## TRANSMITTALof OMAHALEAD SIT E SOI LREMEDIATIO NFIL EFOLDE R 

# SAID# : (.^liqC >Date : K 10 ^ A l Address : i^ % \ \H^ ^ ift/f ^ Remediatio nContractor : Coasta l Environmenta l Group

_Year : _200 B
SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S / 

### Vide o o f property (DVD ) Executiv e Summar y EPA-provide dproperty sketc h 0Signe dAcces s Agreemen t for subjec t property W ^ Signe dAcces s Agreement(s ) for adjacent property EZRestoratio nAgreemen t -0 " Settlemen t document s (i.e. , for damag e o r t o replac e plants , etc. )

- & Confirmatio ndat a

B ^ Photograph s fH-(rycCPc/filio^
. bcCfi(Vfr(U^ \V ! ^ Un , EAs-buil t sketc h 0^ Satisfactory restoratio nsigne db y Property Owne r I ZProperty close-ou t chec k lis t signe db y EPA "tPDescriptio nofarea s no t meetin g RO D cleanu p criteri a 0 Utility clearance s (2

f Property informatio nfromDougla s Coimt y Assessor' s Offic e D 

# • D
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CONTACT FOR M Propert y I D # 

# tp'^4^ ^ Propert y Address : 

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# 1 M Mf ^



# A V Initial Contact : Date : Time : Action : SecondContact : Date : Time : Action : Fina l Contact : Date ; Time : Action : Fina l Action : Transmi t t

o EP AD Other Action : D

Comment : Owner Comment (s) : Site Coordinator Comment (s) :

### _ _ 

## Propert yAcces s Checklis t PropcrnlD : [(^'^U^I D D WOR K STARTED ON : / / D WOR K COMPELTE D ON : Propert yAd d re»:2l4:2,( ^ VlU'^-Wv/^ V
Rente r AH.Ir<.<c - ^ Addres s Phone : F«LV : Cell/Pager : Additiona l Inlnrmxtion : 

## Phone : /'uoz ) ;^2g-^/^ 1 \Mor t ccm^.g.r{L{Q2 ) 0\U)^-^Q2 "

D Notificatio n Lette r Sem : Bv : Acceu ' AprccmCD t 

### Sipicd:\j_/Jiy/C 3 

## ^^'-VfecAtiPj - Vir)v^VK;l'ng j Reslonttio n Agreemen t 

### Signed : lL/ii(?/Q ^ 

## By^qp/rAl ^ UflvgVt^biiA^x

•Topsoi l Samplin g (i f applicublt ) D Disposa l Samplin g ( Kupplictble ) B j : D Gnrdc n Snmplia g (i f applicable ) By : D Utilit yClearanc e Called : By : © • Video/Photo s (Before ) 

### On:_it_/2k'. ^ 

## ^y - Srfftv a /flcW\ o

•Video/Pholo s (During ) OD : Bv : D Video/Pholo s (After ) On : By : D Video/Pholo s (30-Dny ) O D : By : O Propert yComplelio n Agreemen l Signed : / /
_ By : D Fina l Repor t Issued : By : Ai rMoniiorin K{n n applicabl e

D Communit yd Crc w O D : / / By : RcsuJts : D ComrounltA ' D Crc w On : / / By : Remits : D Communit AD Cn:\ y On : / / Bv : ResulU :

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## • Douglas Coimt y Accoun t In||^^tio n Pag e 1 of 2
Dougla s County , Nebrask a Propert yRecor d - R081133000 0 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-5 0 ft wes t o f52n d S t - Viewo n Ma p Infonnatio n i s vali d a s o f2009-5-1 2 Treasurer' s Ta xRepor t Ne wFeatur e ^ • •• •Aut o Sale s Searc h Owne r HOUGHTALIN G HEATHE R D ETA L 243 6 N 4 5 AV E OMAH AN E 68104-000 0 Propert yInformatio n Ke yNumber : 113 3 000 0 0 8 Accoun t Type : Residentia l Parce l Number : 081133000 0 Parce l Address : 243 6 N 4 5 A V OMAH AN E 68104-000 0 Lega l Description : CUiklRMON TLO T1 1 BLOC K3 5 0 X 12 5 Valu e Informatio n Lan d Improvemen t Tota l 200 9 $6,400.0 0 $101,900.0 0 $ 108,300.0 0 200 8 $6,400.0 0 $ 101,900.0 0 $ 108,300.0 0 200 7 $6,400.0 0 $101,900.0 0 $ 108,300.0 0 200 6 $6,400.0 0 $101,900.0 0 $ 108,300.0 0 200 5 $6,400.0 0 $ 70,400.0 0 $ 76,800.0 0 200 4 $6,400.0 0 $ 64,000.0 0 $ 70,400.0 0 Lan d Informatio n Acre s S F Unit s Dept h Widti i Vacan t 0.1 4 6250. 0 1. 0 125. 0 50. 0 N o Improvemen t Informatio n Buildin g 1



## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accoimtno=R081..
. 6/7/20091 

## 1 Dougla s County Accoun t I i^^^i itio n 

### Pag e 2 of 2

M a t N « A V

l A.^^ ^ 11 D ^ ^ ^ 

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# ns n t ^^ H 

# Q I^H I 

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» « « >* * H MM>*M * CLIC KT O ENLARG E IMAG E Squar e Footage : 2446. 0 Perimete r 0. 0 Uni t Type : En d

Buil t As : 2 1/ 2 Stor yUnfi n HVAC : Centra l Ai rt o Ai r Exterior : Fram e Viny l Interior : Drywal l Roo fCover : Compositio n Shingl e

Roo fType : Hi p Floorcover : Allowanc e
Yea r Percen t Yea rBuil t Remodele d Remodele d 191 8 0 0 % Detai l Typ e Detai l Descriptio n Ad d O n Fenc e Chai n Lin k Applianc e Allowanc e Applianc e Fireplac e Masonr y Basemen t Bsmn t Bloc k 8 f t Fixtur e Additiona l Fixture s Fixtur e Bas e Fixture s Fixtur e Bat h Ful l Garag e Detache d Porc h Sla b Roo fCei l D O «) « FlratFtoo r iSMOt q « Swoo d Fkia r 114 8 Oiq*

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CLIC KT O ENLARG E IMAG E | Percen t Complete : 100.0 % Quality : Averag e Condition : Averag e Cond o Squar e Footage : 0. 0 Rooms : 10. 0

Units : 2. 0 Batlis : 3. 0 Bedrooms : 3. 0 Stories : 2. 0 Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 Adjuste d Yea r Physica l Ag e Buil t 191 8 9 1 Unit s 1. 0 1. 0 1. 0 1288. 0 1. 0 1. 0 3. 0 720. 0 224. 0



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

### Pag e 1 o f 1

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

# ] [
YOU RTICKE T NUMBE RI S 2326027
. Origina l Cal l Date : 7/24/0 9 Time : 5:4 8 pm Op : ELIZABETH1879 0 Wor k t o Begi n Date : 7/28/0 9 Time : 6:1 5 pm State : N E County : DOUGLA S Place : OMAH A Address : 243 6 Street : N45TH AV E Twp : 15 NRng : 13 E Sect-Qtr : 08-S W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : lead remediatio n Locatio n o f Work : INCLUD E AL L EASEMENT S LOCAT E ENTIR E PROPERTY Remarks : FA X AL L CLEAR S TO : (877)662-421 1 : UNSUR E O F CORNE R LOT . Compan y: COASTAL ENVIRONMENTA L SERVIC E Contac t Name : ELIZABET H Phone : (877)662-421 0 Wor k Being Don e For : coasta l Dept h o f Excavation : 4f t Corne r Lot : N Front : Y Rear : Involve s Tunnelin g o r Horizonta l Boring : N Explosives : N CXCAT V MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C
Servic e Are a Contac t Phon e Number Utilit y Typ e Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , IN C HEID I Alt : 402934046 9 Emerg : 402932975 7 

