## TRANSMITTALo f OMAH ALEA D SIT E SOILREMEDIATIO NFIL EFOLDE R
SA]D# : 

# Wi
. Dale : 

# J h n \ i Addres,s : Wf ] ^ 111 ^

V 

### Remediatio nContractor : Coasta l Environmenta l Group

_Year : _20]0ARRA
_



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# i SOI LREMEDIATIO N

PROPERT Y FIL EFOLDE RDOCUMENT S Vide o o f property (DVD ) Executiv e Summar

y EPA-provide dproperty sketc h Signe dAcces s Agreement fo r subjec t properl y Signe dAcces s Agreement(s ) fo r adjacent property Restoratio nAgreemenl Settlemen t

documenl s (i.e. , fo

r damag e or

t o replac e plants , etc. ) Confirmatio n dat a 

### Photograph s \\ < h f

^f(K^ff ^ ^ tft^^'^e ^ \'TQ' P As-buil l sketc h Satisfactory restoratio nsigne db y Property Owner Property close-ou t

check lis t signe db y EP

A Descriptio no f

area s not meetin g RO D cleanu p criteri a Utility clearance s Property inftrmatio nfro

mDougla s County Assessor' s Offic e

Signatur e 3021883 2



# w m Superfun d

## Property Acces s Checklis t 

# p PropertylD : \c^^(^\ ^ Propert y Address : \«j-^c i _5> Lli
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. --^ - D WOR K STARTE D D WORKCOMPELTE D ON : ON : _ / /

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### Fax : Cell/Pager : Moi.
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. °l\M<» , Renter : Phone : Fax : Ccll/Pager :

tJSfcSLkk ^ Additiona l IiiforroHtion :

' nNotificatio nLette r [y l Acces s Agreemen t
^ Restoratio nA<j;recment 1 O Topsoi l Samplin g (i f applicable ) O Disposa l Samplin g (i f applicable ) GGarde nSamplin g (i f applicable ) [ ^ Utilit y Clearanc e PVideo/Photo s (Before ) D Video/Photo s (During ) 1 D Video/Photo s (After ) ID Video/Photo s (30-Day ) 1 1 • Propert y Completio nAgreemen t D Fina l Repor t ' Sent ; / / Signed : \o
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Omah a Lea d Sit e

### Dougla s County Accoun t It^Matio n i^M a 

### Pag e 1 of 3
Dougla s County , Nebrask a Propert yRecor d - R126269000 0
Informatio n i s vali d a s o f2010-8-1 6 Prin t Repor t Vie wInteractiv e GI S IMa o Treasurer' s Ta xReoor t Ne wFeatur e • •- ^

^ Subdivisio n Sale s Searc h Owne r AYALAPAU L R
142 7 S 1 7 S T OMAH AN E 68108-000 0 Propert yInformatio n Ke yNumber : Accoun t Type : Parce l Number : Parce l Address : Lega l Description : 626 9 000 0 1 2

Residentia l 126269000 0 142 9 S 1 7 S T OMAH AN E 68108-000 0 HARTMAN S AD D LO T3 1 BLOC K0 S 3 3 N 4 5 FTW98. 5 F T3 3 X 98. 5 Valu e Informatio n
201 0 200 9 200 8 200 7 200 6 200 5 Lan d $3,600.0 0 $3,600.0 0 $3,600.0 0 $3,600.0 0 $3,600.0 0 $3,600.0 0 Improvemen t $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 Tota l $3,600.0 0 $3,600.0 0 $3,600.0 0 $3,600.0 0 $3,600.0 0 $3,600.0 0 Sale s Informatio n

Sale s Date : Dee d Type : Price : Grantor : Grantee : Valid/Invalid : Exclusio n Reason : Sale s Date : Dee d Type : Price : Grantor : 2006-09-1 2

Q C Book : 200 6 Page : 10505 2 $750.0 0 GALASK ARANDAL L AYALAPAU L R Vali d

1998-10-0 8 D Book : 210 3 Page : 60 2 $18,000.0 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accotmtinfo.jsp?accountno=R12..
. 8/20/201 0

