## TRANSMITTA Lo f OMAH A LEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R SAI D # : ^ 9 'yX^
.Date : /0~/3'6 S Address : <^9.l?
. FAg^R£MC ^ iMVd
. Remediatio nContractor : Coasta l Environmenta l Group

_Year : _200 8 SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S Vide o o f property (DVD ) xecutiv e Summary ^ J > ^ 

### EPA-provide dproperty sketc h^ Signe dAcces s Agreemen t fo r subjec t property Signe dAcces s Agreement(s ) for adjacent property ,'<t//W ' Restoratio nAgreemei^-J r Settlemen t document s (i.e. , for damag e or to replac e plants , etc.)/^ ' Confirmatio ndat a. 

## Photograph s hri^^{LUA.)/irio<\ ^ Cji^ieko^ ^ 8d-^AU. i %'d£ul^\^t^^^ ^ 

# \

-e r As-buil t sketc h Satisfactory restoratio nsigne db y Property Owne^ ^ 4031644 3 

### Property close-ou t chec k lis t signe db y EPA^'"TM" " Descriptio nofarea s no t meetin g RO D cleanu p criteri a Superfun d 

# Tw ' Utility clearance s •VUti/^HT* " Property informatio nfromDougla s Count y Assessor' s Offic e 

# y 

# y y ^ t i t£ ^ 

# kU i ^ to<>LrajJ rr\ty<rv < 

# l^/t f Dat e 

# duJ^i^-^l^ZUft^iiX ^ 

# (p/z^ M

# Property Acces s Checklis t 1 Propert y ID : ^C^ * ^. ^ 3 nWOR K STARTE D ON : / / Propert y Addrc.s.s : nWORKCOMPELTE D ON : / /
Owner : )<.(^^VK.4 ^ P)\C K 

### i r Renter : Address:^Ly^^^^^^ ^ ^ Phone : Fax : Cell/Page r Phone : Additiona l Information : 

# ^S^'^l^Q
. Fax : Cell/Pa»cr : fa<0 ' f ^f^ ^ 

# ¥ Notificatio nLette r 

### Sent : 5^/1/0/ ^ 

# B.v:]AWr)'o k I I Acces s Agreemen t Signed : / / Bv : I I Restoratio nAgreemen t Signed : / / By : I I Top.soil Samplin g (if ap|)licablc ) Bv : nDisposa l Samplin g (i f applicable ) Bv : CH Garde n Samplin g (i fapplicahle ) Bv : ^ Utility Clearanc e CA\\iii\:(a_IJ^IC ^ 

# ^y-t c ims\i \\^cL2^ ^ Video/Photo s (Before ) By : [L ^ 

# w On-.Sl-^J^ ^ nVideo/Photo s (During ) On : Bv : ^ Video/Photo s (After ) 0n:0^/^/ ^ B v ^ nVideo/Photo s (30-Day ) On : Bv : B Propert y Coin|)letio nAgreemen t Signed?^ 6 /oil/C I 

# By : 4 i I I Fina l Repor t Issued : Bv : Ai r Monitorin g (a s applicabl e ) j C H Communit y C H Cro v On : / / By : Results : [ 1 1 C H Communit y C H Cre w On : / / B,v : Results : j C

H Communit y C H Cre w On : / / 

### By : 1 Results : j
Omah a Lea d Sit e

## CONTAC T FORM Propert y I D U Propert y Address : Initia l Contact : Secon dContact : Fina l Contact : Fina l Action :

Comment : Owne r Commen t (s) : Sit e Coordinato r Commen t (s) : 

# A^1^ 3 2%I3 Flnc^r^H d Date : Time : Action : Date : Time : Action : Date ; Time : Action : Transmi t to EP A D Othe r Action : D

ci^rke- S

### Dougla s County Accoun t Infhrmatio n Pag e 1 o f 1 t^jm a
Dougla s County , Nebrask a Propert yRecor d - R174522000 0 Prin t Repor t Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t o f14 4 S

