### TRANSMITTA L of OMAH ALEA D SIT E SOI L REMEDIATIO N FIL E FOLDE R 

## SAI Dit ^ 7 7) ^ I DATE : 5/o 2 I / I A ADRESS : 1^/ / l l Z 5 SA REMEDIATIO N CONTRACTOR : COASTA L ENVIRONMENTA L GROU P Contract : EP-R7-09-0 6

SOI L REMEDIATIO N PROPERT YFIL E FOLDE R DOCUMENTS H Executiv e Summar y ^

EPA-provide d propert ysketc h W Signe d Acces s Agreemen t fo rsubjec t propert y Signe d Acces s Agreemen t (s ) fo radjacen t propert y M Restoratio n Agreemen t fST " Settlemen t document s (i.e. , fo rdamag e or to replac e plants , etc. ) ^

Confirmatio n dat a O ^ Photograph s SO D Pre-Excavatio n Excavatio n >S

P As-Buil t sketc h Satisfactor yrestoratio n signe d byPropert yOwne r Propert yclose-ou t chec k lis t signe d byEP A Descriptio n of area s of area s no t meetin g RO D cleanu p criteri a J j Utilit yclearance s Tl Propert yInformatio n fro m Dougla s Count yAssessor' s Offic e D 

## 9f COASTA L SignatureSignature - i Signature - EP A.«< > 

### i?' " * Date Date 3026291 9 Superfun d

## Propert yAcces s Checklis t Propert y ID : ^T^p^ / Propert y Address : /^y ^ /I / ^^ T "^^T— ^ D n WOR K STARTE D WOR K COMPELTE D ON : ON : / / / /

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n n Q Notificatio nLette r Acces s Agreemen t Restoratio nAgreemen t Topsoi l Samplin g (i f applicable ) Disposal Samplin g (i f applicable ) Garde nSamplin g (i f applicable ) Utility Clearanc e ideo/Photo s (Before ) Video/Photo s (During ) Video/Photo s (After ) Video/Photo s (30-Day ) Propert y Completio nAgreemen t Fina l Repor t Sent : / / By : 

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### By : 1

• Communit y Results : • Cre w On : / / By :

• Communit y Results : • Cre w On : / / By :

Omah a Lea d Sit e

### Dougla s Count y Accoun t I t^|^u) n Pag e 1 of 2
Dougla s County , Nebrask a Propert yRecor d Informatio n i s vali d a s o f 2010-8-3 0 ­ R194528000 0

Ne wFeatur e - ^ ­ f - ^ Prin t Reoor t Vie wInteractiv e GI S Ma o

Treasurer' s Ta xReoor t Subdivisio n Sale s Searc h Owne r ORDUN AALONZ O ETA L 243 6 PARKE R S T OMAH AN E 68111-000 0 Propert yInformatio n Ke yNumtier : 452 8 000 0 1 9 Accoun t Type : Residentia l Parce l Numtier : 194528000 0 Parce l Address : Lega l Description : 191 1 N 2 5 S T OMAH AN E 68111-000 0 PARKER S AD D LO T7 BLOC K6 N 5 0 FT5 0 X 12 6 Valu e Informatio n 201 0 200 9 200 8 200 7 200 6 200 5 Lan d $400.0 0 $400.0 0 $400.0 0 $400.0 0 $400.0 0 $400.0 0 Improvemen t $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 Tota l $400.0 0 $400.0 0 $400.0 0 $400.0 0 $400.0 0 $400.0 0 

### Sho wAl l Transaction s

Lan d Informatio n Acre s S F Unit s Deptf i Widt h Vacan t 0.0 6 3000. 0 0. 0 60. 0 50. 0 Ye s



### http://douglasne.mappmg-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R l 94..
. 9/2/201 03/31/201 1 www.dhon.org/irthinternet/DHONNotic.
. . 

