TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: /S2j[,>e> Date: /x/l3l2^07 

Address: 2£>2D 3 32, 

Remediation Contractor: Coastal Environmental Group_ Year: 2007 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 

W • Executive Summary 

0^ EPA-provided property sketch .. . 

Signed Access Agreement for subject property 

Si^ed Access Agreement(s) for adjacent property 

Restoration Agreement 

Settlement documents (i.e., for damage or to replace plants, etc.) 

Confirmation data 

Photographs PfcjiW CX^JLx) duriAgl ^ P^)'^<^^M^ 

As-built sketch . . . ^ 

0 ^ Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 9 / 2sl / cX)0 7 

O i • Description of areas not meeting ROD cleanup criteria 

Utility clearances 

Property informationfi-om Douglas County Assessor's Office 

D •'• 

v.. row)riM a^jQ^^s d\eckhslr ••• I 

'/£^^^^^S I%l2m7 

ignature 

40312825 

II 

Superfund 
Final Report Property Check List (piease place with each file) 

Hard Copy Information 

1. Property Check List 

'2 . Site Working Drawing Map •• " . • 

3. EPA originals Map i­

^4. Douglas County Assessor's Map • ~; 

'3 . Property Contact Sheet * : 

Agreement 

L Access Agreement . • ' , 

2. Restoration Agreement ' '',( 

IVIiscellaneous Documents •? 

L Final Map from the Field ' i^ : = 

2. Change Orders ; :'v " . 

3. XRFData ' "^ • I 

4. Any emails or PC correspondences '•. - ' ' 

Property Completion 

1. Executive Summary 

2. AS BUILT „ 

I vzi 3. Property Completion Agreement r, 

£23 4. Any buyout info or reimbursement info/^/ri 

jj I 5. Check or money order copies f^ IfY . 

JS3^ &. EPA Property Close Out Fonn : 

Q ^ 7. Attached Begin Video .; , 

Electroni c Documentatio n 

Drawings 

j m 1. EPA original ' 

Q 2. Working Drawing i 

Q 3. AS Built.vso ? 

Q 4. AS Built.jpg . '• 

Photos ' 

r n I Begin Photos ' , ' • 

,—1 2 During/Excavation Photos 

y 3 Sod Photos • . • : " • 

jdl 4 . 30-Day Sod Photos 

Scanned Documents 

ril] ' Final Documents , 

{•^—I 2 . Executive Summary ' 

Videos 

1 ^ ' Begin Video 

r-1 2.. My Movie ' 
Property Access Checklist 

P.ope.-ty ID: /5^P^ ^ 

Property Address: ^^p. ^ S ? ^ jf^i ^ 

n

n

 WORK STARTED

 WORK COMPELTED

 ON:

 ON:

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Ow ner: C-Gt^c);

.Address: t'^ci .

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Fax: 

Renter: 

Phone: 

Fax: 

Cel[/Pa"er: 

Additional Iniormation; 

Cell/Pa"er: 

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C J

 Notification Letter 

Access .A<ireenient 

Restoration A<ireement 

Topsoil .Samplinji (if applic ible) 

Disposal Samplinj; (if applicable) 

Garden Samplin<; (if applicable) 

L'tilitx Clearance 

\'idco/Photos (Before) 

Video/Photos (During) 

Sent: / 

Sianed: 7 " /T" ft:^ 

Sis:ned:3^/t3 ^ ( ^ 

/ / 

/ 

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Called: X'^/Gi l 

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1 

11 

D Video/Photos (After) 

j n Video/Photos (3(I-Dav) 

1 1 Property Completion Agreement 

! • Final Report 

On:

On: 

Signed:

Issued:

 / 

/

 /

 / 

/ 

j«^ . By: 

By:

By: 

__.__ _____ ! 

1 

1 

Air .Monitoring (as applicable) 

1 1 Community 

Results: 

D CrcM ! On: / _ ' B>: 

n Communit} 

Results: 

n CrcM On: / _ ;B> : , 

I 1 Community D

Results:

 C're« 1 On: / / ' By: 1 

1 

Omaha Lead Site 
^\K Acce^t>oe-ro %^^ Bva^€5 A^ 1^X14^(00 Ab, km 

Tota ^ ^ l CIHFan (!|Ban t Square Footage to be Excavated = 2306 'V*T ' 

