TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: \b\i\ JiUA \ Date: 

Address: I ^^ ^ 4 \t ^ ^ < 

Remediation Contractor: Coastal Environmental Group_ Year: _200O 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

^ Video of property (DVD) 

0 Executive Summary 

0 EPA-provided property sketch 

IZ Signed Access Agreement for subject property 

^B' Signed Access Agreement(s) for adjacent property 

10 Restoration Agreement 

J^ Settlement documents (i.e., for damage or to replace plants, etc.) 

•B- Confirmation data 

DO/ Photographs 7^^ V?i^ W >r (?^tAv|/m^ y 'h^6?^^^rig ^ 

0 As-built sketch 

U Satisfactory restoration signed by Property Owner 

w Property close-out check list signed by EPA 

•& • Description of areas not meeting ROD cleanup criteria 

a/ Utility clearances 

\3 Property information from Douglas County Assessor's Office 

D 

30054459 

•li 

Superfund 
• • ^ « 

Property Access Checklist 

Property ID: \^{^\ ^ 

PropertyAddrcis; | O^g^fe <^ \ ^ ^fj " 

n

D

 WORK STARTED

 WORKCOMPELTED

 ON: __/__/_ 

ON:__/__/_ 

Owner: Thirhf /XC Afldrcss: 

3510 Pbdgc Sf. 

Fax: ^ 

5n- ^^.!^^ 

Renter 

Phone: 

Fax: 

Cell/Pagen 

Additioaal Information: 

Cell/Pagen 

D Notfflcatlon Letter 

£ 1 Access Agreement 

J 0 Restoration Agreement 

D Topsoil Sampling (if applicable) 

D Disposal Sampling (if applicable) 

n Garden Sampling (if applicable) 

a Utility Clearance 

^ Video/Photos (Before) 

O Video/Pbotos (Daring) 

D Video/Photos (After) 

D Video/Photos (30-Day) 

' HS»«)pcrty Completion Agreemait 

It] Final Report 

Sent: / / 

Signed: ^/Xi^0 9 

Signed: ^/IU/0 9 

/ / 

/ / 

/ / 

Called: / / 

On:9_/J^/0? l 

On: / / 

On: / / 

On:__/ / 

Slgncd((Z/^/g ^ 

Issued: / / [ 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

Air Monitorine (as applicable 

O Community QCrew 

Results: 

On: / / By: 1 

O Community

ResuHs: 

 D Crew On: / / By: . 

n Community

Results: 

 D Crew | On: / / By: 

Omaha Lead Site 
• • 

Douglas Cotmty Account L|tfuT|^ion Page 1 of3 

Douglas County, Nebraska Property Record - R1522060000 

Print Report 

NEW Feature - Parcel Dimensions available (9 scale 0-50 n west of 52nd St - Vie w OH Ma p Information is valid as of 2009-8-3 Treasurer's Tax Report 

New Feature -*•*• * Auto Sales Search 

Owner 

THIRTY LLC 

3510 DODGE ST 

OMAHA NE 68131-0000 

Property Informatio n 

Key Number: 2206 0000 15 

Account Type: Residential 

Parcel Number: 1522060000 

Parcel Address: 1938 S 12 ST 

OMAHA NE 68108-0000 

Legal Description: KOUNTZE 4TH ADD SUPP LOT 7 BLOCK 6 N 1/2 30 X 125 

Value Informatio n 

Land Improvement Total 

2009 

2008 

2007 

2006 

2005 

2004 

$3,800.00 

$3,800.00 

$3,800.00 

$3,800.00 

$3,800.00 

$3,800.00 

$69,800.00 

$69,800.00 

$69,800.00 

$37,200.00 

$37,200.00 

$37,200.00 

$73,600.00 

$73,600.00 

$73,600.00 

$41,000.00 

$41,000.00 

$41,000.00 

Sales Informatio n 

Sales Date: 2007-10-31 

Deed Type: WD 1 Book: 2007 Pago; 127621 

Price: $35,051.00 

Grantor: Bank of New York 

Grantee: Thirty LLC 

Valid/Invalid: Invalid 

Exclusion Reason: Bank Sale 

Sales Date: 2007-04-25 

Deed Type: TRD Book: 2007 Page: 052462 

Price: $0.00 

Grantor: HAWK CAMILLE R 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R15... 8/22/2009 
Douglas County Account L^rn^^on Page 2 of3 

