## TRANSMITTA Lo f OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R

SAI D # : 

# %1/^l y Date : 

# \\n \ o

Retnediatio nContractor : Coasta lEnvironmenta lGroup

_ Year ; 20 0 ^ 

## SOI LREMEDIATIO N PROPERT YnLEFOLDE RDOCUMENT S
J A 

## Vide o of property (DVD ) Executiv eSummar y EPA-providedproperty sketch SignedAcces s Agreement fo r subject propert y SignedAcces s Agreement(s ) fo r adjacen t propert y RestorationAgreement -B
- 

## Settlement document s (i.e. , fo r damag eor to replac eplants , etc. ) Confirmationdata Photograph s '^C^Ajlg ^ V \ H6xC/Wf^V-<s ^ 

# ei As-built sketch 

# d Satisfactor y restoratio nsignedby Propert y Owner Propert y close-out check list signedby EP A 

# I T Descriptionof area s not meeting RO D cleanup criteri a Utilit y clearance s Propert y infonnatio nfro mDougla s Count y Assessor' s Office


# \ h I

- 7 signature Dat e 3005483 9 Superfun d

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O^Tne r 

# TXXArii. ^ tou3\pR Renter : Address : Phone: Fax : Cdl/Page n Phone : Q,^/^-c;,ey^ ^ Additionai Information : Fax : Cell/Pager
D NotfflcationLette r Sent : / /

. By : 

### ^Z AAcces aAgreement Sl8ned;9-/^/Q ^ 

## By^eOnrrr/^% ]y\Restoratio nAgrecinent 

## Si8ned:g_r2M/ ^ By

- eOfTPff^ s D TopsoilSamplin g (I f applicable ) By : 

### D Disposa lSamplhi g (if applicable ) By : D Garde nSamplin g (if applicable ) / 

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# »yMQi(ai(/ i R.e'ii|flt 4 Q^VIdeo/PlMrtn s (Before) On : i " / C I<i 1 By

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• Communit y QCre w | On : / / 

## JBy : 1 Results :

Omah a Lea d Sit e

# Propert y I D # Propert y Address : InitialContact : Secon dContact : FinalContact : Fina lAction :

Comment : Owner Comment (s) :
Site Coordinator Comment (s) : CONTACTFOR M

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# \^' 4 s . 35 a Date9/z4iC ^ Time:\giDC b Action:'S^tycAKcOfJS : Date : Time : Action : ^ Date ; Time : Action : Transmit t

o EP AD Other Action : D

•

## Douglas Count y Accoim t Infor^||io n Page1 of 2

Dougla s County , Nebrask a Propert yRecor d - R070229000 0 Prin tRepor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-5 0 ftwes to f52n d S t- VJeWO n Ma p 

### Informatio n i s vali d a s o f2009-9-1 5 Treasurer' s Ta xRepor t Ne wFeatur e -•"•- •Aut o Sale s Searc h Owne r ROWLETTDANN YR ETA L 130 4 8 3 5 S T OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumber : 022 9 OOO O 0 7 Accoun tType : Residentia l Parce / Number : 070229000 0 Parce l Address : 130 4 S 3 5 S T OMAH AN E 68105-000 0 Lega l Description : BOULEVAR D TERRAC E LOT2 BLOC K1 1/ 2 VA C ALLE Y&48. 5 X131. 2 Valu e Informatio n Lan d Improvemen t Tota l 

## 200 9 $6,400.0 0 $138,600.0 0 $145,000.0 0 200 8 $6,400.0 0 $138,600.0 0 $145,000.0 0 200 7 $6,400.0 0 $138,600.0 0 $145,000.0 0 200 6 $6,400.0 0 $77,300.0 0 $83,700.0 0 200 5 $6,400.0 0 $77,300.0 0 $83,700.0 0 200 4 $6,400.0 0 $77,300.0 0 $83,700.0 0 Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 4 6419. 0 1. 0 131. 0 49. 0 N o Impro t vemen Informatio n Buildin g 1



## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accoimtno=R07..

. 9/17/2009

## bougla s County Accoun t Infor^^o n Pag e2 of 2 r^j^ c

2 1/ 2 STOR YUNFINISHE D

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fisnvc9ecl.f ft C«Kli>dE«n m raosact 1 CLIC KTO ENLARG E IMAG E j CLIC KTO ENLARG E IMAG E Squar e Footage : 1754. 0 Percen tComplete : 100.0 % Perimete r 0. 0 Quality : Goo d Uni tType : Condition : Fai r

Buil tAs : 2 1/ 2 Stoi 7 Unfi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 8. 0 Exterior : Fram e Aluminu m Units : 1. 0 Interior : ! Drywal l Baths : 1. 5 Roo fCover : 1 Compositio n Shingl e Bedrooms : 4. 0

Roo fType : Hi p Stories : 2. 5 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 Yea r Percen t Adjuste d Yea r Yea rBuil t Physica l Ag e Remodele d Remodele d Buil t 191 0 0 % 191 0 9 9 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Unfinishe d Atti cW/floo r 780. 0 Applianc e Allowanc e 1. 0 Basemen t Bsmn tBloc k 8 f t 

### 936. 0 Basemen t Minima l Finis h 500. 0 Fixtur e Bas e Fixture s 

### 1. 0 Fixtur e Bat h Ful l 1. 0 Fixtur e Bat h Hal f 1. 0 Garag e Detache d 576. 0 Porc h Sla b Roo fCei l 184. 0 Porc h Sla b Roo fCei l 96. 0



