## TRANSMITTALo f

OMAHALEAD SIT E SOI LREMEDIATIO NFIL EFOLDE R SAID# : Z^ipQl
. 

## Date : 'Z\\<^\tP ) Address : 7_^^ ^ AAa^U^ . Remediatio nContractor : _Coasta l Environmenta l Group
_ Year : 200 8 SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S Vide o ofpropert y (DVD ) 5} / 

### Executiv e Summary EPA-provide dproperty sketc h Signe dAcces s Agreemen t for subjec t property Signe dAcces s Agreement(s ) for adjacent property 5 K Restoratio nAgreemen t Settlemen t document s (i.e. , for damag e o r t o replac e plants , etc. ) Confirmatio ndat a 

# w Photograph s ^<L- ofC/LxArHSC K ejLCjCu)ca\!S<K ^ So-c^cu^ , \t ^ ^^ ^ D 

### As-buil t sketc h Satisfactory restoratio nsigne db y Property Owne r 4031644 2 

### Property close-ou t chec k lis t signe db y EPA Superfun d 

# m Descriptio no f area s no t meetin g RO D cleanu p criteri a Utility clearance s Property informatio nfro mDougla s County Assessor' s Offic e

D 

# ^h"^^^ ^ Signatur e 

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# ^/M/O ^

# (i ^ Propert yAcces s Checklis t [Propert y ID : ^U|(^; ^

Propert y .4ddres.s : ;^^^LJ (YVxf ) ^<jf
. D n WOR K STARTE D WORKCOMPELTE D ON : ON : / /
Owner : ^y^Y^ Q "l^^^ K Address:^^ ^ P^y^ ^ B/, j Rentcr:__^/ ^ r.1 . ^^^Il^'-JSa , Phone : Fa.v : Phone : Fax : MOa-Sim-UH^ / Cell/Pagcr : Additiona l [nformation : Cell/Pager : O Notificatio nLette r I5 ( Acces s Agreemen t 1 ^ Restoratio nAgreemen t C

H Topsoi l Samplin g (i f applicable ) 1 1 Disposal Sam|)lin g (if applicable ) 1 1 Garde nSamplin g (ifapplicable ) Sent : / / Signed : S " / IM /<^ % Signed:'^/!' / /CS ^ / / / / / / By : 

# B.v : i\-hjdkicM \ B.v : ^ . W-r/c A By : By : By : 0 ^ n In Utility Clearanc e . Video/Photo s (Before ) Video/Photo s (During ) Video/Photo s (After ) Called : ^ / ^ lO ^ 

## On: S /IM/B l On : / / On : / / 

## By:(,/^ l V^Vl'C^ ' B.v : (irooo n, "t^^ o dr \ By : By : 1 nVideo/Photo s (30-Day ) On : / / By : [ M n Propert y Comj)letio nAgreemen t

Filial Re|)or < Signed : / /

/ 9-/0 ^ Issued : / / 

## B.v:'B^,; ^ By : Ai r Monitorin g (a s ap()licabl c H

D Communit y C H Cre w ) Results : On:

_ _/
_ / 

## B.v : 1 1 C

H Communit y Results : C H Cre w On:

_ _/_
_ / By :
1 C H Communit y Results : C H Cre w On:
_ _/
_ / By : 1
Omah a Lea d Sit e

### # » 

## CONTAC T FORM Propert y I D # 

# 9.%1 3 Propert y Address : 

# QMUhpkSt
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T Action : (i^o v

# M i ff\Qj<!^C\»^Q
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## Initia l Contact : Date ___^^_

_ Time : Uc>*v ^ 

## . Secon dContact : Date:£/[M/{ ^ Time:<^ ^'^ mAction : S i (AH ^ Fina l Contact : Date : Time : Action : Fina l Action : Transmi t t o EP AD Othe r Action : D