Property Classification: 800 TotalCTi italraip Zon 2 e Linear Footage to be Excavated = 66 /f''^ 

Descnptton of post excavation areas: F1. front yard left-hand quadrant. F2, front yard right-hand quadrant; B1, ba<*yard left-hand quadrant; B2. backyard right-hand quadrant; 

DZ. drip zone (1-3 foot area of soil around the foundation of the house). 
Name: Oc-^ , <r, C-a J J y Omaha Lead Site Date: '^-"l"-^3 Nortti Arrow —i 

Address: 'Z'^^O^ . J - ^X-<( / Site Sketch Time: 

Phone: t^fc^ - C? '-it - 7 ^ W& 

JeamCrcc.-) ^ d<e (^£^-^Jy BVID# \S'0^^- S XRF Code S'SO^ 

• Sample Number Lead Concentration Confirmation Sample 

f'Yes n No 0 

f^Yes n No S 

e-iYes a No B 

i)2Yes a No 13 •g: ppm Yes 1^ No n 

ppm Yes n No CD 

ppm Yes, • No • 

( i/U) b ^ C 

/ S 

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^SEJi^IH I I \ i i i 

5 . ^^^ ^ 
Owner 

CADDY GREG T 

ETAL 

2820 S 32 AVE 

OMAHA NE 68105-0000 

Property Information 

Key Number: 

Account Type: 

Parcel Number: 

Parcel Address: 

Legal Description: 

100 FEET buffer of parcel(s): 1409550000 

0955 0000 14 

Residential 

1409550000 

2820 S 32 AV 

OMAHA NE 68105-0000 

ILER ADD LOT 5 BLOCK 3 50 X 114.5 
Property ID # 

Property 

Address: 

Initial Contact: 

Second Contact: 

Final Contact: 

Final Action: 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

CONTACT FORM 

JS^ ^ 

r??^^ S 3p-/gvs^ 

Date: Time: Action: 

Date: Time: Action: 

Date: Time: Action: 

Transmit to EPA D Other Action: D 
* 

COASTA L ENVINONMENTA L 

CROUP , INC . 

Consent For Access To Property 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner) consents to and authorizes the United States 

Environmental Protection Agency (EPA) or Its authorized representatives, collectively 

the Grantee, to enter and perform certain environmental response activities upon the 

following described premises: 

Owner's Name: Cl^e; L^^M Daytime Phone: 

Address of Property 

covered by this 

Agreement: P' ^ So B^.^L 

PURPOSE OF RESPONSE ACTIVITIES 

The EPA Is requesting access to collect soil samples and remove soil that contains 

elevated concentrations of lead and may pose a health hazard. The area(s) will be 

excavated to remove contaminated soil. The removed contaminated soil will be 

replaced with clean materials and the area will be restored to its original condition. This 

work is being performed under the Omaha Lead Superfund Site remediation program. 

A representative of Coastal Environmental Group, contracted by USEPA, will contact 

the Grantor In-person to discuss the work to be performed, the Grantor will have an 

opportunity to review and approve the planned soil removal, and restoration work before 

It begins. Once the work is finished, the Grantor will be asked to review the work and 

confirm that it Is complete and meets with the Grantor's approval. Upon completion, the 

Grantor will receive written documentation from EPA that the property has been 

remediated. 

ENVIRONMENTAL RESPONSE ACTIONS 

By signing this Access Agreement, the Grantor is granting the EPA, its employees, 

contractors and subcontractors the right to enter the property, at all reasonable times 

and with prior notice, for the sole purpose of performing the work. This access shall 

remain in effect until the work has been satisfactorily completed. The Grantor also 

agrees to: 

Page 1 of 2 
- o 

\ ~l " o* COASTAL * > - -*-^^ ENVIRONMENTA L 

^" i PBO-t*-*^ G R 0 U F , 

• Remove obstructions including boats, trailers, vehicles, playscape Items, wood 

piles, dog houses, etc; 

• Remove flower bulbs or plants that the Grantor or the Grantor's tenant may wish 

to save; 

• Water and maintain replacement vegetation, including fertilizer application, as 

necessary subsequent to an initial watering period by EPA; 

• Abide by health and safety guidance provided by EPA; 

• If the property is rented, assist EPA In obtaining tenant approval for access to the 

property to perform the work. 

• Allow videotaping and/or photographing of the property. 

AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to interfere or tamper with any of the work activities, or with any 

of the work done, or with the equipment used on his property, or to undertake any 

actions regarding the use of said property which would tend to endanger the health or 

welfare of the Grantees or the environment, or to allow others to use the property In 

such a manner. 

Should you have any questions about this program, please contact Coastal 

Environmental Group, at (877) 234-6270. 

0lg i rant access to my properties

 D I do not grant access to my properties 

,n h 

Signature Date 

G I would like to be present during any sampling that is required. 

Page 2 of 2 
COASTA L 

Restoration Agreement 

The purpose of this agreement is to provide a mutual agreement as to conditions of the property prior to 

remediation activities. This will also serve as documentation for the purpose of assuring that restoration 

activities are completed to the satisfaction of the property owner and the United States Environmental 

Protection Agency (EPA). 

Property ID: /ST.^ ^ 

Property Address: ^Z^Z O S 3 Z ^U( T 

Owner: ^^^ ^ ^dbC f 

Phone: /^?,^'/^^0 Gf:r z^ f 

On the attached diagram(s) indicate area(s) to excavated and depth of excavation, location of all known 

utilities, subsurface features, surface structures and landscaping features, access location(s) to be used by 

contractor, and the direction of North. Indicate distances, depths, material t> pes. etc. Indicate digital photos 

by referencing the photo-log number with an arrow indicating direction of view. 

Items To Be Removed By Owner Before Start Of Remediation: 

(Use additional sheets as necessary) 

The removal, storage, disposal, and/or return of these items is the Owner's responsibility. 

Item: n.ZA^^TS VItem: 

Item -.^ Item:

: ^-. 

Item: 

Item: 

Item: 

Item: 

Item: 

Page ^ - 1 of. 
COASTA L • NVIMONMENTA L 

C « O U P . IM C 

Items To Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

^^TIA/ J pMyor5 4/iyA

Page 2 of

 S'^^ft^ ^ 

 to 
 i 

COASTA L 

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

Item: 

^=oh 

Item: 

^oiu 

Item:

item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 3 o, ^ 
COASTA L INVinONMfNTA L 

C n o u p . IM C 

Landscape Inventory 

(Use additional sheets as necessary) 

Item

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

trunk diameter 

Number of trees <= 2 inch 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers. Heads, etc. 

.Anach a sketch ot" ihe 

sprinkler lav out. 

Number of and size of 

each garden/ flower bed 

area. 

.Anach a sketch of relati\e 

sizes and locations. 

 Quantity 

Z57^ 

7 ^ 

pii^ti/ee 

^ 

0 

Unit Condition/Type/Species 

Square feet 

Each 

' 

Each 

Each 

Each 

Square Feet 

Page 4 of ±j _ 
COASTA L (MVIROMMIMTA L 

e n o u p IMC . 

Item 

Agreed upon value of 

Diant materials not to be 

replaced bv contractor. 

Note this \alue will be 

used to issue a plant 

voucher to the property 

owner. 

Agreed upon list of plant 

materials that will be 

replaced by contractor. Be 

very specific and detailed. 

Include a sketch of were 

each plant v\ill be placed 

b\ the comracior. 

Agreed upon area of 

property to be replaced 

with grass sod. 

Include a sketch ox the 

.irea(s) to be leplaoed V'.iih 

grass sod. 

Area of Cit>' or County 

property to be landscaped 

per their requirements. 

Include a sketch oi the 

area is I 

Easement Area, to be 

excavated 

^<^€i^tf/V t 

Quantity 

Of 

Unit 

$ 

Condition/Type/Species 

< / 

237* 

Each 

SF 

1 

^cyf^ivo4> SF 

SF 

Page 5 of. ^ 
COASTA L 

Additional Comments / Instructions: 

• Check the box if Owner does not want CEG to document interior foundation walls and possible 

pre-existing damage. By checking this box CEG is not responsible for any damage done to the 

interior of house, including foundation cracks or fissures. 

ST^g ree ! I I do not agree 

Pag ^ e 6 of 
)S-^/"f^ ^ ~t\aUT .A.cgf^S t>ue-T-o vii(r| i6V,Z5tg 

•fr . 

