### %


## TRANSMITTAL of OMAHALEAD SIT E SOI LREMEDIATIO NFIL EFOLDE R
SAID# : .'SZ^M ^ Date : \n\7JLo[Cf \ Address : 317 AM 1 4 'M Remediatio nContractor : Coasta l Environmenta l Group

_Year : 200 8
SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S S - ^ Vide o of property (DVD ) tK ^ Executiv e Siunmary Sr

EPA-provide dproperty sketc h Sy ^ Signe dAcces s Agreemen t for subjec t property vll ^ Signe dAcces s Agreement(s ) for adjacent property SY"^ Restoratio nAgreemen t ^ Settlemen t document s (i.e. , for damag eor to replac e plants , etc. ) [iU- ^ Confirmatio ndat a B ^ Photograph s [h'tfCf^tCV ^ , 0 ^ As-buil t sketc h Q—Satisfactory restoratio nsigne d by Property Owne r B-^ " Property close-ou t chec k lis t signe dby EPA
^ Descriptio nofarea s not meetin g RO D cleanu p criteri a B ^ Utility clearance s SU ^ Property informatio nfromDougla s Coimt y Assessor' s Offic e 

# • . D 

# Ma m latur Dat e Ignatur e e Sign : 3005453 2 Superfun d

### # #



## Propert yAcces s Checklis t Propct^lD : 3 ^ f^U ^ Propert yAddre. : <^>-p ^ a K S 7 U 1 ^ D DWOR K STARTE D WOR K COMPELTE D ON
. ON : _ / / /_ /
Owner : ^p^^^^ ) Address : ly^l^K S Rcnie r Phone :

Phone : F«x : Ccll/Pager

. PJLV : Cell/Pager : Additiona l Inlnrmntion-
.

D NotiriCiilio n Lette r j S ^ Acce u Afrccmcn l JS ^ Restonitio o Agreemen i O Topsoi l Samplin g (i f applicuble ) O Ditposi U Samplin g (r f upplicable ) Q Garde n Samplin g (i f applicable ) D Uiilil yClearanc e ^S [ Video/Photo s (Before ) O Villeo/Photo s (During ) D Video/Pholo * (After ) D Viileo/Photo s (30-Djiy )

•Propert yComplelio n Agrcemen i 1 D Finn l Repor t Sent : / / Signed : t^// ^

l( P Signed:t o /L ^

/PP \ 1 1 1 1 1 1 Called : / / On:j(^/25/i2 ^ On : / ' / On : / / On : / / Signed : / / Issued : / / By : 

## »J=Ell7/*i^4V N By

= Rirnhe^^/ V By : By : By : By : 

## 8y-^vxa\f v By : 0 By : By ; By : By : Ai rMonilorint ! {» s iipplicabie )

D Communit yD Cre w Results : On : / / By :

D Comrounit? ' Rc«ulis : •Cre w On : / / By :
O Communir i ResulU : D Crc> v On : / / By :

Omah a Lea d Sit e

# g »

CONTACT FOR M Propert y I D #Z l UM ^ Propert y Address : 

# -M7 4 N7 M ^ ^ Initial Contact : Date : Time:
_ Action : SecondContact : Date : Time : Action : Fina l Contact : Date : Time ; Action : Fina l Action : Transmit t

o EP AD Other Action : D

Comment : Owner Comment (s) : Site 

# f o t^^' ^ -^ko^^ ^ i,e. ^ fu\'ei^5 > Coordinato r Comment (s) :Dougla s Coimt y Accoun t 

# m atio n Pag e 1 of 2
Dougla s County , Nebrask a Propert yRecor d - R171559000 0 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-5 0 ft wes t o f 52n d S t - VleVt fO n Ma p Informatio n i s vali d a s o f2009-5-1 2 Treasurer' s Ta xRepor t Ne wFeatur e ••->- •Aut o Sale s Searc h Owne r THOMA S DEBORA H K 372 4 N 2 4 S T OMAH AN E 68110-000 0 Propert yInformatio n Ke yNumber : 155 9 000 0 1 7 Accoun t Type : Residentia l Parce l Number : 171559000 0 Parce l Address : 372 4 N 2 4 S T OMAH AN E 68110-000 0 Lega l Description : MARYSVILL E AD D LOTN 4 4 E 10 0 F T4 4 X 10 0 Valu e Informatio n Lan d Improvemen t Tota l 200 9 200 8 200 7 200 6 200 5 200 4 $2,200.0 0 $2,200.0 0 $2,200.0 0 $2,200.0 0 $2,200.0 0 $2,200.0 0 $60,000.0 0 $60,000.0 0 $60,000.0 0 $60,000.0 0 $17,900.0 0 $16,200.0 0 $62,200.0 0 $62,200.0 0 $62,200.0 0 $62,200.0 0 $20,100.0 0 $18,400.0 0 L^n d Informatio n Acre s 0. 1 S F 4400. 0 U nit s 1.0 Dept h 100. 0 Wdt h 44. 0 Vacan t N o Improvemen t Informatio n Buildin g 1