## http://dougIasne.mapping-online.com/DougIasCoNe/static/accountinfo.jsp?accountno=R07..

. 9/17/200 9

### • • • • 

## Pag e1 of 2

" >
\ rCreat e Anothe rTicke t^[ i

. Bac k t o Irt h Intertiet- ^ i[ ; SendEnriaj l J



## • YOU RTICKE TNUMBE RI S 2383178

.
Origina l Cal l Date : 10/09/0 9 Time : 7:2 9 a m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 10/14/0 9 Time : 8:0 0 a m State : N E County : DOUGLA S Place : OMAH A Address : 130 4 Street : S 3ST H S T Twp : 15 NRng : 13 E Sect-Qtr : 28-NW Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : LEA D REMEDIATIO N Locatio n o f Work : INCLtJDE AL L EASEMENT S LOCAT E ENTIR E FRON T O F PROPERT Y Remarks : FAX AL L CLEAR S TO : (877)662-421 1 : UNSUR E O F CORNE R LO T Compan y: COASTA L ENVIRONMENTA L SERVIC E 

### Contac t Name : ELIZABET H Phone : (877)662-421 0
Wor k Bein g Don e For : COASTA L Dept ho f Excavation : 4 F T Come r Lot : N Front : Y Rear : Y Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V LEVEL 3 MUD0 2 OMAHACO F 0PPDGPR 6 QLNNEI F

Servic e Are a 

## Contac t Phon eNumbe r UtiUt 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 3 COMMUNICATIONS , LL C 

## N AAlt : Emerg : 877366834 4 Day : 402504782 3 MUD0 2 

## METROPOLITA NUTILITIE S DISTRIC TSAND YAlt : Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT YO FOMAHA-TRAFFICSEWE RRO NAlt : 402444516 1 Emerg : 402444516 0

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

. . 10/9/200 9

## Page2 of 2
• • • •

0PPDGPR 6 OMAH APUBLI C POWE RDISTRIC TN A 

## Day : 406728934 3 Alt : 4062071494 Emerg : 888728934 3

QLNNEI FQWES TLOCALNETWOR K N A 

## Day : 406728934 3 Alt : 4062071494 Emerg : 888728934 3

http://www.dhon.org/irthintemetDHONNoticeCreation/MessageText.asp?ret=<RESULTS..

. 10/9/2009OLS# : 2036 2 Dat e Excavated : 10/17/0 9 Dat e USEP ASigne d Off : 11/5/0 9 COASTA L 

# As-Buil t Drawin g
Are a Sodden : 259 1 s a f t 

# Omah aLea dSuperfun dSit e EMVIRONHiNTA L i R O U r , I N e

Owne rName : DANN YR ROWLETT A d dress : 1304 S 3 5 ST

phone : H : 402-346-554 1 W : 402-677-281 6 Sampl e Numbe r RYASCPXA-2036 2 RYBSCPXA-2036 2 RYCSCPXA-2036 2 RYDSCPXA-2036 2 RDZSCPXA-2036 2 R6ZSe-PXA'203O 2 Rf»2;QCrXA-203G 2 - F 1 F 2 B l B 2 D Z 

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Re v4 046141.012 3Alt " *« •

COASTA l IKVIROHniMIA I C I O t l P

. IN C 

# Consen tfc fAcces s T o Pfopeft 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 perfon n certai n environnnenta l respons e activitie s upo n th e foilovk^in g describe d premises

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. PURPOS E OF RESPONS E 

### AcTivrriE S Th e EP AI s requestin g acces s t o collec tsol i sample s an d remov e soi l tha tcontain 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 vtnt i 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 perfbmned , 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 tbegins

. 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 confin m tha ti ti 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 tth e propert y 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 subcontractor s th e rightt o ente rth e property , a tal l reasonabl e time s an d wit h prio rnotice , fo rth e sol e purpos e o fperformin g th e wort;

. Thi s acces s shal l remai n i n effec tunti l th e wor k ha s t)ee n satisfactorii ycompleted

. Th e Granto rals o agree s to :

Pag e 1 o f2^A*"**"! !

COASTA l tHTIMOMHIKTA I ^ % e I t

. IH C 

### ( Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; cRemov e flowe rbulb s o rplant s tha tth e Granto ro rth e Grantor' s tenan tma ywis h t o save ; e Wate ran d maintai n replacemen tvegetation , includin g fertilize rapplication , a s necessar ysubsequen tt o a n initia l waterin g perio d b yEPA ; cAbid e b yhealt h an d safet yguidanc e provide d b yEPA ; * I fth e propert yi s rented , assis tEP Ai n obtainin g tenan tapprova l fo racces s t o th e propert yt o perfor m th e work

. cAllo wvideotapin g and/o rphotographin g o fth e property

.
AGREEMEN TNO TT O INTERFER E 

### Th e Granto ragree s no tt o interfer e o rtampe rwit h an yo fth e wori < activities , o rwit h an y o fth e wor k done , o rwit h th e equipmen tuse 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 welfer 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 tthi s program , pleas e contac tCoasta l Environmenta l Group , a t(402 ) 991-119 9

n tacces s t o mypropertie s D i d o no tgran taccess t o mypropertie s

Signature Signature Date

O I woul d lik e t o b e presen tdurin g an ysamplin g tha ti s required

.

