## TRANSMITTALof OMAHALEAD SIT E SOI LREMEDIATIO NFIL EFOLDE R
SAI D 

### Date : 

# 1 1 Address : 1^ 1 O Z|s | l"/ ^ W Remediatio nContractor : _Coasta l Environmenta l Group _ Year : 20« 9 SOI LREMEDIATIO N PROPERT YnLEFOLDE RDOCUMENT S Vide o o f property (DVD ) 

## a / Executiv eSummary 

# A EPA-provide dproperty sketc h 

# A Signe dAcces s Agreemen t for subjec t property Signe dAcces s Agreement(s ) for adjacent property Restoratio nAgreemen t Settlemen t docimient s (i.e. , for damag e o r t o replac e plants , etc. ) -& - Confirmatio ndat a



# tA ' Photograph s \k (S^(>yi^W l ^ ^Cf(\lfi(^a ^ 3 ^ ffi ^ As-buil t sketc h Satisfactory restoratio nsigne db y Property Owner 

# t / Property close-ou t chec k lis t signe db y EPA Descriptio no f area s no t meetin g RO D cleanu p criteri a 

# A Utility clearance s 

# A Property informatio nfi'omDougla s County Assessor' s Offic e 

# i h y signature Dat e 3021753 9 Superfun d• •


# Propert y Acces s Checklist PropertylD : ;:>^U22 . D WOB K STARTE D ON : / / D WORKCOMPELTE D 0N:

_ Property Address : 5-7^ ^ /y ^ Z ^ hV . Renter : 

# o^'^' ^ \^ih u \ar)C<vi n Address : Phone: Fax : Cdt/Page r Phone : 4K^^ . (^L|C|Q ^ Additional Infonnation : Fax : Cell/Pager : D NotificationLette r Sent : / / By : ^ Acces s Agreement 

## Signed : tL/0/ ^ By : ^ Restoratio nAgreement 

## Signed : i/./i^/Q 3 By : D Topsoil Samplin g (iTappIkabfe ) / / By : Q Disposa l Samplin g (if applicable ) / / By : D Garde nSamplin g (if applicable ) / / By : 5 ^ Utilit y Clearanc e 

## Called : _lL/i^/i:2 Q 

# By : j Ir-^ro ^ Q ^ Video/Photo s (Before ) 

## ^:dliJ2nJ S By : ^rya m Q Video/Photo s (During ) On : / / By : D Video/Photo s (After) On : / / By : D Vidco/Photo s (30-Day ) On : / / By : D Property Completio nAgreement Siened :/ / By : D Final Report Issued :/ / By : Ai r Monitorin g (aaaoDlicable D Communit y Q Cre w On : / / By : Results : Q Commnnit y Q Cre w On : / / By : Resnhs : DConuminit y QCrc w On : / / By : Results :
Omah a Lea d SK e

## Douglas Count y Accoun t Infotau^o n Pag e1 of 2 )r|U^ 0 Dougla s County , Nebrask a Propert yRecor d - R201509000 0 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-5 0 ft wes t o f52n d S t - ViewO H Ma p Informatio n I s vali d a s o f2009-10-1 5 Treasurer' s Ta xRepor t Ne wFeatur e - •- > ^ Aut o Sale s Searci i Owne r JACKSO N ISAIA H ETA L 370 2 N 2 3 S T OMAH AN E 68110-000 0 Propert yInformatio n Ke yNumber : 150 9 000 0 2 0 Accoun t Type : Residentia l Parce l Number : 201509000 0 Parce l Address : 370 2 N 2 3 S T OMAH AN E 68110-000 0 Lega l Description : PLAINVIE WLOT6 BLOC K1 2 5 0 X12 4 Valu e Informatio n Lan d Improvemen t Tota l 

