### TRANSMITTA Lo f OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R
SAI D # : tr??>SU aDate : S/2o/i n Address : Z ^ fSf ^ Fnn-hm^W ^ Bxi d Remediatio nContractor : Coasta l Environmenta l Group

_Year : 200 9
SOI LREMEDIATIO N PROPERT YFIL EFOLDE RDOCUMENT S

^ Vide o o f property (DVD ) \y Executiv e Summary \y EPA-provide dproperty sketc h 0 ^ Signe dAcces s Agreemen t for subjec t property Signe dAcces s Agreement(s ) for adjacent property 

# feT Restoratio nAgreemen t Lj/ nSettlemen t docimient s (i.e. , for damag e o r t o replac e plants , etc. ) Vy Confirmatio ndat a ^ Photograph s ^ As-buil t sketc h V

y Satisfactory restoratio nsigne db y Property Owner 'fe ' Property close-ou t chec k lis t signe db y EPA t]// ^ Descriptio nofarea s no t meetin g RO D cleanu p criteri a t f

Utility clearance s ^ 

### Property informatio nfromDougla s Coimty Assessor' s Offic e 

## ^

R(^.4nrQlio n Ohanae : Qrij^ r 

# •

Signature Dat e 3021800 0 Superfun d

# •

Propert y Acces s Checklis t Property ID : (,A<^^Lt Property Address : 

## 7^9.UF;kY.WnP\\lB^ ^ D DWOR K STARTE D WORKCOMPELTE D ON : ON : 

### J I 

### l_ I 

## o^"*^" ^ Krx\y\op^.\^\i\\\rLy^y , Address : Rente r Phone : 

# SAM e '•'>°'"^--UQ?? ) ss i - Quu- ^ Fax : Fax : Cell/Page n Additional biformation : Cell/Page n
D NotificationLette r [ ^ Acces s Agreement ] S Restoratio nAgreement D Topsoil Samplin g (if applicable ) D Disposa l Samplin g (if applicable ) D Garde nSamplin g (if applicable ) \ ^ Utmt y Clearanc e Q^Ideo/Photo s (Before ) D Video/Photo s (Dnring ) nVideo/Photo s (After) nVIdeo/Phoft w (30.Day ) ^p 3 Property Completio nAgreement tnFinal Report Sent : / / Signed : li_/Ul/i2 9 Signed : IL/IU/ ^ / / / / / / Called : UA ^ lOf \ 

## On : JifJ±l_S
. On : / / On : / / On : / / 

## Signed : i_/^_/l£ ? Issued : / / By : By : By : By : By : By : By : l l \9)\0 ^ 

# ^ry^/ o By : By : By : By : By : Ai r Monitorin e (a s aiwlicable ] O Commnnit y QCrc w Results : On : / / By : 

# 1

D Commnnit y Reantts : DCre w On : / / By :
DComnranh y Results : QCrc w On : / / By :

Omah aLea dSit e

## Douglas Count y Accoun t Infomiation Page 1 of3 xm^ t Dougla s County , Nebrask a Propert yRecor d - R081207000 0 Prin t Repor t NE WFsntii m - Pflmfi l Dimfinsinn s availahl n ( ^ sral H 0-S O ft wes t o f52n d S t - ViOWO n Ma p Infomiatio n i s vali d a s o f2009-10-1 5 Treasurer' s Ta xReoor t Ne wFeatur e - » - > ^ Aut o Sale s Searc h Owne r WILLIAM S KATHLEE N M 245 6 FONTENELL E BLV D OMAH AN E 68104-000 0 Propert yInformatio n Ke yNumber : 120 7 OOO O 0 8 Accoun t Type : Residentia l Parce l Number : 081207000 0 Parce l Address : 245 6 FONTENELL E B D OMAH AN E 68104-000 0 Lega l Description : CLAIRMON TLOT1 BLOC K6 5 0 X12 5 Valu e Informatio n
200 9 200 8 200 7 200 6 200 5 200 4 Lan d $6,400.0 0 $6,400.0 0 $6,400.0 0 $6,400.0 0 $6,400.0 0 $6,400.0 0 Improvemen t $45,400.0 0 $45,400.0 0 $45,400.0 0 $45,400.0 0 $76,800.0 0 $69,800.0 0 Tota l $51,800.0 0 $51,800.0 0 $51,800.0 0 $51,800.0 0 $83,200.0 0 $76,200.0 0 Sale s Informatio n Sale s Date : 2007-07-2 5 Dee d Type : W D Book : 200 7 Page : 08561 7 Price : $ 108,210.0 0 Grantor : Walke rCletti s R eta l Grantee : William s Kathlee n M Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 1994-10-2 5 Dee d Type : D Book : 199 6 Page : 164 Price : $ 64,900.0 0 Grantor :


## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO..
. 10/23/2009 

# 1

### Dougla s County Accoun t Infojuatio n Pag e 2 o f 3 oma z
Grantee : Valid/lnvalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 5 6534. 0 1. 0 0. 0 0. 0 N o Improvemen t Informatio n Buildin g 1

MS«fC«TE"ej.EBC '

Fin i Floo r , Ssoon d Floo r :^ n SSO. O SO

. j t 2 1/ 2 STOR YLNFI N BxntEkxke c I X0 5 5 t

CLIC KT O ENLARG E IMAG E CLIC KT O ENLARG E IMAG E Squar e Footage : 1100. 0 Percen t Complete : 100.0 % Perimete r0. 0 Quality : i Averag e Uni t Type : Condition : i Averag e

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

Roo fType : Gabl e Stories : 2. 0 Floorcover : I Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 yea r Percen t Adjuste d Yea r Yea r6ui7 t Physica l Ag e Remodele d Remodele d Buil t 192 2 0 0 % 192 2 8 8 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Fenc e Chai n Lin k 1. 0 Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 550. 0 Basemen t Minima l Finis h 152. 0


### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO.
. . 10/23/200 9

## Douglas Count y Accoun t Infoanation Page 3 of3 amas
Fixture Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Garag e Detache d 378. 0 Porc h En d Scree n 176. 0



## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO..
. 10/23/2009Pag e 1 o f 1

Creat e Anothe rTicke t Bac k t o Irt h Inteme t i[ fSendEma H | 

# ] C

• YOU RTICKE T NUMBE RI S 2407201
. Origina l Cal l Date : 11/16/0 9 Time : 9:1 9 a m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 11/18/0 9 Time : 10:0 0 a m State : N E County : DOUGLA S Place : OMAH A Address : 245 6 Street : FONTENELL E BLV D Twp : 15 NRng : 13 E Sect-Qtr : 08-S W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : LEA D REMEDIATION Locatio n o f Work : INCLUD E AL L EASEMENT S LOCAT E ENTIR E PROPERTY Remarks : FA X AL L CLEAR S TO : (877)662-421 1 : UNSUR E O F CORNE R LO T Compan y: COASTAL ENVIRONMENTA L SERVIC E Contac t Name : ELIZABETH Phone : (877)662-421 0 Wor k Being Don e For : COASTAL Dept ho f Excavation : 4 F T Corne r Lot : N Front : y Rear : Involve s Tunneling o r Horizonta l Boring : N Explosives : N CXCAT V

MUDO l OMAHACO F0PPDGPR 5 QLNNEI C

Servic e Are a Contac t Phon e Numbe r Utilit y Typ e
CXCAT V CO XCOMMUNICATIONS , IN C HEID I Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7
MUDO l METROPOLITA NUTILITIE S DISTRIC TSAND Y Day : 402504782 3 Alt : Emerg : 402504797 0

OMAHACO FCIT YO FOMAHA-TRAFFIC.SEWE R RICHATRAFFI C Day : 402444719 7

Alt : 402444516 1

Emerg : 402444516 0

OPPDGPR 5 OMAH APUBLI C POWE RDISTRIC T N A Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3
QLNNEI C QWES TLOCA LNETWOR K N A Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT.
. . 11/16/200 9OLS# : 6356 4 

# As-Buil t Drawin g ^ Dat e Excavated : 11/27/0 9 Dat e USEP ASigne d Off : 1/19/1 0 C OASTA L 

# Omah aLea dSuperfun dSit e Are a Sodden : 480 6 s a f t ENVIRONMENTA L e ft O U P , INC

. 

