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

SAID# : 31A?> ^
. Date : -^^jj^/n Q Address : ';^^3^ ^ \-\aV^-\vna nKyl P Remediatio nContractor : _Coasta l Environmenta l Group
_ Year : 200 8
SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S Vide o o f property (DVD ) 4031480 1 

### Executiv e Summary 

# iiiil i y EPA-provide dpropert y sketc h Superfun d 

### Signe dAcces s Agreemen t fo r subjec t property Signe dAcces s Agreement(s ) fo r adjacent property Restoratio nAgreemen t Settlemen t document s (i.e. , for damag e o r to replac e plants , etc. ) Confirmatio ndat a 

# y Photograph s Prg.

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# y Descriptio no f area s no t meetin g RO D cleanu p criteri a Utility clearance s 

# y Property informatio nfromDougla s Coimt y Assessor' s Offic e

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### [ Sent : / / Signed : _[i/JJ/i2 & Signed : ii/12/. ^ / / / / / / Called : jX/I£i/ ^



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### Dougla s County Accoun t Inf<^|^tio n Pag e 1 of 2 x|^ t
Dougla s County , Nebrask a Propert yRecor d - R174801000 0 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-5 0 ft wes t o f90t h S t - ViewOf l Ma p 

### Informatio n i s vali d a s o f2008-9- 4 Treasurer' s Ta xRepor t Ne wFeatur e ^ - • - > Aut o Sale s Searc h 

### Owne r HIL L SHARLE TA 243 0 HARTMA N AV E OMAH AN E 68111-000 0 Propert yInformatio n Ke yNumber : 480 1 000 0 1 7 Accoun t Type : Residentia l Parce l Number : 174801000 0 Parce l Address : 243 0 HARTMA N AV OMAH AN E 68111-000 0 Lega l Description : MILLE R PAR KPLAC E LO T8 BLOC K0 5 0 X 128. 7 Valu e Informatio n Lan d Improvemen t Tota l 200 8 $2,600.0 0 $40,200.0 0 $42,800.0 0 200 7 $2,600.0 0 $30,200.0 0 $32,800.0 0 200 6 $2,600.0 0 $30,200.0 0 $32,800.0 0 200 5 $2,600.0 0 $30,200.0 0 $32,800.0 0 200 4 $2,600.0 0 $27,300.0 0 $29,900.0 0 200 3 $2,600.0 0 $27,300.0 0 $29,900.0 0 Sale s Informatio n Sale s Date : 1994-06-2 7 Dee d Type : Book : 198 1 Page : 58 7 Price : $ 29,590.0 0 Grantor : Grantee : Valid/Invalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 4 6450. 0 1. 0 129. 0 50. 0 N o Improvemen t Informatio n


### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R l 7..
. 1 1 /4/200 8-nr—niTT^ u ; • ^ ~-'W^'^-'^~^' ~ 

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### 1100. 0 Percen t Complete : 

### 100.0 % Perimete r 0. 0 Quality : Fai r Uni t Type : Condition : Averag e

Buil t As : Ranc h Cond o Squar e Footage : 0. 0

HVAC : Force d Ai r Rooms : 6. 0 Exterior : Fram e Viny l Units : 

### 1. 0 Interior : Drywal l Battis : 

### 1. 0 Roo fCover : Compositio n Shingl e Bedrooms : 3. 0

Roo fType : Gabl e Stories : 

### 1. 0 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 

### 190 5 199 3 0 % 

### 190 5 10 3 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 

### 1. 0 Basemen t Bsmn t Bloc k 8 f t 

### 1100. 0 Fixtur e Bas e Fixture s 

### 1. 0 Fixtur e Bat h Ful l 

### 1. 0 Garag e Detache d 240. 0 Porc h Sla b Roo fCei l 

### 161. 0 Porc h Sla b Roo fCei l 24. 0



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. 1 1 /4/200 8.*>•'"' ' 