### 200 9 $7,000.0 0 $37,400.0 0 $44,400.0 0 200 8 $7,000.0 0 $37,400.0 0 $44,400.0 0 200 7 $7,000.0 0 $37,400.0 0 $44,400.0 0 200 6 $7,000.0 0 $37,400.0 0 $44,400.0 0 200 5 $7,000.0 0 $13,300.0 0 $20,300.0 0 200 4 $7,000.0 0 $12,100.0 0 $19,100.0 0 Lan d Informatio n 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 Impro t vemen Informatio n Buildin g 1



## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accoimtno=R2.. . 10/22/2009

### Dougla s County Accoun t Infqm^^o n Pag e 2 o f 2 om^^ o

J702M23St .
T2 r ""•V " lii > 6v M«
­

' JSTS *

! stor y

CLIC KTO ENLARG E IMAG E CLIC KT O ENLARG E IMAG E Squar e Footage : 1416. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Fai r Uni t Type : Condition : Averag e

Buil t As : 2 Stor y Cond o Squar e Footage : 0. 0

HVAC : Force d Ai r Rooms : 8. 0 Exterior : Fram e Sidin g Units : 1. 0 Interior : Drywal l Batiis : 1. 0 Roo fCover : Compositio n Shingl e Bedrooms : 4. 0

Roo fType : Hip/Gabl e Stories : 2. 0 Floorcover : Allowanc e Foundation : ' Bloc k 

### -+

- Sprinkle rSquar e Footage : | 0. 0 Yea rBuil t Yea r Remodele d Percen t Remodele d Adjuste d Yea r Buil t Physica l Ag e 191 0 197 4 0 % 191 0 9 9 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 696. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Garag e Detache d 308. 0 Porc h En d Scree n 133. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R2. . . 10/22/200 9

### Pag e1 of 2

" > Creat e Anothe rTjcke t .^ ^

j Bac k t o Irt h Interne t 

### L-^nJf.T'j'JLj l

• YOU RTICKE TNUMBE RI S 2409700 . Origina l Cal l Date : 11/19/0 9 Time : 7:4 2 a m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 11/23/0 9 Time : 8:1 5 a m State : N E County : DOUGLA S Place : OMAH A Address : 370 2 Street : N23R D S T Twp : 15 NRng : 13 E Sect-Qtr : 03-SW,10-NW Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : LEA D REMEDIATIO N Locatio n o f Work : INCLUD E AL L EASEMENT S LOCAT E ENTIR E PROPERT Y Remarks : FAX AL L CLEAR S TO : (877)662-421 1 : UNSUR E O F CORNE R LOT S 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 ALTS7 2 CXCAT V MAGELLANMUDO l OMAHACO F 0PPDGPR 5 QLNNEI C



### Servic eAre a Contac t Phon eNumber UtiUt y Typ e ALT87 2 WINDSTREA M COMMUNICATIO NN A Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3 CXCAT V CO XCOMMUNICATIONS , IN C HEIDI Day : 402934046 9 Ah : 402934046 9 Emerg : 402932975 7 MAGELLA N MAGELLA NMIDSTREA M PARTNER S L

P DEBORA H Day : 918574709 8 AU : 

### Emerg : 918574709 8 MUDO l METROPOLITA NUTILITIES DISTRIC TSAND Y 

### Day : 402504782 3 Ah : Emerg : 402504797 0
http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT. . . 11/19/200 9

### Pag e 2 of 2

OMAHACO FCIT YO FOMAHA-TRAFFIC,SEWE R 

### RICHH-RAFFI C Day : 402444719 7

AU : 402444516 1 Emerg : 402444516 0
0PPDGPR 5 OMAH APUBLI C POWE RDISTRIC T 

### N A 

### Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3 QLNNEI C QWES TLOCALNETWOR K 

### N A 

### Day : 406728934 3 Ah : 406207149 4 Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT. . . 11/19/200 9OLS# : 3242 2 

# w As-Buil t Drawin g ^ Dat e Excavate d :11/27/0 9 Dat e USEP ASiane d Off : 2/3/1 0 C OASTA L 

# Omah aLea dSuperfun dSit e ENVIRONMENTA L Are a Sodden : 45 0 s q f t CROUP , IN C 

### 3242 2 Omah a Lea d Sit e Exterio rPain t Nort h Arro w Sit e Sketc h •Goo d [ 3 Poo r Samplin g Address : 370 2 N 2 3 S T [ ] No t pain t Lea d Sampl e Sample s Collecte d Sampl e Numbe r 

