### TRANSMITTA Lo f OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R
SAID# : ^>H1 ^ Date : l l jl o ((^ ^ Address : t4^ ^ \\H < m. Remediatio nContractor : Coasta l Environmenta l Group

_Year : ^Si69r '
SOI LREMEDIATIO N PROPERT YFIL EFOLDE RDOCUMENT S Vide o o f property (DVD ) Executiv e Summar y EPA-provide dproperty sketc h 0 Signe dAcces s Agreement for subjec t property vtflft ' Signe dAcces s Agreement(s ) for adjacent property iZ

lRestorationAgreemen t

- a• Settlemen t documents (i.e. , fo r

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o replac e plants , etc. ) "C

T Confinnationdat a 0 Photograph s • / As-buil t sketc h Q' Satisfactor y restorationsigne dby Propert y Owne r E

f Property close-ou t chec k lis t signe db y EP A 0 Descriptio no f area s not meetin g RO D cleanup criteri a 0 Utility clearance s 0 Property informatio nfro mDougla s Count y Assessor' s Offic e D D

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D Ciirdc n Sdoiplio g (i fapplicable ) D Ulilii yClearanc e JSTVideo/Photo s (Before ) D Video/Phoio s (During ) D VIdeo/Phoio s (After ) D Viileo/Photo i (30-Djiy ) D Propert yComplelio n A|;recmcn i D Fin* ! Repor t 1 Sent ­ / / Signed:U_/Zk/C2 3 

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## CONTACTFOR M Propert y I D U(/^^M^ Q Propert y Address : 

## 1,M-) M rs ^

M'Sq y Initia l Contact : Dale : Time : SecondContact : Date ; Time : Fina l Contact : Dale : Time : Fina l Action : Transmit t

o EP AD

Comment : Owner Comment (s) : Site Coordinator Commen t (s) : *



## Action : Aciion : Aciion ; Other Action ; D

### ojjBpi a 

### ^ Dougla s County Accoun t Ioj[Bpiatio n Pag e 1 of 2 • Dougla s County , Nebrask a Propert yRecor d - R081136000 0 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-S O ft wes t o f52n d S t - ViewO H Ma p Informatio n i s vali d a s o f2009-5-1 2 Treasurer' s Ta xRepoi t Ne wFeatur e -•-•- » Aut o Sale s Searc h Owne r ANDERSO N KENNET H L ETA L 242 4 N 4 5 AV E OMAH AN E 68104-000 0 Propert yInformatio n Ke yNumber : 113 6 000 0 0 8 Accoun t Type : Residentia l Parce l Number : 081136000 0 Parce l Address : Lega l Description : 242 4 N 4 5 AV OMAH AN E 68104-000 0 CLAIRIVtON TLO T1 4 BLOC K3 5 0 X 12 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 $55,600.0 0 $55,600.0 0 $55,600.0 0 $55,600.0 0 $53,400.0 0 $48,500.0 0 Tota l $62,000.0 0 $62,000.0 0 $62,000.0 0 $62,000.0 0 $59,800.0 0 $54,900.0 0 Lan d Informatio n Acre s 

### 0.1 4 S F 6250. 0 Unit s 

### 1. 0 Dept h 

### 125. 0 Widt h 5 0. 0 Vacan t N o Improvement Informatio n Buildin g 1



### http://douglasne.mapping-online.com/DougIasCoNe/static/accountinfo.jsp?accountno=R081.
. . 6/7/200 9

### dnm s 

### ^ Dougla s County Accoun t IijjMmatio n Pag e 2 of 2 

# t

MMNISA V

M B "I P FIntFtoo r SaoondFtoo r «82.0Bq.«
. <720< q I IO O I
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CLIC KT O ENLARG E IMAG E CLIC KT O ENLARG E IMAG E Squar e Footage : 1354. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 2 1/ 2 Stor yUnfi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 6. 0 Exterior : Fram e Viny l Units : 1. 0 Interior : Drywal i Baths : 1. 0 Roo fCover : Compositio n Shiingl e Bedrooms : 3. 0

