## TRANSMITTA Lo f OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R
SAID # : ,^qS O Date : q/ j 3./.c ^ Address : ^^RFlorfn^^ g y\\] d Remediatio nContractor : Coasta l Environmenta l Grou p Year : 200 8
SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S Vide o o f property (DVD ) 

# y Executiv e Summary 

# y EPA-provide dproperty sketc h 

# m Signe dAcces s Agreemen t fo r subjec t property Signe dAcces s Agreement(s ) for adjacent property 

# y Restoratio nAgreemen t 4031542 8 Superfun d 

# 1 Settlemen t document s (i.e. , for damag e o r t o replac e plants , etc. ) Confirmatio ndat a Photograph s •^e-I.^riMl^lSil ^ LjCC/J^iaridn I (fAg J So d / 

### As-buil t sketc h 

# y Satisfactory restoratio nsigne db y Property Owne r 

# y Property close-ou t chec k lis t signe db y EPA Descriptio no f area s no t meetin g RO D cleanu p criteri a Utility clearance s 

# 7 Property informatio nfro mDougla s County Assessor' s Offic e 

# y "iVf)^:>^L > flxu^s d\eJ4af 

# y CjbynA - J^r A D 

# taC^^Uh ^ 

# ^//^/g|^ ^ Signatur e 

# y-fd^U ^ 

# w/ m

### %



## Propert yAcces s Checklis t Propert y ID : 3'^^<^ ^ 

### • WORK STARTE D ON : / /_ nWORKCOMPELTE D ON : / / Propert y Address:Q^ ^ I: ^ Flr^/rir , Renter : Address : Phone : Fax : Cell/Pilfer : Phone : Additiona l Information : Fax : Cell/Paoc n/^/d-^^q ^ Owner:-^^^^^ ^ "DenV^^ ^

O Notificatio nLette r Sent : / / By : ^ Acces s A<»recmen t Sijined : / / By : \y C Restoratio nAgreemen t Signed : / / By : [ UTopsoi l Samplin g (if applicable ) / / By : r~ l Dispo.sa i Samplin » (if applicable ) / / By : 1 1 Garde nSainplin » (if ap|)licahle ) / / 

## By : 1 0 ' Utility Clearanc e 

### Called : ^/^/£2 1 

## ^y-Qc
. ^ • 3 1 0 Video/Photo s (Before ) 

### Oxi:yi_l^lQS
_ By:^ C nVideo/Photo s (During ) On : / / 

## By : 1
nVideo/Photo s (After ) On : / / By : nVideo/Photo s (3«-Day) On : / / 

## By : 1 L

UPro|)crt y Completio nAgreemen t Signed : / / By : 

# 1 1 1 Fina l Repoi t Issued :/ / By : 

# 1
Ai r IVlonito i in g (a s ap|)lical)le ) 1 1 Communit y [ H Cre w On : / / 

### By ; 1 Results : C

D Communit y 0 Cre w On : / / 

## B y : . I I Results : 1 1 Coininunit y O Cre w On : / / 

# 1 Results :

Omah a Lea d Sit e

### Pag e 1 of 2

Creat e Anothe rTicke t Bac k t o Irt h Interne t Sen d Emai l ly-' m



### YOU RTICKE T NUMBE RI S 2093379
. Origina l Cal l Date : 7/29/0 8 Time : 10:2 2 a mOp : ELIZABETH1879 0 Wor k t o Begi n Date : 7/31/0 8 Time : 10:4 5 a m State : N E County : DOUGLA S Place : OMAH A Address : 381 7 Street : FLORENC E BLV D Twp : 15 NRng : 13 E Sect-Qtr : 03-S W.*.>»•' • Tv\;p : Rng : Sect-Qtr : '"'// ' ...i.,., . Lega l Given : C ""**' * Typ e o f Work : lea d remidiatio n Locatio n o f Work : LOCAT E ENTIR E PROPERT Y AL L TH E WA Y T O TH E STREET . Remarks : FAX AL L CLEAR S TO : (877)662-421 1 : UNSUR E O F CORNE R LOT . y . Compan y: COASTA L ENVIRONiyiENTA 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 Corne r Lot : N Front : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V MAGELLANMUDO l OMAHACO F 0PPDGPR 5 QLNNEI C

