## TRANSMITTALo f

OMAHALEAD SITE SOI LREMEDIATIO NFIL EFOLDER SAID#: '^^^t ^ Date : 

# ? P 

# 1
Address : 

# . hii Y [ ^^ ^ ^r Remediatio nContractor : Coasta l Environmenta l Grou p Year : 200 8
SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S D 

### Vide o o f property (DVD ) Executiv e Summary 

# y EPA-provide dproperty sketc h Signe dAcces s Agreemen t fo r subjec t property Signe dAcces s Agreement(s ) fo r adjacent property Restoratio nAgreemen t Settlemen t document s (i.e. , fo r damag e or to replac e plants , etc. ) 

# y Confirmatio ndat a Photograph s 'i^ZerSLj.riiJckn/i ^ CiP^atiyi j 30'cLuSd<:i j jiruJ Sd d As-buil t sketc h Satisfactory restoratio nsigne db y Property Owne r Property close-ou t check lis t signe db y EPA Descriptio no f area s no t meetin g RO D cleanu p criteri a Utility clearance s Property informatio nfro mDougla s County Assessor' s Offic e 

# • D D

# (p^ Propert y Acces s Checklis t Property ID : 3^<~S ^ nWORK STARTE D ON : / / j nWORKCOIMPELTED ON : / / Property Address : f^/ ^ A / 3^ ^ Sh
Owiie i Renter : ~^>? l 

## Ry^s r f^y H Phone : Addres s 

## yy^% Uk^^lttM^v t Fax : 

## Otn^h^^N B Q7il3 \ Cell/Pa<£er : Phone : d/^ ^ - -^g^f^
. %Lf ^ Additiona l Information : Fax : Cell/Pa«ie i
I I Notificatio nLette r Sent : Bv : iM Acces s Ajjrecmcn t Siirned : S / f^/° 2 

## B.v : ^ .OoJf/c L 1X

1 Restoratio nA<>recmen t Signed : ^ / 1^ 1 ^ H 

## B.v : fi.D6/y;(jU C

U Topsoi l Samplinj i (if applicahle ) Bv : C

D Disposal Samplin g (if applicahle ) Bv : C

U Garde nSamplin g (if applicahle ) Bv : l^f'- l

- ^^oH^1% T Called : b I 1 / t' j mIJtility Clearancx^2C ' m^' ^ 

# ^y£[m:s^y^k^i^L^iei n [ ^ Video/Photo s (Before ) On : S^/1:^/0 % 

### y - /^./3r6UK j nVideo/Photo s (During ) On : Bv : nVideo/Photo s (After ) On : Bv : D Video/Photo s (30-Day ) On : Bv : I I Propert y Completio nAgreemen t Signed : Bv : C

U Fina l Repor t Issued : Bv : Ai rMonitorin g (as applicable ) j CU Communit yC U Cre w On : / / By : Results : j C J Communit } C D Cro v On : / /



### . l l B.v : Resulls : 1 CU Communit yCU Cre w On : / , / 

### By : 1 Results : 1

Omah a Lea d Sit e

## Propert y I D # 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) : 

## CONTAC T FORM


# /<v/ 3 /y
. jy y . Date :S-)3>-0 S Time : j'^pr v Action : o-He A^ ci^ | /yic A

Date:^^i'^-£) f Time:M"'pr n Action : <>/yeri.
. Date : Time : Action : Transmi t t o EP AD Othe r Action : D

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^'\a-o- b SfoJ^ e U> / owner , d ^ UrJ c o nU^^nesck^ ' 

