### TRANSMITTA Lo f OMAH A LEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R SAID# : 8^Sl ^ Date : /d-/3-o d Address : /^3Q L/V J 3 5 S T Remediatio nContractor : Coasta l Environmenta l Group

_Year : _2008 _ SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S )

/ Vide o o f property (DVD ) ^^^'" ^ y T Executiv e Summar y EPA-provide dproperty sketc h' ^ '^^"^ ^ signe dAcces s Agreemen t for subjec t property 

# v/^ Signe dAcces s Agreement(s ) for adjacent property • jy ^ Restoratio nAgreemen t , t~-f/ nSettlemen t document s (i.e. , for damag e or to replac e plants , etc. ) /v^ ^ yS ^ Confirmatio ndat a- i

y ' Photograph s prg,-^.)(/-/gJgA6vN ^ Q^JTryAhi^ ^ ts^Uki^C^ ^ ^0'^,^^^' ^ H ^ As-buil t sketch/l»4e>5 .

- H Satisfactory restoratio nsigne db y Property Owner J 3 Property close-ou t chec k lis t signe db y EP A kdl|f ^

'^ Descriptio nofarea s no t meetin g RO D cleanu p criteri a -H- ^ Utility clearance s yy ^ Property informatio nfro mDougla s County Assessor' s Offic e

D 

# 't4^fy^^h^ t
Si^atur e Dkte \ 

# y^^^-'f^tici/yJ^A^'J' ^ <^^ ^

## Propert yAcces s Checklis t Propert y ID : S*^Si M D WOR K STARTE D ON : / / D WORKCOMPELTE D ON : __/__/

_ Propert y .4ddrc.s.s : j^^gt M 3.'-^'^ ^ ^ Renter : 

# """^:'^^IH^dett e ^Wa^hLQQt o Address : Phone : Fax : Cell/Pager : Additiona l Information : Fax : C e



## "'^'''^«^'-- c9frQ-b3t. i 1 1 Notificatio nLette r Sent : / / By : ^ T Acces. s Agreemen t Signed : 0 /1 ^ /2 % 

## ^y.p C P^Restoi'atio nAgiecnien t Signed : C? / l< \/ O ^ 

## By.<c C 1 1 Topsoi l Samplin g (i f appliciibic ) / / By : 0 Dispo.sa l Sam|)lin g (i f applicable ) / / By : 1 1 Garde nSamplin g (if applicable ) / / By : IpS s litilit v Clearanc e 

## Called: 6 /5^/O S 

## B.v:^^7r^' ? M 1 nVideo/Photo s (Bcfoi-e ) 

## On : ^ /d^/d ^ B.v : fih j D Video/Photo s (During ) On : / / By : nVideo/Photo s (Aftci- ) On : / / By : j D Video/Photo s (3()-Day ) On : / / By : 1 1 Propert y Completio nAgreemen t Signed : / / By : 1 1 Fina l Repor t Is.sued : / / By : Ai rMonitorin g (a s applicahle )

1 1 Communit yCH Ci'c w On : / / 

# 1 Results : j E ] Communit y[ U Cro v On : / / By : Results : 1 E H Communit yQ Cre w On : / / By : Results :
Omah aLea dSit e

## CONTAC T FORM Property I D #X^5'>' V Property Address : 

# lQ33yyy3l^y r Initial Contact : Date : Time : Action i Secon dContact : Date : Time : Action ; Final Contact : Date : Time : Action i Final Action : Transmi t t o EPA D Othe r yAction : D

