### TRANSMiTTA L o f OMAH ALEA D SIT E SOI L REMEDIATIO N FIL E FOLDE R SAID # 

# l^g)q g DATE : 

# 5/21/1 1 ADRESS : i^l( 0 % I' D 'b ^ REMEDIATIO N CONTRACTOR : COASTA L ENVIRONMENTA L GROU P Contract : EP-R7-09-0 6

SOI L REMEDIATIO N PROPERT YFIL E FOLDE R DOCUMENTS \ B Executiv e Summar y a . EPA-provide d propert ysketc h H Signe d Acces s Agreemen t fo rsubjec t propert y hij ^

Signe d Acces s Agreemen t (s ) fo radjacen t propert y Y i Restoratio n Agreemen t IVO " Settlemen t document s (i.e. , fo rdamag e o rt o replac e plants , etc. ) Confirmatio n dat a BNfhotograph s SO D Pre-Excavatio n Excavatio n As-Buil t sketc h Satisfactor yrestoratio n signe d b yPropert yOwne r Propert yclose-ou t chec k lis t signe d b yEP A Descriptio n o f area s o f area s no t meetin g RO D cleanu p criteri a Utilit yclearance s Propert yInformatio n fro m Dougla s Count yAssessor' s Offic e D 

## 5/ v Signature - EP AX? " Dat e Superfun d

# v\ Propert yAcces s Checklis t Propert y ID : nWOR K STARTE D ON : __/__ / 

# mw Propert y Address : nWOR K COMPELTED ON : / / 

## • Ify/ o 

# 57t) S^^^^-r Owner : Renter : 

# • 39^ ^ 7^7y2JU ^ Address : Phone : Fax : Cell/Pager : Phone : Additional Information : 

## g)M^ - 7<ap ^ Fax : Cell/Pager :

nNotificatio nLette r Sent : / / By : CS^Acces s Agreement 

## Signed : J^/fl_/i£ ) By : |7 t Restoratio nAgreement 

### Signed : f^ l( ^ If O By : LUTopsoi l Samplin g (if applicable ) 1 1 By : Q Disposa l Samplin g (if applicable ) 1 1 By : D Garde nSamplin g (if applicable ) 1 1 By : D UtiUt y Clearanc e CaUed : / / By : D Video/Photo s (Before) On : / / By : nVideo/Photo s (During ) On : / / By : D Video/Photo s (After) On : / / By : D Video/Photo s (30-Day ) On : / / By : r~l Propert y Completio nAgreement Siened : / / By : D Final Report Issued : / / By : Ai r Monitorin g (a s applicable ) Q Communit y QCre w On : 

### / / By : 1 Results :

• Conmiunit y O Cre w On : / / By : Results :

• Conmiunit y O Cre w On : 

### / / 

### |By : 1 Results :
Omah a Lea d Sit e

### Dougla s Count y Accoun t Infi^natio n Pag e 1 of 2 Dougla s County , Nebrask a Propert yRecor d Informatio n i s vali d a s o f 2010-8-1 6 ­ R221993000 0
Ne wFeatur e " ^ * ^ - ^ Prin t Repor t Vie wInteractiv e GI S Ma o

Treasurer' s Ta xReoor t Subdivisio n Sale s Searc h Owne r MLAD YJOH N B ETA L 150 6 S 2 5 S T OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumtier : 199 3 000 0 2 2 Accoun t Type : Residentia l Parce l Numtier : 221993000 0 Parce l Address : Lega l Description : 151 0 S 2 5 S T OMAH AN E 68105-000 0 SHULL S 2N D AD D LO T3 BLOC K1 4 5 0 X 12 6 Valu e Informatio n 201 0 200 9 200 8 200 7 200 6 200 5 Lan d $2,200.0 0 $2,200.0 0 $2,200.0 0 $2,200.0 0 $2,200.0 0 $2,200.0 0 Improvemen t $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 Tota l $2,200.0 0 $2,200.0 0 $2,200.0 0 $2,200.0 0 $2,200.0 0 $2,200.0 0 Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 4 6300. 0 0. 0 126. 0 50. 0 Ye s



### http://douglasne.mapping-online.coni/DouglasCoNe/static/accountinfo.jsp?accoimtno=R22. . . 8/20/201 03/31/201 1 www.dhon.org/irthinternet/DHONNotic.
. Creat e Anothe rTicke t t^ l Sen d Emai l Bac k toirt h Intemet


