### % 

# TRANSMITTALof OMAH ALEAD SITE SOILREMEDIATIO NFILEFOLDER
SAID # : 

# ^m n Date : V^jo' ) Address : K o 1 ^^ ^ V Remediatio nContractor : Coasta l Environmenta l Group
_ Year : 200 8 SOI LREMEDIATIO N PROPERT YFIL EFOLDE RDOCUMENT S 

# a/ Vide o ofproperty (DVD ) Executiv e Summar y EPA-provide dproperty sketci i Signe dAcces s Agreemen t fo r subjec t property Signe dAcces s Agreement(s ) for adjacent property Restoratio nAgreement /
( • • • 

### Settlement document s (i.e. , for damag e or to replac e plants , etc. ) ^ '* > ^ ^ 

### Confirmatio ndata 

# Photograph s pre^jDcO/lJaxiorx ^ .CMCaJ/i.^ ci/ \3o-Jcu ^ ^thJ i so d As-buil t sketch 

# y Satisfactory restoratio nsigne db y Property Owner 

# y Property close-out chec k lis t signe db y EP A Descriptio nofarea s no t meetin g RO D cleanup criteri a Utility clearance s Property informatio nfro mDougla s Count y Assessor' s Offic e nryjQ-er-ia
. f\.oj;es K QVie^lcXiSX : 4031646 7 

### D D Superfun d


### 15at e 

# if/y/ o 

# 'o l

## Propert yAcces s Checklis t 1 Propert y ID : ^l/\^\ ^ nWOR K STARTE D ON : nWOR K COIVIPELTE D Propert y Addrc.s.s : j*^0 \\fi^^i y 

# y ON : 

# -H- 1

Owner : Renter : 

# C/1T 1 Of 0\AP^ m Address : Phone : 

# ^t) l \^t ^ Fax : Cell/Pager : Phone : Additiona l Information ; 

# 4q q^%\l ^ ^ CHM s Fax : Cell/Pase i :
O Notitlcatio nLette r Sent : / / By : 0 ^ Acces s Agreemen t Signed : ^/_L/: ^ By : ^ \ ^ Restoratio nAgreemen t Signed : ^ / \ / ^ 

### By : Kh ' 1 1 Topsoi l Sam|)lin g (if a|)plicablc ) / / By : O Disposal Samplin g (if applicable ) / / By : O Garde nSamplin g (if applicable ) / 1 By : |[ ^ Utility Clearanc e Called : ^ / t) /V ^ By : ^ 0 1 \2 f Video/Photo s (Before ) 

# On:3l/id/O i ^yK{f\/ \ nVideo/Photo s (During ) On : / / By : nVideo/Photo s (After ) On : / / By : nVideo/Photo s (30-Day ) On : ,/ / By : CH Propert y Completio nAgreemen t Signed : / / 

## By : 1 nFina l Re|)ort Issued : / / 

# By : II Ai r Monitorin g (a s applicabl e 1 1 Communit y LUCre w ) Results : On : / / 

# 1 1 LJCommunit y Results : LUCre w On : / / Bv :
LUCommunit y Results : LUCre w On : / / By :

Omah a Lea d Sit e

### Dougla s County Accoun t In^jamatio n Pag e 1 of 2

nf^jm a
Dougla s County , Nebrask a Propert yRecor d - R193499000 0 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-5 0 f t west o f90t h St - ViewO n 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 CIT YO F OMAH A PLANNIN G DEP T 1819FARNAMST#111 1 OMAH AN E 68183-000 0 ' Propert yInformatio n Ke yNumber : 349 9 000 0 1 9 Accoun t Type : E xGovernmen t Parce l Number : 193499000 0 Parce l Address : 150 1 YATE S S T OMAH AN E 68110-000 0 Lega l Description : PADDOC KPLAC E LO T8 BLOC K3 N 9 0 F T Valu e Informatio n Lan d Improvemen t Tota l 200 8 $0.0 0 $0.0 0 $0.0 0 200 7 