Servic e Are a Contac t Phon e Numbe r Utilit y Typ e 

### Day : 402934046 9 CXCAT V CO XCOMMUNICATIONS , IN C 

### HEID I Ah : 402934046 9 Emerg : 402932975 7 Day : 918574709 8 

### MAGELLA NMAGELLA NMIDSTREA M PARTNER S L P TONYAAlt : Emerg : 918574709 8 Day : 402504782 3 MUDO l METROPOLITA NUTILITIE S DISTRIC TEDWIN AAlt : 

### Emerg : 402504794 6 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFIC.SEWE R 

### RO NAh : 402444516 1 Emerg : 402444516 0

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 7/29/200 8

### Pag e 2 of 2 Day : 406728934 3 0PPDGPR5 OMAH APUBLI C POWE RDISTRIC TN AAlt : 888728934 3 

### Emerg : 406728934 3 Day : 406728934 3 QLNNEIC QWEST LOCA LNETWOR K

N AAh : 

### Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 7/29/200 8

### Dougla s County Accoun t Infiannatio n Pag e 1 of 2 iTcmi a
Dougla s County , Nebrask a Propert yRecor d - R151253000 0 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t of90t h S t - ViewO n Ma p Infomiatio n i s vali d a s o f2008-6-1 9 Treasurer' s Ta xRepor t Ne wFeatur e ->-•- •Aut o Sale s Searc h Owne r NEA L ROS E
381 7 FLORENC E BLV D OMAH AN E 68110-000 0 PropertyInformatio n Ke yNumber : 125 3 000 0 1 5 Accoun t Type : Residentia l Parce l Number : 151253000 0 Parce l Address : Lega l Description : 381 7 FLORENC E B D OMAH AN E 68110-000 0 KIRKWOO D AD D LO T4 BLOC K4 W1/ 2 5 0 X 7 0 Valu e Informatio n
200 8 200 7 200 6 200 5 200 4 200 3 Lan d $1,900.0 0 $1,900.0 0 $1,900.0 0 $1,900.0 0 $1,900.0 0 $1,900.0 0 Improvemen t $36,400.0 0 $36,400.0 0 $36,400.0 0 $5,700.0 0 $5,200.0 0 $5,200.0 0 Tota l $38,300.0 0 $38,300.0 0 $38,300.0 0 $7,600.0 0 $7,100.0 0 $7,100.0 0 Lan d Informatio n Acre s 0.0 8 S F 3500. 0 Unit s 1. 0 Dept h 70. 0 Widt h 50. 0 Vacan t N o Improvement Informatio n Buildin g 1



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R15.
. . 7/17/200 8

### Dougla s County Accoun t Infonnatio n Pag e 2 o f 2

Secon d Floo r .leiTaissewcEB D 470. 0 sq . « . "3 T .—(

^ l i e Fir a floo r S8I0«D.«
. , „ WE T »f<i i 11/ 2 STOR YFI N '< 

# 3
esmtiBfc:.-j.kf i 9e i C l u ) t i W ti n U* f {si r

IDE O 1 1 I I ;...»?
. J

CLIC KT O ENLARQ E ii^fl/^Q E CLIC KT O ENLARG E IMAG E Squar e Footage ; 1351. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Fai r Uni t Type : Condition ; Fai r

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

Roo fType ; Gabl e Stories ; 1. 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 5 0 % 190 5 10 3 Deta/7 Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 881. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Porc h Sla b Roo fCei l 160. 0 Use r Atti cFul l Finis h 470. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno==R15.
. . 7/17/200 8

## CONTAC T FOR M Property I D # Property Address : 

# :'^f(l' } f}ore7)r e Rv/d Initia l Contact : Date : Time : Action : Secon dContact : Date : Time : Action : Fina l Contact : Date : Time : Action : Fina l Action : Transmi t t o EP AD Othe r Action : D

1 vi>^v/ \I r^^^
_ 2 ^ \ ^ • 1 II ^ ^W ^ ! 1 

## Comment : Owner Comment (s) :
Site Coordinato r Comment (s) :

# As-Buil t Drawin g COASTA L 

# Omah aLea dSuperfun dSit e

Name : A^^ A ^— Omah a Lea d Sit e Date : ^V!^?/ ^ Nort h Arro w Address : J^/ 7 y=y^aSttf^ ^ ^i>y > Sit e Sketc h Time : /a...5- ^ Phone : < ^

