## TRANSMITTALo f

OMAH ALEAD SIT E SOI LREMEDIATIO NFIL EFOLDE R ^ 

### SAID # : 

# n . Date : / - Address : 1^\ < f^l ^ ^ Remediatio nContractor : _Coasta l Environmenta l Group _ Year : 200 i 

# T

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# a

/ D D D 

### SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S Vide o o f property (DVD ) Executiv e Stunmary EPA-provide dproperty sketc h Signe dAcces s Agreemen t for subjec t property Signe dAcces s Agreement(s ) for adjacent property Restoratio nAgreemen t Settlemen t document s (i.e. , for damag e or t o replac e plants , etc. ) Confirmatio ndat a Photograph s ^« > W n{o ^ > b<6VMloi ^ Y ih ' 6)cflVni\<yv a As-buil t sketc h Satisfactory restoratio nsigne db y Property Owne r Property close-ou t chec k lis t signe db y EP A Descriptio no f area s no t meetin g RO D cleanu p criteri a Utility clearance s Property mfbrmatro nfromDougla s County Assessor' s Offic e



## "Daf e Superfun d« •

Propert yAcces s Checklis t Proptrr ) ID : 

# 32 S nWOR K ST/VRTE D ON : / / D WOR K COMPELTE D ON : / Propert y Addrt»:^ip^\F=^PQy 4 3 ^ Ren.e r V^,^^^-f. ^ Owne r "^j^fjfi ^ ^x^o^fi \ Addrtss : Phone : L^g y Q^2. S P,L\ : Cell/Pager : &V>f^V».t<f e V)^V\ \ Additionu l Inlnrmntion : Phon e L\o^,c4S^-\v2 A F«x : Ccll/Pjge r D Nutincalio n Leitc r Scm : / / By : ^ Acces s AgreemcB i Signed : ^ 1 ^

CP i B3=O0A-6L\| f o ^3 ^ RertorniiO D Agreeme m Sin»td:** j /. ? lOO \ 

## B>Y^n ^ D To|)»oi l Samplin g (i f applicublt ) 1 1 By : D DispoiR j Sarnplin g (f t applicable ) 1 1 J By : D Gnrdc n Snmplio g (i f applicable ) / / By : n Uiilil yClearanc e Called : / / , By : •Video/Photo s (Before ) On : / / By :
• Video/Phoio s (During ) O B : / / By : D Video/Pholo i (After ) On : / / By : D Video/Phoio s (30-Djiy ) On : / / By : ^ Propert yComplelio n Agreemen t Signed:/^//^/ ^ By : D Finn ' Rcpo n Issued : / / By : Ai rMonilorint ; (j u iii>pticabl e )

D Communit yD Cre w 1 Oo : / / By : RuuJls : D Communit yD Crc x On : / / By ; Rc«ulls : 1 D Communir i D Crv« - On : / /
... . Results :
Omah a Lea d Srt e

### Dougla s Coimty Accoun t Iij£|raiatio n < 

### Pag e 1 of 2 ^^^i Dougla s County , Nebrask a Propert yRecor d - R l 14445000 0 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-5 0 n wes t o f52n d S t - ViewO H Ma p Informatio n i s vali d a s o f2009-8- 3 Treasurer' s Ta xRepor t Ne wFeatur e H * ^ ^ Aut o Sale s Searc h Owne r BRYAN TELLE N L ETA L 390 8 N 4 0 S T OMAH AN E 68111-000 0 Propert yInformatio n Ke yNumber : 444 5 000 0 1 1 Accoun t Type : Residentia l Parce l Number : 114445000 0 Parce l Address : 251 5 FOR TS T OMAH AN E 68111-000 0 Lega l Description : GLENGO E PLAC E LOT1 3 BLOC K1 4 5 X 12 0 Valu e Informatio n Lan d Improvemen t Tota l 

### 2009 $2,500.0 0 $40,300.0 0 $42,800.0 0 200 8 $2,500.0 0 $40,300.0 0 $42,800.0 0 200 7 $2,500.0 0 $40,300.0 0 $42,800.0 0 200 6 $2,500.0 0 $40,300.0 0 $42,800.0 0 200 5 $2,500.0 0 $14,600.0 0 $17,100.0 0 200 4 $2,500.0 0 $13,200.0 0 $15,700.0 0 Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 2 5400. 0 1. 0 120. 0 45. 0 N o Improvemen t Informatio n Buildin g 1