### YOU RTICKE T NUMBE RI S 2700324 . Origina l Cal l Date : 3/31/1 1 Time : 3:3 5 pm Op : ALFONSO1879 0 Wor k t o Begi n Date : 4/04/1 1 Time : 4:0 0 p m State : NE County : DOUGLA S Place : OMAHA Address : 151 0 Street : S 25T H S T Twp : 15 NRng : 13 E Sect-Qtr : 28-N E Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : Lea d Remediatio n Locatio n o f Work : LOCAT E ENTIR E PROPERTY , AL L EASEMENT S AN D T O TH E PEDESTA L Remarks : FA X AL L CLEAR S TO : (402)934-281 1 : PLEAS E INCLUD E AL L EASEMENT S Company; COASTA L ENVIRONMENTA L SERVIC E Contac t Name : ALFONS O Phone ; :402)934-283 7 Wor k Bein g Don e For : Coasta l Dept h o f Excavation : 4f t Corne r Lot : NFront : Y Rear ; Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N CXCATV LEVEL 3 MUD0 2 OMAHACO F 0PPDGPR 6 QLNNEI F 

### UtiUt y Servic e Are a Contac t Phon e Numbe r Typ e Day : 402934046 9 CXCATV CO X COMMUNICATIONS , IN C HEIDI Alt : 402934046 9 Emerg : 402932975 7 Day : 877366834 4 LEVEL3 COMMUNICATIONS , LEVEL S N A AH: LL C Emerg : 877366834 4 Day : 402504782 3 

### METROPOLITA NUTILITIES MUD0 2 SAND Y Alt : 

### DISTRIC T Emerg : 402504797 0 Day : 402444719 7 

### CITY O FOMAHA
- OMAHACO F RICHAIRAFFIC Alt : 402444516 1 TRAFFIC,SEWER Emerg : 402444516 0 dhon.org/irthinternet/. ../MessageText.as.
. 1/ 23/31/201 1 

### 0PPDGPR 6 LWWw.dhon.org/irthinternet/DHONNotic.
. 

### OMAHA PUBLIC POWER DISTRIC T EL M LOCATIN G Day : 406728934 3 Alt : 4062071494 Emerg : 888728934 3 

### QLNNE l FQWES T LOCALNETWORK EL M LOCATIN G Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3

dhon.org/irthinternet/. ../MessageText.as.
. 2/ 203/31/1 1 02:4 2 P M 512-328-3933 , Leve l Thre e Communicatio n 01/0 1

To : COASTA L ENVIRONMENTA L SERVIC E Attn : ALFONS O Voice : 402934283 7 Fax : 402934281 1 Re : Respons e t o Di g Reques t Thi s i s a n Iti^oxtan t Messag e fro mLeve l 3 Cononunication s replyin g t o you r reques t t o locat e ou r undergroun d facilitie s i n th e are a describe d o n th e On e Cal l Cente r ticket . 

# /let s
Ticket : 270032 4 County : DOUGLA S Place : OMAH A Address : 151 0 S 2ST H S T t LEVEL3 : Leve l 3 Cononunication s ha s determine d ou r facilitie s ar e clea r o f th e di g sit e describe d b yyou r On e Cal l Cente r ticket . Leve l 3 Communication s wil l no t hav e t o locat e an yundergroun d utilitie s a t thi s di g site . I f yo u hav e an y questions , pleas e contac t Leve l 3 Communication s a t 1-800-441-0223 .
Ticket : 270032 S County : DOUGLA S Place : OMAH A Address : 2€2 €PARKE R S T LEVEL3 : Leve l 3 Communication s ha s determine d ou r facilitie s ar e clea r o f th e di g sit e describe d b yyou r On e Cal l Cente r ticket . Leve l 3 Communication s wil l no t hav e t o locat e an yundergroun d utilitie s a t thi s di g site . I f yo u hav e an y questions , pleas e contac t Leve l 3 Communication s a t 1-800-441-0223 .

I f yo u hav e an yquestions , pleas e contac t Leve l 3' s Asse t Managemen t Tea ma t 1-800-441-0223 .