Comment : Owne r Commen t (s) : Sit e Coordinato r Commen t (s) :

i

### Dougla s County Accojuklnformatio n o\m^ x Pag e 1 o f 3
Dougla s County , Nebrask a Propert yRecor d - R092081000 0 Prin t Repor t Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t o f1 4 4 S

t - YiewPIT I Ma p Informatio n i s vali d a s o f2008-4-1 7 Treasurer' s Ta xRepor t Ne wFeatur e ->-•- •Aut o Sale s Searc h Owne r ISA M SHEH U POBO X 1106 6 OMAH AN E 68111-000 0 PropertyInformatio n Ke yNumber : 208 1 000 0 0 9 Accoun t Type : Residentia l Parce l Number : 092081000 0 Parce l Address : 222 4 MAPL E S T OMAH AN E 68110-000 0 Lega l Description : DENISE S AD D LO T7 BLOC K3 5 0 X 12 2 Valu e Informatio n Lan d Improvemen t Tota l 200 7 $4,800.0 0 $22,200.0 0 $27,000.0 0 200 6 $4,800.0 0 $22,200.0 0 $27,000.0 0 200 5 $4,800.0 0 $22,200.0 0 $27,000.0 0 200 4 $4,800.0 0 $3,800.0 0 $8,600.0 0 200 3 $4,800.0 0 $3,800.0 0 $8,600.0 0 200 2 $0.0 0 $0.0 0 $0.0 0 Sale s Informatio n Sale s Date : 2007-07-1 2 Dee d Type : Q C M Book : 200 7 Page : 08148 9 Price : $0.0 0 Grantor : CARIN G NETWOR KIN C Grantee : ISA H SHEH U Valid/lnvalid : Invali d Exclusio n Reason : Multipl e Parce l Sal e Sale s Date : 2005-10-0 5 Dee d Type : W D Book : 200 5 Page : 13804 1 Price : $18,500.0 0 Grantor : Estat e o fClaybe m Wmoor e 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R092.
. . 5/8/200 8 

# J01U|^ I 

### Dougla s County Accou«ynformatio n Pag e 2 of 3 \
Grantee : Carin g Networ k In c Valid/lnvalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 4 6100. 0 1. 0 122. 0 50. 0 No Improvemen t Informatio n Buildin g 1 222 4 Mapl e

. » 

### 0 " • « • 

### ""^,^ . Mt f '.tvnx i ICIOOSQF I m a MT•x<r \ n n
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CLIC KTO ENLARG E IMAG E CLIC KTO ENLARG E IMAG E Squar e Footage : 1778. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Wor n Ou t

Buil t As : 2 1/ 2 Stor yUnfi n Cond o Squar e Footage : 0. 0 HVAC : Force d Ai r Rooms : 7. 0 Exterior : Fram e Sidin g Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo fCover : Compositio n Shingl e Bedrooms : 3. 0

Roo fType : Gabl e Stories : 2. 5 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 Yea r Percen t Adjuste d Yea r Yea rBuil t Physica l Ag e Remodele d Remodele d Buil t 190 0 0 0 % 190 0 10 8 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 782. 0 Basemen t Minima l Finis h 675. 0 Fixtur e Bas e Fixture s 1. 0 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R092.
. . 5/8/200 8

### Dougla s County Accotjiynformatio n Pag e 3 of 3 ot^l^ T
Fixtur e Bat h Ful l 1. 0 Garag e Detache d 480. 0 Porc h En d Soli d Wal l 168. 0



### http://douglasne.mapping-onhne.com/DouglasCoNe/static/accountinfo.jsp?accountno=R092.
. . 5/8/200 8

# As-Buil t Drawin g COAST AL 

# Omah aLea dSuperfun dSit e CNVIRONMENTA L OROUP , INC f 

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### Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p In c

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## # Exterio rPain t Nort h Arrow 

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# 2969 2 Nort h Arro w Exterio rPaint 

### Omah a Lea d Sit e •Goo d Samplin g Address : 2224 MAPLE S T 

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### .*^^°1''^^. . COASTA L ENVIRONHENTA L CROUP , INC
. 

### Consen t Fo rAcces s T o Propert y RIGH TO F ENTR YTO 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 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 follov\/in g describe d premises :



## Owner's Name : ^/l^A u ^XS^I ^ D^ytTM«Phone:l4|>)3^,3|^ - (^Ljq j

Addres s o fPropert y covere d b ythi s Agreement : PURPOS E O F RESPONS E ACTIVITIE S 

