## TRANSMITTALo f

OMAH ALEAD SIT E SOI LREMEDIATIO NFIL EFOLDER sAiD# : j^n^^L g Date : \Z ^ Z'ZQI Q Address : gZ?! ^ p J l\C > cS j Remediatio nContractor : Coasta l Environmenta l Grou p Year : 200 8 SOI LREMEDIATIO N PROPERT Y nLEFOLDE RDOCUMENT S Vide o ofpropert y (DVD ) Executiv e Summary EPA-provide dproperty sketc h 3021763 9 

### Signe dAcces s Agreemen t for subjec t property Superifun d 

### Signe dAcces s Agreement(s ) for adjacent property % 

### Restoratio nAgreemen t Settlement document s (i.e. , fo r damag e o r to replac e plants , etc. ) Confinnatio ndat a Photograph s f f t (y^gfViiVtigi/ v \^ O ^hA ^ Ifav f As-buil t sketc h B f 

### Satisfactor y restoratio nsigne db y Property Owne r 

# a r Property close-ou t chec k lis t signe db y EPA Descriptio no f area s no t meetin g RO D cleanu p criteri a % 

### Utility clearance s Property informatio nfro mDougla s County Assessor' s Offic e 

# d [ J D D

^ ^ ^ 

### Date 

# ^m> ^

## Propert y Acces s Checklis t Propert y ID : ^)CM1\S ) Propert y Addrcas : ^ : ^ M LJ O S l n D

WOR K STARTED WORKCOMPELTE D ON : ON : / / / / 

# ^""• ^ Sf.bca^n,Ci J^?cra M Address :
Phone : Fax : ^ IP77
- (0i5 | 

### Cell/Page r 

# -hmp-oio ^ Rente r Pbone : Fax : Cdl/Page n Additiona l Infonnation :

D

O Q
D D D D D Notificatio nLette r Acces s Agreemen t Restoratio nAgreemen t Topsoi l Samplin g (i f applicable ) Disposa l Samplhi g (if applicable ) Garde nSamplin g (if applicable ) JUili^ ^ Clearanc e Video/Photos (Before ) Video/Photo s (During ) Video/Photo s (After) Video/Photo s (30-Day ) Propert y Completio nAgreemen t Final Repor t Sent : By : 

### Signed ; _ll/_U./O g 

# Eyil L Signed ; _U_/JL/£ ^ 

## »y-T,-C
. By ; By : / /
. 

### By : Called : lL/iM/jQ 3 

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On:Jl/_L|/_ 2 By : ' C1>Ul ^ On : On : By : On : By : Signed: . / / 

### By : Issued : / / 

### By : Ai r Monitorin e (a s applicabl e D Communit y DCrc w Results : On : / / By : 

# 1
D Conununit y Results : QCre w On : / / |By : . _. D Communit y Results : DCre w On : / / By :


### Omah aLeadSit e

## Douglas Count y Accoim t InfQ||wtio n Pag e 1 of 2 

# m Dougla s County , Nebrask a Propert yRecor d - R251920000 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 - VleWO n Ma p Informatio n i s vali d a s o f2009-10-1 5 Treasurer' s Ta xRepor t Ne wFeatur e ^ - > " •Aut o Sale s Searc h Owne r ANZALD O JANIC E M 91 0 S 3 7 S T OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumber : 192 0 000 0 2 5 Accoun t Type : Residentia l Parce l Numbe r 251920000 0 Parce l Address : 323 7 N 4 0 S T OMAH AN E 68111-000 0 Lega l Description : WESTMORELAN D LO T20 3 BLOC K0 1/ 2 VA C ALLE YAD J & L T20 3 4 0 X 140.5 6 Valu e Informatio n Lan d Improvemen t Tota l 200 9 $500.0 0 $0.0 0 $500.0 0 200 8 $500.0 0 $0.0 0 $500.0 0 200 7 $500.0 0 $0.0 0 $500.0 0 200 6 $500.0 0 $0.0 0 $500.0 0 200 5 $500.0 0 $0.0 0 $500.0 0 200 4 $500.0 0 $0.0 0 $500.0 0 Sale s Informatio n Sale s Date : 2005-02-0 2 Dee d Type : WD M Book : 200 5 Page : 01242 9 Price : $2,000.0 0 Grantor : HUD U INVESTMENT S Grantee : JANIC E M ANZALD O ValidHnvalid : Invali d Exclusio n Reason : Multipl e Parce l Sal e Sale s Date : 2000-04-2 1 Dee d Type : Book : 216 4 Page : 13 3 Price : $270.0 0 Grantor : 

