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

## Date : ^|^S|f) q Address : d-sipy ^ ^ ^ P^ ^ "Eft " 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 ) 4031480 3 

### / 

### Executiv e Summary Superfun d 

# y EPA-provide dproperty sketc h & ^ 

### Signe dAcces s Agreemen t fo r subjec t property 

# m Signe dAcces s Agreement(s ) fo r adjacent property \^ y 

### Restoratio nAgreemen t Settlemen t document s (i.e. , fo r damag e o r to replac e plants , etc. ) Confirmatio ndat a 

# y Photograph s prc-ex/^AJlnn ^ D jCjbdcJnr^A ^ J^n ASd ^ As-buil t sketc h 

# w Satisfactory restoratio nsigne db y Property Owne r Property close-ou t chec k lis t signe db y EPA 

# m Descriptio no f area s no t meetin g RO D cleanu p criteri a 

# y Utility clearance s Property informatio nfromDougla s County Assessor' s Offic e 

# y D 

# 4- Dat e Ignature ytO'^^-CA- . 

# yT^^cd^ti ^ ^y ^

### Propert yAcces s Checklis t Propert ) ID : |Z_^g ^ Property Address:.,^^ ^ V O C, ^v ^ ^t. . n D

WOR K STARTE D WORK COMPELTE D ON : / /_ ON : __/__/ _ 

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Phone : n\^'BU-^'^ l F« : Cell/Pager . Rente r Phone : Fa,\ : Cell/Pager : Additiona l Information :

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D D D E 0 D n D C

D D Notificatio nLette r Acces s Agreemen t Restoratio nAgreemen t

Topsoi l Samplin g (i f applicable ) DisposaJ Samplin g (t f applicable ) Garde nSamplin g (i f applicable ) Utilit y Clearanc e Video/Photo s (Before ) Video/Photo s (During ) Video/Photo s (After ) Video/Photo s (30-Day )

Propert y Completio nAgreemen t ''"inal Repor t Sent : / / Signed : U / |D / 0 & Siencd : i \/ j O / O ^ / / / / / / Called : i l / lb /C & On : I I / ( ^ (? ^ On : / / On : / / On : / / Sipicd : / / Issued : / / Bv : 

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- £^ylci A By : By : By : By : By : Ai r Monitorin g (a s applicable ) D Communit y D Cre w | Results : On : / / | By : |
D Community ' Results : D Cre w | On : / / | By : |
D Communit j Results : D Cre w On : / / | By :

Omah a Lea d Sit e

## CONTACT FOR M Propert y I D U Propert y Address : Initia l Contact : Secon dContact : Fina l Conlact : Fina l Action :

Comment : 0\vne r Commen t (s) : Sit e Coordinato r Commen t (s) : 

# 7q 5 

# 2U2 1 NIf) 5 T Date : Time : Date : Time : Date : Time : Transmi t to EP AD Action : Action : Aclion : Othe r Action : D

### Dougla s County Accoun t Informatio n Pag e 1 of 2 nnat i Dougla s County , Nebrask a Propert yRecor d - R200368000 2 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-5 0 ft wes t o f90t h S t - ViewO n Ma p Informatio n i s vali d a s o f2008-9- 4 Treasurer' s Ta xRepor t Ne wFeatur e -•->- > Aut o Sale s Searc h Owne r WOOD S LUCILL E 262 2 N 2 5 S T OMAH AN E 68110-000 0 Propert yInformatio n Ke yNumber : 036 8 000 2 2 0 Accoun t Type : j Residentia l Parce l Number : 200368000 2 Parce l Address : 262 2 N 2 5 S T OMAH AN E 68110-000 0 Lega l Description : PATRIC KPLAC E LOT2 BLOC K2 AL L LT S 1 & 2 9 0 X 11 0 Valu e Informatio n Lan d Improvemen t Tota l 200 8 $2,800.0 0 $60,300.0 0 $63,100.0 0 200 7 $2,800.0 0 $60,300.0 0 $63,100.0 0 200 6 $2,800.0 0 $60,300.0 0 $63,100.0 0 200 5 $2,800.0 0 $60,300.0 0 $63,100.0 0 200 4 $2,800.0 0 $14,700.0 0 $17,500.0 0 200 3 $2,800.0 0 $14,700.0 0 $17,500.0 0 Lan d Informa tio n Acre s S F Unit s Dept h Widt h Vacan t 0.2 2 9900. 0 1. 0 110. 0 90. 0 N o Impro vemen t Informatio n Buildin g 1



