### # 

## TRANSMITTALof OMAHALEAD SITE SOI LREMEDIATIO NFIL EFOLDER
SA1D# : ^^V^ \ Date : 

# w 

# i M
Address : Kp-^ l OUl O ^J ^ Remediatio nContractor : _Coasta l Environmenta l Grou p Year : 2010ARR A
SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCIIMENT S Vide o o f property (DVD ) Executiv e Summar y EPA-provide dproperty sketc h Signe dAcces s Agreemen t fo r subjec t property

- & Signe dAcces s Agreement(s ) fo r adjacent property 

## B f Restoratio nAgreement Settlement document s (i.e. , fo r damag e or to replac e plants , etc. ) -& ' Confirmatio ndat a



# Z Photograph s m^CMPT^Q ^ 

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# 1/ Satisfactory restoratio nsigne db y Property Owne r 

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Signatur e Dat e
3026101 7 

# 1 1 Superfun d

# i^J Propert yAcces s Checklis t Property ID : ')j\()C \| D WOR K STARTE D ON : / /_ D WORKCOMPELTE D ON : / / Propert y Addrcs
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• Video/Photo s (During ) On : / / By : D Video/Photo s (After) On : / / By : D Video/Photo s (30-Day ) On : / / By : O Propert y Completio nAgreemen t Signed : / / By : D Final Report Lssued : / / By : 

# .y Ai rMonitorin g (a s applicable )
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Omah a Lea d Sit e

### Dougla s Coimt y Accoimt Ii^jtamatio n Pag e 1 of 2

t^Mm a % Dougla s County , Nebrask a Propert yRecor d - R021017000 0 Prin t Repor t Vie wInteractiv e GI S Ma o Informatio n i s vali d a s o f2010-8-3 0 Treasurer' s Ta xRepor t Ne wFeatur e - » - > ^ Subdivisio n Sale s Searc h Owne r THOMPSO N D L
168 2 WHITMOR E S T OMAH AN E 68112-000 0 Propert yInformatio n Ke yNumber : 101 7 000 0 0 2 Accoun t Type : Residentia l Parce l Number : 021017000 0 Parce l Address : 150 3 OHI O S T OMAH AN E 68110-000 0 Lega l Description : LAND S SEC-TWN-RG E 10-15-1 3 W5 8 FTSU B LT7 TAX LT8 & E 5 8 W38 8 F T TAXLT 9 Valu e Informatio n
201 0 200 9 200 8 200 7 200 6 200 5 Lan d $500.0 0 $500.0 0 $500.0 0 $500.0 0 $500.0 0 $500.0 0 Improvemen t $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 Tota l $500.0 0 $500.0 0 $500.0 0 $500.0 0 $500.0 0 $500.0 0 Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.2 1 9280. 0 0. 0 160. 0 58. 0 Ye s



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R021.
. . 9/3/201 0

### Dougla s County Accoun t Informatio n Pag e 2 of 2



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. . 9/3/201 03/31/201 1 www.dhon.org/lrthintemet/DHONNotic.. l

# t Creat e Anothe rTicke t Bac k 

## ^Wt l h Intemet Sen d Emai l



## • YOU RTICKE T NUMBE RI S 2700066
. Origina l Cal l Date : 3/31/1 1 Time : 1:1 8 pm Op : ALFONSO1879 0 Wor k t o Begi n Date : 4/04/1 1 Time : 1:4 5 p m State : NE County : DOUGLA S Place : OMAHA Address : 150 3 Street : OHI O S T Twp : 15 NRng : 13 E Sect-Qtr : 10-SE-S W 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 : (402)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 MCINE B MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C


## Utilit y Servic e Are a Contac t Phon e Nunibe r 

## Typ e Day : 402934046 9 

## CXCATV CO X COMMUNICATIONS , IN C HEIDI AH : 402934046 9 Emerg : 402932975 7 Day : 800289342 7 

## N O CAL LPER MCINEB MC I Alt : 

## MEM O Emerg : 800289342 7 Day : 402504782 3 

## METROPOLITA NUTILITIES MUDO l 

## SAND Y MU D Ah : 

## DISTRIC T Emerg : 402504797 0 Day : 402444719 7 CITY O FOMAHA

- OMAHACO F RICH/TRAFFIC Alt : 402444516 1 TRAFFICSEWE R Emerg : 402444516 0 dhon.org/irthlnternet/.../MessageText.as..