Page 2 of 2- J ^
COASTA L 

# Restoratio n Agreemen t Th epurpos eo f thi s agreemen t i s t o provid eamutualagreeme ma s t o condition s ofth eproperty prio r t o remediatio nactivities

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QChec k th ebo x if

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

XL3t-3207 5 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s AVERAG E LOCATIO N INSPECTO R COR l CO R 2 MIS C NOT E Use rLogi n

iP b C d A g S r U R b T h S e A s H g Z n W C u N i C o Fe M n C r T i S c C a K S 

## Certificat e o fVerificatio n

27 2 SOI L 2009-10-2 0 15:2 9 120.0 0 Fina l (Av g O f268-27 1 J 130 4 s 3 5 s t VENTR Y b 2 1 3 clearenc e ep a gu n EP

A

pp m 138.829-— ^ — < LO D < LO D 119.19 4

< LO D 51.10 9 < LO D < LO D < LO D < LO D 161.94 1

< LO D 36.37 7 < LO D < LO D 15568.97 1

483.89 2

< LO D < LO D < LO D < LO D < LO D < LO D < LO D Supervise d Bv : & i ± ^

±
±

± i

± i

^ 

# ?Q J 

# ?e A Erro r -18.5Q7_ J 20.53 6 14.89 2 8.63 6 22.26 8

6.66 5 14.61 5 6.01 9 23.88 7 12.80 7 24.45 5 76.20 6 21.99 6 75.08 5 169.25 4 410.15 0 107.93 2 152.73 9 296.87 5 763.13 9 104.70 4 1149.05 6 1775.11 2 1245.35 6 V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 26 8 Mod e SOI L Tim e 

### 2009-10-2 0 15:2 7 Duratio n 

### 30.0 0 Sequenc e Fina l Flag s SAMPL E 

### 2036 2 LOCATIO N 130 4 s 3 5 s t INSPECTO R VENTR Y CORl b 2 CO R 2 

### 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r T i S c C a K S pp m 

### 117.82 8

< LO D < LO D 126.34 1

< LO D 54.56 9 < LO D < LO D 26.21 6 < LO D 154.31 1

< LO D < LO D < LO D < LO D 16350.20 5



### 572.89 1

< LO D < LO D < LO D < LO D < LO D < LO D < LO D Supervise d By : d b


### ±

±
±

± Erro r 

### 17.62 5 21.58 1 15.58 6 9.02 3 22.43 3

6.91 5 14.44 2

5.94 5 15.72 1 12.58 6 24.34 6 75.28 1 32.97 9 77.77 6 171.41 8 428.35 7 117.47 3 121.70 0 191.45 3 590.25 9 102.25 7 1279.99 5 1194.45 3 1039.21 5 V

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

XL3t-3207 5 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s SAMPL E LOCATIO N INSPECTO R COR l CO R 2 MIS C NOT E Use rLogi n

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r T i S c C a K S pp m 147.97 9

< LO D < LO D 122.29 5

< LO D 47.17 4 < LO D < LO D < LO D < LO D 161.90 3

< LO D < LO D < LO D < LO D 15353.62 0

440.68 2

< LO D < LO D < LO D < LO D < LO D < LO D < LO D Supervise d By : 

## Certificat e o fVerificatio n

26 9 SOI L 2009-10-2 0 15:2 8 30.0 0 Fina l 2036 2 130 4 s 3 5 s t VENTR Y b 2 1 3 clearenc e ep a gu n EP

A

±
±

± Erro r 18.85 9 19.99 2 14.48 1 8.63 8 21.81 4

6.40 5 14.21 5 6.15 3 24.33 7 13.02 2 24.26 2 77.87 4 30.97 2 74.65 0 164.84 7 403.08 8 103.31 0 166.19 4 294.47 6 723.12 3 175.50 7 1056.19 9 1233.89 3 1076.05 6 V

# Therm o S C I E N T l F I C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 27 0 Mod e SOI L Tim e 

### 2009-10-2 0 15:2 8 Duratio n 

### 30.0 0 Sequenc e Fina l Flag s SAMPL E 2036 2 LOCATIO N 130 4 s 3 5 s t INSPECTO R VENTR Y CO R1 b 2 CO R 2 

### 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r T i S c C a K S pp m ± 

### 123.55 5 ±

< LO D < LO D 109.35 0 ±

< LO D 50.52 4 ± < LO D < LO D < LO D < LO D 151.50 7 ±

< LO D 39.70 3 ± < LO D < LO D 15226.48 5 ±



### 497.44 5 ±

< LO D < LO D < LO D < LO D < LO D < LO D < LO D Erro r 

### 17.65 7 20.44 5 14.43 1

8.32 1 22.99 5

6.69 4 14.81 2

6.07 4 22.54 6 13.01 0 23.63 1 70.68 7 22.14 1 73.83 3 171.87 8 404.83 9 108.46 7 202.60 5 431.64 4 1020.97 4

106.31 2 898.19 6 2207.64 8 1366.68 1 Supervise d By : V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 27 1 Mod e SOI L Tim e 2009-10-2 0 15:2 9 Duratio n 30.0 0 Sequenc e Fina l Flag s SAMPL E 2036 2 LOCATIO N 130 4 s 3 5 s t INSPECTO R VENTR Y CO R 1 b 2 CO R 2 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r T i S c C a K S pp m 166.15 4

< LO D < LO D 118.79 1

< LO D 52.16 8 < LO D < LO D < LO D < LO D 180.04 5

< LO D 51.38 7 < LO D < LO D 15345.56 9

424.54 9

< LO D < LO D < LO D < LO D < LO D < LO D < LO D ±

±
±

- ±

' ±

± Erro r 19.88 5 20.12 8 15.06 8

8.56 1 21.82 9

6.64 5 14.99 4

5.90 2 25.08 4 12.60 8 25.58 1 80.98 3 23.20 9 74.08 0 168.87 3 404.31 7 102.47 6 120.45 6 269.92 8 718.20 1

34.73 9 1361.83 5 2464.45 5 1499.47 2 Supervise d By : V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 27 7 Mod e SOI L Tim e 2009-10-2 0 15:3 4 Duratio n 120.0 0 Sequenc e Fina l Flag s AVERAG E \5y g o f273-27 6 1 LOCATIO N 130 4 s 3 5 s t INSPECTO R VENTR Y COR l f l CO R 2 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A



