## TRANSMITTALo f

OMAH ALEA D SIT E SOILREMEDIATIO NFIL EFOLDER SAID#: i ^ S'l^ i Date : 

## :' ; l \0 ^ 

### Address : ^Cl S ^\ H ^ 1 Remediatio nContractor : _Coasta l Environmenta l Group
_ Year : 200 ^


### SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S ^ Vide o o f property (DVD ) 5

/ Executiv e Summar y ^ EPA-provide dproperty sketc h 

# 4 Signe dAcces s Agreemen t fo r subjec t property Signe dAcces s Agreement(s ) fo r adjacent propert y > ^ ^



# s/ ' Restoratio nAgreement Settlement document s (i.e. , fo r damag e or to replac e plants , etc. ) 

## \^-l k 

# \k'^ Confirmatio ndat a

\ ^ Photograph s f H hcC^P['^'< ^ ." ^ \y^(An^Q nV 'h v ^J ^ ^ ^ ^ As-buil t sketc h 13 ' Satisfactor y restoratio nsigne db y Property Owner W

( Propert y close-ou t check lis t signe db y EP A J0 ' Descriptio no f area s no t meetin g RO D cleanup criteri a iZ

i Utility clearance s 0' Propert y informatio nfro mDougla s Count y Assessor' s Offic e D D 

# , . 7 D 

# l//#// ^ v n'/
. ' ' Signature Date 3005 4 020 

# liili II I 

# lllllllllll l ^ Super fun d 

## A

### Propert yAcces s Checklis t Properr , L P jQ^'"?' ! D WOR K STARTED O N _/ ;_ D WOR K COMPELTE D O N / ; Propcn \ Add^e^ i ".>^<JO C ^\f\ P
Rente r AdJn;< $ Phone 

# 35) 6 ?in z S- r FiL\ : Cell/Page r Additionu l Inlnrmxtio n 

### Phon e L/Q2 - 5-^^-72^ 3 F«^ Ccll/Pige r

• Notificjlio n L.tltc r Sent : / / By : S l Acees i AprceiricD l SlEiicd - L f 1/ ^ 1 0 9 

### ^yOar \ Tfrh»chzv ~ Renorvtio D Agreemen l 

### Signed - lfi_/ia/fl 3 j ^ 

### By-D^in ^rb^^^W:/ ­
• Topjoi l Stnipim g (i f ipplicubic ) 

### / / By
. 0 Dispoia J Samplin g (r f jpplictble ) 

### / / B y

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### / / By :

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### ^ ynrlc^n/A^tr/ i D Video/Phoio s (During ) On : / / B.V
. D Video/Photo * (After ) On : / / B y D Vi(leo/Pho»o i (30-D«y ) On : / / hy
. D Propert yComplelio n At;recinen i Signe d / / By : D Fina l Repor t Isiued : / / By : Ai rMonilorin g {*! > jpplicable )

[_

J Communrt yL J Crcv i D o / / By : Rciuiti
. D Comrounit) - D Cre w On - / / By
. Re m li s D Communir i D Cn; « O n / / RMUIU :

Omah a Lea d Su e

### Dougla s County Accoun t IriMmatio n Pag e 1 of 3 .iMm a Dougla s County , Nebrask a Propert yRecor d - R122122000 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 - Viewo n Ma p Informatio n i s vali d a s o f2009-5-1 2 Treasurer' s Ta xRepor t Ne wFeatur e ->-•- •Aut o Sale s Searc h Owne r ERLBACHE R DANIE L R ETA L 351 8 PIN E S T OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumber : 212 2 000 0 1 2 Accoun t Type : Residentia l Parce l Number : 122122000 0 Parce l Address : 351 8 PIN E ST OMAH AN E 68105-000 0 Lega l Description : GRIFFI N & SMITH S 1STSU B LOT1 7 BLOC K6 E 4 4 F TLT1 6 & W6 FT5 0 X 12 8 Valu e Informatio n
200 9 200 8 200 7 200 6 200 5 200 4 Lan d Improvemen t $6,400.0 0 $212,200.0 0 $6,400.0 0 $212,200.0 0 $6,400.0 0 $212,200.0 0 $6,400.0 0 $93,500.0 0 $6,400.0 0 $93,500.0 0 $6,400.0 0 $93,500.0 0 Tota l $218,600.0 0 $218,600.0 0 $218,600.0 0 $99,900.0 0 $99,900.0 0 $99,900.0 0 Sale s Informatio n Sale s Date : 2002-12-2 0 Dee d Type : Price : Grantor : W D $169,950.0 0 SooAr ; 223 2 Page : 47 0

