### TRANSMITTA Lo f OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R SAID # : l^^H ^ Date : l2--5i-n ^ Address : ^8b O lA3r\ah^ ' ^ ^ Remediatio nContractor : Coasta l Environmenta l Group

_Year : 200 8 SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S Vide o o f property (DVD ) H

/ Executiv e Summary 0 EPA-provide dproperty sketc h V Signe dAcces s Agreemen t fo r subjec t property f?|| T Signe dAcces s Agreement(s ) fo r adjacent property ^ Restoratio nAgreemen t iM M Settlemen t document s (i.e. , fo r damag e or t o replac e plants , etc. ) ^ Confirmatio ndat a. 

## 1 /

Photographs T^fe^'t)C(iaA)( m(> nGjc/yiJa:^L>/l so A^ r\t ^ 'So d y As-buil t sketc h S Satisfactory restoratio nsigne db y Property Owne r M Property close-ou t chec k lis t signe db y EPA |¥| nDescriptio no f area s no t meetin g RO D cleanu p criteri a H Utility clearance s ^ Propert y informatio nfro mDougla s County Assessor' s Offic e

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^"•"^^'Woh A T Address : ^^^ ^ ^(^hnfiu\< ^ Renter : Phone : j Fax : Ph«"^"^55C.-13c ^ Fax : Cell/Pager : Additiona l lut'ormation : Cell/Pager : O y 1— . I/ ] ni l

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Omah a Lea d Sit e

## CONTAC T FOR M Property ID # 

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### Dougla s County Accoun t InfoMaation Pag e 1 of 2 Dougla s County , Nebrask a Propert yRecor d - R121575000 0 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t o f90tt i S t - VleWO n Ma p Informatio n i s vali d a s o f2008-7-1 4 Treasurer' s Ta xRepor t Ne wFeatur e -•-•- • Aut o Sale s Searc h Owne r YESHNOWSK I JOH N ETA L 386 0 WRIGH TS T OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumber : 157 5 000 0 1 2 Accoun t Type : Residentia l Parce l Number : 121575000 0 Parce l Address : 386 0 WRIGH TS T OMAH AN E 68105-000 0 Lega l Description : GRAN TPLAC E LOT3 6 BLOC K4 5 0 X 12 4 Valu e Informatio n Lan d Improvemen t Tota l 200 8 $14,000.0 0 $80,600.0 0 $94,600.0 0 200 7 $14,000.0 0 $80,600.0 0 $94,600.0 0 200 6 $14,000.0 0 $76,000.0 0 $90,000.0 0 200 5 $14,000.0 0 $76,000.0 0 $90,000.0 0 200 4 $6,400.0 0 $84,800.0 0 $91,200.0 0 200 3 $6,400.0 0 $84,800.0 0 $91,200.0 0 Sale s Informatio n Sale s Date : 2005-05-3 1 Dee d Type : W D Book : 200 5 Page : 06568 8 Price : $90,000.0 0 Grantor : Mil o AKarni k eta l Grantee : Joh n TYeshnowsl< i eta l Valid/Invalid : Vali d Exclusio n Reason : Lan d Informatio n



### 7/3 

# A/ . Acre s S F Unit s Dept h Widt h Vacan t 0.1 4 6200. 0 1. 0 124. 0 50. 0 N o Improvemen t Informatio n 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R12. . .

### Pougla s County Accoun t Infc^^tio n Pag e 2 of 2 

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## 1 1/ 2 STORYFINISHE D CLIC KTO ENLARG E IMAG E Squar e Footage : 1292. 0 Percen t Complete : 100.0 % Perimete r0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 1 1/ 2 Stor yFi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 6. 0 Exterior : Fram e Sidin g Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo fCover : Compositio n Shingl e Bedrooms : 3. 0

Roo fType : Gabl e Stories : 1. 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 192 4 0 % 192 4 8 3 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 912. 0 Basemen t Outsid e Entranc e 1. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 308. 0 Porc h Sla b Roo fCei l Garag e Detache d 160. 0 20. 0 Use r Atti cFul l Finis h Porc h Sla b Roo fCei l 380. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R12. . . 7/31/200 8Pag e 1 o f 1

