## TRANSMITTA Lof OMAHALEAD SIT E SOI LREMEDIATIO NFIL EFOLDE R
SAID# : 

## ^(?1P Q 

# 1 n/i p Date : 

# ! i Address : 

# hMf lD< v ^ r Remediatio nContractor : Coasta l Environmenta l Grou p Year : 200 9 SOI LREMEDIATIO N PROPERT Y HL EFOLDE RDOCUMENT S 

# y Vide o o f propert y (DVD ) 

# y Executiv e Summary EPA-provide dproperty sketc h 

# y Signe dAcces s Agreemen t for subjec t property 

# -s

- Signe dAcces s Agreement(s ) for adjacent property 51 / 

### Restoratio nAgreemen t Settlemen t document s (i.e. , for damag e o r t o replac e plants , etc. )

• B - 

### Confirmatio ndat a 

# y Photograph s ff e V^^|1^4 ^ V ^(Mlm(fl i \^( h 

# t / As-built sketc h Satisfactory restoratio nsigne db y Property Owne r 

# y Property close-ou t chec k lis t signe db y EPA Descriptio nofarea s no t meetin g RO D cleanu p criteri a Utility clearance s Property informatio nfromDougla s Coimty Assessor' s Offic e 

# • • D 

### Signatur e 3021799 0 Superfun d

### #



## Propert yAcces s Checklis t Propert yID : D WOR K STARTE D ON
. _/ /_ 

# ^QWoi ^ D WOR K COMPELTE D ON : / / Pr.|,. m Ada,... , ^ ^ :gf>/ f,«. r Rente r Owne r 

## ^y^.K ^ pTi^ ^ Addrass : Phone : FiLv : 

# 'Tiyh^^ ^ Cell/Pager : P^onc : 1<S^^^2 ^ Additiona l Int'ormittion : ?*\ : Ccll/Pager
.

• Nutirictftio n Lette r Sent : Bv : Acces 5 Agreemen t 

### Slpicd: JilXL't A By : Reslomtio D Agreemen t Stptcd : II I l l lO ^ By : I I Topsoi l Samplin g (i f •pplicublc ) By : Q Disposi U Samplin g (r f applicable ) By : O Giirde n Snmplin g (i f applicable ) By : Uiillt vClearanc e Called : ^/J_/i2 ^ 

# ^ a //^fi(0 9 Video/Photo s (Before ) 

### On:jL'jL'± ­
• Video/Photo s (During ) O n Bv^ ' D Video/Phot0 4 (After ) O n / / B y D Video/Photo s (30-D«y ) O o By : pcrt yCompletio n Agreemen l 

## Sip^d./lJ^lp l By : j/ D Fina l Repor t Issued : By : 

# u
Ai rMoniforin K(inapplicable )

[ U Communit yC U Cre w On : 1 1 By : Results : D Comraunitj ' (Z l Cre w O n : / / By : Results : ~.
• Communit yQ Crv w On : / / By : ResulU :
Omah a Lea d Sit e

## Dougla s Coimt y Accoun t Inf^H|tio n Pag e 1 of 4 ^H^ C Dougla s County , Nebrask a Propert yRecor d - R174857000 0 Prin t Repor t NE WFeatur e - Pares I Dimension s availabi e (5 ) scai e 0-5 0 ft wes t o f52n d S t - VlO WO 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 Searc h Owne r FRIZEL L EARNI E ETA L 243 6 IDAS T OMAH AN E 68112-000 0 Propert yInformatio n Ke yNumber : 485 7 000 0 1 7 Accoun t Type : Residentia l Parce l Number : 174857000 0 Parce l Address : 243 6 IDAS T OMAH AN E 68112-000 0 Lega l Description : MINN E LUS ALO T1 2 BLOC K3 W1/ 2 L T1 1 & AL L 6 6 X 12 0 Valu e Informatio n Lan d Improvemen t Tota l 200 9 $5,400.0 0 $69,300.0 0 $74,700.0 0 200 8 $5,400.0 0 $69,300.0 0 $74,700.0 0 200 7 $5,400.0 0 $66,800.0 0 $72,200.0 0 200 6 $5,400.0 0 $66,800.0 0 $72,200.0 0 200 5 $5,400.0 0 $66,800.0 0 $72,200.0 0 200 4 $5,400.0 0 $48,900.0 0 $54,300.0 0 Sale s Informatio n Sale s Date : 2007-05-1 5 Dee d Type : W D Book : 200 7 Page : 09860 2 Price : $0.0 0 Grantor : FRIZEL L EARNI E Grantee : FRIZEL L EARNI E ETA L Valld/lnvalld : Invali d Exclusio n Reason : Famil ySal e Sale s Date : 2006-03-2 5 Dee d Type : C D Book : 200 6 Page : 03490 6 Price : $0.0 0 Grantor : Estat e o fWalte rFrizel l J r 

## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl..
. 10/23/2009

## Dougla s Count y Accoun t InfoMatio n Pag e 2 of 4
Grantee : Valld/lnvalld : Exclusio n Reason : Sale s Date : Dee d Type : Price : Grantor : Grantee : Valid/Invalid : Exclusio n Reason : Sale s Date : Dee d Type : Price : Grantor : Grantee : Valid/Invalid : Exclusio n Reason : Sale s Date : Dee d Type : Price : Grantor : Grantee : Valld/lnvalld : Exclusio n Reason : Sale s Date : Dee d Type : Price : Grantor : Grantee : Valid/Invalid : Exclusio n Reason : Sale s Date : Dee d Type : Earni e J Frizel l Invali d Famil ySal e 2006-02-1 6 Q C $0.0 0 Yan o AMcClai n Walte rFrizel l J rETA L Invali d
2006-02-1 3 Q C $0.0 0 Darre n WMcClai n ETA L Walte rFrizel l J rETA L Invali d
2006-02-1 3 Q C $0.0 0 Dian a L Cas s Walte rFrizel l J rETA L Invali d
2006-02-1 3 Q C $0.0 0 Mario n J McClai n Walte rFrizel l J rETA L Invali d
2006-02-0 7 Q C Book : 200 6 Page : 03945 2

Book : 200 6 Page : 03944 9

Book : 200 6 Page : 03945 1

Book : 200 6 Page : 03945 3

Book : 200 6 Page : 03945 0 

## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl..
. 10/23/2009

### Dougla s County Accoun t InfQ|«|tio n Pag e 3 of4
Price : $0.0 0 Grantor : jerr yAMcClai n ETA L Grantee : Walte rFrizel l J rETA L Valid/Invalid : invali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 8 7920. 0 1. 0 120. 0 66. 0 N o Improvemen t Informatio n Buildin g 1

243 6 M a S) TvreSlory 

# ^ 3 "fj^y ^

D^** 1 e*c * 8 •

CLIC KT O ENLARG E IMAG E Squar e Footage : 1481. 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 yUnfi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 6. 0 Exterior : Fram e Viny l Units : 1. 0 Interior : Drywal l Baths : 1. 5 Roo fCover : Compositio n Shingl e Bedrooms : 3. 0

Roo fType : Hi p Stories : 2. 0 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : i 0. 0 yea rBuil t Yea r Remodele d Percen t Remodele d Adjuste d Yea r Buil t Physica l Ag e 192 4 0 % 192 4 8 6 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Applianc e Fireplac e Masonr y 1. 0 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl.
. . 10/23/200 9

## Dougla s Count y Accoun t InfagM|tion Pag e 4 of 4
Basemen t Fixtur e Fixtur e Fixtur e Garag e Porc h Porc h Bsmn t Blocl < 8 ft Bas e Fixture s Bat h Ful l Bat h Hal f Detache d En d Soli d Wal l Sla b RoofCei l 728. 0 1. 0 1. 0 1. 0 576. 0 112. 0