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R171.
. . 6/7/200 9

### Dougla s County Accoun t fl^V atio n 

### Pag e 2 of 2

-03
. i l u o B f t SKon d Roa c
' J Fn t Floo r T»,0» « 777< m . D O

. 1 tKHaa-m m 2 STOR Y 7! 3 0l l
CLIC KT O ENLARG E IMAG E CLIC KT O ENLARG E IMAG E Squar e Footage : 

### 1530. 0 Percen t Complete : 

### 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 2 Stor y Cond o Squar e Footage : 0. 0

HVAC : Centra l Ai rt o Ai r Rooms : 8. 0 Exterior : Fram e Viny l Units : 

### 1.0 Interior : Drywal l Baths : 

### 1.0 Roo fCover : ! Compositio n Shingl e Bedrooms : 4. 0

Roo fType : Hip/Gabl e Stories : 2. 0 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : ; 0. 0 yea rBuil t Yea r Remodele d Percen t Remodele d Adjuste d Yea r Buil t Physica l Ag e 190 5 0 0 % 190 5 

### 10 4 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 

### 1.0 Basemen t Bsmn t Bloc k 8 f t 753. 0 Basemen t Outsid e Entranc e 1. 0 Fixtur e Bas e Fixture s 

### 1.0 Fixtur e Bat h Ful l 

### 1.0 Garag e Detache d 

### 216. 0 Porc h Enc l Soli d Wal l 

### 147. 0 Use r SOURC E 3 1. 0



### http://douglasne.mapping-onIine.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl71.
. . 6/7/200 9

# Remot e ID : Rpag e o f
1 ;o x 3 44 8

O K 74103 . 4-709 8 4-746 6
>n lowin g OneCsi l 1 Agenc ydi g t i clcet s C3L 1 1 e d i n fc>y : 

### -tor- : COASTA L ENVIRONMENTA L SERVIC E imber- : 8776624 2 H Numk>er : 8776624 2 1 0 .t e : 2 009/07/ 2 8 ci : 593.93 3 >e CLEA R o- fund e i- g r-oun d -Fsic i 1 i t i e s -For- : 

### MAGELLA NRIRELIN E Ticke t Nunriber - E?cceiv£itoi " Contsic t 

### D i g Addnes s 232825 3 ELIZABET H 593. 9 N52N D S T 232830 0 232830 3 ELIZABET H ELIZABET H 3.48 0 SRENCE R S T 2 1 2 4 MARL E S T « 232830 4 ELIZABET H 3 7 2 4 N2 4T H S T 232830 9 ELIZABET H 2 57 0 WHITMOR E S T

HoLv e sin yquestions
. plesLs e conteic t MsigellBi n OneCa.l l Bi t 93.8/ 5 74—709 8 

# J

### Pag e 1 of 2 • #

" > [ Creat e Anothe rTicke t ] 1 Bac k t o Irt h Interne t ] Sen d Emai l



## • YOURTICKE T NUMBERI S 2328304
. Origina l Cal l Date : 7/28/0 9 Time : 4:2 6 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 7/30/0 9 Time : 5:0 0 p m State : N E County : DOUGLA S Place : OMAH A Address : 372 4 Street : N24T H S T Twp : 15 NRng : 13 E Sect-Qtr : 03-SW,04-SE,09-NE,10-N W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : lea d remediatio n Locatio n o f Work : INCLUD E AL L EASEMENT S LOCAT E ENTIR E PROPERT Y Remarks : FAX AL L CLEAR S TO : (877)662-421 1 : UNStJR E O F CORNE R LO T Compan y: COASTA L ENVIRONMENTA L SERVIC E Contac t Name : ELIZABET H Phone : (877)662-421 0 Wor k Bein g Don e For : Coasta l Dept h o f Excavation : 4 ft . Corne r Lot : N Front : Y Rear : Y Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N ALTS7 2 CXCAT V MAGELLANMUDO l OMAHACO F 0PPDGPR 5 QLNNEI C



