h 

TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

\<p SAID #: \SM 

Date: V y 

Address: Y W WpO(/U/i?P<K W 

Remediation Contractor: Coastal Environmental Group_ Year: 20i 06 

SOIL REMEDIATION 

PROPERTY HLE FOLDER DOCUMENTS 

Video of property (DVD) 

Executive Summary 

EPA-provided property sketch 

Signed Access Agreement for subject property 

Signed Access Agreement(s) for adjacent property 

izf Restoration Agreement 

e Settlement doctmients (i.e., for damage or to replace plants, etc.) 

•B-Confiimation data 

Photographs y^^'^oy i \ fU W^-^^ ^ 

As-built sketch 

Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

Utility clearances 

Property information from Douglas County Assessor's Office 

1 t7 to 

)ate 
it 

Property Access Checklist 

PrepertylD; It^l^CSp^ Q WORK STARTED ON: 

ON: 

Ownen Pjrtj/jp 'Tfr^ow)^/\ 

Address: 

i^nc: 4(3e. ^/^ . ,<k/lO 

Fax: 

Cfeii/Pagen :jn2 . 7/^.15-^ ^ 

Roiten 

Pttone: 

Fax: 

CMPagtr. 

Additional Information: 

D Notificottoo Letter 

[^ Access Agreement 

^ Restontioa Agreement 

D Ttopson Sampling (tf applicable) 

D DispottI Sampling Cif applicable) 

Q Garden Sampling (ffapplicfdile) 

" ^ Utility aearance 

<E1 VideomHrtos (Before) 

a Video«botos (Dating) 

a VideonPhotos (After) 

D VIdeomiotos (30-Day) 

D Final Report 

Sent: / / 

Signed: i^/i^/ ^ 

Signed: ifi/^/ ^ 

/ / 

/ / 

/ / 

Called: KL/^S-'CS 

0«:jl'iy.l123 

O K I 1 

Om / / 

OB: / / 

Signed: / / 

Issued: / / 

By: 

By: 

By: 

By: 

By: 

By: 

Br.i \Ci\;:i\ 

Bj^(^p<kxkAin 

By: 

By: 

By: 

By: 

By: 

Air Monitorine {aa applicable 

DCommnnHy OCrew 

Results: 

On: / / By: 1 

DCommnnHy

Resnits:

 DCrevr On: / / By: . 1 

DConmmnlty

Resnits: 

 DCrc w On: / / By: 

Omaha Lead Site 
Douglas County Accoimt I[j^iM^io i n Page 1 of2 

Douglas County, Nebraska Property Record - R1221080002 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - VJe W O n Ma p Information is valid as of 2009-9-15 Treasurer's Tax Report 

New Feature ^ - • - • Auto Sales Search 

Owner 

THOMPSEN BRUCE A 

ETAL 

3511 WOOLWORTH AVE 

OMAHA NE 68105-0000 

Property Informatio n 

Key Number: 2108 0002 12 

Account Type: Residential 

Parcel Number: 1221080002 

Parcel Address: 3511 WOOLWORTH AV 

OMAHA NE 68105-0000 

Legal Description: GRIFFIN & SMITHS 1ST SUB LOT 3 BLOCK 6 -EX E 1 N 115 FT- LT 3 

Value Informatio n 

Land Improvement Total 

2009 $7,100.00 $237,200.00 $244,300.00 

2008 $7,100.00 $237,200.00 $244,300.00 

2007 $7,100.00 $237,200.00 $244,300.00 

2006 $7,100.00 $126,400.00 $133,500.00 

2005 $7,100.00 $126,400.00 $133,500.00 

2004 $7,100.00 $126,400.00 $133,500.00 

Sales Informatio n 

Sales Date: 2007-11-30 

Deed Type: WD Book: 2007 Page: 133730 

Price: $270,000.00 

Grantor: O'Boyle Connie L 

Grantee: Thompson Bruce A etal 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.18 8178.0 1.0 141.0 58.0 No 

Improvemen t Informatio n 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R12... 9/17/2009 
Douglas County Account Ii^^Ajji^io j^^jl^i i n Page 2 of 2