12. 0



## http://douglasne.mapping-onUne.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl..
. 10/23/2009

## Pag e 1 of 2

" > Creat e Anothe rTicke t - J ^ Bacj < to-irt h Interne t -.•-_. ) Sen d Emai l , | 

## YOURTICKE T NUMBE RI S 2404942
. Origina l Cal l Date : 11/11/0 9 Time : 12:1 5 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 11/16/0 9 Time : 7:1 5 a m State : N E County : DOUGLA S Place : OMAH A Address : 243 6 Street : ID AS T Twp : 16 NRng : 13 E Sect-Qtr : 27-SW,28-SE,33-NE,34-N W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e p 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 LO T Compan y: COASTA L ENVIRONMENTA L SERVIC E Contact 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 : Y Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V MAGELLAN METR O MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C
UtUit y Servic e Are a Contac t Phon e Numbe r Typ e 

## Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , IN C HEID I 

## Alt : 402934046 9 Emerg : 402932975 7 Day : 918574709 8 X

* A/-C TT AX T MAGELLA NMIDSTREA M PARTNER S TM:T>r.i > AU MAGELLA N
. _ DEBORA H 

## Alt : Emerg : 918574709 8 Day : 402457230 7 METR O METR O COMM
. COLLEG E CHRI S 

### Ah : 402672703 3 Emerg : 402457231 3 Day : 402504782 3 MUDO l METROPOLITA NUTILITIE S DISTRIC T SAND Y 

### Alt : 

## Emerg : 402504797 0
http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT..
. 11/11/2009

### Pag e 2 of 2

OMAHACO FCIT Y O FOMAHA-TRAFFIC.SEWE R 

### RICH/TRAFFI C Day : 402444719 7

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

### N A 

### Day : 406728934 3 Ah : 406207149 4 Emerg : 888728934 3 QLNNEI C QWES T LOCALNETWOR K 

### N A 

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

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT.
. . 11/11/200 9OLS# : 4090 0 Dat e Excavated:11/19/0 9 Dat e USEP ASigne d Off : 1/21/1 0 

# As-Buil t Drawin g COASTA L Are a Sodden : 165 6 s q f t 

# Omah aLea dSuperfun dSit e
4090 0 Exterio rPain t Omah a Lea d Sit e • Goo d Sit e Sketc h Q^Poo r Samplin g Address:243 6 ID AS T [| ] Not pain t 

# f
Sampl e Numbe r Lea d Sampl e Sample s Collecte d LAB Concenlralio n Collecte d Fim i y^Itf
. D B T. \ RYASCPXA-4090 0 F l pp m 

### D Date : 'iJ2lio/ J RYBSCPXA-4090 0 F 2 

### IH 5 pp m 

### D Time ; IB--S O A n RYCSCPXA-4090 0 B l pp m 

### D Sample s Analyze d RYDSCPXA-4090 0 B2 

### -it'^ i pp m 

### [ T RDZSCPXA-4090 0 D Z pp m XR F Unit : {pSH O Book : 22£
_ 

### D RGZSCPXA-4090 0 G Z pp m Date : 

### D lo-o' ^ n e RPZCOPX A40000 PZ - pp m Time : 

### D Lto
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### jQiU

_ • Resul t 35 8 pp m 

# n

. = Front Right , 8 1 = Back Left , 8 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , P Z = Pla ; Ali^Lodrant s are a s viewe d Jrp m th e street , facin a pfopert y

' 'K'Jlc ^ Z l .\u g


### Legen d Dri p Zon e Excavate d Quadrant s Excavate d Concret e Are areplace dwit h Are a replace d wit h Are a lef t bar e 

