### TRANSMITTA L of OMAH ALEA D SIT E SOI L REMEDIATIO N FIL E FOLDE R SAID* 3 1 b% ] DATE: ^ / f?//t
. ADRESS : H I \ 0 ' Pm>UV/j | Sl ^ REMEDIATIO N CONTRACTOR : COASTA L ENVIRONMENTA L GROU P Contract : EP-R7-09-0 6

SOI L REMEDIATIO N PROPERT YFIL E FOLDE R DOCUMENTS

^

Executiv e Summar y V0 EPA-provide d propert ysketc h

iv / Signe d Acces s Agreemen t fo rsubjec t propert y fW ^ Signe d Acces s Agreemen t (s ) fo radjacen t propert y \ n Restoratio n Agreemen t fo^Settlemen t document s (i.e. , fo rdamag e or to replac e plants , etc. ) ^

Confirmatio n dat a \jj i Photograph s SO D Pre-Excavatio n Excavatio n <G As-Buil t sketc h *^i ] Satisfactor yrestoratio n signe d byPropert yOwne r VD Propert yclose-ou t chec k lis t signe d byEP A KMTDescriptio n of area s of area s no t meetin g RO D cleanu p criteri a

J n Utilit yclearance s V ] Propert yInformatio n fro m Dougla s Count yAssessor' s Offic e



### •
Sigijaturg - fOASTA L COAST Signature Signature - COAS T Signature - EP A^J j ^ Date 3026292 3 ^^^ ^ Superfun d^ 

## Propert yAcces s Checklis t Propert y ID : ^ f '^^ / 

### WOR K

STARTED . / D ON : / Propert y Address:^;^ ^ Pf/^j ^ ^ 

### D WORKCOMPBLTED ON : / / Renter : Address : Phone : Fax : Cell/Pager : Phone : Additiona l Information : Owner : ^^^ ^ TT^UJAZJ C 

# Ll9yi»r ^ Fax : Cell/Pager : D Notificatio nLette r Sent : / / By : ^ Acces s Agreemen t Signed : V o / T D / ,. 0 v»>^ t By : S Restoratio nAgreemen t Signed : v o / 3s>/t o By=^»^o ^ D Topsoi l Samplin g (i f applicable ) / / By : IZ

I Disposal Samplin g (i f applicable ) / / By : D Garde nSamplin g (i f appiicable ) / / By : 1 ^ UtiUt y Clearanc e Called : V V / SL ? / v w By = v.^,«/. o \..,<t.nA.^ A1 Q Video/Photo s (Before ) On:_\ ^ 1J^ / \.c > By : '^it...' ^ D Video/Photo s (During ) On : / / By : nVideo/Photo s (After ) On : / / By : D Video/Photo s (30-Day ) On : / / By : Q Propert y Completio nAgreemen t Siened : / / By : nFina l Repor t Issued : / / By : Ai r Monitorin e (a s applicable )
• Conmiunit y • Cre w On : / / 

### By : 1 Results :

• Communit y • Cre w On : / / By : Results : Q Communit y DCre w On : / / By : Results :
Omah a Lea d Sit e

## Douglas Count y Accoun t I

n

&|a|tio n 

## Pag e 1 of 2 Dougla s County , Nebrask a Propert yRecor d - R143895000 0 Prin t Reoor t Vie wInteractiv e GI S Ma o Informatio n i s vali d a s o f 2010-8-3 0 Treasurer' s Ta xReoor t Ne wFeatur e r rf4 > rf Subdivisio n Sale s Searc h Owne r MOOR E S R KENNET H 406 6 SPENCE R S T OMAH AN E 68111-000 0 Propert yInformatio n Ke yNumtier : 389 5 000 0 1 4 Accoun t Type : Residentia l Parce l Number : 143895000 0 Parce l Address : 411 0 PINKNE YS T OMAH AN E 68111-000 0 Lega l Description : KENWOO D AD D LO T43 3 BLOC K0 W4 5 FTLT S 43 5 43 4 & 4 5 X 12 0 Valu e Informatio n Lan d Improvemen t Tota l 201 0 $900.0 0 $0.0 0 $900.0 0 200 9 $900.0 0 $0.0 0 $900.0 0 200 8 $900.0 0 $0.0 0 $900.0 0 200 7 $900.0 0 $0.0 0 $900.0 0 200 6 $900.0 0 $0.0 0 $900.0 0 200 5 $900.0 0 $0.0 0 $900.0 0 

