# TRANSMITTA Lof OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R 

# V \ 

# u SAI D # : Date :

RemediationContractor : Coasta lEnvironmenta i Grou p Year : 200 1

SOI LREMEDIATIO N PROPERT YnLEFOLDE RDOCUMENT S 

# A Video of property (DVD ) Executiv eSummar y EPA-providedproperty sketch 

# tf SignedAcces s Agreement fo r subject propert y SignedAcces s Agreement(s ) fo r adjacen t propert y / 

## RestorationAgreement Settlemen t dociunent s (i.e. , fo r damag eo r t

o replac eplants , etc. ) Confirmationdata 

# A Photograph s hy^h\AA ^V iUlS^<!Ai/>^TVw- t As-built sIcetc h Satisfactor y restoratio nsignedby Propert y Owner 

# d Propert y close-out check list signedby EP A Descriptionof area s not meeting ROD cleanup criteri a 

# d Utilit y clearance s Propert y informationfro mDougla s Count y Assessor' s Office

### • • 

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## Propeit y Acces s Checklis t Property ID : l-^^^-O, ^ Property Address : f^l- ^ ^ ja,- ^ S4

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WORKSTARTED WORK COMPELTED ON : ON:

. / / / /


## Owner : ^QYYy5

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. S'oU? ^ Fax : Ccll/Pager

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D NotfflcationLette r

D TopsoilSamplin g (if applicable ) D Disposa lSamplhi g (if applicable ) D Canlc nSamplin g (if applicable ) S JUtilit y Clearanc e Q^VIdeo/Photo s (Before) D Video/Pboto s (Daring ) D Video/Photo s (After) D Video/Photo s (30-Day) D Property CompletionAgreement 1 D FinalReport Sent : / / 

## sipit6^i2A i S Q Slgned:y_/2X/( ^ / / / / / / 

## Called : iQ./g_/Q a On:J2/_^/ ^ On : / / On : / / On : / / Signed : /

. 1 Issued : / / 

## By : By : By : By : By : By : By : By : By : By : By : By : By : 

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Omah a Lea d Sit e

### • • 

## Dougla s Count y Accoun t I

j|ira|do n Page1 of 2

Dougla s County , Nebrask a Propert yRecor d - R252107000 0 Prin tRepor t NE WFeatur e - Parce l Dimension s avaiiabi e @ scal e 0-5 0 ftwes to f52n d S t- VleWOf l Ma p 

### Informatio n i s vali d a s o f2009-9-1 5 Treasurer' s Ta xRepor t Ne wFeatur e ^ ^ -* Aut o Sale s Searc h Owne r SWOBOD AJAME S A
81 7 S 3 7 S T OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumber : 210 7 000 0 2 5 Accoun tType : Residentia l Parce l Number : 252107000 0 Parce l Address : 81 7 3 3 7 S T OMAH AN E 68105-000 0 Lega l Description : WES TOMAH ALOT3 BLOC K2 0 N 4 7 F TW11 2 F T4 7 X11 2 Valu e Informatio n L^n d Improvemen t Tota l 

### 200 9 $10,500.0 0 $114,200.0 0 $124,700.0 0 200 8 $10,500.0 0 $114,200.0 0 $124,700.0 0 200 7 $10,500.0 0 $94,000.0 0 $104,500.0 0 200 6 $10,500.0 0 

### $94,000.0 0 $104,500.0 0 200 5 $10,500.0 0 $82,500.0 0 $93,000.0 0 200 4 

### $10,500.0 0 $42,000.0 0 $52,500.0 0 Ljin d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 2 5264. 0 1. 0 112. 0 47. 0 N o Improvemen tInformatio n Buildin g 1



## http://douglasne.mapping-online.com/DouglasCoNe/static/accotmtinfo.jsp?accoimtno=R25..

. 9/17/2009

### • • 

## Dougla s County Accoun t I |||K|nndo n Pag e2 of 2

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### Squar e Footage : 1487. 0 Percen tComplete : 100.0 % Perimete r 0. 0 Quality : , Averag e Uni tType : En d Condition : I Goo d

Buil tAs : 2 1/ 2 Stoi 7 Unfi n Cond o Squar e Footage : \ 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 6. 0 Exterior : Fram e Viny l Units : : 1. 0 Interior : Drywal l Baths : \ 2. 0 Roo fCover : Compositio n Shingl e Bedrooms : 3. 0

Roo fType : Hi p Stories : 2. 5 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 Yea r Percen t Adjuste d Yea r Yea rBuil t Physica l Ag e Remodele d Remodele d Buil t 191 2 0 0 % 191 2 9 7 Defai Y7/p e Detai l Descriptio n Unit s Ad d O n Fence 1. 0 Applianc e Allowanc e 1. 0 Basemen t Bsmn tCon e 8 f t 672. 0 Fixture Bas e Fixture s 1. 0 Fixture Bat h Ful l 2. 0 Porc h En d Soli d Wal l 78. 0 Porc h Sla b RoofCei l 180. 0 Use r Coul d b e 2 apt s 0. 0 Use r Wire Fence 1. 0



## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R25.