Comment : Owne r Commen t (s) : Site 

# \i^ ^

^\\ ^ p^^ ^ 

# i ^ 'v^i i f^j^lHt t ^ i Coordinato r Commen t (s) :

### Dougla s County Accoun t Infomatio n Pag e 1 o f 1 (^xa a Dougla s County , Nebrask a Propert yRecor d - R060824000 2 Prin t Repor t Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t of 14 4 St - Vie w0, n Ma p Informatio n i s vali d a s o f 2008-5-1 9 Treasurer' s Ta xRepor t Ne wFeatur e ->->- • Aut o Sale s Searc h Owne r WASHINGTO N HARRIETT E D 331 9 LAFAYETT E AV E OMAH AN E 68131-000 0 Propert yInformatio n Ke yNumber : 082 4 000 2 0 6 Accoun t Type : Residentia l Parce l Number : 060824000 2 Parce l Address : Lega l Description : BEMI S PAR KLO T1 BLOC K6 S 4 6 F T46X5 0 Valu e Informatio n Lan d Improvemen t Tota l 200 8 $500.0 0 $0.0 0 $500.0 0 200 7 $500.0 0 $0.0 0 $500.0 0 200 6 $500.0 0 $0.0 0 $500.0 0 200 5 $500.0 0 $0.0 0 $500.0 0 200 4 $0.0 0 $0.0 0 $0.0 0 200 3 $0.0 0 $0.0 0 $0.0 0 Sale s Informatio n Sale s Date : 2001-01-0 4 Dee d Type : Book : 217 1 Page : 32 8 Price : $100.0 0 Grantor : Grantee : Valid/Invalid : Invali d Exclusio n Reason : Invali d Sal e Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.0 5 2300. 0 1. 0 50. 0 46. 0 Ye s



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R06. . . 6/12/200 8

### a R l 

## o L U Z 

### c 3 O 

## o ( 0 _j

o O ) 

## o o

### 8951 4 

# #As-Buil t Drawin g C OAST AL 

# Omah aLea dSuperfun dSit e INVmONMINTA L GROUP , t N C

Exterio rPain t Nort h Arro w Omah a Lea d Sit e • Goo d Sit e Sketct i • Poo r Sarviplin g Address : 1032 N 33 ST l^ f No t pain t SampH e Numt)e r Lea d Sampl e Sample s Collecte d 

# i LA B Concentratio n Collectej i Fir m R YASCPXA-8951 4 F1 pp m Dat e to - 3 0 -o- r RYBSCPXA-8951 4 F2 pp m 

# n Tim e 

### 3-0 0 RYCSCPXA-8951 4 B1 / 2 8 pp m 

# n Sample s Analyze d RYDSCPXA-8951 4 B2 I Hq^f t pp m D r^DgOOrX A0001 4 B 2 pp m D 

# n XR F Unit : GiSH2
. Book : J* ^ ? r^C20GPXA-80S1 4 GZ pp m D D Date : I J • OS " -o 7 pp m D 

# n Tim e 

### A ^ La b RYASCPLA-8951 4 Staf f ; Resul t 188pp m Numbe r of Sample s •• / J 

## r\%v / 

# i Legend : F1 = Fron t Left
. F2 = Fron t Rigtit , B1 = Bac k Left , 82 = Bac k Righ t DZ = Dri p Zone , GZ = Garden
. PZ = Pia y Al l quadrant s ar e as viewe d fro m th e street , facin g propert y 

### ENTS^RE L NO V 0 2 1M 1 OLS# : 8951 4 Dat e Excavated:6/27/0 8 Dat e OSEP ASigne d Off:7/31/0 8 Are a Sodde d 109 0 sq ft



### Legen d Dri p Zon e Excavate d Quadrant s Excavate d Concret e Are a replace d wit h Are a replace d witJ i 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 .

## 8951 4 Exterio rPain t Nort h Arro w 

### Omah a Lea d Sit e • Goo d 

### Sit e Sketc h • Poo r Samplin g Address : 103 2 N 33 ST [v f No t pain t Sampl e Numbe r Lea d Sampl e Sample s Collecte d U\ B Concentratio n Collec t e( J Firm : F M I^W - C C RYASCPXA-8951 4 Fl pp m Date : 10 ~ 3 0 ~o 7 RYBSCPXA-8951 4 F2 pp m 

# n Time : 3 • OO RYCSCPXA-8951 4B1 

# / zs pp m 

### D Sample s Analyze d RYDSCPXA-8951 4 B2 pp m 

### D RDZOCrXA-09i31 4 BZ pp m 

### D D XR F Unit : ^5*^ Z Book : |*^J ? RGZOCnXA-8951- 4 GZ pp m 

### D D Dat e I ) -OS " -O l pp m Tim e 

# • D „ La b RYASCPLA-8951 4 

# An . Staf f i Resul t 18 8 pp m Numbe r of Sample s = I '- f j / 

# ns\ y Legend : Fl = Fron t Left , F2 • Fron t Right , 81 = Bac k Left , B2 = Bac k Righ tDZ = Dri p Zone , GZ = Garden , PZ = Pla y Al l quadrant s ar eas viewe d fro m th e street , facin g propert y



# i^^^^y••:„:,..,, , Re

x ."