### Th e EP Ai s requestin g acces s t o collec t soi l sample s an d remov e soi l tha t contain s elevate d concentration s o flea d an d maypos e a healt h hazard
. Th e area(s ) wil l b e excavate d t o remov e contaminate d soil
. Th e remove d contaminate d soi l wil l b e replace d wit h clea n material s an d th e are a wil l b e restore d t o it s origina l condition
. Thi s wor k i s bein g performe d unde rth e Omah a Lea d Superfun d Sit e remediatio n program . Arepresentativ e o fCoasta l Environmenta l Group , contracte d byUSEPA , wil l contact th e Granto rin-perso n t o discus s th e wor k t o b e performed , th e Granto rwil l hav e a n opportunit yt o revie wan d approv e th e planne d soi l removal , an d restoratio n wor k befor e i t begins
. Onc e th e wor k i s finished , th e Granto rwil l b e aske d t o revie wth e wor k an d confir m tha t i t i s complet e an d meet s wit h th e Grantor' s approval
. Upo n completion , th e Granto rwil l receiv e writte n documentatio n fro m EP Atha t th e propert yha 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 , 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 ofperformin g th e work
. Thi s acces s shal l remai n i n effect 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^s-^i O su .
COASTA L ENVIHONMENTA L GROUP , INC
. 

### 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 maywis 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 byEPA ; Abid e byhealt h an d safet yguidanc e provide d byEPA ; I fth e propert yi s rented , assis t EP Ai n obtainin g tenan t approva l fo racces s t o th e propert yt o perfor m th e work
. Allo wvideotapin g and/o rphotographin g ofth e property
. AGREEMEN TNO TT O INTERFER E -- 

### Th e Granto ragree s no t t o interfer e o rtampe rwit h an yofth 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 (877 ) 234-6270
.
M i l gran t acces s t o m ypropertie s D I d o no t gran t acces s t o m ypropertie s 

# C ^ r-/y-tf; f Signatur e Dat e ^ Signatu n Dat e

O 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 f2COASTA L C R O U 1 

## Restoratio n Agreemen t Th e purpos e ofthi s agreemen t i s to provid e amutual agreemen t a s to condition s ofth e property prio r to remediatio nactivities
. Thi s wil l als o serv e a s documentatio nfo r th e purpos e o f assurin g that restoratio n activitie s are complete dto th e satisfactio no f th e property owner andth e Unite dState s Environmental Protectio nAgenc y (EPA) .

Property ID : ^C^(^ ^ 2 , Property Address : 3,-^-^t ( (Y\rAplg
. ^ . Owner : ^V^\^ ^ -^.^O M 

### Phone : ^^g^

_ ^Q ^ ^ ^^i^C^ [
Onth e attache ddiagram(s ) indicate area(s ) to excavate danddept ho f excavation , locatio no f all know n utilities , subsurfac e features , surfac e structure s andlandscapin g featureS i acces s location(s ) to b e usedby contractor , andth e directio no f North
. Indicate distances , depths , material types , etc . Indicate digita l photo s by referencin g th e photo-lo g number wit ha narro w indicatin g directio no f view
. 

## Item s To Be Remove d B yOwne rBefore Star t Of Remediation : (Us e additiona l sheet s a s necessary ) Th e removal , storage , disposal , and/o rretur n o f thes e item s i s th e Owner' s responsibility
. Item : Item : Item : Item : 

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### Pag e 1 o f /_COASTA L
Item s T o B e Remove d B yContracto rDurin g Remediatio n An d No t Replace d (Us e additiona l sheet s a s necessary ) 'tem:(xV \ 9\cxM< ; , JlcU^O^T S , C oCi ^ ^/ \ Vi^Z.
. Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item :

Pag e 2 o fIj ^COASTA L ENVIRONMENTA L CROUP , INC
. 

### Item s T o B e Remove d B yContracto rDurin g Remediatio n An d Replace d (Us e additiona l sheet s a s necessary ) Item : 

# K\onj2
_ Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item :



### Page s 

# o fji
.COASTA L ENVIRONMENTA L



## Ite m

Pre-existin g property area , that wil l b e excavated , that i s covere dwit hgrass .

Numbe r o f tree s > 2 inc h trunk diamete r

Numbe r o f tree s < = 2 inch trunk diamete r

Numbe r o f Sprinkle r Zones , Contro l Valves, " Timers , Heads , etc . Attac hasketc ho f th e sprinkle r layout
.
Numbe r o f an dsiz e o f eac hgarden/ flower be d area . Attac hasketc ho f relativ e size s andlocations
. 