### so.o o $0.0 0 $0.0 0 200 6 $0.0 0 $0.0 0 $0.0 0 200 5 $0.0 0 $0.0 0 $0.0 0 200 4 $0.0 0 $0.0 0 $0.0 0 200 3 $0.0 0 $0.0 0 $0.0 0 Sale s Informatio n Sale s Date : 2003-11-2 1 Dee d Type : SW D Book : 200 4 Page : 03051 3 

### Price : $0.0 0 Grantor : LR C Grantee : Cit yo fOmah a Valid/lnvalid : Invali d Exclusio n Reason : Sal e b yGov t Agenc y Sale s Date : 2001-10-1 1 Dee d Type : SH D Book : 200 4 Page : 03051 2 Price : $0.0 0 Grantor : Sherif f


### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R193.
. . 7/9/200 8

### Dougla s County Accoun t InfiMmation Pag e 2 of 2 i^jm a
Grantee : Valid/Invalid : Exclusio n Reason : LR C Invali d Sal e byGov t Agenc y Lan d Informatio n Acre s 0. 1 S F 4500. 0 Unit s 0. 0 Deptf i 90. 0 Widt h 50. 0 Vacan t Ye s Lan d Attribute s Attribut e Attribut e Descriptio n Negativ e Influenc e Locatio n 8



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl93.
. . 7/9/200 8

### Pag e1 of 2 # #
Creat e Anothe rTicke t Bac k t o Irt h Interne t Sen d Emai l


### YOU RTICKE TNUMBE RI S 2078206 . 

# • 2^1 ? Origina l Cal l Date : 7/09/0 8 Time : 5:3 4 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 7/11/0 8 Time : 6:0 0 p m State : N E County : DOUGLA S Place : OMAH A Address : 150 1 Street : YATE S S T Twp : 15 NRng : 13 E Sect-Qtr : 10-SE-SW,15-NE-NW Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : Lea d Remidiatio n Locatio n o f Work : ENTIR E PROPERT Y AL L TH E WAY T O TH E STREET . Remarks : FA X AL L CLEAR S TO : (877)662-421 1 : UNSUR E O F CORNE R LOT . 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 : NFront : Y Rear : Y Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N CXCAT V LEVEL S MAGELLANMCINE B 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 CXCAT V CO XCOMMUNICATIONS , IN C HEID I 

### ^y t 402934046 9 Emerg : 402932975 7 Day : 877366834 4 LEVEL S LEVEL S COMMUNICATIONS , LL C N A 

### Emerg : 877366834 4 Day : 918574709 8 MAGELLANMIDSTREA M MAGELLA N TONYA 

### Alt : PARTNER S LP 

### Emerg : 918574709 8 Day : 800289342 7 N O CAL L PE R MCINE B MC I 

### Alt : MEM O 

### Emerg : 800289342 7 http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 7/9/200 8

### Pag e 2 of 2 # #
MUDO l METROPOLITA NUTILITIE S DISTRIC T EDWINA 

### Day : 402504782 3 Alt : Emerg : 402504794 6
OMAHACO FCIT YO FOMAHA-TRAFFICSEWE RRO N 

### Day : Alt : 402444719 7 402444516 1 Emerg : 402444516 0
OPPDGPR 5 OMAH APUBLI C POWE RDISTRIC TN A 

### Day : 406728934 3 Alt : 888728934 3 Emerg : 406728934 3 QLNNE1 C QWES TLOCA LNETWOR K N A 

### Day : 406728934 3 Al t 

### Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 7/9/200 8

# As-Buil t Drawin g C OAST AL 

# Omah aLea dSuperfun dSit e ar^/T Nortt i Arro w Omah a Lea d Sit e Owne rName : C/f-y^l£^Oms/T S Sit e Sketc h Address : j^O / >^/te S <S^
. Phone : H ; W : 

