## TRANSMITTALo f

OMAH ALEA D SIT E SOILREMEDIATIO NFIL EFOLDE R
SAID.-
. ^^y^ll
_ Date : ^ 

# yi t Addres s l/tP Wt- \t ^ ^ ^ f Remediaiio nConliactor : Coasla l Enxironmenla l Grou p Year : JOIOARR A
SOILREMEDIATJO N PROPERT V FIL EFOLDE RDOCUMENT S ( / 

### Vide o o f properl y (DVD ) / 

### Executiv e Summar y 

# A EPA-provide dproperl y sketc h 

# A Signe dAcces s Agreemen l fo r subject properl y 

# 7 Signe dAcces s Agreement(s ) fo r adjacent properl y Resloratio nAgreement Selllenien t document s (i.e, , fo r damag e or l o replac e plants , etc ) Confinnatio n dat a 

# A Photograph s f^6r)c<^^rU ^ Y ^tASfr^w \\^Ox j 

# y As-buil l skelc h / 

### Salisfaclory restoralio nsigne db y Properl y Owner / 

### Property close-ou l check lis l signe db y EP A Descriptio no f area s not meetin g RO D cleanu p criteri a 

# A Utilit yclearance s 

# y Properl y infonpati^fro mDougla s County Assessor' s Offic e

Signatur e 30218827 

# nil Superfun d

## VV Propert yAcces s Checklis t PropertylD : ^^^/ ^ Propert y Address : ;^, , j ^ ^ ^ ^ ^ n nWOR K STARTE D WORKCOMPELTE D ON : ON : / // /
Owner : ' ^ ^ ^ ^ ^ ^ Address : 

# Ow\alAPi , ^«
. (^Sdoy [ Phon e Fax : 

# 3^5- ^ ^YP ^ Cell/Pager : Renter : Phone : Fax : Cell/Pager : Additiona l Infomiation :

D Q Q G D [ ^ Q
^ D D D Q n Notificatio nLette r

Acces s Agreemen t Restoratio nAgreemen t TopsoU SampUn g (i f appUcable ) Disposal Samplin g (i f appUcable ) Garde nSampUn g (i f applicable ) UtiUt y Clearanc e Video/Photo s (Before ) Video/Photo s (During ) Video/Photo s (After ) Video/Photo s (30-Day ) Propert y Completio nAgreemen t Fina l Repor t Sent : / / Siened : V i / v m/ v o Siened : v o /v w Un I I I I I I CaUed : A x /fe^/v o On : \ o / vt o /

V 0 On : / / On : / / On : / / Siened : / / Issued : / / By : By : By : By : By : By : By : By : By : By : By : By : By : Vi^^-V C V»^Ot

\v|\o/v O ^\Oi , \A^rA ^

Ai r Monitorin g (a s appUcable ) r~ l Conununit y H ] Cre w Results : On : / / By :
[~~

l Communit y Results : D Cre w On : / / By :

• Conununit y Results : C D Cre w On : / ' / By :

Omah a Lea d Stt e

### Dougla s County Accoun t I

i^^i^tio n Pag e 1 of 2
Dougla s County , Nebrask a Propert yRecor d - R074759000 0 Prin t Reoor t Vie wInteractiv e GI S Ma o Informatio n i s vali d a s o f2010-8-3 0 Treasurer' s Ta xReoor t Ne wFeatur e ^ - ^ • * Subdivisio n Sale s Searc h Owne r STIGGE R ROBER T ETA L 4722N61ST#D- 1 OMAH AN E 68104-203 9 Propert yInformatio n Ke yNumber : 475 9 OOO O 0 7 Accoun t Type : Residentia l Parce l Number : 074759000 0 Parce l Address : 201 1 N27S T OMAH AN E 68111-000 0 Lega l Description : CARLBER G SU B DI V LO T7 BLOC K1 W10 0 FT3 7 X 10 0 Valu e Informatio n Lan d Improvemen t Tota l 201 0 $300.0 0 $0.0 0 $300.0 0 200 9 $300.0 0 $0.0 0 $300.0 0 200 8 $300.0 0 $0.0 0 $300.0 0 200 7 $300.0 0 $0.0 0 $300.0 0 200 6 $300.0 0 $0.0 0 $300.0 0 2005 $300.0 0 $0.0 0 $300.0 0 Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.0 8 3700. 0 0. 0 100. 0 37. 0 Ye s



