## TRANSMITTA Lo f OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R
SAI D # : 2^31 6 Date : Z\2.0\C< ] Address : 74Z ^ felODClO St " Remediatio nContractor : Coasta l Environmenta l Group
_ SOI LREMEDIATIO N PROPERT YFIL EFOLDE RDOCUMENT S y Vide o o f property (DVD ) sy Executiv e Summary \y EPA-provide dproperty sketc h sy Signe dAcces s Agreemen t fo r subjec t property (^ hSigne dAcces s Agreement(s ) fo r adjacent property \y Restoratio nAgreemen t Year : _2008
_

4031543 6 

## I I I 

# II I "^ un d



## f4|i \Settlemen t document s (i.e. , for damag e o r to replac e plants , etc. ) y Confirmatio ndat a y Photograph s ^i_-{LXf^n.ln^/W x ^.jCC/Jukoa , ^d j ^A^ USo d 0 As-buil t sketc h s y Satisfactory restoratio nsigne db y Property Owner y Property close-ou t chec k lis t signe db y EPA |ip

V Descriptio no f area s no t meetin g RO D cleanu p criteri a y Utility clearance s y Property informatio nfromDougla s County Assessor' s Offic e



# „ y y t ^ { n y <^jSviltL6f-prvr v D



# L^.my}^7 ) ^lonip ^ Signature Signature ' Dat e 

# ^7 y ^7i^^C£ ^

# m Propert yAcces s Checklis t Propert y ID : iS^^Xe ; Propert y Address : r^^^ ^ 9AfVY\( ^ <5 \ n nWOR K STARTE D WORKCOMPELTE D ON : ON : / / / / 

## O""'^' ^NArsVrrr
. \rAvY5)trv^ S Address :


## Phone : 342,-25^2. 0 Fax : Cell/Pasjer : Renter : Phone : Fa.\ : Cell/Pager : Additiona l Information :

1 1 Notificatio nLette r ly Acces s Agreemen t \y Restoratio nAgreemen t nTopsoi l Samplin g (ifapplicable ) 1 1 Disposal Samplin g (if applicable ) nGarde nSamplin g (if applicable ) Ily Utility Clearanc e

D Video/Photo s (Before ) nVideo/Photo s (Durinj; ) 1 D Video/Photo s (After )

nVideo/Photo s (3()-Day )

• Pro|)ert y Completio nAgreemen t 1 1 Fina l Repor t Sent : / / 

## Signed : JL/.23/Q g Signed : J8_/23/ofi
. / / / / / / 

## Called : ft / 2 8 /0 % On : / / On : / / On : / / On : / / Signed : / / l.s.sued : / / By : By.^ Q By : ^^ ^ By : By : By : 

## B.v : 0^- 2 0 8 By : By : By : - . By : 

## By : By : 

## j

Ai r Monitorin g (a s applicabl e 1 Communit } H H Crc M ) Results : On : / / Bv :
L JConununit y Results : E H Cre « On : / / 

## B y : I j

nCommunit y Results : • Cre w On : / / B, :

Omah a Lea d Sit e 

# I

# CONTAC TFORM Property I D #9?3\5 ' Property Address : 

# aM,^? ) ?)\Ohd 0 T^ i Initial Contact : Date : Time : Action : Secon dContact : Date : Time : Action : Final Contact : Date : Time : Action ; Final Action : Transmi t to EPAD Othe r Action : D 

# 3Ma-a^r^o Comment : Owne r Comment (s) : Site Coordinato r Comment (s) :

## .Dougla s County Accoun t Informatio n Pag e 1 o f 1
Dougla s County , Nebrask a Propert yRecor d - R194442000 0 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-5 0 ft wes t o f90t h St - Vje WO H Ma p Informatio n i s vali d a s o f2008-6-1 9 Treasurer' s Ta xRepor t Ne wFeatur e -•->- > Aut o Sale s Searc h Owne r MOBEC O INDUSTRIE S
1141 3 HICKOR YR D OMAH AN E 68144-000 0 PropertyInformatio n Ke yNumber : 444 2 000 0 1 9 Accoun t Type : Residentia l Parce l Number : 194442000 0 Parce l Address : 242 8 BLOND O S T OMAH AN E 68111-000 0 Lega l Description : PARKER S AD D LO T5 BLOC K1 W1/ 2 3 0 X140.8 7 Valu e Informatio n Lan d Improvemen t Tota l 200 8 $200.0 0 $0.0 0 $200.0 0 200 7 $200.0 0 $0.0 0 $200.0 0 200 6 $200.0 0 $0.0 0 $200.0 0 200 5 $200.0 0 $0.0 0 $200.0 0 200 4 $200.0 0 $0.0 0 $200.0 0 200 3 $200.0 0 $0.0 0 $200.0 0 Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.0 9 4230. 0 0. 0 141. 0 30. 0 Ye s



## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R19.
. . 7/17/200 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 2119034
. Origina l Cal l Date : 8/28/0 8 Time : 12:1 6 p m Op : ELIZABETH18 7 9 0 Wor k t o Begi n Date : 9/02/0 8 Time : 12:4 5 p m State : N E County : DOUGLA S Place : OMAH A Address : 242 8 Street : BLOND O S T Twp : 15 NRng : 13 E Sect-Qtr : 09-SE,10-SW,15-NW,16-N E Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : lea d remidiatio n Locatio n o f Work : LOCAT E ENTIR E PROPERT Y AL L TH E WA Y T O TH E STREE . Remarks : FAX AL L CLEAR S TO : (877)662-421 1 : VACAN T LOT . : 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 ho 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 S MAGELLAN MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C

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

## Day : 402934046 9 CXCAT V CO XCOMMUNICATIONS , IN C 

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

## N AAlt : Emerg : 877366834 4 Day : 918574709 8 MAGELLA NMAGELLA NMIDSTREA M PARTNER S LPTONY AAlt : 

## Emerg : 918574709 8 Day : 402504782 3 MUDO l METROPOLITA NUTILITIE S DISTRIC TSAND YAlt : 

## Emerg : 402504794 6
http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 8/28/200 8

## Pag e 2 of 2 Day : 402444719 7 OMAHACO FCIT YO FOMAHA-TRAFFIC,SEWE R 

## RO NAlt : 402444516 1 Emerg : 402444516 0 Day : 406728934 3 0PPDGPR 5 OMAH APUBLI C POWE RDISTRIC T 

## N AAlt : 888728934 3 Emerg : 406728934 3 Day : 406728934 3 QLNN E1 C QWES TLOCA LNETWOR K 

## N AAlt : Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 8/28/200 8

# As-Buil t Drawin g ^r COASTA L 

# Omah aLea dSuperfun dSit e INVIRONHINTA L G I I O U P
. IN C 

## 2731 5 Exterio rPain t Nort h Arro w 

### Omah aLea dSit e •Goo d Samplin g AddrMs : 242 8 BLOND O S T 

### Sit e Sketc h Q Poo r Phone : H (402)342-282 0 ALT : 

# f [^No t pain t Sampl e Numbe r Lea d Sampl e LA B Sample s Collecte d Concentratio n Collecte d Firm : m \^ 0 • Pe > RYASCPXA-2731 5 F l 

## 12/ 3 p p m 

## D Date : 7 - 1 2

- 6 ^ RYBSCPXA-2731 5 F 2 p p m Time : I D 'O O o-r ^ RYCSCPXA-2731 5 B l p p m 

# n Sample s Analyze d RYDSCPXA-2731 5 B 2 p p m 

### EZ l 

# I

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### D XR F Unit : 6>5H 2 Book : 1 8 H 

# n 

# n RGZGOrXA-2731 5 G * p p m Dat e 

### /?- Q 

### ^ 7 

# n La b RYCSCPLA-2731 5 p p m 

## D Tim e 

# A n I Resul t 

## D 

# n 80 3 pp m Staff : Numbe ro fSample s - 

## KS W 

# i Legend : F l = Fron t Left , F 2 = Fron t Rigtit , B l = Bac k Left
. B 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , P Z = Pla y Al l quadrant s ar e a& yiSMM d fro m th e street , facin g propert y OLS# : 27? 1 

## i Dat e Excav a ted : .<

)/13/0 8 Dat e USEP ASig r led G ff : 11/21/0 8 Are a Sodde t 2 sqf t
8 1 = 265 PP M 6"

F 1 = 83 PP M 6"