Grantee : Valid/Invalid : Vali d Excl Reason : usio n Sale s Date : 1990-09-1 7 Dee d Type : 

### Price : Grantor : $43,000.0 0 Book : 188 4 Page : 68 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R122.
. . 6/6/200 9nMDi a 

### Dougla s County Accoun t InlJMmation 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 4 6400. 0 1. 0 128. 0 50. 0 N o Improvemen t Informatio n Buildin g 1

ai j a q f

t ! WOMOKI
. ' „ 

# "

l TWr d Floo r 392 0sqf l H fHrstRoo r • "; 1062.0s( ] f l " i Secon d Floo r TT F 88 0 Osq t t • w r

2 1/ 2 STOR YFINISHE D

CLIC KT O ENLARG E IMAG E CLIC KT O ENLARG E IMAG E Squar e Footage : 2334. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quaiity : Averag e Uni t Type : Condition : Goo d

Buil t As : 2 1/ 2 Stor yFi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 8. 0 Exterior : Fram e Aluminu m Units : 1. 0 Interior : Drywal i Baths : 2. 5 Roo fCover : Compositio n Shingl e Bedrooms : 5. 0

Roo fType : 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 191 5 0 0 % 191 5 9 3 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 Applianc e Fireplac e Masonr y 1 0 Basemen t Bsmn t Bloc k 8 f t 940. 0


### http://douglasne.mapping-onIine.com/DouglasCoNe/static/accountinfo.jsp?accountno=R122.
. . 6/6/200 9

## Douglas Count y Accoun t Inigmatio n Page 3 of 3

nlam s
Fixtur e 1 Fixtur e 1 Fixtur e 1 Fixtur e

Garag e Porc h Porc h Use r Use r Additiona l Fixture s Bas e Fixture s Bat h Ful l Bat h Hal f Detache d En d Soli d Wal l Woo d Dec k 200 2 BO E 19 5 Atti cFul l Finis h 

## 1.0 

## 1 1. 0 2. 0 1. 0 312. 0 170. 0 

### 257. 0 1 1. 0 

### 392. 0 1



## http://douglasne.mapping-oiiline.com/DouglasCoNe/static/accountinfo.jsp?accountno=R122..
. 6/6/2009

## CONTACT FOR M Propert y I D M 

# \^5 n Propert y Address : 

# ^-^•\ ^ p>o c Initial Contact : Date : Wn/fl ^ Time:_t5 ^ Action : | e^\-^y^; ^ Secon dContact : Date : Time : Action : 0 Fina l Contact : Dale : Time : Action : Fina l Action : Transmi t t

o EP AD Othe rAction : D



## Comment : Owner Comment (s) : Site Coordinato r 

# UP^- f fl.^t( l ^ ^ ^' ^ \f\ot^^ , Comment (s) :

### Pag e 1 of 2

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



### • YOU RTICKE T NUMBE RI S 2311555
. Origina l Cal l Date : 7/07/0 9 Time : 12:3 7 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 7/09/0 9 Time : 1:1 5 p m State : N E County : DOUGLA S Place : OMAH A Address : 351 8 Street : PIN E S T Twp : 15 NRng : 13 E Sect-Qtr : 28-NW,29-N 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 : FA X 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 : 4f t Corne 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 Are a Contac t Phone Nuinber 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 AAlt : Emerg : 877366834 4 Day : 402504782 3 MUD0 2 METROPOLITA NUTILITIES DISTRIC T SAND Y Alt : Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFIC,SEWE RRO N Alt : 402444516 1 Emerg : 402444516 0

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 7/7/200 9

### Pag e 2 of 2

0PPDGPR 6 OMAH APUBLI C POWERDISTRIC T N A 

### Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3
QLNNE1 FQWES T LOCA LNETWOR K N A 

### Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3

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. . 7/7/200 9

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# f

# As-Buil t Drawin g ^ OLS#:1957 7 Dat e Excavated:7/13/0 9 COASTA L 

# Omah aLea dSuperfun dSit e tNVIRONMENTA L Dat e USEP ASigne d Off : 7/22/0 9 Q R O U r. IN C Are a Sodden : 190 0 s q f t 

