## TRANSMITTALo f

OMAH ALEAD SITE SOILREMEDIATIO NFIL EFOLDER

SAID # 

## ^^^ UDate : ^|l|| l Address : " ^ \t ^ M Hf ^ "/ ( Remediatio nContractor : Coasta l Environmenta l Group

_ Year : _2010ARRA
_ SOI LREMEDIATIO N PROPERT YFIL EFOLDE RDOCUMENT S 

# t / Vide o o f propert y (DVD ) Executiv e Summar y 

# J EPA-provide dpropert y sketc h Signe dAcces s Agreemen t fo r subjec t propert y -L

LSigne dAcces s Agreement(s ) fo r adjacen t propert y URestoratio nAgreemen t Settlemen t document s (i.e. , fo r damag e o r t o replac eplants , etc. ) -P

- Confirmatio ndat a a

/ Photograph s \\ i b^^l^V ^ X^i^^V^lv ^ ^ h ^ It/ As-buil t sketc h Satisfactory restoratio nsigne db y Property Ow^ne r Property close-ou t chec k lis t signe db y EPA -fi " Descriptio nofarea s no t meetin g RO D cleanup criteri a ( M Utility clearance s y Property informatio nfro mDougla s Count y Assessor' s Offic e


## • a 

# / > "^yy ^ Ignatur eDat e 3021849 5 Superfun d

### # #



## Propert yAcces s Checklis t PropertylD : ^SD (p ( P Property Addres s ^/-^^^^ ^ n n

WOR K STARTE D WORKCOMPELTE D ON : ON : / / / / 

## ^'^^'Y^jy<4^>-,< ^ AUy\A^ ^ Addren: ' ' O


## Phone : Cff^f^f^^Z: ^ Fax : Cell/Page n Rcnte n Pbone: Fax : Cdl/Pager : Additionai Iirforniation :

D NotificationLette r ^ Acces s Agreement Cp
. Restoratio nAgreement E JTopsoil Samplin g (if applicable ) D Disposa l Samplin g (if applicable ) D Garde nSampUng (if applicable ) SLUtilit y Clearanc e

, 0 video/Photo s (Before ) Q Video/Pboto s (Dnring ) O Video/Photo s (After) D Video/Photo s (30-Day ) D Property Completio nAgreemeat D Final Report Sent : / / 

## Signed : J^// ^ ^4
. Signed : j ^ / / ^ ^ / / / / / / 

## Caned:Jt_/ZiJL/fl3



# OmMlJFiA ^ On : / / On : / / On : / / Siened : / / Isnied : / / By : By : By : By : By : By : , . By : 

# /MM ^r-OcMi/iz:) ' By : By : By : By : By : 

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Ai r Monitorin efa s aonlicable ) D Communit y DCmr Results : On : / / 

### By : 1
D Communit y DCre w | On : / _ / By : Results : D Communit y QCrc w On : / / By : Results :
Omah a Lea d Sit e

## Douglas Count y Accoun t Infot]M|ion Page1 of3 >t|M|l C
Dougla s County , Nebrask a Propert yRecor d - R241489000 0 Prin t Reoor t NE WFaatur s - PaitM l Drmnnsion s availabl e l § scal e 0-5 0 ft wes t o f52n d S t - VieWO R Ma p Informatio n i s vali d a s o f2009-10-1 5 Treasurer' s Ta xRepor t Ne wFeatur e •*•*• * Aut o Sale s Searc h | Owne r MONE YKRISTA N E ETA L 312 9 N 4 8 S T OMAH AN E 68104-000 0 Propert yInformatio n Ke yNumber : 148 9 000 0 2 4 Accoun t Type : Residentia l Parce l Number : 241489000 0 Parce l Address : 312 9 N 4 8 S T OMAH AN E 68104-000 0 Lega l Description : WAVERLYPAR KLOT2 3 BLOC K3 4 0 X123. 3 Valu e Informatio n Lan d Improvemen t Tota l 200 9 $5,700.0 0 $63,200.0 0 $68,900.0 0 200 8 $5,700.0 0 $67,100.0 0 $72,800.0 0 200 7 $5,700.0 0 $67,100.0 0 $72,800.0 0 200 6 $5,700.0 0 $67,100.0 0 $72,800.0 0 200 5 $5,700.0 0 $39,600.0 0 $45,300.0 0 200 4 $5,700.0 0 $36,000.0 0 $41,700.0 0 Sale s Informatio n Sale s Date : 2007-06-2 9 Dee d Type : W D Book : 200 7 Page : 07477 1 Price : $75,000.0 0 Grantor : KEITGE S MARGARE TJ ETA L Grantee : MONE YKRISTA N E ETA L Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 2007-06-2 6 Dee d Type : W D Book : 200 7 Page : 09925 9 Price : $0.0 0 Grantor : Keitge s Margare t J eta l 