. . 9/17/200 9

### Pag e1 of 2

" >
I Creat e Anothe rTicke t Bac k t o Irt h Interne t [ Sen d Emai l |



### • YOU RTICKE TNUMBE RI S 2387333

.
Origina l Cal l Date : 10/15/0 9 Time : 1:4 2 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 10/19/0 9 Time : 2:1 5 p m State : N E County : DOUGLA S Place : OMAH A Address : 81 7 Street : S 37T H S T Twp : 15 NRng : 13 E Sect-Qtr : 20-S E 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 : FAXAL L CLEAR S TO : (877)662-421 1 : UNSUR E O F CORNE R LO T Compan y: COASTA L ENVIRONMENTA L SERVIC E Contac t Name : ELIZABET H Phone : (877)662-421 0
Wor k Bein g Don e For : COASTA L Dept ho f Excavation : 4 F T Come r Lot : N Front : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N BSHPCLK S CXCAT V MUDO l OMAHACO F 0PPDGPR 5 PAETE C QLNNEI C



### Servic eAre a Contac t Phon eNumber Utilit y Typ e

BSHPCLK S NEBRASK AHEALT H SYSTE M N A Day : 402552346 0 Alt : 402552334 7 Emerg : 402559511 1

/-Y/-AXA / CXCAT V CO XCOMMUNICATIONS ,

_. p „_„ . HEIDI 

## Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7

MUDO l METROPOLITA NUTILITIES DISTRIC T SAND Y Day : 402504782 3 Alt : Emerg : 402504797 0

OMAHACO F CIT YO FOMAHA

TRAFFICSEWE R RICH/TRAFFI C Day : 402444719 7 Alt : 402444516 1 Emerg : 402444516 0

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. . 10/15/200 9

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NO NEE D T O CAL LOU T PAETE C PAETE C COMMUNICATION S EMERGENC Y

QLNNEIC QWESTLOCA LNETWOR K

N A 

## Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3 Day : 800289190 1 Alt : Emerg : 800289190 1 Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3

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. . 10/15/200 9

# As-Buil t Drawin g C OASTA L 

# Omah aLea dSuperfun dSit e INVIRONHINTA L O H O U P , IN C

Name : -ic,•-^« ^ St.ji: ? b ocic < Omah a Lea d Sit e Date : Nort h Arro w Address : ^/ 7 .5 , I7>f

. Sit e Sketc h Time : Phone :

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## Legen d Concret e Dri p Zon eExcavate d Quadrant s Excavate d Are areplace d So d wit h Are areplace dwit h Rock/Mulc h Are alef t bar e 

## Contrac t # : EP-R7-07-0 5 Coasta lEnvironmenta lGrou p Inc

.

### • • • •
Name : ocv-ve i husbtiAo.

. Omah a Lea d Sit e Date :
. 

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## Ooiisen tfo fAcccis s T o Propferl 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 Agenc y(EPA) o rits authorize d representatives , collectivel y th e Grantee , t o ente ran d perfor m certai n envlronmenta l respons e activitie s upo n th e followin g describe d premises :

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# j ^ 5UJIA?SA/A) A

Addres s o fPropert y covere d b ythi s 

# S/75 3 7 ^ Agreement :
PURPOS E O F RESPONS E ACTIVITIE S 

## Th e EPAi s requestin g acces s t o collectsoi l sample s an d remov e soi l thatcontain 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 remove contaminate d soil

. Th e remove d contaminate d soi l wil l be 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 Lead Superfun d Site remediatio n program
. Arepresentativ e o fCoasta l Environmenta l Group , contracte d b yUSEPA , wil l contact th e Granto rin-perso n t o discus s th e wor k t o b e performed , th e Granto rwil l have a n opportunityt o revie wan d approve th e planne d soi l removal , an d restoratio n wori c before i tbegins

. Onc e th e wor k i s finished , th e Granto rwil l b e aske d to revie wth e work an d confir m tha ti ti s complet e an d meets wit h th e Grantor' s approval

. Upo n completion , th e Granto rwil l receive writte n documentatio n fro m EP Athatth e property has bee n remediated

.
ENVIRONMENTA LRESPONS E ACTION S 

## B

ysignin g thi s Acces s Agreemeni , th e Granto ri s grantin g th e EPA , its employees , contractors an d subcontractors th e rightt o ente rth e property , a tal l reasonabl e time s an d wit h prio rnotice , fo rth e sol e purpos e ofperformin g th e work

. Thi s acces s shal l remai n i n effectunti l th e wor k has bee n satisfactoril ycompleted

. Th e Granto rals o agree s to :

Pag e 1 o f2COASTA l tNViaONHFKTA I 

### '''• ' A e » o u » I Kc



### ' Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; rRemov e flowe rbulb s o rplant s tha tth e Granto ro rth e Grantor' s tenan tma ywis h t o save ; Wate ran d maintai n replacemen tvegetation , includin g fertilize rapplication , a s necessary ' subsequen tt 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 tEP Ai n obtainin g tenantapprova l fo racces s t o th e propert yt o perfor m th e work

. tAllo wvideotapin g and/o rphotographin g o fth e property

.
AGREEMEN TNO TT o INTERFER E 

### Th e Granto ragree s no tt o interfer e o rtampe rwit h an yo fth e wori cactivities , o rwit h an y o fth e wor k done , o rwit h th e equipmen tuse 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 tenc i t o endange rth e healt h o r welfar e o fth e Grantee s o rth e environment , o rt o allo wothers t o us e th e propert yi n suc h a manner
.
Shoul d yo u hav e an yquestion s abou tthi s program , pleas e contac tCoasta l Environmenta l Group , a t(402 ) 991-119 9



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## Rfistoratioii

. Agreemsn t Th epurpos eo f thi s agreemen t i s t o provid eamutualagreeme ma s t o condition s o f th epropen y prio r to remediatio nactivities

