## TRANSMITTALof OMAHALEAD SIT E SOI LREMEDIATIO NFIL EFOLDE R

SAID# : P^.r"/ / Date : Address : /<r4<g ' ^ /

l ^ S T Remediatio nContractor : Coasta l Environmenta l Group

_Year : _2011ARRA

_ SOI LREMEDIATIO N PROPERT YFIL EFOLDE RDOCUMENT S Uy Vide o o f property (DVD ) J

/ Executiv eSummary U/ EPA-provide dproperty sketc h USigne dAcces s Agreemen t for subjec t property 'B' ^ Signe dAcces s Agreement(s ) for adjacent property Q

/ Restoratio nAgreemen t ,.D,
. Settlemen t document s (i.e. , for damag e o r t o replac e plants , etc. ) U
. • Confirmatio ndal ^ t

/ Photograph s \ k (>fl4(UffJla ^ -nSo^^y" ^ \^^' ^ { 4 / As-built sketc h IMSatisfactory restoratio nsigne db y Property Owne r Property close-ou t chec k lis t signe db y EPA Descriptio no f area s not meetin g RO D cleanu p criteri a W/ Utility clearance s 

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## Propert y Acces s Checklis t [PropertylD : ^JQ^\[ ON : nWOR K STARTE D / / D WORK COMPELTE D ON;
. / / PropertyAddress : \gi\i ^ [v/
. 2 ^ 5 t " ­ 0,vncr : ^^^^ l ^l^rrU Renter : Address : " J Phone : Ftix : Celi/Pager : Additional Information : Phone : 407^ ' Hf^-^-bya r Fax : Cell/Page r
D NotificationLette r Sent : / / By : \ ^ Acces s Agreement 

### 1 Signed: JL/2a / 1 1 By : [) ( Restoratio nAgreement 

## Signed : 2_/^/li By : D Topsoil Samplin g (if applicable ) / / By : D Disposa l Samplin g (if applicable ) / / By : D Garde nSamplin g (if applicable) ' / / By : D Utilit y Clearanc e Called : / / By : D Video/Photo s (Before) On : / / By : O Video/Pboto s (During ) On ; / / By : nVideo/Photo s (After) On : / / By : nVideo/Photo s (30-Day) On : / / By :

' Q Property CompletionAgreement Siened : / / By : 1 D Pinal Report Issued : / / By : 

# 1
Air Monitorin g (a s applicable ) D Communit y • Cre w On : / / By : Results : O Communit y • Cre w On : / / By ; Results : UCommunit y \Z } Crew On : / / 

# 1 Results :

Omah a Lea d Sit e

## Douglas Coimt y Accoun t Infomiation Pag e 1 of 1
Dougla s County , Nebrask a Propert yRecor d ­ R222909000 0
Informatio n i s vali d a s o f2010-8-3 0 Ne wFeatur e - » - 4 - » Prin t Reoor t Vie winteractiv e Gi S iMao

Treasurer' s Ta xReoor t Subdivisio n Sale s Searc h Owne r HARRI S ROYL ETA L 531 8 N 2 5 S T OMAH AN E 68111-000 0 Propert yInformatio n Ke yNumber : 290 9 000 0 2 2 Accoun t Type : Residentia l Parce l Number : 222909000 0 Parce l Address : Lega l Description : 154 6 N 1 8 S T OMAH AN E 68110-000 0 SMITH S - E V
- AD D LO T3 BLOC K1 6 S 1/ 2 3 3 X14 0 Valu e Informatio n
201 0 200 9 200 8 200 7 200 6 200 5 Lan d $500.0 0 $500.0 0 $500.0 0 $500.0 0 $500.0 0 $500.0 0 Improvemen t $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 Tota l $500.0 0 $500.0 0 $500.0 0 $500.0 0 $500.0 0



## http://dougiasne.mapping-onIine.com/DouglasCoNe/static/accountinfo.jsp?accountno=R222..

. 9/2/201 0www.dhon.org/irthinternet/DHONNotic.