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R20. . . 10/7/200 8*!^PT'^rj3'^::^-v " 

### Dougla s County Accoun t Informatio n Pag e 2 of 2 rmat i

2622N2SS T Steen i Floo r 4K.0Sq . Ft . ,0 . Detache d 312. 0 Sq
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. CLIC KT O ENLARG E IMAG E CLIC KT O ENLARG E IMAG E Squar e Footage : 1760. 0 Percen t Complete : ; 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 1 1/ 2 Stor yFi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 7. 0 Exterior : Fram e Sidin g Units : 1. 0 Interior : Drywal l Baths : 1. 5 Roo fCover : Compositio n Shingl e Bedrooms : 3. 0

Roo fType : Hip/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 8 198 8 0 % 190 8 10 0 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Bric k Venee r 200. 0 Applianc e Allowanc e 1. 0 Applianc e Securit ySyste m 1. 0 Basemen t Bsmn t Bloc k 8 f t 864. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Fixtur e Bat h Hal f 1. 0 Garag e Detache d 312. 0 Porc h En d Scree n 176. 0 Use r ASBESTO S 1. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R20. . . 10/7/200 8

### Pag e 1 o f 1

" > Creat e Anothe rTicke t Bac k t o Irt h Interne t Sen d Emai l 

# L ^ ^ 

# : YOURTICKE T NUMBERI S 2172992 . Origina l Cal l Date : 11/10/0 8 Time : 7:5 1 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 11/14/0 8 Time : 7:1 5 a m State : N E County : DOUGLA S Place : GI^IAH A Address : 262 2 Street : N25T H S T Twp : 15 NRng : 13 E Sect-Qtr : 09-S E Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : Omah a Lea d Locatio n o f Work : LOCAT E ENTIR E PROPERTY , AL L EASEMENT S AN D T O TH E PEDESTA L Remarks : FA X AL L CLEAR S TO : (877)662-421 1 Compan y: COASTA L 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 : 4 f t Corne r Lot : Y Front : Y Rear : Y Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C
Servic e Are a Contac t Phon e Numbe r Utility Typ e Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , INC HEID I Alt : 402934046 9 Emerg : 402932975 7 

### Day : 402504782 3 MUDO l METROPOLITA N UTILITIE S DISTRICT SANDY Alt : 

### Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFIC.SEWE RRO N 

### Alt : 402444516 1 Emerg : 402444516 0 Day : 406728934 3 OPPDGPR5 OMAH A PUBLIC POWE RDISTRICT N A 

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

H A 

### Alt : Emerg : 888728934 3
http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT. . . 1 1 /10/200 8

# As-Buil t Drawin g ^ C OASTA L 

# Omah aLea dSuperfun dSit e '4 5 Exterio rPaint Nortt i Arro w Omah a Lea d Sit e Owne rName : • Good Sit e Sketc h Ad d ress : 2 ^ N 2 5 ST ^ • Poo r Phone : H : W : • No t paint Sampl e Numbe rLea d Sampl e ^. ^ Sample s Collecte d Concentratio n Collecte d Fir m Sverdru o RYASCPXA-74 5 Y A155. 7 pp m 0 • Dat e RYBSCPXA-74 5 Y B J3 0 pp m 0 Q Tim e RYCSCPXA-74 5 Y C pp m • • Sample s Analyze d RYDSCPXA-74 5 Y D J 4 pp m 0 • RDZSCPXA-74 5 DZ JS e pp m 0 • XRF U nit : Boo k RGZSCPXA-74 5 G Z pp m D D Date 5/4/199 9 RPZSCPXA-74 5 PZ pp m Q D Tim e 15:4 4 Staf f Numt)e ro f Sample s = Legend : Y A= Yar d (NE) , Y B = Yar d (SE) , YC = Yard (SW) , Y D = Yard (NW) , DZ = Dri p Zone , G Z = Garden , P Z = Pla y 