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### " ^

Re\ S Cicau d 6/li'200 7 1 0 4 7 « 

## Legen d

Concret e Dri p Zon e Excavate d Quadrant s Excavate d Are a replace d wit h Are areplace dwit h ^ ^ , - ^ , . So d' « T./ W1 V
. ^ HAre alef t bar e Rock/Mulc h ^ ^ 

## Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p In c

### % 

# 2731 5 Exterio rPain t Nort h Arro w 

## Omah a Lea d Sit e Q Goo d Samplin g Address : 242 8 BLONDO ^ 

## Sit e Sketc h • Poo r Phone : » (402)342-282 0 AL T [j3^No t pain t Lea d Sampl e Sample s Collecte d Sampl e Numbe r LA B Concentratio n Collecte d Fir m RYASCPXA-2731 5 F l 

# 12J 3 pp m 

# D Dat e 

# 7 - iZ ' t 7 RYBSCPXA-2731 5 F 2 

# 5 5 H pp m Tim e RYCSCPXA-2731 5 B l 

# ft^q pp m 

# 0 f Sample s Analyze d RYDSCPXA-2731 5 8 2 

# ftqg pp m 

# i n RDZGCPX A2731 5 D Z pp m XR F Uni t (D5H2
. Boo k JB H 

# D D nGZ0CPXA-2731 S G Z pp m Dat e 

# H-^d l D D pp m ^La b RYCSCPLA-2731 5 Tim e 

# D D 

# it L s Resul t 803pp m Staf f Numbe ro fSample s = 

# Ms W 

# y % Legen d F 1 = 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 , P Z = Pla y Al l quadrant s are a s vievw d fro m th e street , facin g property

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# A 2731 5 Exterio rPaint Nortt i Arro w 

## Omah a Lea d Sit e Samplin g Address : 2428 BLOND O S T 

## Sit e Sketc h Q Goo d Q Poo r Phone : H (402)342-282 0 ALT : 

# r [Q^No t paint Lea d Sampl e Sample s Collecte d Sampl e Numbe r Concentratio n Collecte d LA B 

## Firm : TO V 0 •{/£ > RYASCPXA-2731 5 F l 

# 121 3 pp m 

# D Date : 7 - [Z - b 7 RYBSCPXA-2731 5 F2 

# 5 5 ^ pp m Time : JD'C O c^i ^ RYCSCPXA-2731 5 B 1 

# fl^q pp m 

# n Sample s Analyze d RYDSCPXA-2731 5 B2 pp m 

# D 

# I ^°\(^ RDZGCrXA-2731 5 B Z pp m XR F Unit : 0>5H2
. Book : l& H 

# n RGZOGPXA-2731 5 G Z pp m 

# n Dat e 

# fi-^d l D La

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# D Tim e 

# M
. SResult 80 3 pp m Staff : Numbe ro fSample s = 

# D D Ms W 

# %.y
. Legend : F 1 = Fron t Left , F2 = Fron t Right , B l = Bac k Left , B2 = Bac k Righ t DZ = Dri p Zone , G Z = Garden , P Z = Play Al l quadrant s ar e asyiewa d fro m th e street , facin g property 

# ENTERE D JU L2 7 200 7

Rrk' 5 Creale d 6/12'200 7 1 0 4 7 4< > 

## $IO]A^< 7 C, \ 04614 1 012 3 aiTM«rsy)>)no i wi-xr'»i/Mi'3«i f.ofrwniMn'/'W'JN" - n*.
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# W M M

# 2731 5 Exterio rPain t Nort h Arro w 

## Omah a Lea d Sit e •Goo d Samplin g Address : 2428 BLOND O S T 

## Sit e Sketc h •Poor Phone : H ; (402)342-2820 ALT : 

# r [Q^No t paint Sampl e Numbe r Lea d Sampl e Sample s Collecte d LA B Concentratio n Collecte d Firm : 

# F mt^'Pi ^ RYASCPXA-2731 5 F l 

## 121 3 pp m 

# D Date : 7 - IZ - 6 7 RYBSCPXA-2731 5 F2 pp m 

# D Time : I D :0 D o~t ^ RYCSCPXA-2731 5 B 1 

# fl^q pp m 

### Q I Sample s Analyze d RYDSCPXA-2731 5 B2 

## A^ g pp m 

# n RDZGCPX A2731 5 B Z pp m 

# D 

# n XR F Unit : ^5H7
. Book : J& H RCZOCPX A2731 5 G Z pp m 

# D D Dat e 

## / ? Q •^ 7 La

b RYCSCPLA-2731 5 pp m 

# D D Time : 

# M
. ^Resul t 80 3 pp m Staff : Numbe rofSample s • 

# y. 7 M.S W Legend : F l = Fron t Left , F2 = Fron t Right , B l = Bac k Left , B2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , PZ = Pla y Al l quadrant s ar e a s vieMMd fro m th e street , facin g property