# 1 http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accoiintno=R2..
. 10/23/2009

### Dougla s County Accoun t Infornagio n Pag e 2 o f 3 rc^^ c

Grantee : Valid/Invalid : Mone yKrista n E eta l Invali d Exclusio n Reason : Correctiv e Dee d Lan d Informatio n Acre s 0.1 1 Improvement Buildin g 1 S F 4920. 0 Informatio n Unit s 1. 0 Dept h 123. 0 Widt h 40. 0 Vacan t 

### N o

11 C STOR Y3129 N 48 S T Secon d Floo r

»» 6 0 oq . ft Flr « Flo w 894. 0 sq . It
. j t 9 f7 n 

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CLIC KT O ENLARG E IMAG E CLIC KTO ENLARG E IMAG E Squar e Footage : 1340. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 1 1/ 2 Stor yFi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 5. 0 Exterior : Fram e Aluminu m Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo fCover : Compositio n Shingl e Bedrooms : 2. 0

Roo fType : [ Gabl e 

### Stories : I1.5 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : ! 0. 0 yea rBuil t Yea r Remodele d Percen t Remodele d Adjuste d Yea r Buil t Physica l Ag e 192 1 0 0 % 192 1 8 9 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Fenc e Chai n Lin k 960. 0 Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 882. 0 Fixtur e Bas e Fixture s 1. 0


### http://douglasne.mapping-onHne.com/DouglasCoNe/static/accountinfo.jsp?accountno=R2..
. 10/23/200 9

## • Douglas Cotmt y Accoun t Infona^o n rm^ c Page3 of 3

Fixture Bat h Ful l 

### 1.0 Porc h Enc I Scree n 

### 96. 0



## http://douglasne.mapping-online.com/DouglasCoNe/static/accoimtinfo.jsp?accountno=R2„
. 10/23/2009

### Pag e1 of 2 %

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## • YOU R TICKE T NUMBE R I S 2404482 . Origina l Cal l Date : 11/10/0 9 Time : 7:3 6 p mOp : ELIZABETH1879 0 Wor k t o Begi n Date : 11/16/0 9 Time : 7:1 5 a m State : N E County : DOUGLA S Place : OMAH A Address : 481 7 Street : DAVENPOR T S T Twp : 15 NRng : 13 E Sect-Qtr : 19-NE,20-N W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : lea d remediatio n Locatio n o f Work : INCLUD E AL L EASEMENT S LOCAT E ENTIR E PROPERT Y Remarks : FAX AL L CLEAR S TO : (877)662-421 1 : tJNSUR E O F CORNE R LO T Compan y: COASTA L ENVIRONMENTA L SERVIC E Contact Name : ELIZABET H Phone : (877)662-421 0 Wor k Bein g Don e For : Coasta l Environmenta l Grou p Dept ho f Excavation : 4 fee t Corne r Lot : NFront : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N BSHPCLK S CXCAT V MUDO l OMAHACO F OPPDGPR S QLNNEI C


