TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID# : ^yj"]" ] Date: \llff jlO 

u 

Address: 

Remediation Contractor: Coastal Environmenta l Group _ Year: _20i 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

cf Video of property (DVD) \^'hiO(A\l^<K\j/^ 

M Executive Summary 

\sA EPA-provided property sketch 

IBi Signed Access Agreement for subject property 

"C Signed Access Agreement(s) for adjacent property 

\A Restoration Agreement 

"CT Settlement documents (i.e., for damage or to replace plants, etc.) 

t r Confirmation data 

y Photographs f(^ ^ y(A^i(XW^ 

M As-built sketch 

B^ Satisfactory restoration signed by Property Owner 

B Property close-out check list signed by EPA 

-& Description of areas not meeting ROD cleanup criteria 

0 Utility clearances 

Sy Property information from Douglas County Assessor's Office 

D 

D 

D 

30054814 

•ii 

Superfund 
m 

Property Access Checklist 

Propcrt^lD D WORKSTARTED ON: / / : 2'^?^4 R 

D WORK COMPELTED ON: / / Propeny Address: m^ ^ P ttSS S\ 

Rcnier Oxvnc: ^^.(XY ^ Tuit^d M 

Addre,«: c- ' ' Phone: 

FiLv: 

Cell/Pager: 

Phone: t^O*^- 73^ 0 Additionul Inl'nrmxtion: 

Fsv 

Ccll/Pager. 

D Notification letter Sent: . / / By: 

M Access Agreement Signed: 1 /^/Q9 . 

»>•= QL'VC.VVO 

[Q Restonttion Agreement Signed: Jl/21/i a By: l9t,'\av\Q 

CD Topsoil Sampling (if applicuble) / / By: 

CD DispoiAl Sampling (rf applicable) / / By: 

D Gnrdcn Sompling (if applicable) / / By: 

D Utility Clearance Called: / / By: 

D Video/Photos (Before) On-ZLlZi'M ^y-Oc^.\An J^/a^. Q Video/Photos (During) On: / / By: ' 

D Video/Photo* (After) On: / / By: 

D Video/Photos (JO-Djiy) Oo: / / By: 

C3 Property Completion Agreemeni Signed: / / By: 

• Final Report Issued: / / By: 

Air Monitorint! (iU upplicable) 

D Community CD Crew On: / / B.. 

Rc&uJts: 

Q Community' CD Crew On: / / By: 

Results: 

CD Community Q Crew On: / / j By: 

ResulU: 

Omaha Lead Site 
Property ID # 

Property 

Address: 

Initial Contact: 

Second Contacl: 

Final Contact: 

Final Action: 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

CONTACT FORM 

a?)?^M^ 

^\ m QA-SIS S^ 

Date: Jp/iA/ Time: r4rS Action: i^^T Mi A 

Date: ' ' Time: Action: 

Date: Time: Actton: 

Transmit to EPA a Other Action: D 

?0 f3A h ov^C 
Douglas County Account Infonm||ion Page 1 of3 naatui 

Douglas County, Nebraska Property Record - R2018130000 

Print Report 

NEW Faature - Parcel Dimensions available (gl scale 0-50 ft west of 52nd St - Vie w O n IMa p Information is valid as of 2009-6-16 Treasurer's Tax Report 