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1

### Dougla s County Accoun t Informatio n Pag e 1 o f 3 lun t inrorm a
Dougla s County , Nebrask a Propert yRecor d - R164210000 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 - Vie wO n Ma p Informatio n i s vali d a s o f2008-4-1 7 Treasurer' s Ta xRepor t Ne wFeatur e -*-*- • Aut o Sale s Searc h Owne r MEYE R RODGE R ETA L 364 8 LAFAYETT E AV E N E OMAH AN E 68131-000 0 Propert yInformatio n Ke yNumber : 421 0 000 0 1 6 Accoun t Type : Residentia l Parce l Number : 164210000 0 Parce l Address : 141 2 N34S T OMAH AN E 68131-000 0 Lega l Description : LOWE S AD D LO T2 BLOC KU N 34. 5 F TLO T1 & E 2 0 N 34. 5 F T34. 5 X 8 0 Valu e Informatio n Lan d Improvemen t Tota l 200 7 $ 1,700.0 0 $ 43,200.0 0 $ 44,900.0 0 200 6 $ 1,700.0 0 $ 43,200.0 0 $ 44,900.0 0 200 5 $ 1,700.0 0 $ 43,200.0 0 $ 44,900.0 0 200 4 $ 1,700.0 0 $ 16,900.0 0 $ 18,600.0 0 200 3 $ 1,700.0 0 $ 16,900.0 0 $ 18,600.0 0 200 2 $0.0 0 $0,0 0 $0.0 0 Sale s Informatio n Sale s Date : 2006-09-1 1 Dee d Type : W D Book : 200 6 Page : 11026 2 Price : $34,500.0 0 Grantor : CENTE X HOM E EQUIT YCOMPAN YLL C Grantee : MEYE R RODGE R ETA L Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 2005-12-0 7 Dee d Type : TR D Book : 200 5 Page : 15539 2 Price : $ 52,850.0 0 Grantor : Eri cH Lindquis t


### http://douglasne.rnapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R164.
. . 5/7/200 8

### Dougla s Count y Accoun t Informatio n Pag e 2 o f 3 3un t intorm a

Grantee : Valid/Invalid : Exclusio n Reason : Cente xHom e Equit yCompan y Invali d Sal e t o Mortgag e - Ban k Lan d Informatio n Acre s 0.0 6 S F 2800. 0 Unit s 1. 0 Dept h 80. 0 Widt h 35. 0 Vacan t N o Improvement Buildin g 1 Informatio n

N o Sketc h Availabl e

CLIC KT O ENLARG E IIWIAG E Squar e Footage : 1117. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 1 1/ 2 Stor yFi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 6. 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 : 1. 5 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 191 0 0 0 % 191 0 9 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 665. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Porc h En d Scree n 154. 0


### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R164.
. . 5/7/200 81. 0 

### Dougla s Count y Accoun t Infonnatio n_ ^ Pag e 3 o f 3 ount iniormatio n^_ ^ ^ ^
Use rNE WROO F



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R164.
. . 5/7/200 8

## 2558 5 

# w As-Buil t Drawin g
COASTA L 

# Omah aLea dSuperfun dSit e

Exterio rPain t Omah a Lea d Sit e n Goo d Sit e Sketc h [ ^

Poo r Samplin g Address : 141 2 N 3 4 S T n No t pain t Sampl e Numbe r Lea d Sampl e LA B Sample s Collecte d Concentratio n Collecte d 

# I Firm : RYASCPXA-2558 5 F l 3 I Q pp m 

# n Date : 17.--7-0- 7 RYBSCPXA-2558 5 F 2 pp m 

# n Time : '>:'^4

. A M RYCSCPXA-2558 5 B l pp m 

### D Sample s Analyze d RYDSCPXA-2558 5 B 2 pp m 

# n nOZeGPXAI!S58 5 B e pp m 

### D 

# n XR F Unit : ^6H 0 Book : 

## ICil
. RCZSCPX A3668 8 Oi
­ pp m 

### D D Date : J 2 - l9 > - O T RPZSCPX Aasse s P2 ­ pp m 

### D Tim e 

# n 2t ± Staf f 

### i^^\ y Numbe ro f Sample s = L | Legen d 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 A N quadrant s ar e a s viewe d tro m tti e stree t faan g propert y

