### TRANSMITTA Lo f OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R SAID# : 

# ^^/"f Date : 

# /^/V/^ 7 Address : /3^S ^ S J2 ^ Sf ' Remediatio nContractor : Coasta l Environmenta l Grou p Year : 200 7 SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S Vide o o f property (DVD ) Executiv e Summary EPA-provide dpropert y sketc h, ^ Signe dAcces s Agreemen t for subjec t propert y D 

### Signe dAcces s Agreement(s ) for adjacen t propert y Restoratio nAgreemen t D 

### Settlemen t document s (i.e. , for damag e o r t o replac e plants , etc. ) Confirmatio ndat a Photograph s As-buil t sketc h. Satisfactory restoratio nsigne db y Property Owne r Property close-ou t chec k lis t signe db y EP A Descriptio nofarea s not meetin g RO D cleanu p criteri a D Utilit yclearance s D 

### Property informatio nfromDougla s Coimty Assessor' s Offic e D D , D
^ ^ 4031787 3 Superfun d

## Fina l Repor t Propert y Chec k Lis t (piease plac e wit heac hfile) Har dCop y Informatio n \ . Propert y Chec k Lis t 'Sv ^ Sit e Workin g Drawin g Ma p - ^ EP Aoriginal s Ma p H , Dougla s Count y Assessor' s Ma p 'S . Propert y Contac t Shee t Agreemen t "~i->Acces s Agreemen t

2 . Restoratio nAgreemen t Miscellaneou s Document s ~1^Fina l Ma p fi-omth e Fiel d -2^hang e Order s f^f ^ -f^r^RFDat a -4rA.n y email s o r P O correspondence s r^jf ^ Propert y Completio n \l . Executiv e Summar y "X A S BUIL T " ^ Propert y Completio nAgreemen t ^ "NyAn y buyou t inf o o r reimbursemen t inf o t^/r T ~~5 : Chec k o r mone y orde r copie s y\i/ A '&>JEP APropert y Clos e Ou t For m "^?T-Attache dBegi nVide o 

## Electroni c Documentatio n Drawing s ~T > EP Aorigina l "2? ^ Workin g Drawin g -± - A S Built.vs o -4r-A S Built.jp g

Photo s ~-\—. , Begi nPhoto s -^— ^ During/Excavatio nPhoto s -*— ' So dPhoto s - ^ 30-Da y So dPhoto s Scanne dDocument s "" ^ Fina l Document s -^^^"^ Executiv e Summar y Video s Begi nVide o 

### 2 . M y Movi e

### Propert yAcces s Checklis t Propert y ID : ^ Q ^ | ^ Property .\ddrcss : | ^^ 5 S 2.Q , ^j . n n

WOR K STARTED WORKCOMPELTE D ON : ON : / /



### ^ ' ' "''• • 3CaMCj ^ Address : 

### Ct^n^So M ' ( J Renter : Phone : Fax : 1 1 

### Phone : ^5 ^ Fax : 

### 3^'75^/ ^ Cell/Pauer : Additiona l Intormation : 1 Cell/Pa<;er :



### D Notificatio n Lette r Sent : / / By : ^ 

# m

u 

# • D .Acces s .\<ireenicn t Restoratio n Ajireenien t Topsoi l Samplin g (i f appli c able ) Disposa l Samplin g (i f applicahle ) Garde n Samplin " (i f ap|)li c able ) Signed : ~^ 11 ^

lO' ^ 

### Signed : i / / ^7 / 0- ? / • / 

### ^ y(Uu^r s ^y-Chiz< s B.> : By : B\ :

- ^ 

### S i D 

# j D

n D 

# l a l'tilit > Clearanc e Video/Photo s (Before ) \ ideo/Photo s (During ) Video/Photo s (.\fter ) Video/Photo s (3()-Day ) Propert yCompletio n Agreemen t Fina l Repor t 

### Called : 7 . ' ^ O T On:3:'P- / i0 2 On : / On : / / On :

• Signed : / Issued : / / 

### B.^:/A 6 B.^<lKe,: s B> : By : By : By : 

### '^\2,^7<?fir5? S

l l .Ai rMonitorin g (a s applicable )