Building 1 

^ ^ L i. T «K«3 L«.;t 

i l\ '" ,,(r L W ^ c .^ii^^TM^- L • 'WtKF^^I^ ^ ^'T^^^^^^^^^H i I3IT 

j t r "" 1 L PinFirst Floor ecorrtFlo or 

1187 0 M n 1143 Osq fl. •" 

ton 

" f t>« 

i"l!^ *" 2 1/2 STORY FINIS SHED rhirci 'Floor 

41 • 75 0 9q ft : ^ F •Ifl^iv i (t 

^ "w -^ t 

! CLICK TO ENLARGE IMAGE | i CLICK TO ENLARGE IMAGE j 

Sq uare Footage: 2705.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Good 

Unit Type: Condition: Average 

Built As: 2 1/2 Story Fin Condo Square Footage: I 0.0 

HVAC: Central Air to Air Rooms: 12.0 

Exterior: Masonry Common Brick Units: • 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 4.0 

Roof Type: Gambrel Stories: 2.5 

Floorcover: Allowance Foundation: Block 

' Sprinkler Square Footage: 0.0 

Year Percent Yea ^dyus^^dyear p^^ysical Age r Built ^^ ^modeled 1 Remodeled 

19 14 0 ' 0% 1914 95 

Detail T ype Detail Description Units 

Add On Unfinished Attic W/floor 1123.0 

Applianc :e Allowance 1.0 

Baseme nt Bsmnt Block 8 ft 1163.0 

Fixture Additional Fixtures 1.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Garage Detached 456.0 

Porch Knee Wall 153.0 

Porch Open Slab 350.0 

Porch Slab Roof Ceil 154.0 

Porch Wood Deck 224.0 

User ' Attic Full Finish 1 

1 375.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R12... 9/17/2009 
Page 1 of2 

Create Anotherj][cket J [ ~ jBack to Irth Intgrnet^ j J I [ Send Ernail ] 

• YOUR TICKET NUMBER IS 2388329. 

Original Call Date: 10/17/09 Time: 1:18 pm Op: ELIZABETH18790 


Work to Begin Date: 10/21/09 Time: 7:15 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 3511 Street: WOOLWORTH AVE 


Twp: 15N Rng: 13E Sect-Qtr: 28-NW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: Lead Remediation 


Location of Work: INCLUDE ALL EASEMENTS LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (877)662-4211 


: UNSURE OF CORNER LOT 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name: ELIZABETH Phone: (877)662-4210 


Work Being Done For: Coastal 


Depth of Excavation: 4ft Comer Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV LEVEL3 MUD02 OMAHACOF 0PPDGPR6 QLNNEIF 


Service Area Contact Phone Number UtiUty Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

LEVEL3 LEVEL3 COMMUNICATIONS, LLC NA 

Day: 8773668344 

Alt: 

Emerg: 8773668344 

MUD02 METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RICH/TRAFFIC

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreationyMessageText.asp?ret=<RESULT... 10/17/2009 
Page 2 of2 

0PPDGPR6 OMAHA PUBLIC POWER DISTRICT NA 

Day:

Alt:

 4067289343 

 4062071494 

Emerg: 8887289343 

QLNNEIF QWEST LOCAL NETWORK NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 10/17/2009 
wm OLS#: 19708 

^As-Buil Date Excavated: 10/27/09 t Drawing Date USEPA Sianed Off:11/5/09 

COASTA L Omaha Area Sodden: 918 sa ft Lead Superfund Site 

Name; ^otftfr c ^^of^^i ^ Omaha Lead Site Date: jyT/^ ^ North Arrow 

Address; 3^/ / t.^.^7^^-^H. Site Sketch Time: 

Phone; VA? - ^Y ^ ^yfe i 

Quadrants Excavated 

Area replaced

Sod 

 with Area replaced with 

Rock/Mulch Area left bare 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group Inc . 
• • 

Name: ^<**rif7 ^'^ci^A. . Omaha Lead Site Date: 7//T/o^ North Arrow 

Address: 3'f'/ / u^^'<^ri'' \ Site Sketch Time: 

Phone: vaZ - "^Y? yf Z i 

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Name: ^^trtt/'c ^ttteri^AcAddress: ^^^ / utt/H.^i»'-f\ 

Phone: y<^ ~ 3^ ^ ­ '/f Z J 

Omaha Lead Site 

Site Sketch 

Date:

Time: 

 7//^/^ ^ NorthArrow

^ 

—i 

team'^ ^ /a^.j r /»£ ^ BVID# / 9 7/9 )P XRF Code 

Sample Number Lead Concentration 

Lab 

RYBSCPLA-19708 

315 ppm 

I T * 1"^ ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

/=^f Y / ?<r 

X 

•rcTc ;t(3^ 

:> : 

Vii ti ^ Y 

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.•v*""-"*. 