### Creat e Anothe rTicke t Bac k tOTTt h Intemet 

## t^ S 

# "c * I Sen d Emai l



## • YOURTICKE T NUMBE RI S 2700327
. Origina l Cal l Date : 3/31/1 1 Time : 3:3 7 pm Op : ALFONSO1879 0 Wor k t o Begi n Date : 4/04/1 1 Time : 4:0 0 pm State : N E County : DOUGLA S Place : OMAHA Address : 191 1 Street : N25T H S T Twp : 15 NRng : 13 E Sect-Qtr : 09-SE,16-N E Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : Lea d Remediatio n Locatio n o f Work : LOCAT E ENTIR E PROPERTY , AL L EASEMENT S AN D T O TH E PEDESTA L Remarks : FA X AL L CLEAR S TO : ( 4 02)934-281 1 : PLEAS E INCLUD E AL L EASEMENT S Company: COASTA L ENVIRONMENTA L SERVIC E Contac t Name ; ALFONS O Phone : (402)934-283 7 Wor k Bein g Don e For : Coasta l Dept h o f Excavation : 4f t Corne r Lot : NFront : Y Rear ; Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N CXCATV LEVEL 3 MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C 

## Utilit y Servic e Are a Contac t Phon e Numbe r Typ e Day : 402934046 9 CXCATV CO X COMMUNICATIONS , IN C HEIDI Ak : 402934046 9 Emerg : 402932975 7 Day : 877366834 4 LEVEL S COMMUNICATIONS , LEVEL S N A Ak : LL C Emerg : 877366834 4 Day : 402504782 3 

## METROPOLITA NUTILITIES MUDO l S/^DYMU D Alt : 

## DISTRIC T Emerg : 402504797 0 Day : 402444719 7 

## CITY O FOMAHA

- OMAHACO F RICHTRAFFI C Ak : 402444516 1 TRAFFICSEWE R Emerg : 402444516 0 dhon.org/irthinternet/. ../MessageText.as..
. 1/ 2

### 3/31/201 1 j ^ www.dhon.org/irthinternet/DHONNotic..
. 

## W^Day : 406728934 3 r^ni^T^r^no^ OMAHAPUBLIC POWEREL M y ,^__ , ,^ , 0PPDGPR 5 j^jg^^ ^ LOCATIN G ^ = 406207149 4 Emei^ : 888728934 3 

## Day : 406728934 3 FTM QLNNEI C QWES T LOCALNETWOR K TM\^T ^ Alt : 406207149 4 LOCAHNC J 

## Emerg : 888728934 3

dhon.org/irthinternet/.../MessageText.as..
. 2/ 2

# As-Buil t Drawin g COASTA L 

# Omah aLea dSuperfun dSit e OLS# : 2709 1 Dat e Excavated : 4/9/201 1
. . 

# r Dat e USEP A Signe d Off : 4/19/201 1 Are a Sodden : 101 2 s a 

# %lli i 2709 1 Exterio rPain l Omah a Lea d Sit e Owne rNain« : RICHAR D D Mt'lER 3 I K Sit e Sketc h • Goo d Address : 1911Ji2 5 S T • Poo r

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. «/f|:-«!20 0 [ig'No t pain t Lea d Sampl e Sample s Collecte d Sampt e Numbe r LA B Concentratio n Collecte d Firm : RYASCPXA-2709 1 F 1 2.S 0 pp m 

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### D Sample s Analyze d RYDSCPXA-2709 1 B 2 IS Q pp m 

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

# 2709 1 

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### Date : /0'Z7-^S ' Time : B!2 l Staff : l ^

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### Date : /0'Z7-^S ' Time : P^y j Staff : rLAj i

Omah aLeadSit e 4613 0j^^eosr,. ^

COASTA l IIIVIIOHHIItlA l C t 0 t l r. IN C 

## Consen t fo rAcces s T o Property ' RIGH TO F ENTR YTO 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 rits 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 : ^ 

## OiPUMT ^ ALOtJl * Owner' s Name : Daytim e Phone:2 ® S * ^lS {

Addres s o f Propert y 

## /^/ /

h 7 2 S g ^ covere d b ythi s 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 that contain s elevate d concentration s of lea 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 be replace d wit h clea n material s an d th e are a wil l b e restore d t o its origina l condition
. Thi s wor k i s bein g performe d unde rth e Omah a Lead Superfun d Sit e remediatio n program . Arepresentative of Coasta l Environmenta l Group , contracte d b yUSEPA , v\nl l contac t th e Granto rin-perso n t o discus s th e wor k t o b e perfonned , th e Granto rwil l hav e a n opportunit yt o reviewan d approve th e planne d soi l removal , an d restoratio n wor k before i t begins
. Once th e wor k i s finished , th e Granto rwil l b e aske d t o reviewth e work 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 F receive writte n documentatio n fro m EP Athat th e propert y has 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 , its employees , contractor s an d subcontractor s 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 of perfomiin g th e work
. Thi s acces s shal l remai n i n effect unti l th e wor k has bee n satisfactoril ycompleted
. Th e Granto rals o agree s to :

