## TRANSMITTA Lo f OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R
SAI D # : 2^^/ ^ Date : 2\n\( A Address : 2^2 ^ S)\or\d O S f RemediationContractor : Coastal Environmenta l Group

_Year : 200 8
SOI LREMEDIATIO N PROPERT Y nLEFOLDE RDOCUMENT S H

^ Video of propert y (DVD ) B^ Executive Summar y ^ EPA-p.,videdpTMp.r. y sketch

y

r H

^ Signe dAcces s Agreemen t for subjec t propert y Signe dAcces s Agreement(s ) for adjacent property 

## Q

/ RestorationAgreemen t 4031473 6 inHliNHi l Superfun d



## t ^ Settlemen t documents (i.e. , fo r

damag e or t

o replac e plants , etc. ) Q

^ Confirmationdata S ^ Photograph s ^r^^^jfy^Jthfi^ ^ -gf^r^J/i>fe»V^ .-S/^d , ^fui j Scd , S

/ As-built sketch Sr

Satisfactory restoratio nsigne db y Property Owne r Q / Property close-ou t chec k lis t signe db y EPA fq^ nDescriptio no f area s no t meetin g RO D cleanu p criteri a GJ / Utilit y clearance s 

## [ r

Propert y information fi-omDougla s Count y Assessor' s Office


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WOR K STARTED WORK COMPELTED ON : __/__/
_ ON : __/__/
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### Owner : ^Y^^ Q\ndi\.\^ti\n Address :


## Phone: 3^2'2ft2 0 Renter : Phone : Fax : Cell/Pager : Additional Information : Cell/Pager :

n 0 " 0 G D D 0 D n n D D D

NotificationLette r

Acces s Agreement Restoratio nAgreement Topsoil Sampling (if applicable ) Disposa l Samplin g (if applicable ) Garde nSampling (i f applicable ) Utilit y Clearanc e Video/Photo s (Before) Video/Photo s (During ) Video/Photo s (After ) Video/Photo s (30-Day) Property CompletionAgreement Final Repor t Sent : / / Signed : 5_/2a/efl
. Signed : ft /TJ/Bft / / / / / / 

## Called : _S_/26/0fi
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## CONTACT FOR M Propert y I D #^llWl r Propert y Address : 

# aa?> U P^r^rvHn? ^ Initia l Contact : Date : Time : Action : SecondContact : Date : Time:
_ Action:
_ Fina l Contact : Date : Time:
_ Action ; Fina l Action : Transmit to EP AD Othe r

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# 3M 3 -^'kfi o Comment : Owne r Commen t (s) : Sit e Coordinator Commen t (s) :• • 

### Dougla s County Accotug|afonnatio n Pag e 1 o f 1 lUflliafonni
Dougla s County , Nebrask a Propert yRecor d - R194441000 0 Prin t Repor t NE

WFaatur a - Parce l Dimensions availabl e G scal e 0-5 0 ft wes t o

fgoi h S t - VlO WO n Ma p Informatio n i s vali d a s o f2008-6-1 9 Treasurer' s Ta xRepor t Newpeatur e iH>.*>#[>^ : Aut o Sale s Searc h Owne r MOBEC O INDUSTRIE S
1141 3 HICKOR YR D OMAH AN E 68144-000 0 Propert yInformatio n Ke yNumbsr : 444 1 OOO O 1 9 Accoun t Type : Residentia l Parce l Numbe r 194441000 0 Parce l Address : Lega l Description : 242 6 BLOND O S T OMAH AN E 68111-000 0 PARKER S AD D LO T5 BLOC K1 E 1/ 2 3 0 X 140. 7 Valu e Informatio n
200 8 200 7 200 6 200 5 200 4 200 3 Lan d $200.0 0 $200.0 0 $200.0 0 $200.0 0 $200.0 0 $200.0 0 Improvemen t $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 Tota l $200.0 0 $200.0 0 $200.0 0 $200.0 0 $200.0 0 $200.0 0 ijin d Informatio n Acre s 0.0 9 S F 4230. 0 Unit s 0. 0 Depti i 