### Sho wAl l Transaction s

Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 2 5400. 0 0. 0 120. 0 45. 0 Ye s



## http://douglasne,mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R14..
. 9/15/201 03/31/201 1 www.dhon.org/irthinternet/DHONNotic.
. . 

### Creat e Anothe rTicke t 

## S B [Sen d Emai l Bac k tWR h Intemet



## • YOURTICKE T NUMBE RI S 2700333 . Origina l Cal l Date : 3/31/1 1 Time : 3 4 1 pm Op : ALFONSO1879 0 Wor k t o Begi n Date : 4/04/1 1 Time : 4 1 5 p m State : N E County : DOUGLA S Place : OMAHA Address : 411 0 Street : PINKNE Y S T Twp : 15 NRng : 13 E Sect-Qtr : 08-NE-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 PROPERTY , AL L EASEMENT S AN D T O TH E PEDESTA L Remarks : FA X AL L CLEAR S TO : (402)934-281 1 : PLEAS E INCLUD E AL L EASEMENT S Company; COASTA L ENVIRONMENTA L SERVIC E Contac t Name : ALFONS O Phone : (402)934-283 7 Wor k Bein g Don e For : Coasta l Dept h o f Excavation : 4f t Corne r Lot : NFront : Y Rear ; Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N CXCATV MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C 

## Utilit y Servic e Are a Contac t Phon e Numbe r 

## Typ e Day : 402934046 9 

## CXCATV CO X COMMUNICATIONS , IN C HEIDI Alt : 402934046 9 Emerg : 402932975 7 

## Day : 402504782 3 METROPOLIT/y^ J UTILITIES MUDOl SAND Y MUD Alt : DISTRIC T Emerg : 402504797 0 Day : 402444719 7 CITY O FOMAHA
- OMAHACO F RICHAFRAFFI C Alt : 402444516 1 TRAFFICSEWE R Emerg : 402444516 0 Day : 406728934 3 

## OMAHAPUBLIC POWER EL M 0PPDGPR 5 /Ut : 406207149 4 

## DISTRIC T LOCATIN G Emerg : 888728934 3 dhon.org/irthinternet/. ../MessageText.as.
. 1/ 23/31/201 1 ^ ^ www.dhon.org/irthinternet/DHONNotic..
. ^ ^ 

## W^Day : 406728934 3 QLNNEIC QWES T LOCA LNETWOR K

r^r^A-nxTr ^ Alt : 4062071494 LUCAllN U 

## Emerg : 888728934 3

dhon.org/irthintemet/.../MessageText.as..
. 2/2

# I PAs-Buil t Drawin g ^ C OASTA L 

# Omah aLea dSuperfun dSit e CNVmONHCNTA L C M O U P
. IN C OLS# : 3138 1 Dat e Excavated : 4/14/201 1 Dat e USEP A Signe d Off : 6/28/201 1 

# r Are a Sodden : 3712sof t 

# 3/36 / Exterio rPain t NoithArro w Omah a Lea d Sit e Ow n e rNam e t.£>HNB U CAVITUO H Sit e Sketc h • Goo d .Address : qu o pi>iKfjEV ^ • Poo r

Phons : « [g^No t pain t Lea d Sampl e Sampte s Collecte d Sampl e Numbe r LA B Concentratio n Collecte d Firm : FP A Fi g g i RVASCPXA-3f3fl / F l / 2 0 _pp m 