# Z

. /

/

/ ^ / / ^ y ^ y y y y y-y ^ 

# "/'/"ry y OLS# : Z4 S , Yp'5 4 Dat e Excavated:11/19«bdi55. 7 Dat e USEP ASigne d Off : 12/18/200 8 Are a Sodde d 134 6 s q f t



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

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

## 74 5 Nort h Arro w Exterio rPain t Omah a Lea d Sit e Owne rName : Sit e Sketc h • Goo d 

# A \ Address : 2622 N 2 5 S T • Poo r W : Phone : ^ ­ • No t pain t Sampl e Numbe r RYASCPXA-74 5 ^ Y A Lea d Concentratio n

155. 7 pp m Sampl e Collecte d LA B 

# • Fir m Date Sample s Collecte d Sverdru p RYBSCPXA-74 5 RYCSCPXA-74 5 RYDSCPXA-74 5 ^ \ Y B f, , Y C ^>Y D 43 0 8 4 pp m pp m pp m 

# • D D D Tim e Sample s Analyze d RDZSCPXA-74 5 DZ 15 6 pp m 

## D XR F Unit : Book
. RGZSCPXA-74 5 RPZSCPXA-74 5 G Z PZ pp m pp m 

# a 

# • D 

# • Date : Tim e 5/4/199 9 15:4 4 Staf f Numbe ro fSample s = ' 4 Legend : Y A= Yar d (NE) , Y B = Yar d (SE) , YC = Yar d (SW)
. Y D = Yard (NW) , DZ = Dri p Zone , G Z = Garden , P Z = Pla y [H^Uv^SP ^ ot y



# lo-lg}: ^ l^S ^ i^y/ ; Re

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# 1 745 Exterio rPain t Nort h Arro w Omah a Lea d Sit e Owne rName : Sit e Sketc h 

### • Goo d 

# A Address : 2622 N25S T • Poo r

Phone : H : W : [ ^ No t pain t Sampl e Numbe r Lea d Sampl e Sample s Collecte d LA B Concentratio n Collecte d Firm : Sverdru p RYASCPXA-74 5 Y A 155. 7 pp m 

## M 

# a Date : RYBSCPXA-74 5 Y B 43 0 pp m 

# D Time : RYCSCPXA-74 5 YC pp m 

# a a Sample s Analyze d RYDSCPXA-74 5 Y D 8 4 pp m 

# D RDZSCPXA-74 5 D Z 15 6 pp m 

# D XR F Unit : Book : RGZSCPXA-74 5 G Z pp m 

# n 

# • Date : _ 

### 5/4/199 9 RPZSCPXA-74 5 P Z pp m 

# a Time : 15:4 4 

# n Staff : Numbe ro fSample s = i 4 Legend : YA= Yar d (NE) , Y B = Yard (SE)
. Y C = Yar d (SW) , Y D = Yar d (NW)
. D Z = Dri p Zone , G Z = Garden , P Z = Pla y 

# 7 WyyA . ' ^ ^^ ^

////// / 

# 7 7/7//77/7/77 ~

## 74 5 Exterio rPain t Nort h Ann w 

### Omah a Lea d Sit e Owne rName : 

### Sit e Sketc h • Good 

# A \ Address : 2622 N 2 5 S T • Poo r Phone : H : W : Q No t pain t Sampl e Numbe r Lea d Concentratio n Sampl e Collecte d LA B Finn : _ Sample s Collecte d Sverdru p RYASCPXA-74 5 Y A 155. 7 pp m 

# a Date : _ RYBSCPXA-74 5 Y B 43 0 pp m 

# D Time : _ RYCSCPXA-74 5 RYDSCPXA-74 5 RDZSCPXA-74 5 YC Y D D Z 84 15 6 pp m

pp m

pp m 

# D D 

# a 

# • XR F Un i Sample s Analyze d t : Book : RGZSCPXA-74 5 G Z pp m 

# a n Date:
. 5/4/199 9 RPZSCPXA-74 5 PZ pp m 

# a Time : _ 15:4 4 Staff : Numbe ro fSample s = i 4 Legend : Y A= Yar d (NE) , Y B = Yar d (SE) , Y C = Yar d (SW) , Y D = Yard (NW) , D Z = Dri p Zone , G Z = Garden , P Z = Pla y