^ Created : 9C5/2n0 7 OS 44:4 3

## 8951 4 Exterio rPain t NorthArrow 

### Omah a Lea d Sit e • Goo d Sit e Sketc h • Poo r Sannplin g Address : 103 2 N 3 3 S T fi i No t pain t Lea d Sampl e Sample s Collecte d Sampl e Numbe r LA B Concentratio n Collectw l Firm : F M I^W - C C RYASCPXA-8951 4 F l pp m Date : I D - 3 0 -O T RYBSCPXA-8951 4 F 2 

### 1 1 2 pp m 

### D Time : 3 • O O RYCSCPXA-8951 4 B l 

### I 2 8 pp m 

### D Sample s Analyze d RYDSCPXA-8951 4 B 2 pp m 

### D RDZOCrXA-09G1 4 D Z pp m 

### D D XR F Unit : Gt'iH Z Book : |^ ? nGZOCPXA-8051 4 G Z pp m 

### D D Date : 1 ) ' C S '0~ l pp m 

### D D 

## Time : At i La b RYASCPLA-8951 4 

### Staff : l^SU / s Resul t 18 8 pp mNumbe ro f Sample s = i '-l Legend : F l = Fron t Left , F 2 Fron t Right , 8 1 = Bac k Left , B 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , P Z = Pla y Al l quadrant s ar e a s viewe d fro m th e street , facin g propert y 

# E 

# ;N T ER ] 3 D ' M M 

## 0 2 Z i ;07



# foe . = ^ c O " 

## cb > ^ ^ 

# /z e : / 4 

# 5

S I 

# e z l o ^ 2 N . S i 

## t 5 T 

# I 

# i F F 2 U I 

# IB'= ^ 17 3 2 

# 1 ; 1 «. > 

## N . S? > ^ 

## ^ 1 . Rev 5 Crc«cd : 9'2f:2(>a 7 0 8 4 4 4 3 w<>i4roi; 3 y : HI

- M

t > x* > w >» ' ;•• ' -•o r M ' i(» r w J«» r ite r

»• ' >ij ' m ; iU i ;r« f * B ' :D)). ' y— 7 Ma

r .oa

r .'«; TCOASTA L CHVUOHfflNTA t C I O U rI ( • C 

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

### Granto r(th e propertyowner ) 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 followin g describe d premises :

Owner' s Name : 

# Hft^fiw ^ m^m m Daytim e Phone :

Addres s o f Propert y covere d b ythi s 

# w ^ %^ ^ . Agreement : PURPOS E O F RESPONS E ACTIVITIE S 

### Th e EPAi s requestin g acces s t o collect soi l sample s an d remov e soi l tha t contain s elevate d concentration s o f lea 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 f Coasta l Environmenta l Group , contracte d b yUSEPA , wil l contact th e Granto rin-perso n t o discus s th e vwDr 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 property 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 subcontractors th 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 f performin 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 f 2JUN-19-200 8 13:4 4 

# I I

, 1



### •Remov e obstruction s indudin g boats , trailers , vehicles , playscap e iterns
. 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 maywis h t o save : • Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , a s necessarysubsequen t t o a n iniiia l waterin g perio d b yEPA : • Abid e b yhealt h an d safetyguidanc e provide d b yEPA : • I f th e propert yi s rented , assis t EP Ai n obtainin g tenan t approva l fo racces s t o th e propert yt o perfor m th e work
. •Allo wvideotapin g and/o rphotographin g o f th e property . AGREEMEN TNO T