V o ? > cl^/'^-^ST r 

### - « ^



## 7 7 7~ /

T^^yy / XR FCod e •SB'O I Tea m -24c/A7?^//9'// / BVI D # 3 ZO'yy , Sampl e Numbe r Lea d Concentratio n Confirmatio n Sampl e 

## 5 V 

# m o t aV y/Ye s n 

## 'S T >=^Ye s n 

## QS^ L ^^ ^

/ ^ oo m -^/Ye s 1= 1 

## YPSCLPy Ar3^ ^ YID-^S(LPX(: \A'37^ W DD m

28 9 PP M @ 6 "



### Legen d Concret e Dri p Zon e Excavate d Quadrant s Excavate d Are a replace d wit h Are a replace d wit h Are a lef t bar e So d ' ' Rock/Mulc h 

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

## J 

# ^n-ios y al l hoiTlO
. f^ j 

# > j
. r ­ Name : yU^A (~ Address ; ?y/ 7 ^•=y>as^t^ & iff'i^i ) 

## Phone: ^>y^7 > <y^y^~y>si y Omah a Lea d Sit e Sit e Sketc h Date : Time : <yy z yAi ^ .y^^yC-^ ^ Nort h Arro w 

# 7 7 T / Tea m Z^/^/STyn/^/S// / 

# TysTT j

_BVID #
. 3 Z<f<y XR F Cod e 

### 5B0 \ Lea d Concentratio n Confirmatio n Sampl e 

# m o ^ ^" 7 pp ^ ^5 ^

pp m /^/Ye s n ^^ 7 Ye s n ^•/Ye s n ^Z.Ye s •= ! ^7Ye s a

"Ye s a

Ye s • N o N o N o N o N o ta - N o • N o •


# ^>:'#~4?/.... i y>r9y¥ ^ ^ -

OmahaLea dSit e 4613 0

### Name : y^^ 4 i - . Omah a Lea d Sit e Address : jy/ 7 yy>.iZetf^e
. ^iT p Sit e Sketc h Phone : ^^o:? > <^7^~7>Si y 

### Tea m 2/ ^

h 757^0/ ^

7^// / BVI D # 3 Zfyy Sampl e Numbe r Lea d Concentratio n 

# g7[MQ£> L )35 V pp m 

# n^^Dzadpy AS97F W pp m //y)^!^ ^ pp m pp m pp m Date : -^/^j/b^ " Nort hArro w — i 

### Time : y<^yc y 

### i ^ 7

XR F Cod e 

## 55-Q f Confirmatio n Sampl e /^Ye s ° y<ZYe s n ^/Ye s n ^^lYe s C : ^zYe s "^ ^ Yes n Yes •



### PUUH ^ \L^V ^
OmahaLeadSite 4613 0Nam e X^rim"* ^

Tt4^oy^V>^^ A"JR
. Omah a Lea d Sit e Date:oQ - iS-0 3 Nort h Arro w Address : . 3 ft \ W.'^•^aoXo ^ S t Sit e Sketc h Time : "S'.MS^f n Phone : 

## l^/f t 

# t
XRFCodjfrl'SO ^ Tea m <^i.c.^jQ^\5,VYm^H ^ BV1D#JM2L1S
_ Sampl e Numbe r Lea d Concentratio n Confinnatio n Sampl e 

## g^J^^cJ(^-3g3>9S > ^,Ye s t n N o S ] pp m QYe s t D N o 5 3 pp m o Ye s O N o I S pp m No s a pp m 

## 1 o2or±: 5 ¥ pp m N o S oiXe s n Ye s n No c n pp m Ye s • N o n pp m



## ^o^<^l^ ^ SV
Omah aLea dSit e 4613 0

# M) ( # COASTA L fNVIROHnlNTA t r • o u p . I M f 

## 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 followin g describe d premises :

Owner' s Nam e Daytim e Phone : ( V<5 2 ) U *^" " ^ ^

t 7 

### QAM-7 ^ 

## D^nX^no ;

Addres s o fPropert y covere d b ythi s Agreement : 

## 3^) 7 ^loY-^nC ^ ^\vJ r
PURPOS E O F RESPONS E ACTIVITIE S 

### Th e EP AI 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 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 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 wt)r 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 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 , contractor s an d subcontractors th e right 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 ;