Grantee: BANK OF NEW YORK AS TR 

Valid/Invalid:

Exclusion Reason:

 \ invalid 

'• Sale to Mortgage - Bank 

Sales Date:

Deed Type:

Price:

Grantor:

Grantee: 

Valid/Invalid: 

Exclusion Reason: 

 2006-03-09 

\ WD 

! $84,000.00 

] Chad Allington 

Debra Mclntyre 

Valid 

Book: 2006 Page: 039436 

Sales Date: 

Deed Type: 

Price:

Grantor: 

Grantee:

Valid/Invalid: 

Exclusion Reason: 

2005-05-16 

WD 

 $60,000.00 

Jerry Mainelli Etal 

 Chad Allington 

Valid 

Book: 2005 Page: 057486 

Land Informatio n 

Acres 

0.08 

SF 

3750.0 

Units 

1.0 

Depth 

125.0 

Width 

30.0 

Vacant 

No 

Improvemen t Informatio n 

Building 1 

•1 pp^n^m 

^^^^S j 1=^=^1 

WM 

Wt 

1»3eS12ST 

EMIS H 

2S0SI 

•?-

FWltFlDar 

SS1ASq.Fl 

Mir *io 

ijir'iVlfVtr" 

Ranch Bir w aiotk B If 

7M.0 Sq. n 

1 CLICK TO ENLARGE IMAGE j CLICK TO ENLARGE IMAGE 

Square Footage: 856.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Fair 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R15... 8/22/2009 
• • 

Douglas County Account I: lArmation Page 3 of3 

Unit Type: 

Built As: Ranch 

HVAC: Central Air to Air 

Exterior: Frame Vinyl 

Interior: Drywall 

Roof Cover: Composition Shingle 

Roof Type: Gable 

Floorcover: Allowance 

Year Percent Year Built Remodeled Remodeled 

1900 0 0% 

Physical Age Built 

mm 

Average 

0.0 

5.0 

1.0 

1.5 

2.0 

1.0 

Block 

0.0 

Condition: 

Condo Square Footage: 

Rooms: 

Units: 

Baths: 

Bedrooms: 

Stories: 

Foundation: 

Sprinkler Square Footage: 

Adjusted Year 

1900 109 

Units 

1.0 

736.0 

400.0 

1.0 

1.0 

1.0 

1.0 

28.0 

Detail Type 

Appliance 

Basement 

Basement 

Fixture 

Fixture 

Fixture 

Fixture 

Porch 

Detail Description 

Allowance 

Bsmnt Block 8 ft 

Finished 

Additional Fixtures 

Base Fixtures 

Bath Full 

Bath Half 

Encl Screen 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl 5... 8/22/2009 
• • 

Property ID # 

Property 

Address: 

Initial Contact: 

Second Contact: 

Final Contact; 

Final Action: 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

CONTACT FORM 

\%\o\\ 

\^^ ^ % 1^ SV 

Date:

Date:

Date;

 Time: 

 Time: 

 Time: 

Transmit to EPA D 

Action: 

Action: 

Action; 

Other Action: D 
• • 

Page 1 of2 

"> 

Create Another Ticket f Back to Irth internet Send Email | 

• YOUR TICKET NUMBER IS 2367937. 

