLea dSuperfun dSit e

Name : <i cv't fU^/Zi'-* ^ Omah a Lea d Sit e Date : {^-6-c } Nort h Arro w Address : 2 J?/ I 5 , 3 ?'^A Sit e SIcetc h Time : Phone : •? ! ; - )yi, ~ C/7< r < Tea m ^^^( / X/ V .^^^^^VID # / T-^" ^

/ XR F Cod e 

# BSO \ Sampl e Numbe r Lea d Concentratio n Confirmatio n Sampl e r<Ye s a N o 12 1 

# £lh r^Yes a N o c a pp m a<i( g t 5 PP" ! ^ ' Ye s • N o 5 3 pp m ^» - Ye s n N o C S pp m i:»XYe s n N o 1 3 pp m / Ye s • N o 1 ^ pp m / Ye s • N o • pp m

.QJLS#:-15a2 1 i pat e Excavated : 11/5/0 8 gate ; USEP ASiante d Off:[12/9/^^ Are a Sodde d 362 8 si q JP t



# 5 vJ'-;

- Legen d Concret e Dri p Zon e Excavate d Quadrant s Excavate d Are areplace dwit^h Are areplace dwitl i Are alef t bar e So d' ' Rock/Mulc h 

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

### Name : <cdffU^/^" ^ Omah a Lea d Sit e Date : 

### <^-4'C ) Nort h Arro w Address : 2 }?/ l 5
. J ?-^A Sit e Sketc h Time : Phone : ^ ; ­ 5W - ^/7 0 <
Tea m ^^/( / X/^ / ^;^^VI D # / ^ i^ / XR F Cod e 

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### d.^P i 

### Z 9 Kpp m i?7,Ye s / Ye s n t n N o 12 1 N o |* r pp m Ye s D N o •


## .-<t> ' , A:--i < / ' A/Ay1 

## i -vli— , t-ypT• " y--;A-^ y 

# yyy\ y

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. ??t^ A Phone : fe; - 3 V K- < f /

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XR F Code .^6^ P I Confirmatio n Sampl e /^/Ye s n N o B I /^^Ye s n N o C & / ? ' Ye s • N o ^ / ^ Ye s n N o •5 ' ^T^Ye s a N o 13 ^ / Ye s n N o ^

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# i# • 

### Name : <coifi^^fH^ ^ Omah a Lea d Sit e 

### Date : ^-€'0 } Nort h Arro w 

### Address : 2 ;P/ / 5
. J i^^f ^ Sit e Sketc h Time : 

### Phone : foi ­ Jr^ ­ ^/'7 0 <



# s.yy- pCOASTA L CNVIRONHENTA l H«in' ^ C •O U p . IN C 

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

### Granto r(tli e propert yowner ) consent s t o an d autfiorize s th e Unite d State s Environmenta l Protectio n Agenc y(EPA ) o rit s autfiorize 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 : vbAcOvKLA/^/^

. WcOfi^' ^ Daytim e Phone : ^^ ^ , 

# iSkJ/d ^

Addres s o fPropert y covere d b ythi s 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 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 it s origina l condition
. Thi s worl < 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 byUSEPA , wil l contac t 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 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 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 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 , at 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 o f2COASTA L ENVIRONniNTA L GROUP , I h C



### •Remov e obstruction s includin g boats , trailers , vehicles , playscape items , woo d piles , do g houses , etc ; •Remov e flowe rbulb s o rplant s tha t th e Granto ro rth e Grantor' s tenan t maywis 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 waterin g perio d b yEPA ; •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 perfor m 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 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 (712 ) 352-018 8 ^\g n Q i d o no t gran t acces s t o m ypropertie s I gran t acces s t o m ypropertie s

Signatur eDate

Q

1 woul d lik e t o b e presen t durin g an ysamplin g tha t i s required
.COASTA L t t ' (KOMMINTA i a « « u '
. 1 rc 

## Restoratio n Agreemen t Th e purpose o f thi s agreemen t is t o provid e amutua l agreemen t as t o conditions o f th e propert y prio r t

o remediatio nactivities
. Ihi s wil l also serv e a s documentatio nfo r th e purpose of assurin g tha t restoratio n activitie s ar e complete dt o th e satisfactio no f th e propert y owne r an dth e Unite dStates Environmenta l Protectio nAgenc y (EPA)
. Propert y ID : /S3 ^ I Propert y Address : ^^^I f S Z2>^ ^ S V O'^"'''"