### ."CIXT ' ssm.T i ITTM-lT k
... . • 

# 8 1 6^ 5 JU L2 7 200 7 U
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Crealed : 6/12/200 7 1 0 4 7 4 9 rjwioo fJ* : 1 '• /a> ' XK^MCixo ' :i u-I»?2W.«i;!W3«',ln'Wfjowwr.' j .'Rr'3WW"» fW'x ri«,rMn j Re^ 5 04614 1 012 3

### <7^> *
COASTA L 

# m \ fNVIKONMlNTA l

^ c ^ - ^ C > 0 U P
. IN 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 : \ i ^ ^
_ ^ Daytim e Phone:^^^ ^ ^^ ^

^ ^^^ ^ 

### owner' s Name : ^bhc O ^doS^.t ^

Addres s o fPropert y covere d b ythi s 

# Oirvh<^^ B Ionia n Agreement :
PURPOS E O F RESPONS E ACTIVITIE S 

## Th e EP Ai s requestin g acces s t o collect 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 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 o fCoasta l Environmenta l Group , contracte d byUSEPA , 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 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 meets wit h th e Grantor' s approval
. Upo n completion , th e Granto rwil l receiv e writte n documentatio n fro m EPAtha t th e property ha s bee n remediated
. ENVIRONMENTA LRESPONS 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 , 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 effect 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 V^4^a^* ^ COASTA L ^ V < PCNVmOHHENTH l



### •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 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
I gran t acces s t o m ypropertie sD I d o no t gran t acces s t o m ypropertie s 

# y77ly(/y777ky77yyy/Ms\/^ ^ 7"y Signatur e 7 ^ Date / / SignatureDate

IZ I I woul d lik e t o b e presen t durin g an ysamplin g tha t i s required
.COASTA L 

# Restoratio n Agreemen t Th e purpos e ofthi s agreemen t i s to provid e amutua l agreement a s l o condition s ofth e propert\ ' prio r t o remediatio nactivities
. Thi s vvii i als o serv ea s documentatio nfo r th epurpos eo f assurin g tha t restoratio n activitie s are complete dt o th e satisfactio nofth e propert y owner an dth eUnite dState s Environmental Protectio nAgency (EPA)
.

PropertylD : Q^^j ^ Propert y Address : g^^^ ^ B/onnlz ) ^ • Owner : m^QP f .C.<,AAi)^/e- 6 Phone : 

# t^zn-S^5L-^^ Q
O nth e attache ddiagram(s ) indicate area(s ) t o excavatedanddept ho f e.\ca\ation
. locationo f all know n utilities , subsurfac efeatures , surfac e structure s an dlandscapin g features , acces s location(s ) t o beusedby contractor , andth e directio no f North
. Indicate distances , depths , material tvpes , etc . Indicate digita l photo s b

y referencin g th e photo-lo g number wit ha narro w indicating directio no f view
. 

## Item s T o B e Remove d B yOwne rBefor e Star t O fRemediation : (Us e additiona l sheet s a s necessary ) Th e removal , storage , disposal , and.'o rretur n o fthes e item s i s th e Owner s responsibility
.

Pag e 1 of
.COASTA L 

## Item s T o B e Remove d B yContracto rDurin g Remediatio n An d No t Replace d (Us e additiona l sheet s a s necessary ) Item : Item : ^ X / - ^ V



### , Item : \ Item : Item : \

Item : \ \ Item : \

i Item :

Item : \ \
Item : Item : Item : Item : • \



### ^-­ ^ \ \ \ / Item : ' 1 

### Item :

Pag e 2 of
.COASTA L



### Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item :

1 

### Item :

Item : Item : 

### Item s T o B e Remove d B yContracto rDurin g Remediatio n An d Replace d (Us e additiona l sheet s as necessary )
^ ^
_---^ ^ y 

# 7
\ \ \ \ ^ 

### \ \ \. ^
\ )

—

—

Pag e 3 o f

# w t

COASTA L 

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

## Ite m

Pre-exislin g propert yarea , that wil l b e excavaied , tha i i s covere d wit h grass . 