New Feature -^ "¥ -¥ Auto Sales Search 

Owner 

TWEEDY BRYAN P 

ETAL 

4188 CASS ST 

OMAHA NE 68131-0000 

Property Informatio n 

Key Number: 1813 0000 20 

Account Type: Residential 

Parcel Number: 2018130000 

Parcel Address: 4188 CASS ST 

OMAHA NE 68131-0000 

Legal Description: POPPLETON PARK LOT 11 BLOCK 11 50 X 123.81 

Value Informatio n 

Land Improvement Total 

2009 

2008 

2007 

2006 

2005 

2004 

$6,400.00 

$6,400.00 

$6,400.00 

$6,400.00 

$6,400.00 

$6,400.00 

$94,900.00 

$94,900.00 

$81,000.00 

$81,000.00 

$81,000.00 

$58,000.00 

$101,300.00 

$101,300.00 

$87,400.00 

$87,400.00 

$87,400.00 

$64,400.00 

Sales Informatio n 

Sales Date: 2006-03-21 

Deed Type: WD Book: 2006 Page: 029777 

Price: $0.00 

Grantor: Bryan Tweedy 

Grantee: Bryan Tweedy Etal 

Valid/Invalid: Invalid 

Exclusion Reason: 

Sales Date: 1995-03-02 

Deed Type: D Book: 2000 Page: 345 

Price: $55,000.00 

Grantor: 

http://douglasne.mapping-online.coin/DouglasCoNe/static/accountinfo.jsp?accountno=R201... 7/7/2009 
Douglas County Account Inforn||tion Page 2 of3 rnMko 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.14 6150.0 1.0 123.0 50.0 No 

Improvemen t Information 

Building 1 

2 1/2 Story 4188 Cass St 

3MMiotfCMng 

ZMn» 

emrtetxHB ?M[i5a Ft 

CLICK CLICK TO ENLARGE IMAGE TO ENLARGE IMAGE 

Square Footage: 1686.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

Built As: 2 1/2 Story Fin Condo Square Footage: j 0.0 

HVAC: Central Air to Air Rooms: 6.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 2.0 

Roof Cover: Composition Shingle Bedrooms: 4.0 

Roof Type: Gable Stories: 2.5 

Floorcover: Allowance Foundation: ! Block 

Sprinkler Square Footage: 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1915 0% 1915 93 

Detail Type Detail Description Units 

Add On Fence Wood 1.0 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 768.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 2.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R201... 7/7/2009 
Douglas County Account Infora||io >nn|| n Page 3 of3 c 

Garage Detached 216.0 

Porch End Screen 30.0 

Porch Open Slab 200.0 

Porch Slab Roof Ceil 234.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R201... 7/7/2009 
Page 1 of2 

"> 

Create Another Ticket Back to Irth Internet j I, Send Ernajl ] ' y ]E 

• YOUR TICKET NUMBER IS 2332178. 

Original Call Date: 8/03/09 Time: 12:05 pm Op: ELIZABETH18790 


Work to Begin Date: 8/05/09 Time: 12:45 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 4188 Street: CASS ST 


Twp: 15N Rng: 13E Sect-Qtr: 17-SE-SW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: LEAD REMEDIATION 


Location of Work: INCLUDE ALL EASEMENTS LOCATE ENTIRE PROPERTY 


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


: UNSURE ABOUT CORNER LOT 


Company : COASTAL ENVIRONMENTAL SERVICE 


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


Work Being Done For: COASTAL 


Depth of Excavation: 4 FT Corner Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUDOl OMAHACOF 0PPDGPR5 PAETEC QLNNEIC 


Service Area Contact Phone Number 

UtiUty 

Type 

CXCATV COX COMMUNICATIONS, 

INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MXJDOl METROPOLITAN UTILITIES 

DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHATRAFFICSEWER RON 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

OPPDGPR5 OMAHA PUBLIC POWER 

DISTRICT NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/3/2009 
Page 2 of2 

Day: 8002891901 

PAETEC PAETEC COMMUNICATIONS EME^GHS^^^ ^ ^^ ^ ''^^*' 

Emerg: 8002891901 

Day: 4067289343 

QLNNEIC QWEST LOCAL NETWORK NA Alt: 4062071494 

Emerg: 8887289343 

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

COASTA L Omaha Lead Superfund Site 

Name: "7^/^/ ^ Omaha Lead Site 

Site Sketch 

Omaha Lead Site 46904.783-01 

Legend 

Concret e Drip Zone Excavated Quadrants Excavated 

Area replaced with Area replaced wit:h 


Area left bare 
 Sod Rock/Mulch 


Contract #: EP-R7-07-05 Coastal Environmental Group Inc. 