t • ViewOf l Ma p Informatio n i s vali d a s o f2008-5-1 9 Treasurer' s Ta xRepor t Ne wFeatur e -•-•- > Aut o Sale s Searc h Owne r BLAI R KENNET H ETA L 540 5 JAYNE S S T OIVIAHAN E 68104-000 0 Propert yInformatio n Ke yNumber : 452 2 000 0 1 7 Accoun t Type : Residentia l Parce l Number : 174522000 0 Parce l Address : 281 3 FLORENC E B D OIVIAHAN E 68110-000 0 Lega l Description : MILLAR D & CALDWELL' S AD D LO T3 9 BLOC K0 N 5 0 W 139. 5 F T& E 7 5 W139. 5 N22.7 S 123.2 5 & E 1 5 W 64. 5 N 21.2 0 S 123.2 5 F T Valu e Informatio n
200 8 200 7 200 6 200 5 200 4 200 3 Lan d $600.0 0 $600.0 0 $600.0 0 $600.0 0 $600.0 0 $600.0 0 Improvemen t $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 Tota l $600.0 0 $600.0 0 $600.0 0 $600.0 0 $600.0 0 $600.0 0 Sale s Informatio n Sale s Date : 2002-09-3 0 Dee d Type : Q C Book : 200 3 Page : 24075 0 Price : $600.0 0 Grantor : ROBER TPERR Y Grantee : KENNET H BLAI R ETA L Valid/Invalid : Invali d Exclusio n Reason : Lan d Sal e Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 9 8395. 0 0. 0 115. 0 73. 0 Ye s


### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R l 7.. . 6/11/200 8

### n 

## o U J 

### ^ ' c 3 

## o o ( A m 3 

### o Q_D

__Rfflnote

_ID:

_R.l>ag e o f Ticlce

Origi: i Wcri c : : State: : Addr e 3 Twp : I Twp : Lega l Typ e z- Locat l Remar k Ccrtipai:" ! Contac ; Alt
. C Worl c ,: ! Dept h Invol v CXCAT V

CD : 204513 1 LCal l Date : ; Begi nDate : 

### I

E 281 3 Rng : 13 E tog: Lven : N County : DOUGLA S Street : FLORENC E BLVD

Sect-Qtr : 10-S W Sect-Qtr : Work : LEA D REMEDIATIO N U O f Work : LOCAT E ENTIR E PROPERT Y

: COASTA L EKVIRONMENTA L SERVIC E Kame : ELIZABET H titact : MARCO S C R RO NBROWN l.r. g Don e For : TH E EP A li

" Excavation : 4F T Corne r Lot: H ^ Tunnelin g o r Horizonta l Borin g : N MAGELLA NMODO l OMAHACO F 6/02/0 8 Time : 1 : 3 6 pn n Op : LJ S 6/04/0 8 Time : 2:0 0 p m Place : OMAHA

Phone : (402)991-119 9

Front : Y Rear : Explosives : N 0PPDGPR 5 QLNNEI C

# As-Buil t Drawin g C OASTA L 

# Omah aLea dSuperfun dSit e ENVIRONMINTA L cn o u r. IN C 

### 2975 3 Exterio rPain t Nort h Arro w Omah a Lea d Sit e Samplln a Addre«« : 28i3FLORENCE^B D Sit e Sketc h • Goo d • Poo r Phone : H (402)245-113 2 ALT : [ ^

No t pain t Lea d Sampl e Sample s Collecte d Concentratio n Collecte d LA B Firm : A^wUi^/lf : RYASCPXA-2975 3 F 1 

### /g / pp m 

### D Date : "''^il - x''o t RYBSCPXA-2975 3 F 2 ^g- V pp m ^ Time : Z.y > Pi ^ RYCSCPXA-2975 3 B 1 /iq g pp m 

### D Sample s Analyze d

Sampl e Numbe r

RYDSCPXA-2975 3 B 2 2Tf l pp m 

### & D RD2SCPXA-2975 3 D Z pp m 

## 33^ ^ Q ' XR F Unit : CS'^ Z Book : \9> t 

# n nogocnxA-gQ753—ez - pp m 

### D D Date : ^/OS'/Q- ? pp m La

b RYBSCPLA-2975 3 

### D Time : j^t L 

# n 5 Resul t 24 9 pp m Staff : Numbe ro f Sample s = ^ 

## ^^ W Legend : F l = Fron t Left , F 2 = Fron t Right , B 1 = Bac k Left , 8 2 = Bac k Righ t D Z = Dri p Zone
. G Z = Garden , P Z = Pla y Al l quadrant s ar e a s viewe d fro m th e street , facin g propert y



### Legen d Dri p Zon e Excavate d Quadrant s Excavate d Concret e Are a replace d wit h Are a replace d wit h Are a lef t bar e So d Roclc/Mulc h 