- XWxn ^ ^.UJcxU^ n Phone : 

## 3>?ri-s^G>c. X O

nth e anache ddiagram(s) indicat e area(s) t o excavate dan ddept ho f excavation, locatio no f al l know n utilities , subsurfac e features , su/fac e structures an dlandscapin g features , acces s location(s) t o b e use db y contractor , an dth e directio no f North
. Indicat e distances , depths , materia l types , etc . Indicat e digita l photos b

y referencin g th e photo-lo g numbe r wit ha narro w indicatin g directio no f view
. item s T o B e Remove d B yOwne rBefoi ^ Start O fRemediation : (Us e additiona l sheet s a s necessary ) Th e removal , storage , disposal , and/o rretu m o fthes e item s i s th e Owner' s responsibility
. 

# 5
la rIfgld- S /^> y^>^^/A24^/ c Item : Item : Item : Item : 

### Item : Item : Item : 

### Pag e 1 o fQ pC O AS T AL ftitvlHOH««|MTA L O « O WP , I M t C 

### Item s T o B e Remove d B yContracto rDurin g Remediatio n An d No t Replace d (Use additiona l sheets a s necessary ) Item : . 

# /^ y. W/ / p^^ ^ fe^ TAe.Jjii^ y Item : Item : Item : Item : Item : item : Item : Item : item : Kem : Kem :
Kem : 

### Item : Kem :

Pag e 2 

## o f

## hC O AS T AL C AO U P ^ I Nt C 

### Item s T o B e Remove d B vContracto rDurin a Remediatio n An d Replace d (Us e additiona l sheet s a s necessary ) Item : / 

# & 3 P J h ? item : 

# hz
. 

# -hP i 

# y Item : ' /
Item : /
Item : /

/ item : /
item : 

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# y
/ Kem : 

# y ttem: 

# y item : 

# y item : y ^ 

### Item : /

Pag e 3 

## o f

( pCOASTA L 0 I I e u p , ' * t ^



## Ite m

Pre-existin g property area , tha t wil l b e excavated , tha t i s covere dwithgrass .

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 , Cohtro l Valves , Timers , Heads , etc . Attac hasketc ho f th e sprinkle r layout
.

Numbe r o f an dsiz e o f eac hgarden / flowe r be d area . Attac hasketc ho f relativ e isize s an dlocations
. 

### Landscap e Inventory (Us e additiona l sheet s a s necessary ) 

## Quantity Unit Condition/Type/Specie s

Squar e feet

• ^ Eac h


### /

Eac h

/ 

# f Eac h

^ 

# 3KS Eac h Squar e Fee t

Pag e 

### 4 o f( aCOASTA L (NVIHOMrVftNTA I C M O WP t M C 

## Item Agree dupo nvalu e o f plan t material s no t to , b e renlace db v contractor . Not e thi s valu e wil l b e use dt o issu e aplan t vouche r t o th e propert y owner . Agree dupo nlis t o f plan t material s tha t wil l b e replace db y contractor . B e ver y specifi c an ddetailed
. Includ e asketc ho f wer e eac hplan t wil l b e place d b y th e contractor . Agree dupo nare ao f propert y t o b e replace d withgras s sod
. Includ e asketc ho f th e area(s ) t o b e replace dwith gras s sod
.

Are aofCit y o r Count y propert y t o b e landscape d pe r thei r requirements
. Includ e asketc ho f th e are a(s )

Easemen t Area , t o b e excavate d 

## Quantity 

# 0 Unit



## s Condition/Type/Specie s



# V

- . 

# i Eac h

S F

S F 

# y

0 

# y S F 

# y

Pag e 5 of
.C OAST A 1.

AddKiona i Comment s / Instructions :



# p/o A« 5 4395.
.

D Chec k th e bo x ifOwne rdoe s no t wan t CE G to documen t Interio rfoundatio n wall s an d possibl e pre-existin g damage
. Bycheckin g thi s bo xCE G is no t responsibl e fo ran ydamag e don e to th e interio r ofhouse , includin g foundation crack s orfissures.

i Skoatar Contiactor sS^oatar e Dat e Pag e 6 of
.