## Douglas Cotmt y Accoun t Ii^H|atio n i^H| a 

## Pag e 2 of3

Grantee : Valid/Invalid : Exclusio n Reason : Vali d 

### Sho wAl l Transaction s Lan d Informatio n Acre s 0.0 7 S F 3234. 0 Unit s0. 0 Deptt i 98. 0 Widt h

33. 0 Vacan t

Ye s



## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R12..
. 8/20/201 0

### Pag e 1 of 2

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



### • YOU RTICKE T NUMBE RI S 2632009
. Origina l Cal l Date : 11/02/1 0 Time : 9:3 5 a mOp : ELIZABETH1879 0 Wor k t o Begi n Date : 11/04/1 0 Time : 10:0 0 a m State : N E Address : 142 9 Covmty : DOUGLA S Street : S 17T

H S T Place : OMAH A
Twp : 15 NRng : 13 E Sect-Qtr : 27-N W 

### 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 : FAX AL L CLEAR S TO : (877)662-421 1 : UNSUR E I 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 : 4 F T Come r Lot : N Involve s Tunneling o r Horizonta l Boring : N ATTNEBR l CXCAT

V LEVEL S MCINE B 0PPDGPR 6 QLNNEI F QWESTNE SPRINTNE Front : Y Rear : Y Explosives : N METHODI S MUD0 2 OMAHACO F

Servic e Are a

ATTNEBR l ATT/T Contac t Phon e Numbe r 

### Day : 8002413624 9 Alt : Emerg : 8002413624 9 UtiUt y Typ e

/-V/-AXX 7 CO X COMMUNICATIONS , TrcTr, ! CXCAT V p^ p HEID I 

### Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7

LEVEL 3 LEVEL S COMMUNICATIONS ,

LL C 

### N A Day : 877366834 4 Alt : Emerg : 877366834 4

MCINE B MC I N O CAL LPERMEM O 

### Day : 800289342 7 Alt : Emerg : 800289342 7
http://www.(lhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS..
. 11/2/201 0Pag e 2 of 2

METHODI S

MUD0 2

OMAHACO F

OPPDGPR 6 METHODIS THEALT H

SYSTEM S

METROPOLITA NUTILITIE S DISTRIC T

CIT Y O FOMAHA

TRAFFICSEWE R

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QLNNEI FQWES TLOCALNETWOR K ELM LOCATIN G

QWESTN EQWES TLON GDISTANC E

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C O Day : 888847475 7 Alt : Emerg : 888847475 7 Day : 402504782 3 Alt : Emerg : 402504797 0 Day : 402444719 7 Alt : 402444516 1 Emerg : 402444516 0 Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3 Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3 Day : 800283423 7 Alt : Emerg : 800283423 7 Day : 800521057 9 Alt : Emerg : 800521057 9

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS..
. 11/2/201 0COASTA L 

# i k As-Buil t

Drawin g ^ Omah aLea dSuperfun dSit e OLS# : 1988 6 Dat e Excavated : 11/9/201 0 Dat e USEP ASigne d Off : 12/2/201 ^ Are a Sodden : 202 0 s a f t ' 1988 6

Omah a Lea d Sit e Sit e Sketc h Samplin g Address : 1129 S 1 7 S T Eirteno rPaint Q Goo d
•Poor [ ^ f^o t pain t Sampl e Numbe r RYASCPXA-1988 6 F l RYBSCPXA-1988 6 F 2 RYCSCPXA-1988 6 B l RYDSCPXA-1988 6 8 2 RPgOCPXA-1900 0 B ? Lea d Concentratio n 

# z n 2fi l 122- 1 Cal l RGZ6CPX A1088 6 nrzocpxAlaee

s -e z -pa pp m pp m pp m pp m pp m pp m pp m Sampl e Collecte d 

# I
D D D LA B 

## n D 

## n n n D 

## n Numbe rofSample s = | V \ | | Q | Sample s Collecte d

Fim , FOf t Oft , fl.r Date : l2.-l7-f> B Tim e ^••H C (>ft ] Sample s Analyze d XR F Uni t (BSH O Book : 7 2 T Dal e 0 /