# I LA B Concentratio n Collecte d Firm : P E C.C
. E K RyASCPXA-3242 2 F l 2 / e pp m 

### D Dale : .S']°t-i t RYBSCPXA-3242 2 F 2 pp m 

### D Time : li t O S A.KA
. RYCSCPXA-3242 2 B 1 pp m 

### D 

## .^A . Sample s Analyze d RYDSCPXA-3242 2 B 2 pp m 

### D 

## 3GH RDZSCPXA-3242 2 D Z ppm 1 0 3 

### D XR F Unit : Co*iH n Book : 20T RCZSOPX A3242 2 SZ - —- pp m 

### D D Dat e 2.f ^ •0- 7 ^ . nPZGCrXA-324g g P? - * " pp m 

### D D A M Tim e 

# E ] Staf f Numbe ro fSample s = 

### /^6i / Legend : F l = Fron t Left
. F 2 = Fron t Right , B l = Bac k Left , B 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , P Z = Pla y Al l quadrant s ar e a s viewe d fro m (ti e street , facin g propert y "L J I , B l ^ ­ 

# iiiNTEFFDJ G>...r.. % 

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## 1^ ; DRrV E J : .pi.my . 

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## ^TTAAy t
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. 'yyyyyyyyA^ A F 2 = 77PPM@13 " 

# a/a.: . ' 

## F l; ' i ^^J^9i i EA=163PPM@1 " 

### ^IJliJSi: , RevilMJS. N tftaie d 26-Ket>-(H i 

### Legen d Concret e Dri p Zon e Excavate d 

### Quadrant s Excavate d Are a replace d wit h So d ' ^ Are a replace d wit h Rock/Mulc h n . 

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

# h

# 11^ 7 A . 

# 5T) S 

# N <93 ^ 3242 2 Omah a Lea d Sit e Exterio rPain t Noriri Arro w Sit e Sketc h •Goo d [ g Poo r Samplin a Address : 370 2 N 2 3 S T Q No t pain t Sampl e Numbe r RYASCPXA-3242 2 RYBSCPXA-3242 2 RYCSCPXA-3242 2 RYDSCPXA-3242 2

~ ROZSCPXA-324a2 ^

F^CgSCPX A3342 2 RPgSCPXA-3g4g g Lea d Sampl e Sample s Collecte d 

# i LA B Concentratio n Collecte d Firm : F 1 2 / e pp m 

### D Date : F Z p p m 

### D 

## 57 7 Time : 8 1 pp m 

## n B 2 PPJTl 

### D

D Z 

### 7 0 3 p p m 

### D XR F Unit : G3 - pp m 

### D Dat e 

## n -Pf
- pp m Tim e 

# E

n Staf f Numbe ro fSample s ' ? £CC
. £
. K .^-\<\-' ^ Ir
. O S A
. , n^ . Sample s Analy7e d Ca^i^ O Book : 20 7

^•2.f>.-0- 7 

### A/ ^ Mfiu ^ Legend : F 1 = Fron t Left
. F 2 = Fron t Right , B l = Bac k Left , B 2 = Bac k Righ t D Z = Dr i p Zone , G Z = Garden , P Z = Pla y •)•' Al l quadrant s ar e a s viewe d Iro m Iti e sireet
. facin g propert y W- j H I ' Y'

### 3242 2 

# v l ^ 1 /^ ^

Exterio rPain t Nort h Arro w Omah a Lea d Sit e •Goo d Sit e Sketc h 0^Poo r Samplin g Address : 370 2 N 2 3 ST |~ 1 No t pain t Lead Sampl e Sample s Collecte d Sampl e Numbe r LA B Concentratio n Collect e Firm : V i CC
. £ •K RYASCPXA-3242 2 I F l 2 / e pp m 