Roo fType : Hi p Stories : 2. 0 Floorcover : Allowanc e Foundation : Btocl < Sprinkle rSquar e Footage : 0. 0 Yea r Percen t Adjuste d Yea r Yea rBuil t Physica l Ag e Remodele d Remodele d Buil t 191 4 0 % 191 4 9 5 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Basemen t Bsmn t Blocl < 8 f t 672. 0 Fixture Bas e Fixture s 1. 0 Fixture Batt i Ful l 1. 0 Garag e Detaclie d 576. 0 Porct i Sta b RoofCei l 192. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R081.
.. 6/7/200 9

## Page 1 of 1

•» •

" > [ Creat e Anothe rTicke t ] } Bac k t o Irtt i Interne t | Sen d Emai l |

YOU RTICKE TNUMBE RI S 2326026
. Origina l Cal l Date : 7/24/0 9 Time : 5:4 8 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 7/28/0 9 Time : 6:1 5 p m State : N E County : DOUGLA S Place : OMAH A Address : 242 4 Street : N4STH AVE Twp : 15 NRng : 13 E Sect-Qtr : 08-S W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Wor)c : lead remediatio n Locatio n o f Wor)c : INCLUD E AL L EASEMENT S LOCAT E ENTIR E PROPERTY Remarlcs : FA X AL L CLEAR S TO : (877)662-421 1 : UNSUR E O F CORNE R LOT . Compan y: COASTA L ENVIRONMENTA L SERVIC E Contac t Name : ELIZABETH Phone : (877)662-421 0 Wor k Being Don e For : coasta l Dept ho f Excavation : 4f t Corne r Lot : N Front : Y Rear : Involve s Tunneling o r Horizonta l Boring : N Explosives : N CXCAT V

MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C
Servic e Are a Contac t Phone Number Utilit y Typ e
CXCAT V CO XCOMMUNICATIONS
. IN C HEIDI Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7
MUDO l METROPOLITA NUTILITIES DISTRIC TSAND Y Day : 402504782 3

Alt :

Emerg : 402504797 0

OMAHACO FCITYO FOMAHA-TRAFFIC,SEWE R RO N Day : 402444719 7

Alt : 402444516 1 Emerg : 402444516 0

OPPDGPR 5 OMAH APUBLI C POWE RDISTRIC TNA 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



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. 7/24/2009

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. IT R TJ > RYASCPXA-6349 9 F1 / 2 «= ) o m Date : 'JNIcA RYBSCPXA-6349 9 RYOCOPXA-6340 9 RYDSCPXA-6349 9 RDZSCPXA-634 » RO200PXA-634B 0 RPZBOPXA-6340 0 F2 B4

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COASTA L

" 1 PRO'*' ' cI 0 u rIN C 

## Consen t fo rAcces s To 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 rits 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 : K^»,*«,H v ^•^cleft'^NO i

Addres s o fPropert y 

# aMl H^ l\c, ^ A ^ 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 its origina l condition
. Thi s wor k i s bein g performe d unde rth e Omah a Lea d Superfun d Sit e remediatio n program . Arepresentativ e o fCoasta l Environmenta l Group , contracte d byUSEPA , wil l contac t th e Granto rin-perso n t o discus s th e wor k t o b e performed , th e Granto rwil l hav e a n opportunit yt o revie wan d approv e th e planne d soi l removal , an d restoratio n wor k befor e i t begins
. Onc e th e wor k i s finished , th e Granto rwil l b e aske d t o revie wth e wor k an d confir m tha t i t i s complet e an d meet s wit h th e Grantor' s approval
. Upo n completion , th e Granto rwil l receiv e writte n documentatio n fro m EPAtha t th e propert y ha s bee n remediated
.
ENVIRONMENTA LRESPONS E ACTION S 

