## TRANSMITTALof OMAHALEAD SIT E SOI LREMEDIATIO NFIL EFOLDE R

SAID # : 

## 1^=^05 1 Date : 

# '^f^^M f Address ; THR' ^ ^ ) Q S-4 Remediatio nContractor ; Coasta l Environmenta l Grou p Year ; 2010ARR A
SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S B ^ y - ^ &^ f J "•8° ^ <y Vide o ofpropert y (DVD ) Executiv e Summary EPA-provide dproperty sketc h Signe dAcces s Agreemen t fo r subjec t property Signe dAcces s Agreement(s ) for adjacent property Restoratio nAgreemen t Settlemen t document s (i.e. , fo r damag e o r to replac e plants , etc. ) Confirmatio ndat a Photograph s Y k iy^^k^(M \^OhlkVio ^ V V- ^ As-buil t sketc h Satisfactory restoratio nsigne db y Property Owne r Property close-ou t chec k lis t signe db y EPA Descriptio nofarea s no t meetin g RO D cleanu p criteri a Utility clearance s Property informatio nfromDougla s County Assessor' s Offic e

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### Dat e 3026101 0 Superfun d

## Propert yAcces s Checklis t Property ID : 

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O NotificationLette r Q ^ Acces s Agreement H ' Restoratio nAgreement D Topsoil Samplin g (if applicable ) O Disposa l Samplin g (i f applicable ) O Garde nSamplin g (if applicable ) D Utilit y Clearanc e ^ Video/Photo s (Before ) D Video/Photo s (During ) nVideo/Photo s (After)
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### Dougla s County Accoun t InfiJB|atio n Pag e 1 of 2

Dougla s County , Nebrask a Propert yRecor d
Informatio n i s vali d a s o f2010-7-3 0
Owne r DUNCA N JAC KL ETA L 313 6 S 1 6 S T OMAH AN E 68108-000 0 Propert yInformatio n ­ R210005000 0 Prin t Reoor t Vie wInteractiv e GI S JUIa o Treasurer' s Ta xRepor t Ne wFeatur e ->-•- » Subdivisio n Sale s Searc h

Ke yNumber : Accoun t Type : Parce l Number : Parce l Address : Lega l Description : Valu e Informatio n Lan d 201 0 200 9 200 8 200 7 200 6 200 5 Lan d Informatio n Acre s S F 000 5 OOO O 2 1 Residentia l 210005000 0 278 9 SI O S T OMAH AN E 68108-000 0 REDFIELD S AD D LO T4 BLOC K1 2 5 X 67. 6

$100.0 0 $100.0 0 $100.0 0 $100.0 0 $100.0 0 $100.0 0 Improvemen t $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 Tota l $100.0 0 $100.0 0 $100.0 0 $100.0 0 $100.0 0 $100.0 0

Unit s Dept h Widt h Vacan t 0.0 3 1700. 0 0. 0 68. 0 25. 0 Ye s



### http://douglasne.mapping-online.com/DouglasCoNe/static/accoimtinfo.jsp?accountno=R21.

. . 8/14/201 0

### 3/31/201 1 www.dhon.org/irthinternet/DHONNotic.

. . rCreat e Anothe rTicke t Bac k th Inteme t -Sen d Emai l



## • YOU RTICKE T NUMBE R IS 2699970

. Origina l Cal l Date. ; 3/31/1 1 Time : 12:4 3 pm Op : ALFONSO1879 0 Wor k to Begi n Date- ; 4/04/1 1 Time : 1:1 5 pm State : NE County : DOUGLA S Place : OMAHA Address : 278 9 Street : S lOT H ST Twp : 15 NRng : 13 E Sect-Qtr : 27-SE,34-N E Twp : Rng : Sect-Qtr : Lega l Given : C Typ e of Work : Lea d Remediatio n Locatio n of Work : LOCAT E ENTIR E PROPERTY , AL L EASEMENT S AN D TO TH E PEDESTA L Remarks : FA X AL L CLEAR S TO : (402)934-281 1 : PLEAS E INCLUD E AL L EASEMENT S Compan y: COASTA L ENVIRONMENTA L SERVIC E Contac t Name : ALFONS O Phone : (402)934-283 7 Wor k Bein g Don e For : Coasta l Dept h of Excavation : 4f t Corne r Lot : NFront : ¥'• . Rear : Y Involve s Tunnelin g or Horizonta l Borin g : NExplosives : N ;, CXCATV LEVEL 3 MUD0 2 • OMAHACO F 0PPDGPR 6 PAETE C •• QLNNEI F



