## TRANSMITTA Lof OMAH A LEA D SIT E SOI LREMEDIATIO N FIL EFOLDE R SAI D # : 

# M i Date : 

# t ^\ y Address : \^^ ^ ff%­ h i Remediatio n Contractor : Coasta l Environmenta l Group _ Year : 200 i % 

### SOI LREMEDIATIO N PROPERT Y nLEFOLDE RDOCUMENT S 

# d Vide o o f property (DVD ) Executiv e Simimar y EPA-provide dproperty sketch SignedAcces s Agreement fo r subject property SignedAcces s Agreement(s ) fo r adjacen t propert y Restoratio n Agreement Settlement document s (i.e. , fo r damag e o r t

o replac e plants , etc. ) Confinnatio n dat a

,

/ 

# d d Photograph s ^" ^ ^ h^ ^ ^ V^OrfWV ) ^ ^1 ^ As-built sketc h Satisfactor y restoratio nsignedb y Propert y Owner Propert y close-out check lis t signe dby EP A Descriptio n o f area s no t meetin g RO D cleanup criteri a Utilit y clearance s Propert y informatio n fro mDougla s Count y Assessor' s Oflfic e Vf<Hr<y ^

Dat e ' 3005484 6 

# H I Superfun d

# vv Propert yAcces s Checklis t Property ID : /^ft-7 1 nWORKSTARTE D ON : / / Propert y Address : p ;^- J p(yf\^f ^ n WOR K COMPELTED ON : / / Owner : HV/ZyTJC ^ QfaV^t l Renter : Address : Phone : Fax : Cell/Pager : Phone : Additional Information : 

# (Mof ) g\3q--Tn u Fax : Cell/Pager :

n Notificatio n Lette r Sent : / / By : ,0\Acces s Agreement Siened: ^ / J^/O ^ ByR . I T 

### ./ Q Restoratio nAgreement 

### Signed:^ ! g_lC ^ By=^ e D Topsoi l Samplin g (if applicable ) 

### 1 1 By : D Disposa l Samplin g (if applicable ) 

### 1 1 By : Q Garde nSamplin g (I f applicable ) 

### 1 1 By : nUtilit y Clearanc e CaUed : / / By : ^ Video/Photo s (Before ) 

## On:^/26/0 9 By = QhaMi/ ^ nVideo/Photo s (During ) On : / / By : D Video/Photo s (After) On : / / By : nVideo/Photo s (30-Day ) On : / / By : n Propert y Completio n Agreement Siened : / / By : n Final Report Issued : / / By : Air Monitorin g (a s applicable ) • conununit y • Cre w On : / / 

# 1 Results : 0 Conununit y O Cre w On : / / By : Results :

• Conununit y • Cre w On : II . By : Results :
Omah a Lea d Sit e• • 

## Dougla s Count y Accoun t I n|Mjm||ion Pag e 1 of 3 Dougla s County ^ Nebrask a Propert yRecor d - R123981000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e (§ ) scal e 0-5 0 ft wes t o f 52n d S t - ViewO H Ma p Informatio n i s vali d a s o f 2009-9-1 5 Treasurer' s Ta xRepor t Ne wFeatur e ^ - ^ - ^ Aut o Sale s Searc h Owne r GREE R MYRTIC E C ETA L 173 7 PAR KAV E OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumber : 398 1 OOO O 1 2 Accoun t Type : Residentia l Parce l Number : 123981000 0 Parce l Address : 173 7 PAR KAV OMAH AN E 68105-000 0 Lega l Description : HANSCO M PLAC E LOT1 5 BLOC K1 8 5 0 X 15 0 Valu e Informatio n Lan d Improvemen t Tota l 200 9 $6,800.0 0 $113,700.0 0 $ 120,500.0 0 200 8 $ 6,800.0 0 $113,700.0 0 $ 120,500.0 0 200 7 $ 6,800.0 0 $113,700.0 0 $ 120,500.0 0 200 6 $ 6,800.0 0 $114,100.0 0 $ 120,900.0 0 200 5 $ 6,800.0 0 $114,100.0 0 $ 120,900.0 0 200 4 $ 6,800.0 0 $114,100.0 0 $ 120,900.0 0 Sale s Informatio n Sale s Date : 2004-08-3 0 Dee d Type : W D BooJIr : 200 4 Page : 11589 1 Price : $100,000.0 0 Grantor : DEBORA H 8 ARCHE R ETA L Grantee : MYRTIC E C GREE R Valid/Invalid : Vali d Exclusio n Reason : Saie s Date : 2004-04-2 8 Dee d Type : Q C SooJIr : 200 4 Page : 06585 9 Price : $0.0 0 Grantor : DEBORA H CLAPPE R ETA L 

## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accoimtno=R l 2.. . 9/17/200 9

### Dougla s County Accoun t InJ^jr^^o n Pag e 2 o f 3 

## iJHr^^ o Grantee : \ DEBORA H S CLAPPE R ETA L Valid/Invalid : Invali 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. 0 150. 0 50. 0 N o Improvemen t Informatio n Buildin g 1

w r 

# r t w 23 0 **. r H r 

### r i " ' ^

• l j u o SvcofKtnoo rl« | '7^7 0 M B ^t j 

## >

yL "'"" " A 7»WflC*3i f K L 

### ^'o'r r airrfr9oc»'i n

It.*» 0 wt t 2 1/ 2 STOR YFINISHE D iliHm.i,utMiia»M^iiiuu'*M.-Bsaa a CUC K T O ENLARG E IMAG E CUC K T O ENLARG E IMAG E Squar e Footage : 2608. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Goo d

Buil t As : 2 Stor y Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 10. 0 Exterior : Fram e Aluminu m Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 4. 0

Roo f Type : Gabl e Stories : 2. 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 188 5 0 % 188 5 12 3 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 ft 1176. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R12. . . 9/17/200 9

## Dougla s Count y Accoun t InJ^jm^o n ^^^ ^ Pag e 3 o f 3 njur^i c Porc h En d Scree n 160. 0



## http://douglasne.mapping-online.com/DougIasCoNe/static/accountinfo.jsp?accountno=Rl2.. . 9/17/2009

## Propert y I D # 

# A S : Initial Contact : Secon dContact : Final Contact : Fina l Action :

Comment : Owner Comment (s) : Site Coordinato r Comment (s) : CONTACT FOR M Ipun i 

# \IA } r^^K.fi V Date : Time ; Action :

Date : Time : Action : Date : Time : Action : Transmit l o EP A D Other Action : D

### Pag e 1 of 2

" > Creat e Anothe rTicke t Baci ct o irth Interne t y . Sen d Emai l ]



### • YOU RTICKE T NUMBE RI S 2369038 . Origina l Cal l Date : 9/21/0 9 Time : 3:3 6 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 9/23/0 9 Time : 4:1 5 p m State : N E County : DOUGLA S Place : OMAH A Address : 173 7 Street : PAR K AV E Twp : 15 NRng : 13 E Sect-Qtr : 28-NE-S E Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : LEA D REMEDIATIO N Locatio n o f Work : INCLUD E AL L EASEMENT S LOCAT E ENTIR E PROPERT Y Remarks : FAX AL L CLEAR S TO : (877)662-421 1 : UNSUR E O F CORNE R LO T 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 h o f Excavation : 4 F T Come r Lot : N Front : Y Rear : 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



### Servic e Area Contac t Phon e Numbe r Utilit y Typ e Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , IN C 

### HEID I Alt : 402934046 9 Emerg : 402932975 7 Day : 877366834 4 LEVEL 3 LEVEL 3 COMMUNICATIONS , LL C 

### N A Alt : Emerg : 877366834 4 Day : 402504782 3 MUD0 2 

### METROPOLITA NUTILITIE S DISTRIC T SAND Y Alt : Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFICSEWE RRO NAlt : 402444516 1 Emerg : 402444516 0
http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 9/21/200 9

### Pag e 2 of 2

0PPDGPR 6 OMAH A PUBLI C POWE RDISTRIC T 

### N A Day : 406728934 3

Alt : 406207149 4 Emerg : 888728934 3 QLNNEI FQWES T LOCALNETWOR K 

### N A Day : 406728934 3

Alt : 406207149 4 Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 9/21/200 9OLS# : 1887 1 Dat e Excavated:10/6/0 9 Dat e USEP ASione d Off : 10/23/0 9 

# As-Buil t Drawin g COASTA L Are a Sodden : 325 8 s q f t 

# Omah aLea dSuperfun dSit e 1887 1 Owne rName : DEBORAH S ZUCK Address : 173 7 PAR KA V Phone : H : 402-533-903 9 Sampl e Numbe r RYASCPXA-1887 1 F l RYDGCPXA-1667 1 F2 - RYCSCPXA-1887 1 B l RYDSCPXA-1887 1 B 2 RDZSCPXA-1887 1 D Z Ua

b RYCSCPLA-1887 1 Resul t 44 0 pp m Omah a Lea d Sit e Sit e Sketc h W: 402-393-2633 Lea d Concentratio n Sampl e Collecte d LA B /> & pp m 