### D Date : .V\'\-'r { RYBSCPXA-3242 2 I F 2 51 1 pp m 

### D Time : II-.Q S n..i^
. RYCSCPXA-3242 2 I B l 39, \ pp m 

### D Sample s Analyze d RYDSCPXA-3242 2 I B2 3Cf 4 .pp m 

### D RDZSCPXA-3242 2 I DZ 7 0 3 pp m 

### D XR F Unit : CafJH O Book : 20 7 nczecpx A32422—s^ ­ pp m 

### D Date : At - Z9b , - o V r^rzocpxA024gg—p? - pp m Time ; A M 

# E

n Staff ; M6V / Numbe ro fSample s = 5 Legend : F 1 = Fron t Left , F 2 = Fron t Right , B 1 = Bac k Left
. B 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , P Z = Pla y
MA Y2 21200 8

f^.iL^:^A^.\)(U\,<^' ^

# 3242 1 Omah a Lea d Sit e Sit e Sicetc h Sampiin q Address : 3702 N 23 S T Sampl e Numbe r 

### Lea d Sampl e LA B 

### Concentratio n Collecte d RYASCPXA-3242 2 F 1 

# z i e pp m 

# D RYBSCPXA-3242 2 F2 pp m 

# a 5 7 7 RYCSCPXA-3242 2 B 1 pp m 

### [I r 

# .2B_ L D RYDSCPXA-3242 2 8 2 pp m 

# 3G ^ 

# n RDZSCPXA-3242 2 D Z pp m 

# D nGzccpxA-3a4a2—ez - pp m 

# D 

# a nPZ0GrXAO242 2 PS
- pp m 

# D 

# n Numbe ro fSample s = | 5 | \ Q XR F Unit : Cof^H o Book : 

## 20 1 Date : B - if e - 0* 7 Time : 

### A M Staff : MfiU/ ^ | Exterio rPain t Nort h Arro w •Good [ g Poo r •No t pain t Firm : Date : Time : Sample s Coliecte d P E C.C
. £. u .K-'\<h'< k ll'.O S iV.KU v Sample s Analyze d

Legend : F l = Fron t Left , F 2 = Fron t Right , B l = Bac k Left , B 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , P Z = Pla y Al l quadrant s ar e a s viewa d fro m th e street , (adn g property.•v^*";<> . COASTA l fHVIffONKIHTA l CROUP
. IH C 

## 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 Environnrtenta l Protectio n Agenc y(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 : 

# SZ^^" ^

Owner' s Nann e Daytim e Phone : 

# I'^iki/^ i J^tevv
- 16 1 • 

# M'? ^
Addres s o fPropert y 

# 2 5 T- T covere d b ythi s 

# 37^z i^ 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 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 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 perfomned , 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 confim i 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 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 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 fperfonrtin 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

### .>*^'-"v
. COASTA L tHViaOHHIKTA L 6 « O U » I h C 

### ( Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , wo piles , do g houses , etc ; o d
cRemov e flowe rbulb s o rplant s tha t th e Granto ro rth e Grantor' s tenan t ma yw t o save ; is h

« Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , necessar ysubsequen t t o a n initia l waterin g perio d b yEPA ; a s 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 th e propert yt o perfor m th e work
. t o a 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 (402 ) 991-119 9 

# /d^ l I gran t acces s t o mypropertie s [ U I d o no t gran t acces s t o mypropertie s

signatur e C \ Dat e / / Signature Date
D I woul d lik e t o b e presen t durin g an ysamplin g tha t i s required
.

Page 2 o f2« T 

# ^4L.: ^ COASTA L 

### Restoratso n Agreemen t Th epurpos e o f thi s agreemen t i s t o provid e amutua l agreemen t a s t o condition s ofth e properl y prio r t o remediatio nactivities . Thi s wil l als o serv ea s documentatio nfo r th epurpos eo f assurin g tha t restoratio n activitie s ar e complete dt o th e satisfactio no f th eproperty owne r an dth e Unite dState s Environmenta l Protectio nAgenc y (EPA) .

