## TRANSMITTALo f

OMAH ALEAD SITE SOI LREMEDIATIO NFIL EFOLDER SAI D # : ^a^6 l Date : ^p4^|CP l Address : \?,V ^ S> ^ 6 S T Remediatio nContractor : Coasta l Environmenta l Group
_ Year : 200 8
SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S Vide o o f property (DVD ) 4031549 0 

### Executiv e Summai ^ Superfun d 

### EPA-provide dproperty sketc h Signe dAcces s Agreemen t fo r subjec t property 

# m Signe dAcces s Agreement(s ) fo r adjacent property Restoratio nAgreemen t Settlemen t document s (i.e. , fo r damag e or to replac e plants , etc. ) Confirmatio ndat a 

## Photograph s p^e^-^^fLflJQi^oyv ^ je.)C.c/h\aIim ^ (to/U^o d As-buil t sketc h 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 Utility clearance s Property informatio nfro mDougla s County Assessor' s Offic e

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## Propert yAcces s Checklis t Propert j ID : Z Q 3 ^ 1 nWOR K STARTE D ON : / / Property Address : ) ^ " 7 $ 7 f ^ " ^ J " D WOR K COMPELTED ON : / / 

# Owner : Y^-^^ ] \(f^rirr Renter : Phone : Fa.\ : Cell/Pager : Phone : 70" ; _)7t,l- | Additional Information : Fax : Cell/Pager
. Address : S^m^ ^

D NotificationLette r Sent : / / By : ^ Acces s Agreement Siened : | 0 / )' K 1 0 ^ By : 

# u Q Restoratio nAgreement Signed : Jli/il/ ^ By : 

# L d \Z

\Topsoil Samplin g (i f applicable ) / / By : dDisposa l Samplin g (i f applicable ) / / By : C

U Garde nSamplin g (i f applicable ) / / By : \ ^ Utilit y Clearanc e Called : ill/A/fl S By : 

# ]Oinio ^ 7 ] Video/Photo s (Before) On:42_/jLb/Ji S By : 

# N,chu\a ^ nVideo/Photo s (During ) On : / / By : nVideo/Photo s (After) On : / / By : D Video/Photo s (30-Day) On : / / By : dProperty CompletionAgreement Signed : / / By : nFinal Report Issued : / / By : Air Monitorin g (a s applicabl e ) nCommunit}

- O Crew On : / / By : Results :

• Community ' D Crew On : / / By : Results : 1 1 Community ' Q Crew On : / / By : Results :
Omah a Lea d Sit e 

# 1

### #



## CONTACT FOR M Propert y I D # 7.035 1 Propert y Address : )1.1~ 7 S 1 ^ S T — 

## Initia l Contact : Date : Time : Action : Secon dContact : Dale : Time : Action : Fina l Contact : Date : Time : Action : Fina l Action : Transmi t to EP AD Othe r Action ; D

Comment : Owne r Commen t (s) : Sit e Coordinato r Commen t (s) :

i

### Dougla s County Accoun t Informatio n Pag e 1 of 3 rormat
Dougla s County , Nebrask a Propert yRecor d - R22194800G 0 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t of90t h S t - VijWO n Ma £ Informatio n i s vali d a s o f2008-9- 4 Treasurer' s Ta xRepor t Ne wFeatur e -•->- > Aut o Sale s Searc h Owne r KEENE R PAU L C ETA L 131 7 S 2 5 S T OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumber : 194 8 000 0 2 2 Accoun t Type : Residentia l Parce l Number : 221948000 0 Parce l Address : 131 7 S 2 5 S T OMAH AN E 68105-000 0 Lega l Description : SHULL S 2N D AD D LO T1 8 BLOC K1 2 5 0 X 12 6 Valu e Informatio n Lan d Improvemen t Tota l 200 8 200 7 200 6 200 5 200 4 200 3 $4,900.0 0 $4,900.0 0 $4,900.0 0 $4,900.0 0 $4,900.0 0 $4,900.0 0 $80,400.0 0 $80,400.0 0 $79,000.0 0 $79,000.0 0 $79,000.0 0 $79,000.0 0 $85,300.0 0 $85,300.0 0 $83,900.0 0 $83,900.0 0 $83,900.0 0 $83,900.0 0 '
Sale s Informatio n Sale s Date : 2003-07-2 5 Dee d Type : W D Book : 200 3 Page : 16124 9 Price : $51,334.0 0 Grantor : Gale n R Myer s ETA L Grantee : Pau l C Keene rETA L Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 1996-06-0 6 Dee d Type : D Book : 203 9 Page : 55 0 Price : $65,000.0 0 Grantor :


### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accoimtno=R22.
. . 9/27/200 8

### Dougla s County Accoun t Informatio n Pag e 2 o f 3 :or|^t i
Grantee : Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 1993-06-1 4 Dee d Type : Book : 195 3 Page : 39 7 

### Price : $46,950.0 0 Grantor : Grantee : Valid/Invalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 4 6300. 0 1. 0 126. 0 50. 0 N o Improvemen t Informatio n Buildin g 1

If ) '.r*liiiVJ» l (4 4 d -i ^ a M O ti p

liC r %« FIn l rVOC f 87 4 0 s q 1 1 Swsn d Floo r •n^Qt q ft

u t •$ 0 ^

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## 2 STOR Y
tW- Ktlxk!. ' « Fi n Bsm t nt i irK l i n bu l L v CLIC KT O ENLARG E IMAG E Squar e Footage : Perimete r Uni t Type :

Buil t As :

HVAC : Exterior : Interior : Roo f Cover :

Roo fType : Fioorcover : 1706. 0 0. 0 2 Stor y Centra l Ai rt o Ai r Fram e Viny l Plaste r Compositio n Shingl e Gabl e Allov(/ance Percen t Complete : Quality : Condition : Cond o Squar e Footage : Rooms :

Units : Baths : Bedrooms : Stories : Foundation : 100.0 % Averag e Goo d 0. 0 7. 0 1. 0 3. 0 3. 0 2. 0 Bloc k


### http://douglasne.mapping-online.com/DouglasCoNe/static/accounfinfo.jsp?accountno=R22.
. . 9/27/200 8

### Dougla s County Accoun t Infonnatio n Pag e 3 o f 3 onjmt i
Sprinkle rSquar e Footage : 0. 0 Yea rBuil t 191 0 Detai l Typ e Ad d O n Applianc e Basemen t Basemen t Fixtur e Fixtur e Fixtur e Garag e Porc h Porc h Porc h Yea r Remodele d 0 Percen t Remodele d 0 % Detai l Descriptio n Fenc e Chai n Lin k Allowanc e Bsmn t Bloc k 8 f t Minima l Finis h Additiona l Fixture s Bas e Fixture s Bat h Ful l Detache d En d Soli d Wal l En d Soli d Wal l Sla b w/Step s Adjuste d Yea r Buil t Physica l Ag e 191 0 9 8 

### Unrts 1. 0 1. 0 864. 0 550. 0 2. 0 1. 0 3. 0 240. 0 192. 0 144. 0

20. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R22.
. . 9/27/200 8

### Pag e 1 of 2

Creat e Anothe rTicke t Bac k t o Irt h Interne t Sen d Emai l



### • YOU RTICKE T NUMBE RI S 2157637
. Origina l Cal l Date : 10/18/0 8 Wor k t o Begi n Date : 10/22/0 8 Time : Time : 7:2 0 p m 7:1 5 a m Op : ELIZABETH1879 0
State : N E Address : 131 7 County : DOUGLA S Street : S 25T H S T Place : OMAH A Twp : 15 N Twp : Rng : 13 E Rng : Sect-Qtr : 28-N E Sect-Qtr : Lega l Given : C Typ e o f Work : lea d remidiatio n Locatio n o f Work : LOCAT E ENTIR E PROPERT Y STARTIN G INCLUDIN G TH E HOUS E AN D : AL L TH E WA Y T O TH E STREET . Remarks : FA X AL L CLEAR S TO : (877)662-421 1 Compan y: COASTA L ENVIRONMENTA L SERVIC E Contac t Name : ELIZABET H Phone : (877)662-421 0 Wor k Bein g Don e For : coasta l Dept h o f Excavation : 4f t Corne r Lot : N Front : Y Rear : Y Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V LEVEL S MCLEODN E MUD0 2 OMAHACO F 0PPDGPR 6 QLNNEI F QWEST 2