Total C ^K (Iv t Square Footage to be Excavated = 2306 

Total urip Zone Linear Footage to be Excavated = 66 

tS:-, % 

Legend 

p^-vj Concrete 

North Arrow Omaha Lead Site 

Omatia, Nebraska 

o 

Excavated Area 

Existing Structure 

Fence 

Permanent Landscaping 

Quadrant Boundary 

Street Boundary 

Tree/Shrub 

HScale 

1 Incti = 20 feet or 1 grid = 5 x 5 ft 

^.vfl sr„.. 

Jl^ir C I — HvtlrnlV-nLogi. \n 

F1 . 

F2 

B1 

Property Number 

OLS-15268 

Property Address 

2820 S 32 AVE 

Post Excavation Concentrations (ppm) 

B2 Play Area 

DZ Easement 

Garden Other 

Description of post excavation areas; F1, front yard lelt-tiand quadrant; F2, front yard hghit-liand quadrant: B1, bad<yard left-hand quadrant; B2, backyard right-tiand quadrant; 

DZ, drip zone (1-3 foot area of soil around ttie foundation of the house). 

.<vi^Ji:;'-. - ,„ 
PROPERTY CLEARANCE WORKSHEET 

Date 

Project 

mitncn 

Onnaha Lead -- Fixed Price 

Property ID 

Property 

Address 

J^TM 

75^&JO SO ^2^ ^ 

XRF ID 0107-51 Measurement 

Count/Time 

Field Shots 

Shot # 

e?o 

Reading 

(r>M 

^ ^ 

^ 

Sample Area 

s • ^ 

Tcr I Q-0>^' 

Shot # Reading Sample Area 

Sample Area 

Aliquot 

1 

2 

3 

4 

5 

I n Situ 

Reading 

F^'g^ 

Composite Readings 

(Bag) 

<^y i^-7 

qc^- XRF Corrected Value --> 

(use calibration chart or add 

20"/o to value) 

Composite 

Average 

(Bag) 

lOR 

(36 

Composite 

(Dried & 

Sieved) 

Analytical 

Spilt Sent 

? 

Lab 

Number 

Analytical 

Results 

Sample Area 

Aliquot 

1 

2 

3 

4 

5 

I n Situ 

Reading 

'Cf?- ri-\u ^ h ' 

Composite Readings 

(Bag) 

4 3 

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XRF Corrected Value ­ > 

(use calibration chart or add 

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Composite 

Average 

(Bag) 

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Composite 

(Dried & 

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Pass/Fai l ? 

Analytical 

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Lab 

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2 

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4 

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I n Situ 

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(Bag) 

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Composite 

(Dried & 

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Pass/Fai l ? 

Analytical 

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7 

Lab 

Number 

Analytical 

Results 

Sample Area 

Aliquot 

1 

2 

3 

4 

5 

I n Situ 

Reading Composite Readings 

(Bag) 

XRF Corrected Value ­ > 

(use calibration chart or add 

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Composite 

Average 

(Baq) 

Composite 

(Dried & 

Sieved) 

Pass/Fail ? 

Analytical 

Spilt Sent 

7 

Lab 

Number 

Analytical 

Results 

Sample Area 

Aliquot 

1 

2 

3 

4 

5 

I n Situ 

Reading Composite Readings 

(Bag) 

XRF Corrected Value ­ > 

(use calibration chart or add 

20% to value) 

Composite 

Average 

(Bag) 

Composite 

(Dried & 

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Pass/Fai l ? 

Analytical 

Spilt Sent 

? 

Lab 

Number 

Analytical 

Results 

use AdDinonAL SHEETS I F 

XRF Technician's Signiture {^ahii(^i^ -((,. i t r^ 
PROPERTY CLEARANCE WORKSHEET 

^ 5 ^ 

Date Property ID otjrnjin /•^^// /

Property Project Omaha Lead — Fixed Price Address ^^Ji/) So ,^S)Ai J 

Measurement XRF ID 

0107-51 Count/Time 

Field Shots 

Shot # Reading Sample Area Shot # Reading Sample Area 

%% g R» ­ 231 '±k 

Sample Area M-£^ 

I n Situ Composite Composite Analytical Aliquot Composite Readings 

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(Bag) 

Composite 

Average 

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Number 

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2 

3 

4 

47f.--^ i 

^ ^ 04 XRF Corrected Value - > 

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Composite Readings 

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5 

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Lab Analytical Reading 

Average (Dried & Spilt Sent (Bag) 

Number Results 1 

(Baq) Sieved) 7 

2 

3 

4 

XRF Corrected Value - > 

5 (use calibration chart or add 

2 0 % to value) 

Sample Area Pass/Fai l ? 