# , H I 

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Re v4 046141.012 3COASTA L ENVIRONHINTA l e R o u r . IN C 

## 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 Name : Daytim e Phone : 

### LUCJL P LL)OCKJ<=
. 

## '?•/•/-g^9 ^ Addres s o fPropert y covere d b ythi s Agreement : PURPOS E O F RESPONS E ACTIVITIE S 

### Th e EP Ai s requestin g acces s t o 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 have a n opportunityt o revie wan d approv e th e planne d soi l removal , an d restoratio n wor k before 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 meets 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 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 :
Pag e 1 o f2COASTA L tNVIKONNrNtA l C I 0 U P
. IN C



### •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 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 (712 ) 352-018 8
gran t acces s t o mypropertie s O I d o no t gran t acces s t o m ypropertie s

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

## Restoratio n Agreemen t The purpos e o f thi s agreement i s to provid e amutua l agreement a s t o condition s o f the propert y prior to remediatio nactivities . Thi s will als o serv e a s documentatio nfo r the purpos e o f assurin g tha t restoratio n activitie s ar e completedt o the satisfactio no f the propert y owne r andth e Unite dStale s Environmenta l Protectio nAgenc y (EPA) . Propert y ID : ^t/ ^ Propert y Addresl : ^(^ ^ AJ.^S ^ 

### .S ^ Owner : 

### ^uci li e LAJOQO^T^ 

## Phone : S^^^j ^ /</d^ ) ^^ f

7 ' f^C.<9 9 O

nthe attacheddiagram(s ) indicat e area(s ) t o excavatedan ddept ho f excavation , locationof al l know n utilities , subsurface features , syrfac e structure s an dlandscaping features , acces s location(s ) t o be use db y contractor , an dthe directiono f North . Indicat e distances , depths , materia l types , etc . Indicat e digita l photo s b

y referencing th e photo-lo g numbe r wit ha narrow indicating directiono 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 : 

### Srr \ 

# ^ l l 

# l^k t n^ S ~ — ^ Item : \ Item : ^ ^ item : ^,y ^ Item : ^y ^ Item : ^y ^ Item : y Item : / Pag e 1 o f 

# 1 ^

# 1 ^ ^ COASTA L a n o u p . IN C Item s T o B e Remove d B yContracto rDurin g Remediatio n An d No t Replace d (Us e addrtiona l sheet s a s necessary ) Item : Item : Item : Hem : Item : Item : item : Item : Item : Item : Item : Item : Item : Kem : Kem :

Pag e 2 

## .L PC Q AS T AL e a o u rIN 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 : 

# ^ K Item : 

# i K- y ^ item : Item : Item : Item : Item : Item : Item : Kem : Item : Item : Item : Item : Kem :

Pag e 3 of(j P• ^ COASTA L



## item

Pre-existin g propert y area , tha t will be excavated , tha t i s covere dwit hgrass .

Number of tree s > 2 inch trunk diameter

Number o f tree s <= 2 inch trunk diameter

Number o f Sprinkler Zones , Contro l Valves , Timers , Heads , etc . Attachasketchof the sprinkler layout .
Number o f an dsiz e o f eac hgarden / flowe r be d area . Attac hasketchof relativ e size s an dlocations . 

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

### Quantit y Uni t 

## Condition/Type/Specie s

% Squar e fee t

Eac h

Eac h

Eac h

Eac h Squar e Feet

Pag e 4 of/ ^COASTA L O n o u rIM C 

## Ite m Quantity Agree dupo nvalu e of plan t material s no t to b e replace dbv contractor . Note thi s valu e will b e ^ use dt o issu e aplan t vouche r t o th e propert y owner . Agree duponlis t o f plan t material s tha t will b e replace db y contractor . B e ver y specifi c an ddetailed . 