### Landscap e Inventor y (Us e additiona l sheet s a s necessary ) 

## Quantit y Uni t Condition/Type/Specie s 

# F2 , 8 5 Square feet 

# ^Q ^ Each



## 1 Each

-

Eac h ^
- ^ i

^ Each Square Feet

Pag e 4 

### of6 ?COASTA L 

## Ite m Agree dupo nvalu e of plan t material s no t t o b e replace db v contractor . Note thi s valu e wil l b e use dt o issu e aplan t vouche r t o th e propert y owner . Agree dupo nlis t o f plant material s that will b e replace dby contractor . B e ver y specifi c anddetailed
. includ e asketc ho f were eachplan t wil l b e place d by th e contractor . Agree dupo nare aof property to b e replace d wit hgras s sod
. Includ e asketc ho f th e area(s ) t o b e replace dwit h gras s sod
.
Are ao f Cit y o r County property t o b e landscape d pe r thei r requirements
. Includ e asketc ho f th e are a(s )

Easemen t Area , t o b e excavate d 

## Quantit y Uni t Condition/Type/Specie s

^ ^ S ^
i



# n ^ Each
•_ 

# b 2 S F 

# X S F

S F

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# A .C O AS T AL
• MVIMOMMCHTA L


### Additiona l Comment s / Instructions :

, ^ ^ O fD^OU A
. '

D Chec k th e bo xi f Owne 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 ydieckin g thi s bo xCE G i s no t responsibl e fo ran ydamag e don e t o th e interio ro f house , includin g foundatio n crack s o rfissures
.

^ I O I d o no t agre e agre e 

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SM # 

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Averag e la b sampl e # BVI D # '^'^^^ t XR F PROPERT YSAMPL E SHEE T "Zc^ l Addres s 

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### yiof>' ^ sampl e lengt h 3 0 se c

Readin g Sampl e are a Shot # Readin g Sampl e are a 

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# ^

y 

# yy Averag e La b resul t Sampl e are a XR F Avg
. Signature
. 

## Prin t \KkU< ^ MlhlV ^

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 80 8 Mod e SOI L Tim e 2008-07-1 5 16:3 0 Duratio n 120.7 1 Sequenc e Fina l Flag s AVERAG E ^Av g o f804-80 7 J ADDRES S 222 4 mapl e s t QUAD/ZON E INSPECTO R £1ATEU S DEPT H SAMPL E TYP E ICLEARANC E I NOT E

Supervise d By :

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 80 4 Mod e SOI L Tim e 2008-07-1 5 16:2 8 Duratio n 30.1 3 Sequenc e Fina l Flag s BVI D # 2969 2 ADDRES S 222 4 mapl e s t QUAD/ZON E B 2 INSPECTO R MATEU S DEPT H 1 2 SAMPL E TYP E CLEARANC E NOT E
pp m ±Erro r P b 183.98 3 ±16.96 2 Supervise d By :

# 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 QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 109.10 2 Supervise d By : 

## Certificat e o fVerificatio n

80 5 SOI L 2008-07-1 5 16:2 9 30.2 9 Fina l 2969 2 222 4 mapl e s t B 2 MATEU S 1 2 CLEARANC E

± Erro r ± 13.96 4

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 450.23 7 Supervise d By : 

## Certificat e o fVerificatio n

80 6 SOI L 2008-07-1 5 16:2 9 30.2 5 Fina l 2969 2 222 4 mapl e s t B 2 MATEU S 1 2 CLEARANC E

± Erro r ± 26.01 0

# 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 202.69 3 Supervise d By : 

## Certificat e o fVerificatio n

80 7 SOI L 2008-07-1 5 16:3 0 30.0 4 Fina l 2969 2 222 4 mapl e s t B 2 MATEU S 1 2 CLEARANC E

± Erro r ± 17.67 1

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 81 3 Mod e SOI L Tim e 2008-07-1 5 16:3 6 Duratio n 139.7 7 Sequenc e Fina l Flag s AVERAG E jAv g o f809-81 2 ADDRES S 222 4 mapl e s t QUAD/ZON E |D Z INSPECTO R MATEU S DEPT H Ml 3 SAMPL E TYP E K.CLEARANCEJ P NOT E