### Bysignin 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 , at 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 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

### %
/// •^ ^
COASTA L C H O U rIN C " I PRO-"*' ' 

### 9 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 maywis h t o save ; e 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 byEPA ; e Abid e byhealt h an d safet yguidanc e provide d byEPA , cI 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 , at (402 ) 991-119 9

M4..gran t access t o m ypropertie s D I d o not gran t acces s t o m ypropertie s


# /^....^:&^^^^A^
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Signatur e Dat e Signatur e Dat e

D 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 f2^ COAST A iNvmoMnrMf l 

## Restoratio n Agreemen t Th e purpos e ofthi s agreemen t i s t o provid e amutua l agreemen t as t o conditions ofth e propert y prio r t

o remediationactivities
. Thi s wil l als o serve as documentatio nfo r

the purpose of assurin g tha t restoratio n activitie s ar e complete dt o the satisfactiono f

the propert y owne r an dth e Unite dState s Environmenta l ProtectionAgenc y (EPA)
. Propert y ID : ^^ty^ ^ Propert yAddress ; 2M2 M < J MS"* ^ >^tie
. 

### O^"- ^ K^An^t UAfsJicrio n PhoDef^Q/^^^^3

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nthe attache ddiagram(s) indicat e area(s ) t o excavate , surfac e structure s an dlandscapin g features an d acces s location(s ) t o b e use db y the contractors . Indicat e distances , depths , materia l types , etc . Photographicall y an dVideographlcall y documen t th e existin g conditions ofthe propert y an dthe basemen t i

f necessary . Item s to b e Remove d b yth e Owne rbefor e Star t o fRemediation : Th e removal , storage , disposal , and/o rretur n o fthes e item s i s th e Owner' s responsibility
.



## r\*^h ^ ^«A~MjV pAe^'^^' S Item : Item : Hem :



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# '^••4. A VbO ttem:
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## Ite m Pre-existin g property area , that wil l b e excavated , that i s covere dwit hgrass . Number o f tree s > 2 inc h mink diameter Number o f tree s < = 2 inch trunk diameter Number o f Sprinkler Zones , Contro l Valves , Timers , Heads , etc . Attachasketcho l the sprinkler lavoui
. Number o f andsiz e o f eachgarden / flowe r be d area . Aiiac hasketchof relaiiv c size s an dlocations
. Agree dupo nvalu e o f plant material s no t t o b e replace db v contractor . Not e till s Naliic will h t usedl o issue H plun i \oiielie r l o th e propcrt > owner . Easement Area , to b e excavate d 

## Quantit y 

# h i 0 2 

# 0 ' 

# 0 

# f

^

^ 

# v ^ Landscap e Inventory Uni t Quadrant s

Each
Each

Each

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## Condition/Type/Specie s



# ?e*. WU^ u \\ 6
Pag e 2 of
.k-
. C O AS-I AI

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### I Addttiona l Comments / Instructions : 

# \J\c \^^tJ^c^'^^v ^ ISL/sVe s m\rc>v^ r C^ W p o Z~ ^ ^o.v/1 ^ te^-fore

- ej£<:avo+iov \

Q Chec k th e box ifOwne rdoe s no t wan t GE G to documen t interio rfoundatio n wall s an d possibl e pre-existin g damage
. Bycheckin g thi s boxGE G is not responsibl e fo ran ydamag e don e to th e interio r ofhouse , includin g foundatio n crack sorfissures
.

H j agre e Q I do no t agre e

Owner' Owner' s s Signatur

Signatur e e Dat Date e Contrauor' Contrauor' s s Signatur

Signatur e e Date ' 

### Pag e 3 of ,

### Account: 

### 240445-1 155340 K L. ANDERSON 

# b3L\W Service address: 2424 N 45TH AVE Call 

### 554.7777 if 

### you smell gas. No charge to check gas leaks. Have heating system checked every year by a qualified heating contractor. Keep chimneys and flues free of debris.