# f Sampl e Numbe r Lea d Sampl e Sample s Collecfe d LA B Concentratio n Collecte d Fir m ME/ i RYASCPXA - 2 7H / TF 1 7 5 0 pp m 

### D Date : RYBSCPXA-£>7-y/7 " F 2 J/ Q pp m 

## I T D Time : RYCSCPXA-^7-y/7 " B 1 7¥. 9 pp m 

### D Sample s Analyze d RYDSCPXA-2>7-V/7 - B 2 ^ g pp m 

### D nOgCCPX AB2 - ~ pp m 

### D D XR F Unit : 

### _QQ3

_Book : _S3
. nCgOCPX A 62 - pp m 

### D D Date : _ RPgOGPXA - -P2
- pp m 

### D D Time : 

## AJk L Staff : Numbe r ofSample s = | lj
. \ —• 

## P
. (/ahnfia n Legend : F l = Fron t Left , F 2 = 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 properl y OLS# : 2741 7 Dat e Excavate d :7/15/200 8

. natellRFP ASignpr i Of fB/ l A/^QQ g Are a Sodderr : 459 0 s q (f t



### Legen d Concret e Dri p Zon e Excavate d Quadrant s Excavate d Are areplace dwiti 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 .

# fe^^ ii^ii^^^ m ^ 

# ar^/ T Exterio rRam i Nort h Arro w Onrtah a Laa d Sit e Owne rName : C//yJJl P Om^h a Goo d 

# f Sit e Sketc h Address : /SD J Y^fSS ^ (Sf
. Poo r Phone: H W : No t pain t Lea d Sampl e Sample s Collecte d Sampl e Numbe r LA B Concentratio n Collecte d Firm : 

### RYASCPXA
- 2 7H / T^ 1 TS D pp m 

## D Date : RYBSCPXA-^7V/7 " F 2 3f O pp m 

## D Time : RYCSCPXA-^•^^/T ' B l 7^. 9 pp m 

## D Sample s Analyze d RYDSCPXA-^;riy/7

- B 2 i^i^ppn i 

## D RDZSCPX AB2
­ ~ pp m 

# n D XR F Un i

### I : QO S Book : l^ Q WGZSCnXA ' -G^
- " pp m 

## D Date : 

## D nrzsGPXA • -P2
- ~ pp m 

## D Time : 

## D 

# A M Numbe ro fSample s = A t Staf f 

# F , (/cihn.'ici n Legend : F 1 = Fron t Left
. F 2 = Fron t Right , B 1 = Bac k Left , B 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , P Z = Play Al l quadrant s ar e a s viewe d fro m th e streel , facin g propert y

llW 4 04OI4 I Oi.' ?Exterio rPain t Nort h Arro w 

### Omah a Lea d Sit e Owne rName : Q/ yo P Qms/i a Goo d 

### Sit e Sketc h Address : /5K) / X9f&. ^ <9 A Poo r 

### Phone : H W : 

# f No t pain t 

### Lead Sampl e Sample s Collecte d Sannpl e Numbe r LA B Concentratio n Collecte d Firm : RYASCPXA- ^ rV/ rF 1 7 5 D pp m 

# n Date : RYBSCPXA-^7Vy;/ 7 F 2 ___i2/Q_Pp m 

# \s r D Time : RYCSCPXA-<f7'y/7 ' B 1 7^. 9 pp m 

# n Sample s Analyze d RYDSCPXA-^;ry/; rB2 

## D RDZSCPXAB2 - - ~ pp m 

## D 

# n XR F Unit ; 

## 60 3 Book ; ^523 1 -G2 - pp m 

## D 

# n nozcopx/ ^ Date : _ 

# a - i ~o* ^ RrZGCPXA - -«? - pp m 

## D 

# n Time : 

# A M Staff ; 

# P
. chhnao n Numbe rofSample s • Legend ; F 1 = Fron t Left , F2 = 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 y Al l quadrant s are a s viewe d fro m th e street , facin g property