## Quantit y Uni t

Square fee t 

## Condition/Type/Specie s 

# O<oc^vccf< ^

^yy- cryo^T ^

Numbe ro ftree s > 2 inc h irun k diamete r 

### %
. Eac h



### jj Numbe ro ftree s '- = 2 inc h

trun k diamete r 

# ~y Eac h

\ Numbe rySprinkle r Zones
. Contro l Valves
. Timers
. Heads , eic
. Aiuic h a skeic h u fih e ;.pii:ikle: - k;\ OUT
. 

## Lr- > Eac h \

Numbe ro fan d siz e o f eac h garden / flowe rbe d area . •'•.;.;ii.] : ; ; >KCiC!' i v i ......ul'. C -l;'e ^ Z\n.}
. localion-.
. - ^ Eac h Square Feet



### Pag e 4 o f

# m ^

COASTA L 

## Ite m Agree d upo n valu e o f plan t material s no t t o b e replace d b vcontractor
. Not e thi s valu e wil l be use d t o issu e a plan t >ouctie rt o th e propert ) owner . Agree d upo n lis t o fplan t material s tha t wil l be replace d b ycontractor
. B e veryspecifi can d detailed
. Includ e n sketc h c\ ^

wer e eiic h plan t uil l b e pbce d b_

\ ih e coniracioi
. Agree d upo n area o f propertvt o b e replace d wii h gras s sod
. ''icii:d cu skeu:l l >>; ih c .iiea(s ) U ' h e ;epl.icc J '•'-•li' i

.Are a ofCit yo rCount ) propertvt o be landscape d perihei rrequirements
.

Easemen t Area , t o b e excavate d 

## Quantit y

^ 

## Uni t



# * 0 Condltion/Type/Specie s



# ^ k Eac h



### - 

# ^(oyy j S F



### ^ 

# y ^ S F



### SF

Pag e 5 o f

# ^ KJo^ y \c7r
. •Chec k th e bo xI fOwne 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 fhouse , includin g foundatio n crack s o rfissures
.
QId o no t agre e 

# i^TkTer'yyyym'y ^ yyy Contractor' s Signature Date Pag e 6 of
.Dat e Projec t XRFID #

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# 5^^ ^ Averag e

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Averag e la b sampl e # BVID # cO"7?^i S XR F PROPERT YSAMPL E SHEE T 

# ^- \^-o & Addres s ^^a ^ V^\C'^>- AA O ^ ^ • Omah a lead F P 2n d yea roptio n Sampl e tim e am/p m 

# e,3yy \ sampl e lengt h 3 0 se c Readin g Sampl e are a Shot # Readin g Sampl e are a aa u -r^o'' - \(\.^S ^ 3&0 S \oa
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. ft! Dept h 380 T loH.ti-b t \-^.^: i Dept h cSlQ
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Readin g Sampl e are a Shot # Readin g Sampl e are a ^- i k^ , t : \\.- m dBi S m7
. 3i5 - \u-it.< ! '^u.To i \S.3-3 - 

# f^ 3S\u > ^ir^iH-UH t \'b...3T 

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\a.'o ^ Dept h .-S^i T 1^3 - 31- " t-i6.6 i Dept h 77
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# u 83.^\.g, ^ \Q
. -^ O Averag e i ^ M .c/zu^ ^ \' ^ .y ^
Readin g Sampl e are a Shot # Readin g Sampl e are a i)vo-J B t i&.i H 33^.3 3 - \'^--2. a ,^-"^ ^ dii)o.S Ti \8.U U Dept h Dept h \ ,9u3.6Hln'» ^ c^Vl.^ U t \ S .^ p Averag e