HI ! Communit y Results : D Cre w! On : — / B^ : j
1 1 Communit y 1 Results : D Cre w! On : / / 

# 1 By : 

# I
1 1 Communit y D j Results : Crc M On : / ! B} : j 1
Omah a Lea d Sit et Square Footag e t o b e Excavate d = 91 9 ^/ ^ PropertyClassification : 80 0 n e Linea rFootaq e t o t) e Excavate d = 11 2 // ^ 

### / ^ /



# O ^" ^
Omah a Lea d Sit e Concret e Omaha , Nebraska Excavate d Are a Propert yNumbe r Existin g Structur e Scal e OLS-2021 4 Fenc e Permanen t Landscapin g 1 Inc h = 2 0 fee t o r1 gri d = 5 x5 f t Propert yAddres s 132 5 S 2 6 S T Quadran t Boundar y j^n*'. ' iff* . Pos t Excavatio n Concentration s (ppm ) Street Boundar y F l . B 2 PlayAre a Tree/Shru b 

## PPP^ ^



# ^ F 2 6 1 DZ Garde nEasemen t Othe r Descriptio n ofpost excavatio n area s Fl . fron t yar d ieft-fian d quadrant ; F2 , fron t yar d right-fiand quadrant ; Bl , bacityard ieft-fian d quadrant ; B2 , backyard nght-han d quadrant ; DZ , dri p zon e (1- 3 foo t are a o fsoi i aroun d th e foundatio n o fth e house )

### Dougla s Coimt y Pag e 1 of 2 Dougla s County , Nebrask a Propert yRecor d ­ R221890000 0 Informatio n I s vali d a s o f2007-5- 9 Value s not finalize d unti l afte rBoard ofEqualizatio n Prin t Repor t Vie wo n Ma p 

### Owne r CAMPSE YFRANCE S ETA L 132 5 S 2 6 S T OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumber : 189 0 000 0 2 2 Accoun t Type : Residentia l Parce l Number : Parce l Address : Lega l Description : 221890000 0 132 5 8 2 6 S T OMAH AN E 68105-000 0 SHULL S 2N D AD D LO T1 6 BLOC K1 0 5 0 X 12 7 Valu e Informatio n 200 7 200 6 200 5 200 4 200 3 200 2 Lan d $4,900.0 0 $4,900.0 0 $4,900.0 0 $4,900.0 0 $4,900.0 0

$0.0 0 Improvemen t $83,700.0 0 $63,600.0 0 $63,600.0 0 $63,600.0 0 $63,600.0 0 $0.0 0 Tota l $88,600.0 0 $68,500.0 0 $68,500.0 0 $68,500.0 0 $68,500.0 0 $0.0 0 Sale s Informatio n Dat e Typ e Boo k 

### Pag e Pric e Lan d Informatio n Acre s 0.1 4

I S F 6350, 0 F F 50. 0 Unit s 

### 1.0 Dept h 

### 127. 0 Widt h 50. 0 Vacan t N o Lan d Attribute s Attribut e Attribut e Descriptio n Improvement Informatio n Buildin g 1



### http://douglasne.mapping-online.coni/DouglasCoNe/static/accountinfo.jsp?accountno=R22. . . 7/25/200 7

### Dougla s County Pag e 2 of 2

173 0 SI O S T Erv: l 3Cfft«f i r s 0 S- 3 F l IIJ SM:cri]Ftoc < JWidSf l f t su B U

» W0 S o R •3( 1 n a Jif f E*- i &£Tw n " M 0 S H » . 1 1.' 2 Stor y Bnrrt B*>z k 9 f t »6 7 0S< i R elici t t o Enlarg e Imag e Clic k t o Enlarg e Imag e Squar e Footage : ! 1359. 0 Percen t Complete : 100.0 % Perimete r0. 0 Quality : Averag e Uni t Type : Condition : Averag e Cond o Squar e Footage : 0. 0 Buil t As : 1 1/ 2 Stor yFi n Rooms : 5. 0 HVAC : Centra l Ai rt o Ai r Units : 1. 0 Exterior : Fram e Sidin g Baths : 1. 0 Interior : Drywal l Bedrooms : 2. 0 Roo fCover : Compositio n Shingl e Stories : 1. 5