• bS
- • 0° l Tim e P m StaffPTS U Legend : F 1 = Fron t Lefl , 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 = Al l quadrant s ar e a s viewe d fro m tti e stree t facin g propeit y Pia '



# ENTERE D DE C 2 3 i m

Concret e Are areplace dwit h

So d 

# m Legen d

Dri p Zon e Excavate d Are areplace dwit h Rock/Mulc h Quadrant s Excavate d Are alef t

bar e Contrac t

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

# X i 6/ ^ -r ' \ . , 

# \\ m 1988 6 Omah a Lea d Sit e Sit e Sketc h Samplin g Address : 142 9 S 1 7 S T Exterio rPain t
•Good

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Sampl e Numbe r RYASCPXA-1988 6 F l RYBSCPXA-1988 6 F 2 RYCSCPXA-1988 6 B l RYDSCPXA-1988 6 8 2 KDZ3CPXA-1900 0 BZ RCZSCPX A1088 6 G Z RrZCCPXA.1088 6 P2 - Lea d Concentratio n 

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## D D D D 

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## 1988 6 Omah a Lea d Sit e Sit e Sketc h Samplin g Address : 142 9 S 1 7 S T exterio rPain t
•Goo d

•Poo r 2 1 No t pain t Nort h Arro w

Sampl e Numbe r RYASCPXA-1988 6 F 1 RYBSCPXA-1988 6 F 2 RYCSCPXA-1988 6 B 1 RYDSCPXA-1988 6 B 2 RDZ3CPXA--1900 0 BZ " RCZSGPX A1988 6 S Z nPZGGPXA-1088 6 PZ Lea d Concentratio n 

## z n 2f? 7 122. 1 Col l pp m

pp m pp m pp m pp m pp m pp m Sampl e Collecte d



### D D D LA B 

### D 

## a n n n n n Numbe ro fSample s = | V \ | | Q | Sample s Collecte d

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H O Book ; 9 Z T Dat e Tim e Staff : O /

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- •0° \ 

### _&n

. 

## rns u Legend : F l = Fron t Left , F 2 • Fron t Right , 8 1 = Bac k Left , B 2 = Bac k

Righ t D Z = Dri p Zone , G Z = Garden , P Z = Pia ; Al l quadrant s ar e a s viewe d fro m th e street , facin g propert y

o" - 

# X

## 1988 6 Omah a Lea d Sit e Sit e Sketci i Samplin q Addrsss ! 142 9 S 1 7 S T Exterio rPain t
•Goo d D^Poo r [ 3 No t pain t NorthArrow

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F2 B l B 2 -BZ Lead Concentratio n 

# z n pp m

RDZSCPXA

* 19000 nOZCCPX

A10886 6 Z nPgOCPX

A1000 6 PZ - /2?T / pp m /f f/ 7 oo m

—pp m
" ~ Po m rpp m Sampl e

Collecte d



## D D D LA B 

## a D D n n n n Numbe ro fSample s = | t ^ | | Q | Sample s Collecte d

Fimi : FDf l nfl , fl.f Date : l2.-l7./sf t Time : : M'-M

Q ( W Sample s Analyze d XR F Unit : QiSH O Book : ^Z T Date : 0 1 • Q ^

• Q^f Time : ^rr \ 

## Staff : rns u Legend : F l = Fron t Left , F 2 = Fron t Right , B l = Bac k Lefl

. B 2 = Bac k

Righ t DZ = Dri p Zone , G Z = Garden , P Z = Pia ; Al l quadrant s ar e a s viewe d fro m tt wstreet , taclng propert y



# n

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COASTA l fHVItONHtNTA l C I 0 U f