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

## I ^ M ^ 

## 2975 3 Samplin g Address : 281 3 FLORENC E BD Phone : H:^iBapi 6 .113 3 ALT : Keky\<dA
. 

### Omah a Lea d Sit e Sit e Sketc h Ijhj r Exterio rPaint
• Goo d
• Poo r 0^ ^

No t paint Nort h Arro w

Sampl e Numbe r RYASCPXA-2975 3 RYBSCPXA-2975 3 RYCSCPXA-2975 3 RYDSCPXA-2975 3 RDZSCPXA-2975 3 ROZGCrXA-2075 3 pp m 

## D 

# M . ,La b RYBSCPL^-2975 3 Time ; 2 Resul t 249pp m Staff : Numbe ro f Sample s 

## I 

# ^s w Legend : F 1 = Fron t Left , F 2 = Fron t Right , B l - Bac k Left , B 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , P Z = Pla y Al l quadrant s are as viewe d fro m th e street , facin g propert y 

# ENTERE D 9 ' • 

# , 0 t/j
. \i 

### iU L2 J Z007 : " 1 

## Zl B : 

## 6 2 , ^
^ 

# X ^

t 

## b~L^S3' ^ /<f/....
. 7.e,x ^ f uxLthic e 9,i \ ID 

# n:. . Lea d Sampl e Sample s Collecte d LA B Concentratio n Collecte d Firm : F l 

## J.d L pp m 

## D Date : o -^^ ; i - r'^ o > F 2 

## 25- y pp m 

### Time : l- p P< ^ B l 

## /i^ s pp m 

# u D Sample s Analyze d B 2 

## 27 8 pp m 

## D pp m 

## D XR F Unit : LS^ Z Book : f ^ D Z 

# .^5 ± -GZ - pp m 

# u D Date : 9/OS'/<b 7 

## D

,

Re

v 5 Create d inflQ(i l 1 1 0 6 1 5 04(.M1.0I2 3 V ?oo 7 W Wa» i WO TK w w " aoe r K» 7 JOO J? :.'XPT;(»7»O Iju)'x»»JW'!W'M)'i»'M;3WTj«)jjacJMtrxw'xc'>»»J3OTino-MijT»a r rt»iroo'»i-x«';t»~KC'x*^^ Tn
- •

## 2975 3 \ Exterio rPain t Nort h Arro w ^

Omah a Lea d Sit e Q Goo d Samplin g Address : 281 3 FLORENCE BD Sit e Sketc h Q Poo r Phone : n : l<oa)^< i 4<o a ALT:

_ ^^^ji-o/ A/j^ > |2 | No t pain t Sampl e Numbe r Lead Concentratio n Sampl e Collecte d LA B Fim i Sample s Collecte d 

### /^4 w^rlif : RYASCPXA-2975 3 F l J S / pp m 

## D Date RYBSCPXA-2975 3 RYCSCPXA-2975 3 RYDSCPXA-2975 3 F 2 8 1 8 2 7^ V ZTf i pp m pp m 

## D D Tim e 

## 1-ppi ^ Samptes Analyze d RDZSCPXA-2975 3 D Z 33 9 pp m 

## D XR F Unit : LS^ Z Boo k ^ ^ ROEGCPX A2075 3 -GZ La

b RYBSCPLA-2975 3 SResu H 24 9 pp m • " pp m pp m Numbe rofSample s = 

## D D ^ 

## D D / Date Time : Staf f 9/0^/0 7 

# M .

^^w Legenj l F 1 = Fron t Left , F 2 = Fron t Right
. B 1 = Bac k Left , 8 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden
. P Z = Pla y A l quadrant s ar e a s vievve d fco m th e streel
. facin g propert y

# 2975 3 Omah a Lea d Sit e Samplin g Address : 281 3 FLORENC E B D 

### Sit e Sketc h Phone : ^ - (402)24S4132 ALT : Sampl e Numbe r RYASCPXA-2975 3 RYBSCPXA-2975 3 RYCSCPXA-2975 3 RYDSCPXA-2975 3 RDZSCPXA-2975 3 nOZOCPX A2075 3 La

b RYBSCPLA-2975 3 " 8 Result 24 9 pp m Lea d Sampl e Concentratio n Collecte d F l F2 

### 2 ^ ^ B 1 /T^ 8 8 2 2Tf t DZ 3 3 9 GZ ­ " pp m pp m pp m pp m pp m 

## D pp m 

## D pp m Numbe ro fSample s = ^ LA B 

### D [2 1 D D D D D 

## J Exterio rPain t Nort h Arro w Q Goo d 

### • Poo r [2''^Not paint Sample s Collecte d Fir m Dat e Tim e Sample s Analyze d XR F Unit : loS*¥ Z Book ; l£ ^ Date ; 9/Q£Ve> 7 Time ; 