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


### YOU RTICKE T NUMBE RI S 2177219
. Origina l Cal l Date : 11/18/0 8 Time : 7:1 9 a m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 11/20/0 8 Time : 7:4 5 a m State : N E County : DOUGLA S Place : 0M7UIA Address : 243 0 Street : HARTMANAV E Tv/p : 16 NRng : 13 E Sect-Qtr : 33-SE,34-S W ,: . Twp : Rng : Sect-Qtr : ' / Lega l Given : C , , Typ e o f Work : Omah a Lea d Locatio n o f Work : LOCAT E ENTIR E PROPERTY , AL L EASEMENT S AN D T O TH E PEDESTA L Remarks : FAX AL L CLEAR S TO : (877)662-421 1 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 h o 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 CXCAT V SPRNTPC S MAGELLANMETR O MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C

Servic e Are a Contac t Phon e Numbe r UtiUty Typ e
CXCAT V CO X COMMUNICATIONS , IN C 

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

MAGELLA NMAGELLA NMIDSTREA M PARTNER S L P


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. TONY A



### - Day : 918574709 8 Alt : 

### Emerg : 918574709 8

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. COLLEG E 

### CHRI S Day : 402457230 7 Alt : 402672703 3 Emerg : 402457231 3

MUDO l METROPOLITA NUTILITIE S DISTRIC T SAND Y 

### Day : 402504782 3 Alt : 

### Emerg : 402504797 0

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT.
. . 11/18/200 8

### Pag e 2 of 2
Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFIC.SEWE R 

### RO NAlt : 402444516 1 Emerg : 402444516 0 Day : 406728934 3 0PPDGPR 5 OMAH APUBLI C POWE RDISTRIC T 

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### N AAlt : Emerg : 888728934 3 Day : 402537180 0 SPRNTPC S SPRIN T SPECTRU M LP 

### Alt : 402537181 0 Emerg : 800521057 9

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. . 11/18/200 8

# As-Buil t Drawin g ^
COASTA L 

# Omah aLea dSuperfun dSit e

93 4 Exterio rPain t Omah a Lea d Sit e rOwne rName : SHARLE TAHIL L • Goo d Sit e Sketc h Address : 243 0 HARTMA N A V 

# 4 QPoo r Phone : »-iSI-(>79 6 W- Q Not pain t Lea d Sampl e Sample s Collecte d Sampl e Nunnbe r LA B Concentratio n Collecte d Firm : RYASCPXA-3793 4 F 1 ___2J^pp m 

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### Legen d Concret e Dri p Zon e Excavate d Quadrant s Excavate d Are a replace d wit h So d ^ ' Are a replace d wit h Rock/Mulc h Are a lef t bar e 

### Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grovip Inc .

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### Omah a Lea d Sit e Owne rName : SHARLE TAHIL L • Goo d 

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COASTA L fNVltDNMINTA t C • O U P

. IN 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 :

Owner' s Name : Daytim e Phone : 

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Addres s o fProperty covere d b ythi s Agreement : 

# ^yjt o jf^drria A/l\7
. 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 L RESPONS 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 :
Page 1 o f2^^••^• ^ COASTA L
"^ 1 —-jjj ^ [MVrllOPiHriiTt l



### •Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; •Remove 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 byEPA ; •Abid e byhealt h an d safetyguidanc e provide d b yEPA ; •I fth e propertyi s rented , assis t EP Ai n obtainin g tenan t approva l fo racces s t o th e propertyt o perfor m th e work

. • Allo wvideotapin g and/o rphotographin g ofth e property
. AGREEMEN TNO TT O INTERFER E 

### Th e Granto ragree s not 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 undertake an y action s regardin g th e us e o fsai d propertywhic h woul d ten d t o endange rth e healt h o r welfar e ofth e Grantee s o rth e environment , o rt o allo wothers t o us e th e propertyi 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 , at (712 ) 352-018 8

"r^ ^

I gran t acces s t o m ypropertie sD I d o no t gran t acces s t o m ypropertie s

SHgnature Dat e Signatur eDat e

O1 woul d lik e t o b e presen t durin g an ysamplin g tha t i s required

.COASTA L a ' ' t NONM B NTA l 

## Restoratio n Agreemen t The purpos e o f thi s agreement i s to provid e amutua l agreement a s t o condition s o f the propert y prior to remediationactivities
. Thi s will als o serv e a s documentatio nfo r th e purpos e o f assurin g tha t restoratio n activitie s ar e completedt o the satisfactio no f the propert y owne r andth e Unite dState s Environmenta l Protectio nAgenc y (EPA)
. Propert y ID : 3:^^ ^ PropertyAddress:^<^3 ^ /^^/^^. ^ / ^ Owner : 