Original Call Date: 9/20/09 Time: 4:33 pm Op: ELIZABETH18790 


Work to Begin Date: 9/23/09 Time: 7:15 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 1938 Street: S 12TH ST 


Twp: 15N Rng: 13E Sect-Qtr: 27-NE-SE 


Tv/p: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: lead remediation 


Location of Work: LOCATE ENTIRE PROPERTY, ALL EASEMENTS AND TO THE PEDESTAL 


Remarks: FAX ALL CLEARS TO: (877)662-4211 


: UNSURE OF CORNER LOT 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name: ELIZABETH Phone: (877)662-4210 


Work Being Done For: coastal 


Depth of Excavation: 4ft Comer Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


ATTNEBRl CXCATV LEVEL3 MCINEB MUD02 OMAHACOF 0PPDGPR6 


PAETEC QLNNEIF 


Service Area Contact Phone Nuniber 

Utility 

Type 

ATTNEBRl ATT/T 

Day: 80024136249 

Alt: 

Emerg: 80024136249 

CXCATV COX COMMUNICATIONS, 

INC HEIDI 

Day: 4029340469 

Ah: 4029340469 

Emerg: 4029329757 

LEVEL3 LEVELS COMMUNICATIONS, 

LLC NA 

Day: 8773668344 

Ah: 

Emerg: 8773668344 

MCINEB MCI NO CALL PER MEMO 

Day:

Alt: 

 8002893427 

Emerg: 8002893427 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/20/2009 
• • 

Page 2 of2 

MUD02 METROPOLITAN UTILITIES 

DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHATRAFFIC.SEWER RON 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

OPPDGPR6 OMAHA PUBLIC POWER 

DISTRICT NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

PAETEC PAETEC COMMUNICATIONS NO NEED TO CALL OUT 

EMERGENCY 

Day: 

Alt: 

Emerg: 

8002891901 

8002891901 

QLNNE 1F QWEST LOCAL NETWORK NA 

Day: 

Alt: 

4067289343 

4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/20/2009 

• A . 18611 

Omaha Lead Site Exterior Paint North Arrow Owner Name: JERRY W MAINELLI 

Site SIcetch • Good 

• Poor 

Ef^Not paint 

Omaha Lead Site 46130 
xq??"!) S m

18611 

Omaha Lead Site Owner Name: JERRY \AnyiAINELU_ 

Site SItetch Address: 1938 S 12_ST 

Phone: .^Jlc:^iJ X 5^1 

Sampl Lead Sample e Number LAB Concentration Collected 

RYASCPXA-18611 D D 

RYBSCPXA-18611 ppm D n RYCSCPXA-18611 vX"^ ppm [Fi 

RYDSCPXA-18611 ^^\ \ ppm D ET 

RDZSCPXA-18611 J5Jli4_ppm D HT 

RGZSCPXA-18611 ppm D D 

RPZSCPXA-18611 ppm D D D 

Number of Samples = 3 

fg>c—^g-j c./'^s: 

Exterior Paint North Arrow 

• Good 

• Poor 

0^No t paint 

Samples Collected 

Firm: .-^/ f 5 

Date: 5'^-0 ^ 

Time: f- Z Y 

Samples Analyzed 

XRF Unit: ^ 1 \ Book: [^ ^ 

Date: [ o - ^ - Q ' 4 

Time: -Pf^ 

Staff on t 

S(j5ictehi&r;-Te3r5D.li. 

.ead Site 
18611 

Omaha Nortti Arrow Lead Site Exterior Paint Owner Name: JERRY W MAINELLI 

Sit • Good e Sl(etch Address: 1938 812 ST 

D Poor 

Phone. »S90'ioiJy ^ |2f^Not paint 

Sample Number Lead Sample Samples Collected LAB Concentration Collected Finn: ^ ^ ^ 

RYASCPXA-18611 n n Date: 

RYBSCPXA-ISeil D D Time: ^2r 

RYCSCPXA-18611 n Samples Analyzed RYDSCPXA-18611 

RDZSCPXA-18611 ET 

n 

n XRF Unit: ^ n Book:ua- RGZSCPXA-18611 D D Date:_ lg-Q\ -0 4 

RPZSCPXA-18611 D Time: _ 

n f i n 

Staff: Number of Samples = ,; 3 2fvp 

"<d/Vwj: 

ENTERED 

^'t/Hfp Iap4 'fei-nan 

HP ^'- ; 

9^^^ .gL^ 'aoi 

p » m. n. .$. 