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# t Day : 406728934 3 : POWE R „ 

## OPPDGPR 5 °'^TM''°'TM ^ EL M LOCATIN GM : 4062071494 Emerg : 888728934 3 Day : 406728934 3 QLNNEIC QWEST LOCA LNETWOR K

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. 2/ 2

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## Consent ; fo rAcces s T o Propert y RIGH TO F ENTR YT O PREMISE S 

### Granto r(th e propertyowner ) consent s t o an d authorize s th e Unite d State s Environmenta l Protectio n Agenc y(EPA) o 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 :

Ov)(fiei;^s/Name : Daytim e Phone : 

# <!Z^

- y - ^zi/f }

Addres s o fPropert y covere d b ythi s 

# / 3 OZ ? 

# o l i o j' T Agreement ;
PURPOS E O F RESPONS E ACTIVITIE S 

### Th e EPAi s requestin g acces s t o collect soi l sample s an d remove soi l tha t coritain s elevate d concentration s o flea d an d maypos e a healt h hazard

. Th e area(s ) w/il 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 rnaterial s an d th e are a wil l b e restore d t o Iti 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 rennediatio n program . Arepresentativ e ofCoasta l Environnrienta l Group , contracte d byUSEPA , v^l l contact th e Granto rin-perso n t o discus s th e wor k t o b e performed , th e Granto rvyil l have a n opjjortunit yt o revie wan d approv e th e planne d soi l remoyal , an d restoriatio 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 v^t h th e Grantor' s approval

. Upo n completion , th e Granto rwil l receiv e vvritte h documentatio n fro m EP Atha t th e property ha s 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 , contractors an d subcontractors th e righ t t o ente rth e property , a t al l reasonabl e time s an d wit h prio rnotice , fo rth e sol e purpos e o fperformin g th e work

. Thi s acces s shal l remai n i n effect unti l th e wori t ha s bee h satisfactoril ycompleted

. Th e Granto rals o agree s to :

Pag e 1 of2COASTA l
ct i a u rIM C


### e 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 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 ; cAbid 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

. c . 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 intierfer e o rtampe rwit h an yo fth e wor k activities , o rwit h an y o fth e wbri < done , o rwit h th e equipmen t use d o n hi s property , o rt o undertak e an y action s regiardin g th e us e b fsai d propert ywhic h woul d ten d t o endarige 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 Environrttefita l Group , a t (402 ) 991-119 9

^

I gran t acces s t o m ypropertie s G t d o no t gran t acces s t o mypropertie s

Signature Signature Dat e

D I wotil d lik e t o b e presen t durin g an yisampltn g tha t i s required

.

Page 2 o f2COASTA L CMVinOMHCMTA L CROUP , IMC

. 

## Restoratio n Agreemen t Th e purpos e o f thi s agreemen t i s t o provid e amutual agreemen t a s t o condition s o f th e property prio r t o remediatio nactivities
. Thi s wil l als o serv e a s documentatio nfor th e puipos e o f assurin g that restoratio n activitie s ar e complete dt o th e satisfactio no f th e property owne r an dth e Unite dState s Enviroiunental Protectio nAgenc y (EPA)
.

Property 

# ID : 

# 29^? / Property Address : / y~ 0 j , 

# o- s r zyk ) Owner :

. Tko-T/ ^ af al/ J 

### Pc^-r \ I^C \ 

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. O nth e attache ddiagram(s ) indicate area(s ) t o excavate , surfac e structure s an dlandscapin g feature s an d acces s location(s ) t o b e use db y th e contractors . Indicate distances , depths , material types , etc . Photographicall y an dVideographicall y document th e existin g condition s ofth e property an dth e basement i f necessary . 

### Item s t o b e Remove d b yth e Owne rbefor e Star t o fRemediation : Th e removal , storage , disposal , and/o rretur n o fthes e item s i s th e Owner' s responsibility

.