### D Date : 4 1 Wj Of , RVBSCPXA-3i3a / F

2 6>6>5 _pp m 

### D Time : IV^ ^ RycscpxA-3/3a / B I ;22 - _pp m 

### D Sample s Analyze d RVDSCPXA-a/a^ / B

2 .pp m 

### D ROaSCPXA - DZ - pp m 

### D D XR F Uni t <^r7 1 Book : 

## m RSZscexA ^ -G2 - pp m 

### D D Date : ^-^ii-o u BPZSCEXA - J2Z - pp m 

### D D Time : 

### P h Staff : ^ ^ U Numbe ro f Sample s = Legend ' F l = Fron t Lef t F 2 = Fron t Right , B l = Bac k Left , B 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , P Z = Pla y A D quadrant s ar e a

s vtew« d Fro m th a street , facin g propert /



### Legen d Concre't e Dri p Zon e Excavate d Quadrant s Excavate d Are a replace d wit h Are a replace d wilU i 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 .

# L L y/ ^ 3i3a i Exterio rPaint Nort h Arro w Omah a Lea d Sit e Ow n e rName : LCNNB U CAWTUO M • Goo d Sit e Sketc h Address : t^ilOJitiJiiM ^ • Poo r Phone : H W : \ [g^o t paint Sampl e Numbe r Lea d Sampl e Sample s Collecte d LA B Concentratio n Collecte d Firm : FD/ ^ F & ( J RVASCPXA-3f3fl / F l / 2 0 pp m 

## D Date : 

# A 

# 2 2 w iiSs RyBSCPXA-3/3a / F2 6.(< 5 pp m 

## D Time : RyCSCPXA-3/3a / B l / ^2 , ppnf i 

## D Sample s Analyze d RVDSCPXA-3/35 / B 2 .8* 7 pp m 

## D ReZSCPXA - D2 - * • pp m 

## D D XR F Unit : Q<0 2 Book : // g RGZSCEXA
. -G2 - 

## D D Date : ^ - :?• ? -0<<
. gpZSnPXA r ~ pp m 

## D D Time : ,^^^ 2 Staff : m\f / Numbe rofSample s = Legend - F l = Fron t Left , F 2 = Fron t Right , B l = Bac k Left , B 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , PZ = Pla y Al l quadrant s ar e a s viewe d fro m th e street , fadn g propert y

# 3i3a t Exterio rPain l Nort h Arro w Omah a Lea d Sit e Ow n e rName : LCNN^ U CAWTUOA J • Goo d Sit e Sketc h • Poo r Phone : ^ • W : 

# f [g^o t paint Sampl e Numbe r Lea d Sampl e Sample s Collecte d LA B Concentratio n Collecte d Firm : 

## Fp/ > F ^ y ^ RyASCPXA-3/3fl / F 1 

### /2 Q pp m 

## D Date : 

# Uji l ah
. RyBSCPXA-3/3a / F2 

### Li> 5 pp m 

## D Time : RyCSCPXA-3/3a / B l 

### I I Z pp m 

## D Sample s Analyze d RyDSCPXA-3/3,g / B 2 

## _S 1 pp m 

## D ROZGCPXADZ ­ pp m 

## D D XR F Unit : CtO I Book : }i i RGZSCPXA
. . -GZr ~ pp m 

## D D Date : M - :i. i -OL > gPZSCPXA
. 

### JJZ
­ pp m 

## D D Time : PA 1 Staff : //<?(, / Numbe rofSample s = Legend : F l = Fron t Left , F2 = Fron t Right , B l = Bac k Left , B 2 = Bac k Righ t DZ = Dri p Zone , G Z = Garden , P Z = Pla y Al l quadrant s ar e a s viewe d fro m th e street , facin g propert yExterio rPain t North Arro w 