# D So d Rock/Mulc h 

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

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### D Date : 1/2l/o 8 

# y RYBSCPXA-4090 0 F 2 l3U > pp m 

### D Time : lO-i^ Q M \ RYCSCPXA-4090 0 B l ^ 1 IM I po m

35 8 pp m RYDSCPXA-4090 0 B 2 3 3 ' ^ pp m 

### 0 ' Sample s Analyze d 

## n RDZSCPXA-4090 0 D Z - ] ? 5 1 oo m 

## a XR F Unit ; (nSH O Book : 72 ^ RGZSCPXA-4090 0 G Z ^ 6 0 pp m 

## a Dat e loo' i o B nPZCCPX A4000 0 PZ ­ - pp m 

### D Tim e 

## J m
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### m^i ^

. = Fron t Right , B l = Bac k Left , 8 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , P Z = Pla :
, raci r_ Al l quadrant s ar e a s viewe d frp m th e street , racingpropeft y



# i^tu ^

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# Cc m 2,^hriMnd:li<x^ct Exterio rPaint Omah a Lea d Sit e • Goo d Sit e Sketc h 0^Poo r Samplin g Address : 2436 IDAS T Q No l paint Lea d Sampl e Sample s Collecte d Sampl e Numbe r LA B Concenlralio n Collecte d Pi'- mjyinr
. mT A RYASCPXA-4090 0 F 1 1 I J ppm 

### D Date : •illlhl i RYBSCPXA-4090 0 F 2 

### D Time : ih^^ o A n RYCSCPXA-40S0 O B l ^ " 1 ft* / pp m Sample s Analyze d RYDSCPXA-4090 0 B 2 _3j3.3__PP m 

### D RDZSCPXA-4090 0 O Z • f^S l pp m XR F Unit : (nSH O Book : 77C i RGZSCPXA-4090 0 G Z 2 G O pp m 

### D Date : IQ-Q' ^ • Q 6 nPgOCPX A4000 0 P2r - pp m 

## a Time : 

### /?/n 

## n ,La b RYDSCPLA-4090 0 Staff : ^^U j Numbe ro fSample s • • Resul t 35 8 pp m 

# L D

= 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 ; Al l quadrant s ar e a s viewe d fro m (h e streel , racin g propeft y ••>-^
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# lis , pp m 

### D Date : 1/2 1 Jo 8 RYBSCPXA-4090 0 F 2 pp m 

### D Time : ll-s-.^J O A n RYCSCPXA-4090 0 B l pp m 

### D Samples Analyze d RYDSCPXA-4090 0 B 2 pp m E T 

### [ T RDZSCPXA-4090 0 D Z 

### \3( e pp m 

### D XR F Unit : (,,SH O Book : 72C : RGZSCPXA-4090 0 G Z pp m 

### D Dat e 

### loo' i -o e nnzocpx A40000—pz - pp m D 

### D Tim e 

## Am
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# y

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### I I S pp m 

## n Date : Jiaiioa
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### I3< e pp m 

### D Time : Ih-fS O Kt \ RYCSCPXA-4090 0 B 1 

### lli H pp m 

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### ^6 P pp m 

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### D D Tim e 

## Am

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## ras u

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COASTA l IHVIItONHIHTA I *^
. pno't'' ' CROUP
. IN C 

### Consen t fc fAcces s T o Propert y RIGH TO F ENTR YT O PREMISE S 

### Granto r(th e propertyowner) consent s t o an d authorize s th e Unite d State s Environmenta l Protectio n Agenc y(EPA ) o rit s authorize d representatives , collectivel y th e Grantee , t o ente ran d perforn n certai n environmenta l respons e activitie s upo n th e followin g describe d premises : ,i^^ , 7 ^
Owner' s Name : Daytim e Phone : 

# Pnry^Q
. ^y\T.a \
Addres s o fPropert y covere d b ythi s Agreement : 

# "2^^^ ^ \S)r \?i \ PURPOS E O F RESPONS E ACTIVITIE S 

### Th e EPAi s requestin g acces s t o collect soi l sample s an d remove soi l tha t 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 its 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 perfonned , th e Granto rwil l hav e a n opportunityt o revie wan d approv e th e planne d soi l removai , 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 EPAtha t th e property ha s bee n remediated
. ENVIRONMENTA L RESPONS E ACTION S 