PropertylD ; 5^^^ ^ Propert y Address : 37^ ^ / Q Ty^Z"'^^ ' 

### Phone : A^ ) - jyAi n O nth e attache ddiagram(s ) indicat earea(s ] t o excavate , surfac estructure s an dlandscapin g feature s and acces s location(s ) t o b e use db y th e contractors . Indicatedistances , depths , material types , etc . Photographicall y an dVideographicall y documen t th eexistin g condition s ofth eproperty an dth ebasemen t i f necessary . 

### Item s t o b e Remove d b yth e Owne rbefor e Start o fRemediation : Th e removal , storacje , disposal , and/o rretur n o fthes e itom s I s th e Owner' s responsibility
. ttem: 

# L IA . 

# . 6U / 

# P/^ i Item : Item : ttem:

Item s to^b e Remove d 

### b yth e Contracto rDurin g Remediatio n an d No t Reolace d ttem: 

### V'^^-^/ f 

# IA , 

# . s ?U A 

# ]y r iyy y ttem: 

### ' / ttem: ttem:

Pag e 1 of
. 

# ?•'•{ ^ 

# €(l ^ COASTA L Item s t o B e Remove d B yContracto rDurin g Remediatio n an d Replace d ttem: 

# f^/A ­ ttem: 

# 5 P ' Item : ttem:



### Ite m Pre-existin g propert y area , that wil l b e excavated , tha t i s covere dwh hgrass . Numbe r o f tree s > 2 Inc h trunk diamete r Numbe r o f tree s < = 2 inc h trun k diamete r Numbe r o f Sprinkle r Zones , Contro l Valves , Timers , Heads , etc . Aiiath!i sU'icl i ol lli e .».rrirkloi liiv'.iii i Numbe r o f an dsiz eo f eac hgarden / flowe r be d area . Atiiit h;i ski.'ir h1) 1 rdiitivi ' <iZi" S nndlociiiiiMi s Agree dupo nvalu e o f plan t material s no t t o b e replace db y contractor . \oi< ' l!-ii ' \HIII C SS\\ \n t i;six ' 10 li t U

( . 1 plan ; >oiK-lu'.
- l( j lh e|;riii)crl \ iis

\ner . Easemen t Area , t o b e excavate d 

# f^- A^rP ­ /^^ ; 1) ^

Landscap e Inventor y Quantit y 

# >"^ /

O z

; / 

# 7A

/ 

# y ^ Uni t Qiifldrant s

Eac h Eac h

Eac h

Eac h Squar eFee t

S

Eac h 

### Condition/Type/Specie s



# PtMDl/^f ^ &5C.IT . Pag e 2 of
.C O AS 1 AL enow'
. *•* «
!! Addttiona i Comment s / Instructions : 

# ]t dfUm hSm ^ i-Louei^ 56^c> s



# L

'~~~ f^^ec k th e bo xifOwne rdoe s no t wan t CE G to documen t interio rfoundatio n wall s an d possibl e p e-exlstin g damage
. Bycheckin g thi s bo xCE G is no t responsibl e fo ran ydamag e don e to th e interio rofhouse
. Includin g foundatio n crack s orfissures
.

O Iagre e O I do no t agre e

Owner' s Signatur e \ JDate^ Contractor' s SignatureDate Pag e 3 of
.BVI D #^4 ^ XR F PROPERTYSAMPL E SHEE T Dat e 

## nianic H Addres s Projec t Omah a Lea d ARR A Sampl e tim e XR F 1D # 

### SMDS Q sampl e lengt h Shot # Readin g Sampl e are a Shot # 

## (Kzz i^^^i e 

# ra qc^ 

## q^c , '\[c-^\ ^ Dept h 

# q s Qa o ^1-^ic
. 4 5 ^ ^ Averag e *^ 1 " J ^l ^ Averag e Shot # Readin g Sampl e are a Shot # 

## <^32 \ 

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. ^ S S 

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## ^3! ^ 

# m^-^ ^ 1 3 Averag e ^^ 8 I t 3 ^ Averag e Shot # Readin g Sample.are a Shot # Dept h Averag e Averag e
RETES TAREA S Shot # Readin g Sampl e are a Shot # Dept h Averag e Averag e Signatur e 