Your Gas Use 

# I 

# . I
Rs113MYonths 

## 1. 

## I R.112Yonth.

- 

## I I 

## I Th~s Month Last Year Bllllna units 16 18 Use per day 05 0 6 Average cost per day $0 76 $1 13 Number of days in brlllng cycle 31

. 29 1723 Harney St. Omaha, NE 68102 a 402 554 6666 e-mall cuslomer~servoe@mudomaha corn website w mudomaha com 

## METROPOLITAN UTILITIES DISTRICT



### Live 

### Green. Think Blut Billing date Sep 23,2009 Previous balance $112.00 Payment reoeived -Thank you 112.00 CR Current charges 112.00 New balance 112.00 

## b 

## Total 

## due Oct 8,2009 $1 12.00 Your budget payment of S112.W la due Oot 8.20W Budget varlancee.

Current= -(50.36 Tots1 = -$I65 77
Detaik. of current chalges 

### GAS RESIDENTIAL RATE A: Aug 17 to 

### Sep 17

Meter Number 288559 Current read (actual): 2633 

## - Previous read (actual): 2617 

# - 16 CCF Gas Use: 16 

### CCF x 1.021 (heat value) 

### = 16.336 therms

16 days 8.431 therms at 0.4632 = $3.91 15 days 7.905therms at 0.5283 

# - 4.18 Sewice Charge 12.00 Gas Cost b $20.09 Gas Inhastructure Replacement 3.00

10
0 osl Nw Deo Jan Feb Ma epl May Jun Jd Aw Ssp Your Water Use
This Month Last Year Billma unlts: 14 15 Use per day Average cost per day. Number of days in Liling cycle: 0.5 $0.79 30 0.5 $0.83 29 

### WATER RESIDENTIAL 

### RATE W-1: Aug 17 

### to 

## Sep 16 Meter Number 93160402 Size: 518 -inch Current read (actual): 1593 

## - Previous read (actual): 1579 

# - 14 CCF

Water Use: 14.000 CCF or 10,472 gallons 9.000 CCF at 0.9614 

# - $8.65 5.000 CCF at 1.3451 = 6.73 Servioe Charge 4.86 Water Cost 

### b $20.24 Water Infrastructure Replacement 2.00 Budget Payment Plan Interest 0.09 CR City of Omaha Sewer 1236 Sales Tax 4.04 ) Current Charges $61.64

### Oat e Project XRF[D #

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# Prin t iil;Q^ih)HntoOPr>^ ^

# 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 240 9 Mod e SOI L Tim e 2009-07-3 1 10:3 7 Duratio n 122.3 8 Sequenc e Fina l Flag s ! AVERAG E Av g o f2405-2408 ] ADDRES S 242 4 N 4 5 av e QUAD/ZON E B 2 INSPECTO R Nicola s DEPT H 4 SAMPL E TYP E CLEARANC E NOT E

pp m Erro r Pf e f227.81 5 ± 18.90 9 Supervise d B y 

## 2jp(l/!LJl^iJ{ ^

# 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 219.18 5 Supervise d By : 

## Certificat e o fVerificatio n

240 5 SOIL 2009-07-3 1 10:3 4 30.6 2 Fina l 6349 9 242 4 N 4 5 av e 8 2 Nicola s 4 CLEARANC E

± Erro r ± 18.29 3

# 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 247.85 3 Supervise d By : 

## Certificat e o fVerificatio n

240 6 SOI L 2009-07-3 1 10:3 5 30.6 4 Fina l 6349 9 242 4 N 4 5 av e B 2 Nicola s 4 CLEARANC E

± Erro r
± 20.29 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 253.80 0 Supervise d By : 

## Certificat e o fVerificatio n

240 7 SOI L 2009-07-3 1 10:3 6 30.5 3 Fina l 6349 9 242 4 N 4 5 av e B 2 Nicola s 4 CLEARANC E