### Servic e Area Contac t Phon e Numbe r Utilit y Typ e ALT87 2 WINDSTREA M COMMUNICATIO N N A Day : 406728934 3 Ah : 406207149 4 Emerg : 888728934 3
CXCAT V CO X COMMUNICATIONS , IN C HEID I Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7
MAGELLA N Day : 918574709 8

MAGELLA NMIDSTREA M PARTNER S L PDEBORA H Alt : Emerg : 918574709 8
MUDO l METROPOLITA NUTILITIE S DISTRIC T SAND Y Day : 402504782 3

Alt : Emerg : 402504797 0

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 7/28/200 9

### Pag e 2 of 2

OMAHACO FCIT Y O FOMAHA-TRAFFICSEWE RRO N 

### Day : 402444719 7 Alt : 402444516 1 Emerg : 402444516 0

OPPDGPR 5 OMAH APUBLI C POWE RDISTRIC T N A 

### Day : 406728934 3 Ah : 406207149 4 Emerg : 888728934 3
QLNNEI C QWES T LOCALNETWOR K N A 

### Day : 406728934 3 Ah : 406207149 4 Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 7/28/200 9

# As-Buil t Drawin g COASTA L 

# Omah aLea dSuperfun dSit e
33Q ^ Extepio rPain t Nort h Arro w Omah a Lea d Sit e Owne rU»mo : DEBORA H KTHCM ^ Sit e Sketc h Address : a^^Q f N & ^ ST

. •Poo r Phone : HiC^OS.' ) 88^-0^0 0 r~ | No t pain t Sampl e Numbe r Lea d Sampl e LA B Sample s Collecte d Concentratio n Collecte d Firm : /=73K ; gO > K W RYASCPXA-olSM S F l 

### D Date : S / 2 S J ^5 ^ RYBSCPX A,ga(;4 ^ F 2 

# • Time : ?^^ 0 RYCSCPX A,3R64» 6 B I 

# • Sample sAnalyze d RYDSCPXA-otaiMt S B 2 

### D RDZSCPXA-,5{8£i4 ^ D Z 

### D XR F Uni t ROJOCPX A0 2 

# n D Oat e 

### D Tim e Staff : Numtie ro f Sample s = /

. 

# m l Legend : F l = 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 AH quadrant s a m a s viewe d fro m th e street , taon g propeft y 

# ENTEB13 D 2- 5 tm % • OLS#:3264 2 a/5/0 9

F : 8/13/0 9

Legen d Concret e Dri p Zon e Excavate dgg j Quadrant s Excavate d Are areplace d So d wit h Are areplace dwit h Rock/Mulc h Are alef t bar e Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc ,HL.Itto-*. ^ 

## (^

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## 77/ 4 

# 330 ^ Extejjo rPain t Nort h Arro w 

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

### Sit e Sketc h Address : SPMM^^ Z •Poor



## Phone : H:M^18Bid:M£ > Q Notpaint Sampl e Numbe r Lead Sampl e Samples Collecte d LA B Concentratio n Collecte d Fimi : n> ^

eO i Kl* ^ RYASCPXA-ol2(o4 g F 1 

## D Date : s/ZS^^ r RYBSCPXA-5!l8i£J4 ^

F

2 

# t D Time : <^'^ 0 RYCSCPXA-3aS4* & B 1 

## D Samples Analyze d RYDSCPXA-ol8(i4 £B 2 RD2SCPXA-,3Q54 £D Z 

## D XR F Unit : 

### RGZocpx Ae z _ii__pp" i 

## D Date : _ 

## D 

# m^- ^ (jf
. RPZSGPXA-3a54i & -B^ - (O M ppm 

## D D Time : _ Staff

. 

