## TRANSMITTALo f

OMAHALEA D SIT E SOILREMEDIATIO NFIL EFOLDE R 

# SAI D # : _3j^trL_.
. Date : ^j H /( ' Address : Remediatio nContractor : Coasta l Environmenta l Grou p Year : 2010ARR A SOI LREMEDIATIO N PROPERT V FIL EFOLDE RDOCUMENT S \ /

Vide o o f property (DVD ) WExecutiv e Summar y 1 /

EPA-provide dproperty sketc h U Signe dAcces s Agreemen t fo r subjec t property y Signe dAcces s Agreement(s ) fo r adjacent property ll

ZRestoraiio nAgreement -T ' Settlemen t document s (i.e. , fo r damag e o r to replac e plants , etc. )

— - Confirmatio ndata t /

Photograph s f k iVAw^fTcM -f

- 6o^^n< ^ ^ ^ ^ !(j / As-buil t sketc h y Satisfactory restoratio nsigne db y Property Owner : / 

### Property close-ou t chec k lis t signe db y EPA Descriptio no f area s no t meetin g RO D cleanu p criteri a [ 0 Utilit y clearance s / 

### Propert y informatio nfro mDougla s Count y Assessor' s Offic e

signatur e 3023737 0 

# Hil l Superfun d

## Property Acces s Checklis t
r ; I ;

Propert Property ID : :^^^, ^ Propert Propert y Address : 3«iV ^ _ H ^Itt..,.^-.-.—. , D O WOR K STARTED WOR K COMPELTE D ON : ON : _/ / /_ /
Owner : Ad drests : ^c>«>A«-»
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• Notificatio nLette r Sent : / / By : ^ SI Q O Q 5 ] [^ D D n Q D Acces s Agreemen t Restoratio nAgreemen t Topsoil Sampiin g (if applicable ) Disposa l Samplin g (i f applicable ) Garde nSamplin g (if applicable ) Utilit y Clearanc e Video/Photo s (Before ) Video/Pboto s (During ) Video/Photo s (After) Video/Photo s (30-Day ) Propert y Completio nAgreemen t Fina J Repor t Signed : ^o . / i^ / , « Signed : v. ? / > / »o / / / / / / Called : W/ v\/ 10 On : xo / -^ / x. . On : / / On : / / On : / / Sisned : / / Issued : / / By : uvu\ c By : Vi^c V By : By : By : 

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# 1 Ai r Monitorin g (a s applicable ) nCommunity D Cre w Results : On : / / By : Q Community ' Results : D Cre w On : / / Bv : Q Communit j Results : QCre w On : / / By :

Omah a Lea d Sit e

### Dougla s County Accoun t Ij^nnatio n Pag e 1 of 3 iT^pa s Dougla s County , Nebrask a Propert yRecor d - R070144000 0 Prin t Report
. Vie wInteractiv e GI S Ma o Informatio n i s vali d a s o f2010-10-1 2 Treasurer' s Ta xReoor t Ne wFeatur e ^ T » T » Subdivisio n Sale s Searc h Owne r SANDER S WILLI S ETA L 0/ 0 SANDR AOAMAOH O U C 391 1 N18S T OMAH AN E 68110-000 0 Propert yInformatio n Ke yNumber : 014 4 000 0 0 7 Accoun t Type : Residentia l Parce l Number : 070144000 0 Parce l Address : 391 3 N 1 8 S T OMAH AN E 68110-000 0 Lega l Description : BOULEVAR D PAR KAD D LO T1 4 BLOC K8 N 1 0 FTLO T1 3 & S 3 0 FTLO T1 4 4 0 X 12 5 Valu e Informatio n Lan d Improvemen t Tota l 201 0 $7,000.0 0 $13,200.0 0 $20,200.0 0 200 9 $7,000.0 0 $13,200.0 0 $20,200.0 0 200 8 $7,000.0 0 $15,800.0 0 $22,800.0 0 200 7 $7,000.0 0 $15,800.0 0 $22,800.0 0 200 6 $7,000.0 0 $15,800.0 0 $22,800.0 0 200 5 $7,000.0 0 $14,000.0 0 $21,000.0 0 

### Sho wAl l Transaction s

Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 1 5000. 0 1. 0 125. 0 40. 0 N o Improvemen t Informatio n Buildin g 1