Roo fType : Gabl e Foundation : Bloc k Floorcover : Allowanc e Sprinkle rSquar e Footage : 0. 0 Yea rBuil t Yea r Remodele d Percen t Remodele d Adjuste d Yea r Buil t Physica l Ag e 192 0 0 % 192 0 8 7 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 ft 967. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Garag e Detache d 180. 0 Garag e Detache d 160. 0 Porc h En d Scree n 25. 0 Porc h En d Scree n 154. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R15. . . 7/25/200 7

## 2021 4

Omah aLeadSit e 4613 0

## CONTAC T FORM Property I D # (^^/ / 

## Property Address : 

# P 7 K S P f ^ Initial Contact : Date : Time : Action : Secon dContact : Date : Time : Action : Final Contact : Date : Time : Action : Fina l Action : Transmi t to EP AD Othe r Action : D

Comment : Owne r Commen t (s) : Site Coordinato r Commen t (s) :• * COASTA L FNVinONMENTA L CROUP . IN C 

## Consen t Fo rAcces s T o Propeit y RIGH TO F ENTR YT O PREMISE S 

### Granto r(th e propert yowner ) 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 Name : 

### ffiAJUCe' ^ CAITIPS ^



### Daytim e Phone : 'g^S'' 151 6

Addres s o fPropert y covere d b ythi s 

# I3>Z65> Z^s r 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 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 contac t 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 

### Bysignin 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 o fperformin g th e work . Thi s acces s shal l remai n i n effec t 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'^••-:im ^ V^^J ^ ,

- * ^ \ * <. v

COASTA L ENVIRONMENTA L CROUP . 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 ma ywis 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 b yhealt 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 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 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 Coastal Environmenta l Group , a t (877 ) 234-6270 .



## [? f I gran t acces s t o m ypropertie s D I d o no t gran t acces s t o m ypropertie s 

# 4.^HC.e^> ^

'^y'^^aT e '/'^/' ' Signatur e Dat e

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

!f.-c i ­

; • (
Pag e 2 o f2

## Restoratio n Agreemen t Th e purpos e o f thi s agreement i s t o provid e amutua l agreement a s t o condition s ofth e property prio r to remediatio nactivities . Thi s wil l als o serv e a s documentatio nfor th e purpos e o f assurin g that restoratio n activitie s ar e complete dt o th e satisfactio nofth e property owne r an dth e Unite dState s Environmental Protectio nAgenc y (EPA) .

PropertylD : ^d2/<7^ " Propert y Address : /- ^ ^ ^ J ^7/^P^ T Owner : /^^^^^ ^ /^,^MP<. ^ Phone : 

# ?^?7T/S
O nth e attache ddiagram(s ) indicate area(s ) to excavate dan ddept ho f excavation , locatio no f al l known utilities, subsurfac e features , surfac e structure s an dlandscapin g features , acces s iocation(s ) to b e use db y contractor , an dthe directio no f North . Indicat e distances , depths , material t>pes , etc . Indicate digital photo s by referencin g the photo-lo g number wit ha narro w 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 : 

### K)ON € Item : Item : Kem : Item : ttem : Item : Item : Pag e 1 of . ^COASTA L • MVtMOMM C MTA l G « O U P IM C 

### 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 : 

### Mrr^^'^r ^ ^cPo ^ i ^ bZ - Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : 

### Item :

Pag e 2 

## of &COASTA L flMVinOMMIMTAt. C « O W» IM C 

### 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 : Item : 

### 3 o I ( • Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : item : Item : Item :

Pag e 3 o f^COASTA L 

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

### Ite m 

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

Pre-existin g propert y area , tha t will b e excavated , that Squar e fee t 

# /O^t
­ i s covere dwithgrass .

Numbe r o f tree s > 2 inch Each trun k diamete r

Numbe r o f tree s < = 2 inc h Eac h trun k diamete r /

Numbe r o f Sprinkle r Zones . Contro l Valves , Timers . Heads , etc . Eac h .^nac hasketc ho f th e ^ sprinkle r lavout .
Numbe r o f an dsiz e o f eac hgarden / flower be d area . Eac h Squar e Feet ^

. •\nac haskeic hof relativ e size s an dlocations .