04614 1 012 3 

# iNort h Arro w 

### Exterio rPaint 

### Omah a Lea d Sit e Owne rName : C/f yo P Omah a Goo d 

# f Sit e Sketc h Address : /S'O / y^/&. ^ c9/
. Poo r Phone : H W : 

### No t paint Lead Sampl e Sample s Collecte d Sampl e Numbe r LA 8 Concentratio n Collecte d Firm ; RYASCPXA - 2 TH t TF 1 

### 7 5 0 pp m 

## D Date : RYBSCPXA-^^-y/7 " F2 

### _iM2_Pp m 

## D Time ; RYCSCPXA-^7"^/ 7 8 1 7^ Q pp m 

## D Sample s Analyze d RYDSCPXA-^T-y/T - 8 2 

### yy g pp m 

# n nDZCCPX/ > 92 - J Z pp m 

# u XR F Unit : A0 9 Book; 3^ 1 

## D nczccpx A -6 ^

_ Z pp m 

## D Date: Q- 1 - 0* A 

## D nrzscpxA ' - p ^
_ I pp m 

## D Time ; 

# A M D Staff : 

# P- dahnfio n Numbe ro fSample s = j f-/
. Legend : F l = Fron t Left , F2 = Fron t Right , 8 1 = Bac k Left , 8 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , P Z = Pla y Al l quadrant s ar e a s vie>Me d fro m th e street , facin g propert y



# B l 

# B a T*f3
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# isor.y/^t&s T 

# r
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Re v4 ' 04614 1 012 3COASTA L EHVIRONHIMTAI , C •O U t
. IH C 

## Consen t Fo rAcces s T o Propert y RIGH TO F ENTR YT O 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^QnUl' l '

Owner' s Name : Qj\\ j ^ OrV^oWs
. Daytim e Phone : ^/y^-:^ / ^ a 

# \£ o (vy-e. ^ ^ Addres s o fPropert y covere d b ythi s Agreement : I 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 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
. J ENVIRONMENTA LRESPONS 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 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 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 of2COASTA L EMViaONMINTItt , 

### ^ '"IMIOT* ' CROUP,
. IM C



### •Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; •Remov e flowe rbulb s o rplant s tha t th e Granto ro rth e Grantor' s tenan t ma ywis h t o save ; •Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , a s 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



# Ej^ r gran t acces s t o m ypropertie s D I d o no t gran t acces s t o m ypropertie s 

# -y-yo ^ Signature Dat ^

O

I 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 ofthi s agreemen t i s to provid e amutua l agreemen t a s t o condition s ofth eproperT>' prio r to remediatio nactivities
. Thi s will 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 epropert y owner an dth e Unite dState s Environmental Protectio nAgenc y (EPA) .

Propert y ID : 

# TPTri Propert y Address : l^D \yoJ^f < SP ^ Owner : C^,) ^ ^ Omx\^( K Phone : 

## HD2'h^^i'/'<rK A^ thy O nth e attache ddiagram(s ) indicate area(s ) to e.xcavate danddept ho f e.vcavation , locationo f all know n utilities , subsurfac efeatures , surfac estructure s an dlandscapin g features , acces s location(s ) t o be usedb y contractor , andth e directio no f North
. Indicate distances , depths , material t\pes , etc . Indicat e digita l photo s b

y referencin g th e photo-lo g number wit ha narrow indicatin g 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 o fCOASTA 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 : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : 

# L

Pag e 2 o f^^^^^~ ^ ^ ^ COASTA L 

### Item s T o B e Remove d B yContracto rDurin g Remediatio n An d Replace d (Us e additiona l sheet s a s necessary ) Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item :

Pag e 3 of
.

# M C

COASTA L 

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

### Ite m Quantit y Uni t Condition/Type/Specie s

Pre-existin g propert yarea , tha t wil l b e excavated , tha t i s covere d wit h grass .