## Omah a Lea d Sit e Ow n e rName : LCNNB U CAvJTUo M • Goo d 

## Sit e Sketc h Address: , qll C P>'MKfOE V ^ • Poo r Phone : H ; W : \ (g^No t pain t Sampl e Numbe r Lea d Sampl e Sample s Collecte d LA B Concentratks n Collecte d 

## Firm : FP/ ^

E&jA
. RyASCPXA-3/3fl / F 1 /2 0 pp m 

## D Date ; A| >< ? j of c 

# iUi i RyBSCPXA-3/3a / F 2 6 ? I B 5 pp m 

## D Time : RycscpxA-3/3a / B I / 22 , pp m 

# n Sample s Analyze d RyDSCPXA-3/3^ / B 2 8 1 pp m 

## D RBZOCPXA - DZ­ —pp m 

## D XR F Unit : CJO I Book : J/d

_ 

## D RGZSCPXA
. G2 ­ - pp m 

## D Date : H-::>i-OL > 

## D gPZSCPXA n 

## -ez - pp m 

## D Time : /V 7 

## D Staff : ^^i ^ Numbe rof Sample s Legend : F l = Fron t Left , F2 = Fron t Right , B 1 = Bac k Left , B 2 = Bac k Righ t DZ = Dri p Zone , G Z = Garden , P Z = Pla y Al l quadrant s ar e a s viewe d fro m th e street , facin g propert y 

# ENTERE D M l ] m m 8 1

I : ^ ^ 

## I 2 0



# T

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• ^ ^ 

# n

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## M 

# m % : ppe f5: ^ Re

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### >^''*'l^*' u

COASl A1 [NVItOMKIXU I cI 0 u rI h c 

### Consen t \o \ AocciSi^ - T o Piopc-irl y RIGH TO F ENTR YT O PREMISE S 

### Granto r(th e property ' owner) consent s t o an d authorize s th e Unite d State s Environmenta l Protectio n Agenc y(EPA ) o i it 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 : ^ i ^ C /
Owner' s Name : Daytim e Phone : 

## /(o^r e T rf^e/int^fj ^ 

# y/oi-¥S6^^H 9
Addres s o fPropert y covere d b ythi s Agreement : 

# "(" ^ ?in7 i ric ^ s y 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 its origina l condition
. Thi s wor k i s being , 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 perfonned , th e Granto rwil l hav e a n opporlunit 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 

### Bysignin 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 f performin 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

## XA/ y

## : C0A.S 1 A l IhVIROhKtKTA l C R O U f I Kc 

### I Remov e obstruction s includin g boats , trailers , vehicles , playscap e ilems , woo d piles , do g houses , elc ; fRemov e flowe rbulb s o rpiant s tha t th e Granto i o rth e Granlor' s tenan t ma ywis h t o save ; I Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , a s necessary ' subsequen 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 i acces s l o th e property ' t o perfor m th e work
. t Allo wvideotapin g and/o rphotographin g of th 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 f th e wor k activities , o rwit h an y ofth 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 wothers 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 contact Coasta l Environmenta l Group , a t (402 ) 991-119 9

D 1 gran t acces s t o m ypropertie s O I d o not grant acces s t o m ypropertie s

natur e

Dat e Sig i 

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

Pag e 2 o f 2COA S T AL • NVmONMINTA L GROUP , INC
. 

## Restoratio n Agreemen t The purpos e of thi s agreemen t i s to provide amutua l agreemen t a s to condition s of the propert y prior to remediationactivities
. Thi s will als o serve a s docimientationfo r the purpos e of assiiring tha t restoratio n activitie s ar e completedto the satisfactionof th e propert y owne r an dthe UnitedState s Environmenta l ProtectionAgency (EPA) .