### 6356 4 Exterio rPain t Omah a Lea d Sit e •Goo d Sit e Sketc h [T^Poo r Samplin g Address : 245 6 FONTENELL E B D Q No t pain t Lea d Sampl e Sample s Collecte d Sampl e Number LA B Concentratio n Collecte d 

# I Fir m pg . a-C

. CK - RYASCPXA-6356 4 F l ^(Il U pp m 

### D Date : IP-7-08 - RYBSCPXA-6356 4 F 2 U22
. pp m 

### D Tim e IO:i9 rA-w^
. RYCSCPXA-6356 4 B l .5fl O pp m 

### D Sample s Analyze d RYDSCPXA-6356 4 B 2 MfS H pp m 

### D RDZSCPXA-6356 4 D Z HZd O pp m XR F Unit : t^'JHC i Book : IT O 

## n nOgOCPX A6966 4 GZ - pp m Date : l b • 2. t • 0 & 

### D RPZSCPX A636 6 < PS — pp m - 

## n Time : Hr o 

### D 

# E Staff : f*^'^ U Numbe ro fSample s = Legend : F l = Fron t Left , F 2 = Fron t Right , 8 1 = Bac k Left , 8 2 = Bac k Righ t D Z = Dii p Zone
. G Z = Garden , P Z = Pla ; Al l quadrant s ar

e a

s viewe d from the street , facrng propert y



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EA=108PPM@1 " 

# iu : Rc\',>> * CreJKd , (iS-Scr-* !


### Legen d Concret e Dri p Zon e Excavate d Quadrant s Excavate d Are a replace d wl't 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
.

## I LH

# i n

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Sampllri g Address : 245 8 FONTENELL E B D Omah a Lea d Sit e Sit e Sl<etc h Exteno rPaint Q Good 0'Poo r Q No t pain l Nortt i AfTO W

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. CK ' RVASCPXA-635 M F l m»t * Dcm D Date : /O-T-aa RYBSCPXA-B3S M F 2 _JtZ2^PP m 

## a Time : in-.if rA.w . RYCSCPXA-8356 4 B 1 Sample s Analyze d RY0SCPXA-53SB 4 B 2 

## _aao_pp m a a _fLSjaL_Pp m RDZSCPXA-«35« 4 D Z 

## n XR F Unit : ^*iH O Book : 22L ^ 126 0 pp m nOgCCPX A83Sg 4 S* ­ ~ pp m 

## a D Date ; ip-2. 1 •O d RPZ6CPXA.8366 4 PZ - ~ pp m 

## o D Time : 

### J r Staff : m^L j Numbe ro fSample s » | 5 \ \ Q | Legend : F 1 » Fron t Left
. F 2 = Fron t Right , B 1 = Bac k Lefl , B 2 = Bac k Righ t 0 2 = Dri p Zone
. G Z = Garden

. P Z = Pla ; AH quadreni s ar e 8 9 viewe d fro m Hi e street , factn g p i 

# i f ( ^ ' ^

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## /^V'vlXV^^

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# I LA B Concentratio n Collecte d Firm : PE - d-C - CK ­ l?YASCPXA-6356 4 F l M i aIMpp m D Date : iQ-T-aq : RYBSCPXA-e356 4 F 2 U12
. pp m D Time : ln:\9 rA»W. - RYCSCPXA-6356 * 8 1 ^fi O Do m Sample s Analyze d RYDSCPXA-6356 4 B 2 Mfi H pp m 

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# n D 

# S Staff : Numbe ro fSample s = | 5 \ \ Q | 

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_ Legend : F 1 = Fron t Left , F 2 = Fron t Right , B 1 = Bac k Left , B 2 = Bac k Righ t D Z = Dri p Zone
. G Z = Garden , P Z = Pla ;


## (Wl^V ? f ^6356 4 Exterio rPain t NoithAtTw t Omah a Lea d Sit e •Goo d Sit e SIcetcl i [pfPoo r Sampim g AddreM : 245 6 FONTENELL EB D Q Not pain t Sampl e Numbe r Ua d Sampl e Sample s Colleded LA B Concentratio n Collecte d Flm t pg . QC
. g-K - RYASCPXA-63564 F l D Date : iO-7-oa - RYBSCPXA-63564 F2 yjli2^pp m D Time : /Q-.f gA.vv - RYCSCPXA-6356 4 8 1 _S£0

_pp m D Sample s Analyze d RYDSCPXA-6356 4 8 2 Mfi M Do m RDZSCPXA-63S6 4 DZ 4/2fl Q ocn . 