Pag e 1 of2

### < # COASTA L fNVIIONM fNTk l c•o u ' ' < •r



### •Remov e obstruction s includin g boats , trailers , vehicles , playscap e Items , woo d piles , do g houses , etc ; • Remov e flowe rbulb s o rplant s tha t th e Granto ro rth e Grantor' s tenan t ma ywis h t o save ; • Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , a s necessar ysubsequen t t o a n initia l waterin g perio d b yEPA ; •Abid e b yhealt h an d safet yguidanc e provide d b yEPA ; •I 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 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 vwul 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 (712 ) 352-018 8 

## J^ i I gran t acces s t o m ypropertie s O I d o no t gran t acces s t o mypropertie s

Signatur e Date Signature Dat e

O

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

### 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 dt o th e satisfactio nofth e propert y owner an dth e Unite dState s Environmental Protectio nAgenc y (EPA)
.

PropertylD : y%J ) Propert y Address : 1^^]- ] ^^
. Owner : ^fx) U |^^|<^| i 

### i ^ Phone : 

### ^ n <f|v j p<i n
O nth e attache ddiagram(s ) indicate area(s ) t o excavatedanddept ho f excavation , locationo f al

l know n utilities , subsurfac e features , surfac e structure s an dlandscapin g features , acces s location(s ) t o be usedb y contractor , andth e directio no f North
. Indicate distances , depths , material tvpes , etc . Indicate digita l photo s b

y referencin g th e photo-lo g number wit ha narro\ ^ indicating directio no f view
. 

### Item s T o B e Remove d B yOwne rBefor e Star t O f 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 : ^ / / n 1 1 < 

# fli t 9 ^ //i/i/ y - " ^ Item : y ^
Item : / ^ 

# ^ y Item : y Item ; y Item : -^
Item : y Item :
Pag e 

### i o f [/ /COASTA L 

### Item s T o B e Remove d B yContracto rDurin q Remediatio n An d No t Reoiace d (Us e additiona l sheet s a s necessary ) Item : . Item : r 

# y u ?m i 

# /ib o 

# 1 0 '1f t Item : _______ ^

' 1 * •. ^l - " r' •/ Item : /
Item : / 

### y Item : /
Item : /
Item : /
Item : /
Item : /
Item : /
Item : /
Item : /
Item ; Item :

Pag e 2 o fF^^^^^ ~ COASTA L 

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

# 4l?I L 7 

# ^ h ^- H Item : Item : 

### ^\ ) \y i 

# h -f - 

# pt Yv^ ^ 

# ^ /
Item : /
Item : / 

### y Item : /
Item : /
Item : /
Item : /
Item : /
Item ; /
Item ; /
Item : /
Item : /
Item :

Pag e 3 o f 

# cC O AS " I AL 

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

### Ite m Quantit y Uni t Condltion/Type/Specie s

Pre-existin g propert yarea , tha t wil l b e excavated , tha i i s covere d wit h grass . 

# •n Squar e fee t 

# ftvi fy^f i

Numbe ro ftree s trun k diainete r > 2 inc h 

# L y Q Eac h 

# \
\ 

# {\
^

Numbe ro ftree s •' = 2 inc h trun k diainete r 

# \ 7 \ Fnr h 

# y a . - ^ 

# ^ 

# u^i y 

# fwt- , \M?^ki ^

Numbe ro fSprinkle r Zones
. Contro l Valves
. Timers
. Heads , etc
. -Auacl i a sketcl i \i\ ' in c i]iiii-ikle r!a \ out
. ,-— \ 

# 7 y

^ Eac h

Numbe ro fan d siz e o f eac h sarden
. flowe rbe d area . -•.:.j\.i , :'
. ^.^cic! : ^' i
.. ; ,;::• , c -i;'e > :'.n.. \ locations
. i 

## ryy 

# 77 Eac h Squar e Fee t

Pag e 4 

# J

# m ^

COASTA L 

### Ite m Agree d upo n valu e o f plan t material s no t t o b e replace d b vcontractor
. Not e thi s \alu e wil l b e use d t o issu e a plan t >ouche rt o th e propert > owner . Agree d upo n lis t o fplan t material s tha t wil l be replace d b ycontractor
. B e veryspecifi can d detailed
. Includ e a sketc h o fwei e eac h plan t w'\\ \ b e place d h \

th e contracior
. Agree d upo n area o f propert N t o b e replace d u it h gras s sod
. ''iCll:d e a vl-eU'l i o' i ill c .iieais ) U l h e :epr.K'(.- j '.^'I' l Ll'-a-. s ^0d
.