# .^^^^^f//V/// I Phone : V ^ -/^^ g
O

nthe attache ddiagram(s ) indicat e area(s ) t o excavatedan ddept ho f excavation , locationof al l know n utilities , subsurface features , syrface structure s an dlandscaping features , acces s location(s ) t o be use db y contractor , an dthe directiono f North
. Indicat e distances , depths , materia l types , etc . Indicat e digita l photo s b

y referencing the photo-lo g numbe r wit ha narrow indicating directiono f view
. Item s T o B e Remove d B yOwne rBefor e Star t O fRemediation : (Us e additiona l sheet s a s necessary ) Th e removal , storage , disposal , and/o rretur n o fthes e item s i s th e Owner' s responsibility

. Item : 

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### Item s T o B e Remove d B yContracto rDurin g Remediatio n An d No t Replace d (Us e additiona l sheet s a s necessary ) Item :
Kem : '
Item : Item : Kem : Item :
Item : item :
Item :
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Kem : Hem :
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Pag e 2 

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Item : Kem :



### Page s 

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COASTA L K*«>inONr«K M TA l OHOUP
. IM C 

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

### Ite m 

## Quantit y Uni t Condition/Type/Specie s

Pre-existin g propert y area , tha t will be excavated , tha t Squar e fee t i s covere dwit hgrass .

Number of tree s > 2 inch Each trun k

diamete r

Number o f tree s <= 2 inch Eac h trunk diameter

Number o f Sprinkler Zones , Control Valves , Timers , Heads , etc . Eac h Attachasketchof the sprinkler layout
.

Number of an dsize o f 

# /^K ^ eachgarden / flowe r be d area . Eac h Squar e Feet Attac hasketchof relativ e size s an dlocations
.

Pag e 4 

## o ft eCOASTA L (MViJiONrOHTA l C H O U P ( M C 

### Ite m Agree dupo nvalu e of plan t material s no t to b e replace dbv contractor . Note thi s valu e will b e use dto issu e aplan t vouche r to th e propert y owner . Agree duponlis t o f plan t material s tha t will b e replace db y contractor . B e ver y specifi c an ddetailed
. includ e asketchof wer e eachplant will b e place d by th e contractor . Agree dupo nare aof propert y t o b e replace d wit hgras s sod
. Include asketcho f th e area(s ) to b e replace dwit h gras s sod
.
Are ao f Cit y o r Count y propert y to b e landscape d per thei r requirements
. Include asketcho f the are a(s )

Easement Area , to b e excavate d 

### Quantit y Urii t 

## Condit'on/Type/Specie s

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doe s no t wan t CE G to documen t interio rfoundatio n wall s an d possibl e pre-existin g damage

. Bycheckin g thi s bo xCE G is no t responsibl e fo ran ydamag e don e to th e interio r of house , includin g foundatio n crack s orfissures. 

# f^ I agre e O I do not agre e 

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RETES TAREA S Readin g Sampl e are a Sh0t # Readin g Sampl e are a Dept h ^^.^"- ^ ^ Dept h / 

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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 f Verificatio n
XL3t-3208 9 Readin g N o 445 0 Mod e SOIL Tim e 2008-11-2 6 13:2 9 Duratio n 122.9 2 Sequenc e Fina l Flag s AVERAG E fAv g o f 4446-444 9 ADDRES S 243 0 hartma n QUAD/ZON E # 2 INSPECTO R Ventr y DEPT H 6 SAMPL E PCP E CLEARANC E NOT E

Supervise d By :

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 222.91 5 Supervise d By : 

## Certificat e o fVerificatio n

444 6 SOI L 

### 2008-11-2 6 13:2 6 30.5 8 Fina l 

### 3793 4 243 0 hartma n B 2 Ventr y 

### 6 CLEARANC E

± Erro r
± 18.10 6- y -'yysnf,^-'- " 