### Day : 402504782 3 MUDO l METROPOLITA NUTILITIES DISTRIC T SAND Y Alt : 

### Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFICSEWE RRO N 

### Alt : 402444516 1 Emerg : 4024445160 Day : 406728934 3 OPPDGPR 5 OMAH APUBLI C POWE RDISTRICT N A 

### Alt : 4062071494 Emerg : 888728934 3 Day : 406728934 3 QLNNEIC QWES T LOCA LNETWOR K N A 

### Alt : 4062071494 Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 7/24/200 9

# As-Buil t Drawin g COASTA L 

# Omah aLea dSuperfun dSit e

6349 6 Exterio rPain t Mort h Arro w Omah a Lea d Sit e Sit e Sketc h •Poo r Samplin g Address : 243 6 N 4 5 , r~ 1 No t pain t Sampl e Numbe r Lea d Concentratio n Sampl e Collecte d LA B Firm ; Sample s Collecte d P C C.C

. E - K : . RYASCPXA-6349 6 F l 

## Lii pp m 

### D Dat e y O - 2. 7 - O SiRYBSCPXA-6349 6 F 2 pp m 

# a Time ; 1 O • . . b - i p . 1 ^
. nVCOOrX A6340 6 RYDSCPXA-6349 6 B l B 2 

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# n n n Sample s Analyze d RDZSCPXA-6349 6 D Z pp m 

# n XR F Uni t AJ5«V 0 Book : 2.2J O nOZOGrXA-6340 6 RP2SCPXA-6349 6 G Z P Z 

### . 7 3 pp m pp m Numbe ro f Sample s = | 5 \ I 

### D 

# n Date ; Time ; Staff ; _ t l O' S 0 & A. ^ 

### m-^u ? 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 ' Al l quadrant s ar e as viewe d fro m th e street , facin g propeft y OLS# : 6349 6 Dat e Excavate d :7/30/0 9 Dat e USEP ASigne d Off : 8/11/0 9



### Legen d ^

### \'\ ' Concret e Dri p Zon e Excavate d • ; < Quadrant s Excavate d
Are a replace d wit h Are a replace d wit h Are a lef t bar e So d Rock/Mulc h 

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



# yVwUivl *V ­ 

## 6349 6 E)rterio rPain t Nort h Arro w 

### Lea d Sit e J \J i Z i (^ ^ wOmalf a Lo g^oo d 

### tr > ^\ ^ Ske i Sit e e Sketc h
•Poo r Samplin g Address : 2436 N 45 AV Q No t pain t Sampl e Numbe r Lea d Sampl e Sample s Collecie d LA B Concentratio n Collecte d Firm : y£ ' Cc

. EK
. RYASCPXA-6349 6F1 

## __L2Ji
_ pp m 

## D Date : | 0 -Z7-OS r RYBSCPXA-6349 6 F2 

## 22- 7 pp m 

# 0' D Time : IO'

. S' l (^ f ^ RYCOCnX A6340 6 h\ - pp m 

# D D Sample s Analyze d RYDSCPXA-6349 6B2 pp m 

# a 

# in 3 RDZSCPXA-6349 6DZ pp m 

# n XR F Unit : Ce5'-l 0 Book : ZZ O nOZ0CrXA-C340 G S2 - pp m 

## D Dat e II tJ ^ 0& RPZSCPXA-6349 6 PZ 

## Z7 3 pp m 

## D Tim e 

### JB J Staf f Numbe r ofSample s • 

## msi ^ Legend : Fl = Fron t Left , F2 = Fron t Right , B1 = Bac k Left , B2 = Bac k Righ t DZ = Dri p Zone , GZ = Garden , PZ = Pla ) Al l qD5Si«Qt5_3r eas viewe d fro m Ih e street , facin g property

f.iled : ]i;i-.Sep-ii 8

## 6349 6 Exterio rPain t Nort h Arrw y 

### Omah a Lea d Sit e |3^oo d 

### Sit e Sketc h •Poo r Samplin g Address : 2436 N 4 5 A V Q No t pain t Lea d Sampl e Sample s Collecte d Sampl e Numbe r LA B Concentratio n Collecte d Firm : ?£ • Cc