## Servic e Are a Contac t Phon e Numbe r Utilit y Typ e CO X Day : 402934046 9 CXCATV COMMUNICATIONS , HEIDI Alt : 402934046 9 IN C Emerg : 402932975 7 LEVEL S Day : 877366834 4 LEVEL S COMMUNICATIONS , NA Alt : LLC Emerg : 877366834 4



## MUD02 METROPOLITA N UTILITIES DISTRIC T SAND Y Day : 402504782 3 AH : Emerg : 402504797 0


## OMAPL\CO F CITYOFOMAHA

TRAFFICSEWE R RICH/TRAFFIC Day : 402444719 7 AH : 402444516 1 Emerg : 402444516 0 dhon.org/irthinternet/.../MessageText.as.

. 

### 1/ 23/31/201 1 ^ ^ www.dhon.org/irthinternet/DHONNotic...^ ^ 

## W9 Day : 406728934 3 0PPDGPR6 °'^T'"^"^''° ^ EL M LOCATIN G

## Al : 4062071494 Emerg : 888728934 3 Day : 800289190 1 „^^.^ ^ PAETE CNO NEE D

TO CAL LOU T ,^ r A P I rC Alt * 

## COMMUNICATION S EMERGENC Y Emerg : 800289190 1 Day : 406728934 3 QLNNEI FS^f.II;^^' ^ EL M LOCATIN G Alt Alt: : 406207149 406207149 4 4 NETWOR K Emerg : 888728934 3

dhon.org/irthintemet/.../MessageText.as..

. 2/ 2

# As-Buil t Drawin g COAST AL 

# Omah aLea dSuperfun dSit e ENVIBONHIHTA L

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. IN C OLS# : 1S0S 1 Dat e Excavated : 4/7/201 1 Dat e USEP ASigne d Off : 5/3/ : 

## 1505 1 Are a Sodden : 90 0 s q f t

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COASTA l thVIIOH«(»fTA t C I 0 U r, IM C 

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

### Granto r(th e propertyowner) consent s t o an d authorize s th e Unite d State s Environmenta l Protectio n Agenc y(EPA) o rits authorize d representatives , collectivel y th e Grantee , t o erite ran d perfor m certai n environmenta ! respons e activitie s upo n th e followin g describe d premises : icY) ^ I

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covere d b ythi s Agreement ; 

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PURPOS E O F RESPONS E ACTIVITIE S 

### Th e EPAi s requestin g acces s t o collect soi l sample s an d remove soi l tha t contain s elevate d concentration s oflea d an d maypos e a healt h hazard

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

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

. Thi s wor k i s bein g performe d unde rth e Omah a Lea d Superfun d Site remediatio n program . Arepresentativ e o fCoasta l Environmenta l Group , contracte d byUSEPA , wil l contact th e Granto rin-persp n t o discus s th e wor k t o b e perfonmed , 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 befbre i t begins

. Onc e th e wor k i s finiished , th e Granto rwil l b e aske d t o revie wth e wor k an d confir m tha t r 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 

### B

ysignin 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 tirne s an d wit h prio rnotice , fo rth e sol e purpos e ofperformin 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 ycorttpleted

. Th e Granto rals o agree s to :

Pag e 1 o f2- „ * COASTA L ..t'- ^ ct o' u r. IK C 

### t Remov e obstrijction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; cRemov 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 ; fAbid 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

. cAllo wvideotapin g and/o rphotographin g o fth e property

. AGREEMEN TNO TT O INTTERFERE 

### 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 p n hi s property , o rt o undertak e an y action s regiardin g th e us e o fsai d propert ywhic h woul d ten d t o endange rth e healt h o r welfar e o fth e Grantee s o rth e environment , o rt o allo wother s t o us e th e propert yi n suc h a manner . Shoul d yo u hav e an yquestion s abou t thi s program , pleas e contac t Coasta l Environmenta l Group , a t (402 ) 991-119 9

gran t acces s t o m ypropertie s D I d o ho t gran t access t o m ypropertie s


# A 

# '^2^/^ Signatur e Dat e Signature Date

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

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Page 2 o f2C O AS T AL EMVmONnC N TAL o •o u r , INC

. 