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R074.
. . 9/2/201 0

### Pag e 1 of 2

" > [ Creat e Anothe rTicke t ] [ Bac k t o irt h Inteme t ] Sen d Emai l


### YOU RTICKE T NUMBE RI S 2637700
. Origina l Cal l Date : ll/08/l O Time : 5:5 0 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 11/10/1 0 Time : 6:1 5 p m State : N E County : DOUGLA S Place : OMAH A Address : 201 1 Street : N27T H S T Twp : 15 NRng : 13 E Sect-Qtr : 09-SE,16-N E 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 : FAX AL L CLEAR S TO : (877)662-421 1 : UNSUR E I F CORNE R LOT . 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 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 LEVEL 3 MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C

Servic e Are a Contac t Phon e Numbe r UtiUt y Typ e
CXCAT V CO X COMMUNICATIONS , IN C HEID I 

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

LEVEL S LEVEL 3 COMMUNICATIONS , LL C 

### N A 

### Day : 877366834 4 Alt : Emerg : 877366834 4

MUDO l METROPOLITA NUTILITIE S DISTRIC T SAND Y 

### Day : 402504782 3 Alt : Emerg : 402504797 0

OMAHACO FCIT Y O FOMAHA-TRAFFICSEWE RRICH/TRAFFI C 

### Day : 402444719 7 Alt : 402444516 1 Emerg : 402444516 0 Day : 406728934 3
http://www.dhon.org/irthmtemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 11/8/201 0

### Pag e 2 of 2

0PPDGPR 5 OMAH APUBLI C POWE RDISTRIC T ELM LOCATIN G 

### Alt : 406207149 4 Emerg : 888728934 3 QLNNEI C QWES T LOCA LNETWOR K Day :

EL M LOCATIN GAlt : 406728934 3 406207149 4 Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 11/8/201 0

# As-Buil t Drawin g COASTA L 

# Omah aLea dSuperfun dSit e CNVIKONHtNTA L CROUP

. IN C OLS#:2731 8 Dat e Excavated : 11/15/201 0 'ii.t.Te.n..
. .k^nTM.iM<iun.tncA-ivJi r Pat e USEP ASigne d Off : 12/7/201 0 .\\fffAX>j!?AiMMtMixSfaxfXi9fWMtliM^ ^ Are a Sodden : 299 0 s a f t 

### 2.1 3 I g I Name : JPofagz- fgfitie>
- Omah a Lea d Sit e Dat e fA/tAa' T I Addres s ^r>j / »v / g > » ' Sit e Sl(etc h Time : / -St i

Omah aLeadSite 4613 0



### Legen d Concret e Dri p Zon e Excavate d Quadrant s Excavatie d Are a replace d wit: h Are areplace dwit h Are alef t bar e So d' ' Rock/Mulc h 

### Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc
...:AV-^M•J.•^•;:i•3;:i*.i,t^t>'>.;i,*c&.i;>>>.'>>S^>.^».^svi^•.•'>>'.^"•X^>.•>.• ^ '.»>X*.».C*.»,-,?Si,''.*.v\»,'?i%V.*. v 

# m Z'73J S Name : ^ofee/- f^-hi^'^t. r Omah a Lea d Sit e Date : 'f/ft ^ < - North Arro w

—i Address : p o J / A / g > ^ J

^ Sit e Sketc h Time : / 'Se > Phone : g^ 5 g'Vfl ?
~STA?^ST M V^ie•.ic-2.k-GS ' nn^e : />/* i Tea m /^^ u cj,/^ ^ BVID # ^. 7 3/ g XR F Cod e /g3 7 -^2S^.
- /3 3 Sampl e Numbe r Lea d Concerrtratio n Confinnatio n Sampl e F ' Ye s ^ N o O , 