. > M C 

## 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 : Daytim e Phonej ^ ^^g ) Owner' s Nam e 

# ' ^^ l /fya U

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 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 i 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 b yUSEPA , vkni l contac t th e Granto rIn-perso n t o discus s th e wori ct o b e perfomned , 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 worl ( befor e i t begins

. Onc e th e wori ( 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 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 f2V -'*^* ' COASTA L

' < PRO"
- c« 0 1 1 r1 » e



### « 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 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 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

. •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 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

> gran t acces s t o mypropertie s D I d o no t gran t acces s t o m ypropertie s 

# (^^p'^^y:^y ^

^^/y^^ ^ Signature > ^

Dift e ' Signature y ^

^^ ^

Signature Date

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

.

Page 2 of2^

\ C O AS T AL BNVIKOMHBNTA L C •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 to condition s ofth e propert y prior to remediationactivities
. Thi s will als o serve a s documentationfo r the purpos e of

assuring tha

t restoration activitie s ar

e completedto the satisfactionof the propert

y owne r an dthe UnitedState s Environmenta l ProtectionAgenc

y (EPA)
. PropertylD : [^^( p Propert y Address : /

^^ 9 -o ^ Xl^ t Owner : j/^^ \^s ^ &^[ wwner : y^ ^

^ /y- y^

yy ^


### 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 usedb y the contractors . Indicat 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 if necessary . 

## Item s t o b e Remove d b yth e Owne rbefor e Start o fRemediation : Th e removal , storage , disposal , and/o rretu m o fthes e item s i s th e Owner' s responsibility

. Hem : 

# yy ^ Kem :
Hem :
Hem :



## Item s t o b e Remove d Hem : ^



# / y b yth e Contracto r

(y*-- ^ 

## Durin g Remediatio n an d No t Replace d

Item :
Hem :
Hem :

Pag e 1 of

. 

# aC O AS T AL

•NVmONHB N TAL GROUP , IMC

. 

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

Item :
Hem : 

## ^T^^ y 

# ^ h ^ Hem :
Hem :



## Ite m Pre-existing propert

y area , tha t wil l b e excavated , tha

t i s coveredwit

hgrass . Numbe r of tree s > 2 inc

h trun k diamete r Numbe r of tree s < = 2 inc h trun k diamete r Numbe r of Sprinkle

r Zones , Control Valves , Timers , Heads , etc . Attac hasketc

hof th e sprinkle r layout
. Numbe r of an dsize o f eac hgarden / flower bed area . Attac hasketc hof relative size s an dlocations
. Agree duponvalue of

plan t material s not

t o b e replacedbv contractor . Not e thi s valu e will b e usedto issu e aplan t voucher t o th e propert y owner . Easemen t Area, t o b e excavated 

## Landscap e Inventor y

Quantit y 

# S'>)S ^

— • 

# J2 < 

# er 0 ^ 

# y Uni t

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Eac h
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## Condition/Type/Specie s



# ^^"^^ ^ ^2^.=^ ^

Pag e 2 

# M 3COASTA L

•NVIROMneNTA L O •O U P , INC

.

AddKiona l Comment s / Instructions : Th e cit yo fOmah a ordinance s ma yprohibi t yo 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 underlyin 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 fthi s i s th e case , yo u shoul d understan d tha t thi s removin g an d replacin g o fsoi 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 fyo 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 fsoi l b yth e EPA

. I fyo u hav e an yquestio n abou t legalit yo fa certai n drivewa yo rparkin g area , yo u ma ycontac t th e cKyo fOmaha' s Plannin g Departmen t a t (402 ) 444-5150

. [~ 1 Pleas e chec k

thi s bo xi fyo u understan d th e infomiatio n outline d above

. 

# t'- < \Kye ^ 

# ZHi

^ y ^ « 

# -fle

e

I ] 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

. 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 fhouse , includin g foundatio n crack s o rfissures

. 

### Q Id o no t

agre e

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# -^y^y ^ Date 

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.

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### Contractor' s Signature Date Pag e 3 of

. 