## Restoratio n Agreemen t The purpos e of thi s agreemen t i s t o provid e amutua l agreemen t a s to condition s of the propert y prior to remediationactivities

. Thi s will als o serve a s documentationfo r the purpos e of assuring tha t restoration activitie s ar e completedt o the satisfactionof the propert y owne r an dthe UnitedState s Envirormienta l ProtectionAgenc y (EPA)

. Propert y ID : / 5^ ^ ^~ / Propert y Address ; 3 7/ ^ < , j ^ ^~ f Owner : J p ^

cV C Q u-yy^o^ A 

## Phone : ^I Q 2^-T/ O - ? J^ 3 / 30 ^ ^J/ T O

nthe attacheddiagram(s ) indicat e area(s ) t o excavate , surface structure s an dlandscapin g feature s an d acces s location(s ) t o be usedb y the contractors
. Indicat e distances , depths , materia l types , etc
. Photographicall y an dVideographicall y docimien t the existing condition s ofth e propert y an dthe basemen t if necessary . Item s t o b e Remove d b yth e Owne rbefor e Star t o fRemediation : Th e removal , storage , disposal , and/o rretu m o fthes e item s i s th e Owner' s responsibility

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## Landscap e Inventor y Ite m Quantit y Uni t Condition/Type/Specie s Pre-existin g property area , Quadrant s 

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diamete r 

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. 

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### o f(J > VCOASTA L •MVIHOMHM N T A I. a •o u p , IMC

.

Additiona l Comment s / Instructions : Th e cit y ofOmah a ordinance s ma yprohibi t yo u fro m usin g dir t orgrave l area s on you rpropert y as driveway s orvehicl e parkin g areais

. Th e Environmenta l Protectio n Agenc y(EPA ) ma y be removin g an d replacin g soi l underlyin g a grave l ordir t are a on you rpropert ytha t yo u ma ybe usin g as a drivewa y orvehicl e parkin g area . Ifthi s is th e case , yo u shoul d understan d tha t thi s removin g an d replacin g ofsoi l doe s no t mea n tha t an yillega l drivewa y orparkin g are a on you r propert y is mad e legal

. To th e contrary , yo u ma ybe cite d byth e cit y ifyo u us e a grave l ordir t are a as a drivewa y orparkin g arisia , ho t withstandin g an yremova l orreplacemen t ofsoi l byth e EP A ifyo u hav e an yquestio n abou t legalit y ofa certai n drivewa y orparkin g area , yo u ma ycontac t th e cit y ofOmaha' s Plannin g Departmen t at (402 ) 444-5150

. r~ l Pleas e chec k thi s bo x ifyo u understan d th e infomiatio n outline d above

.

•Chec k th e bo xifOwne rdoe s no t wan t CE G to documen t interio rfoundatio n wall s an d possibl e pre-existin g damage

. Bycheckin g thi s bo xCE G is no t responsibl e fo ran ydamag e don e to th e interio r ofhouse , includin g foundatio n crack s orfissures

.


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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 3 2 Mod e SOI L Tim e 2011-04-0 8 10:2 2 Duratio n 91.9 0 Sequenc e Fina l Flag s AVERAG E Av g o f29-3 1 ADDRES S t 278 9 S 1 0 S T QUADRAN T B 2 DEPH T 

# h " XR F TEC H C.PADILL A MIS C CONFIRMATIO N NOT E CLEA R

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Supervise d By :• • 

# Therm o

SCIENTIFI C Therrn o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1 

## Certificat e o fVerificatio n

2 9 SOI L 2011-04-0 8 10:2 0 30.8 7 Fina l 1505 1 278 9 S 1 0 S T B 2 4 " C.PADILL A CONFIRMATIO N CLEA R

Erro r ; 7.83 8 ± 14.38 8 ± 9.35 0 14.84 7 ± 6.64 9 ± 8.62 5 ± 18.80 2 6.30 1 25.13 5 12.19 5 ± 24.69 0

: 84.55 8 ± 22.22 5 ± 51.80 6 178.83 5 ± 383.14 8 ± 113.19 1 XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

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648.71 3 Supervise d Bv :• • 

# Therm o

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

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3 0 SOI L 2011-04-0 8 10:2 1 30.5 2 Fina l 1505 1 278 9 S 1 0 S T B 2 4 " C.PADILL A CONFIRMATIO N CLEA R

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: 15.55 0 ± 6.70 6 12.93 6 ± 20.83 4