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R l 1.. . 8/11/200 9^^i^ti ( 

### Pag e 2 of 2 Dougla s County Accoun t Ii^mnatio n

569 0 s f IC C i Firs

t Pbo f 1070. 0 «

7i r iff ; n»a w wrooi i 11/

2 STOR YH M CLIC KTO ENLARG E IMAG E Squar e Footage : 1639. 0 Percen t Complete : f100.0 % Perimete r 0. 0 Quality : Fai r Uni t Type : En d Condition : Fai r

Buil t As : 1 1/ 2 Stor yFi n Cond o Squar e Footage : 0. 0 HVAC : Force d Ai r Rooms : 6. 0 Exterior : Fram e Viny l Units : 2. 0 Interior : Drywal l Baths : 1. 0 Roo fCover : Compositio n Shingl e Bedrooms : 3. 0

Roo fType : Gabl e Stories : 1. 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 6 0 % 191 6 9 3 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 1070. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Garag e Detache d 216. 0 Porc h Cvr d Woo d Dec k 50. 0 Porc h Cvr d Woo d Dec k 192. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R l 1.. . 8/1 1 /200 9

## Propert y ID # Propert y Address : Initia l Contact : Secon dContact : Fina l Contact : Fina l Action :

Comment : (!)wne r Comment (s) : Site Coordinato r Comment (s) :

. 

## CONTAC T FOR M 1{)Z 1 

# 7.51 5 FFyrfSt
­ Dale : Time : Action :

Date : Time : Action : Date : Time : Action : Transmi t t o EP A D Othe r Action : DPag e 1 of 2 

### # •

" > Creat e Anothe rTicke t [ : _ Ba^ k t o Irth^lnteme t ] j [ Sen d Emai l



### • YOURTICKE T NUMBE RI S 2360358 . Origina l Cal l Date : 9/09/0 9 Time : 3:5 7 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 9/11/0 9 Time : 4:3 0 p m State : N E County : DOUGLA S Place : OMAH A Address : 251 5 Street : FOR T S T Twp : 15 NRng : 13 E Sect-Qtr : 04-N E Twp : 16 NRng : 13 E Sect-Qtr : 33-S E 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 : Y Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V MAGELLAN METR O MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C

Servic e Are a Contac t Phon e Numbe r Utilit y Typ e CXCAT V CO X COMMUNICATIONS , IN C HEID I Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7 MAGELLA NMAGELLA NMIDSTREA M PARTNER S L PDEBORA H Day : 918574709 8

Alt : Emerg : 918574709 8
METR O METR O COMM . COLLEG E CHRIS 

### Day : 402457230 7 Alt : 402672703 3 Emerg : 402457231 3
MUDO l METROPOLITA NUTILITIES DISTRIC T SAND Y 

### Day : 402504782 3 Alt : Emerg : 402504797 0

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

### Pag e 2 of 2 # •
OMAHACO FCIT Y O FOMAHA-TRAFFICSEWE RRO N

0PPDGPR 5 OMAH APUBLI C POWE RDISTRIC T N A
QLNNEI C QWES T LOCA LNETWOR K N A 

### # • 

### Day : 402444719 7 Alt : 402444516 1 Emerg : 402444516 0 Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3 Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3

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

## 62 7 

# ^ ^ As-Buil t Drawin g ^ ^ COASTA L 

# Omah aLea dSuperfun dSit e

Exterio rPain t Nort hArro w Omah a Lea d Sit e Owne rName : • Goo d Sit e Sketc h Address : 251 5 FOR TS T •Poo r 

# t

Phone : H : W : I I No t pain t Sampl e Numbe r Lea d Concentratio n Sampi e Collecte d LA B Firm : Sample s Collecte d Sverdru p RYASCPXA-62 7 Y A 176. 2 pp m 

### D Date : RYBSCPXA-62 7 Y B 433. 2 pp m 

# a Time : RYCSCPXA-62 7 RYDSCPXA-62 7 Y C Y D 319. 4 192. 9 pp m pp m 

### D 

# n Sample s Analyze d RDZSCPXA-62 7 D Z 180 0 pp m 

### E l E l XR F Uni t Book : RGZSCPXA-62 7 G Z pp m 

# n D Date : 10/20/199 9 RPZSCPXA-62 7 P Z pp m 

### D D Time ; 12:1 6 Staff : Numbe ro f Sample s = Legend : Y A= Yar d (NE) , Y B = Yar d (SE) , Y C = Yar d (SW) , Y D = Yar d (NW) , D Z = Dri p Zone , G Z = Garden . P Z = Pla y OLS# : 62 7 PC>f^ T^t - Dat e Excavate d :9/16/0 9 Diit e USEP ASigne d Off : 10/23/0 9 Are a Sodden : 235 8 s a f t



### Legen d Concreti e Dri p Zon e Excavate d Quadrant s Excavate d Are areplace dwili h Are a replace d wit 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 .