Name: __^_^_ _ Omaha Lead Site 

Address: i-//?AA.f { Site SIcetch 

y'/'^ ^ i' Phone: /^ - ^ 

Date XRF Code ^ , t y '^^^"^ -T- , y . y y BVID# , -,/^- ^ <^0S^ / - f-rv /^^(, AA*y y A^f,. 2 > y A f 

3

4 ^

5

Sample Number 

 ig-^c:j;Tj ^ -a:?>?V9 

 RD2^L£5^^^:I23YV9 L 

 ^^^AFoxk-^^Si ^ 

Lead Concentration 

3/^ 

U 9 If 

-^ ^ 

-2 0 

ppm 

ppm 

ppm 

ppm 

ppm 

Confirmation Sampie 

/^/Yes CD 

fil Ye s • 

IJZ Ye s • 

/-"-^Yes iZI 

A Yes • 

No (3 

No a 

No (/] 

No H yz ^ 

No d ] f / ^ 

-^0 

AllfH 

a 

4 

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A 

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Omaha Lead Site 46904.783-01 
Name: 7^/^ ^ Omaha Lead SHe 

Address: cA/'i? ^*f^ Site Sketch r Phone: _ /^-/f 

Omaha Lead Site 46904.783-01 
p 

COASTA L ENVIRONHENTJtl 

'^i PHOi ^ CROUP , INC . 

Consent for Access To Property 

RIGHT OF ENTRY TO PREI^IISES 

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's Name: 

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

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 work 

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 with 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 
.^^'^'^v. 

COASTA L 

ENVmONHENTAL 

'^'•t PHcnt^ CROUP , IN 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 with the equipment used on his property, or to undertake any 

actions regarding the use of said property which 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 (402) 991-1199 

W grant access to my properties 

D I do not grant access to my properties 

x . CAI yjip„£?^A4 • 7zto7 

Signature 

>ate Signature Date 

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

Page 2 of 2 
C > » S T ;% I 

The purpose of this agreement is to provide a mutual agreement as to conditions of the 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 Environmentai 

Protection Agency (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}^. ^ 

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. 

Stems to be Removed by the Owner before StsK of Remediation: 

'! iii ,c-t .ovfi. g'iOfcce, C'isoJfct.1. rrio/ot :6t.;t:t o.' tticvfe iitivifc' ii- U,^. Uv.'it£i ? li^sf.ciiMii^.iiiLy. 

Keim: 

y . A-^W TLt^U^ 

tteim: 

Item: 

Item: 

Items to be Removed by the Contractor During Remediation ar^d Not Replaced 

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

Item 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

trunic diameter 

Number of trees <= 2 inch 

trunic diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

/^Iiach r. sketrli ul llif 

>r|'.ll.lO I h'.MUIl 

Number of and size of 

each garden/ flower bed 

area. 

Aliach ;i ski'lcli 111 rt'liilM i' 

bi?.cf- and U^c;nio^^ 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

"c;: ; ;••.;•. - , U' • .:i , iv . 

;'S"t ' .( • "•''. : •'• ,)!i-ii ­

' cii'.- i V •;: ''.••• !-,, f-l-," ' . 

u i>. rer. 