## http://douglasne.mapping-online.com/DouglasCoNe/static/accoimtinfo.jsp?accountno=R2.. . 10/22/2009

### Dougla s County Accotmt Inf^a^tio n Pag e 2 of 2
Grantee : ValidHnvalid : Exclusio n Reason : Vali d
Lan d Informatio n Acre s 0.1 2 S F 5600. 0 Unit s 0. 0 Dept h 140. 0 Widt h 40. 0 Vacan t Ye s



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R2. . . 10/22/200 9

### Pag e 1 o f 1 

# m

L : Q[g.g* g ^Anothe rTjcke t ^ ^

, . j [riLi^^v^Bac k tojrth ^ Inteme t - \ 

### I | i L:S-'^ny'.^![PM:D l


### YOU R TICKE T NUMBE R I S 2406916 . Origina l Cal l Date : 11/14/0 9 Time : 11:5 1 a mOp : ELI2;ABETH1879 0 Wor k t o Begi n Date : 11/18/0 9 Time : 7:1 5 a m State : N E County : DOUGLA S Place: . OMAH A Address : 323 7 Street : N40TH S T Twp : 15 NRng : 13 E Sect-Qtr : 08-NE Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : LEA D REMEDIATION Locatio n o f Work ; INCLUD E AL L EASEMENT S LOCAT E ENTIR E PROPERTY Remarks : FA X AL L CLEAR S TO : (877)662-421 1 : UNSUR E O F CORNE R LO T Compan y: COASTAL ENVIRONMENTA L SERVIC E Contac t Name : ELIZABET H Phone : (877)662-421 0 Wor k Being Don e For : COASTA L Dept h o f Excavation : 4 F T Corne r Lot : N Front : Y Rear : Involve s Tunnelin g o r Horizonta l Boring : N Explosives : N CXCAT V MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C
Servic e Are a Contac t Phon e Nunibe r Utilit y Typ e 

### Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , IN C HEID I 

### Alt : 402934046 9 Emerg : 402932975 7 Day : 402504782 3 MUDO l METROPOLITA NUTILITIES DISTRICT SAND Y 

### Alt : 

### Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFIC.SEWE R 

### RICH/TRAFFI C Alt : 402444516 1 Emerg : 4024445160 Day : 406728934 3 OPPDGPR 5 OMAH APUBLI C POWE RDISTRICT T N A 

### Alt : 4062071494 Emerg : 888728934 3 Day : 406728934 3 QLNN E1 C QWES T LOCA LNETWOR K N A 

### Alt : 4062071494 Emerg : 888728934 3
http://wvm.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT. . . 11/14/200 9OLS# : 3047 6 

# As-Buil t Drawin g Dat e Excavated : 11/25/200 9 Dat e USEP ASigne d Off : 4/15/1 0 COASTA L 

# Omah aLea dSuperfun dSit e Are a Sodden : 142 2 s o f t


### 3047 6 Exterio rPain t Omali a Lea d Sit e •Goo d Sit e Sketct i • ^Poo r Samplin g Address : 323 7 N 4 0 ST ( 3 No t pain t Sampl e Numbe r Lea d Sampl e Sample s Collecte d LA B Concentratio n Collecte d Firm : FP AOBA J RYASCPXA-3047 6 F l __L5.5__pp m D Date : IO - n-cfi
. 