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### 4/8/201 1 Creat e Anothe rTlclce t Bac k t o Irt h Inteme t Sen d Emai l 

# r

• YOURTICKE TNUMBE RI S 2708604
. Origina l Cal l Date : 4/08/1 1 Time : 2:2 7 pm Op : ALFONSO1879 0 Wor k t o Begi n Date : 4/12/1 1 Time : 3:0 0 pm State : N E County : DOUGLA S Place : OMAHA Address : 154 6 Street : N18T H S T Twp : 15 N. Rng : 13 E Sect-Qtr : 15-N W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : Lea d Remediatio n Locatio n o f Work : LOCAT E ENTIR E PROPERTY , AL L EASEMENT S AN D T O TH E PEDESTA L Remarks : FA X AL L CLEAR S TO : (402)934-281 1 : PLEAS E INCLUD E AL L EASEMENT S Company: COASTA L ENVIRONMENTA L SERVIC E Contac t Name : ALFONS O Phone : (402)934-283 7 Wor k Bein g Don e For : Coasta l Dept ho f Excavation : 4f t Corne r Lot : NFront : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N CXCATV LEVEL 3 MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C


## Utilit y Servic eAre a Contac t Phon eNumbe r Typ e Day : 402934046 9 CXCATV CO XCOMMUNICATIONS , IN C HEIDI Alt : 402934046 9 Emerg : 402932975 7 Day : 877366834 4 LEVEL3 COMMUNICATIONS , LbVbL J^^ ^ N A 

## Alt : Emerg : 877366834 4 Day : 402504782 3 METROPOLITA NUTILITIES MUDOl SAND YMUDAk : DISTRIC T Emerg : 402504797 0 Day : 402444719 7 CITYOFOMAHA

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## LOCAllN O Alt Day : 406728934 3 Ak : 406207149 406207149 4 Emerg : 888728934 3

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## Consen t fo rAccessfT 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 : j^ ^ fkcf^ S Daytim e Phone :

Addres s o fPropert y covere d b ythi s Agreement : 

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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 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 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 f23~ ' ' " V'-" ^ > 'COASTA L

• j

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### cRemov 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 ; <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 (402 ) 991-119 9

10 1 gran t acces s t o mypropertie s D > d o no t gran t access t o mypropertie s

Signature ' f^ Dat e SignatureDate

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## Restoratio n Agreemen t Th e purpos e o f thi s agreemen t i s to provid eamutual agreemen t a s t o condition s o f th eproperty prio r t o remediatio nactivities

. Thi s will als o serv ea s documentatio nfo r th epurpos e o f assurin g that restoratio n activitie s are complete dt o th e satisfactio no f th eproperty owne r an dth e Unite dState s Environmental Protectio nAgenc y (EPA)
.

PropertylD : ^5] ) PropertyAddress ; ]^L/I^i ^ ]Q-^- f 

### 0^^""-= ^oc , fk^r,< , Phone : ljC,^^o(2 ^ Onth e attache ddiagram(s ) indicate area(s ) to excavate , surfac estructure s an dlandscapin g feature s and acces s location(s ) t o b e usedb y th e contractors
. Indicat e distances , depths , material types , etc
. Photographicall y an dVideographicall y document the existin g condition s ofth eproperty andth e basement i f necessary . 

### Item s t o b e Remove d b yth e Owne rbefor e Star t o fRemediation :

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# ( f Attac hasketc ho f relativ e size s an dlocations

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Pag e 2 of

.COASTA L C R O U r, INC

.