Creat e Anothe rTicke t Bac k t o Irt h Interne t Sen d Emai l
YOU RTICKE T NUMBE RI S 2108732 . Origina l Cal l Date : 8/16/0 8 Time : 1:0 6 p mOp : ELIZABETH1879 0 Wor k t o Begi n Date : 8/20/0 8 Time : 7:1 5 a m State : N E County : DOUGLA S Place : OMAH A Address : 386 0 Street : WRIGH T S T Twp : 15 NRng : 13 E Sect-Qtr : 29-SE,32-N E Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : lea d remidiatio n Locatio n o f Work : LOCAT E ENTIR E PROPERT Y AL L TH E WA Y T O TH E STREET . Remarks : FA X AL L CLEAR S TO : (877)662-421 1 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 h o f Excavation : 4f t Corne r Lot : N Front : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V MUD0 2 OMAHACO F 0PPDGPR 6 QLNNEI F

Servic e Are a Contac t Phon e Numbe r Utilit y Typ e Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , IN C HEID I Alt : 402934046 9 Emerg : 402932975 7 Day : 402504782 3 MUD02 METROPOLITA N UTILITIE S DISTRICT SANDY Alt : Emerg : 402504794 6 Day : 402444719 7 OMAHACOFCIT Y O FOMAHA-TRAFFICSEWERRO N Alt : 402444516 1 Emerg : 402444516 0 Day : 406728934 3 0PPDGPR 6 OMAH A PUBLIC POWE RDISTRICT N A Alt : 888728934 3 Emerg : 406728934 3 Day : 406728934 3 QLNNEIFQWES T LOCA LNETWOR K

N A Alt : Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 8/16/200 8

# As-Buil t Drawin g COASTA L 

# Omah aLea dSuperfun dSit e

Name : .'^'l i I t }u,t.ii k Address : '^i(,t D LU'ff^jf - S-f Phon e HcZ - ^•^o'-(jri9 ^ Omah a Lea d Sit e Sit e Sketc h Date : f^-/<'^o' ? Time : / 2 2. 9 

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## ^ , .^ . — N o c C >— ' NO ^- V ^Ye s ° • . N o " ^ pp m rJZYe s S ^ N o O pp m Ye s O N o Q pp m Ye s • N o • Lab RDZSCPLA-1554 8 Resul t 240 0 pp m



# H -rV i^^^ tName : .-^7/ /< i • kat^uk . ' ^ 0( n ah a Lea d Sit e Date : f^-/^-^" ? Nort h Arro w— i Address : '^^(st D LL U M^|'Sf Sit e SIcetc h Time : iZ''Z 9 Phone : V^^rZ- - S'^G'-^JJ^'J ^ 

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## N o 2 ^ pp m !52Ye s 5 ^ N o 1 3 N o ^ pp m pp m Ye s n N o a pp m Ye s • 

### N o • Lab RDZSCPLA-1554 8 Resul t 240 0 pp m



# ^^(A^ l \iofMi^ ,Name : .^^ i U IUyn->i k Omah a Lea d Sit e Date : fr-/^-^^" ? Nort h NrxQ M Address : '^d O Lu<.f9^l - S f Sit e Sketc h Time : gZ-' ^ Phone : HcZ- ^ 5^5-6//yO W 

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### Consen t Fo rAcces s T o Propert y RIGH TO F ENTR YT O PREMISE S 

### Granto r(th e propert yowner ) consent s t o an d authorize s th e Unite d State s Environmenta l Protectio n Agency(EPA ) o rit s authorize d representatives , collectivel y th e Grantee , t o ente ran d perfor m certai n environmenta l respons e activitie s upo n th e followin g describe d premises :

Owner' s Name : Daytim e Phone :