RETES TAREA S Readin g Sampl e are a Shot # Readin g Sampl e are a

' ^ Dept h 

## ^y / Dept h 

# yy Averag e La b resul t Sampl e are a XR F Avg
. Signature^ 

# P„n. ' Ui>:H ^ Mmr^s

# 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 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

380 4 SOI L 

### 2008-09-1 3 20:3 0 121.8 6 Fina l Av g o f3800-380 3 ^42 8 Blond e s t .fB l

. LOPE Z 

# f e

CLEARANC E f

# 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 226.80 2 Supervise d By : 

## Certificat e o fVerificatio n

380 0 SOI L 2008-09-1 3 20:2 8 30.2 4 Fina l 2731 5 242 8 Blond o s t B l LOPE Z 6 CLEARANC E

± Erro r ± 19.71 9

# 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 PI'P E NOT E

pp m P b 274.56 3 Supervise d By : 

## Certificat e o fVerificatio n

380 1 SOI L 

### 2008-09-1 3 20:2 9 30.5 6 Fina l 

### 2731 5 242 8 Blond o s t B l LOPE Z 6 CLEARANC E

± Erro r ± 21.43 9

# 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 288.01 4 Supervise d By : 

## Certificat e o fVerificatio n

380 2 SOI L 2008-09-1 3 20:2 9 30.5 1 Fina l 2731 5 242 8 Blond o s t B l LOPE Z 6 CLEARANC E

±Erro r ±21.87 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 PI'P E NOT E

pp m P b 272.24 7 Supervise d By : 

## Certificat e o fVerificatio n

380 3 SOI L 

### 2008-09-1 3 20:3 0 30.5 5 Fina l 

### 2731 5 242 8 Blond o s t B l LOPE Z 6 CLEARANC E

± Erro r ± 21.25 2

# 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 

### 380 9 Mod e SOI L Tim e 

### 2008-09-1 3 20:3 3 Duratio n 

### 121.4 1 Sequenc e Fina l Flag s AVERAG E Av g o f3805-380 8 , ADDRES S 242 8 Blond o s t QUAD/ZON E B 2 INSPECTO R JjQPE Z DEPT H SAMPL E PVP E CLEARANCE | 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 102.17 2 Supervise d By : 

## Certificat e o fVerificatio n

380 5 SOI L 

### 2008-09-1 3 20:3 1 30.3 2 Fina l 

### 2731 5 242 8 Blond o s t B 2 LOPE Z 6 CLEARANC E

± Erro r ± 13.64 3

# 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 105.58 9 Supervise d By : 

## Certificat e o fVerificatio n

380 6 SOI L 

### 2008-09-1 3 20:3 2 30.5 2 Fina l 

### 2731 5 242 8 Blond o s t B 2 LOPE Z 6 CLEARANC E

± Erro r ± 13.89 7

# 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 104.68 2 Supervise d By : 

## Certificat e o fVerificatio n

380 7 SOI L 

### 2008-09-1 3 20:3 2 30.2 3 Fina l 

### 2731 5 242 8 Blond o s t B 2 LOPE Z 6 CLEARANC E

± 

### Erro r ± 

### 13.61 9

# 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 108.32 5 Supervise d By : 

## Certificat e o fVerificatio n

380 8 SOI L 

### 2008-09-1 3 20:3 3 30.3 4 Fina l 

### 2731 5 242 8 Blond o s t B 2 LOPE Z 

### 6 CLEARANC E

± 

### Erro r ± 

### 14.17 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 AVERAG E ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

P b Supervise d By : 

## Certificat e o fVerificatio n

381 4 SOI L 

### 2008-09-1 3 20:3 9 120.6 2 Fina l Av g o f3810-381 3 242 8 Blond o s t " • i F l

LOPE Z ^ 6

CLEARANCE i

# 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 PI'P E NOT E

pp m P b 75.84 5 Supervise d By : 

## Certificat e o fVerificatio n

381 0 SOI L 

### 2008-09-1 3 20:3 4 30.3 0 Fina l 

### 2731 5 242 8 Blond o s t F l LOPE Z 6 CLEARANC E

± Erro r ± 11.73 7

# 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 96.70 1 Supervise d By : 

## Certificat e o fVerificatio n

381 1 SOI L 

### 2008-09-1 3 20:3 6 30.1 2 Fina l 

### 2731 5 242 8 Blond o s t F l LOPE Z 6 CLEARANC E

± Erro r ± 13.22 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 381 2 Mod e SOI L Tim e 2008-09-1 3 20:3 7 Duratio n 30.0 1 Sequenc e Fina l Flag s BVI D # 2731 5 ADDRES S 242 8 Blond o s t QUAD/ZON E F l INSPECTO R LOPE Z DEPT H 6 SAMPL E TYP E CLEARANC E NOT E

pp m ±Erro r P b 83.52 8 ±12.51 4 Supervise d By :