### Erro r pp m

~ P b 24.17 7 ± 10.13 2 ^

C d < LO D 20.91 7 A g < LO D 15.02 6 S r 126.02 5 ± 9.00 9 U < LO D 22.35 8 R b 54.88 9 ± 6.91 6 T h < LO D 12.61 8 S e < LO D 5.84 9 A s < LO D 13.20 3 H g < LO D 13.54 1 Z n 64.86 1 ± 17.65 6 w < LO D 82.98 5 C u < LO D 31.41 8 N l < LO D 77.16 8 C o < LO D 175.08 7 F e 16352.92 2 ^ 428.28 0 M n 458.38 0 i

. 107.90 7 C r < LO D 142.03 0 V < LO D 299.08 5 T i < LO D 602.94 8 S c < LO D 132.62 3 C a < LO D 1513.77 7 K < LO D 2467.76 7 S < LO D 44690.32 4
Supervise d By : (AXJA 

# m ?fl n

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 27 3 Mod e SOI L Tim e 

### 2009-10-2 0 15:3 2 Duratio n 

### 30.0 0 Sequenc e Fina l Flag s SAMPL E 

### 2036 2 LOCATIO N 130 4 s 3 5 s t INSPECTO R VENTRY COR l f l CO R 2 

### 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r T i S c C a K S pp m 

### 25.95 6 < LO D < LO D 124.82 8

< LO D 53.66 4 < LO D < LO D < LO D 

### < LO D 56.60 0 < LO D < LO D < LO D < LO D 16390.65 4

438.42 4

< LO D < LO D < LO D < LO D < LO D < LO D < LO D Supervise d By : ±
±

±

± ± Erro r 

### 10.19 3 20.97 5 15.23 7 8.95 5 

### 22.29 6

6.86 4 12.20 1

5.62 9 13.38 9 13.08 8 17.14 0 90.36 1 31.04 8 77.18 5 175.55 5 428.47 2 106.66 0 147.25 5

39.05 4 388.02 7 176.68 6 1362.47 9 2755.05 4 1658.85 6 V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 27 4 Mod e SOI L Tim e 2009-10-2 0 15:3 2 Duratio n 30.0 0 Sequenc e Fina l Flag s SAMPL E 2036 2 LOCATIO N 130 4 s 3 5 s t INSPECTO R VENTR Y COR l f l CO R 2 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A



### pp m Erro r P b 17.01 3 ± 9.07 2 C d < LO D 20.16 7 A g < LO D 14.37 4 S r 118.38 7 ± 8.52 5 U < LO D 21.11 9 R b 54.92 6 ± 6.67 0 T h < LO D 12.24 3 S e < LO D 5.75 4 A s < LO D 11.89 4 H g < LO D 13.23 1 Z n 54.12 2 ± 16.16 7 W < LO D 80.67 9 C u < LO D 30.29 8 N i < LO D 75.53 8 C o < LO D 169.62 6 F e 16356.37 9 ± 416.53 8 M n 444.00 9 ± 103.00 4 C r < LO D 122.71 1 V < LO b 495.65 5 T i < LO D 817.71 1 S c < LO D 32.47 6 C a < LO D 1264.92 5 K < LO D 3120.35 1 S < LO D 174023.59 4 Supervise d By :

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 27 5 Mod e SOI L Tim e 2009-10-2 0 15:3 3 Duratio n 30.0 0 Sequenc e Fina l Flag s SAMPL E 2036 2 LOCATIO N 130 4 s 3 5 s t INSPECTO R VENTRY CO R 1 f l CO R 2 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r T i S c C a K S pp m 25.87 2 < LO D < LO D 133.53 9

< LO D 57.20 8 < LO D < LO D < LO D < LO D 78.42 4 < LO D < LO D < LO D < LO D 17312.77 9

507.07 2

< LO D < LO D < LO D < LO D < LO D < LO D < LO D Supervise d By : ±

±
±

± ± Erro r 10.36 8 21.15 6 14.98 3 9.28 7 23.38 2

7.13 2 12.16 2

5.88 3 14.32 4 13.28 5 18.84 6 80.71 7 30.10 7 78.63 8 181.93 7 443.12 1 113.52 4 178.84 0 235.67 3 416.14 7 116.90 6 1835.04 6 1865.92 7 1505.73 7 V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 27 6 Mod e SOI L Tim e 

### 2009-10-2 0 15:3 4 Duratio n 

### 30.0 0 Sequenc e Fina l Flag s SAMPL E 2036 2 LOCATIO N 130 4 s 3 5 s t INSPECTO R VENTRY CO R1 

### f l CO R 2 

### 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r T i S c C a K S pp m 27.86 6 < LO D < LO D 127.34 6

< LO D 53.75 6 < LO D < LO D < LO D < LO D 70.29 9 < LO D < LO D < LO D < LO D 15351.87 4



### 444.01 6

< LO D < LO D < LO D < LO D < LO D < LO D < LO D Supervise d By : ±

±
±

± ± Erro r 

### 10.89 4 21.36 8 15.51 0 9.26 9 22.63 4

6.99 8 13.86 7 6.13 0 13.20 5 14.56 0 18.47 1 80.18 1 34.21 9 77.31 4 173.22 8 424.98 9 108.43 9 119.31 2 425.95 7 789.90 8 204.42 2 1592.65 7 2129.73 6 1573.10 0 V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 28 2 Mod e SOI L Tim e 2009-10-2 0 15:4 1 Duratio n 120.0 0 Sequenc e Fina l Flag s AVERAG E (<^vgof27R-2R 1 ^ LOCATIO N ^^130 4 s 3 5 s t INSPECTO R VENTR Y CO R 1 f 2 CO R 2 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