### Bysignin g thi s Acces s Agreement , th e Granto ri s grantin g th e EPA , it s employees , contractors an d subcontractors th e right t o ente rth e property , a t al l reasonabl e time s an d wit h prio rnotice , fo rth e sol e purpos e o fperformin g th e wori^
. Thi s acces s shal l remai n i n effect unti l th e wori < ha s bee n satisfactoril ycompleted
. Th e Granto rals o agree s to :

Pag e 1 of2

### c 

# r \ V'^^'^*'^ ' ' COASTA L ' i PRO'"-* ' C R O U rI tt C 

### t Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; Remov e flowerbulb s o rplant s tha t th e Granto ro rth e Grantor' s tenan t ma ywis h t o save ; e Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , a s necessar ysubsequen t t o a n initia l waterin g perio d b yEPA ; t Abid e b yhealt h an d safet yguidanc e provide d b yEPA ; « I fth e propert yi s rented , assis t EP Ai n obtainin g tenan t approva l fo racces s t o th e propert yt o perfor m th e work
. • t 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
•^ 1 gran t acces s t o mypropertie s D I d o no t gran t acces s t o mypropertie s

Signature y yPp e Sij Date Signature

O I woul d lik e t o b e presen t durin g an ysamplin g tha t i s required
.

Page 2 o f2COASTA L 

### RestoratSoE ^ Agreemert t The purpos e of thi s agreemen t i s to provide amutua l agreeme mas to condition s ofth e propert y prior t

o remediatio nactivities
. Thi s will als o serv e a s documentationfo r th e purpos e of assuring tha t restoration activitie s ar e completedto th e satisfactio no f th e propert y owne r andthe UnitedState s Envirorunenta l Protectio nAgenc y (EPA) , 

# 'D^Q O Propert y Address : gjj ^ 0^[ ^ \PK '^ ^ Owner : f(^(^^( ^ ^^<-\?^\ \ Phone : 

# .^-^•'.a^i a O

nth e attacheddiagram(s ) indicat e area(s ) t o excavate , surface structure s an dlandscaping feature s en d acces s location(s ) t o b e use dby th e contractors . Indicat e distances , depths , materia l types , etc . Photographically an dVideographicall y documen t th e existing condition s ofthe propert y an dthe basemen t i

f necessary . 

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

### ttem: 

# hmf^mtU l pi/xnf ^ item : Item : 

### Item :



### Item s to b e Remove d b yth e Contracto rDurin g Remediatio n an d No t Reptiace d item : 

# A •n u playj ^ lej- fh^inc J Item :
ttem:
ttem:

Pag e 1 of
.COASTA L 

### Item s to B e Remove dB y Contracto r Durin g Remediatio nan dReplace d ttem: 

# ^/ /

OjnrJ l & d^i l nn dOl.
. ttem: item : item :



### Ite m Pre-existin g propert y area , tha t wil l b e excavated , tha t i s covere dwithgrass . Numbe r o f tree s > 2 inc h trunlc 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 . Aiiachnskeicl i ol lU e Numbe r o f an dsiz e o f eac hgarden / flowe r be d area . AlliithJ ski/irti 1) 1 ri.-!;niv f M/i"snn dloc;lli(Ml ^ Agree dupo nvalu e o f plan t material s no t t o b e replace db v contractor . VcK ' llii ' \«ln c v\ill n i \oiicitt. T f(
. ili f |;ro|)Cil \ u^

^ ner . 

### Quantit y


## M\ A Vll ^ 

# ao ^
I

^ 

### Landscap e Inventor y Unit Condition/Type/Specie s Quadrant s

Eac h
Eac h

Pflch

Eac h Squar e Fee t

$

Easemen t Area , t o b e 

# pendjuo ^ Pom5:A ^ Eac h 

# S ^ excavate d 

### Pag e 2 of
.r:X i C O A S 7 A L r. . a u r. rN c
I Addttiona l Comment s / Instructions :



# i
Q Chec k th e bo xi fOwne rdoe s no t wan t CE G t o documen t interio rfoundatio n wall s an d possibl e pre-existin g damage
. B ycheckin g thi s boxCE G I s not responsibl e fo ran ydamag e don e t o th e interio ro fhouse , includin g foundatio n crack s o rfissures
.