Pag e 1 o f 2V^^jf COASTA L *
..r' ymtHOHHUlTi l

- i ORO^t ^ C ft O U rI Kc 

### cRemov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; e 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 ; cWate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , a s necessarysubsequen t t 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 f th 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
. cAllo wvideotapin g and/o rphotographin g o f th e property
. AGREEMEN TNO TT O INTERFER E 

### Th e Granto ragree s no t t o interfer e o rtampe rwit h an yo f th e wort? activities , o rwit h an y o f th 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 f sai d propert ywhic h woul d ten d t o endange rth e healt h o r welfar e o f th 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 . Should yo u hav e an yquestion s abou t thi s program , pleas e contac t Coasta l Environmenta l Group , a t (402 ) 991-119 9

1 ^ I gran t acces s t o m ypropertie sD I d o not gran t acces s t o m ypropertie s

Signatun ^ Dat e Signatur eDat e

D I woul d lik e t o b e presen t durin g an ysampiin g tha t i s required
.

Pag e 2 o f 2COA S T AL 

## Restoratio n Agreemen t Th e purpos e of thi s agreemen t i s to provide amutua l agreemen t a s to condition s of the propert y prior to remediationactivities
. Thi s will als o serve a s documentationfo r the purpos e of assuring tha t restoration activitie s ar e completedt o the satisfactionof the propert y owne r an dthe UnitedState s Environmenta l ProtectionAgenc y (EPA)
. Propert y ID : 'ly^TT/ / Propert y Address : 1^^/ / //zy^^' ^ Owner : Orclurxct7^l(i^^< i Thone:J^^(yl^ ^ O

nthe attacheddiagram(s ) indicat e area(s ) t o excavate , surface structure s an dlandscapin g feature s an d acces s location(s ) to b e use db y the contractors , hidicat e distances , depths , materia l types , etc . Photographicall y an dVideographicall y documen t the existing condition s ofth e propert y an dthe basemen t i f necessary . Item s t o b e Remove d b yth e Owne rbefor e Star t o f Remediation : Th e removai , storage , disposal , and/o rretur n o f thes e item s i s th e Owner' s responsibility
.

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

Kem :

Pag e 1 of
.COA S T AL 

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

# ^ 7 L Hem : 

# S^ P Kem : Item :



## Ite m Pre-existin g property area , that wil l b e excavated , that i s covere dwithgrass . Numbe r o f tree s > 2 inc h trun k diamete r Numbe r o f tree s < = 2 inc h trunk diamete r Numbe r o f Sprinkle r Zones , Contro l Valves , Timers , Heads , etc . Attac hasketc ho f th e sprinkle r layout
. Numbe r o f an dsiz e o f eac hgarden/ flower be d area . Attac hasketc ho f relativ e size s an dlocations
. Agree dupo nvalu e o f plan t material s no t t o b e replace db v contractor . Not e thi s valu e wil l b e use dt o issu e aplan t vouche r t o th e propert y owner . Easemen t Area , t o b e excavate d 