. Thi s wil lals o serv ea s documentatio nfor th epurpos eo f assurin g tha t restoration activitie s ar ecomplete dt o th esatisfactio no f th eproperty owne r an dth eUnite dState s Environmenta ) Protectio nAgenc y (EPA)

. [propert y ID : ^r^^^-^-^—'^•^"—— " ~ —- —'-" ^ IPropert y Address : ^/ ^ ^ '3'/'^ I'^-'

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. Indicatedistances , depths , materialtypes , etc
. Photographicall y an dVideographicaJl y document th eexistin g condition s ofth eproperty an dth ebasement i f necessary . Item s t o b e Remove d b yth e Owne rbefor e Star to fRemediation : ''il'anoval

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

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

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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-3207 5 Readin g N o 30 5 Mod e SOI L Tim e 2009-10-2 0 16:1 2 Duratio n 30.0 0 Sequenc e Fina l Flag s SAMPL E 2213 5 LOCATIO N 81 7 s 3 7 s t INSPECTO R VENTR Y COR l D Z CO R 2 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A



### pp m Erro r P b 149.60 9 ± 19.77 9 C d < LO D 20.64 4 A g < LO D 15.32 9 S r 140.24 1 ± 9.56 3 < LO D 22.55 3 

## u R b 54.47 2 i 6.99 1 T h 17.80 6 ± 11.17 2 S e < LO D 5.69 1 A s < LO D 24.33 4 H g < LO D 14.22 6 Z n 132.34 2 ± 23.40 7 W < LO D 84.89 1 C u < LO D 33.28 8 N i < LO D 82.23 9 C o < LO D 182.76 9 F e 16958.86 5 i 442.54 6 M n 830.20 9 ± 136.99 7 C r < LO D 197.31 6 V < LO D 198.06 8 T i < LO D 656.88 7 S c < LO D 16.56 2 C a < LO D 641.17 7 K < LO D 2464.64 6 S < LO D 168219.26 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-3207 5 Readin g N o 30 6 Mod e SOI L Tim e 2009-10-2 0 16:1 3 Duratio n 30.0 0 Sequenc e Final Flag s SAMPL E 2213 5 LOCATIO N 81 7 s 3 7 s t INSPECTO R VENTR Y CO R 1 D Z CO R 2 1 3 MIS C clearenc e NOT E ep a gu n Usie rLogi n EP A

pp m ± Erro r P b 120.78 8 18.38 2 C d < LO D 22.01 3 A g < LO D 15.34 8 S r 121.25 2 ± 9.10 6 U < LO D 22.98 6 R b 54.94 0 ± 7.12 1 T h < LO D 16.29 3 S e < LO D 6.65 4 A s < LO D 24.09 4 H g < LO D 13.51 4 Z n 124.21 7 23.04 6 W < LO D 83.76 9 C u < LO D 32.94 1 N i < LO D 77.94 4 C o < LO D 191.65 3 F e 18004.62 7 ± 461.18 4 M n 418.89 2 ± 108.57 7 C r < LO D 35.54 9 < LO D 323.88 5 Ti < LO D 680.03 4 S c < LO D 22.48 5 C a < LO D 886.86 5 K < LO D 1271.24 4 S < LO D 1038.07 8 Supervise d By : V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 31 2 Mod e SOI L Tim e 2009-10-2 0 16:1 7 Duratio n 120.0 0 Sequenc e Fina l Flag s AVERAG E / AV g o f308-31 1 -) LOCATIO N 8i/s:f/s t INSPECTO R VENTR Y COR l f l CO R 2 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A



### pp m Erro r 

### pP b 

### :
. 47.26 4 •±• —i^^ji— ^

C d < LO D \ 21.08 7 • A g < LO D \ 15.28 9 S r 135.10 0 ± 9.39 9 

## u < LO D ; 23.75 2 R b 63.51 5 ., ± 7.46 0 T h < LO D * 13.50 9 S e < LO D : 5.96 2 A s 29.04 2 ± 12.17 3 H g < LO D ; 13.61 1 Z n 77.93 7 ± 18.96 1 W < LO D 80.40 9 C u < LO D 33.35 7 N l < LO D 77.07 1 C o < LO D 178.25 8 F e 15661.33 8 •± 424.03 8 M n 141.24 6 ± 79.71 2 C r < LO D 163.17 9 V < LO D 341.62 8 T i < LO D /^90.27 4 S c < LO D / 55.61 2 C a < LO D 

# y.
. y / 1538.73 2 K < LO D 

## A'• / 2112.07 3 S < LO D / ?j44511.94 5 

# y A r

• 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-3207 5 Readin g N o 30 8 Mod e SOI L Tim e 

### 2009-10-2 0 16:1 5 Duratio n 

### 30.0 0 Sequenc e Fina l Flag s SAMPL E 

### 2213 5 LOCATIO N 81 7 s 3 7 s t INSPECTO R VENTR Y CO R 1 f l CO R 2 

### 1 3 MIS C 

### clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r T i S c C a K S pp m 

### 59.62 7 < LO D < LO D 138.28 9

< LO D 69.70 5 < LO D < LO D 34.37 6 < LO D 76.02 1 < LO D < LO D < LO D < LO D 15473.59 3 

### 119.50 9

< LO D < LO D < LO D < LO D < LO D < LO D < LO D ±
±

±

' ±

±
±

± ± Erro r 

### 13.25 0 20.43 6 14.74 2 9.28 0 23.63 7

7.57 3 12.20 9

5.38 1 12.96 8 12.43 9 18.26 3 75.35 9 32.16 8 73.01 9 170.93 4 412.05 1

74.83 8 185.22 8 

### 398.57 7 801.45 8

99.58 6 1323.85 9 2666.67 5 1567.34 6 Supervise d By : V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 

