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TRANSMITTA Lo f OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R 

## SAID# : 1^5^' ^ Date : ,ajak/i £ Address : i^lJl ^ btCpOn^ T Sj

- Remediatio nContractor : Coasta l Environmenta l Group

_Year : 200 8 SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S S / Vide o ofpropert y (DVD ) Q ^ Executiv e Summary y EPA-provide dproperty sketc h y Signe dAcces s Agreemen t fo r subjec t property j^f [ Signe dAcces s Agreement{s ) fo r adjacent property y Restoratio nAgreemen t PJ| i Settlemen t document s (i.e. , fo r damag e or to replac e plants , etc. ) B ^ Confirmatio ndat a 

## y Photograph s pne.- ^yf^j/ijxtyi ^ ^<VyJ/gJuw^ -fji^A i SOc i \ 7 As-buil t sketc h y Satisfactory restoratio nsigne db y Property Owne r y Propert y close-ou t chec k lis t signe db y EP A IffJI V Descriptio nofarea s no t meetin g RO D cleanu p criteri a WUtilit y clearance s B ^ Propert y informatio nfro mDougla s Count y Assessor' s Offic e 

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l ^ [^ n D D D D Notificatio nLette r Acces AAgreemen t Restoratio nAgreemen t Topsoi l Samplin g (i f applicable ) Disposal Samplin g (if applicable ) Garde nSamplin g (i f applicable ) Utility Clearanc e Video/Photo s (Before ) Video/Photo s (During ) Video/Photo s (After ) Video/Photo s (30-Day ) Propert y Completio nAgreemen t Fina l Repor t Sent : / / Siencd : W/ W/ OP , Signed : 1 \/ 1 \/ Of t / / / / / / 

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### Dougla s County Accoun t InjBmatio n Pag e 1 of 3

i^Bm s • Dougla s County , Nebrask a Propert yRecor d - R052360000 0 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e (3 ! scal e 0-5 0 ft wes t of90t h S t - ViewO n Ma p 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 RAMIRE Z JOS E 276 9 DUPON TS T OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumber : 236 0 000 0 0 5 Accoun t Type : Residentia l Parce l Number : 052360000 0 Parce l Address : 276 9 DUPON TS T OMAH AN E 68105-000 0 Lega l Description : ARBO R PLAC E LOT5 BLOC K3 3 8 1/ 3 X 113. 5 Valu e Informatio n Lan d Improvemen t Tota l 200 8 $4,000.0 0 $74,800.0 0 $78,800.0 0 200 7 $4,000.0 0 $74,800.0 0 $78,800.0 0 200 6 $4,000.0 0 $67,800.0 0 $71,800.0 0 200 5 $4,000.0 0 $67,800.0 0 $71,800.0 0 200 4 $4,000.0 0 $67,800.0 0 $71,800.0 0 200 3 $4,000.0 0 $32,600.0 0 $36,600.0 0 Sale s Informatio n Sale s Date : 2001-01-1 2 Dee d Type : D Sooilr ; 217 2 Page : 08 7 Price : $61,000.0 0 Granto r Grantee : Valid/lnvalid : Vali d Exclusio n Reason : Sale s Date : 1993-10-2 6 Dee d Type : D Boolr : 196 4 Page : 74 3 Price : $32,000.0 0 Grantor :


### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R05.
. . 11/4/200 8Dougla s Count y Accoun t IiiJBmatio n Pag e 2 of 3

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Grantee : Valid/lnvalid : Vali d Exclusio n Reason : Sale s Date : 1993-08-2 7 Page : Deec f Type : Book : 195 9 49 6 Price : $ 29,500.0 0 Grantor : Grantee : Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 1992-02-2 1 Dee d Type : Book : 192 1 Page : 54 9 Price : $ 31,500.0 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 0.0 9 4294. 0 1. 0 113. 0 38. 0 N o Improvemen t Informatio n Buildin g 1

J7e»0UP0MTS T Secon d Floo r 200. 0 sq.« . ai r e o First Floo r 1012. 0 iq.t
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. 1 1 /4/200 8

### Dougla s County Accoun t Inj«natio n Pag e 3 of 3 |an a
Uni t Type :

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

Roo fType : Gabl e Floorcover : Allowanc e Yea r Percen t Yea rBuil t Remodele d Remodele d 188 5 0 0 % Physica l Ag e Condition : Cond o Squar e Footage : Rooms :