# S pp m ^Yg^^/^X A-273/ g _ ^ f a Ye s D f^ o S pp m 6 / Ye s n N o ^ pp m 

### S^Z ? 6 3 Ye s C D N o ^ pp m pp m Ve h P N cD pp m N u D YC A• 

### Nu a La b RYASCPLA-2731 8 pp m 

# CD I E Resul t
. 304f)p m .rrv 

### i 

# pyy Ayiziy^' l ttf-Trim y i M ^ i 

# r^r^- i j-"M-^^^ ^ ^

.!iv.„....|..„t...;„... , 

# r# l I

Omah a Lea d Sit e 4613 0.>.i«i...;<w..i-.i>ri>...i.vir....»..-»-;*
. ivijv-...i...:s«.ii.i«Vi...it«..v..<»S'^ ^ 

# Z73J S Name : ^oberf g^tgja r Oinah a Lea d Sit e Date : %Z/^/(i< r Nort h Arro w Address : Jinj / f ^ ^' > ^ * Sit e Sl(etc h Time : / 'S< ^ Phone : ?M g 8Wfl 7

Tea m A.5 U e.sy^ ^ BVID # ^73/ g



### _XR FCod e /g3 7 &^J^ : 1^3 Sampl e Numbe r Lea d Concentratio n Confirmatio n Sampl e f t Ye s ^ N o 2 ^ pp m ^Yg>S^/OX A-273i a f a Ye s [ ^ N o 2 ;^pp m pp m fe7r.5<^<<>;<;/i^~2.7^>8 6 / Ye s n N o o r 

### ^^bSCpy^'2.731 8 

# 5^ ^ pp m e a Ye s C D N o ^
• Ye s P N O D

OmahaLeadSite 4613 0(*l)6WV»iViVW»:s>W»>->*Vi-'i>-V.«V.-i««Vi'»ii»SVi»i«i<Wi"ii"«> ^ 

# 2.13l g Name : ^gfee^ t gfjgj^* ^ Address : p^tf^ o > *>* Phone : ^H g gfg ? Omah a Loa d SK e Sit s Sketc h Date : Time : f/^»^<
- f•i' 6 NorthArrow ­ i



### Tea m >to u c.</^ ^

BVID # ^ 7 3/ g 

### S+«if^: M ^><vfe\lo-'Zt-o S TtmA-
. pn [ XR FCod e /g3 7 jgfi2^*/5 3 Sampl e Numbe r /gYgSg/>X A-273/ g

La b RYASCPLA-2731 8 Result;^
. :. . 3 ^ 

### Lea d Concentratio n 

# 312
. . ^ 

# fi: 5ifi O pp m pp m pp m pp m pp m pp m pp m Confirmatio n Sampl e f ' Ye s GB ^ f a Ye s a 6 /

Yes n & » Yes D Ye a P Yea O Y M 

### • 

## No B ' 

# No 5 N o » N o I^ ^ N

O D M u Q 

## N

u • 

# Q H

—« ­ 

# "••••SENTW "
i
.


## U L 

# '^79ij5,|^

. H £ / 

# ^ P 

# -J ^ r / 

# ' d I3I ^ ^ ' ^ 

# F

l

l COH*
­ 

### i , w^tj ^ "* • % 

### t - 

## n/5-> »

Omali aLea dSite 4613 0

### \\A/ ^ -'
^ c ? C C A - S " 1 / t 1

c I 0 u ^
. • c C:()iii:t^ii l fl) ' /\(v(.iV!i

- 'i( i ! i()|)c-^(i y 

### RiGH i O F ENTR Y

### T O PREMISE S 

### Granlo i (th e property ' ownei ) consent s t csn d authorize s th e Unite d State s Environmenta l Protectio n Agency(FPA ) o i its authorize d representatives , collectivel y th e Grantee , t o ente ran d perfor m certai n environmenta l lespons e activitie s upor t th e followin g describe d premises :