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO.
. . 10/15/201 0

### Dougla s County Accoun t Mfcrmatio n Pag e 2 o f 3 ' «

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. lllMmfcMiMMIMfM*lll!U-f.WiHS!!Bll l CLIC KT O ENLARG E IMAG E CLIC KTO ENLARG E IMAG E Squar e Footage : 1440. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Poo r

Buil t As : 2 1/ 2 Stor yUnfi n Cond o Squar e Footage : 0. 0 HVAC : Force d Ai r Rooms : 8. 0 Exterior : Fram e Sidin g Units : 1. 0 Interior : Drywal l Baths : 2. 0 Roo fCover : Compositio n Shingl e Bedrooms : 4. 0

Roo fType : Hi p Stories : 2. 5 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 yea rBu/7 t Yea r Remodele d Percen t Remodele d Adjuste d Yea r Buil t Physica l Ag e 191 2 0 0 % 191 2 9 7 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Unfinishe d Atti cW/floo r 672. 0 Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 724. 0 Fixtur e Additiona l Fixture s 1. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 2. 0 Garag e Detache d 228. 0 Porc h Cvr d Woo d Dec k 112. 0 Porc h En d Scree n 20. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO.
. . 10/15/201 0

### Dougla s County Accoun t I n^jbmatio n 

### Pag e 3 o f 3
S 2 O 3 it ' Comis h Blvd I S SahlerS t 

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. I f yo u requir e a mor e exac t propert ylocation , yo u ma yus e th e Interactiv e GI S Map s tha t ar e maintaine d b you r office
.



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO.
. . 10/15/201 0

### 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 NUMBERI S 2616751
. Origina l Cal l Date : 10/13/1 0 Time : 5:5 6 pm Op : ELIZABETH1879 0 Wor k t o Begi n Date : 10/15/1 0 Time : 6:1 5 pm State : N E County : DOUGLA S Place : OMAH A Address : 391 3 Street : N18T H S T Twp : 15 NRng : 13 E Sect-Qtr : 03-S W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : LEA D REMEDIATION Locatio n o f Work : LOCAT E ENTIR E PROPERTY , AL L EASEMENT S AN D T O TH E PEDESTAL Remarks : FA X AL L CLEAR S TO : (877)662-421 1 : UNSUR E I F CORNE R LOT . Compan y: COASTAL ENVIRONMENTAL SERVIC E Contac t Name : ELIZABET H Phone : (877)662-421 0 Wor k Bein g Don e For : COASTAL Dept h o f Excavation : 4 F T Corne r Lot : N Front : Y Rear : Y Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C
Servic e Are a Contac t Phon e Numbe r Utility Typ e 

### Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , INC HEIDI 

### Alt : 402934046 9 Emerg : 402932975 7 Day : 402504782 3 MUDO l METROPOLITA NUTILITIE S DISTRIC T SANDY 

### Alt : Emerg : 402504797 0 Day : 402444719 7 OMAHACOFCIT Y OFOMAHA-TRAFFICSEWERRICH/TRAFFIC Alt : 402444516 1 

### Emerg : 402444516 0 Day : 406728934 3 OPPDGPR5 OMAH APUBLIC POWE RDISTRICT EL M LOCATINGAlt : 406207149 4 

### Emerg : 888728934 3 Day : 406728934 3 QLNNEI C QWES T LOCA LNETWOR K EL M LOCATINGAlt : 406207149 4 Emerg : 888728934 3


### http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT.
. . 10/13/201 0

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# Omah aLea dSuperfun dSit e ENVIKONHENTA L GROUP
. IN C OLS#:3361 3 Dat e Excavated : 10/20/201 0 Dat e USEP ASiane d Off : 11/2/201 0 Are a Sodden : 153 0 s a f t Name : f'f d ^.«^ > Omah a Lea d Sit e Date : NorniAim w Address ; J f/ / / ^ / ? " 57*
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. Omah aLea dSit e 4613 0( (., f C-()|ii:(-ii i U- < / rt •-.-. i ^ 1 1 ' i('|)C- i l y I^IGH I OF EM7RY1 0 PREMISE S 