Units : Baths : Bedrooms : Stories : Foundation : Sprinkle rSquar e Footage : Adjuste d Yea r 

### % Fai r 0. 0 6. 0 1. 0 1. 0 3. 0 1. 5 Bloc k 0. 0 Buil t 188 5 12 3 Unit s 1. 0 1. 0 1012. 0

234. 0 1. 0 1. 0 400. 0 138. 0 1. 0 Detai l Typ e Ad d O n Applianc e Basemen t Basemen t Fixtur e Fixtur e Garag e Porc h Use r Detai l Descriptio n Fenc e Chai n Lin k Allowanc e Bsmn t Bloc k 8 f t Finishe d Bas e Fixture s Bat h Ful l Detache d En d Scree n 2 0 % - 1 F



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R05.
. . 11/4/200 8

### Pag e 1 of 2

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### • YOU RTICKE TNUMBE RI S 2173522
. Origina l Cal l Date : 11/11/0 8 Time : 7:3 7 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 11/14/0 8 Time : 7:1 5 a m State : N E County : DOUGLA S Place : OMAH A Address : 276 9 Street : DUPON T S T Twp : 15 NRng : 13 E Sect-Qtr : 28-S E Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : Omah a Lea d 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 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 ho f Excavation : 4 f t Corne r Lot : N Front : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N ATTNEBR l CXCAT V LEVEL S MCINE B MCLEODN E MUD0 2 OMAHACO F 0PPDGPR 6 QLNNEI F QWEST 2 SPRINTN E

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ATTNEBR l ATT/T Day : Alt : Emerg : 8002413624 9 8002413624 9
CXCAT V CO XCOMMUNICATIONS , IN C HEID I Day : Alt : Emerg : 402934046 9 402934046 9 402932975 7
LEVEL S LEVEL S COMMUNICATIONS , LL C N A Day : Alt : Emer g 877366834 4 877366834 4
MCINE B MC I N O CALLPERMEM O Day : Alt : 800289342 7 Emerg : 800289342 7

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. . 11/11/200 8

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

### Name : fijA^^^Z Omah a Lea d SKe Date : MS/n! ^ Nort h Arro w 

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## 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 : Daytim e Phone : 

# ^^ ^ 'garviire^.3^^^^^<^'' ^
Addres s o fPropert y covere d b ythi s 

# ^7/ 7 iyoy^y^7 y 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 fCoasta l Environmenta l Group , contracte d b yUSEPA , wil l contac t th e Granto rin-perso n t o discus s th e wor k t o b e 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 th e right 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 f2I 

### f XT^^j ^ COASTA L ""t-.ot" * Clour
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### •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 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 Coasta l Environmenta l Group , a t (712 ) 352-018 8
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I gran t acces s t o mypropertie s Q I d o no t gran t acces s t o m ypropertie s


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## Restoratio n Agreemen t The purpos e ofthi s agreement i s to provid e amutua l agreement a s to condition s ofth e propert y prior t

o remediatio nactivities
. Thi s will als o serv e a s documentatio nfo r the purpos e o f assurin g tha t restoratio n activitie s ar e completedt o the satisfactio no f the property ' owne r an dthe UnitedState s Environmenla l ProtectionAgenc y (EPA)
. Propert y ID : / 7 i ? X

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

## Ite m

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

Number of tree s > 2 inch trun k

diameter

Number of tree s <= 2 inch trunk diameter

Number of Sprinkler Zones , Contro l Valves , Timers , Heads , etc . Attachasketch of th e sprinkler layout
.
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. 

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Page4o f KOCOASTA L tNVinor4r«tHTA i C I * O U P IM C 

## Item Agree dupo nvalu e of Dian t material s no t to b e renlace dbv contractor . Note thi s valu e will 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 db y contractor . B e ver y specifi c an ddetailed
. Include asketchof wer e eachplant wil l be place d b

y the contractor . Agreedupo nare aof propert y t o b e replace d wit hgras s sod
. Include asketcho f the area(s ) to be replace dwit h gras s sod
.
Are ao f Cit y or Count y propert y to b e landscaped per their requirements
. Include asketcho f the ai^e a(s )

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D Chec k th e bo xI fOwne rdoe s no t wan t CE G t o documen t interio rfbundatio n wall s an d possi'bl 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 , indudin g fbundatio n crack s o rfissures
.