# d RYBSCPXA-3047 6 F 2 T 3 ? pp m Time : 1 MOprir t RYCSCPXA-3047 6 B l ^ 7 PP" " D Sample s Analyze d RYDSCPXA-3047 6 B 2 ^ O pp m D nDZOOPJC A3047 C S Z ~ ~ Po m 

# n D XR F Un i : (i>SH D Book : 22 0 nOZOCrXA-3047 0 Q g ~ pp m 

# n D Date : II ­ DHo e nPgCCPX A3047 6 P 2 ~ pp m 

# a D Time : Pr ^ ..La b RYBSCPLA-3047 6 j l Resul t 76 8 pp m Numtie ro f Sample s = | l \ | [ I | Staff : . 

### fn'iuJ >

= Fron t Right
. B l = Bac k Left , B 2 = Bac k Righ t D Z = Dri p Zone , G Z = Ganjen , P Z = Pla ;

Kcvlii W("tcuc d I7.,Sop-ii x


### Legen d Concret e Dri p Zon e Excavate d Quadrant s Excavate d Are areplace dwiti h Are areplace dwit h So d Rock/Mulc h Are alef t bar e 

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

## U' ^ I i l

3047 6 Exlerio rPain t Q Goo d Omah a Lea d Sit e Sit e Sketc h samplin g Address : 3237 N i O S T [ 3 No t pain t Sampl e Numbe r Lea d Sampl e Sample s Collecte d LA B Concentratio n Collecte d Fir m FP AD B A J RyASCPXA-3047 6 F 1 pp m D Date : 10 - n-oP , 

# d RYeSCPXA-3047 8 P 2 

### 1 3 5 .pp m Time : 1 -WO M RYCSCPXA-3047 6 B l

. pp m 

## n 

# -£1 . Sample s Analyze d RYDSCPXA-3047 6 B 2 j±Q
_ . pp m D Roncionx A30470—e z pp m 

## a D XR F Un i : G>SH O Book: 22 0 ROHOOrX A30*7 0 SS ­
. pp m D D Dal e I f•OH 0 6 nngCCPX A3047 6 P *

. pp m 

## n n Time ' P r ^ RYBSCPlA-3047 6 ...Lflf c Staff : _ 

### riiu ^ Numbe ro f Sample s = I l i 4 Resul l 76epp»T > • Fron t Right , B 1 = Bac k Left , 8 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden
. P Z = Pla> Al l quadrant s ar e s

s */Iewe< 3 fro m th e street , racing propert y

• ^e^•:r»l ^ r-„.ni„ i p.^c p n H 

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## 0 1 

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Omah a Lea d Sit e Sit e Sketc h Sannplin g Address : 3237 N 4 0 S T Sampl e Numbe r RYASCPXA-3047 6 RYBSCPXA-3047 6 RYCSCPXA-3047 6 RYDSCPXA-3047 6 f?OZ00PX A3047 0 Lea d Concentratio n F l pp m F 2 pp m B l 

## £ J _ pp m B 2 pp m 

## 1 0 0 2 pp m nozoorxA'30470—ez - pp m nPZSCPX A3047 6 P 2 pp m ^La b RYBSCPlA-3047 6 Sampl e Collecte d LA B D E f D 

## n D D D Numbe ro fSample s = | l \ \

\ I ) i Resul t 76 8 pp m _ 

### 3047 6 Exterio rPain t •Goo d • , Poo r [ 3 No t pain t Sample s Collecte d Firm : FPADBAJ Date : iQ - 11'Cf , Time : I -Wpt n Sample s Analyze d XR F Unit : {QSH O Book : aZ O Date : _ II0HO 8 Time : _ r m Staff : rn*}U > Fron t Right
. 8 1 = Bac k Left , B 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , P Z = Pla ; Al t quadrant s ar e a s viewe d fro m th e street , facin g propefl y Tf i )C ' ••X •[ ¥