pp m Erro r 

### 23.65 9 10.051,' / 

# CEH

Cd < LO D 

### 20 , 90 4 A g 

### < LO D 14
. 98 8 S r 

### 128.79 1 ± 

### 9
. 06 5 U < LO D 

### 22 , 22 5 R b 56.51 0 ± 

### 6
. 95 7 T h < LO D 

### 13
. 16 1 S e < LO D 

### 5
. 60 3 A s < LO D 

### 13 , 40 1 H g < LO D 

### 13 , 27 4 Z n 67.45 5 

### 17
. 70 0 W < LO D 

### 78
. 55 3 C u < LO D 

### 31
. 61 3 N i < LO D 

### 76
. 44 6 C o 

### < LO D 182 , 56 1 F e 

### 17298.27 7 ± 

### 439
. 57 7 M n 

### 527.15 0 ± 

### 113
. 03 3 C r < LO D 

### 157
. 56 5 V < LO D 

### 261
. 98 4 T i < LO D 

### 667
. 54 6 31 1 S c < LO D 

### 70
. 85 3 C a < LO D 

### 1268
. 89 6 K < LO D 

### 2817
. 57 9 S < LO D 

### 1669
. Supervise d B 

# ^^jmfe A

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 27 8 Mod e SOI L Tim e 

### 2009-10-2 0 15:3 9 Duratio n 

### 30.0 0 Sequenc e Fina l Flag s SAMPL E 2036 2 LOCATIO N 130 4 s 3 5 s t INSPECTO R VENTR Y COR l f 2 CO R 2 

### 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

pp m ± Erro r P b 

### 18.58 9 ± 

### 9.41 0 C d < LO D 

### 21.11 8 A g < LO D 

### 15.16 9 S r 125.16 8 ± 

### 8.97 1 U < LO D 

### 21.02 7 R b 54.65 7 ± 

### 6.76 9 T h < LO D 

### 12.38 2 S e < LO D 

### 5.27 1 A s < LO D 

### 13.24 9 H g < LO D 

### 14.11 1 Z n 72.91 6 ± 

### 18.24 0 W < LO D 

### 76.89 9 C u 36.93 2 ± 

### 22.45 1 N i < LO D 

### 72.10 2 C o < LO D 

### 175.77 9 F e 16806.25 8 ± 

### 433.73 3 M n 

### 617.61 7 ± 

### 120.05 3 C r < LO D 

### 194.29 4 < LO D 

### 45.23 0 T i < LO D 

### 450.88 1 S c < LO D 

### 31.17 9 C a < LO D 

### 1233.94 1 K < LO D 

### 3695.92 8 S < LO D 

### 1980.13 5 Supervise d By : V

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

XL3t-3207 5 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s SAMPL E LOCATIO N INSPECTO R 

### CO R1 CO R 2 MIS C NOT E Use rLogi n 

## Certificat e o fVerificatio n

27 9 SOI L 

### 2009-10-2 0 15:3 9 30.0 0 Fina l 

### 2036 2 130 4 s 3 5 s t VENTR Y f 2 

### 1 3 clearenc e ep a gu n EP A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n 

### C r T i S c C a K S pp m 

### 18.44 1 < LO D 

### < LO D 126.81 9

< LO D 53.09 5 < LO D < LO D < LO D < LO D 57.36 0 < LO D < LO D < LO D < LO D 17772.86 5

506.37 8

< LO D < LO D < LO D < LO D < LO D < LO D < LO D Supervise d By : • ±
±

±
±

± ± Erro r 

### 9.71 2 21.07 8 15.27 7 9.13 3 22.92 7

6.94 4 13.48 8

6.08 2 13.02 7 13.12 2 16.90 9 78.63 5 31.57 4 80.47 9 188.79 5 451.42 2 113.23 3 159.56 5 218.47 4 282.97 0

34.46 8 1361.17 1 2754.90 2 1595.64 0 V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 28 0 Mod e SOI L Tim e 

### 2009-10-2 0 15:4 0 Duratio n 

### 30.0 0 Sequenc e Fina l Flag s SAMPL E 

### 2036 2 LOCATIO N 

### 130 4 & 3 5 is t INSPECTO R VENTR Y CO R1 f 2 CO R 2 

### 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r T i S c C a K S pp m ± Erro r 28.45 7 

### 10.28 6 < LO D 

### 20.33 9 < LO D 

### 14.09 4 140.98 2 ± 

### 9.18 5

< LO D 

### 22.53 5 61.54 4 ± 

### 7.06 4 < LO D 

### 13.01 7 < LO D 

### 5.26 5 < LO D 

### 13.49 9 < LO D 

### 12.52 7 70.65 6 

### 17.52 3 < LO D 

### 75.87 5 < LO D 

### 29.53 0 < LO D 

### 71.79 2 < LO D 

### 178.47 4 17133.41 2 ± 

### 426.34 7

604.47 5 ± 

### 116.11 8

< LO D 

### 233.34 3 < LO D 

### 415.06 0 < LO D 

### 1116.05 5 < LO D 

### 110.62 8 < LO D 

### 1255.63 0 < LO D 

### 1803.00 1 < LO D 

### 1365.95 6 Supervise d By : V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 

### 28 1 Mod e SOI L Tim e 

### 2009-10-2 0 15:4 1 Duratio n 

### 30.0 0 Sequenc e Fina l Flag s SAMPL E 

### 2036 2 LOCATIO N 

### 130 4 s 3 5 s t INSPECTO R VENTRY CO R1 f 2 CO R 2 

### 1 3 MIS C 

### clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r T i S c C a K S pp m 

### 29.15 0 < LO D < LO D 122.19 3

< LO D 56.74 3 < LO D < LO D < LO D < LO D 68.88 8 < LO D < LO D < LO D < LO D 17480.57 4



### 380.13 1

< LO D < LO D < LO D < LO D < LO D < LO D < LO D Supervise d By : ±

±

± ± Erro r 

### 10.79 6 21.08 1 15.41 1

8.97 2 22.41 2

7.05 0 13.75 5

5.79 4 13.83 0 13.33 4 18.12 7 82.80 4 31.67 2 81.41 1 187.19 8 446.80 5 102.72 6 43.05 6 369.17 1 820.27 7 104.97 0 1224.67 0 3017.75 4 1736.58 4 V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 28 7 Mod e SOI L Tim e 