### 30 9 Mod e SOI L 

### Tim e 2009-10-2 0 16:1 5 Duratio n 

### 30.0 0 Sequenc e Fina l Flag s SAMPL E 

### 2213 5 LOCATIO N 

### 81 7 s 3 7 s t INSPECTO R VENTR Y CO R 1 

### fl CO R 2 

### 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b T h 

### S e A s H g Z n W C u N i C o F e M n 

### C r T

i S c C a K S pp m 

### 18.44 8 < LO D < LO D 127.98 2

< LO D 65.15 6 < LO D < LO D 35.27 6 < LO D 78.06 5 < LO D < LO D < LO D < LO D 17542.52 1 

### 135.50 4

< LO D < LO D < LO D < LO D < LO D < LO D < LO D Supervise d By : ±
±

± ± Erro r 

### 10.08 4 21.53 6 15.97 9 9.47 0 23.81 6

7.69 9 13.74 1 6.45 0 11.13 4 13.93 7 19.46 9 80.63 3 35.49 2 83.90 3 193.97 7 462.34 7

81.99 3 152.88 6 275.78 8 627.15 6

38.27 9 1502.86 2 1999.26 3 1363.99 6 V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 31 0 Mod e SOI L Tim e 2009-10-2 0 1 6 

### 1 6 Duratio n 30.0 0 Sequenc e Fina l Flag s SAMPL E 2213 5 LOCATIO N 81 7 s 3 7 s t INSPECTO R VENTR Y COR l f l CO R 2 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A



### pp m Erro r P b 38.57 9 ± 11.77 8 C d < LO D 21.09 9 A g < LO D 15.33 4 S r 139.42 6 ± 9.46 5 U < LO D 24.14 5 R b 58.12 1 ± 7.24 8 T h 16.69 6 : i 9.86 9 S e < LO D 6.00 0 A s < LO D 16.07 0 H g < LO D 14.20 2 Z n 61.38 3 ± 17.61 9 W < LO D 87.54 8 C u < LO D 30.60 6 N i < LO D 75.65 8 C o < LO D 166.59 2 F e 14239.47 1 ± 401.89 4 M n < LO D 114.02 6 C r < LO D 165.54 6 V < LO D 383.48 4 T i < LO D 928.31 0 S c < LO D 50.36 3 C a < LO b 1976.03 2 K < LO D 2549.29 2 S < LO D 174023.96 9 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-3207 5 Readin g N o 

### 31 1 Mod e SOI L 

### Tim e 2009-10-2 0 16:1 7 Duratio n 

### 30.0 0 Sequenc e Fina l Flag s SAMPL E 

### 2213 5 LOCATIO N 

### 81 7 s 3 7 s t INSPECTO R VENTRY COR l 

### f l CO R 2 

### 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b 

### Th S e A s H g Z n W C u 

### N

i C o Fe M n 

### C r T

i S c C a K S pp m 72.40 2 < LO D < LO D 134.70 1

< LO D 61.07 7 < LO D < LO D 32.01 8 < LO D 96.27 8 < LO D 42.89 2 < LO D 239.15 0 

### 15389.76 9

201.27 7

< LO D < LO D < LO D < LO D < LO D < LO D < LO D ±
±

±
±

±
±
±
± ± ± 

### Erro r 14.65 4 21.27 7 15.10 0 9.38 1 23.41 0

7.32 2 13.28 3 6.01 7 13.87 6 13.86 7 20.49 2 78.09 5 23.44 2 75.70 5 121.02 0 419.86 0

85.99 9 149.05 4 308.66 5 404.17 1

34.21 9 1352.17 4 1233.06 3 1092.46 8 Supervise d By : 

### V

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

XL3t-3207 5 Readin g N o Mod e 

### Tim e Duratio n Sequenc e Flag s AVERAG E LOCATIO N INSPECTO R CO R 1 CO R 2 MIS C NOT E Use rLogi n 

## Certificat e o fVerificatio n

31 7 SOI L 

### 2009-10-2 0 16:2 1 120.0 0 Fina l 

## ^^ygSHSie
- I i

81 7 s 3 7 s t VENTR Y f 2 1 3 clearenc e ep a gu n EP

A

[jPt r



### CT " A g S r U R b 

### Th S e A s H g Z n W C u N i C o F e M n 

### C r T

i S c C a K S pp m -134^136
­



### <ru3 U < LO D 113.96 9

< LO D 54.95 0 < LO D < LO D 84.12 9 < LO D 158.54 4

< LO D < LO D < LO D 

### < LO D 16212.62 9

321.42 7

< LO D < LO D < LO D < LO D < LO D < L O < L l ± -ST

.