'"rcalej ]2-\' m


### Legen d Concret e Dri p Zon e Excavate d Quadrant s Excavate d
Are a replace d wit h Are areplace dwit h Are alef t bar e So d ' ' Rook/Mulc h 

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

## 2558 5 Exterio rPain t Nort h Arrow 

### Omah a Lea d Sit e Q Goo d 

### Sit e Sketc h Samplin g Address : 141 2 N 3 4 S T [ J No t pain t Sampl e Numtie r RYASCPXA-2558 5 RYBSCPXA-2558 5 RYCSCPXA-2558 5 RYDSCPXA-2558 5 F 1 F 2 B 1 B 2 Lea d Concentratio n 

## 3 1 0 pp m pp m pp m pp m Sampl e Collecle d 

# I LA B 

## D 

# n D 

# n Fimi : 

### Dale : Time : Sample s Collecte d r^f ^

guvLC 

### \').-l-O l 11:54 ? A M Sample s Analyze d 

### nogoorx Ajsses—BJ » pp m 

# n D XR F Uni t ^5H 0 BooK : 

## ICil

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## D D Date : II - J9> - Q 7 RPZSCPXA2658 6 F ^ pp m 

# a D Tim e 

## 2lX L Numbe rofSample s = L | Staff : 

# nsw L Legend : F i = Fron t Left

. F 2 = Fron t Right

. B l = Bac k Lef t B 2 = Bac k Righ t D Z = Dn p Zone , G Z = Garden

. P Z = Play Al l quadiani s are a s viewe d fro m th e stree l facn g propert y



# Wfui/n r

## >558 5 Omah a Lea d Sit e Exterio rPain t hJort h Arro w 

### Sit e Sketc h • Goo d [V fPoo r Samplin g Address : 141 2 N 3 4 S T [~~ | No t pain t Sampl e Numbe r Lea d Sampl e Sample s Collecte d 

# I LA B Concentratio n Collecte d Firm : T^ ^

Zxi^

. L C RYASCPXA-2558 5 F l 

# 3 

# 1 0 pp m 

### D Date : )l-l'O l RYBSCPXA-2558 5 F 2 

# 3^ q pp m 

# n Time : U : 5< ^ A M RYCSCPXA-2558 5 B l 

# ^ 2 g pp m 

# n Sample s Analyze d RYDSCPXA-2558 5 B 2 pp m 

### D nDZCGPXA-2558 5 B 2 pp m 

### D D XR F Unit : ^6H 0 Book : 2C) 3 • RGZSCPX A2568 6 GZ
­ pp m 

### D D Date : ^-^'0 7 RPZSCPX A2658 6 P * pp m 

### D Tim e 

# 27 ± Staff : 

# n'^ w Numbe rofSample s • Legend : F l = 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 y Al l quadrant s ar e a s viewe d fro m th e street , facin g property

## 2558 5 Exterio rPain t Nort h Arro w 

### Omah a Lea d Sit e • Goo d 

### Sit e Sketc h [^Poo r r 

### Samplin g Address : 141 2 N 3 4 S T Q No t pain t 

### Sampl e Numbe r RYASCPXA-25585 RYBSCPXA-25585 RYCSCPXA-25585 RYDSCPXA-25585F l F2 B l B 2 Lea d Concentratio n 3 } 0 PPn n 3^ ^

pp m 

## ^2 8 J5ZC

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# I LAB 

## D D D D Firm : 

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### \7-l'O l li:S4 ^

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# n D XR F Unit : ^6H 0 Book : 2C> 3 RCZSCPX A26686 GZ
­ pp m 

## D D Date : J 2-/f i ' O l RPZSCPX A26686 PS
­ pp m 

# n D Time : 

# 2f ± Numbe ro fSample s = ^ Staff : 

# n M Legend : F l = Fron t Left , F2 = Fron t Right , B i = Back Left , B 2 = Bac k Righ t DZ = Dri p Zone , G Z = Garden , P Z = Pla y Al l quadrant s ar e a s viewe d fro m tti e street , facin g propert y