## BVID # \6^9 \ XR F PROPERT YSAMPL E SHEE T Dat e Proiect XRFID #

Shot # 

### rO&^ n cPfiS b c^6S ^ -JSte- O

Averag e

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## ^gn o

Averag e

Shot #

Averag e

Shot #

Averag e la b sampl e # 

## U-8-n R Omah a lea d F P 2n() yea ropilo n



## .^oa q Readin g Sampl e are a ifcpi.c^6 t jci.a T :0«? , (.-^iciq.q n iCflt^.^nti-Q.-if i Dept h

- aou.ftt„-l:\8.a v 

### I c^S-^g^ X \f i •a.C t
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### .'SaQ

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Averag e

Shol # 

### c^Pns L 

## <^fi-i 5 6I8 H c^-l S

Averag e

Shot #

Averag e

RETES TAREA S Readin g Sampl e are a Dept h

La b resul t Sampl e are a XR F Avg
. Signatur e 

## :Q8\ \ "k.^T , ^V , liS'.SC > am/p m 3 0 se c Readin g < os.-A-a-8.i l cO\.<^<^in.iiL? , ^'^•~..i.^^t\o,.u ^ 

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### s-w.'^f^t.ao.s' A ^a.q&*-iC4.y « Sampl e are a ^ Dept h L P ^Mc.vUt \ci.;^g ; Readin g Sampl e are a Dept h



# Hm ^ MWy 4 Prin t

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s AVERAG E ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

Supervise d B y 

## Certificat e o fVerificatio n

286 1 SOI L 2008-11-0 8 13:3 3 121.5 7 Fina l ^Av g o f2857-^84 ^ 281 1 s 33s t ^ ^ I easemen t

Ventr y 1 [CLEARANC E

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 259.64 6 Supervise d By : 

## Certificat e o fVerificatio n

285 7 SOIL 2008-11-0 8 13:3 0 30.2 6 Fina l 1532 1 281 1 s 33s t easemen t Ventr y 1 CLEARANC E

± Erro r ± 19.47 2

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 285.69 4 Supervise d By : 

## Certificat e o fVerificatio n

285 8 SOI L 2008-11-0 8 13:3 1 30.2 6 Fina l 1532 1 2811 s 33s t easemen t Ventr y 1 CLEARANC E

± Erro r
± 19.90 0

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 165.36 8 Supervise d By : 

## Certificat e o fVerificatio n

285 9 SOIL 2008-11-0 8 13:3 2 30.6 4 Fina l 1532 1 281 1 s 33s t easemen t Ventr y 1 CLEARANC E

± Erro r
± 15.78 1

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 226.85 9 Supervise d By : 

## Certificat e o fVerificatio n

286 0 SOIL 2008-11-0 8 13:3 3 30.4 1 Fina l 1532 1 2811 s 33s t easemen t Ventr y 1 CLEARANC E

± Erro r
± 18.41 3

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 286 6 Mod e SOI L Tim e 2008-11-0 8 13:3 6 Duratio n 122.1 5 Sequenc e Fina l Flag s AVERAG E IAV Q o f2862-286 5 ADDRES S 281 1 s 33s t QUAD/ZON E ^ 2 INSPECTO R Ventr y DEPT H 6 SAMPL E TYP E CLEARANC E f NOT E

P b Supervise d B y

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 25.33 0 Supervise d By : 

## Certificat e o fVerificatio n

286 2 SOI L 2008-11-0 8 13:3 4 30.3 3 Fina l 1532 1 281 1 s 33s t F2 Ventr y 6 CLEARANC E

±Erro r ±8.10 8

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 21.99 1 Supervise d By : 

## Certificat e o fVerificatio n

286 3 SOIL 2008-11-0 8 13:3 5 30.3 8 Fina l 1532 1 281 1 s 33s t F2 Ventr y 6 CLEARANC E

± Erro r
± 7.63 2

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 255.62 5 Supervise d By : 

## Certificat e o fVerificatio n

286 4 SOI L 2008-11-0 8 13:3 6 30.9 5 Fina l 1532 1 281 1 s 33s t F 2 Ventr y 6 CLEARANC E