I n Situ Composite Composite Analytical Aliquot Composite Readings 

Lab Analytical Reading 

Average (Dried & Spilt Sent (Bag) 

Number Results 1 

(Bag) Sieved) 7 

2 

3 

4 

XRF Corrected Value - > 

5 

(use calibration chart or add 

2 0 % to value) 

use uDDinoHAL sneers le 

XRF Technician's Signiture neeoeo 
PROPERTY CLEARANCE WORKSHEET 

Date mp Property ID I^MI 

Property Project Omaha Lead -- Fixed Price Address JflM .So 'il M 

XRF ID 0107-51 Measurement 

Count/Time 

Field Shots 

1 

^ 

Sample Area 

w. Shot # Reading Sample Area 

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1 

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Composite Readings 

(Bag) 

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Composite Readings 

(Bag) 

Composite 

Average 

(Bag) 

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7 

Lab 

Number 

Analytical 

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2 

3 

4 

5 

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id 

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2 

3 

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(Bag) 

Composite 

Average 

(Bag) 

Composite 

(Dried & 

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7 

Lab 

Number 

Analytical 

Results 

2 

3 

4 

XRF Corrected Value - > 

5 (use calibration chart or add 

2 0 % to value) 

Sample Area Pass/Fai l ? 

Aliquot 

1 

I n Situ 

Readinq Composite Readings 

(Bag) 

Composite 

Average 

(Bag) 

Composite 

(Dried & 

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Analytical 

Spilt Sent Lab 

Number 

Analytical 

Results 

2 

3 

4 

XRF Corrected Value --> 

5 (use calibration chart or add 

2 0 % to value) 

USE ADDITIONAL SHEETS IE 

XRF ueeoiD Technician's Signiture J^\L\h\X 
7 ^cIv 

'il PMO-^"*'''' 

RESTORATION CHANGE ORDER 

OMAHA LEAD 

Property ID U_^7 ^ 

Property Address 2^2 ^ 3 3^«gv\/ 

Owner Name (^ijjg^ LuJ^yj 

Comments 

Owner Signature 

Contractor Signature 
Page 1 of 1 

tsimmon s @lkgs . he.net 

From:

To:

Sent:

Subject:

 "Lehman Carlton" <ctl@ctlehnnan.net> 

 "tsimmons@lkgs.he.net" <tsimmons(gcoastalhazmat.com?' 

 Saturday, July 21, 2007 7:41 AM 

 Fwd: 2822 S 32 Av 

Begin foPA'arded message: 

From: Bahnke.Donald@epamail.epa.gov 

Date: July 20, 2007 4:50:58 PM CDT 

To: ctl@ctlehman.net 

Cc: France-lsetts.Pauletta@epamail.epa.gov 

Subject: 2822 S 32 Av 

Carlton 

I checked in the database for any previous cleanup at this address. 

This property is below our 400 ppm screening level and does not need 

cleanup. 

Don Bahnke 

US EPA Region 7 

Superfund Divisioxji •^ :

901 N 5th Street f 

Kansas City, KS 06101 

913-551-7747 

, 

's-ii? 

'SS­ ­ f ­

i i 

V55- f ? 

.•;! # 

i|ij;|^|#P 

7/21/2007 
X 

o 

''<.«oTt"=' 

Omaha Lead Site—Fixed Price EP-R7-07-05 

Coastal Environmental Group Inc. 

www.coastalhazmat.com 

COASTA L 

ENVIRONMENTA L 

CROUP , INC . 

EXECUTIVE SUMMARY: 

ND 15268—2820 SOUTH 32' " AVE 

No Issues or Concerns I I Issues/Concerns 

Detail Explanation: 
As-Built Drawing 

COASTA L Omaha Lead Superfund ^ € 

Total Quadrant Square Footage to t>e Excavated = 2306 

PrvB^rtY •folal Drtp Zone Linear Footaoe to be Excavated = 66 Ci9?ateti9ni.fiOff. 

OLS#: 15268 ' 

Date Excavated: 8/7/07 

Date USEPA Signed Off: 8/29/07 

O 

Bush - Leave per 

Owner's Request 

Large Tree -

Leave per 

Owner's Request 

O 

Vr-O 

F1 = 22 PPM 

:i 

^-' ^ f-i- . 