### Additiona l Comments / Instructions : Th e cit yo fOmah a ordinance s ma yprohibi t yo u fro m usin g dirt o rgrave l areas o n you rproperty as driveway s o rvehicl e parkin g areas . Th e Environmenta l Protectio n Agenc y(EPA ) ma yb e removin g an d replacin g soi l underlyin g a grave l o rdirt are a o n you rpropertytha t yo u ma yb e usin g as a drivewayo rvehicl e parkin g area . I fthi s i s th e case , yo u shoul d understan d tha t thi s removin g an d replacin g o fsoi l doe s no t mea n that an yillega l drivewayo rparkin g are a o n you r propertyi s mad e legal

. T o th e contrary , yo u ma yb e cite d byth e cit yi fyo u us e a grave l o rdirt are a as a drivewayo rparkin g area , no t withstandin g an yremova l o rreplacemen t o fsoi l b yth e EPA

. I fyo u have an yquestio n abou t legalit yo fa certai n drivewayo rparkin g area , yo u ma ycontact th e cifyo fOmaha' s Plannin g Departmen t at (402 ) 444-5150

. |T

j Pleas e chec k thi s boxi fyo u understan d th e informatio n outline d above

.

yChec k th e boxi 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

. Bycheckin g thi s boxCE G i s no t responsibl e fo ran ydamag e don e t o th e interio ro fhouse , includin g foundatio n crack s o rfissures

. 

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## w C u 41.42 9 N i < LO D C o < LO D F e 17411.60 0 M n 579.13 1 Supervise d Bv : 

## Certificat e o fVerificatio n

2 6 SOI L 2011-04-1 2 21:4 3 30.9 8 Fina l 2651 1 154 6 N 1 8 S T B 2 4 " M

. MATEU S CONFIRMATIO N CLEA R

Erro r

,« i 7.37 9 ± 14.07 5 ± 7.73 2

* 13.25 3 ± 6.02 8 12.84 7
: 5.24 5 27.69 0 10.76 4 ± 20.98 6

: 82.21 8 ± 20.57 2

: 70.48 8 ] 171.91 2 ± 361.21 1 ± 103.70 6

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

## Certificat e o fVerificatio n

2 7 SOI L 2011-04-1 2 21:4 4 30.7 5 Fina l 2651 1 154 6 N 1 8 S T B 2 4 " M

. MATEU S CONFIRMATIO N CLEA R

Erro r J 7.47 7 ± 14.16 5 ± 7.68 5 13.13 8 ± 5.73 2 11.95 0 ± 20.33 1 4.57 7 ± 18.23 5 11.34 0 ± 22.38 7 82.24 6 ± 20.55 9 71.51 2 ± 125.49 7 ± 386.09 7 ± 100.81 9 XL3t-3208 9 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

M o Z r S r U R b T h P b S e A s H g Z n W C u N i C o Fe M n pp m
< LO D 394.59 4 133.58 0

< LO D 54.60 2 < LO D 242.79 4

< LO D 27.79 0 < LO D 187.51 8

< LO D 38.56 7 < LO D 258.66 7 19647.77 0

512.87 2 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 MiddlesexTurnpil< 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 QUADRAN T DEPH T XR F TEC H MIS C NOT E

M o Z r S r U R b T h P b S e A s H g Z n 

## w C u N i C o F e M n pp m
< LO D 356.39 4 139.44 9

< LO D 57.87 5 < LO D «a04.12 4 < LO D < LO D < LO D 184.30 8

< LO D 40.64 2 < LO D < LO D 16809.41 6

570.59 2 Supervise d By : / 

## Certificat e o fVerificatio n

2 4 SOI L 2011-04-1 2 21:4 0 92.4 8 Fina l "Av g o f21-2 3

154 6 N 1 8 S T B l 4 " M

. MATEU S CONFIRMATIO N CLEA R

; ± ±

: ± ' ± : * : ±

: ±

. ^ y ^ ' / ^

^ X 

# f^

. y y ^ Erro r 7.24 4 13.36 6

7.71 9 12.92 9

5.75 5 10.92 9 

## ^sno p 5.46 0 24.20 4 10.46 7 21.67 5 74.00 0 20.13 2 - 7 68.04 1 / 167.16 8 / 351.89 3 101.31 2 

### 7 i (

.