### 141. 0 Widt h 30. 0 V acan t Ye s



### http://douglasne.mapping-online.com/DouglasCoNe/static/accoiintinfo.jsp?accountno=Rl9.
. . 7/17/200 8

# D Ranot e ID : Rpag e 9 M ^ 9 Magella n One-Ca1 1 P.O . Bo x344 8 Tulsa . O K 7410 1 Phon e 918/574-709 8 Fa x918/574-746 6 Th e followin g 0ne-Ca1 1 Agenc ydi g ticket s calle d i n by : Excavator : COASTA L ENVIRONMENTA L SERVIC E Fa xNumber : 877662421 1 Phon e Number : 877662421 0 > Fa xDate : 2008/08/2 8 Batchid : 52624 9 Wil l b e CLEA R o f undergroun d facilitie s for : MAGELLANPIPELIN E Stat e Ticke t Numbe r Excavato r Contac t Di g Addres s

N E 211903 3 ELIZABET H 242 6 BLOND O S T N E 211903 4 ELIZABET H 242 8 BLOND O S T I f yo u hav e an yquestions , pleas e contac t Magella n OneCal l a t 918/574-709 8• • • • 

### Pag e 1 of 2

Creat s Anothe rTicke t Bac k t o Irt h Inteme t Sen d Emai l


### YOURTICKE T NUMBERI S 2119033
. Origina l Cal l Date : 8/28/0 8 Time : 12:1 4 p mOp : ELIZABETH1879 0 Wor k t o Begi n Date : 9/02/0 8 Time : 12:4 5 p m State : N E County : D01K3LA S Place : OMAH A Address : 242 6 Street : BLOND O S T Twp : 15 NRng : 13 E Sect-Qtr : 09-SE,10-SW,15-MN,16-NE Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : lead remidiatio n Locatio n o f Work : LOCAT E ENTIR E PROPERTY AL L TH E WAY T O TH E STREE . Remarks : FA X AL L CLEAR S TO : (877)662-421 1 : VACANT LOT . : tJNSUR EO FCORNERLO T 

### Compan y: COASTAL 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 : 4f t Come r Lot : N Involve s Tunneling o r Horizonta l Borin g : NFront : Y Explosives : N Rear : Y CXCAT V

LEVEL 3 MAGELLA NMODO l OMAHACO F OPPDGPR S QLNNEI C
Servic e Are a Contac t Phon e Nombe r Utilit y Typ e
CXCAT V CO X COMMUNICATIONS , IN C 

### HEID I Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7
LEVEL3 LEVEL S COMMUNICATIONS , LL C 

### N A Day : 877366834 4 Alt : Emefg : 877366834 4
MAGELLA NMAGELLA NMIDSTREA M PARTNER S L PTONY A Day : 918574709 8

Alt : Emerg : 918574709 8
MUDO l METROPOLrrANUTIUTIE S DISTRICT SAND Y Day : 402504782 3

Alt : Emeig : 402504794 6

ht^:// www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 8/28/200 8• • • • 

### Pag e 2 of 2

OMAHACO FCITYOFOMAHA-TRAFFICSEWE R 

### RO N Day : 402444719 7

Alt : 402444516 1 Emerg : 402444516 0

OPPDGPR S OMAH APUBU C POWE RDISTRIC T 

### N A Day : 406728934 3

Alt : 888728934 3 Emerg : 406728934 3
QLNNEI C QWES T LOCA LNETWOR K 

### N A Day : 406728934 3

Alt : Emerg : 888728934 3

http://www.dhon.org/irtluntemet/DHONNoticeCreatioii/MessageText.asp?ret=<RESULTS.
. . 8/28/200 8

# As-Buil t Drawin g
COASTA L 

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### « < # COASTA L CNVIRONHINTA l C • O U » . IH C ••iwio* " 