COASTA I fitvlltONnlKlAl *'^< Pno^ ^ CROU P IMC 

Consent for Access To Froperty 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner) consents to and authorizes the United States 

Environmental Protection Agency (EPA) or its authorized representatives, collectively 

the Grantee, to enter and perform certain environmental response activities upon the 

following described premises: 

Owner's Name: Daytime Phone: y/y,/^^ j ^^ f 

Address of Property S^/ / (VocL £Vo/e77f ^ V 

covered by this 

Agreement: 

PURPOSE OF RESPONSE ACTIVITIES 

The EPA Is requesting access to collect soil samples and remove soil that contains 

elevated concentrations of lead and may pose a health hazard. The area(s) will be 

excavated to remove contaminated soil. The removed contaminated soil will be 

replaced with clean materials and the area will be restored to Its original condition. This 

work is being performed under the Omaha Lead Superfund Site remediation program. 

A representative of Coastal Environmental Group, contracted by USEPA, will contact 

the Grantor In-person to discuss the work to be perfonmed, the Grantor will have an 

opportunity to review and approve the planned soil removal, and restoration work 

before It begins. Once the work Is finished, the Grantor will be asked to review the work 

and confirm that it Is complete and meets with the Grantor's approval. Upon 

completion, the Grantor will receive written documentation from EPA that the property 

has been remediated. 

ENVIRONMENTAL RESPONSE ACTIONS 

By signing this Access Agreement, the Grantor is granting the EPA, its employees, 

contractors and subcontractors the right to enter the property, at all reasonable times 

and with prior notice, for the sole purpose of performing the worit. This access shall 

remain in effect until the wori( has been satisfactorily completed. The Grantor also 

agrees to: 

Page 1 of 2 
^ 

i

I 

COkSTA L IHVmOMHtKTAt 

C K 0 If P IN C 

t Remove obstructions including boats, trailers, vehicles, playscape items, wood 

piles, dog houses, etc; 

c Remove flower bulbs or plants that the Grantor or the Grantor's tenant may wish 

to save; 

« Water and maintain replacement vegetation, including fertilizer application, as 

necessary subsequent to an initial watering period by EPA; 

< Abide by health and safety guidance provided by EPA; 

( If the property is rented, assist EPA in obtaining tenant approval for access to 

the property to perform the work. 

<t Allow videotaping and/or photographing of the property. 

AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to interfere or tamper with any of the work activities, or with any 

of the work done, or with the equipment used on his property, or to undertake any 

actions regarding the use of said property which would tend to endanger the health or 

welfare of the Grantees or the environment, or to allow others to use the property in 

such a manner. 

Should you have any questions about this program, please contact Coastal 

Environmental Group, at (402) 991-1199 

£H^n grant t access to my properties n i do not grant access to nry properties 

Signature / Date ^ Signature Date 

D I would like to be present during any sampling that is required. 

Page 2 of 2 
Restoratmn Agreement 

The puipose ofthis agreement is to provide a mutual agreement as to conditions ofthe property prior to 

remediation activities. This will aiso serve as documentation fbr the puipose of assuring that restoration 

activities are compieted to the satisfaction of the property owner and the United States Environmental 

Protection Agency (EPA). 

Property IP: j^fjC ? 

Property Address: ^^/ / lJ/ja/tUai^H/[ A J 

o^^'- &j^ ^ -rWom/^^FA/ 

Phone: 7/</V5'f 6 a/J / ^V(^'^/^6' ^ 

On the attached diagram(s) indicate area(s} to excavate, surface structures and landsc^ing features and 

access location(s) to be used by the contractors. Indicate distances, depths, material types, etc. 