# m Numbe ro fSamptes = I ^ i ^—; Legend : F l = Front Left , F 2 = Fron t Right , 8 1 = Bac k

Left , B 2 = Bac k

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# ENTERED ;

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v4 ' 046141.012 3

### C^3 7 77/ 4 Omah a Lea d Sit e Sit e Sketc h Address : ,3?i2^J^^_^r , .



## Phone : H:X40B18a^'(D^0 0 Sampl e Numbe r Sampl e LA B Collecte d RYASCPXA-ot2|;o4 g F 1 _pp m 

## D RYBSCPXA-5g64» S F 2 

### Lg_pp m 

## D RYCSCPXA-,3I8£P4 ^ B I 

### ^J ^

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### .P4; ? pp m 

## D RDZSCPXA-,3g54; g D Z /(OCfl ^

pp m 

## D RGgSCPX AfmZ
~ pp m 

## D D (j d RPZSCPXA-,3aS4, ^ £Z - ^ 9 pp m 

## D Numbe ro fSample s ~ ( ^ "
— ; 

# 3SG ^ Exterio rPaint Nort h Arrsw

•Poo r [~ ] (slot pain t Sample s Collecte d Firm : Fpt ^ eO > i^ ^ Date : S/2 S J^ r Time : ?r5C > Sample s Analyze d XR F Uni t

Date : _ 

# (Ao-'OSrQ' t Time : _ Staff : 

# m Legend : F l = Fron t Left , F 2 = Fron t Right , B l = Bac k Left , B2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , PZ = Pla y A n quadrant s ar e a s viewe d from th e street , facin g propert y 

# ENTERE D M M .2-5-209 5 / 

## c

# QSGY ^ Own« rNam e Address :

Phone : Sampl e Numbe r RYASCPXA-aa54 g F i RYBSCPXA>3j8G4f & P 2 RYCSCPXA-,3II3;P4 £B I RYDSCPXA-^3Q(;4 £6 2 RDZSCP)(A-3g|Q4 ^ D Z nOgOCPXA - G 2 

### (jf
. RnasopxA-<3»aSfi & -BZ Omah a Lea d Sit e Sit e Sketc h

Lead Sampl e Concentratio n Collecte d

i.pp m J - , pp m 

## D LA B 

## D D D D D D D Numbe ro f Sample s = [ A| j —* j Nort h Am w [g^oo d ExtedorPain t

•Poor Q Notpain t Sample s Collecte d 

## Firm : _£M_je2Ljf*i L Date : S/2S;g5 " Time : __2>LS Q Sample s Analyze d XR F Unit :

Date : _ Tlme:
_ Staff

. Legend : F l = 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 « Play Alt quadrant s ar a a s vtswe d (ro m th e street , fbdn g propert y 

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. V COASTA L h-. , .^<fi ^ ENVItONHENTA L •• t PB01 * C I I 0 U P , INC

. 

## Consen t fo rAcces 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 : 

# yiMZ

Owner' s Name : Daytim e Phone : G£-^ ( 

# O^ll Ai ^ ^^^" ^ 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 perfomne 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 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 y 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 , 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 o fperfomnin g th e wori(
. 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 f2ieos>;4
. ^ V**»*^ V COASTA L \ <JC P
. „ ENVIKONHENTA L • ' I PROl* -C 1 O U P
. I N C

. 

### •Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; •Remov e flowe rbulb s o rplant s tha t th e Granto ro rth e Grantor' s tenan t ma ywis h t o save ; •Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , a s necessarysubsequen 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 . Should 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

^ 1 gran t acces s t o m ypropertie sD I d o no t gran t acces s t o m ypropertie s 

# 0/ Dat e ^ / Sigmnur e Oate

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

Pag e 2 o f2C O AS

. TAL G KO U P 

## Restoratio n Agreemen t Th e purpos e ofthi s agreement i s t o provid e amutual agreement a s t o condition s ofth e property prio r t o remediatio nactivities
. Thi s wil l als o serv e a s documentatio nfor th e purpos e o f assurin g tha t restoratio n activitie s ar e complete dt o th e satisiactio no f th e propert y owner an dth e Unite dState s Environmental Protectio nAgenc y (EPA)
.