Pag e 

### 4 of6COASTA L ENVIRONMENTA L CROUP . INC . 

## Ite m - Quantit y Agree dupo nvalu e o f plan t inaterial s no t t o b e replace db v contractor . Not e thi s \alu e will b e 

# A
use dt o issu e aplan t vouche r t o th e propert y owner . Agree dupo nlis t of plant material s tha t will b e replace db y contractor . B e very specifi c an ddetailed . 

# 0 Includ e asketc hof were eac hplan t wil l b e place d b \th e contractor . Agree dupo nare ao f property t o b e replace d witi i gras s sod . Includ e askeic hof :!i e 

# lOil ^ area(s ) l o b e replace d\Mi h gras s sod . Are ao f City o r Count\ ' property t o b e landscape d pe r thei r requirements . Includ e asketc hot ili e 

### / are a( ^ i

Easemen t Area , t o b e excavate d 

### ^ 

## Uni t Condition/Type/Specie s

$

Eac h

S F

S F

S F

Pag e 5 of . /COASTA L


### Additiona l Comments / Instructions : 

## .-7^Jj// ^ /Uinic ^ ^ ; / ^

^

• Chec k th e bo xi fOwne rdoe s no t wan t CE G t o docLjmen t inteno rfoundatio n wail s an d possibl e pre-existin g darrage . Bycheckin g thi s boxCE G i s no t responsibl e fo ran ydamag e done t o th e interio ro fhouse , includin g foundatio n crack s o rfissures .

PtTagre e i i I d o no t agre e

Contractor' s Signatur e Dat e ' I 

### Pag e 6 o f^PROPERT YCLEARANC E WORKSHEE T

Dat e Propert yI D 

# O't^llllO l <^o:i/^ l Propert y Projec t Omah a Lea d ~ Fixe d Pric e 

### //^> ^ Addres s 

# /.li s .< ^ £/ . Measuremen t XRFI D 0107-5 1 Count/Tim e Fiel d Shot s Sho t # Readin g Sampl e Are a Sho t # Readin g Sampl e Are a 

## Z 3 ^ 

# P ^ /i^ T ^ = ^ Sampl e Are a 

# /P Z 

# /^'/ y I n Sit u Composit e Composit e Analytica l Aliquo t Composit e Reading s La b Analytica l Readin g Averag e (Drie d & Spil t Sen t (Bag ) Numbe r Result s 1 (Baq ) Sieved ) 7 2 

## J 3 2.6 . 4 ' ^ I 

# 5 6 XR F Correcte d Valu e ~ > 5 (us e calibratio n char t o rad d 20 % t o value ) 

# 4 S Sampl e Are a Pass/Fai l ? 

# A^^- V I n Sit u Composit e Composit e Analytica l Aliquo t Composit e Reading s La b Analytica l Readin g Averag e (Drie d & Spil t Sen t (Bag ) Numbe r Result s 1 (Bag ) Sieved ) 7 

# i "ZL . 

# m M 

# m MS
- 

# nS L XR F Correcte d Valu e —> 

## " 3 (us e calibratio n char t o rad d 20 % t o value ) 

# IP ± Sampl e Are a Pass/Fai l ? 

# P I up^- I n Sit u Composit e Composit e Analytica l Aliquo t Composit e Reading s La b Analytica l Readin g Averag e (Drie d & Spil t Sen t (Bag ) Numbe r Result s 1 ? ^ 3 (Bag ) Sieved ) 7 2 ~7t 3 7 ^ 3 