### Servic eAre a Contac t Phon eNumber UtiUt y Typ e
BSHPCLK S NEBRASK AHEALT H SYSTE M N A Day : 402552346 0 Alt : 402552334 7 Emerg : 402559511 1
CXCAT V CO XCOMMUNICATIONS , IN C HEIDI Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7
MUDO l METROPOLITA NUTILITIES DISTRIC TSAND Y Day : 402504782 3 Alt : Emerg : 402504797 0
OMAHACO FCIT YO FOMAHA-TRAFFIC,SEWE R RIcnmiAFFI C 

### Day : 402444719 7 Alt : 402444516 1 Emerg : 402444516 0

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. . 11/10/200 9

### Pag e 2 of 2

OPPDGPR S OMAH APUBLI C POWE RDISTRIC TN A

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### Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3 Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3

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. . 11/10/200 9

# As-Buil t Drawin g COASTA L 

# Omah aLea dSuperfun dSit e OLS# : 8506 6 Dat e Excavated : 11/25/200 9 Dat e USEP ASiane d Off : 4/15 | 8506 6 Are a Sodden : 157 5 s a f l Extefio rPam t Omah a Lea d Sit e •Good Sit e Sketc h •Poo r Samplin g Address : 3129 N 4 9 S T g No t pam t Sampl e Numbe r Lea d Sampt e Sample s Collecte d LA B Concentratio n Coitecte d Fir m RYASCPXA-8506 6 F l pp m 

### o f D Oate : ^wo & RYBSCPXA-8506 6 F 2 pp m D Time : i-i o !>•«»• RYCSCPXA-8506 6 B l pp m D Sample s Analyze d RYDSCPXA-8506 6 B 2 pp m 

## n 

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. B l = Bac k Left , B 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , P Z = Pla « AlquKliaiil»ir»aBjipw»idf>raniJ^a«lrMI
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### -ED O Pg.ff T RYASCPXA-8506 6 F l pp m 

### D Dat e 

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# iCOASTA L INVIROHHIKTA l cR o b 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 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 :

Addres s o fPropert y covere d b ythi s 

# '^\v ? 

# A J 43^~ ^ 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 worl ( t o b e perfonned , 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 LRESPONS 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 righ t 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 iiemai 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 f2COASTA L tNVINONH^KTA t CROU P IM C



### « Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; cRemov 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 ; cAbid 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
. <

iAllo 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 wori t 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 (402 ) 991-119 9



### & \ g gran t acces s t o mypropertie s D I d o no t gran t access t o mypropertie s

Signature Date

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

Page 2 of 2COASTA L 

## Restoratso n Agreemert t Th e purpos eo f thi s agreemen t i s t c provid eamutua l 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 nfor th e purpos e o f assurin g tha t restoratio n activitie s ar e complete dt o th esatisfactio no f th eproperty owne r an dth eUnite dState s Environmenta l Protectio nAgenc y (EPA)
.



### Pn-p^lylD : gj- ^ ^ ^ Propert y Addrea : '^)2f ^ /KJ4-^"^ ^ Owner ; j y^/^A ^ ^ ^ Ql^ Y 

# 5!E22ZISL S O nth e attache ddiagram(s ) indicat earea(s ) t o excavate , surfac e structure s an dlandscapin g feature s and acces s location(s ) t o b e use db y th econtractors . Indicate distances , depths , material types , etc . Photographicall y an dVideographicall y documen t th eexistin g condition s ofth eproperty an dth ebasemen t i f necessary . 

### Item s t o b e Remove d b yth e Owne rbefor e Star t o fRemediation : Th e lenoval , storage , disposal , and/o rretur n o fthes e item s i s th e Owner' s responsibility
.
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_ Item :
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# 1COASTA L 

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## Landscap e Inventor y Ite m Quantity Uni t Condition/Type/Specie s Pre-existin g propert y area , Quadrant s that wil l b e excavated , tha t i s covere dwithgrass . 