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## 5 ^ \ \ Item : 

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### Landscap e Inventor y Ite m Quantit y Uni t Condition/Type/Specie s Pre-existin g property area , 

## ^I,f3 ^ Quadrant s tha t wil l b e excavated , tha t i s covere dwit hgrass . Numbe r o f tree s > 2 inc h Eac h 

# 7 t trunk diamete r Numbe r o f tree s < = 2 inc h Eac h 

# y tmnk diamete r Numbe r o f Sprinkler Zones , Contro l Valves , Eac h Timers , Heads , etc . Attac hasketc ho f th e sprinkle r layout
. Nimiber o f an dsiz e o f eac hgarden/ flower be d Eac h area . Square Fee t Attac hasketc ho f relativ e size s andlocations
. 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 . Easement Area , t o b e excavate d 

# I P Eac h 

# if^^ciu ^ ^^A'^ ^ " Y
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# 3COASTA L • MV I ROMnaMTAl

. C •O U P

. INC

.


### Additiona l Comment s / Instructions : Th e cit yo fOmah a ordinance s ma yprohibi t yo u fro m usin g dir t o rgrave l area s o n you rpropert y ci 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 fthi s i s th e case , yo u shoul d understan d tha t thi s removin g an d replacin g o fsoi 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 fyo 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 fsoi l b yth e EP A I fyo u hav e an yquestio n abou t legalit yo fa certai n drivewa yo rparkin g area , yo u ma ycontac t th e cit yo fOmaha' s Plannin g Departmen t a t (402 ) 444-5150
. O Pleas e chec k thi s bo xi fyo u understan d th e informatio n outline d above

.

•Chec k th e bo xi fOwne rdoe s no t wan t CE G t o documen t interio rfoundatio n wall s an d possibl e pre-existin g damage

. 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 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 , MA0182 1 

## Certificat e o f

Verificatio n XL3t-3208 9 Readin g N o 2 3 Mod e SOI L Tim e 2011-04-0 7 2 1 :2 0 Duratio n 90.8 5 Sequenc e Fina l Flag s AVERAG E Av g o f20-2 2 ADDRES S 150 3 OHI O QUADRAN T B 2 DEPH T 13 " XR F TEC H M

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# 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 QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m M o < LO D Z r 415.07 2 S r 156.87 6 U < LO D R b 71.00 8 T h 16.99 0 P b 150.79 7 S e < LO D A s 27.96 3 H g < LO D Z n 258.38 3 W < LO D C u 38.61 1 N i < LO D C o < LO D Fe 18422.00 2 M n 761.96 0 Supervise d By : 

## Certificat e o fVerificatio n

2 0 SOI L 2011-04-0 7 21:1 9 30.5 1 Fina l 2909 1 150 3 OHI O B 2 13 " M

. MATEU S CLEARANC E CLEA R

Erro r \ 7.63 3 ± 14.81 6 ± 8.43 5 14.18 7 ± 6.50 4 ± 8.29 6 ± 17.00 5 6.11 7 ± 15.48 8 11.24 4 ± 26.08 1

: 78.19 2 ± 21.10 5

: 71.36 7 182.85 0 ± 380.78 1 ± 117.26 5

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m M o < LO D Z r 465.38 2 S r 158.02 8 U < LO D R b 72.57 9 T h < LO D P b 171.84 7 S e < LO D A s < LO D H g < LO D Z n 195.99 3 

## w < LO D C u 55.88 3 N i < LO D C o < LO D Fe 19361.48 6 M n 529.99 3 Supervise d By : 

## Certificat e o fVerificatio n

2 1 SOI L 2011-04-0 7 2 1 2 0 30.1 7 Fina l 2909 1 150 3 OHI O B 2 13 " M

. MATEU S CLEARANC E CLEA R

Erro r : 7.99 0 ± 16.12 1 ± 8.77 9

: 15.75 1 ± 6.90 5

: 12.54 6 ± 18.54 8

: 5.86 8 : 24.03 8 12.58 9 ± 24.05 9

: 85.30 3 ± 23.64 8

: 78.04 2 : 194.73 9 ± 404.25 4 ± 107.39 8

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m M o < LO D Z r 405.51 5 S r 159.09 5 U < LO D R b 67.59 1 T h < LO D P b 125.67 2 S e < LO D A s 31.48 6 H q < LO D Z n 210.79 5 

### w < LO D C u < LO D N i < LO D C o < LO D F

e 17224.83 6 M n 573.40 7 Supervise d By : 