± Erro r ± 19.63 4

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 33.78 3 Supervise d By : 

## Certificat e o fVerificatio n

286 5 SOI L 2008-11-0 8 13:3 6 30.4 9 Fina l 1532 1 2811 s 33s t F2 Ventr y 6 CLEARANC E

±Erro r ±8.41 0

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 287 1 Mod e SOIL Tim e 2008-11-0 8 13:4 0 Duratio n 122.0 0 Sequenc e Fina l Flag s AVERAG E i Av g o f2867-2.870 , ADDRES S .281 1 s 33s t QUAD/ZON E *D Z INSPECTO R Ventr y DEPT H 1 3 SAMPL E TYP E i CLEARANC E NOT E

Supervise d By :

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 542.92 0 Supervise d By : 

## Certificat e o fVerificatio n

286 7 SOI L 2008-11-0 8 13:3 7 30.6 8 Fina l 1532 1 2811 s 33s t D Z Ventr y 1 3 CLEARANC E

± Erro r
± 28.45 1

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 286 8 Mod e SOI L Tim e 2008-11-0 8 13:3 9 Duratio n 30.6 1 Sequenc e Fina l Flag s BVI D # 1532 1 ADDRES S 281 1 s 33s t QUAD/ZON E D Z INSPECTO R Ventr y DEPT H 1 3 SAMPL E TYP E CLEARANC E NOT E

pp m ±Erro r P b 492.47 2 ±27.16 3 Supervise d By :

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 512.24 6 Supervise d By : 

## Certificat e o fVerificatio n

286 9 SOI L 2008-11-0 8 13:3 9 30.4 0 Fina l 1532 1 2811 s 33s t D Z Ventr y 1 3 CLEARANC E

± Erro r
± 27.56 0

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 697.45 0 Supervise d By : 

## Certificat e o fVerificatio n

287 0 SOI L 2008-11-0 8 13:4 0 30.3 1 Fina l 1532 1 2811 s 33s t D Z Ventr y 1 3 CLEARANC E

± Erro r
± 32.07 5

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 287 6 Mod e SOI L Tim e 2008-11-0 8 13:4 5 Duratio n 122.1 3 Sequenc e Fina l Flag s AVERAG E ^ Av g o f2872-287 5 ADDRES S 281 1 s 33s t QUAD/ZON E INSPECTO R Ventr y DEPT H ( 6 SAMPL E TYP E |CLEARANCE | NOT E

Supervise d By :

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 238.70 1 Supervise d By : 

## Certificat e o fVerificatio n

287 2 SOI L 2008-11-0 8 13:4 2 30.6 7 Fina l 1532 1 2811 s 33s t B 2 Ventr y 6 CLEARANC E

± Erro r
± 18.91 0

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 210.01 9 Supervise d By : 

## Certificat e o fVerificatio n

287 3 SOI L 2008-11-0 8 13:4 3 30.2 7 Fina l 1532 1 281 1 s 33s t B 2 Ventr y 6 CLEARANC E

±Erro r ±18.34 0

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 272.97 5 Supervise d By : 

## Certificat e o fVerificatio n

287 4 SOI L 2008-11-0 8 13:4 4 30.5 6 Fina l 1532 1 281 1 s 33s t B 2 Ventr y 6 CLEARANC E

± Erro r
± 20.28 8

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 262.92 9 Supervise d By : 

## Certificat e o fVerificatio n

287 5 SOI L 2008-11-0 8 13:4 5 30.6 3 Fina l 1532 1 281 1 s 33s t B 2 Ventr y 6 CLEARANC E

± Erro r
± 19.87 5

### ^*-'*°"-> , 

## i^^^^ \ Omah a Lea d Site^Flxe d Pric e EP-R7-07-0 5 i 5 ^^^y 8 Coastal Environmenta l Group inc
. >5 i ^ ^ ^ ^^"^^JJ ^ www.coastalhazmat.co m na ^ COASTA L EHVIIONHCNTA L G •0 U P , IN C 

# EXECUTIV ESUMMARY : BVID #1532 1 - (281 1 S 3 3 ST )

^ N o Issue s o r Concern s \ ^ Issues/Concern s Detail Explanation

### £>£ , 

# EP A EPAPropert y Clos e Ou t Form Propert ytt : \^?>Q \ Propert yAddress : c^ B U " ^
. '^' Z 'b^
. Date/Time : Owner' s Name : ^coV ^

{ x^r,^\.\L»-ij ^
. „ Quad s Excavated : f j ,t^9: , ?> ^ Contracto rCrou p Oi'-,r\c^\~r-^Ji

. X=Li^^\:u^Sr\V'-^i^''''^ ^
Excavatlo B Genera l Ye s N o 1
.