### T o iNTERFER e Th e Granto ragree s no t t o interfer e o rtampe rwit h an yo f th e vwor k

activities , o rwit h an y o f th e wor k done , o rwit h th e equipmen t use d o n hi s property , o rt o undertak e an y action s regardin g th e us e o f sai d propert ywhic h woul d ten d t o endange rth e healt h o r welfar e o f th e Grantee s o rth e environment , o rt o allo wother s t o us e th e propert yi n suc h a manner . Shoul d yo u hav e an yqueslion s abou t ttii s program , pleas e contact Coasta l Environmenta l Group , a t (712 ) 352-018 8
^ I gran t acces s t o m ypropertie s O I d o no t gran t acces s t o m ypropertie s

' ' Signalur e ADat e / ( Signajur e Daii ^ '


### Q I v/oul d lik e t o b e presen t durin g an ysamplin g tha t i s required
.

^ - d t^SEST O B O 6 T un[
­

## Restoratio n Agreemen t Th e purpos e ofthi s agreemen t i s to provid e amutual agreemen t a s t o condition s ofth e propert y prio r t o remediatio nactivities . Thi s wil l als o serv e a s documentatio nfo r th e purpos e o f assurin g tha t restoratio n activitie s are complete dt o th e satisfactio nofth e propert y owner an dth e Unite dState s Environmental Protectio nAgenc y (EPA) .

Propert yID : yy,\l \ 

### Propert y Address : |0'} 1 V 4 ^^^ ^ ^ f Owner : t^^j^f e Wj^^Mm^TO ^ Phone:(qpt^^^^ ( ^%^( ^ \t\^ ^ »-PZ^ i O nth e attache ddiagram(s ) indicate area(s ) to excavate dan ddept ho f e.xcavation . locatio nof all know n utilities , subsurfac e features , surfac e structure s an dlandscapin g features , acces s location(s ) t o be usedb y contractor , an dth e directio no f North . Indicate distances , depths , material types , etc . Indicate digita l photo s b

y referencin g the photo-lo g number w it ha narro w indicatin g directio no f view . Item s T o B e Remove d B yOwne rBefor e Star t O f Remediation : (Us e additiona l sheet s a s necessary ) Th e removal , storage , disposal , and/o rretur n o f thes e item s i s th e Owner' s responsibility
. Item : 

# vlf7i4: ; Item : Item : Item : Item : 

### Item : Item : 

### Item : Pag e 1 o f j ^COASTA L 

### Item s T o 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 )

Pag e 2 of
.COASTA L ENVinONnEKTA L 

### 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 : Item : Item : 

## itQJ \ 

# u _ 

# ~y^

Item : / 

# y

i Item : y Item : Item : / 

### /

Item : /
Item : / , j
Item : 1 Item :

Item : / / /

•

Item : /
Item : /
Item : / / ;.. . 

# C Page s o f ^COASTA L 

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

## 1 Ite m Quantit y Uni t Condition/Type/Specie s

Pre-existin g propert yarea , tha t wil l b e excavated , tha t i s covere d wit h grass .

Numbe ro f tree s > 2 inc h trun k diamete r

Numbe ro f tree s • = 2 inc h irun k diamete r

Numbe ro f Sprini^le r Zones
. Contro l Valves
. 1 Timers
. Heads , eic
.

Anac h a iNeicl i o \ rh e ipriiikle r!a\oui
.
Numbe ro f an d siz e o f eac h garden / flowe rbe d area . .•''•.u;Ui : ;• ; skciCl i 11 1 ;cia;i\! : ~-i:'e s :in J locations
. 

# y* ^ ciftv, Square fee t 

# y y Eac h

y• : ; • ; 

# j y Eac h

Eac h '^

Eac h Squar e Fee t ^ ,

Pag e 4 

# o,_ k 1COASTA L 

## Ite m Quantit y Uni t Condition/Type/Specie s Agree dupo nvalu e of plan t material s no t t o b e replace db v contractor . Not e thi s valu e will be use df o issu e aplan t >ouche r t o th e propert y owner . 

# j K $

Agree dupo nlis t of plant material s that wil l be replace dby contractor . B e ver y specifi c anddetailed . Includ e asketc hof wer e eac hplant will h e placed b

y [he comracici' . 