Owner' s Name ; i Daytim e Phone :

Addres s o f Propert y covere db y thi s 

### - y 

# oi l Z

# ^ y s t 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 hazar d Th e area(s ) wil l be excavate d t o remov e 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 its origina l condition

. Thi s wor k i s bein g performe d unde rth e Omah a Lea d Superfun d Sil e 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 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 rt i s complet e an d meet s wit h th e Grantor' s approva l Upo n completion , th e Granto rwil l receiv e writte n documentatio n fro m EPAtha t th e property ha s bee n remediated

.
ENVIRONMENTA L RESPONS E ACTION S 

### B

ysignin g ttii 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 wrt h prio rnotice , fo rth e sol e purpos e ofperformin g th e wor k Thi s acces s shal l remai n i n effec t unti l th e wor k ha s bee n satisfactoril ycomplete d Ih e Granto rals o agree s to :

Pag e 1 o f2C CA S 1 Ai i^-vl»o^'K^ ^ TA I cn 0 u » 1 (

. c 

### I Remov e obstruction s includin g hosts , tiaileis , vehicles , pleyscap e ilftm.'^ , wo piles , rioo houses , etc ; o d

< Remov e flov^'e rbulb s o i piaiit s ttia l th e Gianto i o rth e Grantni' s lenEn t t o save ; ma ywis h Wate ran d maintai n leplacemen t vegetation , includin g fertilize rapplicstion , necessary ' subsequen t t o s n initia l waterin g perio d b yEPA ; a s

< Abid e b yhealt h an d safet yguidanc e provide d b yEPA ;
« I fth e property ' i s rented , assis t EP Ai n obtainin g tenan t approve ! fo i th e property ' t o perfor m th e wor k acces s t o I Allo wvideotapin g and/o rphotographin g o fth e properly

. AGREEMEN TNO TT O INTERFER E 

### Th e Granto ragree s no t t o interler e o rtampe rwit h an yo fth e wor k activities , o i wit 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

I gran t acces s t o mypropertie s D I d o no t gran t acces s t o mypropertie s

/^^/^-/^.

_. _ . Signatur e Dat e

Q I woui d lik e t o b t preieit t dufic p an ysamplln o U^E \ i s reqi'iied

.'COASTA L 

## Restoratio n Agreemen t Th e purpos e o f thi s agreemen t i s t o provid e amutua l agreemen t a s t o condition s o f th e propert y prio r t o remediatio nactivities
. Thi s wil l als o serv e a s dociimentatio nfor th e purpos e o f assurin g that restoratio n activitie s ar e complete dt o th e satisfactio no f th e property owne r an dth e Unite dState s Environmenta l Protectio nAgenc y (EPA)
.

Property ID : 

# iri2J l Property Address : 

# zl PZ. 7 s f Owner : 

## lAZi Z 

# n 

# m M

- Phone : 

# 7 Hr^y? z O nth e attache ddiagram(s ) indicat e area(s ) t o excavate , surfac e structure s an dlandscapin g feature s an d acces s location(s ) t o b e use db y th e contractors . Indicate distances , depths , material types , etc . Photographicall y an dVideographicall y document th e existin g condition s ofth e property an dth e basemen t i f necessary . 

## Item s t o b e Remove d b yth e Owne rbefor e Start o fRemediation : Th e removal , storage , disposal , and/o rretu m o fthes e item s i s th e Owner' s responsibility

. Kem : 

# J( J 

# O 

# J U ^ Kem :
Item :
Kem :



## Item s t o b e Remove d b yth e Contracto r Durin g Remediatio n an d No t Replace d Kem : 

# z - Aje. ^ Kem :
Kem :
Kem :



### Page l o f/

## v ^ C O AS T AL
• NVI«ONHI N TAL OROUP , INC

. 