### ±
±

±
±

± 

### Erro r
20.70 4 15.03 3

8.53 7 22.35 4

6.86 9 14.84 1

5.68 5 18.56 5 13.71 5 24.51 9 79.84 5 31.98 9 73.12 3 173.22 2 421.27 5

95.28 6 93.69 5 165.92 0 .38 2 .69 8 .62 7 .55 1 .73 0 Supervise d By : 

### V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 

### 31 3 Mod e SOI L 

### Tim e 2009-10-2 0 16:1 8 Duratio n 

### 30.0 0 Sequenc e Fina l Flag s SAMPL E 

### 2213 5 LOCATIO N 81 7 s 3 7 s t INSPECTO R VENTR Y COR l f 2 CO R 2 

### 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

pp m ± Erro r P b 

### 128.10 0 ± 

### 18.28 5 C d < LO D 

### 20.71 7 A g < LO D 

### 15.12 6 S r 120.88 6 ± 

### 8.91 0 U < LO D 

### 24.01 2 R b 57.18 9 

### 7.19 7 T h < LO D 

### 14.88 7 S e < LO D 

### 5.46 6 A s 68.08 9 ± 

### 18.03 6 H g < LO D 

### 14.37 9 Z n 139.69 0 ± 

### 23.74 3 W < LO D 

### 83.12 8 C u < LO D 

### 33.76 9 N i < LO D 

### 76.46 4 C o < LO D 

### 172.44 0 F e 15353.80 7 ± 

### 417.35 8 M n 

### 306.14 0 ± 

### 95.73 3 C r < LO D 

### 107.32 2 V < LO D 

### 24.92 7 T i < LO D 

### 244.71 6 S c < LO D 

### 28.81 8 C a < LO D 

### 1138.91 8 K < LO D 

### 1997.81 8 S < LO D 

### 1227.24 0 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-3207 5 Readin g N o 

### 31 4 Mod e SOI L Tim e 

### 2009-10-2 0 16:1 9 Duratio n 

### 30.0 0 Sequenc e 

### Final Flag s SAMPL E 

### 2213 5 LOCATIO N 

### 81 7 s 3 7 s t INSPECTO R VENTR Y CO R 1 f 2 CO R 2 

### 1 3 MIS C 

### clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r Ti S c C a K S pp m 

### 150.28 8

< LO D < LO D 109.84 8

< LO D 51.22 4 < LO D < LO D 92.54 3 < LO D 165.58 4

< LO D < LO D < LO D < LO D 16680.35 0



### 370.03 1

< LO D < LO D < LO D < LO D < LO D < LO D < LO D Supervise d By : ±

±

±

± ± Erro r 

### 19.32 6 20.90 5 15.08 5

8.43 1 21.63 3

6.66 2 14.43 1 6.00 6 19.56 4 13.76 4 25.16 5 84.31 3 32.79 1 71.88 8 172.37 3 428.48 3 100.17 2

51.38 9 355.01 5 704.18 6

15.66 7 600.38 3 1190.76 8 825.44 7 V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 31 5 Mod e SOI L Tim e 2009-10-2 0 16:2 0 Duratio n 30.0 0 Sequenc e Fina l Flag s SAMPL E 2213 5 LOCATIO N 81 7 s 3 7 s t INSPECTO R VENTR Y CO R 1 f 2 CO R 2 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

pp m Erro r P b 149.85 3 19.39 1 C d < LO D 21.20 2 A g < LO D 15.33 7 S r 102.29 1 ± 8.21 9 U < LO D 20.92 5 R b 53.81 3 ± 6.71 9 T h < LO D 15.46 3 S e < LO D 5.58 6 A s 106.74 3 ± 20.12 7 H g < LO D 13.56 9 Z n 167.75 1 ± 25.08 2 W < LO D 72.30 2 C u < LO D 31.44 0 N

i < LO D 69.35 9 C o < LO D 178.21 4 F e 16307.30 4 424.84 2 M n 253.22 2 89.65 5 C r < LO D 44.17 5 V < LO D 227.64 6 T i < LO D 399.48 9 S c < LO D 5.13 5 C a < LO D 228.58 9 K < LO D 2849.90 1 S < LO D 1460.12 4 Supervise d By :

# Therm o SCIENTIFI C 

### Therm o Fishe r Scientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 

### 31 6 Mod e SOI L 

### Tim e 2009-10-2 0 16:2 1 Duratio n 30.0 0 Sequenc e 

### Final Flag s SAMPL E 

### 2213 5 LOCATIO N 

### 81 7 s 3 7 s t INSPECTO R VENTR Y 

### CO R1 f 2 CO R 2 

### 1 3 MIS C 

### clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b 

### Th S e A s H g Z n W C u N i C o Fe M n 

### C r T

i S c C a K S pp m ± 

### 108.30 5 ±

< LO D < LO D 122.84 9 ±

< LO D 57.57 2 ± < LO D 

### < LO D 69.13 9 < LO D 161.15 1 ±

< LO D < LO D < LO D 

### < LO D 16509.05 5

356.31 4

< LO D < LO D < LO D < LO D < LO D < LO D < LO D Erro r 

### 16.39 7 19.99 2 14.58 4

8.58 9 22.84 6

6.89 8 14.58 2

5.68 4 16.53 3 13.14 9 24.08 5 79.63 8 29.95 3 74.78 2 169.86 0 414.41 7

95.58 3 171.89 3

56.09 5 561.13 7

17.17 3 686.61 9 2951.71 5 1586.11 0 Supervise d By : 

### V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 32 2 Mod e SOI L Tim e 2009-10-2 0 16:2 6 Duratio n 120.0 0 Sequenc e Fina l Flag s AVERAG E / Av a o f318-32 1 > LOCATIO N 81 7 s 3 7 s t INSPECTO R VENTRY COR l b 2 CO R 2 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A