# As-Buil t Drawin g OLS:1984 8 

## COASTA L DAT E EXCAVATED:4/13/201 1 DAT E USEP ASIGNE D OFF : 5/2/201 1 

# Omah aLea dSuperfun dSite ARE ASODDED : 157 5 Environmenta l Group , Inc . 1984 8 Exterio rPain t Nort h Arro w Omah a Lea d Sit e n Goo d Own» rname : JOH N B MLAD YS R Sit e Sketc h Address : 1S1 0 S 2 5 S T • Poo r

Phona : H 402-345-79O 9 W : Q ' No l pain l Lea d Sampl e Sample s Collecte d Sar-Tipl « Numbe r L A B Concentratio n Collecte d Fir m rrg 5 A></rvi-? ) RYASCPXA-1984 8 F 1 l3Lf pp m 0 " D Dat a 0<f. / I'i/O b RYBSCPXA-1984 8 F 2 ^Be > pp m E T 

## • Tim e i'oi > RYCSCPXA-1984 8 B l _Lilii___PP m Sample s Analyze d RYDSCPXA-1984 8 8 2 lOlf pp m 0 

## • nDaOGPX A1084 8 p p m 

## n 

## • X R F Unit : Book : tS D nGZ€3CPX A1084 8 -6 £ p p m 

## n n Dat e nPgOCPKA- l 004 0 - P Z p p m D 

## n Tim e ^ 

### K . Staff ; <^-s. w Numbe ro f Sample s = t ^ 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

CONCRET E DRI P ZON E EXCAVATE D QUADRANT S EXCAVATE D
ARE AREPLACE D WIT H ARE ALEF TBAR E ARE AREPLACE D WIT H SO D ROCK/MULC H 

### CONTRAC T# : EP-R7-09-0 6 COASTA L ENVIRONMENTA L GROUP , INC
.

## 1984 8

# m 1984 8 Exterio rPaint Nort h Arro w 

### Omah a Lea d Sit e Owne rName : jpHN_ B MLADY^ R • Goo d 

### Sit e Sketc h Address : 151 0 S 25 S T • Poo r P hone : jl l 402-345:790 9 W \ ^

No t pain t Lea d Sampl e Sample s Collecte d Sampl e Numtie r LA B Concentratio n Collecte d Firm : tJ^ S At^/yvt- ^ RYASCPXA-1984 8 F 1 

## JAU . .pp m 

## E f D Date : RYBSCPXA-1984 8 F 2 

## itSa
. .pp m 

## D Time : [•oi > RYCSCPXA-1984 8 B 1 

## 0 ­ JJlii__pp m D Sample s Analyze d RYDSCPXA-1984 8 8 2 

## 0 26l f pp m RDgCCPX A1081 8 B Z pp m 

## D 

# n XR F Unit : (b^^ ^

Book : 15 0 RCZGCPX A1081 8 G Z 

## D D pp m Dat e 

## 2>H'0 L RPgOCPXA1004 0 PZ pp m 

## D D D Tim e 

# K . I 1 Staff : fA^ W Numbe ro f Sample s = i ^ 

### n Legend : F 1 = Fron t Left , F2 = 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 Al l quadrant s ar e a s viewe d fro m th e street , facin g propert y 4 r- t ^ : : : 1^ -

Re v4 ' 046141012 3

# Ilill l 1984 8 Owne rName : JJ?HN. B MLADY_SR
_ Address : 151 0 S 2 5 S T

Phone : H : 402-345-790 9 W : Sampl e Numbe r RYASCPXA-1984 8 RYBSCPXA-1984 8 RYCSCPXA-1984 8 RYDSCPXA-1984 8 nDZCCPX A1081 8 RGZCCPX A1081 8 RPZOCPXA1004 0 Lea d Concentratio n F l 

# -au . F 2 

## U£ ^ B 1 

## lilH . B2 

### 72Mk
­ 9 2 G Z P Z 

### Omah a Lea d Sit e Sit e Sketc h Sampl e LA B Collecte d pp m 

## E f D pp m 

## 0 ^ D pp m 

## 0 - D pp m 

## 0 

# n pp m 

## D D pp m 

## D D pp m 

## D D Numbe ro f Sample s • Exterio rPaint Nort hArro w • Good • Poo r [3 ^ No t pain t Firm : Date : Time : Sample s Collecte d 