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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 99.83 9 Supervise d By : 

## Certificat e o fVerificatio n

372 3 SOIL 2008-11

- 1 8 16:0 1 31.6 0 Fina l 1739 8 276 9 dupon t s t easemen t Ventr y 1 CLEARANC E

± Erro r ± 11.99 9

# 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 Pr'P E NOT E

pp m P b 106.39 3 Supervise d By : 

## Certificat e o fVerificatio n

372 4 SOIL 2008-11-1 8 16:0 1 30.8 7 Fina l 1739 8 276 9 dupon t s t easemen t Ventr y 1 CLEARANC E

± Erro r ± 12.81 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 151.84 6 Supervise d By : 

## Certificat e o fVerificatio n

372 5 SOIL 2008-11-1 8 16:0 2 30.8 7 Fina l 1739 8 276 9 dupon t s t easemen t Ventr y 1 CLEARANC E

± Erro r ± 15.06 2

# 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 184.75 6 Supervise d By : 

## Certificat e o fVerificatio n

372 6 SOI L 2008-11-1 8 16:0 3 30.9 7 Fina l 1739 8 276 9 dupon t s t easemen t Ventr y 1 CLEARANC E

± Erro r ± 16.02 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 AVERAG E ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

P b Supervise d By : 

## Certificat e o fVerificatio n

398 2 SOI L 2008-11-2 0 11:4 1 122.8 1 Fina l .Av g o f3978-398 1 *276 9 dupont ' | B 2 • "Ventr y

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 368.67 2 Supervise d By : 

## Certificat e o fVerificatio n

397 8 SOI L 2008-11-2 0 11:3 9 30.9 7 Fina l 1739 8 276 9 dupon t B 2 Ventr y 1 3 CLEARANC E

± Erro r ± 23.57 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 458.00 7 Supervise d By : 

## Certificat e o fVerificatio n

397 9 SOI L 2008-11-2 0 11:4 0 30.6 6 Fina l 1739 8 276 9 dupon t B 2 Ventr y 1 3 CLEARANC E

± Erro r ± 25.46 2

# 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 333.04 2 Supervise d By : 

## Certificat e o fVerificatio n

398 0 SOI L 2008-11-2 0 11:4 0 30.6 2 Fina l 1739 8 276 9 dupon t B 2 Ventr y 1 3 CLEARANC E

± Erro r ± 22.24 1

# 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 451.50 4 Supervise d By : 

## Certificat e o fVerificatio n

398 1 SOI L 2008-11-2 0 11:4 1 30.5 6 Fina l 1739 8 276 9 dupon t B 2 Ventr y 1 3 CLEARANC E

± Erro r 25.58 2

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 568 1 Mod e SOI L Tim e 2008-12-1 7 12:0 8 Duratio n 121.8 2 Sequenc e Fina l Flag s AVERAG E gAv g o f5677-568 0 ADDRES S *276 9 dupon t QUAD/ZON E INSPECTO R *Ventr y DEPT H 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 567 7 Mod e SOI L Tim e 2008-12-1 7 12:0 5 Duratio n 30.6 1 Sequenc e Fina l Flag s BVI D # 1739 8 ADDRES S 276 9 dupon t QUAD/ZON E G Z INSPECTO R Ventr y DEPT H 1 3 SAMPL E TYP E CLEARANC E NOT E
pp m ±Erro r P b 434.14 1 ±25.18 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 462.88 9 Supervise d By : 

## Certificat e o fVerificatio n

567 8 SOI L 2008-12-1 7 12:0 6 30.9 3 Fina l 1739 8 276 9 dupon t G Z Ventr y 1 3 CLEARANC E

± Erro r ± 26.28 5

# 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 515.65 2 Supervise d By : 

## Certificat e o fVerificatio n

567 9 SOI L 2008-12-1 7 12:0 7 30.1 4 Fina l 1739 8 276 9 dupon t G Z Ventr y 1 3 CLEARANC E

± Erro r ± 28.23 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 531.57 1 Supervise d By : 

## Certificat e o fVerificatio n

568 0 SOI L 2008-12-1 7 12:0 8 30.1 4 Fina l 1739 8 276 9 dupon t G Z Ventr y 1 3 CLEARANC E

± Erro r ± 28.45 6• 

### f^^fJL \ Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 i J^^^ ' I Coasta l Environmenta l Grou p Inc
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www.coastalhazmat.co m ^-ino y COASTA L ENvmOHMENTA L GROUP , 

# EXECUTIV ESUMMARY : BVI D #1739 8 - (276 9 DUPON TST ) N o Issue s o r Concern s [ ^ Issues/Concern s Detai l Explanation: N O ISSUE S PENDING
.