### 2009-10-2 0 15:4 5 Duratio n 

### 120.0 0 Sequenc e Fina l Flag s AVERAG E ( Av e o f283"^^285 3 LOCATIO N 130 4 s 3 5 s t INSPECTO R VENTR Y CO R 1 easemen t CO R 2 1 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

pp m Erro r P h Jl S C d A g • 1 o n oo n < LO D < LO D J •xe , co- 7 18.63 7 13.36 7 /

S r 104.45 0 ± 7.57 9 U < LO D 18.61 2 R b 38.84 2 i 5.47 9 T h < LO D 13.28 6 S e < LO D 5.31 1 A s < LO D 21.17 3 H g < LO D 11.74 6 Z n 128.71 3 ± 20.66 4 

## w < LO D 71.48 8 C u < LO D 27.68 8 N i < LO D 63.38 4 C o < LO D 131.86 1 F e 10757.12 3 ± 317.18 0 M n 289.65 1 ± 82.73 2 C r < LO D 132.29 0 V < LO D 206.23 5 T i < LO D 780.13 3 S c < LO D 88.02 4 C a < LO D 1393.37 1 K < LO D 1109.19 6 S < LO D 1204.42 7 y i Supervise d By.<2\^ ^ 

# IA)

. ^

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 28 3 Mod e SOI L Tim e 

### 2009-10-2 0 15:4 3 Duratio n 

### 30.0 0 Sequenc e Fina l Flag s SAMPL E 

### 2036 2 LOCATIO N 130 4 s 3 5 s t INSPECTO R VENTR Y CORl easemen t CO R 2 1 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r T i S c C a K S pp m 

### 144.38 5

< LO D < LO D 103.81 5

< LO D 35.36 6 < LO D < LO D < LO D < LO D 133.15 2

< LO D 34.45 3 < LO D < LO D 10402.26 5



### 271.83 9

< LO D < LO D < LO D < LO D < LO D < LO D < LO D Supervise d By : ±
±

±
±

±
±

± Erro r 

### 17.47 2 18.39 9 13.75 6 7.60 7 18.21 7

5.30 4 12.38 6 4.97 0 21.83 9 12.65 7 21.26 5 77.38 9 19.91 1 65.84 9 129.27 6 313.99 2

80.95 1 237.64 1 379.57 1 799.78 8 108.54 6 1654.56 6

82.27 1 1138.54 0 V

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

XL3t-3207 5 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s SAMPL E LOCATIO N INSPECTO R CO R 1 CO R 2 MIS C NOT E Use rLogi n 

## Certificat e o fVerificatio n

28 4 SOI L 

### 2009-10-2 0 15:4 3 30.0 0 Fina l 2036 2 130 4 s 3 5 s t VENTR Y easemen t 1 clearenc e ep a gu n EP

A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r T i S c C a K S pp m 

### 142.51 1

< LO D < LO D 98.59 8 < LO D 38.02 0 < LO D < LO D < LO D < LO D 132.07 7

< LO D < LO D < LO D < LO D 10553.65 0



### 317.21 6

< LO D < LO D < LO D < LO D < LO D < LO D < LO D Supervise d By : ±
±

±
±

± ± Erro r 

### 17.16 2 18.61 2 12.99 0 7.32 8 18.48 8

5.39 8 13.85 3 

### 4.97 5 21.19 5 12.30 0 20.80 2 75.17 2 26.75 9 63.10 4 130.69 4 311.08 9

84.47 2 47.44 9 313.71 3 1000.60 3

109.63 6 1401.66 5 1803.08 0 1400.38 6 V

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

XL3t-3207 5 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s SAMPL E LOCATIO N INSPECTO R CO R 1 CO R 2 MIS C NOT E Use rLogi n 

## Certificat e o fVerificatio n

28 5 SOI L 

### 2009-10-2 0 15:4 4 30.0 0 Fina l 

### 2036 2 130 4 s 3 5 s t VENTR Y easemen t 1 clearenc e ep a gu n EP

A

pp m ± Erro r P b 

### 122.02 8 ± 

### 16.39 0 C d < LO D 

### 18.97 5 A g < LO D 

### 13.59 8 S r 104.94 4 ± 

### 7.62 1 U < LO D 

### 19.37 8 R b 43.67 1 ± 

### 5.77 3 T h < LO D 

### 13.43 9 S e < LO D 

### 5.82 7 A s < LO D 

### 20.62 0 H g < LO D 

### 10.86 1 Z n 132.51 9 

### 20.75 0 W < LO D 

### 63.51 2 C u < LO D 

### 27.77 9 N i < LO D 

### 61.38 5 C o < LO D 

### 130.71 1 F e 10638.54 7 ± 

### 316.33 7 M n 

### 271.70 8 ± 

### 80.61 0 C r < LO D 

### 118.80 8 V < LO D 

### 71.38 0 T i < LO D 

### 719.18 9 S c < LO D 

### 111.46 4 C a < LO D 

### 1620.97 7 K < LO D 

### 1275.40 3 S < LO D 

### 1307.81 5 Supervise d By :

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

XL3t-3207 5 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s SAMPL E LOCATIO N INSPECTO R CO R 1 CO R 2 MIS C NOT E Use rLogi n 