Photographically and Videographically document the ousting conditions ofthe propeity and the l»sement if 

necessaiyItems to be Removed by the Owner before Start of Remediation: 

The temoval. storase. di&posat.-and/or return of these Items is the Owner's responsibility. 

Items to be Removed by the Contractor During Remediation and Not Repia(»d 

Item: 

"^cM ^ ^ 

Item: 

Item: ^— ' 

y ^ Item: 

^ 

Page 1of ^ 
-•-;fk ;(rQ^ COASTAI . 

t Item: 

Item: 

Kem: 

Items to Be Removed By Contractor During Remediation and Replaced^ 

f^^u h ­^ v ^ 

f^k? h r p ^ 

Item: 

y\\jm Vz ^ \IQ ^ 

J 

Landscape Imrentory 

Item Qmntity Unit Condition/Type/Species 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

^ y n Quadrants 

Numtwr of trees > 2 inch Each 

trunlc diameter ^ 

Number of trees <= 2 inch \v Each 

Num1)er of Sprinkler 

Zjones, Control Valves, 

Timers. Heads, etc 9 Each 

Numtier of and size of 

each

area. 

 garden/ flower l>ed I Each 

Square Feet h^irer \\oHM \^:ir 

Aiu'tli ;i skclch 1)1 rc!;uivc 

<i/i'S mill loc;lIioIl^ 

materials not to be 

replaced \ N contractor. 

XCIt I'-i" VHIHC v\ill fit 

usrC 10 is;ui .i plan! 

(T S 

• 

\oiii:in.': 1(1 llie i;.-0|icn\ 

Wit iier. 

Easement Area, to be 

excavated Each ^ k Wr^Mi^^ 

Page 2 of " p 
C O A S TJ^ i. 

I. Additional Comments / Instructions: /• . 

Q Check the box if Owner does not want CEG to document interrar foundation walls and possible 

pre-existing damage. By checking this box CEG is not responsible for any damage done to the 

interior of house, including foundation cracks or fissures. 

0 i ag" O I do not agree agree 

Owner's Sii / \ Date Cbntractor's Sisnatnrr Date 

Page 3 of. 
BVID# B3 ^ 

XRF PROPERTY SAMPLE SHEET 

Date 

Project 

lo-'Ll-^e') Omaha lead FP 2nd year option 

Address 

Sample time ^Srj l (L?(»fitn/7^^ 

am/pm 

XRF ID# %7^ ^ sample length 30 sec 

Shot# 

TssSSi:^ 

Reading W ^ 

g? i^/^s ­ 5 ^ ^/ 3 

5V d^/T 

Sample area 

^71 

Depth 

Shol# s 

^ 

-4 

^ 

Reading 

^:^/ / 

^jt-/ / 

iy.-h7U^ ^r^/o 

Sample area 

F/ 

Depth 

Average i?S'ilH Average ^6> ^-' f 0 

Shol# Reading Sample area Shot# Reading Sample area 

^^2 ^ 

^ 

" ^ 

llo^ ^i ^ 

;???> jtpZi^ b: ^ 

Depth Depth 

^ 

Average l^6>>/q Average 

Shot# Reading Sample area Shot # Reading Sample area 

Depth Depth 

Average Average 

RETEST AREAS 

Shot # Reading Sample area Shot# Reading Sample area 

Depth y"" ^ y Depth 

y ^ / 

Average Average 

i lab sample # Lab result Sample area XRF Avg. 

Signature. 

Print Nftf6^ Vmih 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 859 

Mode SOIL 

Time 2009-10-27 10:19 

Duration 120.00 

Sequence Final 

Flags 

[AVE ^ 6£- Avq of 855-858 "7 

TOCA LOCATIO T N 3511 woolworth 

INSPECTOR VENTRY 

COR l em 

COR 2 1 

MISC clearence 

NOTE epa gun 

User Login EPA 

ppm Error 

CPbl 65. P?.-^ -14.292ID 

Cd < LOD 21.311 

Ag < LOD 15.477 

Sr 88.556 ± 8.020 

U < LOD 21.456 

Rb 44.137 ± 6.480 

Th < LOD 13.812 

Se < LOD 6.333 

As < LOD 18.380 

Hg < LOD 14.659 

Zn 103.034 ± 21.508 

W < LOD 84.396 

Cu 37.252 ± 23.496 

Ni < LOD 73.002 

Co < LOD 167.679 

Fe 13937.569 ± 407.037 

Mn 351.366 ± 100.191 

Cr < LOD 142.461 

V < LOD 256.307 

Ti < LOD 599.418 

Sc < LOD y ^ 7 41.885 

Ca < LOD yy .^ 823.571 

K < 1311.751 LOD7 

S 990.197 "fy. i^ 

Supervised By: \y^^ ^ 7 1 ­
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 855 