Propert y ID : jyT'jf / Propert y Address ; ^/y/c ; F7^/f^e.^f~ h Owner : /Uoor e 5'^ { /^g^ ^ M e T V Phone : 

# 702 . -Hfy^ri H J O

nthe attacheddiagram(s ) indicat e area(s ) to excavate , surface structure s an dlandscapin g feature s an d acces s location(s ) to b e usedby the contractors , hidicat e distances , depths , materia l types , etc . Photographicall y an dVideographicall y documen t the existing condition s ofth e propert y an dthe basemen t if necessary . 

## Item s t o b e Remove d b yth e Owne rbefor e Start o fRemediation : Th e removal , storage , disposal , and/o rretur n o fthes e item s i s th e Owner' s responsibility
. Hem : 

## /L/a>i ^ item : Hem : Item :


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

## y^Cf7U>
. Kem : Kem : Kem :


### Pag e l o f 7COA S T AL • MVmONMKNTA L O I I O U P
. INC
. 

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

# ^ y Kem : 

# S j Kem : Kem : 

## Landscap e Inventory Ite m Quantit y Uni t Condition/Type/Specie s Pre-existing propert y area , tha t wil l b e excavated , tha t 

# F z Quadrants i s coveredwit hgrass . Numbe r of tree s > 2 inc h Eac h trun k

diamete r ^ Numbe r of tree s <= 2 inc h Eac h trun k

diamete r ^ Numbe r o f Sprinkle r Zones , Control Valves , Eac h Timers , Heads , etc . Attac hasketc hof th e sprinkle r layout
. Numbe r of an dsize of eac hgarden / flowe r bed Eac h area . Squar e Fee t Attac hasketc hof relative size s an dlocations
. Agree dupo nvalue o f plan t material s not to b e replacedb v contractor . Not e thi s valu e will b e usedto issu e aplan t voucher to th e property owner . Easemen t Area , t o b e Eac h excavated 

## ^2^ ^ Pag e 2 

# .J
_COA S T AL • MViaONMB N T * L O • O U P
. INC
.
AddKiona l Comment s / Instructions : Th e cit yo f Omah a ordinance s ma yprohib Kyo u fro m usin g dir t o rgrave l area s o n you rpropert y a s driveway s o rvehicl e parkin g areas . Th e Environmenta l Protectio n Agenc y(EPA ) ma yb e removin g an d replacin g soi l underlyin g a grave l o rdir t are a o n you rpropert ytha t yo u ma yb e usin g a s a drivewa yo rvehicl e parkin g area . I f thi s I s th e case , yo u shoul d understan d tha t thi s removin g an d replacin g o f soi l doe s no t mea n tha t an yIllega l drivewa yo rparkin g are a o n you r propert yI s mad e legal
. T o th e contrary , yo u ma yb e cKe d b yth e cKyI f yo u us e a grave l o rdir t are a a s a drivewa yo rparkin g area , no t wKhstandin g an yremova l o rreplacemen t o f soi l b yth e EPA
. I fyo u hav e an yquestio n abou t legalK yo f a certai n drivewa yo rparkin g area , yo u ma ycontac t th e cKyo f Omaha' s Plannin g Departmen t a t (402 ) 444-5150
. n Pleas e chec k thi s bo xi f yo u understan d th e Informatio n outline d above
. 

# yt h ^ n F L ^^ ^ h^y7d \

D 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
.



## Emi i Q I d o no t agre e I agre e

Owner' s Signatur e Date Contractor' s Sienatur e Date Page s 

# ^ ZBVID # 

# 313 8 XR F PROPERT YSAMPL E SHEE T Dat e 

## a^\%[pl^/y)\ \ Addres s 

## M-ll n p\nk^y1 ^ ^^ t Project Omah a Lea d ARR A Sampl e tim e am/p m XR F ID # 

## 7,^017
­ sampl e lengt h 3 0 se c

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

## nyi ^ 

# \^ ^ 

# t l l f ^ nSh \^ \

t \U? Dept h Dept h 

## 7. 4 

# 130 1 

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## \^ ^

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### lAf ) 