<$ 

1 

'fl-iri 

s J.lo« (It 

H sl. 

Omaha Lead Site 46130 
1% COASTA L INVIROMniNTAl 

t • O U r . IH C 

Consent For Access To Property 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner) consents to and authorizes the United States 

Environmental Protection Agency (EPA) or its authorized representatives, collectively 

the Grantee, to enter and perform certain environmental response activities upon the 

following described premises: 

Owner' er'ss Name: , Daytime Phone: 

Address of Property 

covered by this 

Aflreement: 

PURPOSE OF RESPONSE ACTIVITIES 

The EPA is requesting access to collect soil samples and remove soil that contains 

elevated concentrations of lead and may pose a health hazard. The area(s) will be 

excavated to remove contaminated soil. The removed contaminated soil will be 

replaced with clean materials and the area will be restored to its original condition. 

This work is being performed under the Omaha Lead Superfund Site remediation 

program. 

A representative of Coastal Environmental Group, contracted by USEPA. will contact 

the Grantor in-person to discuss the work to be performed, the Grantor will have an 

opportunity to review and approve the planned soil removal, and restoration v^rk 

before it begins. Once the work Is finished, the Grantor will be asked to review the 

work and confirm that it is complete and meets with the Grantor's approval. Upon 

completion, the Grantor will receive written documentation from EPA that the property 

has been remediated. 

ENVIRONMENTAL RESPONSE ACTIONS 

By signing this Access Agreement, the Grantor is granting the EPA, its employees, 

contractors and subcontractors the right to enter the property, at all reasonable times 

and wnth prior notice, for the sole purpose of performing the work. This access shall 

remain in effect until the work has been satisfactorily completed. The Grantor also 

agrees to: 

Page 1 of 2 
rf*^'^, 

^ 1 COASTA l 

6 • 0 U r. lh c 

• Remove obstructions Including boats, trailers, vehicles, playscape items, wood 

piles, dog houses, etc; 

• Remove flower bulbs or plants that the Grantor or the Grantor's tenant may wish 

to save; 

• Water and maintain replacement vegetation, including fertilizer application, as 

necessary subsequent to an initial watering period by EPA; 

• Abide by health and safety guidance provided by EPA; 

• If the property is rented, assist EPA in obtaining tenant approval for access to 

the property to perform the work. 

• Allow videotaping and/or photographing of the property. 

AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to interfere or tamper with any of the work activities, or with any 

of the work done, or wih the equipment used on his property, or to undertake any 

actions regarding the use of said pntperty v^ich would tend to endanger the health or 

welfare of the Grantees or the environment, or to allow others to use the property in 

such a manner. 

Should you have any questions about this program, please contact Coastal 

Environmental Group, at (712) 352-0188 

I grant access to my properties 

D I do not grant access to my properties 

W g ^ 

Signature Date Signature 

Date 

Q I would like to be present during any sampling that is required. 
# 

COASTA L 

RestoratioFi Agreement 

The purpose ofthls agreement is to provide a mutual agreemem as to conditions ofthe property prior to 

remediation activities. This will also serve as documentation for the purpose of assuring that restoration 

activities are completed to the satisfaction of the property owner and the United States Environmental 

Protection Agency (EPA). 

Property ID: fd^j/ 

Property Address: M ? <^ 5~7 ^ "^ ^ 

(Owner: -^^^ ^{1.-\L^ Uj y 

^^^'^^ ^ 

On the attached diagram(s) indicate area(s) to excavate, surface structures and landscaping features and 

access location(s) to be used by the contractors. Indicate distances, depths, material types, etc. 

Photographically and Videographically document the existing conditions ofthe property and the basement if 

necessary. 

Items to be Removed by the Owner before Start of Remediation: 

The lenoval. stora.qe. disposal. :and/or return of these items is the Owners responEibiiity. 