### g<f.//^/of e



## 1 o ^ Sample s Analyze d XR F Unit : 

### U> ^ Book : JSO
_ Dat e 

### 2>H' 0 UL
. Tim e ^ Staff : N\^ W Legend : F l = Fron t Left , F2 = Fron t Right , B l = Bac k Left , B2 = Bac k Righ t D Z = Dri p Zone
. G Z = Garden , PZ = Play Al l quadrant s are a s viewe d fro m th e street , facin g property 

### H tr- t : : ; : Tt ^ 

# ENTERE D m i 0 tm i

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. .s.* s .fi t


# O -f v $ • \...(^...:'.
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## .5. . a.^..6 *

Re v 4 04614)012 3COASTA l ^^ - thVIIONHlHTA l " 0 " C 1 0 U f L KC 

## Consen t fo f Acces s T o Propert y RIGH TO F ENTR YT O PREMISE S Granto r(th e propert yowner ) consent s t o an d authorize s th e Unite d State s Environmenta l Protectio n Agenc y(EPA ) o rit s authorize d representatives , collectivel y th e Grantee , t o ente ran d perfor m certai n environmenta l respons e activitie s upo n th e followin g describe d premises : 

# I

Owner' s Nam e Daytim e Phone : HCp-'^-^^- yy^c ^ 

## c_

3 /^ U
Addres s o f Propert 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 f lea d an d ma ypos e a healt h hazard
. Th e area(s ) wil l b e excavate d t o remov e contaminate d soil
. Th e remove d contaminate d soi l wil l b e replace d wit h clea n material s an d th e are a wil l b e restore d t o it s origina l condition
. Thi s wor k i s bein g performe d unde rth e Omah a Lea d Superfun d Sit e remediatio n program . Arepresentativ e o f Coasta 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 perfonmed , 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 f performin 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 f 2,*-«J''V , COASTA L lIlTIIONnFKTA t ^..0.^ ^ C ft O U V . IM C
« Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; e 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 ; « vyate 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 f th 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
. cAllo wvideotapin g and/o rphotographin g o f th 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 f th e wor k activities , o rwit h an y o f th 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 f sai d propert ywhic h woul d ten d t o endange rth e healt h o r welfar e o f th e Grantee s o rth e environment , o rt o allo wother s t o us e th e propert yi n suc h a manner . Shoul d yo u hav e an yquestion s abou t thi s program , pleas e contac t Coasta l Environmenta l Group , a t (402 ) 991-119 9



### BI^ B D I d o no t gran t acces s t o mypropertie s I gran t acces s t o mypropertie s 

## ic-i^'/ d Date Signatur e Date
Q I woul d lik e t o b e presen t durin g an yisamplln g tha t i s required
.

Page 2 o f 2

## COASTA L ENVIRONMENTA L GROUP
. INC
. 

# ADJACEN TPROPERT YACCES S REQUEST
WORKIN G PROPERT YADDRES S )S'77 ^ i" ^ 5 5 I ADJACEN TPROPERT YADDRES S / i 0 ^ S Z^7 > S ' OWNE R NAIVI E j g^ KV ^ J ^ \ ^ C 3 V ACCES S REQUESTED: U.^ e I^V rW coo.'^ reir^% ^ ffc ^ ^ ^ ,

OWNE R SIGNATURE V/OIM I 

### TiyTUZ n I "*" / f ~^ ^ FOREMA N SIGNATUR E SUPERVISO R INITIA L fe^^.^-

SUPERVISO R INITIA L cS^^^ ^COASTA L • MV I RONH I HTA L a H O U P
. INC
. 

## Restoratio n Agreemen t The purpos e of thi s agreemen t i s to provide amutua l agreemen t a s t o condition s of the propert y prior t o remediationactivities . Tlii s will als o serve as documentationfo r the purpos e of assuring tha t restoratio n activitie s ar e completedto the satisfactionof the propert y owne r an dth e UnitedState s Environmenta l ProtectionAgency (EPA) .

Propert y ID : jQ^^f ^ Propert y Address : /S'l O 3 . ':2S' r 7
- Owner : 

# ^.7^ ^ 

# t^\ U 

# r Phone : ^Qp---^HS'-/S't^ i O

nthe attacheddiagram(s ) indicat e area(s ) to excavate , surface structure s an dlandscapin g feature s an d acces s location(s ) to b e usedby the contractors , hidicat e distances , depths , materia l types , etc . Photographicall y an dVideographicall y documen t the existing condition s ofth e propert y an dthe basemen t i f necessary . 