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 2 1 Mod e SOI L Tim e 2011-04-1 2 21:3 8 Duratio n 30.8 2 Sequenc e Fina l Flag s BVI D 2651 1 ADDRES S 154 6 N 1 8 S T QUADRAN T B l DEPH T 4 " XR F TEC H M

. MATEU S MIS C CONFIRMATIO N NOT E CLEA R

pp m Erro r M o < LO D : 7.23 7 Z r 348.40 8 ± 13.23 1 S r 139.82 3 ± 7.71 7 U < LO D 12.83 9 R b 60.80 2 ± 5.85 0 T h < LO D 11.38 3 P b 221.22 4 ,.l^ m . . .-»49,23 & S e < LO D I 5.17 6 A s < LO D : 25.38 7 H g < LO D 10.27 0 Z n 190.70 5 ± 22.00 8 W < LO D 74.80 1 C u 45.63 6 ± 20.46 4 N i < LO D 68.42 8 C o < LO D 164.02 9 F e 16196.12 5 ± 345.06 7 M n 541.90 4 ± 99.17 3 Supervise d By :

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 2 2 Mod e SOI L Tim e 2011-04-1 2 21:3 9 Duratio n 30.9 1 Sequenc e Fina l Flag s BVI D 2651 1 ADDRES S 154 6 N 1 8 S T QUADRAN T B l DEPH T 4 " XR F TEC H M

. MATEU S MIS C CONFIRMATIO N NOT E CLEA R

pp m Erro r M o < LO D ; 7.29 7 Z r 347.07 5 ± 13.24 9 S r 135.01 5 ± 7.62 7 U < LO D : 13.05 3 R b 53.23 5 ± 5.60 9 T h < 1 n n 1 1 01 8 S e < LO D : iMpf^'"' ^ 5.19 8 A s < LO D : 23.69 2 H g < LO D : 10.36 8 Z n 160.31 2 ± 20.43 7 W < LO D : 71.91 5 C u 46.08 0 ± 20.71 2 N i < LO D \ 70.22 6 C o < LO D 166.71 3 F

e 16326.30 6 ± 347.98 4 M n 564.64 0 ± 100.79 2 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpil< 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 QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m M o < LO D : Z r 373.69 7 ± S r 143.51 0 ± U < LO D : R b 59.58 7 ± T h < LO D 

# •• B 196.24 0 ^ ^ < LO D A s < LO D H g < LO D Z n 201.90 6 W < LO D C u 30.21 1 N i < LO D C o < LO D Fe 17905.82 0 M n 605.23 1 

# 1 ^ "

Supervise d By : 

## Certificat e o fVerificatio n

2 3 SOI L 2011-04-1 2 21:4 0 30.7 5 Fina l 2651 1 154 6 N 1 8 S T B l 4 " M

. MATEU S CONFIRMATIO N CLEA R

^^"—~ — ^ ; * ±
± :

: ± ± Erro r 7.19 8 13.61 9 7.81 3 12.89 4

5.80 5 10.38 8

6.00 5 23.53 2 10.76 4 22.58 0 75.28 4 19.21 9 65.47 0 170.76 1 362.62 9 103.97 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 AVERAG E ADDRES S — QUADRAN T T5EPHT XR F TEC H MIS C NOT E

M o 

## Certificat e o fVerificatio n

2 0 SOI L 2011-04-1 2 21:3 6 92.6 6 Fina l

•Av g o f17-1 ^ » H^^^154 6 N 1 8 S T m



### ^^PF 2 4 " M

. MATEU S CONFIRMATIO N CLEA R

pp m
< LO D 1 Z r 380.98 1 ± S r 135.98 7 ± U < LO D 

### : R b 61.14 4 ± T h < LO D P b ^^3.99 1 ± S e < LO D A s < LO D H g < LO D Z n 206.85 5 ± W < LO D C u 53.30 3 ± ^ N i < LO D 