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

Numbe ro ftree s •' = 2 inc h irun k diamete r

Numbe ro fSprinkle r Zones
. Contro l Valves
. Timers
. Heads , etc
. Anac h a sketc h u! ' ih e ipi'iiikle ; !a \ oui
.

Numbe ro fan d siz e o f eac h garde n flowerbe d area . •••.Uin-i : ;•. >^ciC! i K H .Ci::- , c ^l;'e ^ rm j localioni
. 

# h 2 Squar e fee t

Eac h 

### ^

Eac h 

# -6 ^

- ^ Eac h



### ^ Eac h Squar e Fee t
i



### Pag e 4 o f 1COASTA L 

### Ite m Quantit y Agree d upo n valu e o f plan t material s no t t o be replace d b ycontractor
. Not e thi s \alu e wil l be 

### ^ ^ use d t o Issu e a plan t \ouche rt o th e proper! ) owner . Agree d upo n lis t o fplan t material s tha t wil l b e replace d bycontractor
. Be veryspecifi can d detailed
. 

### ^ ^ Includ e a sketc h ot " were eac h plan t ^^il l h e pbce d b_

\ ih e coniiacioi'
. Agree d upo n area o f 

# F 1 proper n t o b e replace d wit h gras s sod
. 

# B i 

# B a ':"iclud e a ^keu: h o; ' ih c .iieais ! U-
. h e :cpljcc a ••^'i h ii'-as s >od
.
.Area o fCir> o rCounr s propert > t o b e landscape d pe rthei rrequireinents
. 

# -6-
. !!" H.U;i.l c1 ^i-,i'UT ! i> ; ;!: c .lie. : iS l

Easemen i .Area , to b e excavate d 

### Uni t Condition/Type/Specie s

$ ^

Eac h


# ^6< ^ a W-txcAYc ^ arajK ^
S F

S F

S F



### Pag e 5 o fC O AS TAL
• MVIROMNIMTA L amour , tn e



### L J 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
. Bycheckin 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 foundatip n cracks o rfissures
.
QId o no t agre e 

# <7V'^ ^ Owner' s Signatu n Date Contractor' s Signature PageSof
.

# 1 1 y BVID # XR F PROPERT Y

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

Shot # 

# : m y ^ JSL L Averag e 1 Sho t # 

## iq q 1 Ktt ) ? 0 | 

### 1 ^02 ^ Averag e

Sho t #

Averag e

Shot # 

# -If i

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\ 2J L Averag e 1 la b sampl e # 

## (|l</h t Addres s 

## i^ i iflxi h "l Y1 Omah a lead F P 2n d yea roptio n Sampl e tim e KH C am/|Pri i sampl e lengt h 3 0 se c^ ^ 

# ym^ ^ Readin g 

### Sampl e area 1 Sho t # Readin g Sampl e are a 1 

## '1^ 4 myy . UHT^ 

# 'inw ^ 

# y.< y ^ 1 n^ < 'ly'MA y\\\ > 

# U Dept h -M C 

### M'^^' l -^H. x Dept h 1 

### ^oC'^ M n.Qff 

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# 'iMi^l t K-i i 

# 6 ^

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. ^ 1 J : jj^ ^ Readin g Sampl e are a 1 1 Sho t # Readin g Sampl e are a 1 "704-^ 5 t ^. U {oM.H}^'^^^ , 