### Item s t o b e Remove d b yth e Owne rbefor e Start o f Remediation : Th e removai , storage , disposal , and/o rretu m o f thes e item s i s th e Owner' s responsibility
. Kem : 

# yio ^ Hem : Hem : Item :


### Item s t o b e Remove d b yth e Contracto r Durin g Remediatio n an d No t Reolace d Hem : 

# yC-^^-^ ^ Kem : Kem : Kem :

Page l of
.COASTA L CNVIRONMCNTA L CROUP
. INC
. 

### Item s t o B e Remove d B yContracto rC lurin g Remediatio n an d Replace d Item : 

# 3 y Item : U y Item : 

## \ r< 7 v\c ^ Item : '



### Ite m Pre-existin g propert y area , that wil l b e excavated , that i s covere dwit hgrass . Numbe r o f tree s > 2 inc h trunk diamete r Numbe r o f tree s < = 2 inc h trunk 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 an dlocations . Agree dupo nvalu e o f plan t material s no t t o b e replace db v contractor . Not e thi s valu e wil l b e use dt o issu e aplan t vouche r t o th e propert y owner . o V \



### Quantit y 

# 'v X j s r 

# y y 

# y r ai\ \ 

# F ^
.
Landscap e Inventor y Uni t Condltion/Type/Specle s Quadrant s

Eac h Eac h

Eac h

Eac h Squar e Fee t

$

Easemen t Area , to b e Eac h excavate d 

# j . r^erUcn ^ /hycjA ^ Pag e 2 of
.COA S T A L KNVinONHC N TAL a n o u p , INC
.
Additiona l Comment s / Instructions : Th e cit yo f Omah a ordinance s ma yprohib Kyo u fro m usin g dir t o rgrave l area s o n you rpropert y a s driveway s o rvehicl e parkin g areas . Th e Environmenta l Protectio n Agenc y(EPA ) ma yb e removin g an d replacin g soi l underiyin g a grave l o rdir t are a o n you rpropert ytha t yo u ma yb e usin g a s a drivewa yo rvehicl e parkin g area . I f thi s i s th e case , yo u shoul d understan d tha t thi s removin g an d replacin g o f soi l doe s no t mea n tha t an yillega l drivewa yo rparkin g are a o n you r propert yi s mad e legal
. T o th e contrary , yo u ma yb e cite d b yth e cit yi f yo u us e a grave l o rdir t are a a s a drivewa yo rparkin g area , no t wKhstandin g an yremova l o rreplacemen t o f soi l b yth e EP A I f yo u hav e an yquestio n abou t legalit yo f a certai n drivewa yo rparkin g area , yo u ma ycontac t th e cKyo f Omaha' s Plannin g Departmen t a t (402 ) 444-5150
. O Pleas e chec k thi s bo xi f yo u understan d th e infonnatio n outline d above
. 

# 7^7-ri. ^ %\ir f no7- i cc ^ c^q^eee l P^- ^ f^-s M '^ ' 

# -p d c^ y i.o. A + u y^ o \y ^ VCTU 5 ttv\ci YKO \r& p y cea ^ po" T cu' T t \e
­ 

# 4^\jjo y ujii \^y7y^ y ^-7 7 ^y^^^ j y 2-y^
-

G Chec k th e bo xi f Owne 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
. B ycheckin g thi s bo xCE G i s no t responsibl e fo ran ydamag e don e t o th e interio ro f house , includin g foundatio n crack s o rfissures
. I agre e O I d o no t agre e

: ^ /t/-1'''' " ^.i^^rc^'- ^ iiyit'i77/ y ner' s Signatur e 7 Date Contractor' s Signatur e Date 

# 9?fZ£ /

u-i^-^ ^ j^^^^^^^^^T ^

^^^/// ^ 3 Pag e 3 of
.BVID # 

# \^m B XR F PROPERT YSAMPL E SHEE T Dat e Addres s Project Omah a Lea d ARR A Sampl e tim e XR F ID # ^^02^-2 ^ sampl e lengt h