### Giento i (th e propert yownei ) conseiil ^ t cci: 6 authiorize s tli e Unite d Slate? , Fnvironmenta l Protectio n Agenc y(FT/\ ) c \ it s outliorize d representstives , collectivel y tfi e Grantee , t o ente i sn d perfor m certoi n eiu'ironinenta l lespons e activities : upor i th e followin g describe d premises :

Ownei' s K'ame : 

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# ('S ' Agreement : 

### PuRPOs E O f RESPONS E 

### AcTivniE 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 hazar d Th e area(s ) vv'il l b e excavate d t o remov e contaminate d soil
. Th e remove d contaminate d soi l w\\ \ b e replace d v^it h clea n material s an d th e are a w/il 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 progra m Arepresentativ e o fCoasta l Environmenta l Group , contracte d b yUSEPA , vv'il l contac t th e Granto rin-perso n t o discus s th e vyor 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 vi'it h th e Grantor' s approva l 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 remediate d
ElSlVIRONMENTA L RESPONS E ACTIOixi S 

### B ysignin g thi s Acces s Agreement , th e Granto ri s orantin o th e EPA , it s employees , contractor s sn d subcontractor s th e righ t t o ente r[h e properly , a t al l reasonabl e time s an d witt i prio rnotice , fo rth e sol e purpos e o fperformin g th e wor k Thi s acces s shal l remai n i n effec t unti l th e wor k ha s bee n satisfactoril ycomplete d Ih e Granto i als o agree s t o

Pag e 1 o f ?i C C A
. S W
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1*0* - 

### Remov e cUosiructioni ­ nic'v.iriin p bor.ls-
. iiDileis , \'c-.hicicj-:
. i';if.ysca[)(- - wcn^y
. woov ' piles , oo o finuse?
. etc;
. ' Remov e flov,'e fhplbs : o i j.jiant s lha l ilu - Gicnlo i o i th e Giantoi' s u-:[,r:n l rwc.) ' vi'is h t o save ; Wate ran d maintai n leplacernen l vegetation , includin g fertilize rappiicriiori , as : necessary ' subsequen t t ca n initia l waterin g perio d b yEPA , ' Abid e b ytieall h an d safet yguidanc e piovide d b yITI^A
. ' I fth e propert yi s rented , assis t EP Ai n obtainin g (enaii l h\i\)icvc^ fo i acces s l o th e propert yt o perfor m th e wor k Allo wvideotapin g and/o rphotograptiin g ofth e properly
. AGREEMEN Tl>JO 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 i v/it h an y o fth e wor k done , o rwit h th e equipmen t use d o n hi s properly , 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 aliovv ' other 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 l o m ypropertie s O I d o no t gran t acces s t o m ypropertie s


# m \\ o Dat e Sipnetur e Dat e

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## COASTA L ENVIRONMENTA L GROUP , INC
. 

# ADJACEN TPROPERT YACCESS REQUES T

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. 

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### ACCES S REQUESTED : VVi(rrvNi'5S7o AA-C i CjO^e
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### OWNE R SIGNATUR E Mjc7(M' l i , jft ^ Ca'/^l^^^Cio Q FOREMA N SIGNATUR E SUPERVISO R INITIA L 

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.COASTA L 

## Restoratio n Agreemen t Th e purpos e o f thi s agreemen t i s t o provid e amutual agreemen t a s t o condition s o f th 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 tha t restoratio n activitie s ar e complete dt o th e satisfactio no f th e property owne r an dth e Unite dState s Environmental Protectio nAgenc y (EPA)
.

Propert y 

## '^••-^iy\ \ Propert y Address : "X^^" ^ 

# u (9- ^ Owner : -^Nf»r< ; Zaf^G< y Phone : 

### Onth 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 use db y th e contractors . Indicate distances , depths , material types , etc . Photographicall y an dVideographicall y document th e existin g condition s ofth e property an dth e basement i f necessary . Item s t o b e Remove d b yth e Owne rbefor e Star t o f Remediation : Th e removal , storage , disposal , and/o rretur n o f thes e item s i s th e Owner' s responsibility
.