## 3047 6 Exterio rPaint Nort h Arrow Omah a Lea d Sit e •Good Sit e Sketc h D/Poo r Samoiin a Address : 323 7 N40 ST Q No t paint Lea d Sampl e Sample s Collecte d Sampl e Numbe r LA B Concentratio n Collecte d Fimi : FP ADBA 3 RYASCPXA-3047 6 F l _L5J5 - pp m 

### D Date : iQ - \1-Cf ^ RYBSCPXA-3047 8 F2 

### 1 3 ^ pp m 

### Ef Time : I -^Oprr \ RYCSCPXA-3047 6 B1 pp m 

### D 

## S J
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## JLQ
. pp m 

### D nDZOOPX A3047 0 BZ pp m 

### D XR F Unit : (oSH O Book : 22 0 nOZOOP)(A-3047 0 92 - pp m 

### D Date : // • OH • O S nPZSCPX A3047 6 P2 pp m 

### D Time : Pn o La b RYBSCPLA-3047 6 Staff : m'iU ? Numbe rofSample s = | 1^ | | I | k Resul t 76 8 pp m •Fron tRight , 81 = Bac k Left , 8 2 = Bac k Righ t DZ = Dri p Zone , GZ = Garden , PZ = Pla ; Al l quadrant s at e as viewe d ffo m th e street, faclngpropeit y

—X' ' ' •'.—>*''*—)^ ~ Pr 

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## Consen t fo rAcces s T o 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 followin g describe d premises :

Owner' s Name : A Daytim e Phone :



# \yr ^ A^-24^t> i
Addres s o fPropert y covere d b ythi s 

# 5zj 7 ^4o^
- 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 f2A * f * 

# •*

. 

# y COASTA L tNVIKONHIKTA L C I I O U rIH C


### « c c c < 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 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 wori ( done , o rwit h th e eqiiipmen 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 Environmenta l Group , a t (402 ) 991-119 9 thi s program , pleas e contac t Coasta l

I gran t acces s t o mypropertie s D I d o no t gran t access t o mypropertie s

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

Page 2 o f2COASTA L C r

» o 1 / • • 

### RestoraHiSo n Agreemen t The purpos e of thi s agreemen t i s to provide amutua l agreemen t as t o condition s ofth e propert y prior t

o remediatio nactivities . Thi s will als o serv e a s documentationfo r th e purpos e o f assuring tha t restoration activitie s are completedt o th e satisfactiono f th e propert y owme r an dthe UnitedState s Environmenta l Protectio nAgenc y (EPA) . Properf y ID ; -^ ^ 7 ( ^ Propert yAddress : "^ Z ^~ 7 / U -4 ^ 

### ]^one : ^ 7 7 ^/g / O

nth e attacheddiagram(s } indicat e aiiea(s) t o excavate , surface structure s an dlandscapm g feature s an d acces s location(s ) to b e usedby th e contractors . Indicat e distances , depths , materia l types , etc . Photographically an dVideographicall y documen t th e existing condition s ofthe propert y an dthe basemen t i

f necessary . 

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

### ttem: 

# ^w S

- I ^^. ^ 

### Item : ttem: ttem:
u . 

### jtem s t o b e Remove d b yth e Contracto rDurin g Remediatio n an d Mot Replace d

ttem: 

# / / rL/fr J UJTJy^U^^ J ttem:
ttem:
ttem:

Pag e 1 of
_• % ' COASTA L
c . I . . t I 

## Item s t o B e Remove dB y Contracto r During Remediatio nan dReplace d ttem: > o / 

# t f^ L item : 

# 'M > f Item : ! ttem: 

## Landscap e Inventor y Ite m 

## Quantity Unit Condition/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 trun k diamete r Eac h Numbe r o f tree s < = 2 inc h trun k diamete r Eac h Numbe r o f Sprinkle r Zones , Contro l Valves , Timers , Heads , etc . Aiinch!i skiMcl i ol tli f •.rr'fl^lo i iHV'.ni i 