# x p Include asketcho f wer e eac hplant wil l be place d b

y th e contractor . Agree dupo nare ao f propert y t o b e replace d 

# ^yf \ wit hgras s sod . Include asketcho f the area(s ) to b e replace dwit h gras s sod . Are ao f Cit y o r Count y propert y t o b e landscape d per thei r requirements . Include asketchof the are a(s ) 

# f

Easement Area , to b e 

# p ? excavate d 

## Unit Condition/Type/Specie s

$

Each 

# 'g,(u e(S-r^^ ^

S F

S F

S F 

# "Jo b^de.4eCM(^e d

Page s 

## of Co 1C O AS T AL • MVIkftOMMCMTAI
. « » • WP
. IM C Additiona l Comment s / Instructions :

D Chec k th e bo xi fOwne rdoe s no t wan t CE G t o documen t interio rfoundatio n wail s an d possibl e pre-existin g damage
. B ycheckin g th s bo xCE G 6 rK> t responsibl e fo ran ydamag e don e t o th e interio ro fhouse , includin g foundatio n crack s o rfissures
.



### c nI d o not agre e

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.

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RETES TAREA S Sho t # Readin g Sampl e are a Shot # Readin g Sampl e are a Dept h Dept h ..-""- ^ Averag e Averag e / ^ ' la b sampl e # La b resul t Sampl e are a XR F Avg
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# 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 380 3 Mod e SOI L Tim e 2008-11-1 9 15:1 1 Duratio n 123.3 8 Sequenc e Fina l Flag s AVERAG E l^v g o f3799-3802
. A ADDRES S 262 2 n 2 5 s t QUAD/ZON E INSPECTO R Ventr y 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 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 364.51 5 Supervise d By : 

## Certificat e o fVerificatio n
379 9 SOI L 2008-11-1 9 15:0 9 30.7 8 Fina l 74S '
. 262 2 n2 5 s t Y B Ventr y 6 CLEARANC E

± Erro r ± 23.02 3

# 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 380 0 Mod e SOI L Tim e 2008-11-1 9 15:1 0 Duratio n 30.9 7 Sequenc e Fina l Flag s BVI D # 74 5 ADDRES S 262 2 n 2 5 s t QUAD/ZON E Y B INSPECTO R Ventr y DEPT H 6 SAMPL E TYP E CLEARANC E NOT E
pp m ±Erro r P b 190.09 8 ±16.97 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 257.87 0 Supervise d By : 

## Certificat e o fVerificatio n

380 1 SOI L 2008-11-1 9 15:1 0 31.1 6 Fina l 74 5 262 2 n 2 5 s t Y B Ventr y 6 CLEARANC E

± Erro r ± 19.42 3

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

-5 ^

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 282.76 4 Supervise d By : 

## Certificat e o fVerificatio n

380 2 SOI L 2008-11-1 9 15:1 1 30.4 7 Fina l 262 2 n 2 5 s t Y B Ventr y 6 CLEARANC E

± Erro r ± 20.58 2

# 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 380 8 Mod e SOI L Tim e 2008-11-1 9 15:1 5 Duratio n 123.6 3 Sequenc e Fina l Flag s AVERAG E ^Av g o f3804-38q|g | ADDRES S 262 2 n 2 5 s t QUAD/ZON E feasement ^ INSPECTO R Ventr y DEPT H i l SAMPL E TYP E ^CLEARANC E NOT E

P b 20 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 236.44 8 Supervise d By : 

## Certificat e o fVerificatio n

380 4 SOI L 2008-11-1 9 15:1 2 30.7 5 Fina l 

## 7 m 262 2 n 2 5 s t easemen t Ventr y 1 CLEARANC E

± Erro r ± 18.44 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 193.73 4 Supervise d By : 

## Certificat e o fVerificatio n

380 5 SOI L 2008-11-1 9 15:1 3 30.8 7 Fina l IM S 262 2 n2 5 s t easemen t Ventr y 1 CLEARANC E

± Erro r ± 16.57 9

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E
pp m P b 186.28 3 Supervise d By : 

## Certificat e o fVerificatio n

380 6 SOI L 2008-11-1 9 15:1 4 30.9 1 Fina l 74 5 262 2 n 2 5 s t easemen t Ventr y 1 CLEARANC E

± Erro r ± 16.27 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 184.98 6 Supervise d By : 

## Certificat e o fVerificatio n

380 7 SOI L 2008-11-1 9 15:1 5 31.1 0 Fina l 74 5 262 2 n 2 5 S t easemen t Ventr y 1 CLEARANC E

± Erro r ± 16.40 9X 

### Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc
. www.coastalhazmat.co m COASTA L {NVIRONMENTA L C R O U r, INC
. 