## a ^ 

# J i 

# & 2 4 

## Z S 7o 7 XR F Correcte d Valu e —> 5 

## 6 3 (us e calibratio n char t o rad d 20 % t o value ) 

# 1 3 L Sampl e Are a Pass/Fai l ? I n Sit u Composit e Composit e Analytica l Aliquo t Composit e Reading s La b Analytica l Readin q Averag e (Drie d & Spil t Sen t (Bag ) Numbe r Result s 1 (Bag ) Sieved ) 7 2 3 4 XR F Correcte d Valu e - > 5 (us e calibratio n char t o rad d 20 % t o value ) Sampl e Are a Pass/Fai l ? I n Sit u Composit e Composit e Analytica l Aliquo t Composit e Reading s La b Analytica l Readin q Averag e (Drie d & Spil t Sen t (Bag ) Numbe r Result s 1 (Bag ) Sieved ) 7 2 3 4 XR F Correcte d Valu e - > 5 (us e calibratio n char t o rad d 20 % t o value ) US E ADDIIIOHA L SHEET S I F XR F Technician' s Signitur e HEEDE D 

# yCf^<'(P^^^^-^rz: ^' • nt Square Footag e t o b e Excavate d = 91 9 ^/ ^ on e Linea rFootag e t o be Excavate d = 11 2 tli .

Descriptio n o fpos t excavatio n area s Fl , frontyar d left-han d quadrant . F2 , fron t yard right-han d quadrant ; Bl , backyard left-han d quadrant ; B2 , backyar d right-han d quadrant ; DZ , dri p zon e (1- 3 foot are a o fsoi l aroun d th e foundatio n o fth e house )

### /,^D^ \ Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 I J^^vfI Coasta l Environmenta l Grou p Inc . V < ^ www.coastalhazmat.co m %PRoi« ^ COASTA L ENVIKONMENTA L C K O U P , IN C 

# EXECUTIV ESUMMARY : 20214—132 5 S 2 6 S T ~x \N o Issue s o r Concern s [ ^ Issues/Concern s Detai l Explanation :

# f^ As-Buil t Drawin g COASTA L 

# Omah aLea dSuperfund^it e

Tota l Quadran t Squar e Footag e to be Excavate d = 91 9 Propert yClassification : 80 0 Tota l Dri p Zon e Linea rFootaa e to be Excavate d = 11 2 

## 1 \ \ \ 

### 1 Alle yj i 

# 1 1

. •- - ^ - OLS# - 2021 4 1 

### ^ 1 ^ 

### ^ ^ "^at e Excavated : 8/11/0 7 "1 " nat o 1 IQPP AQinnor i Dff - 0/7/0 7 I

\ ' . ] • • • • •\ \ 

# ^ > f

• 

### P'

• 

### 1 

# 1

• P—. J 

### < ••' •

"



### _ 4 

## • { < 

## • i

• I



## J « • ' - • • 

### )• X . « •."•' . 

# z • . . Y'^^ \ 

### - ­ 1 ^ 1 1 

### '

- ^

, • • i ^ 

# r W indo wWell s 

# 'i > y DZ DZ = 36 PP M

. _^_ 8 09

PF 

### :== 

# -U 1-

# ul ­ 

# 1 ^ ^ ^ .. . \

. , • ; 

### ^

• 1 

# R - . 

# i t 1

. 

### ^ / ^ A7> / . / ^

/

# >x

—

'.X . 

### Y / ^^S^^-i^Pt ^ i< F2 = 106PP M



# I1 F1 = 58 PP M 

### ^^pi^ > 1 

### ^ 1 • 

## 1 

# li Vr ^ ^^^^ ^ ^ 4 Pl- . ••"•••-». ' •• . •: ' .. • k 

## iP , ••<»••'.;. • •»:-'• '''•;•.'•• ' • ' ' • ^ . ' ••••,:;:.,•;<.•:.. : •:'."• . - '• ' P :* 1 

### ^ _ , Sout h 26 stree t [ Legen d Nort h Arrow s Omah a Lea d Sit e ^^

^ Concret e Omaha . Nebrasl o k'/ l Excavate d Are a Propert yNumbe r OLS - 2021 4 Existin g Structur e 

## H Scal e Propert yAddres s • Fenc e 1 Inc h = 20 fee tor1 gri d = 5 x5 ft t«Vi l 132 5 S 26 ST
• Quadran t Boundar y Pos t Excavatio n Concentration s (ppm )