. EKT
. RYASCPXA-6349 6 F 1 

### t 2 q pp m 

## D Date : \ 0 -IT-O g RYBSCPXA-6349 6 F 2 

### 2 2 " 7 pp m 

## D Time : 10'
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. nYCOGPXA-6340 6 

## D Sample s Analyze d RYDSCPXA-6349 6 B 2 

### _l_!JL3_pp m 

## D RDZSCPXA-6349 6 D Z 

### C t 2f t pp m 

## D XR F Unit ; (o5'^ a Book : 2ZC ) ROZ00rXA-6349 C S3 - - " pp m 

## D Dale : I I •0^0 & RPZSCPXA-6349 6 P Z 

### 2
. I 3 pp m 

## D Time : fl^j Staff : mSL ^ Numbe ro fSample s = | 5 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 i Al l quadrant s ar e a s viev/e d fro m th e street , facin g propert y

Rfv:nri « Created : 10-SepJi 8 rU47n i 01.2 3

## 6349 6 csdBfio rPBin t NDtt h ARON V Omah a Lea d at e H'Ws i ateSkstc h Q Poor SannBn a Atttans : 2438 N 4 5 A V •NOtpBTTI t : Sampt e Nufnbs r ConcsntTHlio n Sampt e Coltete d LA B Firm : Sampt e ColtaiH l ?f r<:.c . £-»c
. RYAKa:T(A«349 8 F l __L2J±
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## D COte : I0-2.1-O8 ' RYB8CPXA«34ff i F 2 22.- 7 pp m 

## D Tmw:
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## D D D D XR F Unit : Date : Sampte s AnalyzB d

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## D Tlnffl : .B t Numba ro fSamptes-J_5_ ] 

## m^u ? Lfigand : P I = Fron t Left , F Z = Fron t R^ , B l

- fticK Left , E B = &ni k R ^ O Z- Ori p Zone , S Z^ ^ Oanten , P Z= Pla ; Ayquaitanli i hul l th s nsimiMt y 

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. COASTA L ENVIRONHENTA L cft 0 u r , INC

. 

## Consen t fo rAcces s T o Propert y RIGH TO F ENTR YT O PREMISE S 

### Granto r(th e propert yowner ) consent s t o an d authorize s th e Unite d State s Environmenta l Protectio n Agenc y(EPA ) o rit s authorize d representatives , collectivel y th e Grantee , t o ente ran d perfor m certai n environmenta l respons e activitie s upo n th e followin g describe d premises :

Owner' s Name : He-i.+W^ ' H«»^c^*^-^^'«<*P*y*''" ® P^°"« = iHol]'*^ ^ "^^ ^

( 'A)c/ i

Addres s o fPropert y 

# 2H3 ^ ^ 

# ^^^A , ( 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 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 fCoastal Environmenta l Group , contracte d b yUSEPA , wil l contac t th e Granto rin-perso n t o discus s th e wor k t o b e performed , th e Granto rwil l hav e a n opportunit yt o revie wan d approv e th e planne d soi l removal , an d restoratio n wor k befor e i t begins
. Onc e th e wor k i s finished , th e Granto rwil l b e aske d t o revie wth e wor k an d confir m tha t i t i s complet e an d meet s wit h th e Grantor' s approval
. Upo n completion , th e Granto rwil l receiv e writte n documentatio n fro m EP Atha t th e propert y ha s bee n remediated
.
ENVIRONMENTA L RESPONS E ACTION S 

### 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 , 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 f2COASTA L 

### \ :<J ^ ENVIKONHENTA L

• * ' PRO''* - 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 necessarysubsequen t t o a n initia l waterin g perio d b yEPA ; • Abid e b yhealt h an d safet yguidanc e provide d b yEPA ; •I fth e propert yi s rented , assis t EP Ai n obtainin g tenan t approva l fo racces s t o th e propert yt o perfor m th e work
. •Allo wvideotapin g and/o rphotographin g o fth e property
. AGREEMEN TNO TT O INTERFER E 

### Th e Granto ragree s no t t o interfer e o rtampe rwit h an yo fth e wor k activities , o rwit h an y o fth e wor k done , o rwit h th e equipmen t use d o n hi s property , o rt o undertak e an y action s regardin g th e us e o fsai d propert ywhic h woul d ten d t o endange rth e healt h o r welfar e o fth e Grantee s o rth e environment , o rt o allo wother s t o us e th e propert yi n suc h a manner . Shoul d yo u hav e an yquestion s abou t thi s program , pleas e contac t Coastal Environmenta l Group , a t (402 ) 991-119 9 