### Consen t Fo rAcces s T o Propeit 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 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 : i f 1 ^ 2.1 1
Daytim e Phone : Owner' s Name:jAofej:0'j^K\c[i^<';£ 5 

# 3m > Qkni o ^
. Addres s o fPropert y covere d b ythi s Agreement :
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 remov e soi l tha t contain s elevate d concentration s o flea d an d ma ypos e a healt h hazard

. Th e area(s ) wil l b e excavate d t o remov e contaminate d soil

. Th e remove d contaminate d soi l wil l b e replace d wit h clea n material s an d th e are a wil l b e restore d t o it s origina l condition

. Thi s wor k i s bein g performe d unde rth e Omah a Lea d Superfun d Sit e remediatio n program . Arepresentativ e o fCoasta l Environmenta l Group , contracte d 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 Isegins

. 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 propert y 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 , contractor s an d subcontractors th e righ t t o ente rth e property , at al l reasonabl e time s an d wit h prio rnotice , fo rth e sol e purpos e o fperformin 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 : \



## • i^ Pag e 1 of2

# V : COASTA L ENVIRONHfMTA l %-«,tt«'' ^ CROUP

. IH C



### •Remove 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 necessar ysubsequen t t o a n initia l waterin g perio d byEPA ; •Abid e byhealt h an d safetyguidanc e provide d byEPA ; •I fth e propertyi s rented , assis t EP Ai n obtainin g tenan t approva l fo racces s t o th e propertyt 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 not 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 propertywhic 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 contact Coasta l Environmenta l Group , at (712 ) 352-018 8 I ^ i gran t acces s t o m ypropertie s Q I d o no t gran t acces s t o m ypropertie s

(-^/ ' Signatur e / ^ Dai e Signatur e/ Dat e

Q

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

.K COASTA L 

## Restoratio n Agreemen t Th e purpos e ofthi s agreemen t i s to provid e amutua l agreemen t a s t o condition s ofth e propert> ' prio r t o remediatio nactivities
. Thi s wil l als o serv e a s documentatio nfo r th e purpos e o f assurin g tha t restoratio n activitie s are complete dto th e satisfactio nofth e propert y owne r an dth e Unite dState s Environmental Protectio nAgenc y (EPA)
.

Propert yID : ^[7^/ ^ 

### Propert y Address : ^l^^^ ^ BlmiL W
. Owner : l^pbeC Q -^^(^0^' ^ Phone : j^^; ^
. ^ ^ - Q^^ O


### O nth e attache ddiagram(s ) indicate area(s ) to excavate dan ddept ho f excavation , locationof al l know n utilities, subsurfac e features , surfac e structure s an dlandscapin g features , acces s location(s ) lo be use dby contractor , andth e directio no f North
. Indicate distances , depths , material tvpes , etc . Indicat e digita l photo s b

y referencin g th e photo-lo g number wit ha narrow indicatin g directio no f view
. Item s T o B e Remove d B yOwne rBefor e Star t O fRemediation : (Us e additiona l sheet s a s necessary ) Th e removal , storage , disposal , and/o rretur n o fthes e item s i s th e Owner s responsibility

. Item :
Item :
Item :
Item :
Item :
Item :

Pag e 1 of

.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 ) Item : ^ " 

# r " * Item :
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### \ Item : X
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Pag e 2 o fCOASTA L (NVII»OH»««KT* L C •

> O O P IN C 

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Item : ^^- ^
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Item :
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Item : ' \ \ Item : \
Item : 

# 1 Item : / ^ Item :

Pag e 3 of

.COASTA L 

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

### Ite m Quantit y 

## Uni t Condition/Type/Specie s

Pre-existin g property area , tha t wil l b e excavated , tha t Squar e feet i s covere dwit harass .

Numbe r o f tree s > 2 inch Each trunk diaineie r

Numbe r of tree s •' = 2 inch Each irunk diamete r

Numbe r o f Sprinkle r Zones
. Contro l Valves
. Timers
. Heads , etc . Eac h - ^ ^ Auachasketc huf the iPi'iiikle;

- !a \OUT
.