## Landscap e Inventor y Quantit y Uni t Condition/Type/Specie s Quadrant s • ^ ^



# 1 Eac h 

# < P Eac h

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# f Eac h Squar e Fee t 

# S $ 

# yy y Eac h
Pag e 2 of
.COA S T AL O • O U P
. INC
.
Additiona l Comment s / Instructions : Th e cit yo f Omah a ordinance s ma yprohibi t yo u fro m usin g dir t o rgrave l area s o n you rpropert y a s driveway s o rvehicl e parkin g areas . Th e Environmenta l Protectio n Agenc y(EPA ) ma yb e removin g an d replacin g soi l underlyin g a grave l o rdir t are a o n you rpropert ytha t yo u ma yb e usin g a s a drivewa yo rvehicl e parkin g area . I f thi s i s th e case , yo u shoul d understan d tha t thi s removin g an d replacin g o f soi l doe s no t mea n tha t an yillega l drivewa yo rparkin g are a o n you r propert yi s mad e legal
. T o th e contrary , yo u ma yb e cite d b yth e cit yi f yo u us e a grave l o rdir t are a a s a drivewa yo rparkin g area , no t withstandin g an yremova l o rreplacemen t o f soi l b yth e EPA
. I f yo u hav e an yquestio n abou t legalit yo f a certai n drivewa yo rparkin g area , yo u ma ycontac t th e cit yo f Omaha' s Plannin g Departmen t a t (402 ) 444-5150
. IK I Pleas e chec k thi s bo xi f yo u understan d th e informzrtio n outline d above
.

G Chec k th e bo xi f Owne rdoe s no t wan t CE G t o documen t interio rfoundatio n wall s an d possibl e pre-existin g damage
. B ycheckin g thi s bo xCE G i s no t responsibl e fo ran ydamag e don e t o th e interio ro f house , includin g foundatio n crack s o rfissures
.



### f)C

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# Ai£^
. y67.y.. ^ •/.-,.-..
. y^d^eu ^ 7oL/c() Owner' s Sji^atur e Date Contractor' s Signature Date Pag e 3 of
.XR F PROPERT YSAMPL E SHEE T 

## BVID # *Z^Cf \ I
Dat e Projec t XR F ID #

Sho t # 

# 3

^ 3- \ 

# Z- B Averag e 

### .oM t Oman i 

## ^ g U a Lea d ARR A 

# 'Hia ^ Readin g 

# 34 1 ^X 5 :^o3 1 2^ 3 zent 2. 3 Sampl e are a 

# B ^ Dept h ^ " ^i/ O t Z 4 Addres s Sampl e tim e sampl e lengt h

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Shot # 

## i^ n M
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Shot # Readin g Sampl e are a Shot # Readin g Sampl e are a " Dept h Dept h Averag e Averag e

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

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

Averag e / Signatur e y 

# "ft Prin t ' ^ 

# yA Dept h
y/ 

# yy ^ /tf ^

(Hff1^> Averag e Dept h

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

## Certificat e o f Verificatio n J<L3t-3208 9

Readin g N o Mod e "Yim e

Duratio n 93.3 8 Sequenc e Fina l Flag s AVERAGE
. Av g o f 36-3 8 ADDRES S 1911 n2 5 s t QUADRAN T B 2 DEPH T 6 " XR F TEC H N
. LOPE Z MIS C confirmatio n NOT E non e

pp m Erro r M o < LO D 8.17 0 Z r 489.88 3 ± 16.55 1 S r 182.17 6 ± 9.37 5 U < LO D 15.02 7 R b 72.81 6 ± 6.84 4 T h 19.03 7 ± 10.05 1 _^_310.80 8 ± '«"-TM-«4TG8? " 

# 'I ' S e < LO D 6.09 9 ± A s 33.63 3 21.50 6 H g < LO D 12.52 1 Z n 216.99 0 ± 25.15 2 W < LO D ^^" ^ 88.^4 2 C u < LO D ^ / 32C98 4 N i < LO D y y78.74 4 

## y^ C o < LO D / /l98.30 3 F

e 20412.555 / ± y414.20 7 M n 596.42 S y ^

112.42 3 

# y Supervise d By : V/' ^ 

# y 

# y

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

## Certificat e o f Verificatio n XL3t-3208 9 Readin g N o 3 6 Mod e SOI L Tim e 2011-04-2 2 13:4 3 Duratio n 30.8 2 Sequenc e Fina l Flag s BVI D 2709 1 ADDRES S 191 1 n2 5 s t QUADRAN T B 2 DEPH T 6 " XR F TEC H N
. LOPE Z MIS C confirmatio n NOT E non e

pp m Erro r M o < LO D 8.33 5 Z r 523.33 3 ± 17.09 7 S r 175.01 9 ± 9.25 1 U < LO D 15.46 5 R b 70.36 7 i 6.83 0 T h I R nfi n ± 10.25 2 P b 