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# MftK. ^(l4(mu )

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

XL3t-3902 2 

## Certificat e o fVerificatio n

Readin g N o Mod e Tim e Duratio n Sequenc e Flag s AVERAG E ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E 4 8 SOI L 2011-01-2 7 11:2 7 91.1 2 Fina l Av g o f45-4 7 142 9 S 1 7 S T E A 1 " C.PADILL A CONFIRMATIO N CLEA R

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-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 4 5 SOI L 2011-01-2 7 11:2 6 30.6 6 Fina l 1988 6 142 9 S 1 7 S T EA 1 " C.PADILL A CONFIRMATIO N CLEA R

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± Erro r

16.95 6 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-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 4 6 SOIL 2011-01-2 7 11:2 7 30.2 7 Fina l 1988 6 142 9 S 1 7 S T E A 1 " C.PADILL A CONFIRMATIO

N CLEA R

P b pp m

165.44 6 ±

± Erro r

19.54 7 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-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 173.85 3 Supervise d By : 4 7 SOI L 2011-01-2 7 11:2 7 30.1 9 Fina l 1988 6 142 9 S 1 7 S T E A 1 " C.PADILL A CONFIRMATIO N CLEA R

±Erro r
±20.18 6

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

XL3t-3902 2 

## Certificat e o fVerificatio n

Readin g N o Mod e Tim e Duratio n Sequenc e Flag s AVERAG E ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E 4 4 SOIL 2011-01-2 7 11:2 4 90.8 7 Fina l Avg of 41-4 3 142 9 S 1 7 S T B 2 4 " C.PADILL A CONFIRMATIO N CLEA R

Supervise d By :

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

XL3t-3902 2 

## Certificat e o fVerificatio n

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 4 1 SOI L 2011-01-2 7 11:2 3 30.3 0 Fina l 1988 6 142 9 S 1 7 S T B 2 4 " C.PADILL A CONFIRMATIO N CLEA R

P b pp m

391.48 5 ±

± Erro r

29.55 8 Supervise d By :

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

XL3t-3902 2 

## Certificat e o fVerificatio n

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 4 2 SOI L 2011-01-2 7 11:2 4 30.2 5 Fina l 1988 6 142 9 S 1 7 S T B 2 4 " C.PADILL A CONFIRMATIO N CLEA R

P b pp m

343.76 4 ±

± Erro r

28.23 1 Supervise d By :

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

XL3t-3902 2 

## Certificat e o fVerificatio n

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 4 3 SOI L 2011-01-2 7 11:2 4 30.3 2 Fina i 1988 6 142 9 S 1 7 S T B 2 4 " C.PADILL A CONFIRMATIO N CLEA R

P b pp m

370.20 9 ±

± Erro r

29.73 2 Supervise d By :

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

XL3t-3902 2 

## Certificat e o fVerificatio n

Readin g N o Mod e Tim e Duratio n Sequenc e Flag s AVERAG E ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E 4 0 SOI L 2011-01-2 7 11:2 2 90.5 7 Fina i Av g o f37-3 9 142 9 S 1 7 S T B l 4 " C.PADILL A CONFIRMATIO N CLEA R

Supervise d B y

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

XL3t-3902 2 

## Certificat e o fVerificatio n

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 3 7 SOI L 2011-01-2 7 11:2 1 30.1 8 Fina i 1988 6 142 9 S 1 7 S T B l 4 " C.PADILL A CONFIRMATIO N CLEA R

P b pp m

172.61 8 ±

± Erro r

20.50 4 Supervise d By :

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

XL3t-3902 2 

## Certificat e o fVerificatio n

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 3 8 SOI L 2011-01-2 7 11:2 1 30.2 1 Fina l 1988 6 142 9 S 1 7 S T B l 4 " C.PADILL A CONFIRMATIO N CLEA R

P b pp m

183.81 3 ±

± Erro r

21.33 1 Supervise d By :