Lagend 

Generate 

l^y i ExcavatKl AT M 

H Existing Stiuctm 

» » * Fwwe 

^2 3 Ptnnaneni Landscaping 

— — — Quadrant Boundary 

^^^ — Street Boundary 

\J> Tiee/Shmb 

OAOOQi^^ ^ 

"South 32 Avenue 

North Arrow 

Scale 

1 Inch • 20 feet or 1 grid = 5 K 5 S 

^<^"% 

F1 . ^.\w HG L F2 

B1 

t'~°^'--'-.;'-nltBustles -

Remove per 

Owner's Request 

i'- ; 

^ 

Omaha Lead Site 

Omaha. Nel>raska 

Property Number 

OLS-15268 

Property Address 

2820 S 32 AVE 

Post Excavation Concentratons (ppm) 

B2 Play Area 

DZ Easennent 

Garden Other 

Description of po«t«iicavM)on arMit F1. front yard l*ft.nand guadranl. F3. front yard right-hand quadrant B1 tiackyard l«ft..rund quadrant. 02, tuckyard right-hand quadrant. 

DZ, drv zone (1-3 tool ariB ol «iri artxind ttta feundation of lh« tiouia). 

Legen d 

Area not Excavated i^^yi Dripzone Excavated K?S^ Quadrants Excavated 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group Inc . 
^ 

Property Completion Agreement 

This agrccmciU dociiiiiciUs Ihc complclion of remedial activities performed on my properly, My 

signature will designate thai 1 am satisfied with the restoration of my property, and that no items arc in 

questions, now, or at any lime in the future, except those items listed below, if any. 

Property lU: ^ t^ "Z^ ^ 

Property Address: 'Z^Z/ ^ S SZ-AJg -

Owner; 

^}^e \ <CA:2>PY 

Phone '- ^S?>' [OaG 

Restoration Items in Question: 

Item: 

FiS^ 9(^EuJAUfi, Item: 

Item: 

Item: 

Item: 

Item: • • • . . . • • .- • • • " : . . . . • ; • . \ ' 

Additional Comments: 

V^ I sigrcc n restoi-iition i.s c«inplcte<l, except a.s noted 

 I I <k» nol «prcc i-cstoration is completed 

1 L-VJo::^ 

Owner's Date 

I
^m EPA 

EPA Property Close Out Form 

Property #: / 5 ; Property Address: ^^< ^ ^SZ'^ -

Date/Time: Owner's Name: <^rv ^ ^..tyV/ y ? X^i

 0^ 1 

Quads Excavated: 

Contractor Group 

Excavation General 

Yes_JSo_ 

1. If necessary, were the correct quadrant(s) excavated and restored? \y 

[ ^ ' 2.

 If necessary, were the correct areas of drip zone excavated and restored? 

Grading Sod and Vegetation 

Yes No 

1. Does the grading around the perimeter of the house in excavated areas generally slope away L-' from the house? 

L / ' 2.

 Has sod been laid in all areas that were excavated? 

3. Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 

day time period) 

4. Are sodded areas generally firm and evenly graded? U ­

5. Are the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day 

tinie period) _^_____ 

6. Was the property graded such that water will not pool on the property? L^^ 

7. Was damage to landscaping or plant materials avoided? t/ ' 

Gates, Fences and Retaining Walls 

Yes No 

I. Do gates open and close freely? (If applicable) 

2. Were all gates or fences taken down during restoration activities reinstalled? (If applicable) L^­

3. Was damage to gates or fences avoided? (If applicable) U^ ' 

4. Was damage to retaining walls avoided? (If applicable) U^ 

Foundation, Siding and Gutters 

Yes iNo 

1. Was damage to the siding or trim avoided? L./ 

2. Was damage to the foundation avoided? 

3. Was damage to windows avoided? L / " 

4. Was damage to windows or door screens avoided? 

5. Was damage to dowTispouts or downspout extensions avoided? L / ^ 

Sidewalks and Driveways (Concrete) 

Yes No 

1. Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 
Owners comments: 

Inspection notes: 

Removal and restoration activates complete including the 30-day sod warranty: 

EPA Representative L_Jn ^ IjaJLJL^ Date: ^^1/0 1