# 1 I gran t access t o m ypropertie s D I d o not gran t acces s t o m ypropertie s 

# ^-^'(zr ^ Signatur e Dat e Signatur e Dat e

G 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 f2C O /U s TA L 

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

Propert y ID : ^ 3 *f<»4 j Propert y Address : 2 »/^ ^ ^ l/ ^ Owner : Hg^Uf ^

Hf>6/ctyvV«.\ i Phone ; ^*/ ^ j Cf^ > ^Qa ? ftg>2 )7'Z' L 

### U L \

O nth e attache ddiagram(s ) indicate area(s ) t o excavate , surfac e structure s an dlandscapin g feature s and acces s location(s ) t o b e usedb y th e contractors . Indicat e distances , depths , materia l types , etc . Photographicall y andVideographically document th e existin g condition s ofth e propert y andth e basement if necessary . Item s t o b e Remove d b yth e Owne rbefor e Star t o fRemediation : Th e removal , storage , disposal , and/o rretur n o fthes e item s i s th e Owner' s responsibility
. 

### 1 item : 

### /(l\t ^

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### Item s t o b e Remove d b y th e Contracto rDurin g Remediatio n an d No t Replace d Item : 

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### 1o fjCOASTA L tMVlKONM f c no u r . NTAI
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## Ite m Pre-existin g propert y area , tha t wil l b e excavated , tha t i s covere dwit hgrass . Numbe r o f tree s > 2 inc h trun k 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 hasketcl i o f lli e spiinklc f lavout
. Numbe r o f an dsiz e o f eac hgarden / flower be d area . Attac hasketc ho f relativi ? size s an dlocaiitMi.s
. Agree dupo nvalu e o f plan t material s no t t o b e replace db v contractor . Not e thi s \alii e wil l h e use d1 0 issu e nplan t vouche r t o th e propcrt > owner . Easemen t Area , t o b e excavate d 

# , ^^\^^ <
^

^



## Landscap e Inventory Quantit y Uni t Condition/Type/Specie s 

# t^ a Quadrant s

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# 1 Pag e 2 of

.^ ^ C O Af S TA L t NVIMO M riLNTAt
. o n o u >•. IN C


### Additioina l Comment s / Instructions :


# '"Dvopc^f f \ ^ bcxcjj ^ O^YVVO\^V ^

G Check th e bo x

ifOwne rdoes no t want CE G to document interio rfoundatio n wall s an d possibl e pre-existin g damage
. Bycheckin g thi s bo xCE GIs no t responsibl e fo ran ydamag e don eto th e interio r ofhouse , includin g foundatio n crack s

orfissures

.
IQf i agre e G I do no t agre e

/ ^ /i^ Contractor Signatur e Dat e Owner' s s Signatur

Signature e /" ^ )

) /l^ e e Contractor' s s Slgnatu r 

### Pag e 3of 2_BVID # L>?MR\ ^ XR F PROPERT YSAMPL E SHEE T Dat e Project XRFID #



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# l u : m amm 'SIO^C l sampl e lengt h 3 0 se c Readin g Sampl e are a Shol # Readin g Sampl e are a 

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 239 7 Mod e SOI L Tim e 2009-07-3 0 16:1 4 Duratio n 121.4 0 Sequenc e Fina l Flag s AVERAG E 

### i5Avg2L23a£2Sg ^ ADDRES S 243 6 N 4 5 av e QUAD/ZON E B 2 INSPECTO R Nicola s DEPT H 6 SAMPL E TYP E CLEARANC E NOT E

±Erro r P b ±/C3A72 7 - / Supervise d 

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

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pp m P b 147.33 2 Supervise d By : 

## Certificat e o fVerificatio n

239 3 SOI L 2009-07-3 0 16:1 2 30,1 7 Fina l 6349 6 243 6 N 4 5 av e B 2 Nicola s 6 CLEARANC E

± Erro r
± 15.21 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 183.06 4 Supervise d By : 

## Certificat e o fVerificatio n

239 4 SOI L 2009-07-3 0 16:1 3 30.5 5 Fina l 6349 6 243 6 N4 5 av e B 2 Nicola s 6 CLEARANC E