### 1957 7 Omati a Lea d Sit e Exterio rPain t Owne rName : DANIE L R ERLBACHE R Sit e Sketch i [3 ^ Goo d Address : 351 8 PIN E S T • Poo r

Phone : H : W : I I No t pain t

Omah aLeadSit e 4613 0 Legen d Concret e Dri p Zon e Excavate d Quadrant s Excavate d Are areplace d So d wit h 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 ,

# 1957 7 Owne rName : DANIEL ^ ERLBACHE R 

### Omah a Lea d Sit e Exterio rPain t Address : 351 8 PIN E S T 

### Sit e Sketc h • Poor Phone : H : Q No t pain t

Omah aLea dSit e 4613 0 ^C.<3L.5ef ^

# 1957 7 Omah a Lea d Sit e ExtBrior^Paint Owne rtfame : PANE L R ERLBACHE R 

## Sit e SItetc h Address : SIBPthES T 

# T T

• Poo r 

### Phone : H : W : Q No t pain t SampleNumbe r Lea d Sampl e 

### S^ple s Colleoted LA B Concentratio n Collecle d RYASCPXA-1957 7 F 1 

# nn pp m 

# • Date : ^ g- ^ RYBSCPXA-1957 7 F 2 

### Pi" ^

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## sT : Omaha Lead Sit e 

### 4613 0 

# L^^t D Sr., ,
COASTA L [NVIRONMENTA l '••tPROl* ^ C I O U r. IN C 

## Consen t fo rAcces s To Propert y 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 perfor m certai n environmenta l respons e activitie s upo n th e follovi/in g describe d premises : //7r-*-7—
. 

# n^ 7 Owner' s Name : Daytim e Phone : 

# Ti^A J ttV'tfiC>>\^( L 

# ^3 3 

# 7Z^ 3

Addres s o fPropert y 

# y6\ % ?lht > ^ r 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 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 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 , 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 o f2.v*^""'"*
. COASTA L ENVIRONHENTA L '^i.PKa^ff ' cI I o U rIH C


### •Remov e obstruction s includin g boats , trailers , vehicles , playscap e 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 ma ywis h t o save ; •Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , a s necessarysubsequen 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 equipment 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 Coastal Environmenta l Group , a t (402 ) 991-119 9
gran t access t o m ypropertie s D I d o not gran t access t o m ypropertie s %



### Signatur e Dat e
G I woul d lik e t o b e presen t durin g an ysamplin g tha t i s required
.

Pag e 2 o f2COASTA L C H O U rIH C 

## Restoratio n Agreemen t Th e purpos e ofthi s agreement i s to provid e amutua l agreement 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 that restoratio n activitie s ar e complete dt o th e satisfactio no f th e propert y owner andth e Unite dState s Environmenta l Protectio nAgenc y (EPA)
.

Property ID : I Q< j '^ ^ Property Address : 7^) ^ pjN ^ Sf
. Owner : T>?^>X ^^^6^(^V^ ^ Phooe : ;^-7,^ ^ • ^^^- ^ Onth e attache ddiagram(s ) indicate area(s ) t o excavate , surfac e structure s an dlandscapin g feature s an d acces s location(s ) t o b e usedb y th e contractors . Indicat e distances , depths , materia l types , etc . Photographicall y andVideographlcally document th e existin g condition s ofth e propert y andth e basemen t if necessary . 

### item s to 13 0 Remove d b ytii e Owne rIsefbr e Star t o fRemediation : fh e removal , storage , disposal , and/o rretur n ofthes e item s i s th e Owner' s responsibility
. ttem: 

# /L- ^ 

# S ^-/ / 

# ?i^m^f 9 Hem : /
Item : Item :



### Item s t o b e Remove d b yth e Contracto rDurin g Remediatio n an d No t Replace d Item : ,


## • l h Item :

Item : 