Addres s o fPropert y 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 tha t contain s elevate d concentration s o flea d an d maypos e a healt h hazard . Th e area(s ) wil l b e excavate d t o remov e contaminate d soil . Th e remove d contaminate d soi l wil l b e replace d wit h clea n material s an d th e are a wil l b e restore d t o it s origina l condition . Thi s wor k i s bein g performe d unde rth e Omah a Lea d Superfun d Sit e remediatio n program . Arepresentativ e o fCoasta l Environmenta l Group , contracte d b yUSEPA , wil l contac t th e Granto rin-perso n t o discus s th e wor k t o b e performed , th e Granto rwil l hav e a n opportunit yt o revie wan d approv e th e planne d soi l removal , an d restoratio n wor k befor e i t begins . Onc e th e wor k i s finished , th e Granto rwil l b e aske d t o revie wth e wor k an d confir m tha t i t i s complet e an d meet s wit h th e Grantor' s approval . Upo n completion , th e Granto rwil l receiv e writte n documentatio n fro m EP Atha t th e propert y ha s bee n remediated . ENVIRONMENTA L RESPONS E ACTION S 

### Bysignin g thi s Acces s Agreement , th e Granto ri s grantin g th e EPA , it s employees , contractor s an d subcontractor s th e righ t t o ente rth e property , at al l reasonabl e time s an d wit h prio rnotice , fo rth e sol e purpos e o fperformin g th e work . Thi s acces s shal l remai n i n effec t unti l th e wor k ha s bee n satisfactoril ycompleted . Th e Granto rals o agree s to :
Pag e 1 o f2

# m i COASTA L EHVIROMMENTA l CROUP
. IN 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
I gran t acces s t o m ypropertie s D I d o no t gran t acces s t o m ypropertie s


## 5 0 ^ ignatur e \ 1 Date Signatur e Date
OI woul d lik e t o b e presen t durin g an ysamplin g tha t i s required .COASTA L 

## Restoratio n Agreemen t Tiie purpos e ofthi s agreement i s lo provid e amutua l agreement a s t o condition s of tiie propert y prior to remediatio nactivities . Thi s will als o serv e a s documentatio nfo r the purpos e o f assurin g tha t restoratio n activitie s ar e completedt o th e satisfactio nof the propertv ' owne r an dthe UnitedState s Environmenta l ProtectionAgenc y (EPA) . Propert y ID : 

# " W Propert yAddress : %% C ' } '6^ V \hlhCA\k f^ 

### Owner : -J^y ^ ?^^NloV»t^ | Plione : 

## L/o L^W'^jnc ? O

nthe attache ddiagrain(s ) indicat e area(s ) t o excavatedan ddept hof excavation , locationof al l know n utilities , subsurface featines , sgrface structure s an dlandscaping features , acces s location(s ) t o b e use db y contractor , an dth e directionof North . Indicat e distances , depths , materia l types , etc . Indicat e digita l photo s b

y referencin g th e photo-lo g numbe r wit ha narrow indicating directionof 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 . Item : 

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Pag e 1 of
. 

# -ACOASTA L FKivlNONriCMTA L cn O U P . ) M C 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 : J • Item : Kem : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item :

Pag e 2 

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COASTA L • ••VlROMMCWTA L C
. H O U rIN C 

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Pag e 3 of
.COASTA L Landscap e Inventor y (Us e additiona l sheet s a s necessary ) 

## Ite m

Pre-existin g propert y area , tha t will be excavated , tha t i s covere dwit hgrass .

Number of tree s > 2 inc h trun k

diameter

Numbe r of tree s < = 2 inc h trun k

diameter

Number of Sprinkler Zones , Contro l Valves , Timers , Heads , etc . Attachasketcho f the sprinkler layout .
Number of an dsize o f eac hgarden / flowe r bed area . Attachasketcho f relativ e size s an dlocations . 