Shot # Readin g Sampl e are a Shot # '&•} - 

# ^ U , \7 , y y



# g i \0 \

t - \ u Dept h 

# m hf^^lc p L P " Averag e 

## IP X 1 Ic^ Averag e

Shot # Readin g Sampl e are a Shot # 

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## y^y^-^i y 

# e/ v 

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## 0< & 2^S5'^Z- M \ " Averag e 

## .5D^ ^Z- \ Averag e Shot # Readin g Sampl e are a Shot # Dept h Averag e Averag e
RETES TAREA S Shot # Readin g Sampl e are a Shot # Dept h Averag e Averag e 

## \6f n k
. 7.. S ,^T
. am/p m 3 0 se c Readin g Sampl e are a Dept h

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Readin g Sampl e are a Dept h

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

### Certificat e o f Verificatio n XL3t-3902 2 

# J - Readin g N o 8 5 Mod e SOI L Tim e 2011-04
- Duratio n 94.5 0 Sequenc e Fina l Flag s AVERAG E Av g o f 82-8 4 ADDRES S 151 0 s 25t h s t QUADRAN T F2 DEPH T 6 " XR F TEC H N
. LOPE Z MIS C confirmatio n NOT E non e
pp m ±Erro r P b ±16.00 2 102.74 9 Supervise d By :

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

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVID i ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E
pp m 91.11 9 Supervise d By : 

### Certificat e o f Verificatio n

8 2 SOI L 2011-04-2 6 11 : 5 9 31.5 8 Fina l 1984 8 151 0 s 25t h s t F 2 6 " N
. LOPE Z confirmatio n non e

± Erro r ±

15.30 6

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

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E
pp m P b 101.89 6 Supervise d By : 

### Certificat e o f Verificatio n

8 3 SOI L 2011-04-2 6 12:0 0 31.4 5 Fina l 1984 8 151 0 s 25t h s t F 2 6 " N
. LOPE Z confirmatio n non e

± Erro r ± 16.01 7

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

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E
pp m P b 115.23 1 Supervise d By : 

### Certificat e o f Verificatio n

8 4 SOI L 2011-04-2 6 12:0 1 31.4 7 Fina l 1984 8 151 0 s 25t h s t F 2 6 " N
. LOPE Z confirmatio n non e

± Erro r ± 16.68 3

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

### Certificat e o f Verificatio n XL3t-3902 2 Readin g N o 8 9 Mod e SOI L Tim e 2011-04-2 6 12:0 4 Duratio n 95.5 2 Sequenc e Fina l Flag s AVERAG E Av g o f 86-8 8 ADDRES S 151 0 s 25t h s t QUADRAN T EA , DEPH T 1 " XR F TEC H N
. LOPE Z MIS C confirmatio n NOT E non e
pp m ±Erro r P b B05.15 2 ±24.79 0 Supervise d By :

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

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E
pp m P b 303.71 5 Supervise d By : 

### Certificat e o f Verificatio n

8 6 SOI L 2011-04-2 6 12:0 3 32.0 0 Fina l 1984 8 151 0 s 25t h s t E A 1 " N
. LOPE Z confirmatio n non e
Erro r 24.67 3

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

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E
pp m P b 326.47 1 Supervise d By : 

### Certificat e o f Verificatio n

8 7 SOI L 2011-04-2 6 12:0 3 32.0 2 Fina l 1984 8 151 0 s 25t h s t E A 1 " N
. LOPE Z confirmatio n non e

± Erro r ± 25.45 8

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

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E
pp m P b 285.27 0 Supervise d By : 

### Certificat e o f Verificatio n

8 8 SOI L 2011-04-2 6 12:0 4 31.5 0 Fina l 1984 8 151 0 s 25t h s t E A 1 " N
. LOPE Z confirmatio n non e