# M . Staff ; 

# ^s W Legend ; F l = Fron t Left , F2 = Fron t Right , B l = Bac k Left , B2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , PZ = Pla y Al l quadrant s ar e a s viewe d fro m th e street , facin g propert y 

# ENTERE D f ^

- . . ,1..
. y

.. . i ^ • TV ' J

## lUL2 3 2007 : /7'j e 

# zi e 1 h \ 6 2 M O

- • • ) 

# 1 1 4 

# F a D^'^s* ? /tf / t * ^ 

### •xs.i^ f u 

## ;?eeNc ^ i5i. vt o 

# f

l

f f

,

Re v 5 Created : 7«/200 7 11:06.1 5 046141.012 3 O T x mjoo T 3ap

> ao i j«u > W T no r MC'MO'BD ' jao'jo mKO Ix» r jao ' V) 7 xtrryx ' xt r )m

T iv r

ne ' XLT-js n ni' ' XE TM AHD ' lae

- TOO Ixa i x» y j mJOD T3K'xo r xt aTVE'jta r jeo : xa i itcT i , > HJP T3BP - Xg, ' n ' Mt ? Wl > »>. •SO ' M) ' JBO* WDJ « P XC 7 1.^v^tOS M
COASTA L ENVIRONMENTA L CROUP , INC
. 

# H^K 3 Consen t Fo rAcces 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 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 : ^^»^/\.fcf K151 , 

### \a.\ r Daytim e Phone : Lit ) 9v - 45^'^" ^

13 ^

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 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 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 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 

### B ysignin 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 of performin 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*lt D STAf ^ 

# m
COASTA L ENVIRONMENTA L GROUP , INC
. 

### Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; Remov e flowe rbulb sorplant s tha t th e Granto r orth e Grantor' s tenan t maywis h to save ; Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , as necessarysubsequen ttoan initia l waterin g perio dbyEPA ; Abid ebyhealt h an d safet yguidanc e provide dbyEPA ; Ifth e propert y is rented , assis t EP A in obtainin g tenan t approva l fo racces s to th e propert yto perfor m th e work
. Allo wvideotapin g and/o rphotographin g ofth e property
. AGREEMEN TNO T

TO INTERFER E Th e Granto ragree s no tto interfer eortampe rwit h an yofth e wor k activities , orwit h an y ofth e wor k done , orwit h th e equipmen t use d on hi s property , orto undertak e an y action s regardin g th e us e of sai d propert ywhic h woul d ten d to endange rth e healt h or welfar e of th e Grantee s orth e environment , orto allo wother s to us e th e propert y in suc h a manner . Shoul d you hav e an yquestion s abou t thi s program , pleas e contac t Coasta l Environmenta l Group , at (877 ) 234-6270
. I gran t access to mypropertie s D I do no t gran t access to mypropertie s 

# S-zr-^ r sigirature ' "* " Date ^

' ' ^ O^^ C Signatur e e <^<< ^ Dat e
O I woul d lik e to be presen t durin g an ysamplin g tha tis required
.

Pag e 2 of 2

### Mr . Blair , M y nam e i s AdamDetric hwithCoastal Environmenta l Services
. I spoke wit h yo u briefl y ove r th e phon e abou t you r property a t 281 3 Florenc e Blvd
. Ou r Hav e bee n schedule dto excavat e you r property , backfill , andso dit
. The y woul dlike to begi nth e wor k

aroun dth e secon dwee k o f June , bu t w e nee dto get you r paperwork processe dsoo n to make thi s happen
. It doesn' t cos t anything ; th e EP A pay s fo r all o f it
. I f yo u hav e an y question s feel free t o call
. Offic e 402-991-119 9 Cel l 402-504-098 1 Thank you , AdamDetric h Sit e Coordinato rCOASTA L 

### Restoratio n Agreemen t Th e purpos e ofthi s agreemen t i s t o provid e amutual agreemen t 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 nfo r th e purpos e o f assurin g that restoratio n activitie s are complete dt o th e satisfactio nofth e property owne r andth e Unite dState s Environmental Protectio nAgenc y (EPA)
.