Numbe r o f andsiz e o f eac hgarden/ flowe r be d area . Each 

# ^ k Squar e Feet M:'e > anj locaiions
.

Pag e 4 o f

# ap ^
C O AS TA 

### Ite m Quantit y Uni t Conditlon/Type/Specie s Agree d upo n valu e o f plan t material s no t t o b e replace d b ycontractor
. Not e thi s valu e wil l b e use d t o issu e a plan t >ouche rt o th e propert ) owner . 

### ~ ^ 

# $ 0 I

Agree d upo n lis t o fplan t material s tha t wil l b e replace d b ycontractor
. Be veryspecifi can d detailed

. Eac h includ e a sketc h o fwere eac h plan t \y'i\ \ b e place d b_

\ th e coniracior

. Agree d upo n area o f propert yt o b e replace d wil h gras s sod

. i'ii.'k:d ca skeu:l i ol ' [li e aiea(s ) u ^

be replace d iv'il i ii'-a-. s >od

. S F •

Are a o fCif > o rCount > propert yt o b e landscape d pe rthei rrequirements

. 

### ^ S F .i

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Easemen t .Area , t o b e excavate d SF , . . - •

Pag e 5 o fC O AS T AL



### L J 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 bo xCE G i s no t responsibl e fo ran ydamag e don e t o th e interio ro fhouse , includin g foundatio n crack s o rfissures.

Q I d o no t agre e 

# ^^^'^^f^s^^Jk i W^ h ^ Contractor' s Signatur e Date Pag e 6 of

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. yo ^ \ ^ '-^ ^ ,^-7-7 ^ 'Asn.w a i 3( , i s \R^.Si^*
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Readin g Sampl e are a Shot # Readin g Sampl e are a JBT.s^ t aa.u T iC' S 3^t a;o.'; o 3iP,..;)ai

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RETES TAREA S Readin g Sampl e are a Shot # Readin g Sampl e are a 

# h - ^ ^

Dept h Dept h / ' ^ / 

### h"H-M n t U-p i 

## T ^ 

# ^ y It-^^t l^.-'^' l Averag e La b resul t Sampl e are a XR F Avg

. c Signatur e Prin t 

## |l/ll^f-0 7 JKlftT ^

# 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 376 7 Mod e SOI L Tim e 2008-09-1 3 11:5 3 Duratio n 120.9 9 Sequenc e Fina l Flag s AVERAG E 4 Av g o f3763-376 6 ADDRES S 242 6 Blond o s t QUAD/ZON E J l INSPECTO R lope z DEPT H SAMPL E TYP E •'CLEARANCE' ^ 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 338.97 1 Supervise d By : 

## Certificat e o fVerificatio n

376 3 SOI L 2008-09-1 3 11:5 2 30.5 2 Fina l 2731 7 242 6 Blond o s t B l lope z 6 CLEARANC E

±Erro r ±24.17 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 322.99 3 Supervise d By : 

## Certificat e o fVerificatio n

376 4 SOI L 2008-09-1 3 11:5 2 30.1 9 Fina l 2731 7 242 6 Blond o s t B l lope z 6 CLEARANC E

± Erro r
± 23.82 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 BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 325.75 0 Supervise d By : 

## Certificat e o fVerificatio n

376 5 SOI L 2008-09-1 3 11:5 3 30.0 3 Fina l 2731 7 242 6 Blond o s t B l lope z 6 CLEARANC E

± Erro r
± 23.78 8

# 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 334.21 7 Supervise d By : 

## Certificat e o f Verificatio n

376 6 SOI L 2008-09-1 3 11:5 3 30.2 5 Fina l 2731 7 242 6 Blond o s t B l lope z 6 CLEARANC E

± Erro r
± 23.88 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 AVERAG E ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

P b Supervise d B y 

## Certificat e o fVerificatio n

377 2 SOI L 2008-09-1 3 11:5 8 121.7 0 Fina l ,Av g o f3768-377 1 '242 6 Blond o s t |B 2 lope z CLEARANCEI T