Mode SOIL 

Time 2009-10-27 10:16 

Duration 30.00 

Sequence Final 

Flags 

SAMPLE 19708 

LOCATION 3511 woolworth 

INSPECTOR VENTRY 

CORl em 

COR 2 1 

MISC clearence 

NOTE epa gun 

User Login EPA 

Pb 

Cd 

Ag 

Sr 

U 

Rb 

Th 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

Cr 

Ti 

Sc 

Ca 

K 

S 

ppm ± Error 

72.469 ± 14.255 

< LOD 20.551 

< LOD 15.057 

90.032 ± 7.739 

< LOD 20.781 

45.788 ± 6.310 

< LOD 12.688 

< LOD 5.976 

< LOD 18.381 

< LOD 13.977 

111.332 ± 21.290 

< LOD 80.820 

47.668 • ± 23.088 

< LOD 70.171 

< LOD 164.830 

14080.219 ± 392.433 

398.257 ± 100.035 

< LOD 114.059 

< LOD 207.766 

< LOD 435.442 

< LOD 14.628 

< LOD 590.112 

< LOD 1634.265 

< LOD 968.580 

Supervised By: 

V 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 856 

Mode SOIL 

Time 2009-10-27 10:16 

Duration 30.00 

Sequence Final 

Flags 

SAMPLE 19708 

LOCATION 3511 woolworth 

INSPECTOR VENTRY 

COR 1 em 

COR 2 1 

MISC clearence 

NOTE epa gun 

User Login EPA 

Pb 

Cd 

Ag 

Sr 

U 

Rb 

Th 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

Cr 

Ti 

Sc 

Ca 

K 

S 

ppm ± Error 

81.122 ± 15.375 

< LOD 21.423 

< LOD 14.943 

94.649 ± 8.154 

< LOD 21.835 

51.652 ± 6.822 

< LOD 13.914 

< LOD 5.935 

< LOD 19.046 

< LOD 14.339 

118.071 22.440 

< LOD 83.472 

< LOD 32.788 

< LOD 72.315 

< LOD 173.889 

15209.257 420.843 

359.854 100.742 

< LOD 138.265 

< LOD 302.949 

< LOD 777.068 

< LOD 25.691 

< LOD 991.801 

< LOD 2309.946 

< LOD 1340.271 

Supervised By: 

V 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 857 

Mode SOIL 

Time 2009-10-27 10:18 

Duration 30.00 

Sequence Final 

Flags 

SAMPLE 19708 

LOCATION 3511 woolworth 

INSPECTOR VENTRY 

COR 1 em 

COR 2 1 

MISC clearence 

NOTE epa gun 

User Login EPA 

ppm ± Error 

Pb 53.745 ± 12.850 

Cd < LOD 20.673 

Ag < LOD 15.142 

Sr 86.749 ± 7.657 

U < LOD 19.783 

Rb 36.916 5.804 

Th < LOD 12.018 

Se < LOD 6.243 

As < LOD 16.849 

Hg < LOD 14.126 

Zn 83.918 ± 19.083 

W < LOD 76.922 

Cu 43.772 ± 22.747 

Ni < LOD 66.940 

Co < LOD 158.566 

Fe 13614.119 387.601 

Mn 376.275 ± 98.699 

Cr < LOD 153.635 

< LOD 285.636 

Ti < LOD 697.882 

Sc < LOD 21.409 

Ca < LOD 825.485 

K < LOD 31.632 

S < LOD 686.881 

Supervised By: 