# ^ k Eac h

Numbe r o f an dsiz e o f eac hgarden / flowe r be d area . AlMt h; i SINC'ICI Io l r<.-l:niv f si/i' S nii dloc;iii(Mi s Eac h Squar e Fee t Agree dupo nvalu e o f plan t material s no t t o b e replace db v contractor . VcK ' ll"ii " *HIII C wil l h i ijst'c ' 10 is;u i . 1 iilisn ! lOticiif. " I dth e i;ropci"l > u> t

nt;r . S

Easemen t Area , t o b e excavate d Eac h
Pag e 2 of .C O AS 1 AL c ^ au f , • Nc

I Additiona l Comment s / Instructions : 

# 1



# m [

j Chec k th e tx)X i 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 ranydamag e don e t o th e interio ro fhouse , includin g foundatio n crack s o rfissures
.

I d o no t agre e 

# \iy\9j:mMiyH^­ Contractor' s Sienaturr Date Pag e 3 of
.BVID # 3g>^- ^ 

### XR F PROPERT Y SAMPL E SHEE T Dat e Projec t XR F ID #

Shot # 

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# 3?7 ^ 

# 1 ^ Averag e

Shot #

Averag e

Shot #

Averag e

Shot # Addres s 

## n-t<^'-cy f Omah a Lea d ARR A Sampl e tim e • ^'^g^ ^ sampl e lengt h Reading Sampl e are a Shot # 

# l^^ dIC r f^2 ^ \>%
. Dept h 

## 2>-}S - 

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RETES TAREA S Readin g Sampl e are a Shot #

Averag e Sianatur e Prin t ^— 1 Dept h 

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# M^ H / ­ /^* ? - /< ^ Readin g Sampl e are a Dept h

Readin g Sampl e are a Dept h

Readin g Sampl e are a Dept h

# 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 37 6 Mod e SOI L Tim e 2010-03-2 6 10:0 9 Duratio n 91.1 3 Sequenc e Fina l Flag s AVERAG E ADDRES S ^^35llN17s t QUADRAN T F 2 DEPH T 6 " XR F TEC H N
. LOPE Z MIS C exitu s NOT E non e

Supervise d By :

# 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 122.00 4 Supervise d By : 

## Certificat e o f Verificatio n

37 3 SOI L 2010-03-2 6 10:0 7 30.5 7 Fina l 3359 6 391 1 N1 7 s t F 2 6 " N
. LOPE Z exitu s non e

± Erro r 15.70 6

# 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 129.08 2 Supervise d By : 

## Certificat e o fVerificatio n

37 4 SOIL 2010-03-2 6 10:0 8 30.0 6 Fina l 3359 6 391 1 N1 7 s t F 2 6 " N
. LOPE Z exitu s non e

± Erro r ± 18.14 5

# 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 132.76 7 Supervise d By : 

## Certificat e o fVerificatio n

37 5 SOIL 2010-03-2 6 10:0 9 30.5 0 Fina l 3359 6 391 1 N1 7 s t F 2 6 " N
. LOPE Z exitu s non e

± Erro r ± 15.77 2

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

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 38 0 Mod e SOI L Tim e 2010-03-2 6 10:1 3 Duratio n 91.5 1 Sequenc e Fina l Flag s AVERAG E &ig-of-377-379-— ^ ADDRES S 391 1 N1 7 s t QUADRAN T easemen t DEPH T 1 " XR F TEC H N
. LOPE Z MIS C exitu s NOT E non e

Supervise d By :

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

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequence Flag s BVI D ADDRES S QUADRANT DEPH T XR F TEC H MIS C NOTE
pp m Pb 120.10 3 Supervise d By : 

## Certificat e o fVerificatio n

37 7 SOIL 2010-03-2 6 10:1 2 30.5 0 Fina l 3359 6 391 1 N1 7 s t easemen t 1 " N
. LOPEZ exitu s non e

± Erro r ± 15.14 2

# 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 Sequence Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOTE
pp m Pb 104.22 1 Supervise d By : 