Servic e Are a Contac t Phon e Numbe r Utilit y Typ e
CXCAT V CO X COMMUNICATIONS , IN C HEID I 

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

LEVEL 3 LEVEL 3 COMMUNICATIONS , LL C N A 

### Day : 877366834 4 Alt : Emerg : 877366834 4
MCLEODN EMCLEODUS A N O NEE D T O CAL LOU T EMERGENC Y 

### Day : 800289190 1 Alt : Emerg : 800289190 1
MUD0 2 METROPOLITA NUTILITIE S DISTRIC T 

### SAND Y Day : 402504782 3 Alt : 

### Emerg : 402504794 6 http://www.dhon.org/irthinteraet/DHONNoticeCreation/MessageText.asp?ret=<RESULT.
. . 10/18/200 8

### Pag e 2 of 2

CIT Y O FOMAHA

- OMAHACO F RO N TRAFFICSEWE R

OMAH APUBLI C POWE R OPPDGPR 6 N A DISTRIC T
QLNNEI FQWES T LOCA LNETWOR K N A

QWEST 2 QWES T LON GDISTANC ESARA 

### Day : 402444719 7 Alt : 402444516 1 Emerg : 402444516 0 Day : 406728934 3 Alt : 888728934 3 Emerg : 406728934 3 Day : 406728934 3 Alt : Emerg : 888728934 3 Day : 800283423 7 Alt : 303992192 6 Emerg : 800283423 7

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT.
. . 10/18/200 8

# As-Buil t Drawin g COASTA L 

# Omah aLea dSuperfun dSit e

Name : k&r - ci-&iA., « irj.j- s Omah a Lea d Sit e Date : ^/p^ ^ Nort h Ane w Address ; -.V ^ 5^ 5 j r Stt e Sketc h Time : Phone : ruo3 ) ?^P-:i??v. 4

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### Legen d Concret e Dri p Zon e Excavate d Quadrant s Excavate d Are areplace d So d wit h Are a replace d wit h Rock/Mulc h Are aleft bar e 

### Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc
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COASTA L ENVIRONKENT& L G n O U rIN 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 Agency(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 follov^in g describe d premises :

Owner' s Name : Daytim e Phone : t^O^- " lOl ^

n(> H 

# P«u i i eeise^ r
Addres s o fPropert y covere d b ythi s 

# 7/ 7 ^-^r. r 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 maypos 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 fCoasta l Environmenta l Group , contracte d b yUSEPA , wil l contact 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 

### 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 fh e righ t t o ente rth e property , at al l reasonabl e time s an d wit h prio rnotice , fo rth e sol e purpos e o fperformin g th e work
. Thi s acces s shal l remai n i n effect unti l th e wor k ha s bee n satisfactoril ycompleted
. Th e Granto rals o agree s to :

Pag e 1 o f2

### # % ^ < # COASTA L ENVIRONMENTA L C « O U F , IN C



### •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 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 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 yofth 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 Coasta l Environmenta l Group , a t (712 ) 352-018 8 

# ¥ I gran t acces s t o m ypropertie s D I d o no t gran t acces s t o m ypropertie s

Signatur e Signatur e Date

O1 woul d lik e t o b e presen t durin g an ysanrtplin g tha t i s required
.

# m #

COASTA L

• r ' (KOWMtNTA l C RO U ^
. IM C 

## Restoratio n Agreemen t Th e purpos e of thi s agreement i s t o provid e amutua l agreement a s t o condition s ofth e propert y prior t

o remediatio nactivities
. Tlii s will als o serv e as documentatio nfo r the purpos e o f assurin g tha t restoratio n activitie s ar e completedt o the satisfactio nofth e propert y owne r an dthe UnitedState s Environmenta l Protectio nAgenc y (EPA)
. Propert y ID : ^(y j § / PropertyAddress : / / / 7 ^ <: ^ C 

### Owner : Phone : lyo;x

- HJ^-P-i^ O
O

nthe attacheddiagram(s ) indicat e area(s ) t o excavatedan ddept ho f excavation , locationof al l know n utilities , subsurface features , syrfac e structure s an dlandscaping features , acces s iocation(s ) t o be use db y contractor , an dthe directiono f North
. Indicat e distances , depths , materia l types , etc . Indicat e digita l photo s b

y referencing th e phofo-log numbe r wit ha narrow indicating directiono f view
. Item s T o B e Remove d B yOwne rBefor e Star t O fRemediation : (Us e additiona l sheet s a s necessary ) Th e removal , storage , disposal , and/o rretur n o fthes e item s i s th e Owner' s responsibility
. Item : 