## Quantit y 

# h 9 

# f f y 

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### Ite m Agree dupo nvalu e o f plan t material s no t to b e replace dbv contractor . Not e thi s \alu e will b e usedto issu e aplan t vouche r to th e propert y owner . Agreedupo nlis t o f plan t material s tha t will be replace db y contractor . B e ver y specifi c an ddetailed . Include asketchof wer e eac hplan t wil l be place d b

y th e contractor . Agreedupo nare aof propert y t o b e replaced wit hgras s sod . Include asketcho f the area(s ) to b e replace dwit h gras s sod . Are ao f Cit y o r Count y propert y to be landscaped per thei r requirements . Include asketchof the aie a(s )

Easement Area , to be excavate d 

### Quantit y 

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^ Pag e 5 of
. iC O AS T A1 . • MVUKOCMCMTA L 

### Additiona l Comments / Instructions :



## " % f \Mh > ^(Vfv ? <* nG>c.-jt^,- f 

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



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# 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 300 0 Mod e SOI L Tim e 2008-08-2 6 11:0 1 Duratio n 121.8 0 Sequenc e Fina l Flag s AVERAG E *^Av g o f2996-299 9 ADDRES S 386 0 Wrigh t s t QUAD/ZON E fD Z INSPECTO R ^PE Z DEPT H SAMPL E TYP E (CLEARANC E NOT E
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# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

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pp m P b 36.78 3 Supervise d By : 

## Certificat e o fVerificatio n
299 6 SOI L 2008-08-2 6 10:5 9 30.5 9 Fina l 1554 8 386 0 Wrigh t s t D Z LOPE Z 1 2 CLEARANC E

±Erro r ±8.88 7

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

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pp m ±Erro r P b 28.23 0 ±8.26 9 Supervise d By :

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

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pp m P b 49.20 1 Supervise d By : 

## Certificat e o fVerificatio n
299 8 SOI L 2008-08-2 6 11:0 1 30.3 3 Fina l 1554 8 386 0 Wrigh t s t D Z LOPE Z 1 2 CLEARANC E

± Erro r ± 9.87 5

# 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 Pr'P E NOT E
pp m P b 43.29 2 Supervise d By : 

## Certificat e o fVerificatio n
299 9 SOI L 2008-08-2 6 11:0 1 30.3 2 Fina l 1554 8 386 0 Wrigh t s t D Z LOPE Z 1 2 CLEARANC E

± Erro r ± 9.50 2

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 300 5 Mod e SOI L Tim e 2008-08-2 6 11:0 5 Duratio n 121.6 5 Sequenc e Fina l Flag s AVERAG E I Av g o f3001-300 4 ADDRES S 386 0 Wrigh t s t QUAD/ZON E INSPECTO R LOPE Z DEPT H 

## P| 6 SAMPL E TYP E CLEARANC E NOT E

Supervise d B y

# 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 15.81 6 Supervise d By : 

## Certificat e o fVerificatio n
300 1 SOI L 2008-08-2 6 11:0 3 30.1 0 Fina l 1554 8 386 0 Wrigh t s t F 2 LOPE Z 6 CLEARANC E

± Erro r ± 7.12 3

# 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 PI'P E NOT E
pp m P b 16.35 5 Supervise d By : 

## Certificat e o fVerificatio n

300 2 SOI L 2008-08-2 6 11:0 4 30.3 4 Fina l 1554 8 386 0 Wrigh t s t F2 LOPE Z 6 CLEARANC E

± Erro r ± 7.09 4

# 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 PI'P E NOT E
pp m P b 24.18 3 Supervise d By : 

## Certificat e o fVerificatio n

300 3 SOI L 2008-08-2 6 11:0 4 30.6 0 Fina l 1554 8 386 0 Wrigh t s t F 2 LOPE Z 6 CLEARANC E

± Erro r ± 7.93 5

# 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 20.23 5 Supervise d By : 

## Certificat e o fVerificatio n

300 4 SOI L 2008-08-2 6 11:0 5 30.6 1 Fina l 1554 8 386 0 Wrigh t s t F2 LOPE Z 6 CLEARANC E

± Erro r ± 7.45 2

### y^^l'"-^ ^ f^l^' o Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 (fiS ^ l^^^v^f Coasta l Environmenta l Grou p Inc . \^^ ^ \^^^p * www.coastalhazmat.co m "iPBo^* ^ COASTA L ENVIItONHENTA L C R 0 U F , INC 

# EXECUTIV ESUMMARY : BVI D #1554 8 - (386 0 WRIGH T ST ) I I N o Issue s o r Concern s ^ Issues/Concern s Detai l Explanation : IT APPEAR S THA T P O HA S MOVE D SO D FRO M D ZAREA S T O WES T O F DRIVEWAY .