# r Each

Agree dupo nare aof property to b e replace d wit hgras s sod . Mu'lud e asketc hoi ' ihc area(s ) u-. be repiace d^^it h iii-as. s >,od . 

# r S F

.Are ao f Cit y o r County ' property to b e landscape d per thei r requirements . 1 S F Includ e a:-e u iS ) -' i -keiv-f i ^.; ' :'r. i i 1 '

Easemen t Area , t o be excavate d S F 

## .1 •



# . 

# - 1

Pag e 5 of
.

# L P.0 3 JUN-19-200 8 13:4 4



### Additional Comment s / Instriictions : 

## ^ HT^

• Chec k th e boxi f Owne rdoe s no t wan t CE G t o documen t interio rfoundatio n wall s an d possibl e pre-existin g damage
. B ycheckin g thi s boxCE G i s no t responsibl e fo ran ydamag e don e t o th e interio ro f house , includin g foundatio n crack s o rfissures.
Q I d o no t sgre e agre e 

# >^/jMuj..y~ ^yui4r M y^, xuictp x Owner' s Signature U Dat e / Contractor' s Signaeur e /

Dat 4 ^ Pag e 6 of ,

OI^S:T O 8 0 e t iJn r TOTA LP.0 3 D I -d.a«;';#5i«**"'^ ^



# FACSIMIL ETRANSMITTA LSHEE T T O FROM :

IMPAMV - ^ nATF
- COMPANY : Coasta l Environmenta l Grou p 

## ^b-l^-Q ^ FA X NUMBER : TOTA LNO . O FPAGE S INCLUDIN GCOVER : 

# (Mtfa-^^\-aint,- ^
SLTRGEN T n FO RREVIE Wn PLEAS ECOMMEN T D PLEAS EPA Y n PLEAS ERECYCL E
NOTEJ,"".OMMENT5
­



# - I f yo o Vuv e an ycioestic n 

# Picas4 .cal l m e ©

- Mo\e ' ^na-iV\\n Q ove r 40 5 pp m 

# ^Dv o \ s eAa\ nan dudn lJUN-19-200 8 13:4 4 P.0 1 

# \]0e dState s Distric t C^t DISTRIC T O FNEBRASK A PROBATIO NOFHC E 

### JAME S P . ROWOLDT CHIE K

PROBATIO NOFHCER 

### MAR Y LE ERANHEI M DEPirrV CHIK K

PROBATIO NO f KICE R 11 1 SOUT H 18 * PLAZA,SUIT EC7 9 OMAHA , N £68102-131 2

COM M (402 ) 661-755 5 FAX (402 ) 661-755 0 

# FA X COVE RSHEE T To : Marcos 

# Phone/Fax : (402)991-206 7 From : Harriett e Washingto n 

# Date : Jun e 19 , 200 8 (2:01pm ) 

# Subject : Agreemen t 

# No . o f

page s includin g thi s one : 3

Note : Thi s Facsimil e transmissio n(and/or the docuinent s accompanying it ) ma y contai nconfidentia l infonnatio nbelongin g t o th e sende r whichi s protecte db y Federa l la w an dloca l Federa l Cour t policy . Thi s infonnatio ni s intende donly fo r the us e o f the individual or entit y namedabove . I f yo u ar e no t th e intende drecipient , yo u are hereb y notifie dtha t any disclosure , copying , distributio no r the takin g of

an y actio ni nrelianc e onrhe content s o f thi s infonnatio ni s strictl y prohibited . I f yo u hav e receive dthi s transmissio ninerror , pleas e notif y u s b y telephon e liste dat)0v e t o arrang e fo r retu m ofth e documents .