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. IN C 

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. Number o f andsiz e o f eac hgarden/ flowe r be d area . Attachasketc ho f relativ e size s andlocations
. Agree dupo nvalu e o f plan t material s no t to b e replace db v contractor . Not e thi s valu e will b e use d( u issu e aplan t vouche r l o th e propert y owner . Easement Area , to b e excavate d 

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Pag e 2 o fCOASTA L ENVIRONMENTAl
. CROUP
. IN C
Additiona l Comment s / Instructions : Th e cit y ofOmah a ordinance s ma yprohibi t yo u fro m usin g dir t orgrave l area s on you rpropert y as driveway s orvehicl e parkin g areas . Th e Environmenta l Protectio n Agenc y(EPA ) ma ybe removin g an d replacin g soi l underlyin g a grave l ordir t are a on you rpropert ytha t yo u ma ybe usin g as a drivewa y orvehicl e parldn g area . Ifthi s is th e case , yo u shoul d understan d tha t thi s removin g an d replacin g ofsoi l doe s no t mea n tha t an yillega l drivewa y orparkin g are a on you r propert y is mad e legal
. To th e contrary , yo u ma ybe cite d byth e cit y ifyo u us e a grave l ordir t are a as a drivewa y orparkin g area , no t withstandin g an yremova l orreplacemen t ofsoi l byth e EPA
. Ifyo u hav e an yquestio n abou t legalit y ofa certai n drivewa y orparkin g area , yo u ma ycontac t th e cit y ofOmaha' s Plannin g Departmen t at (402 ) 444-5150
. r~ l Pleas e chec k thi s bo x ifyo u understan d th e informatio n outline d above
. 

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Chec k th e bo x ifOwne rdoe s no t wan t CE G to documen t interio rfoundatio n wall s an d possibl e pre-existin g damage
. Bycheckin g thi s bo xCE G is no t responsibl e fo ran ydamag e don e to th e interio r ofhouse , includin g foundatio n crack s orfissures
. 

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# 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 AVERAG E ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

Supervise d By ; 

## Certificat e o fVerificatio n

14 7 SOI L 2011-02-2 2 17:0 7 91.0 1 Fina l Av g o f144-14 6 391 3 N 1 8 S T D Z 8 " C.PADILL A CONFIRMATIO N CLEA R

# 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 XRFTEC H MIS C NOT E

pp m P b 170.17 3 Supervise d By : 

## Certificat e o f Verificatio n

14 4 SOI L 2011-02-2 2 17:0 6 30.5 7 Fina l 3361 3 391 3 N 1 8 S T D Z 8 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r ± 18.31 9

# 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 193.61 0 Supervise d By : 

## Certificat e o fVerificatio n

14 5 SOI L 2011-02-2 2 17:0 7 30.2 3 Fina l 3361 3 391 3 N 1 8 S T D Z 8 " C.PADILL A CONFIRMATIO N CLEA R

±Erro r ±21.41 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 130.01 1 Supervise d By : 

## Certificat e o fVerificatio n

14 6 SOI L 2011-02-2 2 17:0 7 30.2 1 Fina l 3361 3 391 3 N 1 8 S T D Z 8 " C.PADILL A CONFIRMATIO N CLEA R

±

Erro r ±

18.22 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 AVERAG E ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

Supervise d By : 

## Certificat e o fVerificatio n

15 1 SOI L 2011-02-2 2 17:1 0 91.3 4 Fina l Av g o f148-15 0 391 3 N1 8 S T EA 1 " C.PADILL A CONFIRMATIO N CLEA R

# 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 14 8 Mod e SOI L Tim e 2011-02-2 2 17:0 9 Duratio n 30.2 5 Sequenc e Fina l Flag s BVI D 3361 3 ADDRES S 391 3 N 1 8 S T QUADRAN T EA DEPH T 1 " XR F TEC H C.PADILL A MIS C CONFIRMATIO N NOT E CLEA R
pp m ±Erro r P b 177.29 3 ±20.49 5 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 182.63 7 Supervise d By : 

## Certificat e o fVerificatio n

14 9 SOI L 2011-02-2 2 17:0 9 30.5 2 Fina l 3361 3 391 3 N 1 8 S T E A 1 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r ± 18.54 2

# 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 159.27 5 Supervise d By : 

## Certificat e o f Verificatio n

15 0 SOI L 2011-02-2 2 17:1 0 30.5 7 Fina l 3361 3 391 3 N 1 8 S T E A 1 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r ± 17.60 4