# g 2
Numbe r o f tree s > 2 inc h Eac h 

# 1 trun k diamete r Numbe r o f tree s < = 2 inc h Eac h 

# 1 trun k diamete r Numbe r o f Sprinkle r Zones
. Contro l Valves , Eac h Timers , Heads , etc . Aiiat h;i skcicl i u l \\M '

• .rr'fklc i IHV'.HI ; Numbe r o f an dsiz eo f eac hgarden / flower be d Bac h area . Squar e Fee t Atlitthi l skcicl i ol rL-!;iIiVL ' ^1/f S niidloc;iiioii. s / Agree dupo nvalu eo f plan t material s no t t o b e replace db v contractor . S VCK ' Ihi ' Milli e Mil l tit liSC f 1 0 IS'.U l
. 1 plHii ; ^Olll•;lt• : ll / ili f |;.-i!|)Crl > U " ner . Rasemen t Area , t o b e Eac h excavate d 

# M 'f^J^y l^65c/ r
Pag e 2 of ,C O AS 1 AL I M vin o M n •MTJk
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. , IN C

; AddKiona l Comment s / Instructions :



### Q Chec k th e bo xI fOwne 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 bo xCE G I s not responsible fo ranydamag e don e t o th e interio rofhouse , inciudin g foundatio n crack s o rfissures
.

[3 ^

agre e C D I d o no t agre e 

# yyisiy/fl&^^' ^ U-l^d ^ 0 [<^y^ ^ ,jMf A /Owner' s Signatur e \Dat e K:t^racfBi>>$Signfltnr rDat e ' / /Coasta l Environmenta l Grou p wa s awarde d a contrac t fro m th e EP At o remov e Lead impacte d soi l fro m residentia l propertie s withi n th e Omah a Area
. Pe rthi s contrac t Sundaywor k activitie s ca n onl yb e performe d wit h writte n consen t o fth e neighborin g residents
. B ysignin g thi s for m 1 acknowledg e tha t 1 understan d tha t excavatio n an d backfil l wor k wil l b e performe d a t th e adjoinin g addres s liste d o n SundayDecembe r6,2009
.
Addres s Propert yOwne r Signatur e



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

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 19.26 4 Supervise d By : 

## Certificat e o fVerificatio n

4 4 SOI L 2009-11-2 5 17:2 8 31.0 1 Fina l 8506 6 312 9 n 4 8 s t D Z 13 " R
. VENTR Y ciearenc e ngn c

± Erro r ± 9.32 4

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

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 4 5 Mod e SOI L Tim e 2009-11-2 5 17:2 9 Duratio n 30.5 4 Sequenc e Fina l Flag s BVI D 8506 6 ADDRES S 312 9 n4 8 s t QUADRAN T D Z DEPH T 13 " XR F TEC H R
. VENTR Y MIS C ciearenc e NOT E ngn c

pp m Erro r P

b < LO D 12.51 4 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-3902 2 Readin g N o 4 6 Mod e SOI L Tim e 2009-11-2 5 17:3 0 Duratio n 30.5 0 Sequenc e Fina l Flag s BVI D 8506 6 ADDRES S 312 9 n4 8 s t QUADRAN T D Z DEPH T 13 " XR F TEC H R
. VENTR Y MIS C ciearenc e NOT E ngn c

pp m Erro r P b < LO D 13.03 7 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-3902 2 Readin g N o 4 3 Mod e SOI L Tim e 2009-11-2 5 17:2 7 Duratio n 92.3 9 Sequenc e Fina l Flag s AVERAG E 