# ^i?/x/!e w Prin t 

# Fii-zobeH i Caccfig ^ 3103 1 KJP'SS V am/p m 3 0 se c Readin g Sampl e are a »/^ q 1-»W J 

## 1 4 

## IU>I/ , t n Dept h 

## \ft3ll« ^ / " WD.^ ^ \( ^ Readin g Sampl e are a Dept h

Readin g Sanipl e are a 

### Dept h

Readin g Sampl e are a Dept h

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

XL3t-3902 2 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
pp m Pb 76.98 5 

## Certlfi c

94 1 SOI L 2010-01-3 0 15:4 9 90.4 8 Fina l Av g o f938-94 0 370 2 N 2 3 S t F 2 1 3 0
. BARAJA S 1 1
Erro r 15.66 2 supervise d By : ^CMW/ )

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

XL3t-3902 2 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 P b 68.52 5 Supervise d By : 

## Certificat e o fVerificatio n

93 8 SOI L 2010-01-3 0 15:4 8 30.1 9 Fina l 3242 2 370 2 N 2 3 S t F2 1 3 O
. BARAJA S 1 1

± Erro r 15.01 5

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

XL3t-3902 2 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 P b 75.90 9 Supervise d By : 

## Certificat e o fVerificatio n
93 9 SOI L 2010-01-3 0 15:4 9 30.1 8 Fina l 3242 2 370 2 N 2 3 S t F2 1 3 O
. BARAJA S 1 1

± Erro r ± 15.76 7

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

XL3t-3902 2 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 P b 86.52 1 Supervise d By : 

## Certificat e o fVerificatio n
94 0 SOI L 2010-01-3 0 15:4 9 30.1 1 Fina l 3242 2 370 2 N 2 3 S t F 2 1 3 O
. BARAJA S 1 1

± Erro r ± 16.20 3^ 

# Therm o

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

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 93 7 Mod e SOI L Tim e 2010-01-3 0 15:3 2 Duratio n 90.6 1 Sequenc e Fina l Flag s AVERAG E ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E
pp m Erro r 

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# H Therm o

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

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 93 4 Mod e SOI L Tim e 2010-01-3 0 15:3 0 Duratio n 30.2 0 Sequenc e Fina l Flag s BVI D 3242 2 ADDRES S 370 2 N 2 3 S t QUADRAN T D Z DEPH T 1 3 XR F TEC H O
. BARAJA S MIS C 1 NOT E 1
pp m ± Erro r P b 191.47 5 ± 22.30 9 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-3902 2 Readin g N o 93 5 Mod e SOI L Tim e 2010-01-3 0 15:3 1 Duratio n 30.2 2 Sequence Fina l Flag s BVI D 3242 2 ADDRESS 370 2 N 2 3 S t QUADRANT D Z DEPH T 1 3 XR F TEC H O
. BARAJA S MIS C 1 NOTE 1
pp m ± Erro r Pb ± 23.25 2 214.03 5 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-3902 2 Readin g N o 93 6 Mod e SOI L Tim e 2010-01-3 0 15:3 2 Duratio n 30.1 9 Sequenc e Fina l Flag s BVI D 3242 2 ADDRES S 370 2 N 2 3 S t QUADRAN T D Z DEPH T 1 3 XR F TEC H O
. BARAJA S MIS C 1 NOT E 1
pp m Erro r P

b 188.79 5 ± 22.27 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 fVerificatio n XL3t-3902 2 Readin g N o 9 7 Mod e SOI L Tim e 2009-11-2 7 13:1 7 Duratio n 93.3 6 Sequenc e Fina l Flag s AVERAG E 

### r?5glor94=96__Il 3 ADDRES S 370 2 n 2 3 s t QUADRAN T e m DEPH T 1 " XR F TEC H R
. VENTR Y MIS C clearenc e NOT E ngn c
pp m Erro r 