± Erro r ± 19.61 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 BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 190.42 2 Supervise d By : 

## Certificat e o fVerificatio n

240 8 SOI L 2009-07-3 1 10:3 7 30.5 9 Fina l 6349 9 242 4 N 4 5 av e B 2 Nicola s 4 CLEARANC E

± Erro r
± 17.42 4

# 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 241 4 Mod e SOI L Tim e 2009-07-3 1 10:4 5 Duratio n 121.0 3 Sequenc e Fina l Flag s AVERAG E Av g o f2410-2413 ' ADDRES S 242 4 N 4 5 av e QUAD/ZON E easemen t INSPECTO R Nicola s DEPT H 1 SAMPL E TYP E CLEARANC E NOT E

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## By : ^M9.P.iiJ: ^

# 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 205.28 4 Supervise d By : 

## Certificat e o fVerificatio n

241 0 SOI L 2009-07-3 1 10:3 8 30.3 2 Fina l 6349 9 242 4 N 4 5 av e easemen t Nicola s 1 CLEARANC E

± Erro r ± 17.42 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 204.34 1 Supervise d By : 

## Certificat e o fVerificatio n

241 1 SOI L 2009-07-3 1 10:4 4 30.3 0 Fina l 6349 9 242 4 N 4 5 av e easemen t Nicola s 1 CLEARANC E

± Erro r 17.73 3

# 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 190.45 9 Supervise d By : 

## Certificat e o fVerificatio n

241 2 SOIL 2009-07-3 1 10:4 4 30.2 2 Fina l 6349 9 242 4 N 4 5 av e easemen t Nicola s 1 CLEARANC E

± Erro r ± 17.11 4

# 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 172.32 8 Supervise d By : 

## Certificat e o fVerificatio n

241 3 SOI L 2009-07-3 1 10:4 5 30.1 9 Fina l 6349 9 242 4 N 4 5 av e easemen t Nicola s 1 CLEARANC E

± Erro r
± 16.29 0

# 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 Readm g N o 243 0 Mod e SOI L Tim e 2009-07-3 1 14:0 8 Duratio n 121.1 9 Sequenc e Fina l Flag s . AVERAG E Av g o f2426-242 9 ADDRES S 242 4 N 4 5 av e 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 91.28 6 12.44 5 Supervise d By : ^C6I^^J{IQ/ \

# 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 103.16 7 Supervise d By : 

## Certificat e o fVerificatio n

242 6 SOI L 2009-07-3 1 14:0 6 30.1 8 Fina l 6349 9 242 4 N 4 5 av e D Z Nicola s 1 2 CLEARANC E

± Erro r
± 13.07 0

# 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 78.27 9 Supervise d By : 

## Certificat e o fVerificatio n

242 7 SOIL 2009-07-3 1 14:0 7 30.5 7 Fina l 6349 9 242 4 N 4 5 av e D Z Nicola s 1 2 CLEARANC E

± Erro r ± 11.69 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 81.49 5 Supervise d By : 

## Certificat e o fVerificatio n

242 8 SOI L 2009-07-3 1 14:0 7 30.2 1 Fina l 6349 9 242 4 N 4 5 av e D Z Nicola s 1 2 CLEARANC E

± Erro r ± 11.88 0

# 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 102.20 2 Supervise d By : 

## Certificat e o fVerificatio n

242 9 SOIL 2009-07-3 1 14:0 8 30.2 3 Fina l 6349 9 242 4 N 4 5 av e D Z Nicola s 1 2 CLEARANC E

± Erro r ± 13.13 2X 

# m
/IfiL'- o Omah a Lea d Site—Fixe d Pric e EP-R7-07.0 5 o J^^^ l I Coasta l Environmenta l Grou p Inc
. ^^^^Tp * www.coastalhazmat.co m

VpRoit' ' COASTA L INVIItONHtHTA L CROU P IN C 

# EXECUTIV ESUMMARY : BVID #6349 9 - (2424 N4 5 AVE) No Issue s o r Concern s | ^ Issues/Concern s Detail Explanation : •Property owne r ha s conce mabou t th e so dandlack o f watering
. Coastal i s to chec k it agai nin th e Spring
.

