## TRANSMITTALo f OMAHA LEAD SIT E SOI LREMEDIATIO NFIL EFOLDE R


# : SAID # 

# ^yj"]" ] Date : \llf f jl O 

# u Address : Remediatio nContractor : Coasta l Environmenta l Group

_Year : _20 i SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S
c f

Vide o o f propert y (DVD ) \^'hiO(A\l^<K\j/ ^ M Executiv e Summar y \s

AEPA-provide dpropert y sketc h IB i Signe dAcces s Agreemen t for subjec t property
" C Signe dAcces s Agreement(s ) for adjacent property \ A Restoratio nAgreemen t "C

T Settlemen t document s (i.e. , fo r damag e o r t o replac e plants , etc. ) tr Confirmatio n dat a y Photograph s f(^ ^ y(A^i(XW ^ M As-buil t sketc h B ^ Satisfactor y restoratio nsigne db y Propert y Owne r B Propert y close-ou t chec k lis t signe db y EP A

- & Descriptio no f area s no t meetin g RO D cleanu p criteri a 0 Utilit y clearance s Sy Propert y informatio nfro mDougla s Count y Assessor' s Offic e D D D



### 3005481 4 

# • i i Superfun d

# m

Propert yAcces s Checklis t
D WORKSTARTE D ON : / / Propcrt^lD : 2'^?^4 R D WOR K COMPELTE D ON : / / Propen y Address : m^ ^ P ttSS S \ Rcnie r Oxvnc : ^^.(XY ^ Tuit^d M Addre,« : c - ' ' Phone : FiLv : Cell/Pager : Phone : t^O*^ - 73^ 0 Additionu l Inl'nrmxtion : Fs v Ccll/Pager
. D Notificatio n lette r Sent : . / / By : M Acces s Agreemen t 

### Signed : 1 /^/Q9
. »>• = QL'VC.VV O [ Q Restonttio n Agreemen t 

### Signed: Jl/21/i a By : l9t,'\av\ Q C D Topsoi l Samplin g (i f applicuble ) / / By : C D DispoiA l Samplin g (r f applicable ) / / By : D Gnrdc n Somplin g (i f applicable ) / / By : D Utilit yClearanc e Called : / / By : D Video/Photo s (Before ) 

## On-ZLlZi' M 

# ^y-Oc^.\A n J^/a^
. Q Video/Photo s (During ) On : / / By : ' D Video/Photo * (After ) On : / / By : D Video/Photo s (JO-Djiy ) Oo : / / By : C 3 Propert yCompletio n Agreemen i Signed : / / By :
• Fina l Repor t Issued : / / By : Ai rMonitorint ! (i U upplicable )

D Communit yC D Cre w On : / / B.
. Rc&uJts : Q Community ' C D Cre w On : / / By : Results : CD Communit yQ Cre w On : / / j By : ResulU :
Omah a Lea d Sit e

## Propert y I D # Propert y Address : Initial Contact : Secon dContacl : Final Contact : Fina l Action :

Comment : Owner Commen t (s) : Site Coordinato r Comment (s) : CONTACT FOR M 

# a?)?^M ^ ^\ mQA-SI S S ^ Date : Jp/iA / Time : r4r S Action : i^^ T Mi A Date : ' ' Time : Action : Date : Time : Actton : Transmit t