# 3 Page l o fCOASTA L rMvmoNMrHTA L e M e o r. IN C 

### Item s t o B e Remove d B yContracto rDurin g Remediatio n an d Replace d Item : 

# 50 ^ ^ —r I
. p 

# " ^

Item Pre-existin g property area , that wil l b e excavated , tha t i s covere dwit hgrass . Numbe r o f tree s > 2 inch trunk diamete r Number o f tree s < = 2 inch trunk diameter Number o f Sprinkler Zones , Contro l Valves , Timers , Heads , etc . Attachasketcho l lhe .sprini<lc r lavciul
. Number o f andsiz e o f eac hgarden / flowe r be d area . Attachasketchol ' relativ e size s an dlocations
. Agree dupo nvalu e o f plant material s no t to b e replace db y contractor . '•ot e tiii s salu c will h t usc dto Issue •Aplunt vouche r 1 0 th e propert j owner . Easement Area , t o b e excavate d 

## Quantit y 

# n
)



### ^ / ^

\


# Y^ s Landscap e Inventory Uni t Condition/Type/Specie s Quadrant s

Eac h
Each

^^Eac h

Eac h Square Feet

$

Each 

# 7^^)>^\yi J Q^f^^b

Pag e 2 o f1
_C i j AS 1 AL



### Additional Comment s / Instructions :

^

• Chec k th e bo xi fOwne rdoe s no t wan t GE G t o documen t interio rfoundatio n waits an d possibl e pre-existin g damage
. B ycheckin g thi s bo xGE G i s not responsibl e fo ran ydamag e don e t o th e interio ro f house , includin g foundatio n crack s o rfissures
.

no t agre e 

# Y'^'^ 9 € , frxcno D U-IA-r A Dat e Contractor' s Signatur e Dat e 

### Pag e 3 o f \

## Property Damage Settlement


# I property ID 

# I

PropW Address 

# I 3518 Pine St 

### owner 

# I ERLBACEER 

### DANIEL R 

# I Phone 

# I I have received from the contractor, Coastal Environmental Group Inc. (Coastal), the sum of $200.00 

### to 

### compensate for water damage to the basement during the removal of lead impacted soil 

### from the property.

Compensation 

### type 

# I Cheek 1853 

### Value of 

### Cheek 

# 1 $200.00 

# I Check to the order of 

# I ERLBACHER DANIEL R 

# I

After 

### excavating 3518 Pine St (BVID 

### 19577) property owner noticed water intrusion to the basement due to 

## improper soil compacting. 

### Property 

## owner received a check for the amount of $200.00 

### dollars to compensate for the repairs 

### of the paint damaged. My signature 

### blow acknowledge8 the mpair of 

### the 

### paint damage; further, I 

### acknowledge that this work 

### wan completed MU.Faotoly and 

### within my and 

### rdoase Coastal Environmental Group, Inc. 

### from further 

### obligations or liability misted 

### to 

### thb propelty.



# 'LIY loq Date Page 1 

### of I

### BVI D # 1^*^7 7 XR F PROPERT YSAMPL E SHEE T Dat e 

## 7-i?> - (y f Addres s 

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. Shot # Readin g Sampl e are a Shot # Readin g Sampl e are a 

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# li

. 

# iias
_ Averag e 2.0\ p iL o t ^.^ ^ Averag e l<Vj.
. H H t I'S. ^ Shot # Readin g Sampl e are a Shot # Readin g Sampl e are a l^O.q'MtM^ S 

# g'R i 5H.H'S t tt^..X T 

# T \ jo a • ^ ^ H ?>^ H Dept h Dept h 

# ii ^ 

# i

i^& Q IM.Ql t l\.-f) l 

# : K Averag e 7? > .U U t 11.1^ ^ Averag e

Shot # Readm 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 Sampt e are a Dept h Deptt i Averag e Averag e la b sampl e # La b resul t Sampl e are a XR F Avg
. Signature ! 

# l^£M i m: L PrmtFi^OAbPi ^ OnC^YQ ^

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

pp m Pt

» 206.25 5 Supervise d By : 

## Certificat e o fVerificatio n

129 1 SOI L 2009-07-1 3 13:2 9 121.9 4 Fina l Av g o f1287-129 0 351 8 Pin e s t D Z Nicola s 1 2 CLEARANC E

± Erro r ± 17.87 9



# U­

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , 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 228.90 6 Supervise d By : 

## Certificat e o fVerificatio n

128 7 SOI L 2009-07-1 3 13:2 7 30.4 7 Fina l 1957 7 351 8 Pin e s t D Z Nicola s 1 2 CLEARANC E

± Erro r ± 18.81 6

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , 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 202.57 9 Supervise d By : 