# 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 P<P E NOT E

pp m P b 77.76 2 Supervise d By : 

## Certificat e o fVerificatio n

381 3 SOI L 2008-09-1 3 20:3 9 30.1 9 Fina l 2731 5 242 8 Blond o s t F l LOPE Z 6 CLEARANC E

± Erro r ± 12.13 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 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

381 9 SOI L 

### 2008-09-1 3 20:4 6 121.7 0 Fina l fAv g o f3815-381 8 ,242 8 Blond o s t 

### IF 2

LOPE Z lit6
.

CLEARANC E 'Hif

# 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 147.37 5 Supervise d By : 

## Certificat e o fVerificatio n

381 5 SOI L 2008-09-1 3 20:4 3 30.3 3 Fina l 2731 5 242 8 Blond o s t F2 LOPE Z 6 CLEARANC E

± Erro r ± 16.15 8

# 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 PI'P E NOT E

pp m P b 129.69 2 Supervise d By : 

## Certificat e o fVerificatio n

381 6 SOI L 

### 2008-09-1 3 20:4 3 30.2 8 Fina l 

### 2731 5 242 8 Blond o s t F2 LOPE Z 6 CLEARANC E

± Erro r ± 15.26 9

# 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 132.36 0 Supervise d By : 

## Certificat e o fVerificatio n

381 7 SOI L 

### 2008-09-1 3 20:4 4 30.6 2 Fina l 

### 2731 5 242 8 Blond o s t F2 LOPE Z 

### 6 CLEARANC E

± 

### Erro r ± 

### 15.51 1

# 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 129.22 1 Supervise d By : 

## Certificat e o fVerificatio n

381 8 SOI L 

### 2008-09-1 3 20:4 6 30.4 7 Fina l 

### 2731 5 242 8 Blond o s t F2 LOPE Z 

### 6 CLEARANC E

± 

### Erro r ± 

### 15.19 2

# 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 382 4 Mod e SOI L Tim e 

### 2008-09-1 3 20:5 5 Duratio n 

### 122.0 9 Sequenc e Fina l Flag s AVERAG E fAv g o f3820-382 3 ADDRES S 242 8 Blond o s t QUAD/ZON E easemen t INSPECTO R ' LOPE Z DEPT H 

### 1 SAMPL E TYP E CLEARANCE • NOT E

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 210.27 9 Supervise d By : 

## Certificat e o fVerificatio n

382 0 SOI L 

### 2008-09-1 3 20:5 3 30.6 5 Fina l 

### 2731 5 242 8 Blond o s t easemen t LOPE Z 

### 1 CLEARANC E

± 

### Erro r ± 

### 18.18 9

# 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 235.32 3 Supervise d By : 

## Certificat e o fVerificatio n

382 1 SOI L 

### 2008-09-1 3 20:5 4 30.4 3 Fina l 

### 2731 5 242 8 Blond o s t easemen t LOPE Z 1 CLEARANC E

± Erro r ± 19.32 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 220.56 9 Supervise d By : 

## Certificat e o fVerificatio n

382 2 SOI L 

### 2008-09-1 3 20:5 4 30.6 3 Fina l 

### 2731 5 242 8 Blond o s t easemen t LOPE Z 

### 1 CLEARANC E

± Erro r ± 18.65 5

# 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 202.88 7 Supervise d By : 

## Certificat e o fVerificatio n

382 3 SOI L 

### 2008-09

- 1 3 20:5 5 30.3 8 Fina l 

### 2731 5 242 8 Blond o s t easemen t LOPE Z 

### 1 CLEARANC E

± Erro r ± 17.83 2

## Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc
. 5S!» ' ^

•. ^ www.coastalhazmat.co m ^PBott"^"^ " COASTA L ENVIRONHENTA L CROUP , INC
. 