o EP A a Othe r

Action : D

? 0 f3 A h ov^ C

## Douglas Count y Accoun t Infonm||io n Pag e 1 of 3 naatu i Dougla s County , Nebrask a Propert yRecor d - R201813000 0 Prin t Repor t NE W Faatur e - Parce l Dimension s availabl e (g l scal e 0-5 0 ft wes t o f 52n d S t - ViewO n IMa p Informatio n i s vali d a s o f 2009-6-1 6 Treasurer' s Ta xRepor t Ne wFeatur e - ^ " ¥- ¥Aut o Sale s Searc h Owne r TWEED YBRYA N P ETA L 418 8 CAS S S T OMAH AN E 68131-000 0 Propert yInformatio n Ke yNumber : 181 3 000 0 2 0 Accoun t Type : Residentia l Parce l Number : 201813000 0 Parce l Address : 418 8 CAS S S T OMAH AN E 68131-000 0 Lega l Description : POPPLETO N PAR KLO T 1 1 BLOC K1 1 5 0 X 123.8 1 Valu e Informatio n Lan d Improvemen t Tota l 200 9 200 8 200 7 200 6 200 5 200 4 $6,400.0 0 $6,400.0 0 $6,400.0 0 $6,400.0 0 $6,400.0 0 $6,400.0 0 $94,900.0 0 $94,900.0 0 $81,000.0 0 $81,000.0 0 $81,000.0 0 $58,000.0 0 $101,300.0 0 $101,300.0 0 $87,400.0 0 $87,400.0 0 $87,400.0 0 $64,400.0 0 Sale s Informatio n Sale s Date : 2006-03-2 1 Dee d Type : W D Book : 200 6 Page : 02977 7 Price : $0.0 0 Grantor : Brya n Tweed y Grantee : Brya n Tweed yEta l Valid/Invalid : Invali d Exclusio n Reason : Sale s Date : 1995-03-0 2 Dee d Type : D Book : 200 0 Page : 34 5 Price : $55,000.0 0 Grantor : 

## http://douglasne.mapping-online.coin/DouglasCoNe/static/accountinfo.jsp?accountno=R201..
. 7/7/200 9

### Dougla s County Accoun t Inforn||tio n Pag e 2 of 3 rnMk o
Grantee : Valid/Invalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 4 6150. 0 1. 0 123. 0 50. 0 N o Improvement Informatio n Buildin g 1 2 1/ 2 Stor y 418 8 Cass S t

3MMiotfCMn g

ZMn » emrtetxH B ?M[i5 a F t CLIC KT O ENLARG E IMAG E CLIC KT O ENLARG E IMAG E Squar e Footage : 1686. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 2 1/ 2 Stor yFi n Cond o Squar e Footage : j 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 : 2. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 4. 0

Roo f Type : Gabl e Stories : 2. 5 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 5 0 % 191 5 9 3 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Fenc e Woo d 1. 0 Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 ft 768. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 2. 0 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R201.
. . 7/7/200 9

## Douglas Count y Accoun t Infora||io n Pag e 3 of 3 >nn|| c Garag e Detache d 216. 0 Porc h En d Scree n 30. 0 Porc h Ope n Sla b 200. 0 Porc h Sla b Roo f Cei l 234. 0



## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R201..
. 7/7/200 9

### Pag e 1 of 2

" > Creat e Anothe rTicke t Bac k t o Irt h Interne t j I , Sen d Ernaj l ] ' y 

# ] E

• YOU RTICKE T NUMBE RI S 2332178
. Origina l Cal l Date : 8/03/0 9 Time : 12:0 5 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 8/05/0 9 Time : 12:4 5 p m State : N E County : DOUGLA S Place : OMAH A Address : 418 8 Street : CAS S S T Twp : 15 NRng : 13 E Sect-Qtr : 17-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 : 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 ABOU T CORNE R LO T 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 : 4 F T Corne r Lot : N Front : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V MUDO l OMAHACO F 0PPDGPR 5 PAETE C QLNNEI C

Servic e Are a Contac t Phon e Numbe r 

### UtiUt y Typ e
CXCAT V CO X COMMUNICATIONS , IN C HEID I Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7
MXJDO l METROPOLITA NUTILITIE S DISTRIC T SAND Y Day : 402504782 3 Alt : 

### Emerg : 402504797 0
OMAHACO F CIT Y O FOMAHA

TRAFFICSEWE R 

### RO N Day : 402444719 7 Alt : 402444516 1 Emerg : 402444516 0
OPPDGPR 5 OMAH A PUBLI C POWE R DISTRIC T 

### N A Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3
http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 8/3/200 9