## (AvgjtSl4 2 ADDRES S 312 9 n4 8 s t QUADRAN T B 2 DEPH T 6 " XR F TEC H R
. VENTR Y MIS C ciearenc e NOT E ngn c

pp m Erro r P b 157.505- ^ 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-3902 2 Readin g N o 4 0 Mod e SOI L Tim e 2009-11-2 5 17:2 6 Duratio n 30.8 2 Sequenc e Fina l Flag s BVI D 8506 6 ADDRES S 312 9 n 4 8 s t QUADRAN T B 2 DEPH T 6 " XR F TEC H R
. VENTR Y MIS C ciearenc e NOT E ngn c

pp m ±Erro r P

b 64.40 2 ±12.34 8 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-3902 2 Readin g N o 4 1 Mod e SOI L Tim e 2009-11-2 5 17:2 7 Duratio n 31.1 7 Sequenc e Fina l Flag s BVI D 8506 6 ADDRES S 312 9 n4 8 s t QUADRAN T B 2 DEPH T 6 " XR F TEC H R
. VENTR Y MIS C ciearenc e NOT E ngn c

pp m Erro r P

b 64.82 3 ± 12.15 7 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-3902 2 Readin g N o 4 2 Mod e SOI L Tim e 2009-11-2 5 17:2 7 Duratio n 30.4 0 Sequenc e Fina l Flag s BVI D 8506 6 ADDRES S 312 9 n 4 8 s t QUADRAN T B 2 DEPH T 6 " XR F TEC H R
. VENTR Y MIS C ciearenc e NOT E ngn c

pp m ±Erro r P b 43.28 8 ±11.15 7 Supervise d By :

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

### Certlfi c XL3t-3902 2 Readin g N o 3 9 Mod e SOI L Tim e 2009-11-2 5 17:2 5 Duratio n 92.1 0 Sequenc e Fina l Flag s AVERAG E PAvTo f36-38- 1 ADDRES S ^IT 9 n 4 8 s t QUADRAN T B l DEPH T 6 " XR F TEC H R
. VENTR Y MIS C ciearenc e NOT E ngn c

Erro r 

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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-3902 2 Readin g N o 3 6 Mod e SOI L Tim e 2009-11-2 5 17:2 4 Duratio n 30.9 6 Sequenc e Fina l Flag s BVI D 8506 6 ADDRES S 312 9 n4 8 s t QUADRANT B l DEPHT 6 " XR F TEC H R
. VENTR Y MIS C ciearenc e NOTE ngn c
pp m ±Erro r P

b 26.84 3 ±9.80 7 Supervise d By :

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

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 26.16 0 Supervise d By : 

## Certificat e o fVerificatio n

3 7 SOI L 2009-11-2 5 17:2 5 30.5 0 Fina l 8506 6 312 9 n 4 8 s t B l 6 " R
. VENTR Y ciearenc e ngn c

± Erro r ± 9.85 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-3902 2 Readin g N o 3 8 Mod e SOI L Tim e 2009-11-2 5 17:2 5 Duratio n 30.6 4 Sequenc e Fina l Flag s BVI D 8506 6 ADDRES S 312 9 n 4 8 s t QUADRAN T B l DEPH T 6 " XR F TEC H R
. VENTR Y MIS C ciearenc e NOT E ngn c

pp m Erro r P b 19.85 8 ± 9.35 6 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-3902 2 Readin g N o 3 5 Mod e SOI L Tim e 2009-11-2 5 17:2 3 Duratio n 91.5 9 Sequenc e Fina l Flag s AVERAG E £Av g o f32-3£ 7 ADDRES S 312 9 n 4 8 s t QUADRAN T e m DEPH T 1 " XR F TEC H R
. VENTR Y MIS C ciearenc e NOT E ngn c

Erro r pp m P b 

## (yixQ.\n'Cy ± Supervise d By :

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

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 116.29 1 Supervise d By : 

## Certificat e o fVerificatio n

3 2 SOI L 2009-11-2 5 17:2 1 30.2 0 Fina l 8506 6 312 9 n 4 8 s t e m 1 " R
. VENTR Y ciearenc e ngn c

± Erro r ± 16.51 9

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

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 106.43 3 Supervise d By : 

## Certificat e o fVerificatio n

3 3 SOI L 2009-11-2 5 17:2 2 30.8 9 Fina l 8506 6 312 9 n 4 8 s t e m 1 " R
. VENTR Y ciearenc e ngn c