## Certificat e o fVerificatio n

28 6 SOI L 

### 2009-10-2 0 15:4 5 30.0 0 Fina l 

### 2036 2 130 4 s 3 5 s t VENTR Y easemen t 1 clearenc e ep a gu n EP

A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r T i S c C a K 

### S pp m 

### 111.95 7

< LO D < LO D 110.44 4

< LO D 38.31 2 < LO D < LO D 25.30 2 < LO D 117.10 4

< LO D < LO D < LO D < LO D 11434.02 9



### 297.84 2

< LO D < LO D < LO D < LO D < LO D < LO D < LO D Supervise d By : ±
±

±
±

±

± Erro r 

### 15.72 3 18.56 4 13.12 5 7.76 2 18.36 3

5.43 9 13.46 6

5.46 9 14.02 6 11.16 9 19.83 8 69.88 0 26.34 5 63.19 8 136.76 3 327.30 2

84.89 7 125.26 0

60.27 6 600.95 2

22.45 0 896.27 5 1276.03 1

970.96 5 V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 26 7 Mod e SOI L Tim e 2009-10-2 0 15:2 3 Duratio n 150.0 0 Sequenc e Fina l Flag s AVERAG E CI^«g-of-2^2=266_ J LOCATIO N 130 4 s 3 5 s t INSPECTO R VENTR Y CORl D Z CO R 2 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

pp m Erro r 

## _E t 39.36 3 

## [16353 ? C d 2 0 90 1 Ag 15 ,23 4 S r ± 8 81 6 U 22 , 97 0 Rb 7 10 6 Th 14 , 01 5 S e 6 , 06 6 A s 15 , 48 6 H g 13 , 71 8 Z n 19 , ,19 2 W 7 7 83 6 C u 32 ,32 4 N

i 76 , 24 2 C o 181 , 76 2 F e 57 4 ± 436
. M n 58 9 ± 114 , C r 02 1 103
. V 12 9 285
. T

i 75 9 464 , S c 44 5 96 , C a 51 8 1135 , K 97 9 1438 , S 47 7 31105 , Supervise d By : 

# ^m m

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 

### 26 3 Mod e SOI L Tim e 

### 2009-10-2 0 15:2 1 Duratio n 

### 30.0 0 Sequenc e Fina l Flag s SAMPL E 

### 2036 2 LOCATIO N 

### 130 4 s 3 5 s t INSPECTO R VENTRY CO R 1 D Z CO R 2 

### 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o Fe M n C r T i S c C a K S pp m ± 

### 49.02 9 ± < LO D 

### < LO D 111.67 0 ±



### < LO D 62.11 9 ± < LO D < LO D < LO D < LO D 73.90 2 < LO D < LO D < LO D 

### < LO D 17411.42 6 ±



### 546.26 9 ±

< LO D < LO D < LO D < LO D < LO D < LO D < LO D Erro r 

### 12.59 5 21.10 8 15.40 5

8.58 9 22.08 5

7.21 4 13.29 2

5.65 1 16.20 6 12.65 5 18.31 1 76.89 6 30.93 9 72.01 9 183.05 0 443.08 3 114.65 2 119.69 2 228.95 6 491.49 4 148.24 3 884.78 5

44.80 2 

### 812.16 0 Supervise d By : 

### V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 

### 26 4 Mod e SOI L Tim e 

### 2009-10-2 0 15:2 2 Duratio n 

### 30.0 0 Sequenc e Fina l Flag s SAMPL E 

### 2036 2 LOCATIO N 

### 130 4 s 3 5 s t INSPECTO R VENTR Y CO R1 D Z CO R 2 

### 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r T i S c C a K S pp m 32.43 0 < LO D < LO D 124.83 3

< LO D 59.80 2 < LO D < LO D < LO D < LO D 60.40 8 < LO D < LO D < LO D < LO D 17811.10 9

529.21 1

< LO D < LO D < LO D < LO D < LO D < LO D < LO D Supervise d By : d b

±
±

± ± Erro r 

### 11.32 3 21.34 9 15.17 2

8.97 5 22.63 6

7.13 6 14.06 0 6.84 9 14.80 2 13.76 3 16.96 5 73.96 5 32.57 7 77.27 6 188.78 8 446.42 0 114.35 3 119.44 1 311.02 9 551.47 2 103.72 2 1065.04 7 2752.56 9 1586.32 1 V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 26 5 Mod e SOI L Tim e 2009-10-2 0 15:2 2 Duratio n 30.0 0 Sequenc e Fina l Flag s SAMPL E 2036 2 LOCATIO N 130 4 s 3 5 s t INSPECTO R VENTR Y COR l D Z CO R 2 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A



### pp m Erro r P b 27.67 4 ± 10.87 1 C d < LO D 21.01 1 A g < LO D 15.44 8 S r 122.50 9 ± 8.99 6 U < LO D 24.23 3 R b 61.88 9 ± 7.41 7 T h 17.51 8 ± 9.89 1 S e < LO D 6.21 8 A s < LO D 14.76 2 H g < LO D 13.92 2 Z n 74.62 2 ± 18.41 7 W < LO D 74.03 2 C u < LO D 31.70 8 N i < LO D 75.51 4 C o < LO D 185.07 8 F e 17438.99 0 i 446.20 9 M n 520.24 9 ± 115.13 0 C r < LO D 196.35 4 < LO D 308.57 5 T i < LO D 402.83 5 S c < LO D 43.14 6 C a < LO D 1704.44 3 K < LO D 69.54 0 S < LO D 150511.15 6 Supervise d By : V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 26 6 Mod e SOI L Tim e 2009-10-2 0 15:2 3 Duratio n 30.0 0 Sequenc e Fina l Flag s SAMPL E 2036 2 LOCATIO N 130 4 s 3 5 s t INSPECTO R VENTRY COR l D Z CO R 2 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A