Property ID : ^^ ^ S 3 Property Address : ^< g [ ^ ^loCiy^O LQiit^c l 

### Owner : Y>iy\^<S \I3|(\i r Phone : V^Q-X' i\S'^ ^ M l3 2
O nth e attache ddiagram(s ) indicate area(s ) to excavate danddept ho f excavation , locationo f al l know n utilities , subsurfac e features , surfac e structure s andlandscapin g features , acces s location(s ) to be usedb y contractor , andth e directio no f North
. Indicate distances , depths , materia l types , etc . Indicate digita l photo s b

y referencin g th e photo-lo g number wit ha n arro w indicatin g 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 : 

### UDVV ^ Item : Item : Item : Item : Item : Item : Item : 

### Page i of ^ 1C O AS TA' L ENV'.ROtMMEI M T AL G R AU 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 additiona l sheet s a s necessary ) Item : 

# M bY\ ^ Item : Item : Item : Item : Item : item : Item : Item : Item : Item : Item : Item : Item : Item :

Pag e 2 o f^COASTA L ENVIRONMENTA L C R C » U P
. INC
. 

### 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 : 

# klo^ ^ Item : Item : item : Item : Item : Item : Item : Item : item : Item : Item : Item : Item : Item :



### Page s O f ^C O AS TA
. L 

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

## Ite m

Pre-existin g property area , that wil l b e excavated , tha t i s covere dwit hgrass .

Numbe r o f tree s > 2 inc h trun k diamete r

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

Numbe r o f Sprinkle r Zones , Contro l Valves , Timers , Heads , etc . Attac hasketc ho f th e sprinkle r layout
.
Numbe r o f andsiz e o f eac hgarden/ flower be d area . Attac hasketc hof relativ e size s andlocations
. 

## Quantit y 

# 6>,f a

- &
.



# -a .

- ^

^ 

## Uni t

Square fee t 

## Condition/Type/Specie s

Eac h
1

Eac h

Eac h
'

Eac h Square Feet

Pag e 4 of
. 

# fo 1COASTAt
. 

## Ite m Quantit y Uni t Condition/Type/Specie s Agree dupo nvalu e of Diant material s no t t o b e renlace db v contractor . Not e thi s valu e will b e use dt o issu e aplan t vouche r t o th e propert y owner . ^ 

## $ 0

Agree dupo nlis t o f plant material s that will b e replace dby contractor . B e very specifi c anddetailed
. Includ e asketc ho f were eac hplan t wii l b e place d b y th e contractor . 

## • a Eac h V

Agree dupo nare ao f property to b e replace d wit hgras s sod
. Includ e asketc ho f th e area(s ) to b e replace dwit h gras s sod
. S F

Are ao f Cit y o r Count y property t o b e landscape d pe r thei r requirements
. ^ S F Includ e are a(s ) a sketc ho f th e

Easemen t Area , to b e excavate d S F



### Pag e 5 of
.C O AS TAt
. • MVlfeOMHCMTAt
. c• e u p . INC
.



### D 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 done t o th e interio ro fhouse , includin g foundatio n crack s o rfissures
.


## I agree [j | I do not agree ^


# : C^ e S-'/^-cj r / i^ner' s Signatur e Date Contractor' s Signatur e Date Pag e 6 

### o f i p

## BVI D #2 9 7^ 3 XR F PROPERT Y SAMPL E SHEE T Dat e \ D ' \3-^0 ^ Addres s 

# 'x^\'^ r^iactvi ^ aiv i Projec t Omah a lea d F P 2n d yea roptio n Sampl e tim e -S^ O ^/p m XR F ID # li\V-lb n VUeMste i ( sampl e lengt h 3 0 se c

Shot # 

## 73 ^ 

## 12} L IX L

IT^l k Averag e Readin g 

## '7&1 ­ ^"^- f 1^ 3 i 

### AO- 3 

### \s^-) ±:^^ a Sampl e are a & / Dept h 131
. ^ ^ 0, 0 Sho t #

Averag e Readin g Sampl e are a Dept h

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

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

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

, la b sampl e # 

### l2^1<-5"!bl'G l La b resul t 

# M'^ cm Sampl e are a 

## M XR F Avg
. 

## \^^X'' M Averag e Signature
_ Prin t .^ ^ 

# A• b-g/o^^t n

### Repor t Number : ^I^All/llcllAffiSt A^^^ ^ Reported : 

# 08-168-231 4 ^i^UmmmmSmmSl^y 06/16/0 8 Account : 

# p^li' i f i Page : 1 o f1 ^^, , ^ ^ 

## m . T ^ • • 1 mm® 

# ^1 ^ Laboratories , Inc
. ^ , . , , , 

## ^^^ ^ Received : 

# °f'; T, ^ Dat e Sampled : " 1361 1 B Stree t • Omaha , Nebrask a 68144-369 3 • (402 ) 334-777 0 • FA X (402 ) 334-912 1 • www.midwestlabsuginio/o g 