# 627 Omah a Lea d Sit e Owne rName : 

### Sit e Sketc h Address:_251 5 FpRTST _

Phone : H : W : Sampl e Numbe r Lea d Concentratio n RYASCPXA-62 7 Y A 176. 2 RYBSCPXA-62 7 Y B U- 433. 2 RYCSCPXA-62 7 Y C 319, 4 RYDSCPXA-62 7 Y D 192. 9 RDZSCPXA-62 7 D Z a ^ 180 0 RGZSCPXA-62 7 G Z RPZSCPXA-62 7 P Z Numbe ro f Sample s Legend ; Y A= Yar d (NE) , Y B = Yar d (SE) , Y C = Y



# /Z6X/:J^^^ ;

Re v 4

# 627 Exterio rPain t Nort h Arro w 

### Omah a Lea d Sit e Owne rName : 

### •Goo d Sit e Sketc h 

# A Address : 251 5 FOR TS T 

### •Poo r Phone : H : W : Q No t paint Lead Sampl e Sample s Collecte d Sampl e Numbe r LA B Concentratio n Collecte d Firm : _ Sverdru p RYASCPXA-62 7 Y A 176. 2 pp m 

## 12 1 

# • Date : _ RYBSCPXA-62 7 Y B vO- ^

433. 2 pp m 

# D Time ; _ RYCSCPXA-62 7 Y C 319. 4 pp m 

# n Sample s Analyze d RYDSCPXA-62 7 Y D 192. 9 pp m RDZSCPXA-62 7 D Z fiJL 180 0 pp m 

## IZI 

# n XR F Un i t : Book : RGZSCPXA-62 7 G Z pp m 

# a n Date : _ 10/20/199 9 RPZSCPXA-62 7 PZ pp m 

# a a Time : _ 12;1 6 Staff ; Numbe ro fSample s = 5 

### 1 Legend ; Y A= Yard (NE) , Y B = Yard (SE) , YC = Ya ^ (SW) , Y D = YlF d (NW) , DZ = Dri p Zone , G Z = Garden , P Z = Pla y 

# 2



# ^a.^aoi s

Re v4 046141012 3

# 62 7 l^ . % Owne rName : Address : 251 5 FOR TS T Phone : ^ • W : 

## Omah a Lea d Sit e Sit e SItetc h Sampl e Numbe r RYASCPXA-62 7 Y A RYBSCPXA-62 7 Y B RYCSCPXA-62 7 YC RYDSCPX;V62 7 Y D RDZSCPXA-62 7 D Z RGZSCPXA-62 7 G Z RPZSCPXA-62 7 P Z Lea d Sampi e LA B Concentratio n Collecte d



### 176. 2 pp m 

# a 433. 2 pp m 

# a 319. 4 pp m 

# n 192. 9 pp m 

# n 180 0 pp m pp m 

# a D .pp m 

## D 

# a Numbe ro fSample s = 5 Exterio rPain t Nort h Arro w • Good • Poo r 

# t [] ] Notpain t Sample s Collecte d Firni : Date : Time : Sverdnj D Sample s Analyze d XR F Unit : Book :

Date : 10/20/199 9 Time : 12:1 6 Staff : Legend : Y A= Yar d (NE) . Y B = Yar d (SE) , Y C = Yar d (SW) . Y D = Yar d (NW) . D Z = Dri p Zone . G Z = Garden , P Z = Pla y 

# V///////// A / 

## YA-I7U.'2 . / / 

# V PZ .

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# V U 

# \eoo 

# 4 t

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|Rev 4 

## AU-T Y 046141.012 3

## >*'2£S . COASTA L IN»l|OMHINia | ft•o wr . IH C 

## Consen t Fo rAcces s T o Propert y RIGH TO F ENTR YTO 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 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 followin g describe d premises :

Owner' s Name : Daytirn e Phone :