## ^ y C o < LO D y 

# y: Erro r 7.34 0 13.74 8

1.^2 1 13.35 2

5.91 8 11.93 3 

### "^i.Baa- i 5.38 3 24.39 1 11.11 4 22.93 2 ^.,^7e;^1 9 21/09 6 )S8.82 5 /165.42 1 Fe 16827.813 / ±/ / 351.91 2 M n 551.1i r 99.93 3 

## yy ? Supervise d By : / 

# ezz 7

# 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 1 7 Mod e SOI L Tim e 2011-04-1 2 21:3 5 Duratio n 30.8 9 Sequenc e Fina l Flag s BVI D 2651 1 ADDRES S 154 6 N 1 8 S T QUADRAN T F2 DEPH T 4 " XR F TEC H M

. MATEU S MIS C CONFIRMATIO N NOT E CLEA R

pp m Erro r M o < LO D 7.41 9 Z r 375.37 0 ± 13.58 6 S r 137.76 4 ± 7.62 6 U < LO D 13.16 4 R b 62.50 0 ± 5.92 0 T h < LO D 11.51 9 P b ---3-482.03 9 ± 17.60 6 S e ' < LO D 5.35 2 A s < LO D 23.45 2 H g < LO D 10.76 2 Z n 208.97 9 ± 22.89 8 W < LO D 77.75 5 C u 55.46 0 ± 20.96 8 N

i < LO D 65.64 0 C o < LO D 162.28 7 F e 16792.01 2 ± 349.57 9 M n 572.11 2 ± 100.73 4
Supervised 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 1 8 Mod e SOI L Tim e 2011-04-1 2 21:3 6 Duratio n 30.7 5 Sequenc e Fina l Flag s BVI D 2651 1 ADDRES S 154 6 N 1 8 S T QUADRAN T F2 DEPH T 4 " XR F TEC H M

. MATEU S MIS C CONFIRMATIO N NOT E CLEA R

pp m Erro r M o < LO D : 7.27 4 Z r 395.55 9 ± 13.88 5 S r 128.91 0 ± 7.40 5 U < LO D 12.93 5 R b 63.04 2 ± 5.92 4 T h 

# IB I ! ^ m ^

^ < LO D 223.68 4 < LO D 

## i : „ 1 " ) O"?" ? 19.29g ^ 5.46 5 A s < LO D 25.15 8 H g < LO D ' 11.25 4 Z n 215.64 0 ± 23.28 3 W < LO D 80.12 5 C u 65.65 5 ± 21.90 2 N i 85.17 1 ± 47.57 6 C o < LO D : 167.10 5 Fe 17289.86 7 ± 355.04 1 M n 587.18 8 ± 101.78 9 Supervise d By :

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

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 1 9 Mod e SOI L Tim e 2011-04-1 2 21:3 6 Duratio n 31.0 2 Sequenc e Fina l Flag s BVI D 2651 1 ADDRES S 154 6 N 1 8 S T QUADRAN T F2 DEPH T 4 " XR F TEC H M

. MATEU S MIS C CONFIRMATIO N NOT E CLEA R

Erro r pp m M o < LO D I 7.32 8 Z r 372.01 4 ± 13.77 3 S r 141.28 9 ± 7.84 8 U < LO D * 13.95 6 R b 57.89 1 ± 5,91 2 T h < LO D 12.06 0 

## ilk — _^6.25 0

. ^ ••^H i B^ 18.89 1 S e < LO D ; 5.33 2 A s < LO D : 24.56 2 H g < LO D : 11.32 6 Z n 195.94 5 ± 22.61 4 W < LO D 78.87 8 C u 38.79 3 ± 20.41 9 N i < LO D ; 69.47 1 C o < LO D : 166.87 1 F e 16401.55 9 ± 351.11 6 M n 494.05 3 ± 97.27 7 Supervise d By :