### COASTA L ENVIRONMENTA L GROU P LEA D ANALYSI S MARCO S MATEU S 241 1 MARTH AS T OMAH AN E 6810 5 Analysi s A s Detectio n Analys t Verifie r Performe d Receive d Unit s Limi t Metho d Dat e Dat e U b number : 143468 5 Sampl e ID : 29753-1B-61208-Q C

Lea d (total ) 17 9 mg/k g 5 EP A601 0 rrd/06-i6 bab/oe-ie

Fo rqiierstion s cojai;&c t C^/ O Su e An n Seit z Clien t Servic e Representativ e sueann@midwestlabs.co m (402)829-989 2 Th e Cfisultfs ) issued o n thi s repor t only.reflec t th e analys t o f tli e 5amp|e(s) submitted
. Fo rapplicabl e test paramaters , Midvyes t Laboratories i s in complianc e wit h NELA C requirements
. Ou rImports an d letter s are for'tli e exclusiv e an d confidentia l us e o fou rclient s anama yno t b e reproduce d i n whol e o ri n part , no rma yan yreferenc e b e mad e t o th e work , th e results , o rth e compan yi n an yadvertising , news release , o rothe rpubli cannouncement s withou t obtainin g ou rprio rwritte n authorization
.

# ^[<^ Lali@rat®rieSj , Inc; : 1361 1 B Street « Omaha , Nebrask a 68144-369 3 •= (402 ) 334-777 0 ° FA X (402 ) 334-912 1 »www.midwestlabs.co m ACCOUNTNUMBE R 

### CHAI N O F CUSTOD YRECORD : Ye s N o PURCHASEORDERNUMBER
. 

### REPORT&BILLT O IDENTIFICATIO N COPYT O j CoaLs\cx \ tr\Vtrt)AmeWTl>c \ 

# ilHl l M..-Vk< xi \ ZI P ZI P PHON E ( ) 

# P^om^^lDCtX-Hl W

Chain-of-Custod ywil l hav e a signatur e upo n receip t bu t n o subsequen t signature s ^^" ^ 02/0 2 Distribution : Origina l accompanie s shipment ; cop yt o Coordinato rFiel d File s • Matri xCode : S O - Soil
. W A- Water
. S L - Sludge , O T- Othe r Ou rrepor t z wIsttsr s sr e fo rth e excljsV e end ccnfidsntie t 4!s s c ? c yciisivi s tn i ni£ yric t i-e
. reprodi-ced >'• ; whole o i i: : peri , .^o{ - n'le yE:.) ' rererenc cb e rr.EC t ' o t.'^i e wck , th e rsEjits
. o rtn e co-ripFn yli' i an)- so'veriising , risw s refajss , o rothe. ' pfbii csnr.eyncerrssnt s withe;." ' cbteiniri C CJ ? VV Xwrjiie n ei!thori?.c:tlor
.

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

## Certificat e o f Verificatio n XL t 1464 4 Readin g N o 12 6 Mod e SOI L Tim e 2008-06-1 2 09:5 1 Duratio n 121.4 9 Sequenc e Fina l Flag s AVERAG E = Av g o f122-12 5 LOCATIO N INSPECTO R detric h CO R 1 C0R 2 MIS C NOT E

pp m Erro r S b < LO D 71.93 2 S n < LO D 66.83 0 C d < LO D 23.15 0 A g < LO D 12.21 6 R h < LO D 10.49 9 P d < LO D 4.62 3 S r 112.82 0 ± 9.15 4 R b 53.70 1 • 6.32 7 P b 137.79 2 19.99 5 1 A u < LO D 16.74 3 P t < LO D 26.86 8 A s < LO D 24.56 1 R e < LO D 60.87 1 Z n 117.33 3 i 28.93 6 O s < LO D 53.52 1 C u < LO D 34.66 1 N i < LO D 70.59 8 C o < LO D ,249:30 2 F e 15960.43 2 - " 430^29 8 M n 450.83 8 ,^' ^ .109.53 5 C r < LO D y118.35 3 I r < LQ D y59.35 8 ( Su p ervise d By : y ^ ''^^ ^ ^