Property Address : " ^ JAA J ^2^"^ ^ ' Owner : pg^gbig^i ^ -Ji\XXtiltY ^ 

# I d
O nth e attache ddiagrain(s ) indicate area(s ) t o excavate , surfac e structure s andlandscapin g feature s an d acces s location(s ) to b e use db y th e contractors . Indicate distances , depths , materia l types , etc . Photographically andVideographically document th e existin g condition s ofth e propert y an dth e basement 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 r returno f thes e item s I s th e Owner' s responsibility
. Item : 

# ^y 9 ^ J I/^<^/< S Kem : Item : Item :



### item s t o b e Rem o )ve d b yth e Contracto rDurin g Remediatio n an d No t Replace d Item : 

# A - ^ / 

# $^f^f/^ 0 Item : / 

### Item : Item :

Page l of
.C O Asj rAL ^r»*'4' j MON».TNTAI

. CROUP

. IN C 

### Item s t o B e Remove d B yContracto rDurin g Remediatio n an d Replace d



## Ite m Pre-existin g property area , that wil l b e excavated , that i s covere dwit hgrass . Numbe r o f tree s > 2 inch trunk diamete r Numbe r o f tree s < = 2 inch trunk diamete r Number o f Sprinkler Zones , Contro l Valves , Timers , Heads , etc . Atiacii asketcho f the sprinkler lavout
. Numbe r o f an dsiz e o f eac hgarden / flowe r be d area . Anachasketchof relativ e size s an dlocations
. Agree dupo nvalu e o f plant material s no t t o b e replace db v contractor . Note thi s \alu c wil l b t uset J to issu e aplant vouche r to th e propert y owner . Easemen t Area , t o b e excavate d 

## Quantit y 

## f

\ ^ i^ A

^ 

# y ^
H/< ^

Z

^



# i^ i Landscap e Inventory Uni t Quadrant s

Eac h
Each

Each

Eac h SquareFee t

$ 

## Condition/Type/Specie s



# rt^.^ j ^e^'y^T s Each

Pag e 2 of
.COASTA L ^nou', < IN C


### Additional Comment s / Instructions : 

# V ^

- ^ • 

# • rtvs­ i^^ D oUulc w ^<^ln ^ G'^<>^ ^ vUulc/Vi ^
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. Sot )
.

D Chec k th e t)oxI fOwne rdoe s not wan t CE G t o documen t Interio rfoundatio n wall s an d possibl e pre-existin g damage
. Bycheckin g thi s boxCE G I s no t responsibl e fo ran ydamag e don e t o th e Interio ro fhouse , includin g foundatio n cracks o rfissures
.



## BTag n Q I d o no t agre e agre e 

# 'Mi* y dCM>
. Conmctor^ s Signatur e Dat e Pag e 3 of
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# ss a Addres s 

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Readin g Sampl e are a Shot # Readin g Sampl e are a 

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

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. Signatur e 2CAe,tfA ^ 

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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 273 0 Mod e SOI L Tim e 2009-08-0 5 17:1 3 Duratio n 121.2 6 Sequenc e Fina l Flag s AVERAG E ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m ± Erro r P b [249^70 2 ± < ^ Supervise d By : 

# f(fAtiKU ^

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 278.11 5 Supervise d By : 

## Certificat e o fVerificatio n

272 6 SOI L 2009-08-0 5 17:1 0 30.2 7 Fina l 3264 2 372 4 N 2 4 s t F l Nicola s 6 CLEARANC E

± Erro r
± 20.34 2

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 260.35 8 Supervise d By : 

## Certificat e o fVerificatio n

272 7 SOI L 2009-08-0 5 17:1 1 30.3 7 Fina l 3264 2 372 4 N 2 4 S t F l Nicola s 6 CLEARANC E

± Erro r
± 20.10 7

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 193.06 3 Supervise d By : 

## Certificat e o fVerificatio n

272 8 SOI L 2009-08-0 5 17:1 2 30.2 9 Fina l 3264 2 372 4 N 2 4 s t F l Nicola s 6 CLEARANC E

± Erro r ± 17.25 9

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 267.27 1 Supervise d By : 

## Certificat e o fVerificatio n

272 9 SOI L 2009-08-0 5 17:1 3 30.3 3 Fina l 3264 2 372 4 N 2 4 s t F l Nicola s 6 CLEARANC E

± Erro r
± 19.89 5

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 273 5 Mod e SOI L Tim e 2009-08-0 5 17:1 7 Duratio n 123.0 1 Sequenc e Fina l Flag s AVERAG E ADDRES S 372 4 N 2 4 S t QUAD/ZON E B l INSPECTO R Nicola s DEPT H 6 SAMPL E TYP E CLEARANC E NOT E

± Erro r P b ± Supervise d By : t^nnJffC K

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 265.67 6 Supervise d By : 