# 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 206.02 6 Supervise d By : 

## Certificat e o fVerificatio n

376 8 SOI L 2008-09-1 3 11:5 5 30.6 1 Fina l 2731 7 242 6 Blond o s t B 2 lope z 6 CLEARANC E

±Erro r ±19.07 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 216.09 4 Supervise d By : 

## Certificat e o fVerificatio n

376 9 SOI L 2008-09-1 3 11:5 6 30.5 7 Fina l 2731 7 242 6 Blond o s t B 2 lope z 6 CLEARANC E

± Erro r
± 19.47 3

# 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 203.47 2 

## 1 Supervise d By : 

## Certificat e o fVerificatio n

377 0 SOI L 2008-09-1 3 11:5 7 30.2 5 Fina l 2731 7 242 6 Blond o s t B 2 lope z 6 CLEARANC E

± Erro r ± 18.85 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 204.71 5 Supervise d By : 

## Certificat e o fVerificatio n

377 1 SOI L 2008-09-1 3 11:5 8 30.2 7 Fina l 2731 7 242 6 Blond o s t B 2 lope z 6 CLEARANC E

± Erro r ± 19.13 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 AVERAG E ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

P b Supervise d B y 

## Certificat e o fVerificatio n

377 7 SOI L 2008-09-1 3 12:0 3 122.3 5 Fina l Av g o f3773-377 6 242 6 Blond o s t F l lope z 6 CLEARANC E

# 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 201.57 2 Supervise d By : 

## Certificat e o fVerificatio n

377 3 SOI L 2008-09-1 3 12:0 1 30.4 8 Fina l 2731 7 242 6 Blond o s t F l lope z 6 CLEARANC E

± Erro r
± 18.57 7

# 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 377 4 Mod e SOI L Tim e 2008-09-1 3 12:0 2 Duratio n 30.5 7 Sequenc e Fina l Flag s BVI D # 2731 7 ADDRES S 242 6 Blond o St QUAD/ZON E F l INSPECTO R lope z DEPT H 6 SAMPL E TYP E CLEARANC E NOT E

pp m±Erro r P b 199.34 6 ±18.50 9 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 186.55 5 Supervise d By : 

## Certificat e o fVerificatio n

377 5 SOI L 2008-09-1 3 12:0 2 30.5 0 Fina l 2731 7 242 6 Blond o s t F l lope z 6 CLEARANC E

± Erro r
± 17.92 7

# 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 377 6 Mod e SOI L Tim e 2008-09-1 3 12:0 3 Duratio n 30.8 0 Sequenc e Fina l Flag s BVI D # 2731 7 ADDRES S 242 6 Blond o s t QUAD/ZON E F l INSPECTO R lope z DEPT H 6 SAMPL E TYP E CLEARANC E NOT E

pp m ±Erro r P b 181.50 0 ±17.76 8 Supervise d By :

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 378 2 Mod e SOI L Tim e 2008-09-1 3 12:0 6 Duratio n 121.9 5 Sequenc e Fina l Flag s AVERAG E |Av g o f3778-378 1 ADDRES S 242 6 Blond o s t " - QUAD/ZON E ^ 2 INSPECTO R • iope z DEPT H SAMPL E TY F E "CLEARANC E NOT E

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 409.40 3 Supervise d By : 

## Certificat e o fVerificatio n

377 8 SOI L 2008-09-1 3 12:0 5 30.2 3 Fina l 2731 7 242 6 Blond o s t F 2 lope z 6 CLEARANC E

± Erro r
± 26.12 3

# 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 427.62 0 Supervise d By : 

## Certificat e o fVerificatio n

377 9 SOI L 2008-09-1 3 12:0 5 30.6 9 Fina l 2731 7 242 6 Blond o s t F 2 lope z 6 CLEARANC E

± Erro r
± 26.34 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 460.07 0 Supervise d By : 