H^ I agre e C D I d o no t agre e 

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

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 24 8 Mod e SOI L Tim e 2010-04-1 2 07:5 2 Duratio n 91.3 5 Sequenc e Fina l Flag s AVERAG E [ Av g o f245-24 ^ ADDRES S ^2436-Ida-st- ^ QUADRAN T DEPH T XR F TEC H ^NrlOPE Z MIS C confirmatio n NOT E non e

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# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Blilerica , 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 88.25 6 Supervise d By : 

## Certificat e o fVerificatio n

24 5 SOI L 2010-04-1 2 07:5 1 30.4 7 Fina l 4090 0 243 6 Id a s t B l 6 " N
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± Erro r ± 14.22 2

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

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pp m P b 77.71 8 Supervise d By : 

## Certificat e o fVerificatio n

24 6 SOI L 2010-04-1 2 07:5 1 30.4 4 Fina l 4090 0 243 6 Id a s t B l 6 " N
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± Erro r ± 13.52 7

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Blilerica , 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 86.94 8 Supervise d By : 

## Certificat e o f Verificatio n

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± Erro r ± 14.18 4

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

## Certificat e o f Verificatio n XL3t-3902 2 Readin g N o 30 4 Mod e SOI L Tim e 2010-01-2 1 11:3 9 Duratio n 90.3 0 Sequenc e Fina l Flag s AVERAG E 

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

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pp m P b 62.98 6 Supervise d By : 

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

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

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pp m P b 75.56 6 Supervise d By : 

## Certificat e o f Verificatio n

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± Erro r ± 16.16 2

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

## Certificat e o f Verificatio n XL3t-3902 2 Readin g N o 30 0 Mod e SOI L Tim e 2010-01-2 1 11:2 7 Duratio n 90.3 2 Sequenc e Fina l Flag s AVERAG E rAva^297-29 9 ) ADDRES S ^ 243 6 Id a SSt.
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pp m P b 64.22 6 Supervise d By : 

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± Erro r ± 16.53 9

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

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

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pp m P b 68.82 4 Supervise d By : 

## Certificat e o fVerificatio n

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## i^jOL \ Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 3 ^^^ ^

I Coasta l Environmenta i Grou p inc
. \^^" ^

www.coa8taihazmat.co m NpRott? ^ COASTA L INVIIONHEKTA l cao u P , II I C 

# EXECUTIV ESUMMARY : BVID #40900-(243 6 ID AST ) No Issue s o r Concern s Q Issues/Concern s Detail Explanation :

### /f^ l 

# ^ 1 EP APropert y Clos e Ou t For m Propert y # : Propert y Addresr.

­ Datc^lrae : Owner' s Nam.:./,..g'rf^l^jj^ y B^i^^'f ^ Quad s Excavaled ; QT * ; f^ ^ iB ^ 

## >rwv<-^ ^ Contracto r Grou p C-CflLgifyi K CVl^ ^ Excavatio nGeneral Ye s N o 1
. I f necessaiy , wer e th e coirec t quadrant(s ) excavate dan drestored ? 

### • 2
. If necessary , wer e th e contc l area s of dri p zon e exc avetcdaodrestored ? / Ye s N o GradlDK So dan dVcsetalio a I
. Doe s the grading aroundthe perimete r ofth e hous e i nexcavaledarea s generall y slope awa y 

### / fromthe house ? 2
. Ha s sodbee nlai dinal l area s tha t wer e excavated ? 

### / 3
. Doe s the so dappea r t

o b e generall y healtti y an dgrowing ? (Onl y evaluat e i

f inspecteda t a3 0 

### y day tim e period)

_— 4
. Ar e sodde darea s generally fir man devenl y graded ? 