## Certificat e o fVerificatio n

273 1 SOI L 2009-08-0 5 17 : 1 5 30.6 9 Fina l 3264 2 372 4 N 2 4 s t B l Nicola s 6 CLEARANC E

± Erro r ± 19.99 8

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 323.07 3 Supervise d By : 

## Certificat e o fVerificatio n

273 2 SOI L 2009-08-0 5 17:1 5 30.9 9 Fina l 3264 2 372 4 N 2 4 s t B l Nicola s 6 CLEARANC E

± Erro r ± 21.91 8

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 265.73 5 Supervise d By : 

## Certificat e o fVerificatio n

273 3 SOI L 2009-08-0 5 17:1 6 30.7 0 Fina l 3264 2 372 4 N 2 4 s t B l Nicola s 6 CLEARANC E

± Erro r
± 20.06 3

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 277.79 0 Supervise d By : 

## Certificat e o fVerificatio n

273 4 SOI L 2009-08-0 5 17:1 7 30.6 3 Fina l 3264 2 372 4 N 2 4 s t B l Nicola s 6 CLEARANC E

± Erro r ± 20.21 6

# 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 274 0 Mod e SOI L Tim e 2009-08-0 5 17:2 1 Duratio n 122.1 8 Sequenc e Fina l Flag s AVERAG E ^%jOf27|6ig73 | ADDRES S 2 4 s t QUAD/ZON E easemen t INSPECTO R Nicola s DEPT H 1 SAMPL E TYP E CLEARANC E NOT E

pp m ± Erro r P b 54!ll E ± 

# Oiil ^ Supervise d By : (VICOJ^IUZP ^

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 47.43 3 Supervise d By : 

## Certificat e o fVerificatio n

273 6 SOI L 2009-08-0 5 17:1 9 30.8 8 Fina l 3264 2 372 4 N 2 4 S t easemen t Nicola s 1 CLEARANC E

± Erro r ± 9.39 8

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 57.70 6 Supervise d By : 

## Certificat e o fVerificatio n

273 7 SOI L 2009-08-0 5 17:2 0 30.5 5 Fina l 3264 2 372 4 N 2 4 S t easemen t Nicola s 1 CLEARANC E

± Erro r
± 10.36 3

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 273 8 Mod e SOIL Tim e 2009-08-0 5 17:2 0 Duratio n 30.5 8 Sequenc e Fina l Flag s BVI D # 3264 2 ADDRES S 372 4 N 2 4 s t QUAD/ZON E easemen t INSPECTO R Nicola s DEPT H 1 SAMPL E TYP E CLEARANC E NOT E

pp m ±Erro r P b 66.47 8 ±10.80 7 Supervise d By :

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 44.84 3 Supervise d By : 

## Certificat e o fVerificatio n

273 9 SOI L 2009-08-0 5 17:2 1 30.1 7 Fina l 3264 2 372 4 N 2 4 S t easemen t Nicola s 1 CLEARANC E

± Erro r ± 9.15 9

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 274 5 Mod e SOI L Tim e 2009-08-0 5 17:2 4 Duratio n 122.3 9 Sequenc e Fina l Flag s AVERAG E ^Ayg-Q f2741^|gg 7 ADDRES S 372 4 N 2 4 S t QUAD/ZON E D Z INSPECTO R Nicola s DEPT H 1 2 SAMPL E TYP E CLEARANC E NOT E

pp m Erro r P b Supervise d By : Z(^^^JtSiSSd i

# 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 274 1 Mod e SOI L Tim e 2009-08-0 5 17:2 2 Duratio n 30.5 6 Sequenc e Fina l Flag s BVI D # 3264 2 ADDRES S 372 4 N 2 4 s t QUAD/ZON E D Z INSPECTO R Nicola s DEPT H 1 2 SAMPL E TYP E CLEARANC E NOT E

pp m Erro r P b 132.94 4 ± 14.48 8 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe r Scientifi c 90 0 Middlese x Turnpik e Billerica , M A0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P

b 118.67 9 Supervise dBy : 

## Certificat e of Verificatio n

274 2 SOIL 2009-08-0 5 17:2 3 30.5 9 Fina l 3264 2 372 4 N2 4 s t D Z Nicola s 1 2 CLEARANC E

± Erro r ± 13.74 0

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 213.73 0 Supervise d By : 

## Certificat e o fVerificatio n

274 3 SOI L 2009-08-0 5 17:2 4 30.6 5 Fina l 3264 2 372 4 N 2 4 S t D Z Nicola s 1 2 CLEARANC E