± Erro r
± 16.73 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 111.79 4 Supervise d By : 

## Certificat e o fVerificatio n

239 5 SOI L 2009-07-3 0 16:1 3 30.1 1 Fina l 6349 6 243 6 N 4 5 av e B 2 Nicola s 6 CLEARANC E

± Erro r
± 13.38 1

# f Therm o

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 239 6 Mod e SOI L Tim e 2009-07-3 0 16:1 4 Duratio n 30.5 7 Sequenc e Fina l Flag s BVI D # 6349 6 ADDRES S 243 6 N 4 5 av e QUAD/ZON E B 2 INSPECTO R Nicola s DEPT H 6 SAMPL E TYP E CLEARANC E NOT E

± Erro r pp m P b 115.58 7 ± 13.56 9 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 234 9 Mod e SOI L Tim e 2009-07-3 0 11:5 6 Duratio n 122.0 1 Sequenc e Fina l Flag s AVERAG E f^^^^3A8 i ADDRES S ^3 6 N 45av e QUAD/ZON E D Z INSPECTO R Nicola s DEPT H 1 3 SAMPL E TYP E CLEARANC E NOT E

pp m ±Erro r P b [r^&:o5T~ i ±^^Z ^ Supervise d By : /'^Ai'j P X ? OZ )

# 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 234 5 Mod e SOI L Tim e 2009-07-3 0 11:5 4 Duratio n 30.2 5 Sequenc e Fina l Flag s BVI D # 6349 6 ADDRES S 243 6 N 4 5 av e QUAD/ZON E D Z INSPECTO R Nicola s DEPT H 1 3 SAMPL E TYP E CLEARANC E NOT E

pp m Erro r P b 523.66 1 ± 27.65 0 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 539.06 0 Supervise d By : 

## Certificat e o fVerificatio n

234 6 SOI L 2009-07-3 0 11:5 5 30.5 6 Fina l 6349 6 243 6 N 4 5 av e D Z Nicola s 1 3 CLEARANC E

± Erro r 28.21 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 409.06 2 Supervise d By : 

## Certificat e o fVerificatio n

234 7 SOI L 2009-07-3 0 11:5 5 30.5 8 Fina l 6349 6 243 6 N 4 5 av e D Z Nicola s 1 3 CLEARANC E

± Erro r
± 24.73 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 632.43 1 Supervise d By : 

## Certificat e o fVerificatio n

234 8 SOI L 2009-07-3 0 11:5 6 30.6 2 Fina l 6349 6 243 6 N 4 5 av e D Z Nicola s 1 3 CLEARANC E

± Erro r
± 30.53 0

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 235 4 Mod e SOI L Tim e 2009-07-3 0 11:5 9 Duratio n 121.6 0 Sequence Fina l Flag s AVERAG E tJiil9-oL235{U 2 ADDRES S 243 6 N 4 5 ave QUAD/ZON E easemen t INSPECTO R Nicola s DEPT H 1 SAMPLE TYP E CLEARANC E NOTE

pp m ±Erro r Pb [362aS— 3 ±(ZZn^SK

. Supervise d By : ^CCf/JU2eJ S

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

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

pp m P b 119.80 1 Supervise d By : 

## Certificat e o fVerificatio n

235 0 SOI L 2009-07-3 0 11:5 7 30.4 3 Fina l 6349 6 243 6 N 4 5 av e easemen t Nicola s 1 CLEARANC E

d : Erro r ± 14.23 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 100.64 8 Supervise d By : 

## Certificat e o fVerificatio n

235 1 SOI L 2009-07-3 0 11:5 8 30.5 4 Fina l 6349 6 243 6 N 4 5 av e easemen t Nicola s 1 CLEARANC E

± Erro r 13.16 1

# 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 235 2 Mod e SOI L Tim e 2009-07-3 0 11:5 9 Duratio n 30.2 1 Sequenc e Fina l Flag s BVI D # 6349 6 ADDRES S 243 6 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

pp m ±Erro r P b 98.07 8 d b 13.14 3 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 93.27 1 Supervise d By : 

## Certificat e o fVerificatio n

235 3 SOI L 2009-07-3 0 11 : 5 9 30.4 2 Fina l 6349 6 243 6 N 4 5 av e easemen t Nicola s 1 CLEARANC E

± Erro r
± 12.95 7

## Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5

•< t PRO!* ' 

# ? Coasta l Environmenta l Grou p Inc
. www.coa8talhazmat.co m ^J ' COASTA L INVmOHHINTA l G «0 U P , IN C 

# EXECUTIV ESUMMARY : BVID #6349 6 - (243 6 N4 5 AVE )
No Issue s o r Concern s I I Issues/Concern s Detail Explanation : NO ISSUES PENDING
.