# EXECUTIV ESUMMARY : BVI D #2731 5 - (242 8 BLOND O ST )

y 

# N o Issue s o r Concern s | ^ Issues/Concern s Detai l Explanation : N O ISSUE S PENDIN G4 

### SiK
. 

# EP A EP APropert y Clos e Ou t For m Propert y Addr«.

- ^49? ^ fi\OYYlO.^ Propert y ff : ^^'^If T
. . Quad s Excavated : Fv
. f ? ^y^ ^ ~ Contracto r Grou p rnT^SMi >-.VAV\yr^nU>e,n-ttL \
Ye s N o Excavatio nGenera l 

# VAm/vlTLO T 1
.i f ncccssuy , wer e th e correc t quadTant(s ) excavate dan drestored ? , y 2
.I f necessary , wer e th e con-cc l area s ofdri p zon e excavate dan drestored ? GradlD K So dan dVecetatio n 

### Ye s N o 1
.Doc s th egradin g aroun dth eperimeie r ofth ehous einexcavate darea s generall y slop e away I fromth ehouse ? 

### 2
. Ha s so dbee nlai dinal l area s tha t wer eexcavated ? 

# y 3
. Doe s th eso dappea r to b egenerall y health y an dgrowing ? (Onl y evaluat e i f inspecte da t a3 0 

# y da y tim eperiod ) 

### 4
. Ar esodde darea s generall y firman devenl y graded ? 

### 5
. Ar eth ejoint s betwee nth eso dstrip s generall y tight ? (Onl y evaluat e ifinspecte da t a3 0 day tim eperiod ) V' 

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

# y 7
. Wa s damag e t o landscapin g o r plan t material s avoided ? Gates , Fence s an dRetainin g Wall s 

### Ye s N o 1
.D o gate s ope nan dclo.s efreely? (I f applicable ) 

### ' 2
.Wer eal l gate s o r fence s take ndow ndurin g restoratio nactivitie s reinstalled ? (Ifapplicable ) 

## i ^; \ 3
.

Wa s damag et o gate s o r fence s avoided ? (Ifapplicable ) 4
.Wa s damag et o retainin g wall s avoided ? (Ifapplicable ) 

# 1 Foundation , Sidio K an dGutter s 

### Ye s N o ( I
.

Wa s dannag et o th esidin g o r tri mavoided ? 2
.Wa s damag et o th efoundatio navoided ? 

# i 3
.Wa s damag et o window s avoided ? 

# y Wa s damag et o window s o r doo r screen s avoided ? 5
.

Wa s damag e l o downspout s o r downspou l extension s avoided ? 

### \ Sidewalic s an dDriveway s (Concrete ) Ves N o 1
.

Wa s damag et o drivewa y surface s avoided ? Vi \ 2
.Wa s damag et o walkwa y surface s avoided ?

# O^'Dcr s comments :

Inspectio nnotes :

Remova l an drestorationactivate s complete including the30-da y so dwarranty :

- — • -) yf
. 

# EP ARepresentative .y^7yy777^_y/^yK.^^y7 ^ Date : // /h. / / o Q ^

## Propert yCompletio n Agreemen t
riii s agreemen i documenls
. ih e complclio n o i remedia l activitie s perlbrme d n n m yproperly
. M ysignalur e Wil l designal e tha i I a m satisfie d wit h th e restoratio n o fm yproperly , an d tha i n o item s ar e m questions , now , o ra i an ylim e i n th e future , excep t thos e item s liste d below , ifan y

Propert yI D ^ ^ 7 ? / 5 

## Property Address : J_Z.;^ ^ (^ 7 ^ ^ ^ ^ s t 

# ^/7! y7^^7L&-^^ y^A^Tby^L y Phon e31.|/ ^ JiyP>( 9 Restoratio n Item s i n Questio n

Item ; Item : Item : Item : Item : Item :

y

\ I ayrc cicstoralio n i s complcled , cxctp l as noler i [ I I fi o nn l aj;ic crestoralio n I s complete d 

# 'yAly{jfc o ^^^^L fypyjt- 7

Owner' s Signalur e ---—Oat c'^Conlraclo i ' s Signatur e 

# ITOf^JUyaAyy]n.^(yui h /t//s/oS ' hal e