.Area o fCir > o rCounr s propert N t o b e landscape d pe rthei rrequirements
.

• r'Li.al c. -r.t'i,-! ! y:< \

Easemen t .Area , t o be excavate d 

### Quantit y

^ 

### Uni t

$ 

### Condition/Type/Specle s

; 3


# y Eac h 

# H y S F 

# \ \

l|VliyL % ^r\i ^

S F 

# \7k^{y^\AA <

S F 

# \ ^

U MTJXU ,

^ Pag e 5 o fCOASTA L c« o u r. ( M c .


### Additiona l Comment s / Instructions :



# . - lf(7 WH

- V ^ ^ •-^'^\y7y-7:77/:: ,

•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 cracks o rfissures
.

1X1 1 agre e 

### Q I d o no t agre e 

# It \7 { Owner' s Signatur e Date Coiuractor' s Signature Pag e 6 of
.

## BviD # y^< o XR F PROPERTY SAMPL E SHEE T Dat e 

# J y Addres s 

## y ^

fi^Ty yUvk ' Projec t Omah a lead F P 2n d yea ropilo n Sampl e tim e am//l 

# y y ^ XRFID # sampl e lengt h 3 0 se c 

# y^yy \ Shot # Readin g Sampl e are a Shot # Readin g Sampl e are a 

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i m i 

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# W W nyyiM.i? s Dept h 

# m ^ 

# •yy^ y y y 

# ~W T 

# yy'^'^ ^

\y \ yy^ Averag e 

# Vi^yy i yy \ Averag e 

# \w. y 

# ^- \'^- %

Shot # Readin g Sampl e are a Shot # Readin g Sampl e are a T , ^ 

## '%y \ i zy . 

# T T 7y \ ^7M|.t<^tS
. h 

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## ^U L lll- g ^ -2-1. ^

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. 

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Shot # Readin g Sampl e are a Shot # Readin g Sampl e are a Dept h Dept h Averag e Averag e

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

## ^.^-^
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. Signatur e 

# ^i^^ t Mrf^^ ^ Prin t

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 286 7 Mod e SOIL Tim e 2008-08-2 3 15:3 0 Duratio n 120.9 5 Sequenc e Fina l Flag s AVERAG E Av g o f2863-286 6 ADDRES S 381 7 Florenc e blv d QUAD/ZON E INSPECTO R "tOPE Z DEPT H 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 Bilierica , 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 299.07 4 Supervise d By : 

## Certificat e o fVerificatio n

286 3 SOI L 2008-08-2 3 15:2 7 30.2 3 Fina l 3295 0 381 7 Florenc e blv d F2 LOPE Z 6 CLEARANC E

± Erro r
± 21.37 1

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Bilierica , 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 275.73 4 Supervise d By : 

## Certificat e o fVerificatio n

286 4 SOI L 2008-08-2 3 15:2 8 30.2 5 Fina l 3295 0 381 7 Florenc e blv d F2 LOPE Z 6 CLEARANC E

Erro r ± 20.00 7 ±

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Bilierica , 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 275.65 1 Supervise d By : 

## Certificat e o fVerificatio n

286 5 SOI L 2008-08-2 3 15:2 9 30.2 3 Fina l 3295 0 381 7 Florenc e blv d F2 LOPE Z 6 CLEARANC E

± Erro r
± 20.86 5

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Bilierica , 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 306.49 6 Supervise d By : 

## Certificat e o fVerificatio n

286 6 SOI L 2008-08-2 3 15:3 0 30.2 4 Final 3295 0 381 7 Florenc e blv d F2 LOPE Z 6 CLEARANC E

± Erro r ± 21.91 1

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 287 2 Mod e SOI L Tim e 2008-08-2 3 15:3 4 Duratio n 120.5 0 Sequenc e Fina l Flag s AVERAG E jAv g o f2868-287 1 ADDRES S 381 7 Florenc e blv d QUAD/ZON E 

### flpz INSPECTO R DEPT H LOPE Z SAMPL E TYP E NOT E CLEARANC E

Supervise d B y

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Bilierica , 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 231.06 3 Supervise d By : 