Addres s o fPropert y covere d b ythi s Aoreement : 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 that 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 remove 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 ofCoasta 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 . Once 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 confim n that 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 vy^itte n documentatio n fro m EP Athat th e property 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 subcontractors th e righ t t o ente rth e property , a t al l reasonabl e time s an d wit h prio rnotice , fo rth e sol e purpos e ofperformin g th e work . Thi s acces s shal l remai n i n effec t unti l th e work ha s bee n satisfactoril ycompleted . Th e Granto rals o agree s to :
Pag e 1 of2COASTA L IMVUeHftrNTA l Clour , tk e



### •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 that 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 , as necessar ysubsequen t t o a n initia l waterin g perio d byEPA ; •Abid e byhealt h an d safetyguidanc e provide d byEPA ; •I fth e propertyi s rented , assis t EP Ai n obtainin g tenan t approva l fo racces s t o th e propertyt 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 not t o Interfer e o rtampe rwit h an yo fth e work 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 propertyv\^ic h woul d ten d t o endange rth e healt h o r welfar e ofth 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 have an yquestion s abou t thi s program , pleas e contact Coasta l Environmenta l Group , at (712 ) 352-018 8 QYgran t acces s t o mypropertie s D I d o no t gran t access t o m ypropertie s 

# I signatur e ^at e SignatureDat e
QI woul d lik e t o b e presen t durin g an ysamplin g tha t i s required .

## 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 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 property owne r an dth e Unite dState s Environmenta l Protectio nAgenc y (EPA) .

Properf y ID : 

# (^ir ? Propert y Address : - i ^ 'y L Owner : 

## eu^yg M -h' c^^^VvWy ^ Phone ; 4^ 7 ZjL.^ ^ ^^ l lA 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 dVideographi(^l 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 fRemediation : rh e lenoval . storaqe , disposal , and/o rretur n ofthes e item s i s th e Owner s responeibility . ttem: ttem: / ttem: Kem :



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

# 1 / U- ^ 

# C^L^ l ite m ttem: ttem:
Page l 

# o- i ICOASTA L C k

( • u ^ I • • t Item s t o B e Remove d B yContracto rDurin g Remediatio n an d Replace d ttem: 

# Sv7iO ^ TSZ - ^ ^ ^ ttem: 

# ^ D Q - Ty-y^ , yi S Item : 

# r
[ I Item : \ 

### Landscap e Inventor y (tern Quantit y Unit Conditlon/Type/Specie s Pre-existin g propert y area , tha t wil l b e excavated , tha t i s covere dwithgrass . Quadrant s Numbe r o f tree s > 2 inc h trunlc diamete r Eac h Numbe r o f tree s < = 2 inc h trun k diamete r 

# 1 Eac h Numbe r o f Sprinkle r Zones , Contro l Valves , Timers , Heads , etc . Miat h; i skfic hol ihti
sri'i'l^l*.' ' liivmi ; 

# ^ k Eac h

Numbe r o f an dsiz e o f eac hgarden / flower be d area . Alliit h;i skcir h1) 1 n-l.itiv f M/o s midloc;iiiiM K 

# I F4ic h SquareFee t Agree dupo nvalu e o f plan t material s no t t o b e replace db v contractor . N'CK ' ll-.i
­ \HIII C «il l M l USI'L ' U ) is'.u i . 1 'IIBII ; ^o^ll.•!K' ^ 1( 1 ih e pr0))cil > D M ntr . S

Easemen t Area , t o b e excavate d 

# ^^- L Eac h 

# •L ^ ,^ ^



### ^ Pag e 2 o f#

C O AS 1 AL C ^

O U ' • » N C
! Addttlona l Comment s / Instructions :



## MCht 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 .

nI do no t agre e Q/ i agre e 

## CRntfid n 

# °l|-^|n Q Owner' s Signatur e Dat e Co i Contractor' s Signatur e Dat e Pag e 3 of . 

# 3

### BVID # UX ^ XR F PROPERTY SAMPL E SHEE T Dat e 

### ^-/f e ' 0 9 Addres s 2-.S'l5 ^ P«rs ^ <J r Project Omah a lea d F P 2n d yea roptio n Sampl e tim e am/p m XRFID # sampl e lengt h 3 0 se c 

# izj^ m Shot # Readin g Sampl e are a Shot # Readin g Sampl e are a 

# nf i ^/ v 

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## 43 i Averag e /^ O " ^ t S ' Averag e 12-'^' ^ I f ^ Shot # Readin g Sampl e are a Shot # Readin g Sampl e are a 

# mk^M
- ^ / 

## 5V / 

# M ^tA H Dept h Dept h 

# s

Averag e Z4 ^

^ / g 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 . Signature^ 

# \&IIJl(l O 

# Print s A^^iini;4t\Cam!k )

### # # 

# m

. 