## ^> t 

# EP A EP APropert y Clos e Ou t For m Propert y# : IS'5'M ^ Propert yAddress : Sf/^c ) S/d^ClYj ^ S 4 Date/Time : Owner' s Name : .V^hr- ) N f.SU^fjoo.<^lr^ " Quad s Excavated : F t F a S^ j Contracto rGrou p CrO/jf, ^

g,^l/'0n(0T<»n.4< M Excavatio n Genera l Ye s N o 1 .

I fnecessary , wer e th e correc t quadrant(s ) excavate d an d restored ? t ^ 2 .I fnecessary , wer e th e correc t areas o fdri p zon e excavate d an d restored ? ^ Gradin g So d an d Vegetatio n Ye s N o I .

Doe s th e gradin g aroun d th e perimete ro fth e hous e i n excavate d area s generall yslop e away fro m th e house ? L ^ 2 .Ha s so d bee n lai d i n al l areas tha t wer e excavated ? u ^ 3 .

Doe s th e so d appea rt o b e generall yhealth yan d growing ? (Onl yevaluat e i finspecte d a t a 3 0 da ytim e period ) 4 .Ar e sodde d area s generall yfui n an d evenl ygraded ? t - ^ 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 tim e period ) 6 .Wa s th e propert ygrade d suc h tha t wate rwil l no t poo l o n th e propertv ? 

### y 7 . Wa s damag e t o landscapin g o rplan t material s avoided ? 1 ^ Gates , Fence s an d Retainin g Wall s Ye s N o I . D o gate s ope n an d clos e freely ? (Ifapplicable ) ly ^ 2 .Wer e al l gates o rfence s take n dow n durin g restoratio n activiiie s reinstalled ? (Ifapplicable ) ty ^ 3 .

Wa s damag e t o gate s o rfence s avoided ? (Ifapplicable ) l ^ 4 .

Wa s damag e t o retainin g wall s avoided ? (Ifapplicable ) 

## A/ A Foundation , Sidin g an d Gutter s Ye s N o 1 .

Wa s damag e t o th e sidin g o rtri m avoided ? Ly ^ 2 .Wa s damag e t o th e foundatio n avoided ? * ^ 3 .

Wa s damag e t o window s avoided ? i ^ 4 .Wa s damag e t o window s o rdoo rscreen s avoided ? ^ 5 .Wa s damag e t o downspout s o rdownspou t extension s avoided ? l ^ Sidewalk s an d Driveway s (Concrete ) Ye s N o 1 .

Wa s damag e t o drivewa ysurface s avoided ? U ^ 2 .Wa s damag e t o walkwa ysurface s avoided ?

## . O.Kner s comments :

Remova l an drestoratio nactivate s complet e includin g th e 30-da y so dwarranty : EPARepresentaW^;^^.^^;^,^ ^ Date : 9/9/y y

## Propert yCompletio n Agreemen t Ihi s agreemen l documeni s th e completio no f remedia l activitie s peri'orme do nm y property . M y signatur e will designat e tliat I a msatisfie dwit hth e restoratio no f my property , an dthat n o item s ar e i nquestions , now , o r at an y tim e mth e fuiure , excep t thos e item s liste dbelow , ifany . Propert y ID : i C~^ ^ ^ 7.^erty~Address: " y^^ ^ \ ^ ^ j Cf/f T ^7 ^ Owner : \^\^ ^ J yg^ ^ ^ , ^ J K

I Phon e 

# • rf 6 -y } 

# M ~ Restoratio n Item s i n Question :

Item : Item : Item : Item : Item : Item :

>f\ J I agre e restoratio n i s completed , excep t a s nole d L I I d o no l ayie crestoratio n i s complete d

vwiit'r' s SignaHir * Dat e C'tmtiaclor' s Signatur e Daf e /