: 5.56 6 27.02 6 : 11.91 1 ± 25.21 6

: 86.83 0 ± 22.39 2

: 77.98 7 : 186.33 6 ± 397.06 5 ± 118.27 1• • 

# Therm o

SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1

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pp m M o < LO D Z r 364.46 5 S r 159.59 5 U < LO D R b 66.24 0 T h < LO D P b 199.35 7 S e , < LO D A s < LO D H g < LO D Z n 192.79 7 < LO D 

## w C u 36.87 5 N i < LO D C o < LO D Fe 16562.54 3 M n 589.85 4 Supervise d By : 

## Certificat e o fVerificatio n

3 1 SOI L 2011-04-0 8 10:2 2 30.5 1 Fina l 1505 1 278 9 S 1 0 S T B 2 4 " C.PADILL A CONFIRMATIO N CLEA R

Erro r
: 7.90 2 ± 14.52 3 ± 8.80 0

: 14.95 7 ± 6.59 2 12.59 9 ± 19.72 8 5.74 4 1 25.93 8 1 11.27 9 ± 23.72 0 81.59 0 ± 22.24 0

: 76.16 2 : 176.81 1 ± 373.76 4 ± 110.45 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 2 8 Mod e SOI L Tim e 2011-04-0 8 10:1 9 Duratio n 91.5 7 Sequenc e Fina l Flag s AVERAG E Av g o f25-2 7 ADDRES S 1278 9 S 1 0 S T QUADRAN T |B I DEPH T 

# 1*
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### ylm.si ^ 

# y . F

e 20946.75 8 / ±/" ^ 422.91 8 M n 747.18 7 / ';7122.43 8 

# y /S
­ " ^ Supervise d By : ( /• • • • 

# 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 2 5 Mod e SOI L Tim e 2011-04-0 8 10 : 1 8 Duratio n 30.5 2 Sequenc e Fina l Flag s BVI D 1505 1 ADDRES S 278 9 S 1 0 S T QUADRAN T B l DEPH T 4 " XR F TEC H C.PADILL A MIS C CONFIRMATIO N NOT E CLEA R

pp m Erro r M o < LO D : 8.01 7 Z r 431.97 1 ± 15.83 0 S r 174.25 0 ± 9.28 2 U < LO D : 15.33 9 R b 74.22 9 ± 6.96 6 T h 17.53 4 ± 8.06 9 P b 74.70 3 ± 13.48 3 S e < LO D 5.67 9 A s < LO D 18.21 4 H q < LO D 13.15 1 Z n 139.10 6 ± 21.14 9 < LO D 90.55 4 

## w C u < LO D 33.22 5 N i < LO D 80.46 4 C o 208.86 9 ± 135.93 1 Fe 20763.57 2 ± 423.02 8 M n 716.15 2 ± 120.91 8 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 QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m M o < LO D Z r 444.72 6 S r 182.16 6 U < LO D R b 68.10 5 T h < LO D P b 98.93 4 S e < LO D A s < LO D H g < LO D Z n 120.21 7 W < LO D C u 35.06 0 N i < LO D C o < LO D F

e 21110.32 0 M n 841.88 8 Supervise d By : 

## Certificat e o fVerificatio n

2 6 SOI L 2011-04-0 8 10 : 1 8 30.5 2 Fina l 1505 1 278 9 S 1 0 S T B l 4 " C.PADILL A CONFIRMATIO N CLEA R

Erro r
: 8.06 8 ± 15.85 5 ± 9.37 5

: 14.60 0 ± 6.61 3 10.82 7 ± 14.75 2

: 5.71 1 : 18.88 1 : 12.35 5 ± 19.66 5 87.15 4

• ± 22.16 8 77.56 6 : 198.76 9 d b 422.03 4 ± 127.56 0• • 

# 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 2 7 Mod e SOI L Tim e 2011-04-0 8 10:1 9 Duratio n 30.5 3 Sequenc e Fina l Flag s BVI D 1505 1 ADDRES S 278 9 S 1 0 S T QUADRAN T B l DEPH T 4 " XR F TEC H C.PADILL A MIS C CONFIRMATIO N NOT E CLEA R

pp m Erro r M o < LO D 8.31 3 Z r 402.60 9 ± 15.34 6 S r 186.47 1 ± 9.55 0 U < LO D : 15.15 1 R b 64.18 8
. ± 6.56 7 T h 11.33 3 ± 7.54 1 P b 87.84 9 ± 14.26 6 S e < LO D 6.12 2 A s < LO D 19.52 0 H g < LO D 12.27 7 Z n 131.05 5 ± 20.57 3 < LO D \ 88.75 4 