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# EP A EP APropert y Clos e Ou t For m Propert ytt : yj^y B PropertyA66rr^.-f' ^

^i ^ '^"-^"T ^ ^ ^ Date/Tlroe : Owner' s N.me:.^T^^,.'^^"'f^T^ ' i^i. - Quad s Excavated : ^:jS ) ^ Gn-f c Contracto rCroupr'na<jg- At > .

1
. I f necessary , wer e th e correc t quadrant(s ) excavate dan dresiored ? 2
. Ifnecessary , wer e th e correc t area s ofdri p zon e excavate dan drestored ? GradiD K So dan dVeceUtio n 1 Doe s th e gradin g aroun dth e pcrimeie r ofth e hous e i nexcavate darea s generall y slop e away fromth e house ? 2
. Hai S so dbee nlai dinal l area s tha t wer e excavated ? 3
. Doe s th e so dappea r t o b e generall y health y andgrowing ? (Onl y evaluat e i f inspecte da t a3 0 da y tim e period ) 4
. Ar e sodde darea s generall y firman devenl y graded ? 5
. Ar c th e joint s betwee nth e so dstrip s generall y fight ? (Onl y evaluat e ifinspecte da t a3 0 day tim e period ) 6 . Wa s th e propert y grade dsuc hthat wate r wil l no l poo l onth e propeny ? 7 . Wa s damag e t o landscapin g o r plan t maierial s avoided ? Gates , Fence s an dRetainin e Wail s i D o gate s ope nan dcloii e freely? (Ifapplicable ) 2
. Wer e al l gate s o r fence s take ndow ndurin g restoratio nactivitie s reinstalled ? 3
. Wa s damag e t o gate s o r fence s avoided ? (Ifapplicable ) 4
. Wa s damag e t o retainin g wall s avoided ? (Ifapplicable ) Foundation , Sidio K an dGulltr s 1
. Wa s damag e t o th e sidin g o r tri mavoided ? 2
. Wa s damag e t o th e foundatio navoided ? 3
. Wa s damag e l o window s avoided ? 4 Wa s damag e t o window s o r doo r screen s avoided ? 5
. Wa s damag e l o downspout s o r downspou l extension s avoided ? Sidewalk j an d Driveway s (Concrete ) 1 Was damag e l o drivewa ysurface s avoided ? 2
. Wa s damage t o walkwa ysurface s avoided ? (Ifapplicable ) yr^yrnv^h^^-jy^cyL. ^

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## Onner s comments :

Inspectio nnotes :

Remova l an drestoratio nactivate s complet e includin g th e 30-day so dwarranty : luidiiu nacuvaic b compit;i c incjuain g me ju-ua y so u warranty . EP ARepresentati ) iivty-7^^^t^><;:^^^^2>^w4:z ^ Date : ///^/ ^ f

## Propert yCompletio n Agreemen t
Thi s agreemen l documeni s th e completio n o fremedia l activilie s perlbime d n n m ypioperiy
. M ysignalur e wil l designal e tha i I a m satisfie d wit h Ih e restoratio n o fm yproperly , an d that n o item s ar e i n questions , now , o ra t an ytim e i n th e fuluie , excep t thos e item s liste d below , ifan y Propert yID " ^ 7 I ? ^ ^ Propert yAddress : ^ / ^ Z^^^ O /\' t ^ f ^ ' ^ Owner : J ^ 3 ^ ff t g mU^ e " ^ 

## Phone : ^J ^ I3 9 7
Restoratio n Item s i n Questio n

Item : Item : Item : Item : Item ; Item ;

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\ I af;rc cic.^toralio n i s completed , excep l a s noler i L I I rio no l ai;ie crestoratio n i s complete d 

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iy^9-0 7 Ownc i ' s SiglTTffiir f7 Dat e CXinlracfor' s Signatur e Dal e