# 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 AVERAG E ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

P b Supervise d By : 

## Certificat e o fVerificatio n

15 5 SOI L 2011-02-2 2 17:1 3 90.9 7 Fina l Av g o f152-15 4 391 3 N 1 8 S T B l 6 " C.PADILL A CONFIRMATIO N CLEA R

# 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 XRFTEC H MIS C NOT E

pp m P b 123.60 4 Supervise d By : 

## Certificat e o fVerificatio n

15 2 SOI L 2011-02-2 2 17:1 1 30.1 8 Fina l 3361 3 391 3 N 1 8 S T B l 6 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r ± 18.24 4

# 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 113.86 3 Supervise d By : 

## Certificat e o fVerificatio n

15 3 SOI L 2011-02-2 2 17:1 2 30.2 4 Fina l 3361 3 391 3 N 1 8 S T B l 6 " C.PADILL A CONFIRMATIO N CLEA R

±Erro r ±17.62 9

# 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 122.78 4 Supervise d By : 

## Certificat e o f Verificatio n

15 4 SOI L 2011-02-2 2 17:1 3 30.5 5 Fina l 3361 3 391 3 N 1 8 S T B l 6 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r ± 16.01 4

### " l Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 \ • o ^o * Coasta l Environmenta l Grou p Inc
. www.coastalhazmat.co m • %Pno-(t^ " COASTA L ENVIRONMENTA L CROUP , INC
. 

# EXECUTIV ESUMMARY : BVI D #33613-(391 3 N1 8 ST )

X 

# N o Issue s o r Concern s Q Issues/Concern s Detai l Explanation : -DANGARVE Y WALKE D TH EPROPERT Y ON11/2/201 0

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. wt-r c th e correc i (juadranKs ) tutavalc dandtcMortri' ' » ' I f nrccsia"^' , v^er e Ihe correr l area s o l dn p 7on c cxcavalc dHn drtsioied " y (irariJD g So dan dVr^ttUlio c _ I Doc s th e gradin g aroun dih e perimete r ofth e hous t i

nexrsvair nar(n< yrncral K ';KI| K t\'.-^ \ 

# y fromib c house ?
_ ? Ha s so dbee nlai di nal l area s lha l wer e excavated' ' 

# y^
­ Doc' s ih c so dappear lo be penerail y heallhy an dgrowing' ' (Onl y evaluai e i ' m^pirti da i s M i y ^ \ day lime ptriod )
_ "1 .'Vr e sodde darea s generall y fir man devenly graded' ' / ' "- Ar e th e joinu ; betwee nTh e so dsmp; : generall y tight' ' (Onl v evaluat e i f inF.pccic da t a~ nda v tjjne period )
_. . ^ , fc Wa s the property grade dsuc htha i wate r w il l no l poo l cnI' K nroptnv ' / _^
_. ^ ^ 7 Wa s damig e l o landscapin g or plan t niaierial t avoided " Z (iBles , rupee s an dRtlainln g Wall s _^ '• * D o gate s openandclos e freely' ' (I f applicahlc ) / Wer e all gate s 0 1 fence s lakendowndurin g restoratio nacti\'ihe 5 reinstalled' ' (I I arDlicat:l ( i y Wa s damag e l o gate s o r fence s avoided' ' (I f applicable , 

# y J Wa s damig e to retainin g wall s avoided' ' (I f applicable ) 

# y' k

oupdaiion , Sidin g an dGuMer s Wa s damag e to the sidin g or tri mavoided' ' y \^'a i damag e inthe foundatio navoided' ' ^ Wa s damag e I c w indow s avoide d" y Wa s demag e to window s o r door screen s avordtd' ' , / ; WH"
. damag e l o downspout s o r downspou t txien'ior' s a \oidc d' 

# y ; SidfViiilk j an dDrivcMay. s (toDcreleJ ^ "i c - ^ ( I Wa s damag e 1 0 drivfua y surfacr s a\(Hrie d ,' • ^ 1 W'a s da-nag r to l^alliv^a ) surface s avoided' ' 

## Z'

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. ,. . _^ . . .. ' Restoratio n Item s i n Question
.

Additiona l Comments :

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