I fnecessary , wer e th e conec t quadrant(s ) excavate d an d restored ? ^ 2
. I fnecessary , wer e th e cooec t areas ofdri p zon e excavate d an d restored ? .-- ' Gradiu KSo d an d Vccctatio B Ye s N o 1
.

Doe s th e gradin g aroun d th e perimete ro fth e hous e i n excavate d areas generall yslop e awa y y from th e house ? 2
.Ha s so d bee n lai d i n al l areas tha t wer e excavated ? ^ 3
.

Doe s th e so d appea rt o b e generall yhealth yan d growing ? (Onl vevaluat e i finspecte d a t a 3 0 t ^ da ytim e period ) 4
.

Ar e sodde d areas generall yfu m an d evenl ygraded ? • 5
.Ar e th e joint s betwee n th e so d strip s generall ytight ? (Onl yevaluat e i finspecte d a t a 3 0 da y tim e period ) y Wa s th e propert ygrade d suc h that wate rwil l no t poo l o n th e property' ' 6 i ^ 7
. Wa s damag e l o landscapin g o rplan t material s avoided ? i ^ Gates , Fence s an d RcUinin £Wall s Ves N o 1
.

D o gate s ope n an d clos e freely ? (I fapplicable ) w ^ 2
. Wer e al l gates o rfence s take n dow n durin g restoratio n activitie s reinstalled ? (Ifapplicable ) i y 3
.Wa s damag e t o gate s o rfence s avoided ? (Ifapplicable ) < ^ 4
.

Wa s damag e t o retainin g wall s avoided ? (Ifapplicable ) 

## t J ^ Foundation , Sidio Kan d Culler s Ye s N o 1
.

Wa s damtg e t o th e sidin g o rtri m avoided ? j . ^ 2
.Wa s damag e t o th e foundatio n avoided ? ly ^ 3
.Wa s damag e t o window s avoided ? y 4
.

Wa s damag e t o window s o rdoo rscreen s avoided ? •y 5
.Wa s damag e t o downspout s o rdownspou l extension s avoided ? Sidewalk s an d Driveway s (Coacrele ) Ve s N o 1
.

Wa s damag e t o drivewa ysurface s avoided' ' ^ 2
.Wa s damag e t o walkwa ysurface s avoided ? t ^

## O rner s comments :

Inspectio nnotes :

Remova l an drestorationactivate s complei e including th e 30-da y sodwarranty : EP A^^\iT^%^i\\2X\\yd,^jUyy^^yyUi^^^-^ ^ jSfl ^ ff p ^

## Propert yCompletio n Agreemen t
Thi s agreemen i document s th e complclio n o fremedia l activitie s perlbrme d o n m yproperty
. M ysignature wil l designat e that I a m satisfie d wit h th e restoratio n o fm yproperty , an d tha i n o item s ar e i n questions , now , o ra l an ytim e i n th e future , except thos e item s lisle d below , i fan y

Propert yID : \f^g ^

\ Propert yAddress : ^f i ^ ^ ^ ^E: ^ ^ ^ 

## Q"""=5Vr-r W\>:^o^\^y ~ P"""^ - ^^\-fS(olo ^ Restoratio n item s i n Question : 

### A-i-e p f/l4bMi-/A/ - I'l^ m /Crv / 'rCtt'^aitl n S/t>r/j^

. • Item : ' ^ ^ ' J item : item : item : Item :
Additiona l Comments :

^ r 0 1 agre e r restoratio n i.fcompleted , excep i a s note d I I I rto no l atjre e restoratio n i s 

# i^h U
Contractor' s Signatur e Dal e