- Stree t Boundar y Fl B2 Pla vAre a HyrttdGt-oL.oqi'' , In t 

# i^ i 

# I ) T ree/ S liru b 

### \- fel/FWW^ B1 Gard e n_ 

### __ a h e r Descriptio nof post excavatio n area s Fl . (ron t yar d lett-han d quadrant . F2 , fron t yar d nghl-han d quadrant , Bl , bacfcyar d lett-lian d quadrant ; B2 , backyard nght-haii d quadrant . 02 , dripzon e {1- 3 foo t are a of soi l aroun d th e foundatio n ofth e house ) 

### Legen d 1

Are ano t Excavate d Dripzon e Excavate d Quadrant s Excavate d 

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

# sm . 

# EP A EP APropert y Clos e Ou t For m Propert y # : fjO'/l/ f Propert y Address : f^ZP Q <f-^^^^ 7 Date/Time : Owner' s Name : PPtA^O^ ^ (CAt^yP^e ^ Quad s Excavated : Contracto r Grou p Excavatioi i Genera l Ye s No 1 .If necessary , wer e th e correc t quadrant(s ) excavate dan drestored ? *- ^ 2 .

Ifnecessary , wer e th e correc t area s ofdri p zon e excavate dan drestored ? ^ Gradin g So dan dVegetatio n Ye 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 fromth e house ? i / 2 .Ha s so dbeenlai di nal l area s that were excavated ? 3 .

Doe s th e so dappea r t o b e generall y health y andgrowing ? (Onl y evaluat e if inspecte da t a3 0 da y tim e period ) 1 ^ 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 u ^ tim e period ) 6 .Wa s the property grade dsuc htha t water will no t poo l onth e property ? 7 .Wa s damag e t o landscapin g o r plant material s avoided ? Gates , FcDce s an dRetainin g Wall s Ye s N o 1 .D o gate s openan dclos e freely? (Ifapplicable ) J A ^ 2 .Wer e al l gate s o r fence s take ndow ndurin g restorationactivitie s reinstalled ? (Ifapplicable ) j^/ > 3 .

Wa s damag e t o gate s o r fence s avoided ? (Ifapplicable ) i ^ 4 .Wasdamagetoretainin g wall s avoided ? (Ifapplicable ) ^ ^ Foundation , Sidin g an dGutter s Ye s No i ^ 1 .Wa s damag e t o th e sidin g o r tri mavoided ? 2 .Wa s damag e t o th e foundatio navoided ? u ^ 3 .

Wa s damag e t o window s avoided ? t ^ 4 .

Wa s damag e t o window s or doo r screen s avoided ? i ^ 5 . Wa s daraag e t o dowTispout s o r downspou t extension s avoided ? t ^ Sidewall u an dDriveway s (Concrete ) Ye s No ' 1 . Wa s damag e t o drivewa y surface s avoided ? ( ^ 2 . Wa s damag e t o walkwa y surface s avoided ? • "

## Owner s comments :

Inspectio nnotes :

Remova l an drestoratio nactivate s complet e includin g th e 30-day so dwarranty : EP A Representativ e J^j^^ ^ yC_^/^i^.JU ^ Date : f ' 7 -0- 7

# Propert yCompletio n Agreemen t Thi s agrccnicnl document s the completion of remedia l activitie s performed on my property . My signatur e wil l dcsignal c lha l I amsatisfiedwit hIh c restoratio n of my properly , an dtha t no ilcm s ar c

in questions , now ,or al an y tim e

inth e future , except thos e item s listedbelow ,if any . Propert y ID : ^^^2-1 4 Propert y Addrcs.s : ^^2. b S LC^^S T Ovvner : 

# Fi^AKJgje'b CA<wP5gi j Phon e 

# •• 5^5'-15\« D Restoratio n Item s in Question :

Item : Item : Item : Hem ; Item : Item :

l*I S I agic c restoratio ni.s compirtrd , excep tas note d 1 1 I <l o no t apre e re.stoiatio n is compictet l



# . - ,, . tfT & v y.-ao ? /p ^ I fip P Ij 2g-(y '^Owner' s Signatur e / Dat ^ Contractor'. s Sij;natur c Dat e