## Pag e 2 of 2 Day : 800289190 1 PAETE C PAETE C COMMUNICATION S EME^GHS^^^ ^ 

### ^^ ^ ''^^* ' 

## Emerg : 800289190 1 Day : 406728934 3 QLNNEIC QWES T LOCA LNETWOR K

N A Alt : 406207149 4 

## Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS..
. 8/3/2009

# As-Buil t Drawin g COASTA L 

# Omah aLea dSuperfun dSit e

Name : 

### "7^/^ / ^ Omah a Lea d Sit e Sit e Sketc h

Omah aLea dSit e 46904.783-0 1 

### Legen d Concret e Dri p Zon e Excavate d Quadrant s Excavate d Are a replace d wit h Are a replace d wit: h Are a lef t bar e So d Rock/Mulc h 

### Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc .Name : __^_^_
_ Omah a Lea d Sit e Address : i-//?AA.f { Sit e SIcetc h 

# y'/' ^ 

# ^ 

# i' Phone : / ^ - ^ XR F Code ^ Dat e , t y'^^^" ^ -T- , y. yyBVID # , -,/^- ^ 

### <^0S ^ / - f-r v/^^( , AA*y yA^f,
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3 4 ^ 

## 5 Sampl e Numbe r

ig-^c:j;Tj ^

-a:?>?V 9 RD2^L£5^^^:I23YV9L 

## ^^^AFoxk-^^Si ^ Lea d Concentratio n 

# 3/^ U 9 If -^ ^ -2 0 pp m pp m pp m pp m pp m Confirmatio n Sampi e 

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### Omah aLea dSit e 46904.783-0 1Name : 

## 7^/^ ^ Omah a Lea d SH e Address : 

### cA/'i ? ^*f ^ Sit e Sketc h 

# r Phone : _ 

### /^-/ f

Omah aLeadSit e 46904.783-0 1

# p

COASTA L ENVIRONHENTJt l '^ i PHOi ^ CROUP , INC
. 

## Consen t fo rAcces s T o Propert y RIGH TO F ENTR YTO PREI^IISE 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 : _, ^ *, ^
Owner' s Name : 

## -ilio ^ '^U>'Ut? S /6t >

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 b e replace d wit h clea n material s an d th e are a wil l be 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 o f Coasta 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 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 l 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 , a t al l reasonabl e time s an d wit h prio rnotice , fo rth e sol e purpos e of performin 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 2

### .^^'^'^v
.

COASTA L ENVmONHENTA L '^'• t PHcnt ^ 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 necessarysubsequen 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 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
. •Allo 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 wor k 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 . 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



# W gran t acces s t o m ypropertie s D I d o no t gran t acces s t o m ypropertie s 

# x . CA I yjip„£?^A 4 

# • 7zto 7 Signatur e >at e Signatur e Dat e
G I woul d lik e t o b e presen t durin g an ysamplin g tha t i s required
.

Pag e 2 o f 2C > » S T; % I



### Th e purpos e of thi s agreement i s t o provid e amutual agreement a s t o condition s o f th e propert y prio r to remediatio n activities
. Thi s will als o serv e a s documentatio n fo r th e purpos e of assurin g that restoratio n activitie s are complete dt o th e satisfactio n of th e propert y owner andth e UnitedState s Environmenta i Protectio nAgenc y (EPA)
.

Property ID : 

# g5"6 ^ I Property Address : \.](C' b Q/IA S 

### ^~ ^ • i 0^"'" = T ) N^t4 ^^AC^Y C 

## I Pbone: ^j-l}^. ^ O n th e attache ddiagram(s ) indicat e area(s ) t o excavate , surfac e structure s an dlandscapin g feature s an d acces s location(s ) t o b e usedb y th e contractors . Indicat e distances , depths , materia l types , etc . Photographicall y an dVideographically document the existin g condition s ofthe propert y andth e basemen t i

f necessary . 