## DE C 1 3 20C 7 *< ­ 

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T3 ^ 5 t Rev- 5 rrcalc J i:-Nnv-0 7.y ^ <; p ^ % "I " o * COASTA L

*•'< , , yJ / ENVIRONMENTA L ^ ""0^ ^ / / CROUP , INC , 

## Consen t Fo rAcces s T o Propert y^ ^ RIGH TO F ENTR YTO 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 : 

# ^t ^

ifiVy ^ Owner' s Name : Da,.imePhona:^^ ^ -^2^_^^ ^

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 collect 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 contact 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 o fperformin 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.^^t D ST , - *

COASTA L ENVIRONMENTA L CROUP , IHC

. 

### 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 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 ofth e property
. AGREEMEN TNO TT O INTERFER E 

### Th e Granto ragree s no t t o interfer e o rtampe rwit h an yofth 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 (877 ) 234-6270
.

rX I gran t acces s t o m ypropertie s D I d o no t gran t acces s t o m ypropertie s


# cp. ^ ^-/H-0 ^ Signatur e Dat e

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

.

Pag e 2 o f2COASTA L E N V I KO N» M F N TAL 

## Restoratio n Agreemen t Th e purpos e ofthi s agreemen t i s to provid e amutual agreemen t a s to condition s ofth e propei1> ' prio r t o remediatio nactivities
. Thi s wil l als o serv e a s documentatio nfo r th e purpos e o f assurin g tha t restoratio n activitie s ar e complete dto th e satisfactio no f th e propert> ' owner andth e Unite dState s Hnvironmental Protectio nAgenc y (EPA)
.

Propert yID : '^^' S ^"^ ^ Propert yAddress : \Lf| ^ k l '^'-H ^ *^-v k 

## Q^""'" = ila ^

Wyji y Phone : ^t.^.'\')p--%Hei
­ 

# y
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 ) t o b e usedb y contractor , andthe directio no f North
. Indicate distances , depths , materia l types , etc . Indicate digita l photo s b

y referencing th e photo-lo g number wit ha narrow 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 : 

# miAi

_1 Item :
Item :

« . 'i , Item :
Item :
Item :

I Item :
Item :


### Pag e 1 o f C ^ 

# 1COASTA L


### 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 ) 

## ^^^"^- '^^\^\(\< \ ^^n^ S oy\rU M ^^^ U " H hoo< ^ p)a/vi- 5 o^t>y^ ^

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# 6 Pag e 2 o fC O AS

. TAL 

### Item s T o B e Remove d B y Contracto rDurin q Remediatio n An d Replace d (Us e additiona l sheet s a s necessary ) Item : 

# \ix\cy

. , OUr f]c^c k 

# (y^ ^ fe.^ic^{^yA'y^<t o Item : '
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Pag e 3 o f 

# 6COASTA 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 coveredwit hgrass .

Numbe r o f tree s > 2 inch trunk 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 an dsiz e o f eac hgarden/ flower be d area . Attac hasketc ho f relativ e size s andlocations
. 

## Quantit y Uni t Condition/Type/Specie s 

# B/,6S l Square fee t


# Itf- f C-ud^ r 

# 1 Each

^ Each



## 1 Each ^ 

# X Each Square Feet



### Pag e 4 of

. 

# 6COASTA L 

### Ite m Agree dupo nvalu e of plan t material s no t t o b e replace db v contractor . Note thi s valu e will b e use dt o issu e aplan t \ouche r to th e propert y owner . Agree dupo nlis t o f plant material s tha t will b e replace dby contractor . B e ver y specifi c anddetailed
. Includ e asketc hof were eachplan t will b e place d b

y th e contractor . Agree duponare ao f property to b e replace d wit hgras s sod
. Includ e asketc ho f th e area(s ) t o b e replace dwit h gras s sod
.