# Therm o

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 250.50 7 Supervise d By : 

## Certificat e o f Verificatio n

444 7 SOI L 

### 2008-11-2 6 13:2 7 30.5 5 Fina l 

### 3793 4 243 0 hartma n B 2 Ventr y 6 CLEARANC E

±
± 

### 19.10 1

# 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 444 8 Mod e SOI L Tim e 

### 2008-11-2 6 13:2 8 Duratio n 

### 30.9 3 Sequenc e Fina l Flag s BVI D # 

### 3793 4 ADDRES S 243 0 hartma n QUAD/ZON E B 2 INSPECTO R Ventr y DEPT H 6 SAMPL E TYP E CLEARANC E NOT E

pp m ±Erro r P b 240.20 8 ±18.95 4 Supervise d By :

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 306.12 4 Supervise d By : 

## Certificat e o fVerificatio n

444 9 SOI L 

### 2008-11-2 6 13:2 9 30.8 6 Fina l 

### 3793 4 243 0 hartma n B 2 Ventr y 

### 6 CLEARANC E

± Erro r
± 21.00 1

# 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 

### Mode Tim e Duratio n 

### Sequenc e Flag s AVERAG E ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

Supervise d By : 

## Certificat e o fVerificatio n

445 5 SOI L 

### 2008-11-2 6 13:3 2 122.3 1 Fina l tAv g o f4451-445 4

243 0 hartma n 

### «G

Z Ventr y S CLEARANC E

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 83.95 5 Supervise d By : 

## Certificat e o fVerificatio n

445 1 SOI L 

### 2008-11-2 6 13:3 0 30.8 1 Fina l 

### 3793 4 243 0 hartma n G Z Ventr y 

### 6 CLEARANC E

±Erro r
±11.71 8

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 47.61 3 Supervise d By : 

## Certificat e o fVerificatio n

445 2 SOI L 

### 2008-11-2 6 13:3 1 30.5 1 Fina l 

### 3793 4 243 0 hartma n G Z Ventr y 

### 6 CLEARANC E

± Erro r
± 9.36 4"l]fni * *=" ' -"••••ir - •"•=J" ; • )!l l S'-'"''-i;i,|-W" ' ' 

# 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 445 3 Mod e SOI L Tim e 2008-11-2 6 13:3 2 Duratio n 30.7 7 Sequenc e Fina l Flag s BVI D # 3793 4 ADDRES S 243 0 hartma n QUAD/ZON E G Z INSPECTO R Ventr y DEPT H 6 SAMPL E TYP E CLEARANC E NOT E

pp m ±Erro r P b 60.16 0 ±10.28 8 Supervise d By :~T~ W 

### wT^n^ ' 

# Therm o

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 120.66 8 Supervise d By : 

## Certificat e o fVerificatio n

445 4 SOI L 

### 2008-11-2 6 13:3 2 30.2 2 Fina l 

### 3793 4 243 0 hartma n G Z 

### Ventr y 6 CLEARANC E

± Erro r
± 13.73 8•'iV-rr " ,'T^-^„-T'^ : J«^ , T'^-T'' " •i-tii ' ''rT'"""'^^'^:''*^'"'"*«T:-*~-5^i;?^i i 

# Therm o

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s AVERAG E ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E Pt'P E NOT E

Supervise d By : 

## Certificat e o fVerificatio n

446 0 SOI L 

### 2008-11-2 6 13:3 7 122.5 2 Fina l

* Av g o f4456-445 9

243 0 hartma n easemen t Ventr y 

# a CLEARANC E

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 99.13 1 Supervise d By : 

## Certificat e o fVerificatio n

445 6 SOI L 

### 2008-11-2 6 13:3 5 30.6 6 Fina l 

### 3793 4 243 0 hartma n easemen t Ventr y 

### 1 CLEARANC E

± Erro r 12.17 6

# 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 445 7 Mod e SOI L Tim e 

### 2008-11-2 6 13:3 5 Duratio n 

### 30.4 8 Sequenc e Fina l C Flag s BVI D # 

### 3793 4 ADDRES S 243 0 hartma n QUAD/ZON E easemen t INSPECTO R Ventr y DEPT H 

### 1 SAMPL E TYP E CLEARANC E NOT E

pp m Erro r P b 119.44 6 ± 13.27 0 Supervise d By :