# ^s^EP A EP APropert y Clos e Ou t For m Propert y Addr«,:

- 747 M S J ^?>,fW^ ^ Propert y «:_k5!ia3 ^ Date/Time : Contracto rGrou p foaa^<i\ \ FnVinrfAgAT ^ J Quad s Excavalfd : Y\ \j ^ 2 Ye s N o Eicavatio D Genera l IIfnecessary , wer e (h e correc t quadrant(s ) excavate dan drestored ? 2 If necessary , wer e th e conec t area s o f dn p ?.on e excavate dan drestored' ' Yes Nt ) IDoe s th e gradin g aroun dth e perimete r o f tti e hous e inexcavate darea s generall y slop e away Gradin g So dan dVegetatio n 

### L / ' fromtb e house ? ^___
_ 2
. Ha s so dbee nlai di nal l area s tha t wer e excavated ? 3 Doe s th e so dappea r to b e generall y health y an dgrowing ? (Onl y evaluat e i f inspecte da t a3 0 i ^ da y tim e period ) C ^ " AAr e sodde darea s generall y fu ^ an devenl y graded ? 5 Ar e th e joint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat e i f inspecte da t a3 0 day tim e period ) 6
. Wa s th e propert y grade dsuc htha t wate r wil l no l poo l o nth e propeny' ' 

## c y 7 Wa s damag e t o landscapin g o r plant material s avoided ? Cates
. Fence s an dRctaipln t Wal b Ve s No ID o gate s ope nan dclos e freely* ' (I f applicable ) 2 Wer e al l gate s o r fence s take ndow ndunn g restoratio nactivitie s reinstalled' ' (Ifapplicablc ) 3 Wa s damag e t o gate s o r fence s avoided ? (I f applicable ) ^ ^ 4
. Wa s damag e t o retainin g wall s avoided ? (I f applicable ) Foupdaiton , Sidin g an dGuHer t Ye s No I
. Wa s damag e t o th e sidin g o r tri mavoided ? 2
. Wa s damag e t o th e foujidatio navoided ? 3
. Wa s damag e t o window s avoided' ' 4 Wa s damag e t o window s or doo r screen s avoided ? 5
. Wa s damag e t o downspout s o r downspou t extension s avoided' ' Sidewalk s an d Driveway s (Concrete ) Ve s No , IWa s damag e l o drivewa y surface s avoided ? 2 Wa s damag e t o walkwa y surface s avoided ? ^ " ^

## Ownen ; comments :

Inspectio nnotes :

Remova l an dreslorationiiclivale s complel e including th e 30-da y sodvvananry : EP ARepresenlaiiv e r^(y>\ l^Cr>,bal l Da,e : W^ ^

### Propert yCompletio n Agreemen t
I hi s a|iieemen i documenls
. th e complelio n o t remedia l acliviiie s perloimc d o n m ypioperl yM yMgnalm e wil l designat e ilia l 1 a m satisfie d wit h th e restoratio n o fm yproperty , an d tha i n o ileiti s ar e m question s now . o ra l an yum e m lh e future , excep t thos e iiem s liste d below , i fan y

Propert y tP : (^7^»^<^Ci Propert yAddre.ss : ^U ^ «- | j J 4 ^ 4\/ ^ Owner : jf^^^^ic W^.J^u-^iy ^ 

### Phon o fHa:n-^^„3-:-.^iH4 ~ ( H^n^^3 > •SlM* ^ Restoratio n Item s i n Question :

Item : 

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Owner' s Sicn;inn rDal e Inn u artn i ' s Signatur e