# -f-^y ^ , / y h^^>^ y Ul,') Item : Item : Item : / / Item : Item : Item : Item :
Pag e 1 of
. 

# c

### #
C p AS TAU fr«viHONr*VMTA L cn o u r. IN C 

### Item s To B e Remove d B yContracto rDurin g Remediatio n An d No t Replace d (Us e additiona l sheet s a s necessary ) Item : /V/?o ^ 

# ^ 1 QIcxn'h ' ( ^ f^ T h<z.l/^'/^ ^ ^ Item : Item : Item : Item : Item : Item : Item : / Item : Item : ttem: Item : Item : Item : Item :

Pag e 2 o fh

### #

COASTA L rNVlMONMCNTA L C R o u r. IN C 

### Item s T o B e Remove d B yContracto rDurin g Remediatio n An d Replace d (Us e additiona l sheet s a s necessary ) Item : . 

# F7 ^ 

# n ^ 

# p a Item : 

# e i Item : Item : Item : ttem: Item : Item : Item : Item : ttem:



# c Pag e 3 of
.I 

### #
C O A5 TAL N*»i(»'oHntNr* t C R O U r. IM C 

### Landscap e Inventory (Us e additiona l sheet s a s necessary ) 

## Ite m

Pre-existin g propert y area , tha t will be excavated , tha t i s covere dwit hgrass .

Number of tree s > 2 inch trun k

diameter

Number of tree s <= 2 inch trun k

diameter

Number o f Sprinkler Zones , Contro l Valves , Timers , Heads , etc . Attachasketchof the sprinkler layout
.
Number o f an dsiz e o f eachgarden / flowe r bed area . Attachasketcho f relativ e size s an dlocations
. 

## Quantity 

# pi L 

# r ' y

/ 

# j ^ 

# y Unit

Squar e fee t 

## Condition/Type/Specie s

Eac h • .

Eac h

Eac h

Eac h Squar e Fee t

Pag e 4 o f 

# 0C O AS> TAL rNviiioNr*ftNT* > cH o u r- . IM C 

## Ite m Quantity Unit Condition/Type/Specie s Agree dupo nvalu e of Dian t material s no t to b e replace dbv contractor . Note thi s valu e wil l b e usedto issu e aplan t vouche r to th e propert y owner . Agree duponlis t o f plan t material s tha t will b e replace dby conn-actor . B e ver y specifi c anddetailed
. Include asketcho f wer e eachplan t wil l be placed b

y th e contractor . Agree dupo nare ao f propert y t o be replace d wit hgras s sod
. Include asketchof the area(s ) to be replace dwit h gras s sod
.
Are aof Cit y o r Count y propert y to b e landscape d per thei r requirements
. Include asketcho f the are a(s )

Easement Area , to b e excavate d 

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. B ycheckin g thi s boxCE G I s no t responsibl e fb ran ydamag e don e t o th e interio ro fhouse , includin g foundatio n cracks ; o rfissures.

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I agre e Q I d o no t agre e

Owoer' s Signature Coofractor' s Signature ^t e Pag e 6 of
.

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# 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 237 4 Mod e SOI L Tim e 2008-11-0 3 11:3 6 Duratio n 122.2 4 Sequenc e Fina l Flag s AVERAG E » Av g o f2370-237 3 ADDRES S 131 7 s 2 5 s t QUAD/ZON E PZ INSPECTO R Ventr y DEPT H • 6 SAMPL E TYP E , CLEARANC E NOT E

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 237 0 Mod e SOI L Tim e 2008-11-0 3 11:3 3 Duratio n 30.8 5 Sequenc e Fina l Flag s BVI D # 2035 1 ADDRES S 131 7 s 2 5 s t QUAD/ZON E P Z INSPECTO R Ventr y DEPT H 6 SAMPL E TYP E CLEARANC E NOT E

pp m ± Erro r P b 211.18 3 ± 18.39 8 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 365.98 9 Supervise d By : 