## n XR F UnH : r^tt d Book : 7 7 Q D nCIZCCPXA-6366 4 O E " " pp m D Date : ib'2^t - a A D RPZSCPX A68664 PZ - • " PP W D Time : D 'ra
. Staff : PiSh ? Numbe ro fSample s ° I S x\ o l Legend : F l = Fron t Left , F 2 = Fron t Right , 8 1 = Bac k Lefl , B2 = Bac k Righ t DZ = Dri p Zone , G Z = Garden , PZ = Pla < A B quadrail s ar s a

s vtewa d (R m the stiBet , IMn g pmpeit y 

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## Consen t fo F Acces s T o Propert 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 : Daytim e Phone : 

# Wl...
. y i

/ l O Addres s o fPropert y 

# 1<\j^ h ycy4^'<J ^ bi-^' ^ 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 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 b yUSEPA , 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 confim n 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 y ha s bee n remediated
.
ENVIRONMENTA LRESPONS 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 i 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

# i -•' JCOASTA L

"* * pqo^ * C H O U » I t * C



### « Remov e obstruction 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 ; €

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 (402 ) 991-119 9
I gran t acces s t o mypropertie s D I d o no t gran t access t o mypropertie s 

# 11-N W SignatureDate

Q I woul d iik e t o b e presen t durin g an ysampiin g tha t i s required
.

Page 2 o f2

# I e



# RESTORATIO NCHANG EORDE R OMAH ALEA D Propert y H ) #(^3S" 6 Y Propert y Addres s 7
. ^ ^ ^ ^ ^ ^ "^ ^ ^'^ ^ ^'*

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# Dat e / ^/^// ^ ? Comment s

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### vCC; : COASTA L G n r . u ' •*
. r 

## Restoratio n Agreemen t The purpos e o f thi s agreemen t i s to provide amutua l agreemen t as to condition s ofth e propert y prior t

o romediationactivities
. Thi s will als o serv e a s documentationfo r the purpos e of assuring tha t restoratton activitie s are completedt o th e satisfactionofth e propert y owne r andthe UnitedState s Environmenta l Protectio nAgenc y (EPA)
. Propert y ID : 

# '^5^/ V Propert y Address : Q^J^ ^ fmh//i /S^u'^ y Owner : ^^4^^^, ^ lAJ.//; , Il/h ^ 

# .!^!!!L^|-f?^^ 3
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nth e attacheddiagram(s ) indicat e area(s ) t o excavate , surface structure s an dlandscaping feature s an d acces s Iocation(s ) to b e usedby th e contractors . Indicat e distances , depths , materia l types , etc . Photographically an dVideographicall y documen t th e existing condition s ofthe propert y an dthe basemen t i

f necessary . 

## Item s t o b e Remove db y th e Owner before Start o

f

Remediation : Th e isnoval , storage , disposal , and/o rretur n o fthes e item s i s th e Owner' s responsibility
. 

### ttem: 

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# H / 

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Pag e 1 of
.COASTA L 

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### Landscap e Inventor y Ite m Quantit y Uni t ConditioTi/Type/Specie s Pre-existing propert y area , Quadrants tha t will b e excavated , tha t i s coveredwit hgrass . 

# 0/ E &,f P 

# D Z
Numbe r o f tree s > 2 inc h Eac h 

# I trun k

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

diamete r Numbe r o f Sprinlde r Zones , Control Valves , Timers , Heads , etc . Eac h Aiiac h , 1 skcicl ) o l lli e '•(•rii'lvlc i liiy'.Kj i Numbe r o f an dsiz e o f eachgarden / flowe r be d Each area . Squar e Fee t Alliit h a ski.'ic h u l rc!;ilivL ' <i/f S nn d lac;itii'i) v Agreeduponvalu e of plan t material s no t to b e replacedb v contractor . VCK ' l!ii ' \«lu cvwl l fl i i:iv C 1 0 li'.u t
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. ' Easement Area , t o b e excavate d 

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! Addttiona l Comment s / Instructions : 

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. B ycheckin g thi s bo xCE G i s no t responsibl e fo ran ydamag e don e t o th e inteiio ro fhouse , includin g foundatio n crack s o rfissures
. 