± Erro r ± 14.07 6

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

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 107.83 0 Supervise d By : 

## Certificat e o fVerificatio n

3 4 SOI L 2009-11-2 5 17:2 3 30.5 0 Fina l 8506 6 312 9 n 4 8 s t e m 1 " R
. VENTR Y ciearenc e ngn c

± Erro r ± 14.16 0,*^^* % 

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# EXECUTIV ESUMMARY : BVID #85066-(312 9 N4 8 ST )
~y | No Issue s o r Concern s Q Issues/Concern s Detail Explanation : -DA NGARVE YWALKE D TH EPROPERT YO N4/15/1 0

# M

EP APropert y Clos e Ou t For m Propert y # : JrSO.(ii,C p Propert y Address : Date/Time : Owner' s Nanr : Quad s Excavated : Contracto r Grou p Excavatio nGenera l 1
.

I f nccessaiy , wer eth e correc t qtiadrant(s ) excavate dan drestored ? 2
.I f necessary , wer eth ecorrec t area s ofdri p zon e excavaie dan drestored ? Gradin g So dan dVenctetio n I
.Doe s th e {Fadin g aroun dth eperimete r ofth e hous e i nexcavaie darea s generall y slop e away fromtb e house ? • 2
.Ha s so dbee nlai di nal l area s that wer eexcavated ? 3
.

Doe s th eso di^jpear t o b egenerall y health y an dgrowing ? (Onl y evaluat ei f inspecte da t a3 0 da y tim eperiod ) , 4
.Ar esodde darea s geneiill y fim i an devenl y graded ? 5
.

Ar eth ejoint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat ei f inspecte da t a3 0 da y tim eperiod ) ___. . 6
.Wa s th eproperty grade dsuc hthat wate r wil l not poo l onth eproperty ^ 7
.

Wa s damag et o landscapin g o r plan t material s avoided ? Gates
. Fence s an dRetainin g Wall s I1
. D o gate s ope nan dclos e fi«ely? (I f applkable ) 2
.Wer eal l gate s o r fence s take ndow ndurin g restotatio nactivitie s reinstalled ? (I f applicable ) 3
.

Wa s damig et o gate s o r fence s avoided ? (Ifappiicable ) 4
.Wa s damag et o retainin g wall s avoided ? (Ifappiicable ) Foundation , SidiB K an dGntier s 1
.Wa s damag et o th e sidin g o r tri mavoided ? 2
.Wa s damag et o th efoimdatio navoided ? 3
. Wa s damag e l o window s avoided ? 4 Wa s damag et o window s o r doo r screen s avoided ? S
.Wa s damag et o downspout s o r downspou l extension s avoided ? Sidewalk s an d Driveway s (Concrete ) 1
. Wa s damag et o drivewa y surface s avoided ? 2 , Wa s damag et o walkwa y surface s avoided ? Ye s N o / / Ye s N o / / / / 

# J y y Ye s N o

/ 

# 7 /
/ Ye s N o 

# J / / / ^ Ve s N o
/

## Ort'tjer s conmients :

I 

## [!n.«!pectio nnotes :

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## Removal andresloratio nactivate s complei eincludin g the 30-da y so dwarranry : EP ARepresentativ e ^c/ ' j ^Date : ii [
_

## Propert yCompietio n Agreemen t
Ihi s agreemen t documenl s ih ecomplclio no t remedia l aciiviiie s perlbime donm y properl y M y signaiui e wil l designat eiha l Ia msalisfie dwithth erestoralio no f my properly , an dthat n o item s ar ei nqueslions
. now , o r a l an y lim ei nth efuluie , excep t thos eilem s liste dbelow , i f an y PropertylD : g^gQU j 

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Restoratio n Item s i n Question :

Item : ttem : Item : Item : Item : Item :

IV I I R|;rc cI'Ktoralio n i s completed , excep t a s nnier i [J I rio no t A|>recrestoratio n it , completcr t 

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Dat e Cftnt i arlor' s Signatur e Dat e