## w C u 59.94 6 ± 24.30 8 N l < LO D J 77.99 1 C o < LO D ; 198.95 2 Fe 20966.38 1 ± 423.69 3 M n 683.52 1 ± 118.83 5 Superviise d By :• • 

# Therm o

SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica ,MA0182 1 

## Certificat e ofVerificatio n
XL3t-3208 9 Readin g No 24 Mod e SOI L Tim e 2011-04-0 8 10:1 6 Duratio n 91.5 7 Sequenc e Fina l Flag s AVERAG E f-Av g of21-2 3 ADDRES S 1 278 9 S 10 ST QUADRAN T |EA DEPH T 

## 1.1 " XR F TEC H C.PADILL A MIS C CONFIRMATIO N NOT E CLEA R

pp m Erro r Mo < LO D 7.60 8 Zr 297.31 9 ± 13.15 4 Sr 172.30 8 ± 8.95 2 U < LO D 14.48 8 Rb 66.43 7 ± 6.45 2 Th < LO D 13.21 8 Rb 276.70 4

_ 22.28 9 Se < LO D 

### ; 5.46 8 As < LO D 

### : 29.35 4 Hg < LO D ; 12.00 8 Zn 228.69 1 ± 25.11 1 W < LO D 1 ai^8 9 Cu 38.23 4 ±^.- ^ 21^61 7 Ni < LO D /72.58 3 Co < LO D 

### y ^ 

# ^y ••y 172.22 5 Fe 16196.219/ / 362.30 1 Mn 502.33 9 101.67 2 

# y ^y> ^ 

## ^ ^ ^ ^ Supervise d By : /y ~• • 

# 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 QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m M o < LO D Z r 278.82 9 S r 164.55 9 U < LO D R b 62.32 4 T h < LO D P b 254.84 5 S e < LO D A s < LO D H g 13.49 8 Z n 258.44 6 

### w < LO D C u 42.18 5 N l < LO D C o < LO D Fe 17166.34 6 M n 445.29 2 Supervise d By : 

## Certificat e o fVerificatio n

2 1 SOI L 2011-04-0 8 10:1 5 30.5 3 Fina l 1505 1 278 9 S 1 0 S T E A 1 " C.PADILL A CONFIRMATIO N CLEA R

Erro r ; 7.53 1 ± 12.78 4 ± 8.75 0 14.22 0 ± 6.26 1 13.14 6 ± 21.53 9

; 5.64 1 28.07 0 ± 8.16 7 ± 26.42 3 78.35 3

. ± 21.95 6

: 75.06 2 174.94 3 ± 372.29 0 ± 98.11 9• • 

# Therm o

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

## Certificat e o fVerificatio n

2 2 SOI L 2011-04-0 8 10:1 6 30.5 2 Fina l 1505 1 278 9 S 1 0 S T EA 1 " C.PADILL A CONFIRMATIO N CLEA R

Erro r 7.66 0 ± 13.56 7 ± 8.95 0

: 14.30 4 ± 6.53 3 13.16 4 ± 24.60 9 \ 5.20 6 l 32.57 7 11.75 8 ± 24.80 6

: 82.54 5 ± 22.07 8

: 71.69 8 : 171.31 5 ± 355.33 4 ± 102.90 6 XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

M o Z r S r U R b T h P b S e A s H g Z n W C u N i C o Fe M n pp m
< LO D 323.59 3 173.09 7

< LO D 69.40 7 < LO D 344.47 0

< LO D < LO D < LO D 222.49 7

< LO D 45.67 6 < LO D < LO D 15643.33 7

529.80 5 Supervise d By :• • 

# Therm o

SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpike

. Billerica , MA0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenci e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m M o < LO D Z r 289.53 6 S r 179.26 9 U < LO D R b 67.58 0 T h 14.41 1 P b 230.79 7 S e < LO D A s < LO D H g < LO D Z n 205.12 9 

### w < LO D C u < LO D N i < LO D C o < LO D F

e 15778.97 6 M n 531.91 9 Supervise d By : 