## Certificat e o fVerificatio n

128 8 SOI L 2009-07-1 3 13:2 7 30.5 3 Fina l 1957 7 351 8 Pin e s t D Z Nicola s 1 2 CLEARANC E

± Erro r ± 17.73 3

# 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 QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 247.97 5 Supervise d By : 

## Certificat e o fVerificatio n

128 9 SOI L 2009-07-1 3 13:2 8 30.3 6 Fina l 1957 7 351 8 Pin e s t D Z Nicola s 1 2 CLEARANC E

± Erro r ± 19.62 0

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , 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 145.56 0 Supervise d By : 

## Certificat e o fVerificatio n

129 0 SOI L 2009-07-1 3 13:2 9 30.5 8 Fina l 1957 7 351 8 Pin e s t D Z Nicola s 1 2 CLEARANC E

± Erro r
± 15.34 7

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

pp m 152.43 8 

## Certificat e o fVerificatio n

129 6 SOI L 2009-07-1 3 13:3 2 121.5 2 Fina l Av g o f1292-129 5 ? 351 8 Pin e s t easemen t Nicola s 1 CLEARANC E

± Erro r ± 15.38 0 f Supervise d B y 

# : ^CMM? ^

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , 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 131.14 6 Supervise d By : 

# f

Certificat e o fVerificatio n

129 2 SOI L 2009-07-1 3 13:3 0 30.5 4 Fina l 1957 7 351 8 Pin e s t easemen t Nicola s 1 CLEARANC E

± Erro r ± 14.32 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 BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 215.20 1 Supervise d By : 

## Certificat e o fVerificatio n

129 3 SOI L 2009-07-1 3 13:3 1 30.0 5 Fina l 1957 7 351 8 Pin e s t easemen t Nicola s 1 CLEARANC E

± Erro r ± 18.49 6

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , 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 119.98 0 Supervise d By : 

## Certificat e o fVerificatio n

129 4 SOI L 2009-07

- 1 3 13:3 1 30.5 2 Fina l 1957 7 351 8 Pin e s t easemen t Nicola s 1 CLEARANC E

± Erro r ± 13.96 4

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , 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 143.42 5 Supervise d By : 

# 4

Certificat e o fVerificatio n

129 5 SOI L 2009-07-1 3 13:3 2 30.4 1 Fina l 1957 7 351 8 Pin e s t easemen t Nicola s 1 CLEARANC E

± Erro r ± 14.73 4

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

pp m Pi » 73.65 9 Supervise d By : 

## Certificat e o fVerificatio n

130 1 SOI L 2009-07-1 3 13:5 7 121.6 7 Fina l Av g o f1297-130 0 351 8 Pin e s t F l Nicola s 6 CLEARANC E

±

Erro r ±

11.29 3

# 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 QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 130.98 5 Supervise d By : 

## Certificat e o fVerificatio n

129 7 SOI L 2009-07-1 3 13:5 4 30.6 1 Fina l 1957 7 351 8 Pin e s t F l Nicola s 6 CLEARANC E

± Erro r
± 14.44 6

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , 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 54.42 6 Supervise d By : 

## Certificat e o fVerificatio n

129 8 SOI L 2009-07-1 3 13:5 5 30.0 9 Fina l 1957 7 351 8 Pin e s t F l Nicola s 6 CLEARANC E

± Erro r ± 10.37 0

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 129 9 Mod e SOI L Tim e 2009-07-1 3 13:5 5 Duratio n 30.6 2 Sequenc e Fina l Flag s BVI D # 1957 7 ADDRES S 351 8 Pin e s t QUAD/ZON E F l INSPECTO R Nicola s DEPT H 6 SAMPL E TYP E CLEARANC E NOT E

pp m ± Erro r P b 35.21 2 ± 8.84 1 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , 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 74.01 1 Supervise d By : 

## Certificat e o fVerificatio n

130 0 SOI L 2009-07-1 3 13:5 7 30.3 5 Fina l 1957 7 351 8 Pin e s t F l Nicola s 6 CLEARANC E

± Erro r ± 11.51 4

# p i^.J^ \ Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 (ffl & g N^R / g Coasta l Environmenta l Grou p Inc
. X^^ ^ ^^^^T ^

www.coastalhazmat.co m XPHO.'^- ^ COASTA L ENVIRONHENTA L CROUP
. IN C 

# EXECUTIV ESUMMARY : BVI D #1957 7 - (351 8 PIN EST )
pv ] N o Issue s o r Concern s \ ^ Issues/Concern s Detai l Explanation : N O ISSUE S PENDIN G

# ^^EP A EP APropert y Clos e Ou t For m Property« : \*^?."^.
. Propert y Address:;^'? > J < O ^ ^ Date/Tine : Owner' s N.me : ,JnQ,
. F-'Cnyyi^ ' Quad s Excavated : -p?