# f l V)o.^% Klt.<^\ Dept h 1 Dept h 

## %%.^nit%l A 

## {.• •1 ^gM V 1 ^ ^ - ^ 1 Averag e Readin g Sampl e are a | Sho t # Readin g Sampl e are a 1 Dept h Dept h Averag e


### RETES TAREA S Readin g Sampl e are a Sho t # Readin g Sampl e are a 1 ^ ( 

## y.'M' ^ \d- ^ [,Q , {"{ i M.f ) Dept h Dept h 

## m.Kt \^.\ ^ 

# ^...-y ^ \\l.l ^ ^ 1^>1 ^ Averag e La b resul t Sampl e are a XR F Avg
. 1 Signature , 

# Prin t \Km ^

\\^fyh/ ^

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 

### 79 2 Mod e SOI L Tim e 

### 2008-07-1 5 15:4 8 Duratio n 

### 30.0 5 Sequenc e 

### Final Flag s AVERAG E ^Av g o f791-79 1 | ADDRES S 150 1 yate s s t QUAD/ZON E fb l INSPECTO R MATEU S DEPT H | 6 SAMPL E TYP E CLEARANC E NOT E

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



### XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 225.78 4 Supervise d By : 

## Certificat e o fVerificatio n

78 8 SOI L 

### 2008-07-1 5 15:4 5 30.0 7 Fina l 

### 2741 7 150 1 yate s s t b l MATEU S 6 CLEARANC E

± Erro r ± 18.65 8

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 207.37 2 Supervise d By : 

## Certificat e o fVerificatio n

78 9 SOI L 

### 2008-07-1 5 15:4 6 30.3 4 Final 2741 7 150 1 yate s s t b l MATEU S 

### 6 CLEARANC E

±Erro r ±17.94 9

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 79 0 Mod e SOI L Tim e 2008-07-1 5 15:4 7 Duratio n 30.1 7 Sequenc e Fina l Flag s BVI D # 2741 7 ADDRES S 150 1 yate s s t QUAD/ZON E b l INSPECTO R MATEU S DEPT H 6 SAMPL E TYP E CLEARANC E NOT E

pp m±Erro r P b 341.98 0 ±22.59 8 Supervise d By :

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 205.48 7 Supervise dBy : 

## Certificat e o fVerificatio n

79 1 SOI L 2008-07-1 5 15:4 8 30.0 5 Fina l 2741 7 150 1 yate s s t b l MATEU S 6 CLEARANC E

± Erro r ± 18.00 4

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 

### 79 8 Mod e SOI L Tim e 

### 2008-07-1 5 15:5 4 Duratio n 

### 121.1 0 Sequenc e Fina l Flag s AVERAG E |Av g o f794-79 7 ADDRES S 150 1 yate s s t QUAD/ZON E B 2 INSPECTO R MATEU S DEPT H SAMPL E TYP E CLEARANC E NOT E

Supervise d By :

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 288.55 1 Supervise d By : 

## Certificat e o fVerificatio n

79 4 SOI L 

### 2008-07-1 5 15:5 0 30.2 5 Fina l 

### 2741 7 150 1 yate s s t 8 2 MATEU S 6 CLEARANC E

± Erro r ± 20.82 2

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 245.90 2 Supervise d By : 

## Certificat e o fVerificatio n

79 5 SOI L 

### 2008-07-1 5 15:5 1 30.3 1 Fina l 

### 2741 7 150 1 yate s s t B 2 MATEU S 

### 6 CLEARANC E

± 

### Erro r ± 

### 19.15 6

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 408.05 7 Supervise d By : 

## Certificat e o fVerificatio n

79 6 SOI L 

### 2008-07-1 5 15:5 2 30.3 2 Fina l 

### 2741 7 150 1 yate s s t 8 2 MATEU S 

### 6 CLEARANC E

± Erro r ± 24.75 7

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 148.98 5 Supervise d By : 

## Certificat e o fVerificatio n

79 7 SOI L 

### 2008-07-1 5 15:5 4 30.2 2 Fina l 

### 2741 7 150 1 yate s s t B 2 MATEU S 6 CLEARANC E

± Erro r ± 15.24 1

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 80 3 Mod e SOI L Tim e 

### 2008-07-1 5 15:5 8 Duratio n 

### 120.4 8 Sequenc e Fina l Flag s AVERAG E fAv g o f799-80 2 ADDRES S QUAD/ZON E 150 1 yate s s t 

# iF l INSPECTO R MATEU S DEPT H SAMPL E TYP E CLEARANC E NOT E

Supervise d By :