## Certificat e o fVerificatio n

378 0 SOI L 2008-09-1 3 12:0 6 30.7 5 Fina l 2731 7 242 6 Blond o s t F 2 lope z 6 CLEARANC E

± Erro r
± 27.52 5

# 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 429.72 7 Supervise d By : 

## Certificat e o fVerificatio n

378 1 SOI L 2008-09-1 3 12:0 6 30.2 8 Fina l 2731 7 242 6 Blond o s t F 2 lope z 6 CLEARANC E

± Erro r
± 26.56 4

# 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 378 7 Mod e SOI L Tim e 2008-09-1 3 12:1 8 Duratio n 122.1 1 Sequenc e Fina l Flag s AVERAG E fAv g o f3783-378 6 f ^ ADDRES S 1 242 6 Blond o s t QUAD/ZON E j feasemeri t INSPECTO R lope z DEPT H ^ 1 SAMPL E TYP E ^CLEARANC E '" ' NOT E

Supervise d B y

# 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 287.53 5 Supervise d By : 

## Certificat e o fVerificatio n

378 3 SOI L 2008-09-1 3 12:1 5 30.3 4 Fina l 2731 7 242 6 Blond o s t easemen t lope z 1 CLEARANC E

± Erro r
± 22.07 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 303.38 1 Supervise d By : 

## Certificat e o fVerificatio n

378 4 SOI L 2008-09-1 3 12:1 7 30.6 8 Fina l 2731 7 242 6 Blond o s t easemen t lope z 1 CLEARANC E

± Erro r
± 22.51 7

# 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 378 5 Mod e SOI L Tim e 2008-09-1 3 12:1 7 Duratio n 30.4 1 Sequenc e Fina l Flag s BVI D # 2731 7 ADDRES S 242 6 Blond o s t QUAD/ZON E easemen t INSPECTO R lope z DEPT H 1 SAMPL E TYP E CLEARANC E NOT E

pp m ±Erro r P b 318.23 7 ±23.27 0 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 325.83 1 Supervise d By : 

## Certificat e o fVerificatio n

378 6 SOI L 2008-09-1 3 12:1 8 30.6 8 Fina l 2731 7 242 6 Blond o s t easemen t lope z 1 CLEARANC E

±Erro r
±23.48 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 AVERAG E ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

Supervise d By : 

## Certificat e o fVerificatio n

400 0 SOI L 2008-09-1 5 13:0 9 121.6 2 Fina l

,vg o f3996-399 9

_242 6 blond o s t ' | F 2 I

. lope z ' 8

RETES T

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 399 6 Mod e SOI L Tim e 2008-09-1 5 13:0 6 Duratio n 30.3 0 Sequenc e Fina l Flag s BVI D # 2731 7 ADDRES S 242 6 blond o s t QUAD/ZON E F 2 INSPECTO R lope z DEPT H 8 SAMPL E TYP E RETES T NOT E

pp m ±Erro r P b 108.26 4 ±13.33 9 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 102.65 5 Supervise d By : 

## Certificat e o fVerificatio n

399 7 SOI L 2008-09-1 5 13:0 7 30.3 3 Fina l 2731 7 242 6 blond o s t F 2 lope z 8 RETES T

± Erro r
± 13.13 4

# 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 76.15 2 Supervise d By : 

## Certificat e o f Verificatio n

399 8 SOI L 2008-09-1 5 13:0 8 30.6 7 Fina l 2731 7 242 6 blond o s t F 2 lope z 8 RETES T

± Erro r
± 11.67 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 BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 84.47 5 Supervise d By : 

## Certificat e o fVerificatio n

399 9 SOI L 2008-09-1 5 13:0 9 30.3 2 Fina l 2731 7 242 6 blond o s t F 2 lope z 8 RETES T

± Erro r
± 12.01 6^•'l-PHS^ ^ 

### Omali a Lea d Site—Fixe d Pric e EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc

. www.coastalhazmat.co m ?»F

COASTA L ENVIKONHENTA L GROUP , INC

. 