### D 3^>:5 " pp m pp m 

### -B — -B - ^APAAppm 

### U g ^ pp m 

### U pp m 

### D D pp m 

### D D Numbe ro f Sample s = 

# H Exterio rPain t Nort hArra w •Goo d g^oo r Q No t pain t Sample s Collecte d Firm : _£Xja_l£sAlXiLL . Date : e> C - 2_7-rO M Tirt)e : \fi j Sample s Analyze d XR F Unit : ^ ' ' ^ Book : ^ A Date : ^'AJA^ ^ Time : A^/ ^ Staff : ^

Omah aLea dSit e 46130 

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

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

# CK C 

# V ^

AV/ ^ 1887 1 Owne r-WanTSTDEBORA H S ZUC K Address : 173 7 PAR KA V 

### Omah a Lea d Sit e Sit e Sketc h Exterio rPain t • Goo d g^oo r Nort h Arro w [] ] No t pain t Sample s Collecte d Firm ; %=V ^

\fts\:\ o



## TM-rt.ti Omah aLeadSite 4613 0

# m M # • 

## 1887 1 Exterio rPain t Nort h Arro w 

### Omah a Lea d Sii e Owne rName : DEBORAj H S ZUC K • Goo d 

### Sit e Sketc h Address : 173 7 PAR KA V Q^oo r Phone : H : 402-533-903 9 W : 402-393-283 3 Q No t pain t Sampl e Numbe r Lea d Concentratio n Sampl e Collecte d LA B Firm : Sample s Collecte d ^^.A\Q.S\:\c . RYASCPXA-1887 1 

# 73 3 ppm \3 A Date : C^Q ­ 2.ZJO M nYDOCrXA-1007 1 RYCSCPXA-1887 1 ~BT RYDSCPXA-1887 1 B 2 Sample s Analyze d RDZSCPXA-1887 1 D i 

### XR F Unit ; ^ ^

"^ ^ Book : 0 y La b RYCSCPLA-18 8 

## Date : ^A^A^j d Result ' 44 0 p



## TM-^t r OmahaLeadSite 4613 0

## 1887 1 Owne rName : DEBORA H S ZUC K Address : 173 7 PAR KA V Phone : H : 402-533-903 9 Sampl e Numbe r RYASCPXAr1887 1 F 1 •RYDOOPXA-1007 1 Fi - RYCSCPXA-1887 1 B l RYDSCPXA-1887 1 B2 R02SCPXA-1887 1 D Z La b RYCSCPLA-1887 1 Resul t 44 0 pp m 

# ENTERE D jyli 2 9iow ;

: J : • • il : 

### Omah a Lea d Sit e Sit e Sketc h W : 402-393-283 3 Lea d Sampl e LA B Concentratio n Collecte d

/3f i pp m 

### D pp m 

### - B — - B ­ 3g ^ pp m J/Aff<i ypp m 

### D D pp m 

# n D op m 

### D D Numt>e ro f Sample s = : 

# H ZIZS2SKIZZ : 

# c ] tpZ'^B ^ ./ ^ 

# E if V 

### ys. - f \ V 

# i r .7.3. ^ ^c X 

### ..iA{ . 

## .17 . S I Acvi«JUA ­ ^ci.r\ ^ • A Exterio rPain t NorthArro w • Goo d Q^oo r 

### < ^
• No t pain t Sample s Collecte d Firm : V^^f t \ftAVT\r . Date : g> C - TLIS Q M Time : \A' . o- y Sample s Analyze d XR F Unit : ^A"^ - Book : ^"A

Date : ^AJA^ ^ Time : P^/f ^ Staff : _ _ j
(>>-' ^ ^^A ^

"V 

### jr : x « ^ ^

Omah aLea dSit e 4613 0,y°"*^e . COASTA l C R O t l P IN C 

## Consen t fo i Acccis s T o Fropfert y RIGH TOF ENTR Y T 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 follov/in g describe d premises :

Owner' s Name : 