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# t Therm o

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

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 9 4 Mod e SOI L Tim e 2009-11-2 7 13:1 5 Duratio n 32.2 3 Sequenc e Fina l Flag s BVI D 3242 2 ADDRES S 370 2 n 2 3 s t QUADRAN T e m DEPH T 1 " XR F TEC H R
. VENTR Y MIS C clearenc e NOT E ngn c

± Erro r pp m P b ± 16.36 8 168.75 0 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-3902 2 Readin g N o 9 5 Mod e SOI L Tim e 2009-11-2 7 13:1 6 Duratio n 30.5 5 Sequenc e Fina l Flag s BVI D 3242 2 ADDRES S 370 2 n 2 3 s t QUADRAN T e m DEPH T 1 " XR F TEC H R
. VENTR Y MIS C clearanc e NOT E ngn c
pp m ± Erro r P b 166.36 2 ± 16.51 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 fVerificatio n XL3t-3902 2 Readin g N o 9 6 Mod e SOI L Tim e 2009-11-2 7 13:1 7 Duratio n 30.5 8 Sequenc e Fina l Flag s BVI D 3242 2 ADDRES S 370 2 n 2 3 s t QUADRAN T e m DEPH T 1 " XR F TEC H R
. VENTR Y MIS C clearenc e NOT E ngn c
pp m Erro r P b 153.35 2 ± 15.84 5 Supervise d By :

## /wA^ \ Omali a Lea d Site—Fixe d Pric e EP-R7-07-0 5 o ^^^^ ^

I

Coasta l Environmenta l Grou p Inc
. V"^^ ^

wvvw.coastalhazmat.co m %PBO^< ^ COASTA L IHVIIOIIHEIITA L clour , IN C 

# EXECUTIV ESUMMARY : BVID #32422-(370 2 N2 3 ST ) No Issue s o r Concern sQ Issues/Concern s Detail Explanation : -COASTA LTO GUARANTE ETH ESO D THROUG H SPRIN G201 0

## EP APropert y Clos eOu t Form 

# 2:^^ ^ Propert y # : ^TJAIL^ . Propert y Address : -. > .^ Q Date/Time: Owner' s Name : /...J . J.l/!^. " 

## '^T9.l^iM i Quad s Excavaied ; F2.t PS ^ Contracto r Crou p Y « N o Excavatio nGenere l 1 .If necessaiy , wereth ecorrrc t quadrant(s ) excavate dan drestored ? 

## A 2 .If necessary , wer eth ecorrec t area s o f dri p zon e excavate dao drestored ? / Gmdln g So dan dVenetatJo n Ye s ^( ) I .Doe s th egradin g aroun dth eperimete r ofth ehous einexcavaie darea s generall y slop e awa y fromth ehouse ? 

# y 2 .Ha s so dbeenlai di nal l area s that %wer e excavated ? 

## A i .Doe s th eso dappea r to b egenerall y healthy andgrowing ? (Onl y evaluat ei f inspecte da t s .1 0 

## A da y tim e period ) Ar c sodde darea s generall y fir mandevenl y graded ? 

## A Ar eth ejoint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat e if inspecte da t a3 0 da y . I tim eperiod ) _ j _ ­ 

# r Wa s th eproperty grade dsuc htha t wate r wil l no l poo l onth e propen y 

### j A 

# "y - Wa s damag e t o landscapin g o r plant material s avoided ? Gates . Fence s aa dReulBio g Wall s Ye s N o 

# v D o gate s openan dclos efl-eely? (I f applicable ) / 2 .Wer eall gate s o r fence s take ndow ndurin g restoratio naclivilie s reinstalled ? (Ifapplicablr ) 

# y 3 .Wa s damag et o gate s or fence s avoided ? (Ifapplicablc } 

## A_ A

.Wa s damag et o retainin g wall s avoided ? (Ifapplicable ) / Foundation , SidJB K an dCutler s — .N o I .Wa s damag et o th e sidin g o r tri mavoided ? / 2 .Wa s damag et nth efoundatio navoided ? / ':. Wa s damag el o window s avoided ? /