± Erro r ± 17.85 5

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

XL3t-3208 9 Readin g N o Mode Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 77.83 2 Supervise d By : 

## Certificat e o fVerificatio n

274 4 SOI L 2009-08-0 5 17:2 4 30.5 9 Fina l 3264 2 372 4 N 2 4 S t D Z Nicola s 1 2 CLEARANC E

± Erro r ± 11.56 9

## i^^QL \ Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 3 ^^^L L I Coasta l Environmenta l Grou p Inc
. M l ^ ^ Xpnorf^ ^ www.coastalhazmat.co m COASTA L INVIIOHHINTA L G •O U P
. IN C 

# EXECUTIV ESUMMARY : BVID #3264 2 - (3724 N2 4 ST )

^ No Issue s o r Concern s Q Issues/Concern s Detail Explanation : Mulc hwa s replace do n8/15/200 9

### St> i 

# EP A EP APropert y Clos e Ou t For m 

# J7.:2. yA/z^.5- h Propert y tf : SZ0>H2^
. Propert y Add r

Ye s N o Excavatio nGenera l 1
.If necessaiy , vrer e th e correc t quadiant(s ) excavate dandrestored? 

# ZV l 2
.If necessaiy , were th e correc t area s of drip zone excavate dandrestored? Gradin g So d an d Vegetatio n Ye s N o 1
.Doe s the gnidin g aroun dth e perimeter ofth e hous e i nexcavate darea s generally slop e awa y fromth e house ? 

# w 2
.Ha s so dbee nlai dinall area s tha t wer e excavated ? 3
.Doe s the sodappear to b e generally healthy an dgrowing ? (Only evaluate if inspecteda t a3 0 

# 17 ' day time period ) 4
.Ar e soddedarea s generally fir man devenly graded ? 

# y ^ 5
.

Ar e th e joint s betwee nth e so dstrip s generally tight ? (Only evaluate if inspecte da t a3 0 da y 

# • " tim e period) 6
. Wa s the propert y grade dsuchtha t wate r will not poo l o nth e property* ] 

# y- ' 7
. Wa s danug e t o landscapin g o r plan t material s avoided ? ^ - ^ Gates , Fcnce aan dRetainin g Wal b ^ I
.D o gate s ope nan dclos e freely? (Ifapplicable ) 2
.

Were all gate s or fence s takendow ndurin g restoration activitie s reinstalled ? (If applicable ) 3
.Wa s damage t o gate s o r fence s avoided ? (ifapplicable ) 

# 1?^
. 4
.Wa s damage t o retaining wall s avoided ? (Ifapplicable ) 

# T7^
Foundation , Sidin g an dGuHer s Ve s >/N o I
.Wa s damage t o th e sidin g o r tri mavoided ? 2
.Wa s damag e t o th e foundationavoided ? 

# y ' 3
.Wa s damage t o window s avoided ? 4
.Wa s damage to window s o r doo r screen s avoided ? 

# Y I/ ' 5
.Wa s damage t o downspout s o r downspoul extension s avoided ? Sidewalk s an d Driveway s (Concrete ) Ye s N o 

# 1

/ 1
.Wa s damage to drivewa y surface s avoided ? 2
.Wa s damage t o walkwa y surface s avoided ?

## Owner s comments :

Inspectio nnotes :

Remova l an dreslorationactivate s complej e incjuding the 30-da y so dwarranty : EP ARepresentativ e LJoKi 

# Uo nDaAnl- ^ pme : ?f/ 3 M

## Propert yCompletio n Agreemen t
Thi s agrcemen i documenls
. th e completio n o i remedia l acliviiie s perloime d o n m yproperl yM ysignatur e wil l designat e llia i I a m satisfie d wit h th e rc-stofalio n ofm yproperly , an d Iha l n o item s ar e i n queslion.s
. now , o ra l an ytim e m th e future , excep l ihos e item s liste d below , ifan y

Propert yfP : ^^(^^ 2 Propert yAddress : ^Y^C ^

ji ) 2* ^ ^ \ Owner : PeW^AJ U 1 Phone ; 

## |iitf<i.)(^^7-^s^g > Restoratio n Item s i n Question :

Item : Ilem : Item : Item : Item : Item :
Additiona l Comment s uiiiuiia i v^vyiiiiiiisiiia
. y

n t

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