# EXECUTIV ESUMMARY : BVI D #2731 7 - (242 6 BLOND O ST )


# No Issue s o r Concern s I I Issues/Concern s
Detai l Explanation :

## s> % 

# EP A EP APropert y Clos e Ou t For m Propert y Addr«.

- ^^^ ^ ^^^^il^ ^ Propert y tt : ^"V??L" V , r • • "t^

- v " —^^-ZZ:J^J^\vv\ ^ ^S" ^ D«ten-Iine : ____^ ^ Owner' s Name;
. .i^h^VlfDjnl S M ^ - ,^ \ Quad s Excavated : Py F a<>^ \fe^ ~ Contracto r Grou p 0 f-A9^a\V ,V\\i\yDW\t7V\^0 ^ Excavatio nGenera l 

## /ACA/^ T ^ ' Ye s N o 1
. If necessaiy , were th e correc t quadrant(s ) excavate dan drestored ? ^ 2
. I f necessary , were th e correc t area s of drip zori e excavate dandrestored ? \ ^ Gradin g So d an d Vegetatio n Ye s N o 1
. Doc s the gradin g aroun dth e perimcic r ofth e hous e i nexcavate darea s generally slope-away 

### v X • fro

mtht4iouse ? 4 ^ ^Cc M ft>i.^ t^tuv^^l-y

2
. Hai s so dbee nlai di nall area s tha t wer e excavated ? ^ 3
. Doe s the sodappear t

o b e generally healthy an dgrowing ? (Only evaluate i f inspecteda t a3 0 / day time period) ^^__
_ 4
. Are sodde darea s generally firman devenly graded ? 

## y 5
. Are di e joint s betweenthe so dstrip 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 will nol poo l o nthe property ? 

## y 7
. Wa s damage t o landscapin g o r plan t material s avoided ? ^ Gates
. Fence s an dRetainin g Wail s Yes N o 1
. D o gate s ope nan dclos e freely? (If applicable ) 2
. Were all gate s o r fence s taitc ndow ndurin g restoratio nactivitie s reinstalled ? (If applicable ) 3
. Wa s damage t o gate s o r fence s avoided ? (If applicable ) 

# t
4
. Wa s damage to retainin g wall s avoided ? (If applicable ) Foundation , Sidin g an dGutter s Yes N o I
. Wa s damage to the sidin g or trimavoided ? 2
. Wa s damage to the foundationavoided ? x j A/ * i\f ^ » \Jb'\ 3
. Wa s damage t o window s avoided ? 

# Il k 4
. Wa s damage to window s o r doo r screen s avoided ? 5
. Wa s damage to downspout s o r downspout extension s avoided ? Sidewalk s an dDriveway s (Concrete ) Ve s N o I
. Wa s damage to drivewa y surface s avoided ? # 2
. Wa s damage to walkwa y surface s avoided ?

_ 1 L 1_

## owner s comments :

Remova l an drestorationactivate s complete including th e 30-da y so dwarranry : EP ARep^esentativj^<;^^^.^0^^,^X^ ^ Date : /Jl/j/nr ^

## Propert yCompletio n Agreemen t
Thi s agreemen l document s Ih e complclio n o l remedia l activitie s performe d n n m yproperly

. M ysignatur e wil l designat e tha t I a m satisfie d wit h th e restoratio n o fm yproperly , an d tha i n o item s ar e m questions

. now , o ra i an ytim e i n th e future , excep i thos e item s liste d below , i fan y

Propc i r y[ D 

# IW I Propert yAddrcs. : ^ t/Q^ ^ glpKlJ o $ f^ 

## o^" " AA ^ ^ec o \ wc^u^Vri-^ S

Restoratio n Item s i n Question :

Item : Item : Item : Item : Item : Item :

I agre e restoratio n i s completed , exctp l a s noler i
L I I d o no t ajjre cresloratin n i s complete d

Ovmcr' s Signafiir e Dat e