### ^1041.07 4 ^— ^ ^ 25.31 2 S e < LO D ^ ^ 6.64 8 A s < LO D 33.66 1 H g < LO D 12.22 5 Z n 226.35 8 ± 25.61 0 W < LO D 84.33 0 C u < LO D 32.66 3 N i < LO D 81.39 3 C o < LO D 194.73 0 Fe 19650.22 3 ± 408.54 6 M n 578.30 9 ± 111.23 9 Sup e rvise d By ;

# 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-3208 9 Readin g N o 3 7 Mod e SOI L Tim e 2011-04-2 2 13:4 4 Duratio n 31.3 5 Sequenc e Fina l Flag s BVI D 2709 1 ADDRES S 191 1 n 2 5 s t QUADRAN T B 2 DEPH T 6 " XR F TEC H N
. LOPE Z MIS C confirmatio n NOT E non e
Erro r pp m

• M o < LO D 7.97 0 Z r 473.84 3 ± 16.20 2 S r 187.66 0 ± 9.43 1 U < LO D 14.88 6 R b 72.72 8 ± 6.78 4 T h 17.40 7 ± 9.79 8 ^^^03.46 9 ±J H ^_?3.60 0 S e ^ ^ ^ < LO D 5.60 0 ± A s 38.56 6 21.24 8 H q < LO D 12.86 4 Z n 208.14 2 ± 24.65 6 W < LO D 92.03 1 C u 45.13 1 ± 22.73 6 N i < LO D ; 74.78 4 C o < LO D : 199.66 5 Fe 21196.85 7 ± 418.73 8 M n 555.67 1 ± 109.24 8 Supervise d By :

# 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-3208 9 Readin g N o 3 8 Mod e SOI L Tim e 2011-04-2 2 13:4 4 Duratio n 31.2 1 Sequenc e Fina l Flag s BVI D 2709 1 ADDRES S 191 1 n 2 5 s t QUADRAN T B 2 DEPH T 6 " XR F TEC H N
. LOPE Z MIS C confirmatio n NOT E non e

pp m Erro r M o < LO D 8.20 4 Z r 472.47 4 ± 16.35 5 S r 183.84 8 ± 9.44 2 U < LO D • 14.73 1 R b 75.35 3 ± 6.91 8 T h 21.64 6 ± 10.10 2 o^ m 

### ^^P87.88 0 ­ . 23.34 Z 

# ?P " A s " ^ < LO D < LO D ~ 6.05( T 31.24 4 ^ H g < LO D 12.47 2 Z n 216.46 9 ± 25.18 9 W < LO D 89.26 7 C u < LO D 32.18 5 N i < LO D 80.05 4 C o 212.69 8 ± 133.67 5 F

e 20390.58 4 ± 415.33 8 M n 655.29 5 ± 116.78 3 Supervise d By :• • 

## 1^^^^ ^

Omah a Lea d Site—Fixe d Pric e EP-R7-09-0 6 S ^^^ 7 I Coasta l Environmenta l Grou p Inc
. .| l ^*^^J ^ www.coastalhazmat.co m TM 

### ""•" ^ COASTA L 

# EXECUTIV ESUMMARY : BVI D #27091

- (191 1 N2 5 ST ) No Issue s o r Concern s [ ^ Issues/Concern s Detail Explanation : COASTA LI S UNABL ET O PROVID EPRE-EXCAVATION , EXCAVATION , AN D SO D PHOTO S A S PAR T O FTHI S FINALPROPERT Y FOLDER
. THES EPHOTO S WER EI N TH EPOSSESSIO NO FA SUBCONTRACTO RTHA T WA S CONTRACTE D T O PERFOR M AL LO FTH ESIT ECOORDINATIO NREQUIRE D B Y TH ESCOPEO FWOR K AN D TH E SUBCONTRACTO RHA S SINC ELEF T TH EPROJECT
. THEREFORE , TH EPHOTO S AR EN O LONGE RAVAILABL E

DANGARVE Y WALKE D AN D SIGNE D OFFO NTH EPROPERT Y A S COMPLET EO N 4/19/2011
.