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

Easemen t Area , t o b e excavate d 

### Quantit y Urii t 

## Condition/Type/Specie s



# ' 0 ^ 

# A Eac h 

# ^ly^
j S F 

# 0 S F

S F 

### - - f rO) ^ VVi'ljl?
.



# ' Pag e 5 of 

# CC O A5 TAL
• NVIROMMCMTA L C « O U P

. IM C


### Additiona l Comment s / instructions :



## - \^ock K- Wc^a ^ Total s cUovoY ^

»«^ ^ C-tJ ^ ^iy^CJ L

n 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

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

.



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# V\^(y i P\)hn^c ^ Prin t

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 51 8 Mod e SOI L Tim e 2008-07-0 8 11:0 3 Duratio n 121.5 7 Sequenc e Fina l Flag s AVERAG E Av g o f514-51 7 ADDRES S 141 2 N 3 4 S T QUAD/ZON E INSPECTO R DEPT H |B I MATEU S 

# I * SAMPL E TYP E CLEARANC E NOT E

Supervise d By :

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

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pp m P b 495.46 6 Supervise d By : 

## Certificat e o fVerificatio n

51 4 SOI L 2008-07-0 8 11:0 0 30.5 7 Fina l 2558 5 141 2 N 3 4 S T B l MATEU S 6 CLEARANC E

± Erro r
± 27.14 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 PI'P E NOT E

pp m P b 286.32 1 Supervise d By : 

## Certificat e o fVerificatio n

51 5 SOI L 2008-07-0 8 11:0 1 30.7 1 Final 2558 5 141 2 N 3 4 S T B l MATEU S 6 CLEARANC E

±Erro r ±20.84 8

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

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

pp m P b 311.74 6 Supervise d By : 

## Certificat e o fVerificatio n

51 6 SOI L 2008-07-0 8 11:0 2 30.0 6 FiBa l 2558 5 141 2 N 3 4 S T B l MATEU S 6 CLEARANC E

± Erro r
± 21.77 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 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 355.01 5 Supervise d By : 

## Certificat e o fVerificatio n

51 7 SOI L 2008-07-0 8 11:0 3 30.2 3 Fina l 2558 5 141 2 N 3 4 S T B l MATEU S 6 CLEARANC E

± Erro r
± 22.92 9

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 50 2 Mod e SOI L Tim e 2008-07-0 8 10:2 5 Duratio n 123.3 5 Sequenc e Fina l Flag s AVERAG E Av g o f498-50 1 1 ADDRES S 141 2 N 3 4 S T QUAD/ZON E B 2 INSPECTO R MATEU S DEPT H | 6 SAMPL E TYP E CLEARANC E NOT E

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 18.48 9 Supervise d By ; 

## Certificat e o fVerificatio n

49 8 SOI L 2008-07-0 8 10:2 2 30.8 4 Fina l 2558 5 141 2 N 3 4 S T B 2 MATEU S 6 CLEARANC E

± Erro r
± 7.32 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 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 13.89 2 Supervise d By : 

## Certificat e o fVerificatio n

49 9 SOI L 2008-07-0 8 10:2 4 30.3 8 Fina l 2558 5 141 2 N 3 4 S T B 2 MATEU S 6 CLEARANC E

± Erro r
± 6.83 6

# 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 19.96 2 Supervise d By : 

## Certificat e o fVerificatio n

50 0 SOI L 2008-07-0 8 10:2 5 31.2 3 Fina l 2558 5 141 2 N 3 4 S T B 2 MATEU S 6 CLEARANC E

± Erro r
± 7.26 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 14.02 7 Supervise d By : 

## Certificat e o fVerificatio n

50 1 SOI L 2008-07-0 8 10:2 5 30.9 0 Fina l 2558 5 141 2 N 3 4 S T B 2 MATEU S 6 CLEARANC E

±Erro r ±6.70 9

# 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 AVERAG E ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

Supervise d B y 

## Certificat e o fVerificatio n

50 8 SOI L 2008-07-0 8 10:4 5 120.9 6 Fina l .Av g o f504-50 7 •^^141 2 N 3 4 S T * easemen t