## Certificat e o fVerificatio n

2 2 SOI L 2011-04-0 7 21:2 0 30.1 7 Fina l 2909 1 150 3 OHI O B 2 13 " M

. MATEU S CLEARANC E CLEA R

Erro r 7.89 4 ± 14.94 1 ± 8.64 4 14.78 5 ± 6.54 1

1 11.60 2 ± 15.98 4 5.88 6 ± 14.88 3 \ 12.10 4 ± 24.51 4 90.14 2 : 30.11 9 72.05 2 180.41 7 ± 375.09 9 ± 106.90 0

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s AVERAG E ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

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

## Certificat e o fVerificatio n

1 9 SOI L 2011-04-0 7 21:1 7 91.2 2 Fina l fAv g o f16-1 8 150 3 OHI O B l 13 " M

. MATEU S CLEARANC E

M n 660.606 / - ^ 115.77 3 

# y Supervise d By : y^ y 

# L F

e 

### •nmi.i° n y ± CLEA R

pp m < LO D 421.42 5 ± 160.67 1 ±

< LO D 67.85 9 ± < LO D ^82.33 4 ±

< LO D < LO D < LO D 475.76 0 ±

< LO D 58.10 5 ± < LO D 

### ^ : ' < LO D , 

## y : Erro r 7.94 1 15.31 0 8.76 3 14.48 3

6.56 6 14.61 3 26.20 8

6.10 4 34.63 7 12.89 6 35.59 9 88.49 8 .,^--^51 5 76.49 5 / 203.14 8 -'• " 427.06 9

# 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 QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m M o < LO D Z r 421.46 8 S r 154.67 0 U < LO D R b 72.24 8 T h 15.61 3 P b 326.57 5 S e < LO D A s 52.60 3 H g < LO D Z n 454.23 4 W < LO D C u 53.30 3 N i < LO D C o < LO D F

e 23800.35 0 M n 648.14 1 Supervise d By : 

## Certificat e o fVerificatio n

1 6 SOI L 2011-04-0 7 2 1 1 6 30.5 2 Fina l 2909 1 150 3 OHI O B l 13 " M

. MATEU S CLEARANC E CLEA R

Erro r * 8.07 3 ± 15.30 0 ± 8.60 4 14.79 3 ± 6.74 8 ± 9.81 8 ± 24.44 4

: 6.50 7 ± 22.26 9

: 12.95 0 ± 34.78 8

1 86.40 5 ± 23.16 1 76.99 5 : 210.87 3 ± 442.99 0 ± 115.68 3

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m M o < LO D Z r 450.49 4 S r 165.93 8 U < LO D R b 63.43 5 T h 15.87 8 P b 429.14 4 S e < LO D A s < LO D H g < LO D Z n 472.58 2 

## w < LO D C u 66.44 8 N i < LO D C o < LO D F

e 21609.62 1 M n 746.13 4 Supervise d By : 

## Certificat e o fVerificatio n

1 7 SOI L 2011-04-0 7 21:1 6 30.5 2 Fina l 2909 1 150 3 OHI O B l 13 " M

. MATEU S CLEARANC E CLEA R

Erro r 7.91 6 ± 15.83 2 ± 8.92 3

: 13.78 6 ± 6.35 6 ± 10.57 3 ± 27.79 1 6.39 4 36.09 8 13.46 9 ± 35.71 1 ] 94.92 6 ± 24.30 4 77.42 0 : 203.02 4 ± 423.76 9 ± 121.47 2

# 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 1 8 Mod e SOI L Tim e 2011-04-0 7 21:1 7 Duratio n 30.1 8 Sequenc e Fina l Flag s BVI D 2909 1 ADDRES S 150 3 OHI O QUADRAN T B l DEPH T 13 " XR F TEC H M

. MATEU S MIS C CLEARANC E NOT E CLEA R

pp m Erro r M o < LO D 7.83 4 Z r 392.31 3 ± 14.79 9 S r 161.40 5 ± 8.76 2 U < LO D 14.87 1 R b 67.89 4 ± 6.59 4 Th < LO D 13.25 0 P b 391.28 3 ± 26.39 0 S e < LO D 5.41 2 A s < LO D 34.41 0 H g < LO D 12.26 9 Z n 500.46 3 ± 36.29 6 W < LO D 84.16 3 C u 54.56 3 ± 23.08 1 N

l < LO D 75.06 9 C o < LO D 195.54 7 F e 20883.42 2 ± 414.44 8 M n 587.54 2 ± 110.16 6 Supervise d By :X 