## Certificat e o fVerificatio n

2 3 SOI L 2011-04-0 8 10:1 6 30.5 2 Fina l 1505 1 278 9 S 1 0 S T EA 1 " C.PADILL A CONFIRMATIO N CLEA R

Erro r 7.63 3 i 13.11 0 ± 9.15 7 14.94 1 ± 6.56 2 ± 8.89 7 ± 20.71 9 5.55 8 27.41 4 12.01 6 ± 24.10 3 83.86 9 31.22 6 70.98 9 170.41 6 ± 359.27 9 ± 103.99 1X 

### Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5

- •riTjB- i ­ Coasta l Environmenta l Grou p Inc

. *^ " ywww.coastalhazmat.co m

%PBoTt ^ COASTA L EHVmONHENTA L CROUP , IN C 

# EXECUTIV ESUMMARY : BVID #15051-(278 9 S 1 0 ST )
No Issue s o r Concern s [ ^ Issues/Concern s
Detail Explanation :• 

# ^ 1 EP APfopert y Clos e Ou t For m Propert y tt : Propert y Addmr

. DateOlme : Owner' s Naib c Qiiad s Excavaltd i Contracto r Grou p
JExcavatio nGenera l 1

.I f necessary , wer e th e correc t quadrant(s ) excavate dan drestored ? 2

.I f necessary , wer e th e correc i area s ofdri p zon e excavate dan drestored ?
Gradio K So dan dVcsctslto n 1 Doe s th e iredih g aroun dth e perimete r ofth e hous e i hexcavaieri area s generall y slop e awa y fromth e house ? 1

.

Ha s so dbeenlai di nal l area s that wer e excavated ? J
.Doe s th e jo dappea r to b e generall y health y and"growing ? (Onl y evaluai e ifinspecte da l a3 0 da y tim e period ) 4

.Ar e sodde darea s generall y fimi andevenl y graded ? 5

.

Ar e th e joint s betwee nth e so d.stri) K generall y tight ? (Onl y evaluat e if inspecte da t a3 0 da y tim e period ) 6
.Wa s th e property grade dsuc htha t wate r wil l not poo l onth e property ? 7
.

Wa s damag e t p landscapin g o r plant maieriai s avoided ? Gates , Fenicc s an dRetBinlD s Wall s 1

.

D o gate s openan dclos e freely? (I f applicable ) 2

.Wer e al l gate s o r fence s take ndowndurin g restoratio nactivitie s reinstalled ? (Ifapplicable ) 3

. Wias damag e t o gate s o r fence s avoided ? (ifapplicable ) 4 Wa s dariiagi j t o retainin g wall s avoided ? (Ifapplicable ) FouDdation,SidiiiRan dCutler s \

. 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 ? Wa s damag e to window s avoided ? 4 Wa s darhag e t o window s o r doo r screen s avoided ? 5

.

Wa s damag e t o downspout s or downspou l extension s avojded ? Sidewalk s an dDriveway s (Concrete ) 1

.Wa s damag e t o drivewa y surface s avoided ? 2

.Wa s damag e t o walkwa y surface s avoided ? Ye s N o / 

## y Ye s N o • ' 

# y y y y 

# y y
Ve s N u / 

# y y y
Y a.N o 

# 7* 1 ^ 

# T 

# 7 / 

# f N o 

# t1 • 

## OM'ner s coininerits :

[lnspect!ir) nno<es :

Removal andrestoratio nactivate s cbrnpiel e includin g the 30-^da y so dwairanry : EP ARepresentiiiiv e ^^: ^ Qate ; 6\5\> \

## Propert yCompletio n Agreemen t
Ihib agreemen t documents , lhe complclio no t remedial acliviiie s perloime do nm y properly

. M y signatur e will designat e liia i I a msatisfie dwilhlhe restoraiio no f m y properly , andlha( no item s ar e i nquestions , now , o r a

l any lim e i

nthe future , excep i thos e item s liste dbelow , i f an y Propert y ID : /^^^S " \ Propert y Address : ^Zi^< \^ ( 0 '^ f 0>.nc. : -rSp ^ ^u,^CJL ^ Phone : 

## Hoz-S-Io

- ^3^ 3 ^OZ-3^6-2t^/ ^
Restoratio n Item s i n Question :

item : Item : Item : Item : Item : Item :

g-rc e restoratio nis complcied , excep t as noted [ IIrio not a^jre^csioratio nis conipletc d 

# l i AJyA/n^^— ^ ^ ~y~J l ncr' s Signatur e Dat e Cont i arlorlfSignaliir c