## Certificat e o fVerificatio n

286 8 SOI L 2008-08-2 3 15:3 1 30.0 5 Fina l 3295 0 381 7 Florenc e blv d D Z LOPE Z 1 3 CLEARANC E

Erro r ± ± 18.54 3

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Bilierica , 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 165.07 6 Supervise d By : 

## Certificat e o fVerificatio n

286 9 SOI L 2008-08-2 3 15:3 3 30.0 3 Fina l 3295 0 381 7 Florenc e blv d D Z LOPE Z 1 3 CLEARANC E

± Erro r ± 16.01 7

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Bilierica , 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 123.15 8 Supervise d By : 

## Certificat e o fVerificatio n

287 0 SOIL 2008-08-2 3 15:3 4 30.2 6 Fina l 3295 0 381 7 Florenc e blv d D Z LOPE Z 1 3 CLEARANC E

± Erro r ± 14.18 0

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Bilierica , 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 147.89 9 Supervise d By : 

## Certificat e o fVerificatio n

287 1 SOI L 2008-08-2 3 15:3 4 30.1 6 Final 3295 0 381 7 Florenc e blv d D Z LOPE Z 1 3 CLEARANC E

± Erro r ± 15.18 8

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 287 8 Mod e SOI L Tim e 2008-08-2 3 15:3 9 Duratio n 120.8 9 Sequenc e Fina l Flag s AVERAG E |Av g o f2874-287 7 ADDRES S 381 7 Florenc e blv d QUAD/ZON E F l INSPECTO R LOPE Z DEPT H 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 Bilierica , 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 356.71 5 Supervise d By : 

## Certificat e o fVerificatio n

287 4 SOI L 2008-08-2 3 15:3 7 30.0 8 Fina l 3295 0 381 7 Florenc e blv d F l LOPE Z 4 CLEARANC E

± Erro r ± 23.24 8

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Bilierica , 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 331.96 1 Supervise d By : 

## Certificat e o fVerificatio n

287 5 SOI L 2008-08-2 3 15:3 8 30.3 1 Final 3295 0 381 7 Florenc e blv d F l LOPE Z 4 CLEARANC E

± Erro r ± 22.63 7

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Bilierica , 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 311.55 5 Supervise d By : 

## Certificat e o fVerificatio n

287 6 SOI L 2008-08-2 3 15:3 8 30.0 7 Fina l 3295 0 381 7 Florenc e blv d F l LOPE Z 4 CLEARANC E

± Erro r ± 21.86 1

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 287 7 Mod e SOI L Tim e 2008-08-2 3 15:3 9 Duratio n 30.4 3 Sequenc e Fina l Flag s BVI D # 3295 0 ADDRES S 381 7 Florenc e blv d QUAD/ZON E F l INSPECTO R LOPE Z DEPT H 4 SAMPL E TYP E CLEARANC E NOT E

Erro r P b 296.33 4 ± 21.42 3 Supervise d By : pp m

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 365 5 Mod e SOI L Tim e 2008-09

- 1 0 14:4 6 Duratio n 122.1 4 Sequenc e Fina l Flag s AVERAG E §Av g o f3651-365 4 ADDRES S 381 7 Florenc e blv d QUAD/ZON E •easem e % INSPECTO R lope z DEPT H SAMPL E TYP E CLEARANC E NOT E

Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Bilierica , 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 341.65 5 Supervise d By : 

## Certificat e o fVerificatio n

365 1 SOI L 2008-09-1 0 14:4 3 30.6 6 Fina l 3295 0 381 7 Florenc e blv d easemen t lope z 1 CLEARANC E

± Erro r ± 23.81 3

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Bilierica , 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 323.25 5 Supervise d By : 

## Certificat e o fVerificatio n

365 2 SOI L 2008-09-1 0 14:4 4 30.4 9 Fina l 3295 0 381 7 Florenc e blv d easemen t lope z 1 CLEARANC E

± Erro r
± 23.15 9

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Bilierica , 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 338.20 2 Supervise d By : 

## Certificat e o fVerificatio n

365 3 SOI L 2008-09-1 0 14:4 5 30.5 3 Fina l 3295 0 381 7 Florenc e blv d easemen t lope z 1 CLEARANC E

± Erro r ± 23.67 4

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Bilierica , 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 316.43 5 Supervise d By : 