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

## Certificat e o f Verificatio n XL t 1464 4 Readin g N o 12 2 Mod e SOI L Tim e 2008-06-1 2 09:4 9 Duratio n 29.6 1 Sequenc e Fina l Flag s SAMPL E 2975 3 281 3 florenc^ y LOCATIO N b l INSPECTO R detric h CO R 1 CO R2 MIS C NOT E

pp m Erro r S b < LO D 72.67 9 S n < LO D 67.23 9 C d < LO D 23.58 5 A g < LO D 12.38 1 R h < LO D 10.95 4 Pd < LO D 4.44 3 S r 111.72 2 i 9.16 7 R b , „ • •« . 47.24 6 ± 6.03 1 P E 154.11 1 21.23 8 A u < LO D 17.63 9 P t < LO D 27.43 5 A s < LO D 25.85 1 R e < LO D 62.55 7 Z n 110.44 5 ± 28.63 4 O s < LO D 54.83 4 C u < LO D 34.82 4 N i < LO D 74.48 1 C o < LO D 252.25 0 Fe 16062.36 4 ± 434.03 1 M n 477.88 3 ± 111.25 4 C r < LO D 98.87 8 I r 63.41 0 ± 42.19 2 Supervise d By :

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

## Certificat e o fVerificatio n XL t 1464 4 Readin g N o 12 3 Mod e SOI L Tim e 2008-06-1 2 09:4 9 Duratio n 30.8 5 Sequenc e Fina l Flag s SAMPL E 2975 3 281 3 florenc e LOCATIO N 

### •b l INSPECTO R detric h CO R 1 CO R 2 MIS C NOT E

pp m Erro r S b < LO D 69.69 0 S n < LO D 64.57 5 C d < LO D 22.08 2 A g < LO D 11.94 7 R h < LO D 9.88 5 P d < LO D 4.61 2 S r 114.90 0 ± 8.99 5 R b 51.39 1 ± 6.05 7 P b " ^53.04 4 .Aan^m^j ^ "•" ' 20.31 5 A u < LO D 16.00 4 P t < LO D 23.74 5 A s < LO D 24.29 1 R e < LO D 61.42 9 Z n 106.96 9 ± 27.58 4 O s < LO D 50.86 4 C u 38.26 1 ± 23,29 8 N i < LO D 69.05 8 C o < LO D 239.96 7 Fe 15519.64 0 ± 413.85 4 M n 392.41 7 ± 102.15 8 C r < LO D 119.21 6 I r < LO D 51.98 6 Supervise d By :

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

## Certificat e o f Verificatio n XL t 1464 4 Readin g N o 12 4 Mod e SOI L Tim e 2008-06-1 2 09:5 0 Duratio n 30.2 2 Sequenc e Fina l Flag s I SAMPL E 2975 3 281 3 florence s

LOCATIO N b l % INSPECTO R detric h CO R 1 CO R 2 MIS C NOT E

pp m Erro r S b < LO D 69.88 2 S n < LO D 65.12 9 C d < LO D 22.86 1 A g < LO D 11.72 0 R h < LO D 9.59 8 P d < LO D 4.68 2 S r 98.01 5 : i 8.50 2 R b 59.57 1 i f 6.51 7 P b ' 128.73 1 ~ 

## "~ 3 19.10 3 A u < LO D 16.42 1 P t < LO D 26.40 2 A s < LO D 23.94 5 R e < LO D 62.69 6 Z n 123.55 8 ± 29.16 0 O s < LO D 53.61 9 C u < LO D 31.36 2 N i < LO D 72.56 3 C o 279.35 1 ± 166.49 2 Fe 16099.93 8 ± 425.82 2 M n 518.90 7 ± 113.67 7 C r < LO D 123.23 5 I r < LO D 56.05 7 Super v se d By :

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

XL t 1464 4 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s SAMPL E LOCATIO N INSPECTO R CO R1 CO R 2 MIS C NOT E

pp m S b < LO D S n < LO D C d < LO D A g < LO D R h < LO D P d < LO D S r 126.64 2 R b 56.59 5 P b 115.28 2 A u < LO D P t < LO D A s < LO D R e < LO D Z n 128.35 8 O s < LO D C u 37.73 8 N i < LO D C o < LO D F

e 16159.79 0 M n 414.14 6 C r < LO D I r 68.45 2 Supervise d By : 