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## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 38 2 Mod e SOI L Tim e 2010-02-1 1 14:2 7 Duratio n 90.5 3 Sequenc e Fina l Flag s AVERAG E \.AM Q n f^TQ-IBT ) ADDRES S 245 6 Fontenell e Blvd
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# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Biilerica , M A0182 1 

## Ceitificat e o fVerificatio n XL3t-3902 2 Readin g N o 37 9 Mod e SOI L Tim e 2010-02-1 1 14:2 5 Duratio n 30.1 9 Sequenc e Fina l Flag s BVI D 6356 4 ADDRES S 245 6 Fontenell e Blvd
. QUADRAN T F l DEPH T 4 XR F TEC H O

. BARAJA S MIS C 1 NOT E 1

pp m ± Erro r P b 103.39 4 ± 17.59 6 Supervise d By :

# H Therm o

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

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 38 0 Mod e SOI L Tim e 2010-02-1 1 14:2 6 Duratio n 30.2 1 Sequenc e - Fina l Flag s BVI D 6356 4 ADDRES S 245 6 Fontenell e Blvd
. QUADRAN T F l DEPH T 4 XR F TEC H O

. BARAJA S MIS C 1 NOT E 1

pp m ± Erro r P b 109.62 4 ± 18.11 1 Supervise d By :

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

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 38 1 Mod e SOI L Tim e 2010-02-1 1 14:2 7 Duratio n 30.1 3 Sequenc e Fina l Flag s BVI D 6356 4 ADDRES S 245 6 Fontenell e Blvd
. QUADRAN T F l DEPH T 4 XR F TEC H O

. BARAJA S MIS C 1 NOT E 1

pp m ± Erro r P b 105.99 3 18.09 6 Supervise d By :

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

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 37 8 Mod e SOI L Tim e 2010-02-1 1 14:1 4 Duratio n 90.3 9 Sequenc e Fina l Flag s AVERAG E ADDRES S ^-'2?56Fontenell e Blvd , QUADRAN T D Z DEPH T 1 3 XR F TEC H 0
. BARAJA S MIS C 1 NOT E 1

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# Therm o

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

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 37 5 Mod e SOI L Tim e 2010-02-1 1 14:1 3 Duratio n 30.2 6 Sequenc e Fina l Flag s BVI D 6356 4 ADDRES S 245 6 Fontenell e Blvd
. QUADRAN T D Z DEPH T 1 3 XR F TEC H O

. BARAJA S MIS C 1 NOT E 1

pp m±Erro r P b 24.75 4 ±12.00 4 Supervise d By :

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

## Certificat eof Verificatio n XL3t-3902 2 Readin g N o 37 6 Mod e SOI L Tim e 2010-02-1 1 14:1 3 Duratio n 30.0 3 Sequenc e Fina l Flag s BVI D 6356 4 ADDRES S 245 6 Fontenell e Blvd
. QUADRAN T D Z DEPH T 1 3 XR F TEC H O

. BARAJA S MIS C 1 NOT E 1

pp m±Erro r P b 26.60 0 ±12.11 8 Supervise d By :# • # • 

# Therm o

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

XL3t-3902 2 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 P b 24.57 5 Supervise d By : 

## Certificat eof Verificatio n

37 7 SOI L 2010-02-1 1 14:1 4 30.1 0 Fina l 6356 4 245 6 Fontenell e Blvd
. D Z 1 3 O

. BARAJA S 1 1

± Erro r ± 12.15 9

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

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s AVERAG E ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

Pb Supervise d B y 

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

XL3t-3902 2 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 P b 110.06 9 Supervise d By : 

## Ceitificat e o fVerificatio n

5 3 SOI L 2009-11-2 7 11:2 7 30.5 9 Fina l 6356 4 243 6 fontenell e e m 1 " R
. VENTR Y clearenc e ngn c

± Erro r ± 14.46 5

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

XL3t-3902 2 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 P b 117.94 4 Supervise d By : 

## Certificat e o fVerificatio n

5 4 SOI L 2009-11-2 7 11:2 8 30.5 8 Fina l 6356 4 243 6 fontenell e e m I " R
. VENTR Y clearenc e ngn c

± Erro r ± 15.04 2

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

XL3t-3902 2 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 P b 97.67 3 Supervise d By : 

## Certificat e o fVerificatio n

5 5 SOI L 2009-11-2 7 11:2 9 30.5 4 Fina l 6356 4 243 6 fontenell e e m 1 " R
. VENTR Y clearenc e ngn c