## Stem s t o b e Remove db y th e Owne r befor e Sts K o

f

Remediation : '! ii i ,c- t .ovfi
. g'iOfcce , C'isoJfct.1
. rrio/o t :6t.;t: t o. ' tticvf e iitivifc' ii

- U,^ . Uv.'it£ i ? li^sf.ciiMii^.iiiLy
. Keim: 

# y . A-^ WTLt^U^ tteim : Item : Item :



## Item s t o b e Remove db y th e Contracto r Durin g Remediatio n ar^ dNo t Replace d

Pag e i o f y ^C
_ ) , * S T M L



## Item Pre-existin g propert y area , that wil l b e excavated , that i s covere dwit hgrass . Number o f tree s > 2 inch truni c diamete r Number o f tree s < = 2 inch trunic diameter Number o f Sprinkler Zones , Contro l Valves , Timers , Heads , etc . /^Iiachr . sketrli u l lli f >r|'.ll.lO I h'.MUI l Numbe r o f an dsiz e of eac hgarden / flower be d area . Aliach; i ski'lcli 11 1 rt'liil M i ' bi?.cf

- an dU^c;nio^ ^ Agree dupo nvalu e of plant material s no t to b e replace db v contractor . "c;: ; ;••.;• . - , U' • .:i , iv
. ;'S"t ' .( • "•''. : •' • ,)!i-ii

­

' cii'.- i V •; : ''.•• • !-, , f-l-," '
. u i>
. rer . Easement Area , to b e excavate d 

### Landscap e Inventoir y 

## Quantity ' Uni t Conditionrrype/Specie s 

# r i Quadrant s 

## y Each Each \

^ 

# A Each

Eac h ^ Square Feet

S

Each 

# ^e 5 j-'-v-v ^ »^ 1 ^6^ y
Pag e 2 

# . y"•AST/ - L



### f Additional Comment e / Instructions :

<» ^^6yM^€.rU. l \jy(-^ ^ ?c;>u v v^ - ' S 4V(Vil^T<^ ^

Vm^ec k th e boxi f Owne rdoe s no t wan t CE G t o documen t interio rfoundatio n wall s an d possibl e ^^B^xistin g damage
. B ycheckin g thi s bo xCE G i s not responsibl e fo ran ydamag e don e t o th e interio ro f house , includin g foundatio n crack s o rfissures
.
|3J-«^re « nJ d o no l agre e

Owner' s Signature /ptitt i ^Contractor' s Signatur e Dat e ' Pag e 3 o f - ^BVI D # 2^^ ^ 

### XR F PROPERTY SAMPL E SHEE T Dat e 

## 'Sliftio' ! Addres s 

### HVS ^ Ca.S S "S A Projec t Omah a lea d F P Zn d yea ropilo n Sampl e tim e am/p m XRFID # 

### ^2^S ^ sampl e lengt h 3 0 se c Shot # Readin g Sampl e are a Shot # Readin g Sampl e are a 

### 3 0 1 g > ^\A Z K\^^lJ b 5t<^ * 3Qi q 

## )^-^^i\S ^ ^ 

## ^Sa
. ^^•g?i^mnt o Dept h Dept h 

### •3n<ft > 

## \3>n.tftvm. m Averag e l?,).0 \ ^ \\\.t{j > Averag e Shot # 

# vn: ^ 5Q.^^^ivn.v^p ^ Readin g Sampl e are a Shol # Readin g Sampleare a 

### 3d7 ^ JA^.iAJia^ M 

### 3Qn s 3olV / ni.U Q A w.i ^ nx.ioqi-n.t^ i 

# 5 Dept h Dept h Averag e -TS.^^^ ^

^

W.Hf Averag e Shot # Readin g Sampleare a Shot # Readin g Sampl e are a Dept h Dept h Averag e Averag e
RETES TAREA S Shot # Readin g Sampleare a Shot # Readin g Sampl e are a Dept h Dept h Averag e Averag e la b sample * La b resul t Sampl e are a XR F Avg
. Signatur e cHjhSJkXi A 