# y 5
. Ar e the joint s betwee nth e sodstrip s generall y tight ? (Onl y evaluat e i

f inspecte da t ^ 3 0 da y 

### y tim e period ) 

# r 6 , Was th e propert y gradedsuc htha t wate r wil l no t pool o nihe property' ' 

# y 7
. Was damag e to landscaping o r plan t material s avoided ? 

### y Gates
. Fence aandRctttnln g Wall s Y « N u 

# r' D o gate s ope nan dclos e finely? (Ifappiicable ) / Wer e al l gate s o r fence s talce ndow nduring restorationactivitie s reinstalled ? (Ifappiicable ) / 3
. Wa s damag e to gate s o r fences avoided ? (Ifappiicable )
_.. . — 4
. Was damag e to retainin g wall s avoided ? (Ifappiicable ) / Foupdation,SidiBgan dGntler s Ye s ,N o I Was damag e to the siding or trimavoided ? / 2 , Wa s damag e to Ih e foundatio navoided ? / 5
. Wa s damag e t

o window s avoided ?

" Wa s damag e to window s or doo r screen s avoided ? 

### / Was damag e t o downspout s o r downspou t extension s avoided ? 

### / SidewaFI aan dDriveway s (Concrete ) Yes N o 1 Was damag e lo drivewa y surface s avoided ? 2 , Wa s damag e lo wallcwa y surface s avoided ? / 

# n /

## OM'ticr s comments :

I in.spectio nno<cs : 

## t " " 

# yy

Removal andrestoratio nactivate s complete includin g the 30-da y sodwarranry : EP ARepresentativ e ^-^j WDate ; il.*'l* °I 

## Propert yCompletio n Agreemen t riii s agreemen l documenl s ih e complclio n ofremedia l acliviiie s perloiiTie d o n myproperl yM ysignalure wil l designal e Iha l I a m satisfie d wil h Ih e restoralio n o fm ypropeily
. an d Iha l n o ilem s ar e m questions , now , o ra t an yliin e i n th e future , except ihos e ilem s hsle d below , i fan y Propert yrP : Lj^^< ^ Propert yAddress : 2q^ O tPASf
. Owner : £^^y^ | ^ ^\?tl \ 

### Phone : 

# 402.-M<rfr-.^;^. q Restoratio n Item s i n Question :

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

## ?L(6i , 5o b A^rrtt ^ ^ ^

^^ ^

<Q^A^^^^ ­

M I Agre e I'Ktoralio n i s coinplcied , excep t a s noie d [_ j I d o no l fl(;recrestoratio n i s complete d 

# .^ ^

A/A ^

(D(yu^;t. ^ j-ZO-A P Dat e Condarfor' s Signatur e Dal eProperl yOwne rSstisfactio n Surve y Onnah a Lea d Superfun d Si t 

### 200 8 Remediatio n Contractor ; Coasta l Environmenta l Grou p 

# m L^r::7r:^r^^^%— 7

JA N I 1 

# SUPERFUN D 201 0 

# DIVISIO N Vtoptft s Qivner' s Name : Mji^ ^

l A| ^

Fp l 7f1 / (abov e informatio n t o be fille d ou t b yremediatio n contracto rprio rt o deliver yo ffor m l o Propert yOwner ) lnstrm;tion s t o Propert yOwner : Thi s for m i s provide d t o yo u as 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 Agenc y(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 an 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 may als o b e provide d i n th e space below , a t th e optio n ofth e propert yowner ) excellent " "ver ygood "

acceptable ^ poor " "ver ypoor " Propert vOw/ner' s Satisfactio n Ratin g Regardin g Contractor' s Wor k 

### 1 0 5 9 4 8 3 7 2
Additiona l Comment s fro m Propert yOwne rtootlonal ; continu e t o bac k o

foae e i fneeded )

Propert yOvimer' s Signatu^^^^^^^^ ^ NttoA-^v ^ ^^-^..^^^^^Date : y-yy > -- / ^