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 304.40 8 Supervise d By : 

## Certificat e o fVerificatio n

79 9 SOI L 

### 2008-07-1 5 15:5 5 30.2 1 Fina l 

### 2741 7 150 1 yate s s t F l MATEU S 6 CLEARANC E

± Erro r ± 21.61 1

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 612.50 2 Supervise d By : 

## Certificat e o fVerificatio n

80 0 SOI L 

### 2008-07-1 5 15:5 6 30.0 7 Fina l 

### 2741 7 150 1 yate s s t F l MATEU S 

### 6 CLEARANC E

±Erro r ±30.96 6

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 330.68 2 Supervise d By : 

## Certificat e o fVerificatio n

80 1 SOI L 

### 2008-07-1 5 15:5 7 30.0 1 Fina l 

### 2741 7 150 1 yate s s t F l MATEU S 

### 6 CLEARANC E

± Erro r ± 22.81 7

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 358.27 8 Supervise d By : 

## Certificat e o fVerificatio n

80 2 SOI L 

### 2008-07-1 5 15:5 8 30.1 9 Fina l 

### 2741 7 150 1 yate s s t F l MATEU S 

### 6 CLEARANC E

± Erro r ± 23.29 4

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 82 2 Mod e SOI L Tim e 2008-07-1 6 09:5 8 Duratio n 120.8 5 Sequenc e Fina l Flag s AVERAG E J Av g o f818-82 1 » ADDRES S 150 1 YATE S QUAD/ZON E 

### iF l INSPECTO R MATEU S DEPT H 

## ft 1 0 SAMPL E TYP E RETES T NOT E CLEARANC E SAMPL E @ 1 0 inche s

Supervise d B y

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 85.13 3 Supervise d By : 

## Certificat e o fVerificatio n

81 8 SOI L 

### 2008-07-1 6 09 : 5 5 

### 30.0 4 Fina l 

### 2741 7 150 1 YATE S F l MATEU S 

### 1 0 RETES T CLEARANC E SAMPL E @ 1 0 inche s

± 

### Erro r ± 

### 11.99 3

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 81 9 Mod e SOI L Tim e 2008-07-1 6 09:5 6 Duratio n 30.5 7 Sequenc e Fina l Flag s BVI D # 2741 7 ADDRES S 150 1 YATE S QUAD/ZON E F l INSPECTO R MATEU S DEPT H 1 0 SAMPL E TYP E RETES T NOT E CLEARANC E SAMPL E @ 1 0 inche s
pp m ±Erro r P b 60.48 8 ±10.63 5 Supervise d By :

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 160.19 6 Supervise d By : 

## Certificat e o fVerificatio n

82 0 SOIL 2008-07-1 6 09:5 8 30.1 2 Fina l 2741 7 150 1 YATE S F l MATEU S 1 0 RETES T CLEARANC E SAMPL E @ 1 0 inche s

± Erro r ± 17.23 1

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 143.15 9 Supervise d By : 

## Certificat e o fVerificatio n

82 1 SOI L 

### 2008-07-1 6 09:5 8 30.1 2 Fina l 

### 2741 7 150 1 YATE S F l MATEU S 

### 1 0 RETES T CLEARANC E SAMPL E @ 1 0 inche s

± 

### Erro r ± 

### 15.14 1

### Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc
. wvvw.coastalhazmat.co m COASTA L INVmONMENTA L GROUP , IN C 