## Certificat e o fVerificatio n

237 1 SOI L 2008-11-0 3 11:3 4 30.5 6 Fina l 2035 1 131 7 s 2 5 s t PZ Ventr y 6 CLEARANC E

± Erro r ± 23.31 9

# 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 237 2 Mod e SOI L Tim e 2008-11-0 3 11:3 5 Duratio n 30.2 3 Sequenc e Fina l Flag s BVI D # 2035 1 ADDRES S 131 7 s 2 5 S t QUAD/ZON E PZ INSPECTO R Ventr y DEPT H 6 SAMPL E TYP E CLEARANC E NOT E

pp m ±Erro r P b 305.18 4 ±20.83 9 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 299.04 7 Supervise d By : 

## Certificat e o fVerificatio n

237 3 SOI L 2008-11-0 3 11:3 6 30.6 0 Fina l 2035 1 131 7 s 2 5 s t PZ Ventr y 6 CLEARANC E

± Erro r ± 21.23 8

# 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 237 9 Mod e SOI L Tim e 2008-11-0 3 11:4 0 Duratio n 122.5 8 Sequenc e Fina l Flag s AVERAG E Av g o f2375-237 8 ADDRES S 131 7 s 2 5 s t QUAD/ZON E D Z INSPECTO R Ventr y DEPT H 1 3 SAMPL E TYP E CLEARANC E , NOT E

P b 919.060 / / ± Supervise d By :

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

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

pp m P b 2076.42 9 Supervise d By : 

## Certificat e o fVerificatio n

237 5 SOI L 2008-11-0 3 11:3 7 30.6 6 Fina l 2035 1 131 7 s 2 5 s t D Z Ventr y 1 3 CLEARANC E

± Erro r ± 56.93 6

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

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

pp m P b 502.90 2 Supervise d By : 

## Certificat e o fVerificatio n

237 6 SOI L 2008-11-0 3 11:3 8 30.9 6 Fina l 2035 1 131 7 s 2 5 s t D Z Ventr y 1 3 CLEARANC E

± Erro r ± 26.95 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 542.11 6 Supervise d By : 

## Certificat e o fVerificatio n

237 7 SOI L 2008-11-0 3 11:3 9 30.6 7 Fina l 2035 1 131 7 s 2 5 s t D Z Ventr y 1 3 CLEARANC E

± Erro r ± 28.11 6

# 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 554.79 1 Supervise d By : 

## Certificat e o fVerificatio n

237 8 SOI L 2008-11-0 3 11:4 0 30.2 9 Fina l 2035 1 131 7 s 2 5 s t D Z Ventr y 1 3 CLEARANC E

± Erro r
± 28.18 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 AVERAG E ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

Supervise d By : 

## Certificat e o fVerificatio n

238 4 SOI L 2008-11-0 3 11:4 3 121.6 8 Fina l Av g o f2380-238 3 131 7 s 2 5 s t easemen t Ventr y 1 CLEARANC E
.

# 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 165.86 3 Supervise d By : 

## Certificat e o fVerificatio n

238 0 SOI L 2008-11-0 3 11:4 1 30.5 3 Fina l 2035 1 131 7 s 2 5 s t easemen t Ventr y 1 CLEARANC E

± Erro r 15.79 8

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

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

pp m P b 195.53 6 Supervise d By : 

## Certificat e o fVerificatio n

238 1 SOI L 2008-11-0 3 11:4 2 30.6 6 Fina l 2035 1 131 7 s 2 5 s t easemen t Ventr y 1 CLEARANC E

± Erro r ± 17.20 7

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

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

pp m P b 207.00 0 Supervise d By : 

## Certificat e o fVerificatio n

238 2 SOI L 2008-11-0 3 11:4 3 30.2 4 Fina l 2035 1 131 7 s 2 5 s t easemen t Ventr y 1 CLEARANC E

± Erro r ± 17.44 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 244.05 0 Supervise d By : 

## Certificat e o fVerificatio n

238 3 SOI L 2008-11-0 3 11:4 3 30.2 5 Fina l 2035 1 131 7 s 2 5 s t easemen t Ventr y 1 CLEARANC E

± Erro r ± 18.79 1

# m Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc
. %

. • J ? www.coastalhazmat.co m VPHO^^ ^ COASTA L ENVIRONMENTA L CROUP , INC
. 