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 142.45 0 Supervise d By : 

## Certificat e o fVerificatio n

445 8 SOI L 

### 2008-11-2 6 13:3 6 30.5 3 Fina l 

### 3793 4 243 0 hartma n easemen t 

### Ventr y 1 CLEARANC E

± Erro r
± 14.68 3

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 114.24 5 Supervise d By : 

## Certificat e o fVerificatio n

445 9 SOI L 

### 2008-11-2 6 13:3 7 30.8 5 Fina l 

### 3793 4 243 0 hartma n easemen t Ventr y 

### 1 CLEARANC E

± Erro r
± 13.16 0

# 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 

### 446 5 Mod e SOI L Tim e 

### 2008-11-2 6 13:4 1 Duratio n 

### 122.8 7 Sequenc e Fina l Flag s AVERAG E fAv g o f4461-446 4 ADDRES S 243 0 hartma n QUAD/ZON E INSPECTO R Ventr y DEPT H 1 3 SAMPL E TYP E CLEARANC E NOT E

Supervise d By :_'r;'-r:r-'-^'^yy^\'l^/T ' -TTViT^pf^Ty^* ^ • 

# Therm o

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 129.67 7 Supervise d By : 

## Certificat e o fVerificatio n

446 1 SOI L 

### 2008-11-2 6 13:3 8 30.7 3 Fina l 

### 3793 4 243 0 hartma n D Z Ventr y 

### 1 3 CLEARANC E

± Erro r
± 13.96 1

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 142.27 5 Supervise d By : 

## Certificat e o fVerificatio n

446 2 SOI L 

### 2008-11-2 6 13:3 9 30.9 3 Fina l 

### 3793 4 243 0 hartma n D Z 

### Ventr y 1 3 CLEARANC E

± Erro r
± 14.63 0

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 125.31 6 Supervise d By : 

## Certificat e o fVerificatio n

446 3 SOI L 

### 2008-11-2 6 13:4 0 30.6 3 Fina l 

### 3793 4 243 0 hartma n D Z Ventr y 

### 1 3 CLEARANC E

± Erro r
± 13.86 4

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 137.30 4 Supervise d By : 

## Certificat e o fVerificatio n

446 4 SOI L 

### 2008-11-2 6 13:4 1 30.5 8 Fina l 

### 3793 4 243 0 hartma n D Z 

### Ventr y 1 3 CLEARANC E

± Erro r
± 14.39 8~";^^~^it.;'rr' ' •jf'^^'rTn^-.rr

. •'wry'^'^rw r 

# 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 601 6 Mod e SOI L Tim e , 2009-01-2 0 12:5 4 Duratio n 121.6 3 Sequenc e Fina l Flag s AVERAG E \Av g o f6012-601 5 ADDRES S 243 0 Hartma n av e QUAD/ZON E iP Z INSPECTO R LOPE Z DEPT H « 6 SAMPL E TYP E CLEARANC E NOT E

Supervise d By :

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 275.98 9 Supervise d By : 

## Certificat e o fVerificatio n

601 2 SOI L 

### 2009-01-2 0 12:5 2 30.5 4 Fina l 

### 3793 4 243 0 Hartma n ave . PZ LOPE Z 

### 6 CLEARANC E

± Erro r ± 20.21 9

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 250.57 6 Supervise d By : 

## Certificat e o fVerificatio n

601 3 SOI L 

### 2009-01-2 0 12:5 3 30.2 5 Fina l 

### 3793 4 243 0 Hartma n ave . PZ LOPE Z 6 CLEARANC E

± Erro r
± 19.26 4

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

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 341.07 5 Supervise d By : 

## Certificat e o fVerificatio n

601 4 SOI L 

### 2009-01-2 0 12:5 3 30.2 5 Fina l 

### 3793 4 243 0 Hartma n ave . PZ LOPE Z 

### 6 CLEARANC E

± Erro r
± 22.57 6

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



### XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s 

### BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 264.50 0 Supervise d By : 

## Certificat e o fVerificatio n

601 5 SOI L 

### 2009-01-2 0 12:5 4 30.5 9 Fina l 

### 3793 4 243 0 Hartma n ave . PZ LOPE Z 

### 6 CLEARANC E

±Erro r ±20.09 2<,t O su . 

### Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc

. V ' ^< ? vvww.coastalhazmat.co m ^•"•P^oxt " COASTA L ENVIItONHENTA L CROUP , rN C

. 

# EXECUTIV ESUMMARY : BVI D #3793 4 - (243 0 HARTMA NAVE )

^ N o Issue s o r Concern s Q Issues/Concern s
Detai l Explanation : N O ISSUE S PENDING
.

# .s^EP A EP APropert ) Clos e Ou t For m Proptrt yM : '^iQ^l'A 

## -^c^Acxy\lAy<
- Dale/Time : Quad s E»cav«lfd : "J^'^^^-^^CyT^ ^ 

## ^^^{^i^urAcxX
Excavatio nGenen I 1 I f nccessiry , w-er t th e correc l quadrant(s ) excavate dandreslored? 2I f necessary , were th e correc l area s o f dri p zone excavaie dan dreslored ? Gradlo g So d an d VrscUlio n 1 Doe s th e gradin g around ih e perimete ro fth e hous e i n excavaie d area s generall yslop e awa y from ib e house ? 2
. Ha s so d bee n lai d i n al l area s tha i wer e excavaied ? 3
.

Doe s th e sod appea rt o b e generall yhealth yan d growing ? (Onl yevaluat e i finspecte d a t a 3 0 da ytim e period ) 4 Ar e sodde d areas generall yfir m an d evenl ygraded ? 5 Ar e th e joint s berwce n th e so d strip s generall ylight ? (Onl yevaluat e i finspecte d a t a 3 0 da y tim e period ) 6 Wa s th e propertygrade d suc h that wate rwil l not poo l o n th e property' ' 7Wa s damag e l o landscapin g o rplan t material s avoided' ' Gam , FcDce s an d Rctainln s Wall s I D o gate s ope n an d clos e freely' ' (Ifapplicable ) 2 Wer e al l gate s o rfence s lakc n dow n durin g resloratio n aciiviiie s reinstalled ? (Ifapplicable ) 3 Wa s dam»g e t o gale s o rfence s avoided ? (Ifapplicable ) 4 Wa s damag e t o retainin g wall s avoided ? (Ifapplicable ) FouDdation , Sidio Kan d Gutter s 1
. Wa s damag e t o th e sidin g o rtri m avoided ? 2 Wa s damag e t o th e foundatio n avoided ? 3Wa s damag e t o window s avoided ? 4Wa s damag e l o window s o rdoo rscreen s avoided' ' 5Wa s damag e l o downspout s o rdownspou t extension s avoided ? Sidewalk s an d Driveway s (Concrete ) Wa s damag e l o drivewa ysurface s avoided'! ' 2Wa s damag e t o walkwa ysurface s avoided' ' 

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### O »Ders comments :

Inspectio n notes :

Remova l anc i resloratio n aclivale s complel e includin g ih e 30-da yso d warrant y EP ARenresent^liv^^^^^^^^^^-^^^'^^'^^ ^ Dal e

# 4

Propert yCompletio n Agreemen t
Thi s agreement documeni s th e complclio no f remedial activilies perlbrma l o nm y properly
. My signaiur e will designat e Iha t I amsalislie dwit hth e restoralio no f m y property , an dthat no item s ar e i nquestions , now , o r a

t an y tim e i nth e future , excep t thos e ilem s liste dbelow , ifany
. Propert y ID : ^'^Q^C / Propert y Addro.s^^y:^g ^ 't^afi fn^l^r^,) ^ i^e ^
Phon e Restoratio n Item s i n Question :

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

# J

/F ^ LJ ' aRret ' rrsl(iralio ni. v completed , excep t a s note d I1 d o not agre e reslomtiu ni s complete d 

# I M Q T>wncr \.Si]>nft(ur r Hal e ontractor' s .Signatur e I