## 2. n XS b Averag e Readin g 

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t H Shot #

Averag e Readin g Sampl e are a Dept h

Shot # Readin g Sampl e are a Shot # Readin g Sampl e are a Dept h Dept h Averag e Averag e

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

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

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

pp m P b 129.04 2 Supervise d By : 

## Certificat e o fVerificatio n

2 5 SOI L 2011-04-2 6 11:0 3 95.0 6 Fina l Av g o f22-2 4 411 0 pinkne yst" ^ F 2 4 " N
. LOPE Z confirmatio n non e
Erro r 17.42 7 *

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

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

pp m P b 135.295 " Supervise d By : 

## Certificat e o fVerificatio n

2 2 SOI L 2011-04-2 6 11:0 1 31.2 6 Fina l 3138 1 411 0 pinkne ys t F 2 4 " N
. LOPE Z confirmatio n non e
Erro r 17.87 8

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

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

pp m P b 121.12 9 Supervise d By : 

## Certificat e o f Verificatio n

2 3 SOI L 2011-04-2 6 11:0 2 31.8 2 Fina l 3138 1 411 0 pinkne ys t F 2 4 " N
. LOPE Z confirmatio n non e

± Erro r ± 16.92 3

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

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

pp m P b 130.70 1 Supervise d By : 

## Certificat e o fVerificatio n

2 4 SOI L 2011-04-2 6 11:0 3 31.9 8 Fina l 3138 1 411 0 pinkne ys t F 2 4 " N
. LOPE Z confirmatio n non e

± Erro r ± 17.48 0

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

## Certificat e o f Verificatio n XL3t-3902 2 Readin g N o 2 9 Mod e SOI L Tim e 2011-04-2 6 11:0 6 Duratio n 94.7 4 Sequenc e Fina l Flag s AVERAG E Av g o f26-2 8 ADDRES S 411 0 pinkne ys t QUADRAN T,_ , . E A DEPH T 1 " XR F TEC H N
. LOPE Z MIS C confirmatio n NOT E non e
pp m ± Erro r P b 119.25 3 ± 17.12 9 Supervise d By :

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

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

pp m P b 109.66 3 Supervise d By : 

## Certificat e o f Verificatio n

2 6 SOI L 2011-04-2 6 11:0 4 31.7 3 Fina l 3138 1 411 0 pinkne ys t EA 1 " N
. LOPE Z confirmatio n non e

d b Erro r ± 16.60 7

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

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

pp m P b 118.72 3 Supervise d By : 

## Certificat e o f Verificatio n

2 7 SOI L 2011-04-2 6 11:0 5 31.7 3 Fina l 3138 1 411 0 pinkne ys t E A 1 " N
. LOPE Z confirmatio n non e

± Erro r ± 16.95 1

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

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

pp m P b 129.37 2 Supervise d By : 

## Certificat e o f Verificatio n

2 8 SOIL 2011-04-2 6 11:0 6 31.2 8 Fina l 3138 1 411 0 pinkne y s t EA 1 " N
. LOPE Z confirmatio n non e
Erro r 17.82 '

## iy;A^ \ Omah a Lea d Site—Fixe d Pric e EP-R7-09-0 6 S ^^^^ I Coasta l Environmenta l Grou p Inc
. .• • \^^^J ^

www.coastalhazmat.co m TM 

### '"•'" ^ COASTA L 

# EXECUTIV ESUMMARY : BVID #31381
- (411 0 PINKNE Y S T ) pxl N o Issue s o r Concern s | ^ Issues/Concern s

• 

## Detail Explanation : COASTA LI S UNABL ET O PROVID EPRE-EXCAVATION , EXCAVATION , AN D SO D PHOTO S A S PAR T O FTHI S FINALPROPERT Y FOLDER . THES EPHOTO S WER EIN TH EPOSSESSIO NO FASUBCONTRACTO RTHA T WA S CONTRACTE D T O PERFOR M AL LO FTH ESIT ECOORDINATIOI NREQUIRE D B Y TH ESCOPEO FWOR K AN D TH E SUBCONTRACTO RHA S SINC ELEF T TH EPROJECT . THEREFORE , TH EPHOTO S AR EN O LONGE RAVAILABLE .