MATEU S 1 CLEARANC E i '

# 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 PT'P E NOT E

pp m P b 164.64 2 Supervise d By : 

## Certificat e o fVerificatio n

50 4 SOI L 2008-07-0 8 10:4 2 30.2 6 Fina l 2558 5 141 2 N 3 4 S T easemen t MATEU S 1 CLEARANC E

± Erro r
± 15.64 1

# 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 PI'P E NOT E

pp m P b 81.85 3 Supervise d By : 

## Certificat e o fVerificatio n

50 5 SOI L 2008-07-0 8 10:4 3 30.2 5 Fina l 2558 5 141 2 N 3 4 S T easemen t MATEU S 1 CLEARANC E

± Erro r
± 11.24 9

# f 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 50 6 Mod e SOI L Tim e 2008-07-0 8 10:4 4 Duratio n 30.0 1 Sequenc e Fina l Flag s BVI D # 2558 5 ADDRES S 141 2 N 3 4 S T QUAD/ZON E easemen t INSPECTO R MATEU S DEPT H 1 SAMPL E PT'P E CLEARANC E NOT E

pp m ± Erro r P b 150.92 2 ± 15.12 8 Supervise d By :

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 50 7 Mod e SOI L Tim e 2008-07-0 8 10:4 5 Duratio n 30.4 4 Sequenc e Fina l Flag s BVI D # 2558 5 ADDRES S 141 2 N 3 4 S T QUAD/ZON E easemen t INSPECTO R MATEU S DEPT H 1 SAMPL E TYP E CLEARANC E NOT E

pp m ±Erro r P b 161.14 1 ±15.43 5 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 XL3t-3208 9 Readin g N o 51 3 Mod e SOI L Tim e 2008-07-0 8 10:5 5 Duratio n 122.7 7 Sequenc e Fina l Flag s AVERAG E i Av g o f509-51 2 ADDRES S 141 2 N 3 4 S T QUAD/ZON E easemen t B INSPECTO R MATEU S "" " DEPT H 1 SAMPL E PCP E CLEARANC E NOT E

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 295.03 8 Supervise d By : 

## Certificat e o fVerificatio n

50 9 SOI L 2008-07-0 8 10:5 2 30.5 3 Fina l 2558 5 141 2 N 3 4 S T easemen t B MATEU S 1 CLEARANC E

±Erro r ±20.20 4

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

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

pp m P b 377.13 8 Supervise d By : 

## Certificat e o fVerificatio n

51 0 SOI L 2008-07-0 8 10 : 5 3 30.6 5 Fina l 2558 5 141 2 N 3 4 S T easemen t B MATEU S 1 CLEARANC E

± Erro r
± 22.72 7

# 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 51 1 Mod e SOI L Tim e 2008-07-0 8 10:5 4 Duratio n 30.7 3 Sequenc e Fina l Flag s BVI D # 2558 5 ADDRES S 141 2 N 3 4 S T QUAD/ZON E easemen t B INSPECTO R MATEU S DEPT H 1 SAMPL E TYP E CLEARANC E NOT E

pp m ±Erro r P b 149.25 3 ±14.46 5 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 260.80 2 Supervise d By : 

## Certificat e o fVerificatio n

51 2 SOI L 2008-07-0 8 10:5 5 30.8 6 Fina l 2558 5 141 2 N 3 4 S T easemen t B MATEU S 1 CLEARANC E

±Erro r ±18.98 5

### Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc

. 

# m www.coastalhazmat.co m 

## <y y COASTA L ENVIRONHENTA L CROUP

. INC

. 

# EXECUTIV ESUMMARY :
th 

# BVI D #2558 5 - (141 2 N34" ' St. )
N o Issue s o r Concern s I I Issues/Concern s
Detai l Explanation :

### ^ - 

# ^^EPA EP APropert y Clos e Ou t For m Propert y # Propert y Address : 

# i^y.
. Owner' s Nam e 

# y M D«ten"lm e Contracto r Grou p p Co^^TTT L Quad s Eicav^ated : ^ \Kyfl X u L- ©
Ye s No Excavatio nGenera l 1.

If necessary , were th e correc t quadrant(s ) excavate dan dreslored? 2.