### Prin t ^jyiheH ^ CDI^VOJ ^

# 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 308 2 Mod e SOI L Tim e 2009-08-1 3 09:3 9 Duratio n 120.8 8 Sequenc e Fina l Flag s AVERAG E Avg6f3078'^30 ^ ADDRES S 418 8 Cas s s t QUAD/ZON E easemen t INSPECTO R Nicola s DEPT H 1 SAMPL E TYP E CLEARANC E NOT E

pp m ± Erro r P b .13 1 " ~ Supervise d By : QpQ^U?DA ^

# 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 91.92 9 Supervise d By : 

## Certificat e o f Verificatio n

307 8 SOI L 2009-08-1 3 09:3 7 30.1 9 Fina l 2384 9 418 8 Cas s s t easemen t Nicola s 1 CLEARANC E

± Erro r ± 12.28 2

# 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 150.93 0 Supervise d By : 

## Certificat e o f Verificatio n

307 9 SOI L 2009-08-1 3 09:3 8 30.2 7 Fina l 2384 9 418 8 Cass s t easemen t Nicola s 1 CLEARANC E

± Erro r ± 15.58 6

# 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 144.88 2 Supervise d By : 

## Certificat e o f Verificatio n

308 0 SOI L 2009-08-1 3 09:3 9 30.2 3 Fina l 2384 9 418 8 Cass s t easemen t Nicola s 1 CLEARANC E

± Erro r ± 14.75 6

# 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 136.28 1 Supervise d By : 

## Certificat e o f Verificatio n

308 1 SOI L 2009-08-1 3 09:3 9 30.1 9 Fina l 2384 9 418 8 Cas s s t easemen t Nicola s 1 CLEARANC E

± Erro r ± 14.40 6

# 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 307 7 Mod e SOI L Tim e 2009-08-1 3 09:3 6 Duratio n 121.7 8 Sequenc e Fina l Flag s AVERAG E 

### B^mc^^^O'74 ^ ADDRES S 418 8 Cas s s t QUAD/ZON E F 2 INSPECTO R Nicola s DEPT H 8 SAMPL E TYP E CLEARANC E NOT E

pp m Erro r P b Supervise d By : QpCj^UXd^A ^

# 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 307 3 Mod e SOI L Tim e 2009-08-1 3 09:3 4 Duratio n 30.5 5 Sequenc e Fina l Flag s BVI D # 2384 9 ADDRES S 418 8 Cas s s t QUAD/ZON E F 2 INSPECTO R Nicola s DEPT H 8 SAMPL E TYP E CLEARANC E NOT E

pp m ±Erro r P b 59.23 5 ±10.64 8 Supervise d By :

# 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 100.70 4 Supervise d By : 

## Certificat e o f Verificatio n

307 4 SOI L 2009-08-1 3 09:3 5 30.5 5 Fina l 2384 9 418 8 Cas s s t F 2 Nicola s 8 CLEARANC E

± Erro r ± 13.03 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 QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 71.39 8 Supervise d By : 

## Certificat e o f Verificatio n

307 5 SOI L 2009-08-1 3 09:3 5 30.5 0 Fina l 2384 9 418 8 Cas s s t F 2 Nicola s 8 CLEARANC E

± Erro r ± 11.22 6

# 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 72.63 5 Supervise d By : 

## Certificat e o f Verificatio n

307 6 SOI L 2009-08-1 3 09:3 6 30.1 8 Fina l 2384 9 418 8 Cas s s t F 2 Nicola s 8 CLEARANC E

± Erro r ± 11.31 1

# p
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## \ Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc
. S^y^y A winww.coa8talhazmat.co m „„^< ^ COASTA L • NVmONNINTA L a > a u r . I N c 

# EXECUTIV ESUMMARY : BVID #2384 9 - (418 8 CAS S ST ) No Issue s o r Concern s \X \Issues/Concern s Detai l Explanation : NO ISSUES PENDIN G

# 0 # 

# EP A ^ 

# EP A Propert y Clos e Ou t For m Pr,per«yAdar«.,Mlftf^rA3^?^
. Propert y#:l2>e>M.Q.
. Date/Time : 

### Owner' s Nane: . 4 I Quad s Excavated : Contracto r Grou p Excavation Genera l I .If necessary , were th e correc t quadiantCs ) excavate dandrestored ? 2
.If necessary , were th e correc t area s ofdri p zone excavate dandrestored ? Gradin g So dan dVcgetotto n Ye s No I .Doe s th e gradin g aroun dth e perimeier ofth e hous e i nexcavate darea s generall y slop e awa y 

# y fromIhe liouse ?
__ ^ ^_
_ 2
.Ha s so dbee nlai dinal l area s that wer e excavated ? 

# ly ' 3
.Doe s th e sodaiqiea r to b e generall y healthy an dgrowing ? (Onl y evaluate if inspecte da t a3 0 da y time period ) • . 