± Erro r ± 24.23 8• ^	 ^ ­ 

### 1^

^^ ^

o Omah a Lea d Site—Fixe d Pric e EP-R7-09-0 6 a ^^^ ^

I Coasta l Environmenta l Grou p Inc
. .. . ^5^^^ ^ www.coastalhazmat.co m ^ 

### "'"• ^COASTA L 

# EXECUTIV ESUMMARY : BVID #19848
- (151 0 S 2 5 ST ) "x l N o Issue s o r Concern s| ^ Issues/Concern s Detai l Explanation :­ •COASTA LI S UNABL ET O PROVID EPRE-EXCAVATION , EXCAVATION , AN D SO D PHOTO S A S PAR T O FTHI S FINALPROPERT Y FOLDER . THES EPHOTO S WER EI N TH EPOSSESSIO NO FA SUBCONTRACTO RTHA T WA S CONTRACTE D T O PERFOR M AL LO FTH ESITECOORDINATIO NREQUIRE D B Y TH ESCOPEO FWOR K AN D TH E SUBCONTRACTO RHA S SINC ELEF T TH EPROJECT . THEREFORE , TH EPHOTO S AR EN O LONGE RAVAILABL E
DANGARVE Y WALKE D AN D SIGNE D OF FO NTH EPROPERT Y A S COMPLET EO N 5/3/2011 .

### Propert yCompletio n Agreemen t Thi s agreemen t document s th e complclio no t remedial aclivme s perloime do nm y properl y M y signalur e will designat e thai I a msatisfie dwit hth e resioralio no f m y properly , an diha l n o ilem s ar e mquestions , now , o r a l an y lime i nth e future , excep l ihos e ifem s liste dbelow , if an y Piopcrt y ID : 

# TW W Propert y Address : | ^ | Q CL , ^X ^ '2^^ ^ Owner : 

# !:}:^^w.^ ^ 

# ?<p ^ Restoratio nItem s inQuestion :

Item : Item : I •• • I I • L U Item : Item : Item : Item :

\r

I J »f>rc c lextoralio n'ts completed , eirccp l a s noler t [_

J I H o no t ai;re c resloratio nis complete dSIK . 

# EP A EP A Propert y Clos e Ou t For m Propert y # : _ PropertyA6ir^-.J^J^^^ , ^i^^cT ^ Date^mc : Owner' s Name ; ./j,'^^'^;:. ^ Quad s Excavated : Contracto r Group . Eicuvatio nGenera l Yes N o 1 .

Ifnecessuy , wer e th e correc t quadrant(s ) excavate dan drestored ? / 2 .

I f necessary , wer e th e correc t areas ofdrip zon e excavate dan drestored ? 

# y CradlD g So dandVegetatjo a Ye s N o I .Doe s th egradin g aroun dth e perimeie r ofthe house i nexcavate dareas generall y slop e awa y fromth e house ? 2 .Has so dbee nlaidi nal l areas tha t wer e excavated ? / 3 .

Doe s th eso dappea r t

o b egenerall y health y an dgrowing ? (Onl y evaluale i f inspecte da t a3 0 / da

y tim e period ) 4 .

Ar e sodde dareas generall y fir man devenl y graded ? / S .Ar e th e joints betwee nth e so dstrip s generall y tight ? (Onl y evaluat e i f inspecte da t a30 da y / tim e period ) 6 .Wa s th e propert y grade dsuc htha t wate r wil l no l poo l n

nth e propen>' ? / 7 .

Wa s damag e to landscapin g o r plan t materials avoided ? / Gates , Fence s an dRctainlu s Wall s Ve s N o 1 . Do gate s ope nan dclos e freely ? (Ifapplicable) / 2 . Wer e al t gates o r fences take ndow ndurin g restoratio nactivitie s reinstalled ? (I f applicable ) 

# y 3 . Was damag e t o gate s o r fences avoided? ( i f

applicable ) 

# y 4 . Wa s damag e to retainin g wall s avoided ? (Ifapplicable) 

# y Foundatioa , Sidin Ran dGutter s Ye s N o I .

Wa s damag e t o th e sidin g o r tri mavoided ? / 2 .

Wa s damag e t o th e foundatio navoided? / 3 .

Wa s damag e t o windows avoided ? / 4 . Wa s damag e t

o window s o r doo r screens avoided ? 

# y 5 , Wa s damag e t

o downnspout s o r downspou i extensions avoided ? 

# y Sidewalks an dDriveway s (Concrete ) Ye s N o I .

Wa s damag e t

o drivewa y surfaces avoided? 2 .

Wa s damag e t

o walkwa y surfaces avoided ? /

## Owner s comments :

Inspectio nnotes :

** *

• l «



## Remova l an dreslorationaclivale s complete includin g the 30-da y so dwarranty : EP A Representativ e ^ ^ Date : «l» W