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-3208 9 Readin g N o 80 9 Mod e SOI L Tim e 2008-07-1 5 16:3 2 Duratio n 30.2 7 Sequenc e Fina l Flag s BVI D # 2969 2 ADDRES S 222 4 mapl e s t QUAD/ZON E D Z INSPECTO R MATEU S DEPT H 1 3 SAMPL E TYP E CLEARANC E NOT E

pp m ±Erro r P b ±36.09 7 892.62 5 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 113.82 3 Supervise d By : 

## Certificat e o fVerificatio n

81 0 SOI L 2008-07-1 5 16:3 4 49.1 1 Fina l 2969 2 222 4 mapl e s t D Z MATEU S 1 3 CLEARANC E

± Erro r ± 14.13 1

# 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 175.70 2 Supervise d By : 

## Certificat e o fVerificatio n
81 1 SOI L 2008-07-1 5 16:3 5 30.2 0 Fina l 2969 2 222 4 mapl e s t D Z MATEU S 1 3 CLEARANC E

± Erro r ± 16.60 1

# 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 386.70 1 Supervise d By : 

## Certificat e o fVerificatio n

81 2 SOI L 2008-07-1 5 16:3 6 30.1 9 Fina l 2969 2 222 4 mapl e s t D Z MATEU S 1 3 CLEARANC E

± Erro r ± 23.74 6

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 83 3 Mod e SOI L Tim e 2008-07-1 6 12:3 2 Duratio n 120.6 7 Sequenc e Fina l Flag s AVERAG E §Av g o f829-83 2 ADDRES S —222 4 mapl e s t QUAD/ZON E •F 2 INSPECTO R ATEU S DEPT H SAMPL E TYP E LCIear a ne e NOT E

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 71.02 1 Supervise d By : 

## Certificat e o fVerificatio n

82 9 SOI L 2008-07-1 6 12:3 0 30.2 0 Fina l 2969 2 222 4 mapl e s t F2 MATEU S 6 Clearanc e

± Erro r ± 10.93 9

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 83 0 Mod e SOI L Tim e 2008-07-1 6 12:3 1 Duratio n 30.1 8 Sequenc e Fina l Flag s BVI D # 2969 2 ADDRES S 222 4 mapl e s t QUAD/ZON E F 2 INSPECTO R MATEU S DEPT H 6 SAMPL E TYP E Clearanc e NOT E
pp m ±Erro r P b 78.30 8 ±11.74 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 64.34 9 Supervise d By : 

## Certificat e o fVerificatio n

83 1 SOI L 2008-07-1 6 12:3 2 30.1 7 Fina l 2969 2 222 4 mapl e s t F2 MATEU S 6 Clearanc e

± Erro r ± 10.69 4

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 34.44 0 Supervise d By : 

## Certificat e o fVerificatio n

83 2 SOI L 2008-07-1 6 12:3 2 30.1 2 Fina l 2969 2 222 4 mapl e s t F2 MATEU S 6 Clearanc e

± Erro r ± 8.54 7

# 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 AVERAG E ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

Supervise d By : 

## Certificat e o f Verificatio n

83 8 SOI L 2008-07-1 6 12:4 7 120.7 5 Fina l jAv g o f 834-837_ | 222 4 mapl e s t feasement MATEU S 'SURFAC E CLEARANCE ]

# 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 144.08 6 Supervise d By : 

## Certificat e o fVerificatio n

83 4 SOI L 2008-07 - 1 6 12:4 3 30.2 8 Fina l 2969 2 222 4 mapl e s t easemen t MATEU S SURFAC E CLEARANC E

± Erro r ± 14.74 0

# 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 176.43 9 Supervise d By : 

## Certificat e o fVerificatio n

83 5 SOI L 2008-07-1 6 12:4 5 30.1 2 Fina l 2969 2 222 4 mapl e s t easemen t MATEU S SURFAC E CLEARANC E

±Erro r ±15.95 0

# 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 161.32 0 Supervise d By : 

## Certificat e o fVerificatio n

83 6 SOI L 2008-07-1 6 12:4 6 30.2 7 Fina l 2969 2 222 4 mapl e s t easemen t MATEU S SURFAC E CLEARANC E

± Erro r ± 15.47 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 137.67 3 Supervise d By ; 

## Certificat e o fVerificatio n

83 7 SOI L 2008-07-1 6 12:4 7 30.0 8 Fina l 2969 2 222 4 mapl e s t easemen t MATEU S SURFAC E CLEARANC E

± Erro r ± 14.45 1

# m Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc
. % u ' j ^ www.coastalhazmat.co m ^-ttPRtfit? ^ COASTA L [NVIRONHENTA L CROUP , INC
. 