### BVI D 

# ^my XR F PROPERT Y SAMPL E SHEE T Dat e Addres s 

## iA3 a ^i
. j?,- ^ 2n d yea roptio n Projec t Omah a lea d F P 2 n Sampl e tim e am/p m XR F 1D # 

### 32.<^ ^ sampl e lengt h 3 0 se c Shot # Readin g Sampl e are a Shot # Readin g Sampl e are a 

# us : uT ^ IC^T^ " 

# &; i Dept h Dept h 

# ^yu . 1/^/^/ 3 J ^ Averag e \^^' ^

tjy Averag e 

### Shot # Readin g Sampl e are a Shot # Readin g Sampl e are a is^t- y IS-QL ? 

### O 6 ^ I37T I S 1 5 ec».jewv«rt V 1 

### \T-^ ^ I S3
. ±/ S Dept h Dept h 

### /r3 Q 

## 17 ^ t \ C \ " Averag e / 5 * / ^ IT Averag e Sho t # Readin g Sampl e are a Shot # Readin g Sampl e are a Dept h Dept h Averag e Averag e 

### RETES TAREAS Shot # Readin g Sampl e are a Shot # Readin g Sampl e are a Dept h Dept h Averag e Averag e

la b sampl e # La b resul t Sampl e are a XR F Avg
. Signatur e Prin t ftiflm b^r'cj n .

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

## Certificat e o f Verificatio n XL3t-3208 9 Readin g N o 31 7 Mod e SOI L Tim e 2008-06-2 7 16:2 6 Duratio n 145.3 7 Sequenc e Fina l Flag s AVERAG E I Av g o f 313-31 6 ^ ADDRES S 103 2 n 3 3 QUAD/ZON E |6 2 INSPECTO R I DETRIC H DEPT H E 6 SAMPL E PI'P E NOT E 

## ..--" 7 ppm / P b Supervise d B y

# 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 317.01 1 Supervise d By : 

## Certificat e o f Verificatio n
31 3 SOI L 2008-06-2 7 16:2 2 30.0 8 Fina l 8951 4 103 2 n 3 3 B 2 DETRIC H 6

± Erro r ± 21.81 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 115.18 1 Supervise d By : 

## Certificat e o f Verificatio n
31 4 SOI L 2008-06-2 7 16:2 4 30.2 9 Fina l 8951 4 103 2 n3 3 B 2 DETRIC H 6

± Erro r ± 14.66 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 75.34 5 Supervise d By : 

## Certificat e o f Verificatio n
31 5 SOI L 2008-06-2 7 16:2 4 30.0 5 Fina l 8951 4 103 2 n3 3 B 2 DETRIC H 6

± Erro r ± 11.77 4

# 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 114.12 9 Supervise d By : 

## Certificat e o f Verificatio n
31 6 SOI L 2008-06-2 7 16:2 6 54.9 5 Fina l 8951 4 103 2 n 3 3 B 2 DETRIC H 6

± Erro r ± 13.44 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 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 f Verificatio n
153 1 SOI L 2008-07-3 0 19:3 0 120.7 8 Fina l I Av g o f 1527-153 0

103 2 N 3 3 s t ~TM " easemen t *1ope z ^ 

# P ^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 136.20 4 Supervise d By : 

## Certificat e o f Verificatio n
152 7 SOI L 2008-07-3 0 19:2 7 30.3 1 Fina l 8951 4 103 2 N 3 3 s t easemen t lope z 1 CLEARANC E

± Erro r ± 14.60 6

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

## Certificat e o f Verificatio n XL3t-3208 9 Readin g N o 152 8 Mod e SOI L Tim e 2008-07-3 0 19:2 8 Duratio n 30.0 7 Sequenc e Fina l Flag s BVI D # 8951 4 ADDRES S 103 2 N 3 3 s t QUAD/ZON E easemen t INSPECTO R lope z DEPT H 1 SAMPL E TYP E CLEARANC E NOT E
pp m ±Erro r P b 137.37 3 ±14.81 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 152.29 4 Supervise d By : 

## Certificat e o f Verificatio n
152 9 SOI L 2008-07-3 0 19:2 9 30.1 2 Fina l 8951 4 103 2 N 3 3 s t easemen t lope z 1 CLEARANC E

± Erro r ± 15.34 0

# 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 176.19 5 Supervise d By : 

## Certificat e o f Verificatio n
153 0 SOI L 2008-07-3 0 19:3 0 30.2 8 Fina l 8951 4 103 2 N 3 3 s t easemen t lope z 1 CLEARANC E