## Certificat e o fVerificatio n

37 8 SOIL 2010-03-2 6 10:1 3 30.4 7 Fina l 3359 6 391 1 N1 7 s t easemen t 1 " N
. LOPEZ exitu s non e

± Erro r ± 14.54 9

# 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 103.56 5 Supervise d By : 

## Certificat e o fVerificatio n

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

I Coasta l Environmenta l Grou p Inc
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wvmw.coastalhazmatco m ^"iPBoT* ^ COASTA L G I O U P , IN C 

# EXECUTIV ESUMMARY : BVID #30476-(323 7 N4 0 ST ) No Issue s o r Concern s [ ^ Issues/Concern s Detail Explanation :

## EP APropert y Clos e Ou t For m Proptrt y # : C^PlL^ ^ Dste/Tlme : 

# —j;:re?;s;ir::^^^isi ^ Quad s Excavated : Contracto r Crou p /^PgL^WL ^ ^j^tjt ^ Ye s N o Excavatio nGenera l 1 . If necessary , wer e th e correc t quadrant(s ) excavate dan drestored* ? 

# L 2 . I r necessary , wer e th e correc t area s o f dri p zon e excavate dan drestored ? / Gradin g So dan dVegeteHo B Ye s N o I Doe s lh e tradin g aroun dth e perimete r ofth e hous e inexcavaieri area s generall y slop e awa y 

### / fromth e house ? 2 . Ha s so dbeenlai di nal l area s that wer e excavated ? 

### / h . Doe s th e so dappea r t o b e generall y health y andgrowing ? (Onl y evaluat e i f inspecte da t a3 0 

### / da y tim e period ) 4 . Ar e sodde darea s generall y firman devenl y graded ? 5 Ar e th e joint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat e i f inspecte da t a3 0 da y / tim e period ) _ 

# r 6 . Wa s th e property grade dsuc hthat water wil l no t poo l onth e property" ' 

# I 

# r 7 Wa s damag e t o landscapin g o r plant maierial s avoided ? Cates . Fencc j aa dReu<BlP £Wati t Ye s N o D o gate s ope nan dclos e freely? (I f applicable ) 2 Wer e all gate s or fence s take ndow ndurin g restoraiio nactiviiie s reinsuiied ? (i r applicablr l .1 . Wa s damag e t o gate s o r fence s avoided ? (i r applicable }

_ - 1 A

. Wa s damag e t o retainin g wall s avoided ? (I f applicable ) Foundation , SidJB K an dCntter ^ .N o Ve

s — I . Wa s damag e t o th e sidin g o r tri mavoided ? 

### / 2 . Wa s damag e t nth e foundatio navoided ? / .' . Wa s damag e to window s avoided ? AWa 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 t extensions avoided ? Sidewalk s an d Driveway s (Concrete ) Ve s N o 1 . Wa s damag e to drivewa y surface s avoided ? 

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

# v

## O^-ncr s coromcnlts :

I fnsT>ectio nnotes :

Removal andresloratio nactivate s complel e includin g the 30-da y sodwarranry : EPARepresentativ e Q"^ ^ Dale : HI'^^' ^I 

# < k

Propert yCompletio n Agreemen t Ihi s agreemen l documenl s lh e complclio n o fremedia l aclivitie s perloime d o n myproperl yM ysignaiui e wil l designat e tha t I a m satisfie d wil h th e restoraho n o fm ypropeily
. an d tha i n o item s ar e i n questions , now , o ra l an ylim e i n th e fiiluie , except thos e ilem s liste d below , i fan y

PropertylD : ^Ur\\ ^ Propert yAddress : 3^
. 2, ^ Owner : 5eb^f^lOA 

### Phone:|Q-^7^(0)|a j k ) ^-T ) AnTY < ^ xU p
Restoratio n Item s i n Question :

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

I 1 agre e r « rcxtoralio n i s completed , excep t a s note d [_ j l/rf o no t ai;re crestorati« n i s tpinpitter i 

# ^CAi^m P itrarlor' s Signatur e Dal e