Easement Area, to be 

excavated 

Landscape Inventoiry 

Quantity' Unit Conditionrrype/Species 

ri Quadrants 

y Each 

Each 

\ 

^ A Each 

Each 

^ 

Square Feet 

S 

Each ^e5 j-'-v-v^ »^1 ^6^ y 

Page 2 . y 
"•AST/ - L 

f Additional Commente / Instructions: 

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

Vm^ec k the box if Owner does not want CEG to document interior foundation walls and possible 

^^B^xisting damage. By checking this box CEG is not responsible for any damage done to the 

interior of house, including foundation cracks or fissures. 

|3J-«^re« n J do nol agree 

Owner's Signature /ptitti ^Contractor's Signature Date ' 

Page 3 of - ^ 
BVID # 2^^ ^ 

XRF PROPERTY SAMPLE SHEET 


Date 'Sliftio'! Address HVS^ Ca.SS "SA 

Project Omaha lead FP Znd year opilon Sample time am/pm 

XRFID# ^2^S ^ sample length 30 sec 

Shot# Reading Sample area Shot# Reading Sample area 

3 0 1 g> ^\A Z K\^^lJb 5t<^* 3Qiq )^-^^i\S ^ ^ 

^Sa . ^^•g?i^mnto Depth Depth 

•3n<ft> \3>n.tftvm.m 

Average l?,).0 \ ^ \\\.t{j> Average 

Shot# 

vn:^ 5Q.^^^ivn.v^p^ 

Reading Sample area Shol# Reading Samplearea 

3d7^ JA^.iAJia^ M 

3Qns 

3olV/ 

ni.UQ A w.i ^ 

nx.ioqi-n.t^i 5

Depth Depth 

Average -TS.^^^^ ^ W.H f Average 

Shot# Reading Samplearea Shot# Reading Sample area 

Depth Depth 

Average Average 

RETEST AREAS 

Shot# Reading Samplearea Shot# Reading Sample area 

Depth Depth 

Average Average 

lab sample* Lab result Sample area XRF Avg. 

Signature cHjhSJkXiA 

Print ^jyiheH ^ CDI^VOJ ^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3082 

Mode SOIL 

Time 2009-08-13 09:39 

Duration 120.88 

Sequence Final 

Flags 

AVERAGE Avg6f3078'^30 ^ 

ADDRESS 4188 Cass st 

QUAD/ZONE easement 

INSPECTOR Nicolas 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb .131 "~ 

Supervised By: QpQ^U?DA ^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 91.929 

Supervised By: 

Certificate of Verification 

3078 

SOIL 

2009-08-13 09:37 

30.19 

Final 

23849 

4188 Cass st 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 12.282 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 150.930 

Supervised By: 

Certificate of Verification 

3079 

SOIL 

2009-08-13 09:38 

30.27 

Final 

23849 

4188 Cass st 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 15.586 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 144.882 

Supervised By: 

Certificate of Verification 

3080 

SOIL 

2009-08-13 09:39 

30.23 

Final 

23849 

4188 Cass st 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 14.756 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 136.281 

Supervised By: 

Certificate of Verification 

3081 

SOIL 

2009-08-13 09:39 

30.19 

Final 

23849 

4188 Cass st 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 14.406 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3077 

Mode SOIL 

Time 2009-08-13 09:36 

Duration 121.78 

Sequence Final 

Flags 

AVERAGE B^mc^^^O'74^ 

ADDRESS 4188 Cass st 

QUAD/ZONE F2 

INSPECTOR Nicolas 

DEPTH 8 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb 

Supervised By: QpCj^UXd^A ^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3073 

Mode SOIL 

Time 2009-08-13 09:34 

Duration 30.55 

Sequence Final 

Flags 

BVID # 23849 

ADDRESS 4188 Cass st 

QUAD/ZONE F2 

INSPECTOR Nicolas 

DEPTH 8 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 59.235 ± 10.648 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 100.704 

Supervised By: 

Certificate of Verification 

3074 

SOIL 

2009-08-13 09:35 

30.55 

Final 

23849 

4188 Cass st 

F2 

Nicolas 

8 

CLEARANCE 

± Error 

± 13.039 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 71.398 

Supervised By: 

Certificate of Verification 

3075 

SOIL 

2009-08-13 09:35 

30.50 

Final 

23849 

4188 Cass st 

F2 

Nicolas 

8 

CLEARANCE 

± Error 

± 11.226 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 72.635 

Supervised By: 

Certificate of Verification 

3076 

SOIL 

2009-08-13 09:36 

30.18 

Final 

23849 

4188 Cass st 

F2 

Nicolas 

8 

CLEARANCE 

± Error 

± 11.311 
p 

y d ^ '­\ Omaha Lead Site—Fixed Price EP-R7-07-05 

Coastal Environmental Group Inc. 