### i^QL' \ Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 o ^^^2 r^ Coasta l Environmenta l Grou p Inc

. S^^^^Z ^ www.coastalhazmat.co m NpHoit ^ COASTA L EllfllOIINENTA l 6 • O U P

. IN C 

# EXECUTIV ESUMMARY : BVID #29091-(150 3 Ohi o St)
No Issue s o r Concern s | ^ Issues/Concern s Detail Explanation : -DA NGARVE Y WALKE D TH EPROPERT Y O N4/19/201 1

## Propert yCompletio n Agreemen t
Thi s iiyiecmen i clocLimeni s th e LOinplcho n o l remedi? ! aciivme s pcMoimtdn n m yproperi yM ysigiiaiur c uuil l designal ciha i I a m saiL^fie d wil h lh e resloralio n o fm ypropeily

. an d iha i n o uem s ar e m quesnons . now , o ra l an ylim e m th e fuiuir.

. excep i ihos e uem s hsle d below , ifan y

Propert)'ID ; i W ^ Propcrry

. Address : f^P ) (j?)^ ^ ^ ^ 

## Owne.-: ^J ^

^^i^O ^ Phone : Restoratio n Item s i n Question :

Additiona l Comments :

^''fcXf ) t-TrcTtc-rcMoralio n wcomplcied , riccp l * % nnltr l [ I I rio nn l Ptji'f crrjioratm n i. vconiplclcr i 

## X 

# f>>Cry...r ^ Owner'." ; Signafnr r Dar r^ 

## EP APropert y Clos e Ou t For m Proptrt y P '' ^ ' ' Propert y Addrwr
. > . ^ ^—.K^VT,
. g/ i "^ Dstt/Tlrae : Qusd i Excavatrd : Contrsfto r Grou p, 

### <Vir ^
y « N o Excavatio D Gencni l 1
.I f ncctssuy , wer t th e correc t quadrani{i ) excavate dandrestored ? 2
.I f necessary , were (he correc i area i ofdri p zon e excavate dan drestored ? 

# y
Gradin g So dac dVmcUtio n Ve s |V o 1
.

Doe s the gradin g arour dthe perimeter ofth e hous e i nexcavaieri area s generally slop e i^vx y frotnth e house ? 2
.Ha s so dbeenlai dinall area s tha t wer e excavated ? 3
.Doe s Ih e so dappea r to b e generall y health y andgrowing ? (Onl y evaluate i f inspecif da i a3 0 / da y lime period ) 4
.

Ai T sodde darea s g«i»eralt y fuman devenl y graded ? 

# r y 5 Ar t thejoint s berwee nth e so dstrip s generall y tight ? (Onl y evaluat e i f inspecte da t z 3 0 ds y i
_tim e period ) 

# -fy ­ ) 6
. Wa s th t property grade dsuc hIha t waier wil l nol poo l o nlhe prnpertx' ' 1 j 7
. Wa s dBiinige t o landscapin g o r plan t maieriai s avoided ? / Gates
. Fence s «n< l ReUialPi ! Wall s ^n , .N o 

# r D o gate s openan dclos e freely? (I f applicable ) 

# ZV^ ~ 2
.Wer e al l gate s o r fence s take ndowndurin g restoratio nactivitie s reinjialied ? (I f app/icablf ) 

# -zy 3
.

Wa s damag e t o gate s o r fence s avoided ? (Ifapplicable ) 4
.

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

# u.

Foupdation , Sidiat«n dCuller s Ves N o Wa s damag e t o th e sidin g or tri mavoided ? 

# y 7
. Wa s damag e t o the foundatio navoided ? 

# y .'
. Wa s damag e l o window s avoided ? 

# y 6 Wa s damag e t o window s or doo r screen s avoided' ' 

# ' y 5
.

Wa s damag e t o downspoui s or downspou l extensions avoided! ' Sidevt-alk s an dDriveway s (Coocrete ) ^'r s N o I 1
. Wa s damag e l o drivewa y surface s avoided ? 2
.Wa. s damag e t o walkwa y surface s avoided' ' 

# '7

## OMper s romiH^ls :

j fn.vpectio nnotes :

Removal a;i dresloralio nactivate s compJele includin g lh e 30-da y .so dwarrant ' L-.P ARcprescnuiiivt ' 9<y » ^e ^ Date ; ^|'''f' L