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

XL3t-3902 2 

## Certificat e o fVerificatio n

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 3 9 SOI L 2011-01-2 7 11:2 2 30.1 8 Fina i 1988 6 142 9 S 1 7 S T B l 4 " C.PADILL A CONFIRMATIO N CLEA R

P b pp m

180.39 4 ±

± Erro r

21.05 2 Supervise d By :

### Omaha Lead Site-Fixed Price EP-R7-07-05 Coastal Environmental Group Inc. www.coastalhazmat.com


# EXECUTIVE SUMMARY: 

# BVID #19886-(1429 

# S 17 

# ST) COASTAL ENVIRONMENTAL GROUP. INC.



# No Issues or Concerns Issues/Concerns
Detail Explanation:

## EPA Property Close 

## Out Form

Quads Excev~trd: Property Addrw Owner's h'emr I Contractor Groul 

### Exra~~t-m!



### __ _ ___ 

### - - _ - --- \t- 

### h~ 1 If necessq, were the correct quadrant(s) excavated and restored7

- 

### - I
- 

### -- - - 

# 4 /A -1 I 2 If necessary, were the correct areas oldr~p lonr cxcava~cd and rcctored7

- - - 

### - -- - 

### - - - - 

### I JI , J

2 Has sod been laid in all arcas that were cxcavated? 

# 1'7 i

4 Am sodded arcas generally 

### Ti and evenly gaded7 ,/I ,

. - L -I Are thejom~s between rh; sod smps generally trght? (Only c\aluatP 71nz~cctcd at a 711 da\ _tlmtpe*) - - ___- 

### - - - - - -- A 

# ' 1 b Was the property graded such thar ualer w111 not pool on tht propem' 

### - - -- 

### - - 

### - - - - -1 7 War damage to landscaping or plan1 marcrials avoided7 

# : /

, - --- 

### - - 

### -- -. - I 7 Was damage to gates or fences avoided? (If applicahlc) - 

## - -- - . . 1 

### 1 4 Was damage lo retaining walls avoided? (If applicable)

- 

# _ - - foundation, Sidia~ and Gufttn -- _ 

### -~ --. . -.

I Was damage to !he siding or trim avoided? I
, -- 

### - - .- - 

### / 2 Was damage tn the foundation avoided? I -- . - : Was damage lo wmdows avoidedq I I - -- I - 1 4 Was damage to wmdows or door screens avo~ded'l I -- -- - 

### ------ -_

~

. Was damage to dounspou~.c or duwnspou~ extension5 avo~dcd''

- - - __ .- . -- . .. 

### _ ___ .- - Sldcwalks and Driveways (Coocs

. 

### - -- - -- 

## - - .- .- I Was damape 10 drivcwey surfarcs avoided'?

-- - 2. Wa? damage to walkway surfacts avoldcdq

.. - -. - 

### -

### OM'per s comnifnls :

Ifn.vr>*'ctir>

nno<e«; :

Remova l an dresioiatioi i ailivalf s t(unplei e iiicludin g ih e 30-da y scx j wanciiif ) [-P ARcprcspniaiiv e ____S' ^ M ' Date ; u|i|i c

## 0:. % Propert yCompletio n Agreemen t

Thi s agieemen i documenl s Ih e compiclio n o l remedia l acliviiie s perloime d on m yproperl yM ysignature wil l designat e llia i i a m salisfie d wil h th e restoralio n o fm yproperly , an d Iha l n o iiem s are i n questions , now , o ra l an ytun e i n th e fulure , excep t ihos e item s liste d below , i fan y Propert yfP

. \€\^^i p Propert yAddress : |q ^ g^ ^ |- | ^ 4 Owner : N^aj^\_{^ytJaJ._

_ Phone : Restoratio n Item s i n Question : Item : Item : Item : Item : Item : Item : =

I ayrc cIc^tomlio n i^ completed , rxccp l a

s note d [ I I rio no t gfirt crcstorittia n i s complete d



# '^.^^ ^ /^y^^y/ n Date ( I actor' s Signatur e Dal e