_. 4 Wa s damag e t o window s o r doo r screen s avoided ? / Wa s damag et o downspout s o r downspou l exiension s avoided ? / Sidewalk s an dDriveway s (Concrete ) Ye s N o I1 . Wa s damag el o drivewa y surface s avoided ? / 2 . Wa s damag et o walkway surface s avoided ? /

## owner s comments ;

Fnspectio nnotes : 

# yy' ^

Removal andresloralio nactivate s complel e inclu(iing the 30-da y sodwarranry : EP ARepresentativ e Qc^ A ^ Date : 2\i\K >

## Propert yCompletio n Agreemen t Thi s agreemen t documents lh e completio n o rremedia l aclivme s perloime d o n myproperty . M ysignalure wil l designat e Iha l I a m satisfie d wil h th e restoratio n ofm ypropeily
. an d Iha l n o item s ar e i n queslions
. now . o ra l an ylim e i n th e future , except Ihos e ilem s lisle d below , ifan y



### PropcrrylD : 3ZQZ2
. Propert y Address : p.-^ ^ M ^ ^ ^ 

# Q""" = lf>iA\ n jAfi^ty ^ Phone : IX<=^\
- ),QQ2 , Restoratio n Item s i n Question :

Item : Item : Item : Item : Item : Item : Additiona l Comments : / 7 T/ ] , ] T i /tZ
. ^ i 

# 0 ^ <oo v-^v. cSi%/^i ^ a^^'o 

# y agre e rutoralio n i s compleled , excep t a s noler i [_ J I rio no t aur^ crestoratio n ii
. complete d 

# iMdoy^^:^_\h h Owner' s Signat n 

### Date y^^bntrarlor' s Sicnatur cDal e

### @ 

# RE C /-£ 8


## . ^h. i Propeit yOwne rSEtisfsciio n Surve y Omah a Lea d Superfun d Si t " '^i^^r{J \ Of\/j^ff) M 200 8 Remediatio n Contractor : Coasta l Environmenta l Grou p Propert yIdentifie rNumber : 'PA l lA^ i Propert yAddress : TV/DT­ ' M "Z^ ^ ^ - Propert yOwner' s Name : K'!> ) i::\ M JOtCAu^^QT ^ (abov e informatio n t o b e fille d ou t b yremediatio n contracto rprio rt o deliver yo l for m l o Propert yOwner) Instruction s t o Propert yOwner : Thi s for m i s provide d t o yo u a s a mean s o ftryin g t o captur e you rleve l o fsatisfactio n wit h th e wor k o fth e above-identifie d remediatio n contractor , a s applicabl e t o th e soi l cleanu p actio n a t you r property . Th e U.S
. Environmenta l Protectio n Agency(EPA ) i s veryintereste d i n you ropinio n regardin g th e wor k performe d byit s contractors . Thi s for m i s intende d t o provid e a n eas ymean s fo ryo u t o expres s you ropinio n abou t th e wor k performe d o n you rproperty . Pleas e indicat e you rleve l o fsatisfactio n wit h th e contractor' s wor k b yselectin g a numerica l ratin g (rangin g fro m 1 t o 10 ) usin g th e followin g ratin g scale , the n pleas e sig n an d dat e th e for m an d retur n i t t o th e USEP Ai n th e attache d self-addresse d & stampe d envelope , (additiona l comment s ma y als o b e provide d i n th e space below , a t th e optio n o fth e propert yowner. ) 9-1 0 "excellent " 7- 8 "verygood " 5- 6 "acceptable " 3-

A "poor " 1-

2 "verypoor " Propert yOwner' s Satisfactio n Ratin e Regardin g Contractor' s Wor k


### ' ^ 5 9 4 8 . 3 7 2 6 1 Additiona l Comment s fro m Propert yOwne r(optional : continu e t o bac k o

fpag e i fneeded )

Propert yOwner' s Signature :