S^y^yA winww.coa8talhazmat.com 

„„^<^ COASTAL • NVmONNINTAL a >a u r. I N c 

EXECUTIVE SUMMARY: 

BVID # 23849 - (4188 CASS ST) 

No Issues or Concerns \X\ Issues/Concerns 

Detail Explanation: 

NO ISSUES PENDING 
# 0

^ EPA 

EPA Property Close Out Form 

Pr,per«yAdar«.,Mlftf^rA3^?^ . Property #:l2>e>M.Q. . 

Date/Time: Owner's Nane:. 4I 

Quads Excavated: Contractor Group 

Excavation General 

I. If necessary, were the correct quadiantCs) excavated and restored? 

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

Grading Sod and Vcgetotton 

Yes No 

I. Does the grading around the perimeier ofthe house in excavated areas generally slope away 

from Ihe liouse? __ ^ ^_ _ y

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

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

day time period) • . 

4. Are sodded areas generally fum and evenly graded? Z^ 

5. Are the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day Z>^ tinte period)

 _^ . 

6. Was the property graded such that water will not pool on the property' 

y 

^ y ' 7.

 Was danuge to landscaping or plant materials avoided? 

Gales, Fences and Retaining Walb 

Yes Nu 

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

zzr 

2. Were all gates or fences taken down during restoration activities reinstalled? (If applicable) y 

3. Was damage to gates or fences avoided? (Ifappiicable) -y' 

4. Was damage to retaining walls avoided? (Ifappiicable) 

Foundation, Siding and GnMers 

I. Was damage to the siding or trim avoided? 

'y 

2. Was damage to the foundation avoided? Z ' 

3. Was damage to windows avoided? Z' 

4. Was damage to windows or door screens avoided? 

5. Was damage to downspouts or downspoul extensions avoided? 

Sidewalks and Driveways (Concrete) 

1. Was damage 10 driveway surfaces avoided? 

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

Inspection notes: 

Removal and restoration aclivales complete mcluding the 30-day sod warranty: 

EPA Represenlalive Lj^l)%yl-^^^ ^ Dale: ^/llf^ 7 
AUG 2 7 2009 

Property Completion Agreement SUPERFUND DIVISION 

This agreemeni documenis lhe completion ol remedial acliviiies perioimed on my property My signaiure 

will designale ihal I am satisfied with lhe restoration of my properly, and thai no Hems are in queslions. 

now, or at any lime in the fvilui-e, except those items listed below, ifany 

Property IP: /^^^tJ^C ^ 

Property Addrc.^»: \-^\^ % CQ^^€ > A>\ : 

Owner: Ttoe^^t SO.VV. 

Phone: f­ 4Q'X--f^-^6 

Restoration Items in Question: 

I Item: 

Item: 

Item; 

Item: 

Item: 

Item: 

Additional Comments: 

vj agree rcstoralion K completed, excepl as noted 

[ I I do not t,y,tKe restoration is compleled 

Owner' s Signahirr 
Property Completion Agreement 

Ihis agreement documenis flic completion of remedial acliviiies perlormed on my pmperly. My sigiuiluie 

will designale that 1 am satisfied wilh the restoration oi'my property, and that no items are in questions, 

now. or at any time in tlie future, excepl those ilems listed lieiow, ifany. 

Property II): 26^^^ ^ 

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

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

l^n~i>fJ''ce restorntion i.s completed, except as noted 

| _ | I do not a^''^*" restoration is completed 

Owner s Siciiaturc iM c r«.nfnictor's .Signature Date