Item: 

Item: 

Items to be Removed by the Contractor During Rejgiediation and IVJot Replaced 

Item: ^ > ^- J " - / 

.T ^--vap-v^Z- ^ 

ttem: 

Item: 

Item: 

Pagel of £_ 
COASTA L 

Items to Be Removed By Contractor Durinfi Remediation and R6placed_ 

Item: 

^X)\\^ ^ h \ , 6 ^ I ^ ^ -¥ item: 

^^h XA ]^ l . P' ^ 

Kem: 

Item: 

l^andscape Inventory 

Item Conditloii/Type/Species 

Pre-existing propeity area, Quadrants that will be excavated, that 

is covered vrith grass. 

Number of trees > 2 inch 

trunk diameter 

Number of trees <= 2 inch 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Aiiat h n sKeich ol the 

'•rr'i'klv.'i iiniui ; 

Number of and size of 

each garden/ flower bed Eacfa 

area. Square Feet 

AlliRh ;i skclch ol rL-!:ilivc 

M/fS.nnd loc;iiiivi-. 

Agreed upon value of plant 

materials not to be 

replaced by contractor. 

Ncl»' Ihi ' > Hliic »MI I nt 

USI'L' 10 i5;u< .! n\-A\y\ 

»QiJi:Iio; ((' the iiropcrl \ 

()>wn;r. 

Easement Area, to be / ? ^ excavated M 

y 

Page 2 o, ^ 
u^ 

C O A S 1 A L 

C » O U r , IN C 

! Additional Comments / Instructions: 

L. 

[ J Check the box If Owner does not want CEG to document interior foundation walls and possible 

pre-existing damage. By checking this box CEG is not responsible for any damage done to the 

interior of house, including foundation cracks or fissures. 

d ] I do not agree 

'(MMJ ^ Mulof 

Owner's Signatnre CoiUractor's Signature Date 

Page 3 of \ 
BVID# /^(B.! ! 

XRF PROPERTY SAMPLE SHEET 


Date 

Project 

XRFID# 

__Shot# 

m±sL T^^y 

fO^Ci> 

Average

Shot# 

ii61 

Average

Shot# 

Average 

Shot# 

Average 

lab sample # 

^B3h^ 

Address 1^3^ 5^ /Z s r 

Omatia lead FP 2nd year opilon Sample time am/pm 

sample length 30 sec 

Reading Sample area Shot# Reading Sample area 

Ih/ ^ l=h <CA-

13. D? ^ 

/n6^ ^ 

Depth 

% Depth /(Hr> 

2k. Mot R 

4/z±L. -ti . •f­ I

 M J ((f, Average "^TX P —I n 

Reading Sample area Shot# Reading Sample area 

% aV^ jr 2^/" i ^? 

Ji2 ­

1 :^ ^ M 

-Z/i. 7^^^- -Jt ^2- B ^ 

t3epth g •J ^ 

_ Z2 Depth 

-i^L M ^ .Z2 . ./i 

^ 3 S"-^ <^if Average 7.A^^2^ I 

Reading Sample area Shot* Reading Sample area 

Depth Depth 

Average 

RETEST AREAS 

Reading Sample area Shot* Reading Sample area 

Depth 

Depth 

Average 

Lab result Sample area XRF Avg. 

Signature mi. 

Px\n 

ll\i^^\iMmiK 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Supervised By: 

Certificate of Verification 

14 

SOIL 

2009-11-25 10:44 

122.45 

Final 

Avg of 10-13 

1938 s 12 st 

B2 

13" 

R. VENTRY 

clearence 

ngnc 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration. 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 245.953 

Supervised By: 

Certificate of Verification 

10 

SOIL 

2009-11-25 10:42 

30.63 

Final 

18611 

1938 s 12 st 

B2 

13" 

R. VENTRY 

clearence 

ngnc 

± Error 

± 20.550 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 277.428 

Supervised By: 