### pp m Erro r Lp b , o n iifi 4 •± ~T57749~- n C d < LO D : , 207283— ^ A g < LO D : 14.58 3 S r 112.03 1 ± 8.30 5 U < LO D ; 21.73 6 R b 56.17 6 ± 6.76 1 T h < LO D : 13.38 9 S e < LO D : 5.70 5 A s 50.30 6 ± 15.33 8 H g < LO D : 13.05 5 Z n 78.56 5 ± 18.11 0 W < LO D 75.57 2 C u < LO D 31.55 0 N i < LO D 76.24 1 C o < LO D 172.66 0 F e 16720.82 4 ± 419.23 5 M n 418.41 1 ± 101.91 4 C r < LO D 89.55 3 V < LO D ^- 1 264.78 4 T i < LO D / 673.46 9 S c < LO D

. / 48.45 1 / C a < LOD / •/ 1177.28 3 K < LOD / / 2103.06 2 S 1382.63 2 

## <\.o p 

# I / / ^ 

# yl
- 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-3207 5 Readin g N o 

### 31 8 Mod e SOI L Tim e 

### 2009-10-2 0 16:2 4 Duratio n 30.0 0 Sequenc e Fina l Flag s SAMPL E 

### 2213 5 LOCATIO N 

### 81 7 s 3 7 s t INSPECTO R VENTR Y CO R 1 b 2 CO R 2 

### 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A



### P

b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r 

### T

i S c C a K S pp m 

### 86.38 1 < LO D 

### < LO D 110.54 1

< LO D 58.14 9 < LO D < LO D 44.58 4 < LO D 73.38 4 < LO D 42.64 6 < LO D 

### < LO D 16180.03 9

472.12 8

< LO D < LO D < LO D < LO D < LO D < LO D < LO D ±
±

±
±

±
±
±

± ± Erro r 

### 15.16 2 20.46 6 14.66 4 8.32 3 21.77 3

6.88 0 13.15 7 6.10 7 14.70 0 13.29 3 17.87 3 76.32 1 22.43 9 75.84 3 171.81 2 415.76 6 106.90 0

53.22 7 321.63 7 567.14 0

27.56 4 1092.81 8 1800.60 9 1212.36 4 Supervise d By : 

### V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 

### 31 9 Mod e SOI L 

### Tim e 2009-10-2 0 16:2 5 Duratio n 

### 30.0 0 Sequenc e Fina l Flag s SAMPL E 

### 2213 5 LOCATIO N 81 7 s 3 7 s t INSPECTO R VENTR Y CO R 1 

### b 2 CO R 2 

### 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b T h S e A s H g Z n W C u 

### N

i C o F e M n C r T i S c C a K S pp m 

### 107.95 3

< LO D < LO D 103.84 3

< LO D 52.67 1 < LO D < LO D 39.65 6 < LO D 76.82 9 < LO D < LO D 89.24 7 

### < LO D 16343.67 9

374.20 7

< LO D < LO D < LO D < LO D < LO D < LO D < LO D Supervise d By : ±
±

±
±

±

± ± 

### Erro r 16.62 5 20.62 4 14.69 2 8.15 2 

### 21.81 8

6.67 2 13.37 6

5.80 4 15.54 1 13.55 1 18.04 9 72.91 7 31.29 9 54.28 5 171.94 6 419.26 2

98.69 2 57.86 4 366.83 9 846.63 3

22.43 5 874.94 4 2134.57 7 1304.16 1 V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 32 0 Mod e SOI L Tim e 

### 2009-10-2 0 16:2 6 Duratio n 

### 30.0 0 Sequenc e Fina l Flag s SAMPL E 

### 2213 5 LOCATIO N 81 7 s 3 7 s t INSPECTO R VENTR Y CO R 1 b 2 CO R 2 

### 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r T i S c C a K 

### S pp m 

### 93.18 6 < LO D < LO D 113.52 3

< LO D 55.35 0 < LO D < LO D 66.74 6 < LO D 98.48 4 < LO D 43.65 9 < LO D < LO D 17005.40 4



### 452.19 9

< LO D < LO D < LO D < LO D < LO D < LO D < LO D ±
±

±
±

±
±
±

± ± Erro r 

### 15.26 0 19.96 6 14.08 0

8.21 4 21.39 9

6.62 5 13.50 9

5.78 9 15.61 8 12.07 0 19.39 8 73.07 6 21.82 9 73.75 8 170.46 9 416.04 6 103.71 3 138.08 2 314.93 4 718.18 8 114.69 1 1592.07 8 1322.83 6 1261.40 1 Supervise d By : V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 

### 32 1 Mod e SOI L Tim e 

### 2009-10-2 0 16:2 6 Duratio n 

### 30.0 0 Sequenc e Fina l Flag s SAMPL E 

### 2213 5 LOCATIO N 81 7 s 3 7 s t INSPECTO R VENTR Y CO R 1 b 2 CO R 2 

### 1 3 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g 

### S r U R b T h S e A s H g Z n W C u N i C o F e M n C r Ti S c C a K S pp m ± Erro r 

### 102.33 6 ± 

### 15.94 7

< LO D 

### 20.07 6 < LO D 

### 14.89 4 120.21 7 ± 

### 8.53 0

< LO D 

### 21.95 2 58.53 5 ± 6.86 6 < LO D 

### 13.51 3 < LO D 

### 5.11 9 50.23 8 ± 

### 15.49 5 < LO D 

### 13.30 7 65.56 4 

### 17.12 0 < LO D 

### 79.97 6 < LO D 

### 28.49 9 < LO D 

### 73.93 5 < LO D 

### 176.41 2 17354.17 8 ± 

### 425.86 5

375.10 8 d : 