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

° Coasta l Environmenta l Grou p Inc . ^'^^g^ ^ V/^^lj ? www.coastalhazmat.co m %pi.oi*' ^ COASTA L ENViaONNINTA l e I I 0 U P . IN C 

# EXECUTIV ESUMMARY : BVID #627
- (251 5 FOR T ST ) ~y | No Issue s o r Concern s [] ] I 

# Issues/Concern s Detail Explanation :

## EP APropert y Clos e Ou t For m Propert ytf : LnX ^ „ Propert y Addr«.-^^ \ ^ ^ ^ ^J
- Date/Time : OwTer ? Name:./jTVDTm^ . ??.t i Quad s Excavated : N^ ^1 ^ Contracto r Crou p Or(VSsVd \PjrvvTT^ O Excavatio nGenera l Ye s N o 1 . I f necessary , wer e th e correc t quadrant(s ) excavate dan drestored ? ^ 2 . I f necessary , wer e th e correc t area s ofdri p zon e excavate dan drestored ? 

# ty ^ Ye s N o Gradin g So dan dVegetatio n I .Doe s th e gradin g aroun dth e perimete r ofth e hous e inexcavate darea s generall y slop e away fromth e house ? 2 .Ha s so dbee nlai di nal l area s tha t wer e excavated ? 

# 17 ' 3 .Doe s th e so dappea r t o b e generall y health y an dgrowing ? (Onl y evaluat e i f inspecte da l a3 0 da y tim e period ) ___ ^ ^ 4 .Ar e sodde darea s generall y fu man devenl y graded ? 5 .

Ar c th e joint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat e i f inspecte da t a3 0 day 

# 17

_ _tim e period )

6 .Wa s th e propert y grade dsuc hthat wate r wil l no t poo l o nth e property ? 7 .

Wa s damag e t o landscapin g o r plan t material s avoided ? Gates , Fepcc s an dRetainin g Wall s Ve s No 1 .D o gate s ope nan dclo.s e freely? (Ifapplicable ) 

# t r Wer e al l gate s o r fence s take ndow ndurin g restoralio nactivilie s reinstalled ? (Ifapplicable ) ^ 3 .Wa s damag e t o gate s o r fence s avoided ? (Ifapplicable ) 

# 7 ' A

.Wa s damag e t o retainin g wall s avoided ? (Ifapplicable ) Foundation , Sidin g an dGmier s Ye s .N o 1 .Wa s damag e t o th e sidin g o r tri mavoided ? tX ' 2 .Wa s damag e t o th e foundatio navoided ? 1 ^ Wa s damag e l o window s avoided ? 4 Wa s damag e t o window s o r doo r screen s avoided ? 5 .

Wa s damag e t o downspout s o r downspou l extension s avoided ? Sidewalk s an dDriveway s (Concrete ) Ye s N o 1 Wa s damag e t o drivewa y surface s avoided ? 

# P 2 .Wa s damag e t o walkwa y surface s avoided ?

## Owner s comments :

Inspectio nnotes :

Remova l an drestorationactivate s complet e including th e 30-da y sodwarranty : EP ARepresentativ e< >



## Propert yCompletio n Agreemen t Thi s agreemen t documenl s th e completiono f remedia l acliviiie s perloimedo nm y properl y M y signatur e wil l designate lha t I a msatisfiedwit hth e restorationo f m y properly , an dtha t n

o Hem s ar e i nquestions , now . o r a

t an y lim e i

nIh e fiiture , except thos e ilems liste dbelow , i f an y Property fD : [^^ H Property Address : 2J^\f ) P'cyV ' SL Owner:-YTv^^^ ^ ?ir\l/lA V 

### Phone : 

# H i UM..m^\.\i^.< ^ Restoratio nItem s i nQuestion : IItem :

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

nyrc ci «torfllio n i s completed , excep t a s note d [_ J I d o no l ^Kre crcstonttin n i » complete d

Owner' s Signatur rDa^fcContrarlor' s Sicnaliir c1 ^ Dal e