# EXECUTIV ESUMMARY : BVI D #2035 1 - (131 7 S 2 5 ST )
I I N o Issue s o r Concern s ^ Issues/Concern s Detai l Explanation : HOMEOWNE RREQUESTE D MULC H INSTEA D O FSOD
.- - 

# t .^EP A EP APropert > Clos e Ou t For m Propert ytt : 'iPOJ^t: ^ Propert yAddreu : \'^ \ 1 S - Q ^ ^V - Datc/Tlmc : Owner' s Name : ?Q-W^JL - Quad s Excavated : \;^? : ,_? ^ Conlracto rCrou p 0JOOL5<V<- ^ t:^^t .roc^.*-^-^'^'^''- ^ Excavatio n Genera l Ve s N o 1 I f necessary , wer e th e correc t quadrant(5 ) excavate d an d restored ? ^ 2 I f necessary , wer e th e correc t areas o f dri p zon e excavate d an d restored' ' ^ Cradlo KSo d an d VeccUtio D Ye s N o 1 Doe s th e gradin g aroun d th e perimete rofth e hous e i n excavate d areas generall yslop e away from th e house ? t ^ 2
. Ha s so d bee n lai d i n al l areas tha t were excavated ? ^ 3
. Doe s th e sod appea rt o be generall yhealth yan d growing ? (Onl yevaluat e i f inspecte d a t a 3 0 ^ daytim e period ) 4 Ar e sodde d areas generall yfuTTi an d evenl ygraded ? ^ 5 Ar e th e joint s t)etwee n th e so d strip s generall ylight ? (Onl yevaluat e i f inspecte d a t a 3 0 da y tim e period ) 6 Wa s th e propert ygrade d suc h that wate rwil l not poo l o n th e property' ' ly ^ 7 Wa s damag e l o landscapin g o rplan t material s avoided ? ^ Gates , Fence s an d ReUinln £ Wall s Ve s ^ o 1 D o gate s ope n an d clos e freely? (I f applicable ) i ^ 2 Wer e al l gate s o rfence s take n dow n durin g restoratio n activitie s reinstalled ? (I f applicable ) 1 ^ 3 Wa s damag e t o gate s o rfence s avoided ? (I f applicable ) ^ 4 Wa s damag e t o retainin g wall s avoided ? (I f applicable ) ^ Foundation , Sidio Kan d Culler s Ye s N o 1
. Wa s damag e t o th e sidin g o rtri m avoided ? u ^ 2 Wa s damag e t o th e foundatio n avoided ? < ^ 3 Wa s damag e t o window s avoided ? i ^ 4 Wa s damag e t o window s o rdoo rscreen s avoided' ' ^ 5 Wa s damag e t o downspout s o rdownspou t extension s avoided ? ^ Sidewalk s an d Driveway s (Concrele ) Yes N o Wa s damag e l o drivewa ysurface s avoided" ^ 2
. Wa s damag e t o walkwa ysurface s avoided ?

# # t O men s comments ;

Inspectio nnotes : 

# /\j o sa dpe r ? ^ R^ut^

- /TUM-IM ^

Removal andrestoratio nactivate s complet e includin g the 30-da y sodwarranty EPARepresenlativ e 

# :^^£^^^<J^^^^^.kJL^t ' Date : //%;^ f% 

# 'lif e Propert yCompletio n Agreemen t Thi s agreement documenl s th e completio no f remedial activiiie s performe do nm y property . My signatur e will designat e Iha t 1 a msalLsfie dwit hiji e restoratio no f m y property , an dthat n o item s ar e i nqucslion.s , now , or a

t an y tim e i nth e future , excep t thos e item s liste dbelow , if any . PropcityjD : ^^^5- /
_ Propert y Address : ^ 3 , ': ^ " ^ Qj^__3t , Owner : fcu^ / ^^^^ ^ 

## Phone : ^07--y^4Y ^ Restoratio nItem s i nQuestion :

Item : Item : Item : Item : Item : Item : Additiona l Comments : 

# J

"TT/L ^ I agre e rrjitoralio ni. s coniptelcd , excep t a s note d I I il o not agre e reslorafiu ni v i-nmpleted

* - : Owner' s .Si)>naliir r l)a ( Confractor's

- .Sijjnatur e Dat e ' I