# m

Propert yCompletio n Agreemen t Thi s agreemen t documen t ih e complclio n o t remedia l acliviiie s perloime d o n myproperl yM ysignalure wil l designat e tha i I a m satisfie d wil h ih e restoratio n o f m ypropeily
. an d tha t n o item s ar e i n questions , now , o ra t an ylim e i n th e fuluie , except thos e ilem s liste d below , i f an y Propert y[D : ^pZjp ^ f Propert yAddress : /^/ / 7172- ^ Owner : 

## (Mlk2^^^T ^ Phone : 

# r-(Qi^ l Restoratio n Item s i n Question :

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

# ''^ V 7"' ^ xr^,^ 9

I Rgrc crestoralio n i s completed , excep t a s note d [_ J I rio /lo l «(>re crestoratio n i. \ complete d

Owner' s SiHt^tiire ' ' " Dat e Cont i arlor' s Signatur e% 

## EP A Propert y Clos e Ou t For m Proptrt y # i JlhT^f.
. Propert y Address : 

# s T ^ Date/TlRic : Owner' s Name: , /4
_ Quad s Excavated : Contraclo r Grou p Yes N o Excavatio nGenera l 1
. I f necessaiy , wer e tli e correc t qiiadrant(s ) excavate dan drestored ? / 2
. I f necessary , wer e th e correc t area s ofdri p zon e excavale dao drestored ? 

# y Yes N o Gradin g So dan dVegelatto a I
. Doe s th e tradin g aroun dth e perimete r ofth e hous e i nexcavate darea s generall y slop e awa y 

# "T T fromth e house ? 2
. Ha s so dbee nlai dinal ! area s that wer e excavated ? / 3
. Doe s th e so dappea r t o b e generall y health y an dgrowing ? (Onl y evalual e i f inspecte da t a3 0 / da y tim e period )
. 4
. Ar e sodde darea s genetall y (ir man devenl y graded ? / 5
. Ar e th e Joint s t>etweenth e so dstrip s generall y tight ? (Onl y evaluat e i f Inspecte da t a3 0 da y / tim e period ) 6 . Wa s th e propeit y grade dsuc hthat wate r wil l no t poo l o nth e property ? / 

# r 7
. Wa s damag e t o landscapin g o r plant material s avoided ? / Gates , Ftacc s an dRetainin g Wall s Ye s N ^ I 1
. D o gate s ope nan dclos e fieely? (Ifapplicable ) 2
. Wer e al l gate s o r fence s take ndow ndurin g restoratio nactiviiie s reinstalled ? (I f applicable ) 

# V 3
. Wa s damag e t o gate s o r fence s avoided ? (Ifapplicable ) 

# 7 

# 7 4
. Wa s damag e t o retainin g wall s avoided ? (Ifapplicable ) Foundation , SidiS K an dGntler s Yes .N o t . Wa s damag e t o th e sidin g o r tri mavoided ? 

# y 2
. Wa s damag e t o th e foundatio navoided ? 

## y 3
. Wa s damag e t o window s avoided ? 

# y 4 Wa s damag e t o window s o r doo r screen s avoided ? 

# y S
. Wa s damag e t o downspout s o r downspou i extension s avoided ? 

### y\ Sidewalk s an dDriveway s (Concrete ) Ye s No I
. Wa s damag e l o drivewa y surface s avoided ? 

# y \ ' 2
. Wa s damag e t o walkwa y surface s avoided ? 

# y

### % 

## OM'tier s comnaents :

(n.spetrtio nno*es :

Removal andresloratio naclivale s complete includin g ih e 30-da y so dwarranty : EP A Representativ e ^9Ws5LDale : iUtl'-t

­

# V
TRANSMITTA Lof OMAHA LEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R
SAI D # : >9^0 9 ! Date : 

# My Address : l9/ l M 2 ^ S T Remediatio nContractor : _Coasta l Environmenta l Group

_Year : _2011ARRA
_ SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S D Vide o o f property (DVD ) nExecutiv e Summary nEPA-provide dproperty sketc h D Signe dAcces s Agreemen t for subjec t property nSigne dAcces s Agreement(s ) for adjacent property D Restoratio nAgreemen t D Settlemen t docimient s (i.e. , for damag e o r t o replac e plants , etc. ) D Confirmatio ndat a D Photograph s D As-buil t sketc h D Satisfactory restoratio nsigne db y Property Owne r D Propert y close-ou t chec k lis t signe db y EP A D Descriptio no f area s not meetin g RO D cleanu p criteri a D Utilit y clearance s D Property informatio nfromDougla s County Assessor' s Offic e D D D
. 

### Signatur e Dat e