### 98.35 0

< LO D 

### 109.04 1 < LO D 

### 55.72 6 < LO D 

### 561.91 7 < LO D 

### 29.11 6 < LO D 

### 1149.29 3 < LO D 

### 3154.22 7 < LO D 

### 1752.60 0 Supervise d By : V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 32 7 Mod e SOI L 

### Tim e 2009-10-2 0 16:3 0 Duratio n 

### 120.0 0 Sequenc e Fina l Flag s AVERAG E Av g o f323-32 6 LOCATIO N 

### 81 7 s 3 7 s t INSPECTO R VENTR Y CO R 1 easemen t CO R 2 

### 1 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r T i S c C a K S pp m 

### 124.87 7

< LO D < LO D 108.87 9

< LO D 52.19 1 < LO D < LO D < LO D < LO D 127.04 2

< LO D 31.87 5 < LO D < LO D 14022.55 7



### 371.45 4

< LO D < LO D < LO D < LO D < LO D < LO D < LO : ±
±

±
±

±
±

± ± 

### Error 17.29 7 20.22 7 14.57 5

8.22 4 21.39 2

6.56 5 14.28 0

5.57 1 22.31 3 13.87 1 21.95 1 79.29 2 21.19 9 70.63 5 158.62 4 384.68 2

97.16 6 148.89 5

86.03 6 561.32 6

47.96 3 1166.88 5 2105.06 9 44729.99 2
Supervise dBy : V

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

XL3t-3207 5 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s SAMPL E LOCATIO N INSPECTO R CO R 1 CO R 2 MIS C NOT E Use rLogi n 

## Certificat e o fVerificatio n

32 3 SOI L 

### 2009-10-2 0 16:2 8 30.0 0 Final 2213 5 81 7 s 3 7 s t VENTR Y easemen t 1 clearenc e ep a gu n EP

A

P b C d A g S r U R b T h S e A s H g Z n W C u N l C o F e M n C r T i S c C a K S pp m 65.78 8 < LO D < LO D 115.02 6

< LO D 48.78 2 < LO D < LO D < LO D < LO D 84.53 3 < LO D < LO D < LO D < LO D 12559.24 4



### 292.55 8

< LO D < LO D < LO D < LO D < LO D < LO D < LO D Supervise d By : ±
±

±
±

± Erro r 

### 13.58 9 20.42 0 14.52 5

8.47 0 20.32 9

6.35 0 13.46 4

5.44 9 17.86 2 14.84 7 19.07 2 82.52 5 32.25 5 73.23 3 153.33 9 367.00 9

90.49 8 187.61 6 199.00 9 814.04 7

30.09 5 1175.40 1 2065.27 9 1329.44 7 V

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

## Certificat e o fVerificatio n
XL3t-3207 5 Readin g N o 32 4 Mod e SOI L 

### Tim e 2009-10-2 0 16:2 9 Duratio n 

### 30.0 0 Sequenc e Fina l Flag s SAMPL E 2213 5 LOCATIO N 81 7 s 3 7 s t INSPECTO R VENTR Y CO R 1 easemen t CO R 2 1 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

pp m 

### Erro r P b 179.28 1 ± 20.51 9 C d < LO D 20.18 2 A g < LO D 15.17 0 S r 106.54 6 ± 8.16 1 U < LO D 19.96 9 R b 49.95 2 ± 6.37 2 T h < LO D 14.36 0 S e < LO D 6.41 5 A s < LO D 26.30 6 H g < LO D 13.86 8 Z n 143.40 1 ± 23.38 8 W < LO D 86.21 8 C u < LO D 31.27 3 N i < LO D 66.69 6 C o < LO D 163.83 7 F e 14953.07 3 ± 398.36 2 M n 385.14 6 • k 99.18 1 C r < LO D 169.89 0 V < LO D 28.92 9 T i < LO D 269.90 7 S c < LO D 22.33 5 C a < LO D 894.17 0 K < LO D 77.24 5 S < LO D 174015.82 8 Supervise d By :

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

XL3t-3207 5 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s SAMPL E LOCATIO N INSPECTO R CO R 1 CO R 2 MIS C NOT E Use rLogi n 

## Certificat e o fVerificatio n

32 5 SOI L 

### 2009-10-2 0 16:2 9 30.0 0 Fina l 2213 5 81 7 s 3 7 s t VENTRY easemen t 1 clearenc e ep a gu n EP

A

±
±

±
±

±
±

± d b Erro r 

### 16.84 2 19.16 4 13.76 8 7.81 5 19.59 4

5.83 5 14.27 5 4.41 9 22.00 1 13.23 5 21.85 3 72.56 8 20.46 6 70.85 5 151.96 7 379.97 6

96.35 6 121.14 1

52.59 1 522.42 5

34.54 4 1368.69 5 3018.14 4 1737.27 8 P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r T i S c C a K S pp m 

### 125.11 7

< LO D < LO D 104.44 8

< LO D 42.39 5 < LO D < LO D < LO D < LO D 137.54 8

< LO D 33.67 4 < LO D < LO D 14620.46 3



### 405.56 2

< LO D < LO D < LO D < LO D < LO D < LO D < LO D Supervise d By : V

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

XL3t-3207 5 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s SAMPL E LOCATIO N INSPECTO R CO R 1 CO R 2 MIS C NOT E Use rLogi n 