# Z ^ 4
.Ar e soddedarea s generall y fuman devenly graded ? 5
.Ar e th e joint s betwee nth e so dstrip s generally tight ? (Onl y evaluate if inspecte da t a3 0 da y 

# Z> ^ tint e period )_^ . 6 . Wa s the propert y grade dsuchtha t wate r will no t poo l o nth e property ' 

# y ^ y ' 7 .Wa s danug e t o landscapin g o r plan t material s avoided ? Gales , Fence s an dRetainin g Wal b Ye s N u 1
. O o gate s ope nandclos e freely? (Ifappiicable ) 

# zz r 2
. Were all gate s or fence s takendow ndurin g restoratio nactivitie s reinstalled ? (If applicable ) 

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

## -y ' 4
.Wa s damag e t o retainin g wall s avoided ? (Ifappiicable ) Foundation , Sidin g an dGnMer s 

# 'y I .Wa s damage t o th e sidin g o r tri mavoided ? 2
.Wa s damag e t o th e foundation avoided ? 

# Z ' 3
.Wa s damag e t o window s avoided ? 

# Z ' 4
.Wa s damag e t o window s or doo r screen s avoided ? 5
.Wa s damag e t o downspout s o r downspoul extension s avoided ? Sidewalk s an dDriveway s (Concrete ) 1
.Wa s damag e 10 driveway surface s avoided ? 2
.Wa s damage t o walkwa y surface s avoided ?

## Owner s comments : # #



## Inspectio n notes :

Removal an drestoratio n aclivale s complete mcluding the 30-da y so dwarranty : EP A Represenlaliv e Lj^l)%yl-^^^ ^ Dale : ^/llf^ 7

## AU G 2 7 200 9 Propert yCompletio n Agreemen t SUPERFUN D DIVISIO N Thi s agreemen i documeni s lh e completio n o l remedia l acliviiie s perioime d o n m ypropert yM ysignaiur e wil l designal e iha l I a m satisfie d wit h lh e restoratio n o f m yproperly , an d tha i n o Hem s ar e i n queslions
. now , o rat an ylim e i n th e fvilui-e , excep t thos e item s liste d below , ifan y

Propert yIP : /^^^tJ^C ^ Propert yAddrc.^» : \-^\^ % CQ^^€ > A>\ : Owner : 

## Ttoe^^ t 

# S O.VV
. Phone : 

# f ­ 4Q'X--f^-^ 6 Restoratio n Item s i n Question : 

### I Item :

Item : Item ; Item : Item : Item : Additiona l Comments :

v j agre e rcstoralio n Kcompleted , excep l a s note d [ I I d o no t t,y,tK e restoratio n i s complele d

Owner' s Signahir r

## Propert yCompletio n Agreemen t Ihi s agreemen t documeni s fli c completio n o f remedial acliviiie s perlorme donm y pmperly
. M y sigiuilui e will designal e that 1 amsatisfie dwilhth e restoration oi'm y property , an dtha t n o item s ar e i nquestions , now . o r at

an y tim e intli e future , excep l thos e ilem s liste dlieiow , ifany
. Propert y II) : 26^^^ ^ 

## j^ropoT^AcidT^ H \ ^<^Q/xs5XfAt ,

Restoratio n Item s i n Question :

Item : Item : Item : Item : Item : Item : Additiona l Comments :

l^n~i>fJ''c e restorntio n i. s completed , excep t a s note d | _ | I d o no t a^''^* " restoratio n i s complete d

Owner s Siciiatur ciM cr«.nfnictor' s .Signatur e Dat e