## Certificat e o fVerificatio n

12 5 SOI L 2008-06-1 2 09:5 1 30.8 1 Fina l 1 2975 3 281 3 florence l 

## tb l detric h

Erro r 75.47 7 70.37 6 24.07 3 12.81 5 11.56 1 4.75 5 ± 9.95 4 ± 6.70 3 ± 19.32 5 16.90 7 29.89 2 24.15 8 56.80 2 ± 30.36 5 54.76 5 ± 25.00 7 66.28 9 257.25 4 ± 447.48 7 ± 111.05 2 132.08 1 ± 44.06 9

### ixJlt^ \ Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 I ^^^V^fCoasta l Environmenta l Grou p Inc
. ^^^^<P * www.coastalhazmat.co m

'<t«,ott ^ COASTA L INVmONHINTA L e 1 1 0 u p . IN C 

# EXECUTIV ESUMMARY : BVI D #2975 3 - (2813 Florenc e Blvd. ) "x l N o Issue s o r Concern s | ^ Issues/Concern s Detai l Explanation :

### S i ^ 

# EPA EP APropert y Clos e Ou t For m 

# MK-y Propert y Addre« : ^^( ^ HoHnU ; Propert y # : Datcn-imc : 1 \ l Owner' s Name : l^HI/'lf-fl l l>ll>^ll^ ~ Quad s Excavated : |^ | Contracto r Grou p CoP(',Vn[ ^ Ye s N o 

# \/AaAr rLo V Excavatio nGenera l 1
.I f necessary , wer e th e correc t quadrant(s ) excavate dan drestored ? 

# y y 2
.I f necessary , 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 house i nexcavate darea s generall y slop e awa y y fromth e house ? 2
.Ha s so dbeenlai dinal l area s tha t were excavated ? 3
.Doe s th e sodappea r t o b e generall y healthy andgrowing ? (Onl y evaluat e if inspecte da t a3 0 da y tim e period ) 4
.

Ar e sodde darea s generall y firni andevenl 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 th e propert y grade dsuc htha t water will no t poo l onth e property ? 7 .Wa s damag e t o landscapin g or plant material s avoided ? Gates , Fence s an dRetainin g Wall s Ye s No I .D o gate s openandclos e freely? (Ifapplicable ) j/ A 2
.Wer e al l gate s o r fence s take ndov mdurin g restoratio nactivitie s reinstalled ? (ifapplicable ) ^ 

# t 3
.Wasdamag e t o gate s o r fence s avoided ? (Ifapplicable ) A/ J 4
.Wasdamagetoretainin g wall s avoided ? (Ifapplicable ) J/ ^ Foundation , Sidin g an dGutter s Ye s No I .Wa s damag e t o th e sidin g o r tri mavoided ? 

# M i 2
.Wa s damag e t o th e foundatio navoided ? 

# A : 3
.Wa s damag e t o window s avoided ? 

## JLM I 4
.

Wa s damag e t o windows or doo r screen s avoided ? 

# A t 5
.Wa s damag e t o downspout s o r downspou t extension s avoided ? 

# J t Sidewalk s an dDriveway s (Concrete ) Ye s N o 1
.Wa s damag e to driveway surface s avoided ? 

## A ^ 2
. Wa s damag e t o walkway surface s avoided ? y ^

## Owner s comments :

Inspectio nnotes :

Remova l an drestoratio nactivate s complet e includin g th e 30-day so dwarranty : EPA'^^V^^^tx^\2X\}i^^7^^^^^J^ Date : 7//C>A a

## Propert yCompletio n Agreemen t This agreement document s the compleliono f remedia l activitie s performedo nm y property . M y signature wil l designate tha t I a msatisfie dwit hthe restoratio no f m y property , andtha t no item s ar e i nquestions , now , o r a

t any lim e i nth e future , excep l thos e ilem s liste dbelow , ifany
. Propert y ID : g9"7^ 3 Propert y Address : ^^<^i3 " f\atV)C( ^ P^\/ J Owner : jCtfim k JMgl r 

## Phone : Ll^^^Qi:^: i Restoratio n Item s i n Question :

Item : Item : Item : Item : ? ; Item : Item :

I I agre e restoratio ni s completed , excep t a s note d 

## I I I d o no t agre e restoratio ni s complete d

f (Tvviier' s Signatur e 

### Rat e Contractor' s Signature 

## atjQ , b-dj'OF ; Dat e