## Certificat e o fVerificatio n

32 6 SOI L 

### 2009-10-2 0 16:3 0 30.0 0 Fina l 2213 5 81 7 s 3 7 s t VENTR Y easemen t 1 clearenc e ep a gu n EP

A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r T i S c C a K S Supervise d By : pp m 

### 129.32 3

< LO D < LO D 109.49 8

< LO D 67.63 5 < LO D < LO D < LO D < LO D 142.68 6

< LO D 33.77 3 < LO D < LO D 13957.44 6

402.55 0

< LO D < LO D < LO D < LO D < LO D < LO D < LO D ±
±

±
±

±
±

± ± Erro r 

### 18.23 9 21.14 1 14.83 8

8.45 2 25.67 7

7.70 2 15.02 0 6.00 0 23.08 3 13.53 4 23.48 9 75.85 7 21.97 8 71.75 7 165.35 1 393.38 0 102.63 0 116.93 2 63.61 5 638.92 3 104.87 7 1229.27 4 3259.60 8 1837.42 6 V

## fAQL \ Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 I ^^^2 ^

I Coasta l Environmenta l Grou p Inc

. Sy^^ Awww.coastalhazmat.co m COASTA L ENVKONMINTA l G lO U P

. IN C 

# EXECUTIV ESUMMARY : BVID #22135-(81 7 S 3 7 ST )
No Issue s o r Concern s [ ^Issues/Concern s
DetailExplanation : -COASTA LT O DRO POFFMULC HAN D ROC K (COMPLETE D 10/27/09 )

# l » EP A EP APropert y Clos eOu t For m Propert y # : ^1^1^^Propert y Addresr.

- fi i ^^^J^^ffeeJU ^ Date/Time : / o ll^-^jO ^Owner' s Nime:

. /fe...i<i(>n.!'J>i> ; LLititfi

- ,1— Quad s Excavated : ^^P'Z L%t

. T>' ^ContractorGniup_C^!-^eiJ__,«j=»A>c£ i
Ye s N o 

### Excavatio nGeneml 

# z y 1

. If necessaiy , wereth ecorrec t quadrant(s ) excavatedandrestored ? 2

. If necessary , wereth ecorrec t area s ofdri p zoneexcavate dandrestored ? Ye s N o Gradin g So dan dVegetatio n I

. Doe s thegrading aroundtheperimeter ofth ehous ei nexcavaie darea s generally slop eawa y 

# y fromth ehouse ?__^____ ^ 2

. Ha s so dbee nlai dinallarea s that wereexcavated ? 

# r ^

3

. Doe s th esodappear to begenerally health y an dgrowing ? (Only evaluateif inspecteda i a3 0 

# r ^ day timeperiod) 4

. Ai esoddedarea s generally nrman devenly graded ? 

# T; ^ 5

. Areth ejoint s betweenth eso dstrip s generally tight ? (Only evaluateif inspecteda t a3 0 da y 

# z ^ tim eperiod) 6

. Wa s thepropert y grade dsuchtha t wate r willno t poo lo nthepropert>' ? 

### y ' 7

. Wa s damaget o landscapin g o r plan t material s avoided ?
Gates , Fence s an dRetainin g Wall s Ves N o 1

. D o gate s ope nan dclos efi-eely ? (Ifappiicable ) 

# zr
I

. Wereallgate s or fence s takendow nduring restoratio nactivitie s reinstalled ? (If applicable) 

# y 3

. Wa s damaget o gate s or fence s avoided ? (Ifappiicable ) 

# z ^

4

. Wa s damaget o retainin g wall s avoided ? (Ifappiicable ) 

# y Foundation , Sidin g an dGutler s Ye s N o I

. Wa s damaget o th esidin g or trimavoided ? 

# y r
2

.Wa s damaget o thefoundationavoided ? 

# Z'

. A 3

. Wa s damageto window s avoided ? 

# y 4

. Wa s damageto window s o r door screen s avoided ? 

# y 5 , Wa s damaget o downspout s or downspou t extension s avoided ? 

# A
Sidewalk s an dDriveway s (Concrete ) Yes N o 1

. Wa s damageto drivewa y surface s avoided ? 

# y A

­ 2

. Wa s damaget o walkwa y surface s avoided ? 

# y

# i » • O^'oer s comments :

Inspectio nnotes :

Remova lan drestorationactivate s complet eiiicluding the30-da y sodwarranty : EP ARepresentativ ejj ^l/A?J/^/l ^Date:/V?/^/^ y

## Propert yCompletio n Agreemen t

Ihi s agreemen i documeni s lh e compielio n o l remedia l acliviiie s perfoime d o n m yproperl yM ysignaiin c wil l designal e Iha l I a m satisfie d wit h th e rc.<:loralio n o fm yproperly , anr i Iha i n o ilem s ar e i n queslion.s

. now
. o ra l an ylim e i n th e future , excep l ihos e iiem s liste d below , ifan y



# '''»p^"y^p

- Sc3)3 3 Propert y Address : ( g p ^pf)'ff " 

# Q""^ " 6a>cff.:f > f^uj^ctoJS I ^T ' mi^j^oA?.

. Restoratio n Item s i n Question :

Item : 

# ' • iHok U

"" " ££l ^ Item : Item ; Item : Item :

I I I nyrc crc^forAlio n « complcltd , Cxccp i n s noter i [ I I rio no l »i;rf crrjtoinrin n i s compleler i

CjfJrrt'iacloi' s Signatur e Dal e