### S» L 

## EP APropert y Clos e Ou t For m Property# : (pS^^. , Propert y A l Date/Time : ,^- , Owner' s N i Quad s Excavated ; Vf e -^Y: ^ Contracto r Ye s N o Excavatio nGenera l 1
.If necessary , were th e correc t quadrant(s ) excavate dandrestored ? 2
.If necessary , were th e correc t area s o f drip zone excavate dandrestored ? 

# T > ^
Ye s N o Gradin g So d an d Vegetatto a I
.Doe s the grading aroun dthe perimeter ofth e hous e i nexcavate darea s generally slop e awa y 

## 1 ^ ' fromthe house ? 2
.Ha s so dbee nlai dinall area s tha t wer e excavated ? 3
.Doe s th e so dappear to b e generally healthy an dgrowing ? (Only evaluate if inspecteda t a3 0 day time period ) 4
.

Ar e soddedarea s generally Fu man devenl y graded ? 

# -iP " 5
.

Are di e joint s betweenth e so dstrip s generally tight ? (Only evaluate if inspecte da t a3 0 da y 

## l / ^ tim e period) 6
.Wa s the propert y grade dsuchtha t wate r wil l not poo ! o nthe property' ? t ^ ^ 7
.

Wa s damage t o landscapin g o r plan t material s avoided ? 

# u- ^ Gates , Fence s an dRetainin g Wall s Ve s N o 1
.D o gate s ope nan dclos e fi-eely? (Ifapplicable ) ^ " ^ I
.Were all gate s or fence s takendow ndurin g restoratio nactivitie s reinstalled ? (If applicable ) 

# 1? ^ 3
.Wa s damage t o gate s or fence s avoided ? (Ifapplicable ) 4
.Wa s damage t o retainin g wall s avoided ? (Ifapplicable ) Foundation , Sidin g an dGutter s Ye s N o 1
.Wa s damage t o th e sidin g o r trimavoided ? 

## I/- " 2
.Wa s damage t o th e foiuidationavoided ? 

# "z:^"
7
.Wa s damage to window s avoided ? 

# 1 ? 4
.Wa s damage to window s o r doo r screen s avoided ? 5
.Wa s damage to downspout s o r downspoul extension s avoided ? Sidewalk s an dDrh'cway s (Concrete ) 

# "v Z 1
.Wa s damage to drivewa y surface s avoided ? 2
.Wa s damage to walkwa y surface s avoided ?

## CM'oer s comments :

Inspectio nnotes :

Remova l an dresiorationaclivale s complet e Including ih e 30-da y so dwarranty : EP ARepresenlativ e /OA K [J/JAKJA ^ 

## Dale : 9U l 0 ^

## Propert yCompletio n Agreemen t
I hi s agreemen t document s the completio no f remedial activitie s perloime do nm y properl y M y signatur e wil l designat e Iha t I a msatisfie dwit hthe restorationo f m y propeily
. andtha i no ilcin s ar e i nqueslions
. now , o r al an y tim e i

n(he future , excep t Ihos e item s liste dbelow , ifan y Propert y ID : ^ ^ ^^ ^ Propert y Address : ^Z^g ^ Wy^/fi/ £ Owner : 

### Phone : ^^^.^^^ 7 Restoratio n Item s i n Question :

Item : 

# N^tz b y^/^^ 5 <0 P 

## /^ef > 

# C*^Mf^ - 

# y^^/, ^ Item : ' Item : Item : Item : Item :
Additiona l Comments :

J> \' sgrc c rcsror«ljo ni < complcttd , excep t a s noter i [_

J I rfo not «(;i;* € retu^tin ni j complete d 

# yyc; ? WH O .< aignariir f Dat e