Certificate of Verification 

11 

SOIL 

2009-11-25 10:43 

30.60 

Final 

18611 

1938 s 12 st 

B2 

13" 

R. VENTRY 

clearence 

ngnc 

± Error 

± 21.576 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 293.101 

Supervised By: 

Certificate of Verification 

12 

SOIL 

2009-11-25 10:43 

30.66 

Final 

18611 

1938 s 12 st 

B2 

13" 

R. VENTRY 

clearence 

ngnc 

± Error 

± 22.068 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 284.046 

Supervised By: 

Certificate of Verification 

13 

SOIL 

2009-11-25 10:44 

30.56 

Final 

18611 

1938 s 12 st 

B2 

13" 

R. VENTRY 

clearence 

ngnc 

± Error 

± 21.727 
i ^A 7 % Omaha Lead Site—Fixed Price EP-R7-07-05 m Coastal Environmentai Group Inc. 

^ www.coastalhazmat.com 

'•"tpRoi*^ COASTAL illVIIOIIHINTAl S IO U P. IN C 

EXECUTIVE SUMMARY: 

BVID # 18611-(1938 S 12 ST) 

No Issues or Concerns Q Issues/Concerns 

Detail Explanation: 
4 ^ E 

il 

EPA Property Close Out Form 

Property #: \Z)\ol i . . Property Addrvss: l^?>f i V U 

^d -

DatcH'Imc: Owner's Nane:. .fLl3n^tyi)^'-^x' . 

Quad Contractor Group /Tt/mf^ A s Excavated; g>) j fi7^ y ^ 

Yes No Excavation General 

I. If necessaiy, were the correct qiiadrant(s) excavated and restored? 

CX' 

2. If necessary, were the correct areas ofdrip zone excavated and restored? 

cy ' 

Gmdlng Yes

 ,No Sod and Vegetation 

1. Does the grading around the perimeter ofthe house in excavated areas generally slope away TTT from the house? 

2. Has sod been laid in all areas that were excavated? 17' 

3. Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 1 / 

day time period) 

4. Are sodded areas generally firm and evenly graded? 17' 

5. Are the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day // ^ 

time period) 

6. Was the property graded such that water will not pool on the propert>'? ly 

7. Was danuge to landscaping or plant malerials avoided? P" 

Gates, Fences and Retaining Walls 

Ves /io 

1. Oo gates open and close freely? (Ifapplicable) 

2. Were all gates or fences taken down during restoration activities reinstalled? (Ifapplicable) 17" 

3. Was damage to gates or fences avoided? (Ifapplicable) IP'­

4. Was damage to retaining walls avoided? (Ifapplicable) ( / 

Foundation, Siding and Gu»er» 

Yes No 

t. Was damage to the siding or trim avoided? 

2. Was damage to the foundation avoided? 17^ 

Was damage to windows avoided? 17^ 

4. Was damage to windows or door sCTeens avoided? 

5. Was damage to downspouts or downspoul extensions avoided? 

Sidewalks and Driveways (Concrete) 

Ycs^ No 

1. Was damage lo driveway surfaces avoided? 1 / 

2. Was damage to walkway surfaces avoided? -7­
Owners comments: 

iDspection notes: 

Removal and resloration activates complete including the 30-day sod vyarranty: 

EPA Representative / /7K .lj/;//i ^ ^ Date:/Q 
Property Completion Agreement 

riiis agrcemeni documents the complclion of remedial activilies perrorineci on my properly. My sigi«ilure 

will designate lhat I am salislied wilh the restoration of my properly, and thai no items are in qucstion.s, 

now, or at any time in the future, except those ilems listed below, ifany. 

PiopcityU): 1<S(^[\ 

Proprrty Address: |<?3 ? S 13 ^ ^- f 

Owner: -tV . f-4-V | UU L 

Phone: *^o3i-S^)o-<445 4 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: ZJ 

Additional Comments: 

.J 

I agree rr.storation is complded, except as noted 

I nol agree rejiUnrntion is; completed 

Contrnetur's- Siirnaturo Date