# EXECUTIV ESUMMARY : BVI D #2969 2 - (222 4 MAPL EST ) 

# I I No Issue s o r Concern s [ ^ Issues/Concern s Detai l Explanation : TRAFFI C WEA RO NFESO D

## Propert yCompletio n Agreemen t Thi s agieemen i documeni s th e completio n o fremedia l activitie s performe d o n m yproperly
. M ysignatur e wil l designal e iha l I a m salislie d wil h th e restoralio n o fm yproperly , an d Iha l n o item s ar e i n questions , now . n ra l an ylim e i n th e fiiUire , excep l thos e ilem s liste d below , il'any
.

Propcr.>MI) : ^^^9 ^

___ Propc. , t yAddress^^ ^ ^

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. 5>^ , _ _

Restoratio n Item s i n Question :

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

# I

"-^•xtj ^ ayrc frrvtoiatio n i.<
. completed , excep t a vnote d I I I d o no \ agre e lestorwtio n i s complete d 

# O r y Owner' s ;^{jfna(nr c Dflf c "Tontracfor' s .S'i;^iiatiir( ' Dat e

## smL 

# EP A EP APropert y Clos e Ou t For m Propert y Addre«:-^^^^ ^ Mr^{>lf.^

- Propert y # : '::^'- \LoS\ Q Date/Time : Owner' s Name : ,i^\.\.iJ}'^ j
. LXJ. f/'^V^ j , , „a ^ . Quad s Excavated : y^ ^ $>2 > ^ \Nf c Contracto r Grou p r.^riS.-^v C T ^ p v v rOTvAAXYlft ^ Ye s N o Excavatio nGenera l 1 .If necessary , were th e correc t quadrant(s ) excavate dan drestored ? 

# X 2 .If necessary , v^fer e th e correc t area s ofdri p zone excavate dan drestored ? / Gradin g So dan dVegetatio n Ye s N o I .Doe s the grading aroun dthe perimeter ofth e hous e i nexcavate darea s generally slop e awa y fromthe house ? L ^ 2 .Ha s sodbee nlai di nall area s tha t wer e excavated ? 3 .

Doe s the so dappea r t

o b e generally health y an dgrowing ? (Only evaluate i f inspecteda t a3 0 

### y day tim e period)
_ ^ 4 .Are soddedarea s generally firman devenl y graded ? 

## y 5
.

Arc th e joint s betweenthe sodstrip s generally tight ? (Only evaluate i f inspecte da t a3 0 da y 

### y tim e period) 6 .Wa s the propert y grade dsuchtha t wate r wil l no t poo l o nthe property- ? 7 .

Wa s damage t o landscapin g o r plan t material s avoided ? 

### y Gates , Fence s an d Rctaininf ; Wall s Ye s N o !
. D o gate s ope n an d clo.se freely? (Ifapplicable ) 2
.Wer e al l gate s o rfence s take n dow n durin g restoratio n activilie s reinstalled ? (Ifapplicable ) 

## J A 3
.

Wa s damag e t o gate s o rfence s avoided ? (Ifapplicable ) 

# v ^ 4
.

Wa s damag e t o retainin g wall s avoided ? (Ifapplicable ) Foundation , Sidin g an dGutler s Ye s N o 1 .Wa s damage t o th e sidin g or trimavoided ? 

## y 2 .Wa s damage to the foundationavoided ? 

## y 3 .

Wa s damag e l o window s avoided ? ^ 4 , Wa s damage to window s o r door screen s avoided ? 

## y 5
.Wa s damage t o downspout s or downspoul extension s avoided ? ^ Sidewalk s an dDriveway s (Concrete ) Ye s N o Wa s damag e to drivewa y surface s avoided ? 2 .Wa s damage to walkwa y surface s avoided ? 

## y 1

## Or^ner s comments :

Inspectio nnotes :

Remova l an drestorationactivate s complet e including the 30-da y so dwarranty : 

# Date : ( I U^/o t