## Certificat e o fVerificatio n

365 4 SOI L 2008-09-1 0 14:4 6 30.4 6 Fina l 3295 0 381 7 Florenc e blv d easemen t lope z 1 CLEARANC E

± Erro r ± 23.06 3^y^-"^ f 

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

# M \ •J ? www.coastalhazmat.co m *^'>i.no- yCOASTA L eNVmONMENTA L cI t 0 u r . INC
. 

# EXECUTIV ESUMMARY : BVI D #3295 0 - (381 7 FLORENC EBLVD )
N o Issue s o r Concern s | ^ Issues/Concern s Detai l Explanation :

# sm . 

# EP A EP APropert y Clos e Ou t For m Propert yff : .^.3^5 0 Propert yAddrew : S^il-fiOfetlC C f^\\ic l Date/Time : Owner' s Name : Vj^fOf fV(rr>Hn y Quad s Excavated : F > . p j Q% / Contracto rCrou p C/Vl,^i[rL t F)nM\rCSYltrY'/\ir J
Excavatio n Genera l Ye s N o 1
. If necessa^' , wer e th e correc t quadrant(s ) excavate dan drestored ? 

### y 2
. I f necessary , wer e th e correc t area s o f dri p zon e excavate dan drestored ? 

# y Gradin g So dan dVegetatio nYe s No 1
. Doe s th e gradin g aroun dth e perimete r ofth e hous e i nexcavate darea s generall y slop e awa y ^ fro mth e house ? 2
. Ha s so dbeenlai dinall area s that were excavated ? 

### y 3
. Doe s th e sodappea r t o b e generall y healthy an dgrowing ? (Onl y evaluat e if inspecte da t a3 0 

## y da y time period ) 4
. Ar e sodde darea s generall y fir mandevenl y graded ? • ^ 5
. Ar e th e joint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat e if inspecte da t a3 0 da y ^ tim e period ) 6
. Wa s the propert y grade dsuc htha t water will not poo l o nth e property ?

- 7
. Wa s damag e t o landscapin g o r plant material s avoided ? L.y Gates , Fence s an dRetainin g Wall s Ye s N o 1
. D o gate s openan dclos e freely ? (Ifapplicable ) 2
.Wer e all gate s o r fence s lake ndowndurin g restoratio nactivitie s reinstalled ? (Ifapplicable ) 1 3
. Wa s damag e t o gate s or fence s avoided ? (Ifapplicable ) 

# y ­ 4
. Wa s damag e t o retainin g wall s avoided ? (Ifapplicable ) Foundation , Sidin g an dGutter sVe s No 1
. Wa s damag e t o th e sidui g o r tri mavoided ? 1 ^ 2
. Wa s damag e t o th e foundatio navoided ? l y 3
. Wa s damag e t o window s avoided ? y 4
. Wa s damag e t o window s or doo r screen s avoided ? L ^ 

### y 5
. Wa s damag e to downspout s o r downspou t extension s avoided ? Sidewalk s an dDriveway s (Concrete ) Ye s N o I
. Wa s damag e to driveway surface s avoided ? j ^ 2
. Wa s damag e to walkway surface s avoided ? y 

# i

## O vner s comments :

Inspectio nnotes :

Removal an drestoratio nactivate s complet e includin g the 30-da y so dwarranty : EPARepresent^tivr7^>^ ^ ^£^^,^^^^3 ^ Date : ^^ ^

### % %



## Propert yCompletio n Agreemen t (hi s agreemeni document s the completiono f remedia l activitie s performedo nm y property . M y signature Wil l designate tha t Ia msatisfiedwit hth e restoratio no f m y properly , an dIha l n o items ar e i nquestions , now , or a

l an y tim e i nth e future , except thos e ilem s listedbelow , ifan y Propcrt j 

## ID : -j^qsz , Propcrt j 1 Address : ~}S \ 7 

### r€f\ce ^ 

# b U Fl o Owner : 

### Bruc e O^nk i /i 5 Phone ; 

# C / i oy? 7 Restoratio n Item s i n Question :

Ite m Item : Item : Item : Item ;

I I I agre e restoratio ni s completed , excep t a s note d I II d o no t a(;re c restoratio ni s conipletc d 

# %\APU
. t)cyik/^ ^ %-y^C > 0 g ­ Owner' s Signature Dat e Contractor' s Signatur e Dac e