## ijQL \ Omah a Lea d Site—Fixe d Pric e EP-R7-09-0 6 Coasta l Environmenta l Grou p Inc

. V ) www.coastalgrp.ne t COASTA L 

# K^y^ ^ ^

INVIIOMNINTA L C > 0 U P

. IN C 

# EXECUTIV ESUMMARY : BVID #2651 1 - (154 6 N1 8 St)
No Issue s o r Concern s Q Issues/Concern s
Detail Explanation : DA NGARVE YWALKE D TH EPROPERT YO N5/4/1 1

## Propert yCompletio n Agreemen t
Thi s agreemen l document s th e completio n o l remedia l activitie s perloime d o n m yproperly

. M ysignatur e wil l designat e iha l I a m satisfie d wit h (h e rcsioralio n o fm yproperly , an d (ha ( n o ilein s ar e i n questions , now , o ra l an ylim e i n th e future , excep t thos e item s liste d below , i fan y

PropertylD : XQ'^U Propcrf y Addrc.ss:|9( ^ ^ ^ M , jTSF ^ Owner : \Z^O^ A[\rXYVi ^ Phone : U j 0^

. - V AC 3 ^ n \l S 

# k

Restoratio n Item s i n Question :

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

y«J 1 nyrc cI'C.^toriilio n i s completed , excep l as nnler i [_ ) I ri o nal-M;i-e cre*lor«tio n i s coniplelcr i

Own«>' 5 Signatiir r

# P^EP A EP APropcrt> ' Clos eOu t For m Propert yH : iMfW

. . Propert yddres5 : JSUU^L-iC^ Prn^-rt vAddre.

. ' Date/Time : Owner' s Name : Quad s Excavaled : Contracto rGrou p
Ve s N o Excavatio n Genera l 1

.i fnecessao' , wer e ih ccorrec t quadrantfs ) excavate d an d restored ? / 2

.I fnecessary , wer e th e correc t area s ofdri p zon e excavale d an d restored ? 

# y

- J Ve s No Grad i o e So dan dVefletatio o 1
.Doe s th e gradin g aroun dth e perimete r ofth e hous e inexcavate darea s generall y slop e awa y 

# y fromth e house ? 

# y 2
. Ha s so dbeenlai di nall area s that wer e excavated ? 3
. Doe s th e sodappea r t

o b e generall y health y an dgrowing ? (Onl y evaluai e if inspecte da t a3 0 

# y da y tim e period ) 4
. .'ir e sodde darea s generall y firman devenl y graded ? 

# y 5
. Ar e th e joint s berwee nth e so dstrip s generall y tight ? (Onl y evaluat e if inspecte da t a3 0 da y 

# y tim e period ) 6
. Wa s th e property grade dsuc htha t wate r wil l no t poo l onth e property ? 7 Wa s damag e t o landscapin g o r plan t material s avoided ? 

# y
Gales

. Fence s an d ReUinin g Wall s Ve s N o i

.

D o gate s ope n an d clo,"; e freely ? (Ifapplicable ) ^ 2

.Wer e al l gate s o rfence s take n dow n durin g restoratio n aciiviiie s reinstalled ? (Ifapplicable ) / 3

.Wa s damag e t o gate s o rfence s avoided ? (Ifapplicable ) 4

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

. \ Fouodation , Sidin g ati d Gotler s Ve s .N o I
.Wa s damag e l o ih c sidin g o r tri mavoided ? 2

.Wa s damag e t o th e foundatio n avoided ? / 3

.Wa s damag e t o window s avoided ?



### — - ­ Wa s damag e t o window s o rdoo rscreen s avoided ? 4 

### / 5

.Wa s damag e l o downspout s o rdownspou l t-'xtension s avoided ? 

# y

Sidewalk s an d Driveway s (Coocrete ) ^'c s Ni l vy_r > Wa s damag e l o drivewa ysurface. ^ avoided' 'i


# r 2

.

Wa. s damag e t o walkwa ysurface s avoided'. '

## Owner s comments :

Inspectio nnotes :

Removal an dresioratio naclivale s complet e incIucJin g (h e 30-day .so dwarranty : EP ARepresenlaiiv e___^_ ^ Dale : s/V/ w