± Erro r ± 14.01 1

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

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 6 4 Mod e SOI L Tim e 2009-11-2 7 11:3 3 Duratio n 93.5 5 Sequenc e Fina l Flag s AVERAG E 1" Ay g o fbI?S3~~ ^ ADDRES S 243 6 fontenell e QUADRAN T F 2 DEPH T 4 " XR F TEC H R
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# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Bilierica , M A0182 1

XL3t-3902 2 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 P b 72.75 5 Supervise d By : 

## Certificat e o fVerificatio n

6 1 SOI L 2009-11-2 7 11:3 2 31.8 2 Fina l 6356 4 243 6 fontenell e F 2 4 " R
. VENTR Y clearenc e ngn c

± Erro r ± 12.77 4

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

XL3t-3902 2 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 P b 73.46 3 Supervise d By : 

## Ceitificat e o fVerificatio n

6 2 SOI L 2009-11-2 7 11:3 3 30.5 1 Fina l 6356 4 243 6 fontenell e F 2 4 " R
. VENTR Y clearenc e ngn c

± Erro r ± 12.80 0

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

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 6 3 Mod e SOI L Tim e 2009-11-2 7 11:3 3 Duratio n 31.2 2 Sequenc e Fina l Flag s BVI D 6356 4 ADDRES S 243 6 fontenell e QUADRAN T F 2 DEPH T 4 " XR F TEC H R
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pp m ±Erro r P b 65.80 5 ±12.12 5 Supervise d By :

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# Therm o

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

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 7 3 Mod e SOI L Tim e 2009-11-2 7 11:3 9 Duratio n 92.7 6 Sequenc e Fina l Flag s AVERAG E ADDRES S 243 6 fontenell e QUADRANT B l DEPHT 6 " XR F TEC H R
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# Therm o

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

XL3t-3902 2 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 P

b 139.36 4 Supervise dBy : 

## Certificat e of Verificatio n

7 0 SOIL 2009-11-2 7 11:3 7 30.6 1 Fina l 6356 4 243 6 fontenell e B l 6 " R
. VENTR Y clearenc e ngn c

± Erro r ± 16.02 9% 

# Therm o

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

XL3t-3902 2 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 P b 126.99 4 Supervise d By : 

## Certificat e o fVerificatio n

7 1 SOI L 2009-11-2 7 11:3 8 31.6 1 Fina l 6356 4 243 6 fontenell e B l 6 " R
. VENTR Y clearenc e ngn c

± Erro r
± 15.20 7

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

XL3t-3902 2 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 P b 130.76 1 Supervise d By : 

## Certificat e o fVerificatio n

7 2 SOI L 2009-11-2 7 11:3 9 30.5 4 Fina l 6356 4 243 6 fontenell e B l 6 " R
. VENTR Y clearenc e ngn c

± Erro r
± 15.57 3

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

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 7 7 Mod e SOI L Tim e 2009-11-2 7 11:4 3 Duratio n 92.6 1 Sequenc e Fina l Flag s AVERAG E 

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pp m Erro r P b 37.829l ^ ± Supervise d 

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

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 7 4 Mod e SOI L Tim e 2009-11-2 7 11:4 2 Duratio n 31.8 2 Sequenc e Fina l Flag s BVI D 6356 4 ADDRES S 243 6 fontenell e QUADRAN T B 2 DEPH T 6' ' XR F TEC H R
. VENTR Y MIS C clearenc e NOT E ngn c

pp m±Erro r P b 37.39 0 ±10.54 2 Supervise d By :

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

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 7 5 Mod e SOI L Tim e 2009-11-2 7 11:4 3 Duratio n 30.3 9 Sequenc e Fina l Flag s BVI D 6356 4 ADDRES S 243 6 fontenell e QUADRAN T B 2 DEPH T 6 " XR F TEC H R
. VENTR Y MIS C clearenc e NOT E ngn c

pp m ±Erro r P b 38.63 0 ±10.75 3 Supervise d By :

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

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 7 6 Mod e SOI L Tim e 2009-11-2 7 11:4 3 Duratio n 30.4 0 Sequenc e Fina l Flag s BVI D 6356 4 ADDRES S 243 6 fontenell e QUADRAN T B 2 DEPH T 6 " XR F TEC H R
. VENTR Y MIS C clearenc e NOT E ngn c

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## ^\A. \ S ^^^2 L ^7^^ ^ ^^tPRO^'' ^ ° 

## Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 Coasta l Environnienta l Grou p Inc
. www.coa8talhazmat.co m ^ 7 v i COASTA L ciour
. IN C 

# EXECUTIV ESUMMARY : BVID #63564-(245 6 FONTENELL EBLVD )
N o Issue s o r Concern s [[ ^ Issues/Concern s Detail Explanation :

## EF APropert y Clos e Ou t Form 

# f(f,J^^ C /lie/ / Properl y#: Propert y Address : 

# (Mid

- Date/Tim e r - <»,-» Jtl

- tjwwc r » name Owner' s Name : : /A
. Date/lime : ../fe-JES'X"r;~^^.'*^^-^=^^^^' ^ Quad s Excavaled ; ^j^^W^/- ^ ffl, b^tP/ ' Contracto r GrovpQQQ^pfa ^ (p^ ^ ExcaYBtlo nGenera l Ye s 	 No 1. if necessaiy , wer eth ecorrec t quadrant(s ) excavate dan drestored ? 

## y 2. If necessary , wer eth ecorrtc t area s ofdri p zon eexcavale dao drestored ? / Ye s No GradlD K So dan dVenetatto a 1 Doe s th egradin g aroun dth eperimete r ofth ehous e incxcavatcri area s generall y slop eaway 

### y fromth ehouse ? 1. Ha s so dbee nlai d inal larea s tha t wer eexcavated ? 

### y

.. . i. Doc s th eso dappea rto begenerall y health y andgrowing ? (Onl y evaluat e if

inspecte d at a

30 

### y da y tim eperiod )

- — 4. Ar c sodde darea s generall y firmandevenl y graded ? 

### y 5 Ar eth ejoint s betwee nth eso dstrip s generall y tight ? (Onl y evaluat e if

inspecte d at a

30 da y tim eperiod ) I^

'6. Wa s th eproperty grade dsuc hthat wate r wil lnolpoo l onth e property" '

' 7. Wa s damag e to landscapin g or plant material s avoided ? 

## y Gates
. Fence s aa dRctaJBln g WaH t Y « No '. Do gate s openanilclos efreely ? (I f applicable ) 

## y 1 2. Wer eallgate s or fence s talcendow ndurin g restoralio nactiviiie s reinstalled ? (If applicable ^ 

## y ( 3 Wa s damag e to gate s or fence s avoided ? (Ifappiicable ) 

## ~ y '

_- i 1.Wa s damag e to retainin g wall s avoided ? (Ifappiicable ) , ; : Foundation , SidiB K an dGnMer » Ve s No I. Wa s damag e to th esidin g or tri mavoided ? 

## y 2. Wa s damag e tnth efoundatio navoided ? 

# y .'
. Wa s damag elo window s avoided ? 

## _y <iWa s damag e to window s or doo r screen s avoided ? 

# y _ 5 Wa s damag e to downspout s or downspou t extension s avoided ? 

# y Sidewalk s »n dDriveway s (Concrete ) Vc s No
I 1. Wa s damag e to drivewa y surface s avoided ? 2. Wa s damag e to walkwa y surface s avoided ? 

### y 

# r y

## v>M'pcr s commenlls :

In.spectio nnotes : j,Jf* 

# y " y *
f* '

Rernoval andrestoratio nactivate s compiete includin g the 30-da y sodwarranry : If.P ARepresentativ e B*^j M Date : i/ii/io

## Propert yCompletio n Agreemen t riii s agreemen t documenl s ih e completio n ofremedia l acliviiie s perloime d o n myproperl yM ysignalui e tt/ill designal e iha l I a m satisfie d wil h th e restoratio n o fm yproperly , an d tha i n o iiem s ar e i n queslions
. now , o ra l an ylim e i n th e future , excep l ihos e ilem s hsle d below , i fan y

rropcrtyIP : (^;2^^^L ^ Propert yAddrcM : 2 g ?a ^ Plf)hAi^l\€

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\}\\\\\<Sf<\S L Phone : X:^^^ ^ ^^j,^ ^ Restoratio n Item s i n Question :

Item : Item : Item : Item : Item : Item :

nyrc crestoratio n 'is completed , excep t a s note d [_ J I d o no t a|;re crestoratio n i s complele d 

# ddkM^' ^ tiHii o Dat e Contrarlor' s Sicnadir cDal e