# ifhi^mA^AZ'^y . ^^ ^

Addres s o f Propert y 

# /WAtti ^ Ai/i ^ 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 f lea 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 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 f Coasta l Environmenta l Group , contracte d b yUSEPA , wil 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 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 rvAi W receiv e writte n documentatio n fro m EPAtha t th e property has 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 , its employees , contractors an d subcontractors 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 f performin g th e work . Thi s acces s shal l remai n i n effect unti l th e wor k has bee n satisfactoril ycompleted . Th e Granto rals o agree s to :
Pag e 1 o f 2

### yf'' i 

### s COASTA l IHVtRONH^KTA l C ft O U rIH C 

## % . A ( 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 maywis h t o save ; t Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , as necessary ' subsequen t t o a n initia l waterin g perio d byEPA ; ( Abid e b yhealt h an d safetyguidanc e provide d b yEPA ; ' I f th e propertyi s rented , assis t EPAi n obtainin g tenan t approva l fo racces s t o th e propertyt o perfor m th e work . t Allo wvideotapin g and/o rphotographin g o f th e property . AGREEMEN TNO TT o INTERFER E 

### Th e Granto ragree s not t o interfer e o rtampe rwit h an yo f th e wor k activities , o rwit h an y of th 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 f sai d propertywhic h woul d ten d t o endange rth e healt h o r welfar e o f th e Grantee s o rth e environment , o rt o allo wother s t o us e th e propertyi 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



## algr a gran t acces s t o m ypropertie s G t d o no t gran t acces s t o m ypropertie s

Signatur e Dat e

Q I woui d lik e t o b e presen t durin g an ysamplin g tha t i s required .

Pag e 2 o f 2^ - - » 

# 0

Restoratao 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 o f th e propert y prio r t o 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 no f th e propert y ovsoie r an dth e Unite dState s Environmenta l Protectio n Agenc y (EPA) .

Propert y ID : AYx"? / ^Propert y Address : / 75- 7 fi^^iYj^ J] / Owner : 

## AA^/tr/rf : ^Y£^! ^ Phone : 

# AAaA ) 9A(/ ' 797Z ^ O nth e attache ddiagram(s ) indicat e area(s ) t o excavate , surfac e structure s an dlandscapin g feature s an d acces s location(s ) t o b e use db y th e contractors . Indicat e distances , depths , materia l types , etc . Photographicall y an dVideographioall 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 Start o f Remediation : Th e (enovat . storage , dii.posal , and/o rretur n o ( thes e itom s i s th e Owne rs responsibility . IIBIII . J Item : / / ' y Kem : Item :



### Item s t o b e Remove d b yth e Contracto rDurin g Remediatio n an d Wo t Replaced _ Item: ^ / 

## y^H^//A?M(yf ^ ^ /^ySAAA< . . fldt^CY ^ Item : A Item : Item :
Pag e 1 o f - >

# p

COASTA L 

## Item s t o B e Remove dB y Contracto r During Remediatio n an dReplace d I ttem : 

### > / > 

# 5 . Ksm : 

# 5. / / l Kem : Item :



## ite m Pre-existin g propen y area , that wil l b e excavated , tha t i s covere dwh 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 , Thners , Heads , etc . Attac h; i sketcl i o l th e ••ri'l'klc i tilV'.HIi Numbe r o f an dsiz e o f eac hgarden / flowe r be d area . Alliith; i skfiL-l i 1) 1 rtlniiv f M/f S nndloc;iiiiMi N Agree dupo n valu e o f plan t material s no t t o b e replace db v contractor . Nci f Ihi
- \nlii c «il l hi
USl' C I U !< : U t . 1 fllHIl i voiKJtt'. ' I dlli e i!ri)|)crl > D M ner . Easemen t Area , t o b e excavate d 

## Landscap e Inventor y Quantity Uni t 

# ^A,0 Z Quadrant s



# 07
- Eac h

/ Eac h 

### /
Eac h 

### / 

# I Eac h Squar e Fee t 

# y S 

# A Eac h 

## Condition/Type/Specie s 

# S/A'^ ^


# fd/^Ai ^ pUoAc/ /

f J o :gX5'-^XA-Q_,^J ^

^ Pag e 2 o fC O A S 1 A L O k

O U ' . • N C ! Additiona l Comment s / Instructions : v ? .« ^ ^ ^ 

# I /.o r tit^A'fce . 

# I A^^y A U /HoAcAi ^ u/ / A/>^' ^ A- ^ P<3
-

Q 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 boxCE G i s no t responsibl e fo ran ydamag e don e t o th e interio rof house , includin g foundatio n crack s o rfissures .