# EXECUTIV ESUMMARY : BVI D #2741 7 - (150 1 YATE S ST ) IIN o Issue s o r Concern s X 

# Issues/Concern s Detai l Explanation :

## smL . 

# EP A EP APropert y Clos e Ou t For m 

# 7"](I n Propert yH
_____ _ ^ '•H i
. 1 __^ , Dateyriroe : t' \ f T i A 

# E E Quad s Excavated : 

# _

N o

N o

N o

.N o

N o 3
. Wa s damag e t o gate s o rfence s avoided ? (Ifapplicable ) 4
. Wa s damag e t o retainin g wall s avoided ? (Ifapplicable ) Foundation , Sidin g an d Gutten i 1
. Wa s damag e l o th e sidin g o rtri m avoided ? 2
. Wa s damag e t o th e foundatio n avoided ? 3
. Wa s damag e l o window s avoided ? 4
. Wa s damag e t o window s o rdoo rscreen s avoided ? 5
. Wa s damag e l o downspout s o rdownspou l extension s avoided ? Sidewalk s an d Driveway s (Concrete ) I
.Wa s damag e t o drivewa ysurface s avoided ? 2
.Wa s damag e t o walkwa ysurface s avoided ? 

# . ^"^ ^

1A^^ yf
. Propert yAddress; - j ; DKAAHf ^ Owner' s Name:
. ./^>1^T T/I.
. .P^.P' ^ Contracto rGrou p OvpCyXf ^ Ye s Excavatio n Genera l VAPAhf TL^T I
. I fnecessary , wer e th e correc t quadrant(5 ) excavate d an d restored ? 

### y 

### y 2
.I fnecessary , wer e th e correct area s ofdri p zon e excavate d an d restored ? Ve s Gradinf ; So d an d Vegetatio n 1
.

Doe s th e grBdin g aroun d th e perimete rofth e hous e i n excavate d areas generall yslop e away 

### A/> ­ from th e house ? 

### y 2
.Ha s so d bee n lai d i n al l areas tha t wer e excavated ? 3
.Doe s th e sod appea rt o b e generall yhealth yan d growing ? (Onl yevaluat e i finspecte d a t a 3 0 da vtim e period ) 4
.

Ar e sodde d areas generall yfirm an d evenl ygraded ? 

### y 5
.Ar e th e joint s betwee n th e so d strip s generall ytight ? (Onl yevaluat e i finspecte d a t a 3 0 da y 

### y tim e period ) 6
. Wa s th e propert ygrade d suc h that wate rwil l no t poo l o n th e property ? 

### y 7 Wa s damag e t o landscapin g o rplan t material s avoided ? y Gates , Fence s an d Retainin g Wall s Ye s 1
.

D o gate s ope n an d clos e freely ? (Ifapplicable ) 

# ± Wer e al l gates o rfence s take n dow n durin g restoratio n activilie s reinstalled ? (Ifapplicable ) 

# P

# r
Ve s

<

• /	 ' 

### A 

## j ^ 

# {/y \ " / \ Ve s


### ^ > 

## j J ^

1

## Owner s comments :

Inspectio nnotes : 

# S o J^rn-uf ) /dis-f-icUc i t> ^ A^y ^ (^A^/i ^



## Removal andrestoratio nactivate s completeincludin g the30-da y so dwarranty : EPARepresental>vg;^I^^^^^.X7 ^ Date : ^^ ^

## Propert yCompletio n Agreemen t This agreement document s thecompletionof remedia l activitie s performedo nm y property . M y signature wil l designate tha t Ia msatisfie dwit hthe restoratio no f m y property , andtha t n

o item s ar e i nquestions , now , or a

t any tim e i

nthe ftiture, except thos eitem s listedbelow , ifany
. Property ID : 3. 1 H i J Property Address : JSO f y t^j- ^ S rf
. Owner : ^. | ^ f ^ ,^^0 . Phone : ^ ^ ^ - $- 1 ^ O if ^ C ky i S Restoratio n Item s i n Question :

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

jy ] Iagre e restoratio ni s completed , excep t a s note d fQ/ i Id o not agre e restoratio ni s complete d 

# /luy.^yy^.. r ^-^ y y^ ~ Owner' s Signatur e i Dat einfractor' s Signatur e