If necessary , were th e correc l area s of drip zone excavate dandrestored ? l y Ye s No Gradin g So d an d Vegetatio n 1.

Doe s th e gradin g aroun d th e perimete rofth e hous e in excavate d areas generall yslop e away t y from th e house ? 2.Ha s so d bee n lai d in al l area s tha t wer e excavated ? y 3.Doe s th e sod appea r to

be generall yhealth yan d growing ? (Onl yevaluat e ifinspecte d at a 30 da ytim e period ) 4.

Ar e sodde d areas generall yfir m an d evenl ygraded ? y 5.Ar e th e joint s h>etwee n th e so d strip s generall ytight ? (Onl yevaluat e ifinspecte d at a 30 da y tim e p)eriod ) 6. Wa s th e properr ygrade d suc h tha t wate rwil l not poo l on th e propert)' ' 7 Wa s damag e to landscapin g orplan t material s avoided' ' Gates , Fence s an dRetainin g Wall s Ye s Nc 1.

Do gate s ope nan dclos e freely? (Ifapplicable ) t-
­ 2.

Wer e all gate s or fence s talce ndowndurin g restoratio nactivitie s reinstalled ? (If applicable ) 3.

Wa s damag eto gate s or fence s avoided ? (Ifapplicable ) 4.Wa s damag e to retainin g wall s avoided ? (Ifapplicable ) / ^ Foundation , SidiD g an d Gutter s Ye s No 1.

Wa s damag e to th e sidin g ortri m avoided ? £- ' 2Wa s damag e to th e foundatio n avoided ? i ^ 3.Wa s damag e to window s avoided ? 1 - ^ 4.

Wa s damag e to window sordoo rscreen s avoided ? 5.Wa s damag e to downspout sordownspou t extension s avoided ? Sidewalk s an dDriveway s (Concrete ) Ye s No 1.Wa s damag e to driveway surface s avoided ? 

### y 2.Wa s damag eto walkwa y surface s avoided ?

## Owo«?rs comments :

Inspectio nnotes :

So d^ ^ Su.A«vc i Q.reji s ^C-S > ^KiHpcc^ 4 bnD(JncAX
. ^/<^JL | 

## Grt^ s V U 

# CD(l\ i |\JWJ L 

## U^-l c

# rc f M-Oxi fiV " ^ ' 

# c i

Removal an drestoralio naclivale s complete includin g th e 30-da y so dwarranty : EP ARQprestnmw^yy^^ ^ 

# Dale;_^A^-^
_

## Propert yCompletio n Agreemen t Thi s agreemen t document s the completionof remedia l activitie s performedo nm y property . My signature wil l designai e tha t I a msatisfie dwit hth e restoratio no f m y property , an dtha t no item s ar e i nquestions , now , or a

t any tim e i nth e future , except thos e item s liste dbelow , ifany
. Propert y ID : ^ J SS ^ Propert y Address : \'- f IQ ^ 7 ^ '}H f f Owner : 

# H
. y ^ r 

# M e^ Y JL-V

­ '- ^ 

### Phone : 7A<! PFjO Q Restoratio n Item s i n Question :

Item : 

# X g



# .^^ ^ 4-c
. yetv^cj^r^ * J hufV<s.' > " h (3 1 VJ ^ v'^V^^ vfirrv V g.»-v 5 Item : 

### S^^ci e ^r «r\s; e V c\, ^ ^ \< a»VO
. I - < v \ «- I Item : Item : Item : Item :
Additiona l Comments :



## ^i^-* ! (s^f{j((b f^yjo y

I A J I agre e restoratio ni s completed , excep t a s note d I I d o no t aure e restoratio ni s complete d I