### pp m Erro r P b < LO D 13.88 6 C d < LO D 21.31 7 A g < LO D 15.27 9 S r 122.89 3 d b 9.01 9 U < LO D 24.58 3 R b 57.45 0 ± 7.27 4 T h 15.09 8 ± 9.46 5 S e < LO D 6.25 3 A s 17.90 8 ± 9.16 9 H g < LO D 14.83 9 Z n 74.06 8 ± 18.72 4 W < LO D 83.14 6 C u < LO D 33.80 7 N i < LO D 79.78 2 C o < LO D 187.90 5 F e 17961.02 0 ± 453.51 2 M n 625.48 2 ± 123.72 8 C r < LO D 39.53 0 V < LO D 311.79 8 T i < LO D 549.55 8 S c < LO D 34.72 4 C a < LO D 1358.94 9 K < LO D 2462.45 7 S < LO D 1470.86 4 Supervise d By :

# mm

Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 Coasta l Envlronmenta l Grou p Inc

. j ^

www.coastalhazmat.co m ~ 

# \yr A ^'tpROT*' ^ COASTA L mviiomitiiTA i clo u p
. m c 

# EXECUTIV ESUMMARY : BVID #20362-(1304 S 3 5 ST )

No Issue s o r Concern s QIssues/Concern s
DetailExplanation :

### 4 

# P EP A EPAProperty Clos eOu t For m Propert y # : Date/Tine : 

### ZO^'X

. Propert y Address;-J?^ ! F^J^^^^L"" " OwTer' s Nan..:

. .g^-AOjl^J^JLJl- Quad s Excavattd ; P\FT , P^ ? -VO7 Contracto r Group'%Mtp
Excavatio nGeneral O VesNo

. 1

.If necessaiy , wereth ecorrec t quadrantCs) excavatedandrestored ? 

# r ^ 2

.tf nccessa^ , wereth ecorrec t area s ofdri p zoneexcavaie dandrestored ?
Gradin g So d an d Vegetatio n 

### 1

.Doe s thetradin g aroundtheperimeier of th ehous ei nexcavate darea s generally slopeawa y 

# z A fromth eIiouse ? 2

.Ha s so dbee nlai dinallarea s tha t wer eexcavated ? 3

.

Doe s th esodappear to b egenerally healthy an dgrowing ? (Only evaluatei f inspecteda t a3 0 

# r y 

# ^ day timeperiod)'•• ' 4

.Aresoddedarea s generally Tir man devenly graded ? 

# z ^

5

.

Arc th ejoint s betweenth eso dstrip s generally tight ? (Only evaluateif inspecteda t a3 0 da y tim eperiod) 6

.Wa s thepropert y grade dsuchtha t wate r willno t poo lo nth epropertj' ' 

# y
7

.Wa s damaget o landscapin g o r plan t material s avoided ? 

# -y ^
Gates , Fence s an dRetainin g Wal b Yes N o 

# zt I

.D o gate s ope nan dclos efreely ? (Ifappiicable ) 2

.Wereallgate s or fence s takendow nduring restorationactivitie s reinstalled ? (Ifappiicable ) 

# Z ^
3

. Wa s damaget o gate s or fence s avoided ? (Ifappiicable ) 

# Z ' 

# y 4

.Wa s damaget o retainin g wall s avoided ? (Ifappiicable ) Foundation , Sidiag an dGutler s 1

.Wa s damaget o th esiding o r trimavoided ? 

# r A

2

.Wa s damaget o th efoundationavoided ? 

# Z ^
3

.Wa s damageto window s avoided ? 

# A y Wa s damageto window s or door screen s avoided ? 5

. Wa s damaget o downspout s o r downspou t extension s avoided ? 

# Z '

Sidewalk s an dDriveway s (Concrete ) Yes N o I

.Wa s damageto drivewa y surface s avoided ? 2

.Wa s damaget o walkwa y surface s avoided ? 

# Z A

# 0 • Ov^'oers comments :

Inspectio nnotes :

Remova lan drestorationactivate s complet eincluding the30-da y sodwarranty :
EP ARepresentativ eJ LJcTh./)A JfyJt ^ Date : //^7c?7I 1 ^ 

# p

Propert yCompletio n Agreemen t

Ihi s agreemen i documeni s th e compielio n o l remedia l aclivme s perioime d o n m yproperl yM ysignaiur e wil l designat e thatI a m satisfie d wit h (h e rtttoralio n o fm ypropeily

. an d thatn o ilem s ar e i n questions , now , o ratan ylim e i n th e fiituie , excep l thos e item s liste d below , ifan y

Propert yID : 2jD?)\jf L 

# '''•'>p^^^^^''""^W^ U != ^

?) K g - Owner : Dr>y^/^l l ^ Qt JQ

# f Phone : MQ Z-•g M 1^.53 ^ ;
Restoratio n Item s i n Question :



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

Additiona l Comments :

I 1 Agre e I'Ktortilio n i tcompleted , excep l a s noter i [J I (t o no taiire crestoratio n i s compjele d


# ^ ?ynroi?nr ^

whlh ^ OwncrV£<Sic n Contrarlor' s Signatur e T' Dal e