# EXECUTIV ESUMMARY : BVI D #74 5 - (262 2 N2 5 ST ) N o Issue s o r Concern s I I Issues/Concern s Detai l Explanation : N O ISSUE S PENDING .S9t 

# EP A EP APropert y Clos e Ou t For m Propert ytl : Datc/Ttmc : 

# 1 ^ < y Quad s Excavaifd : Y\ Propert yAddress : ^^^ ^

M -Z < H- f Owner' s Name : \j(Jll ^

VJOff^Jc , Contracto rCrou p (,vfi(^iy ^ 4 ^

Excavatio n Genera l Ye s N o 1
. i fnccessao' , wer e th e correc t quadrant(s ) excavate d an d restored ? ty 2
. I fnecessary , wer e th e correc t area s o fdri p zon e excavate d an d restored ? y ^ Gradin g So d an d Vecetatio n 1 Doe s th e gradin g aroun d th e perimete ro fth e hous e i n excavate d area s generall yslop e awa y from th e house ? Ye s 

### y N o
2
. 3
. 4 5 6 Ha s so d bee n lai d i n al l area s tha t wer e excavated ?

Doe s th e so d appea rt o b e generall yhealth yan d growing ? (Onl yevaluat e i finspecte d at a 3 0 da ytim e period ) Ar e sodde d area s generall yfuT n an d evenl ygraded ? Ar e th e Joint s t)etwee n th e so d strip s generall ytight ? (Onl yevaluat e i finspecte d a i a 3 0 da y tim e period ) Wa s th e propert ygrade d suc h tha t wate rwil l no t poo l o n th e property' ' i / y ly y ^ 7 Wa s damag e 1 0 landscapin g o rplan t material s avoided ? ^ 1 Gates , Fence s an d ReUinln cWall s 1 D o gate s ope n an d clos e freely? (Ifapplicable ) Ve s L

^ N o
2
. Wer e al l gate s o rfence s take n dow n durin g restoratio n aciiviiie s reinstalled ? (Ifapplicable ) y 3
. Wa s damag e t o gate s o rfence s avoided ? (Ifapplicable ) 

### y 4
. Wa s danug e t o retainin g wall s avoided ? (Ifapplicable ) ^ Foundation , Sidio Kan d Gutter s 1
. Wa s damag e t o th e sidin g o rtri m avoided ? 2 Wa s damag e t o th e foundatio n avoided ? Ye s y u ^ N o

3 Wa s damag e 1 0 window s avoided ? y 4
. Wa s damag e t o window s o rdoo rscreen s avoided ? 

## y 5 . Wa s damag e t o downspout s o rdownspou l extension s avoided ? ty ^ Sidewalk s an d Driveway s (Concrete ) 1
. Wa s damag e t o drivewa ysurface s avoided' ' Ye s u

^ N o
2
. Wa s damag e t o walJrwa ysurface s avoided ? ly

## O ^'^er s comments :

Inspectio nnotes :

Removal an drestoralio nactivate s complet e includin g the 30-da y so dwarrant)' : EPARepresenlaUve.^-y'^^j^^^X.^^^J^^,' ^ Date : l^77^/<^ ^ 

# i

## Propert yCompletio n Agreemen t Ihi s agreement document s the completio no f remedia l activitie s performedo nm y property . M y signaiure wil l designate tha t I a msatisfie dwit hth e restoratio no f m y property , andtha i n o items ar e i nquestions , now , o r a

l any tim e i nthe future , excep t thos e item s listedbelow , ifan y Propert yID : 

# n ^ ^ Propert yAddress : ^^^9g ) V")
. Q'S ^

5^ ^ 

# Q""*"' ^ UxoW y ixDo^ ^ Phone : ^\^-9(g^^ R Restoratio n Item s i n Question :

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

' yC'-^.p u ' "t?''*' ^ restoratio n i s completed , excep t a s note d I I d o no t a(;re e restoratio n I s complete d 

# ^ (<k V Owner' s Signatur e Dat e Contractor' s Signatur e C ( Dat e I

# jL^^ X M 

# 2^" ^ ^ f

Punchlis t Item s ID # 

# 71 f Date: /X-OJ-Qg '
Description : 

## 7 ^ P^nc ^ &<^7 e / ''h'ly ^ j-y-c^cK ^