_ F ^ Contracto r Grou p rr(:^?^ \ ' 9 in\ i \Yt b AOOen- U Ye s No Excavatto D General 1 If necessvy . wer e th e correc t quadrant(s ) excavatedandrestored ? 

# ly 2

If necessary , wer e th e correct area sof dri p zon e excavate dan drestored' ' 

# W^ Gmdlu K So dan dVetclatio B Ves No 1 Doe s lh e gradin g aroun dthe perimeter ofth e hous e inexcavate darea s generally slop e awa y fix)mtb e house ? 

# u- ^ 2. Ha s sodbee nlai d inal l area s tha i wer e excavated ? 3 Doe s the so dappea r Jo be generally health y an ' ^Onl evaluat^ ins|Deci^ a 30 i d d growing'

growing' ' (Onl y y evaluatrj f f inspecio d da

a t t a day tim e period) 4 Are sodde darea s generally fir man devenl y graded ? 

### L ^ 5 Arc th e joint s betwee nthe so dstrip s generally tight ? (Only evaluate if

inspected at a

30 da y 

### L ^ ' tim e period) 6. Wa s the propert y grade dsuchtha i wate r wil l no t poo l onlh c propeny' ' 

### U - " 7 Wa s damageto landscapin gor plan t material s avoided ? Gates
. Fence s ant i Relainin g Wall s Ve s No I. Do gate s ope nan dclos e freely' ' (I f applicable ) 2. Wer e all gate sor fence s takendow nduring restoratio nactivitie s reinstalled' ' (ifappltcable ) 3.

Wa s damageto gate sor fence s avoided ? (I f applicable ) 

### ( / " 

## -L? ^ 4. Wa s damage to retainin g wall s avoided' ' (If applicable ) Fouadatioa , Sidin K

an dCuller s Ye s .N o I. Wa s damageto th e sidin gor trimavoided ? 2 Wa s damage to th e foundationavoided ? 

### I/- " 3 Wa s damage to window s avoided* * 

## \ y ' 4 Wa s damage to window s or door screen s avoided' ' 

# I/ " 5 Wa s damageto downspout sor downspou t extension s avoided'^ \ . ^ Sidewalk s an dDriveway s (Concrete ) Ve s >o I Wa s damage to drivewa y surface s avoided ? 2. Wa s damage lo walkwa y surface s avoided ? 

### ^ '

## Owner s comments :

Inspectio nnotes :

Remova l an dresloratiorv^itMivales compiele^ncludin g lh e 30-da y sodwananry : EP ARepresentiiiive ^-^O/^lJjJlM- ^ Date : '^I'^^l^ l

# 'tS ^ Propert yCompletio n Agreemen t Tins iigrccinci K cidciimcnl s tli c complelio no f remedial iictivilic s pe i roniiecl o nm y properl y My .siyiMltii f will ciesij^naie llia l t a

m.siili.slJci l wilhlh e rcstoralio nd f m y properly , atu l lluil n o itctii s iire i nc|itv.Ntioi>s , now . ora l an y fim c i ntli e liiliire , excep t tlicxs e Hem s lislei l below , ifaii y Pnipert yIt> : 

# li.f7 7 __. _ ._ .. _ Propert y Ad.hcvss : ^ 5- / f

P ( ^T^

_T.L
_ . Owner : p < f ^ o . c W£N ^ Phone : Restoratio n Item s i n Question :

Item :

Additiona l Comments :

bjj-^'llrc i ru;rc t reslornlio ni s coniplclcil , excep t a s note d I I <1< > m» t atjici ' i-i-MorHtiiinI s i-oniplelc d 

# 7- / r" ^ 9 

# L/ \Vi m TvTier' s .Si(>nnrur e Dat e ilrjictor' s .Si|>ii.'itiir e Dtit e 

# 1

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