I agre e O I d o no t agre e 

# %yy . li . y^ . .^/^/ g f
- QJ^r,r. ^ r. ^l^lcA l

' ^ Owner' s Signatur e Date ' Contractor' s Signature D a 

# f^ Pag e 3 o f /BVID # /g)^> l 

### XRF PROPERTY SAMPL E SHEE T Dat e Projec t 

# /^/ i ^? f Omah a lea d F P 2n d yea roptio n Addres s Sampl e tim e 

## i^g l yf^fk . A\" ­ am/p m XRFID # 

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# M J3£ L ^ 

# l^gg . 7^P 3 Readin g 

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# IS l

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## ^1 ) 

## J ^ 1 ^ Averag e "ZAA ^ ( ^ Averag e Shot # Readin g Sampl e are a Shot # Readin g Sampl e are a Dept h Dept h Averag e Averag e
RETES TAREA S Shot # Readin g Sampl e are a Shot # Readin g Sampl e are a Dept h Dept h Averag e Averag e

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

# mPrin t Fiii'i^nlni;-W \

Caro M

# I * • ( » 

## fAQL \ Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 i ^^^^ ^

o Coasta l Environmenta l Grou p Inc . vJ l 

### ^ 5 ^ \ . • P vvww.coastalhazmat.co m

%PHoi« ^ COASTA L INVIIONNINTA L O O U r , IN C 

# EXECUTIV ESUMMARY : BVID #18871-(173 7 PAR K AVE ) No Issue s o r Concern s [ ^ Issues/Concern s Detai l Explanation : -COASTA LT O DRO PO FBAG S O FMULC H FO RPROPERT Y OWNER . (COMPLETE D 10/23/09 )4 

## 0% 

# EP A EP A Propert y Clos e Ou t For m Property*:_133L1 LPropertyAddre«:;ni^lFj^^l ^ 3X " Datc^roc : Contracto rGrou p ^^^^TTiTRrvX/trOTYVgntQ- i Quad s Excavated : '&\,f^2 , Vf l Excavatio nGenera l 1 . If necessary , were th e correc t quadiant(s ) excavate dandrestored ? 

# 'PT ^ 2 . If necessaiy , were th e correc t area s ofdri p zone excavate dandrestored ? 

# Z ^ Ye s N o Gradin g So dan dVcgetatto a I . Doe s th e {redin g aroun dth e perimeter ofth e hous e i nexcavate darea s generall y slop e awa y 

# y ^ fix>mth e house ? ^__ 2 . Ha s so dbee nlai din al l area s tha t wer e excavated ? 

# ~7? ^ 3 . Doe s th e sodappear to b e generally healthy an dgrowing ? (Onl y evaluat e if inspecte da t a3 0 

# y day time period ) 4 . At e soddedarea s generally Hr mandevenly graded ? 

# y 5 . Ar c th e joint s betwee n th e so dstrip s generally tight ? (Only evaluate if inspecte da t a3 0 da y 

# y tint e period) 6 . Wa s th e propert y grade dsuchtha t wate r wil l no t poo l onth e propert>' ? 

# y 

# z ^ 7 . Wa s damag e t o landscapin g o r plan t material s avoided ? Gates , Fence s aa dRetatoln g Wail s Ye s N o 1 . D o gate s ope nan dclos e freely? (Ifappiicable ) 

## y 2 . Wer e all gate s o r fence s takendow ndurin g restoratio nactivitie s reinstalled ? (Ifappiicable ) 

# y 3 . Wa s damage t o gate s o r fence s avoided ? (Ifappiicable ) 

## ly 4 . Wa s damage t o retainin g wail s avoided ? (Ifappiicable ) Foupdation , SidinKan dGutler s Ye s N o 1 . Wa s damag e t o th e sidin g o r tri mavoided ? 

# y 2 . Wa s damag e t o the foundationavoided ? 

# A Z 3 . Wa s damag e t o window s avoided ?

Wa s damag e t o window s or doo r screen s avoided ? 5 . Wa s damag e t o downspout s o r downspoul extension s avoided ? 

# Z ^ Sidcwallt s an dDrivcway i (Concrete ) Ye s N o 1 . Wa s damag e l o driveway surface s avoided ? 

## y 2 . Wa s damage t o walkwa y surface s avoided ? 

# 17

## Owner s comments :

Inspectio n notts :

Remova l an drestorationactivate s complet e including the 30-da y so dwarranty : EP A Representativ e ) Jg \[{y./^j L^ Date : /O/S.t/;; ^

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