• DANGARVE Y WALKE D AN D SIGNE D OFFO NTH EPROPERT Y A S COMPLET EO N 6/28/2011 .I 

## Propert yCompletio n Agreemen t Thi s agreemen t documeni s th e complclio n of remedia l acliviiie s perroime d o n myproperl yM ysignature wil l designat e Iha l I a m satisfie d wit h (h e restoralio n o f m yproperly , an d tha i n o item s ar e i n queslions
. now , o ra l an yinn e i n th e future , except ihos e ilem s liste d below , i fan y

Propert yID : ^{ ^

$^ \ Propert y Address : ^//^"//^i^^i ^ " ^ Owner : ^^.^ ^ ,uJ> V Phon e 

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# i^f H Restoratio n Item s i n Question :

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I I agre e restoralio n i « completed , excep t a s note d [_ J I d o no l ai;re crestoratio n i s complete d

Owner' s Signatur e Dat e Cont i arior' s Signalur e Dal e4 

## tF

% 

## EP APropert y Clos e Ou t For m Propert y# : 

# HM L Propert y Address:

- -p DatcATime : Owncr' s Name: . /i^ ^ Quad s Excavated : Contracto r Grou p Excavatio nGeaera l 1 .

I Fnecessaiy , wer e th e correc t quadrant(s ) excavate dan drestored ? 2 .I f necessary , wer e th e coirec t area s o f dri p zon e excavale dan drestored? Gradin g So d an d Vengtelto n I .Doe s th e gradin g aroun dth e perimete r orth e hous e inexcavate darea s generall y s)op e away fromth e house ? ^ 2 .Ha s so dbee nlai di nal l ana s that wer e excavated ? 3 .Doc s th e so dappea r t o b e genenll y health y an dgrowing ? (Onl y evalual e i f inspecte da i a3 0 da y tim e period ) 4 .Ar e sodde darea s generall y firman devenl y graded ? 5
.

Ar e di e joint s betwee nth e so dsnip s generall y tight ? (Onl y evaluat e i f inspecte da t a3 0 da y tim e period ) 6 .Wa s th e propett y grade dsuc hthat wate r wil l no t poo l o nth e prapem' ? 7 .

Wa s damag e t o landscapin g o r plant material s avoided ? Gates . Fence s an dRetatoln g Wai b I .D o gate s ope nan dclos e freely? (I f applicable ) 2 .Wer e al l gate s o r fence s take ndow ndurin g restoratio nactivitie s reinstalled ? (I f applicable ) 3 .Wa s dainag e t o gate s o r fence s avoided ? (I f applicable ) 4 .Wa s dainag e l o retainin g wall s avoided ? (Ifapplicable ) Foundation , SidiBRflB dGmter s t .Wa s damag e t o th e sidui g o r tri mavoided ? 2 .Wa s damag e t o th e foundatio navoided ? Wa s damag e l o window s avoided ? Wa s dainag e t o window s o r doo r screen s avoided ? 5
.

Wa s damag e l o downspout s o r downspou i extension s avoided ? Sidewalk s an dDriveway s (Concrete ) I .Wa s damag e l o drivewa y surface s avoided ? 2 .Wa s damag e t o wallcway surface s avoided ? 

# .,^f ^

Yes N o / 

# y Yes No 

# y y y y / 

# y y Ve s N o 

# y y 

# - y 

# y Ye s N o 

# r / / 

# r
Ye s N o 

# n y

## Owner s comments :

I ^^
_ 

## jln.spectio nnoles :


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# y

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Rempval andrestoratio nactivate s complete includin g the 30-da y so dwarranry : EPARepresentativ e Qg^A^O y Date:___^_£\i,t\\^