V 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 858 

Mode SOIL 

time 2009-10-27 10:19 

Duration 30.00 

Sequence Final 

Flags 

SAMPLE 19708 

LOCATION 3511 woolworth 

INSPECTOR VENTRY 

COR 1 em 

COR 2 1 

MISC clearence 

NOTE epa gun 

User Login EPA 

ppm ± Error 

Pb 53.557 ± 14.688 

Cd < LOD 22.597 

Ag < LOD 16.768 

Sr 82.794 8.530 

U < LOD 23.425 

Rb 42.192 ± 6.984 

Th 17.176 ± 11.085 

Se < LOD 7.178 

As < LOD 19.245 

Hg < LOD 16.191 

Zn 98.815 23.221 

W < LOD 96.372 

Cu < LOD 39.439 

Ni < LOD 82.583 

Co < LOD 173.429 

Fe 12846.682 ± 427.270 

Mn 271.080 ± 101.289 

Cr < LOD 163.886 

< LOD 228.878 

Ti < LOD 487.280 

Sc < LOD 105.814 

Ca < LOD 886.886 

K < LOD 1271.163 

S < LOD 965.056 

Supervised By: 

V 
• ^ in: 

^^A^'l Omaha Lead Site—Fixed Price EP-R7-07-05 

I ^^^^ ^ I Coastal Environmental Group Inc. vl ^ ^^T^^j f www.coastalhazmatcom 

^^ipno ^ COASTAL ENVItONNIIITAl C lO U r. I UC 

EXECUTIVE SUMMARY: 

BVID #19708-(3511 WOOLWORTH AVE) 

No Issues or Concerns [^ Issues/Concerns 

Detail Explanation: 
»

• p

EPA Property Close Out Form 

3S/r vjAo)w^>^k^ Property #: I0[ln % .. Property Address: 

Date/Time: Owner's Name 

Quads Excavated: p i ^ |^ ^ 

Contractor Group 

Yes No Excavation General 

1. If necessary, were the correct quadrant(s) excavated and restored? 

2. If necessary, were the correct areas ofdrip zone excavated and restored? 1., / 

Gradin Yes No g Sod and VcgctatioB 

I. Does die grading around the perimeter ofthe house in excavaied areas generally slope away 'yy from the house?

 _______ _ 

2. Has sod t>een laid in all areas that were excavated? y^ 

3. Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 

day time period) 

4. Are sodded areas generally fum and evenly graded? y 

5 Are the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day 

time period) 

6. Was the property graded such that water will not pool on the propeny? y

7. Was damage to landscaping or plant materials avoided? 

Gates. Fences and Retaining Walls 

Do gates open and close freely? (Ifapplicable) 

2. Were all gates or fences taken down during restoration activilies reinsulled? (If applicable) 

3. Was damage to gates or fences avoided? (Ifapplicable) y^ 

4. Was damage to retaining walls avoided? (Ifapplicable) -7

Foupdation, SidinK and GuHers Yes No 

t. Was damage to the siding or trim avoided? W ^ 

2. Was damage to the foundation avoided? L ^ ^ 

3. Was damage to windows avoided? IX " 

4 Was damage to windows or door screens avoided? 

5. Was damage to downspouts or downspout extensions avoided? 

Sidewalks and Driveways (Concrete) 

Yes No 

1. Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? -z?^ 
0>»'ncrs comments: 

Inspection notes: 

Removal and resloration activates complele ineluding the 30-day sod warranry: 

EPA Represenlalive j )(V^ IjCtyfiiJL Dale: If/^/Of 
Property Completion Agreement 

Ihis agreement documenls the completion of remedial acliviiies perloimed on my properly My signalure 

will designate that F am satisfied with the resloration of my properly, and that no Hems are in questions, 

now, or at any lime in the future, excepl those ilems listed below, ifany 

PropertylD: \0t~tOP ) 

Property Address: 3^ 1 | )A/nn ) lA/Tirfi ^ 

Phone: /goD\^-Lj( o - BI? D C ^ ll im ' 15^ 3 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

7 ^ ' nyrcc I'Mtoralion it compleled, except as noted 

[ I I do nol if,rte re«lorfltinn is completed 

JA^^ /Ari^/7 ^ ^mny^^ ii/q/r;^ 

Owner's Signatiirr / / Date Conti actor's Signaturb Dale