± Erro r ± 16.10 8X 

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



### v-^^o'" * COASTA L ENVrRONHENTA L C I O U P
. IN C 

# EXECUTIV ESUMMARY :
r d 

# BVI D #8951 4 - (103 2 N33 TM St. ) N o Issue s o r Concern s I I Issues/Concern s
Detai l Explanatio n

## Propert yCompletio n Agreemen t Thi s agreemen t document s th e completio no f remedia l activitie s performedo nm y property . M y signature wil l designate tha t 1 a msatisfie dwit hthe restoratio no f m y property , andtha t n o item s ar e i nquestions , now , o r a

t any tim e i nth e fiiture , except thos e item s liste dbelow , ifany . Propert y ID : ^^Cj^/l ^ iioptiiyiu ; WH^/ H Propert y Address : Ir \nn , jJ SQ^ ^ ^ T Owner : /^^rr/t ^ /JO^^W^t n Phnnp
- / I- A /. I 1 —, « —^ '- J Phone:Lio^:(ff^/~1^3, ^ Restoratfo n Item s i n Question :

Item : Item : Item : Item : Item : Item : Additiona l Comments : , j

I I I iigrci
- ies(oratio ni s compleied , excep t a s note d I I I <l o no t ajjrce resloratio ni s complete d

Owner' s Sigiiariir e /Contractor' s Signatur e Dat e

### Siii . 

# EP A EP A Propert y Clos e Ou t For m 

# yvi^yyy f Propert y # : Q^^l ^ . , Date/Time : Quad s Excavated : |^7 ^ Contracto rCrou p f^Af^'P^' t Ye s N o Excavatio nGenera l \/ACAl ^ Lo T 1 .If necessary , wer e th e conrc t quadrant(s ) excavate dan drestored ? 

# y 2 .If necessary , wer e th e correc t area s ofdri p zon e excavate dandresiored ? 

## y Gradin g So dan dVegetatio n Ve s N o 1 Doe s th e gradin g aroun dth e perimete r ofth e hous e i nexcavate darea s generall y slop e awa y 

# y fromth e house ? 2 .Ha s so dbee nlai di nall area s tha t were excavated ? y ^ 3 .Doe s th e sodappear to be generall y healthy andgrowing ? (Onl y evaluat e i f inspecte da t a.1 0 da y time period ) 

# y 4 .Ar e soddedarea s generall y firman devenl y graded ? 

# y 5 .

Ar e th e joint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat e i f inspecte da t a3 0 da y tim e period ) 

## y 6 .Wa s the propert y grade dsuc htha t water will not poo l o nth e property ? 

## y 7 .

Wa s damag e t o landscapin g or plan t material s avoided ? 

# y 1 Gates . Fence s an dRetainin g Wall s Ye s N o 1 .D o gate s ope nandclos e freely? (ifapplicable ) 2 .Wer e all gate s or fence s take ndowndurin g restoratio nactivities reinstalled ? (Ifapplicable ) 

# pA
­ 3 .

Wa s damag e t o gate s or fence s avoided ? (Ifapplicable ) 

# 4 ^ l

y 4 .Wa s damag e t o retainin g wall s avoided ? (Ifapplicable ) 

# L Foupdation , Sidin g an dGutter s Ye s .N o 1 • — ' " 1 .

Wa s damag e t o th e sidin g o rtri m avoided ? 1 2 .Wa s damag e t o th e foundatio n avoided ? r- ^ \ 

### 1 . ( y 3 .

Wa s damag e t o window s avoided ? 

## fJ A LD A 4 .

Wa s damag e t o window s o rdoo rscreen s avoided ? 

## I 5 .Wa s damag e t o downspout s o rdownspou t extension s avoided ?



### - W
. Sidewalk s an d Driveway s (Concrete ) Ye s N o 1 .

Wa s damag e l o drivewa ysurface s avoided ? 

## A ^ 2 .Wa s damag e t o walkwa ysurface s avoided ? 1 1

## Owner s comments :

Inspectio nnotes :

Removal an drestoratio nactivate s complete includin g the 30-da y so dwarranty : EP A Representalive^^;;^^^,^ ^ Date : 7/3 //O S