## Item s t o B e Remove d B vContracto rDurin a Remediatio n an d Replace d Item : 

# so \ 

# \ Kem : 

# ^ o i Kem :
Item :



## Item Pre-existin g propert y area , that wil l b e excavated , that i s covere dwithgrass . Numbe r o f tree s > 2 inc h trunk diamete r Numbe r o f tree s < = 2 inc h trunk diamete r Numbe r o f Sprinkle r 2^nes , Contro l Valves , Timers , Heads , etc . Attac hasketc ho f th e sprinkle r layout
. Numbe r o f an dsiz e o f eac hgarden/ flower be d area . Attac hasketc ho f relativ e size s an dlocations
. Agree dupo nvalu e o f plan t material s no t t o b e replace db v contractor . Not e thi s valu e will b e use dt o issu e aplan t vouche r t o th e propert y owner . Easemen t Area , t o b e excavate d 

## Quantity 

# r r

lo t 

# z y Landscap e Inventor y Unit Quadrant s

Eac h
Eac h

Eac h

Eac h Squar e Fee t 

# y z $



# \f 

# av^ y Eac h 

## Condition/Type/Specie s



# r

e z)( ^ ^^^ j K^^uih j

Pag e 2 

# c AC O AS T AL
• NVmONHKNTA L OROUP , INC

.


### AddKiona l Comment s / Instructions : Th e cit yo fOmah a ordinance s ma yprohib Kyo u fro m usin g dir t o rgrave l area s o n you rpropert y a s driveway s o rvehicl e parkin g areas . Th e Environmenta l Protectio n Agency(EPA ) ma yb e removin g an d replacin g soi l underiyin g a grave l o rdir t are a o n you rpropert ytha t yo u ma yb e usin g a s a drivewa yo 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 f soi l doe s no t mea n tha t an yIllega l drivewa yo rparkin g are a o n you r propert yi s mad e legal

. T o th e contrary , yo u ma yb e cite d b yth e cit yi f yo u us e a grave l o rdir t are a a s a drivewa yo rparkin g area , no t withstandin g an yremova l o rreplacemen t o f soi l b yth e EP A I f yo u have an yquestio n abou t legalit yo f a certai n drivewa yo rparkin g area , yo u ma ycontact th e cK yo fOmaha' s Plannin g Departmen t a t (402 ) 444-5150

. O Pleas e chec k thi s bo xi f yo u understan d th e informatio n outline d above

.

f l I ^ c" c t H (3 * ^ ^



### G 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 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

.



### [ ^ I agre e Q I d o no t agre e

Owner' s Sigi^iur e M/Bat e Contractor' s Signatur e Date Pag e 3 o f?

### BVID # Z33[ 8 XR F PROPERT Y SAMPL E SHEE T Dat e Project XR F ID #

Shot # 

## 13 1 I3 Z 13 3 Averag e
Shot # 

## 13 ^ 13 ^ 13 ^ Averag e
Shot # 

## ( 3 1 

# m 1 ( Averag e

Shot #

Averag e Signatur e Prin t 

### Zni l A i Z ^ 3 T am/p m 3 0 se c Readin g Sampl e are a 

# ze o 

# i z 4 B A ^

^

i Z L Dept h 

## Z04 i Z l / " 

## Z3 4 

## t ZX
. 

# A

Readin g Sampl e are a Dept h

Readin g Sampleare a Dept h

Readin g Sampl e are a Dept h )-Z [ ' zol \ Omah a Lea d ARR A P.'^^OZ F Readin g 

## 3B L i z e 3"^ ! ±Z S 4(5 i z n

ZZS'^ 

## i Z' ^
Readin g 

## 1 4 t ^ / 5 i ^ ZS t u Sampl e are a 

## 5 1 Dept h 

# /3 " ^ Sampl e are a 

## 6Z

. Dept h 

## 1 3 Addres s Sampl e tim e sampl e lengt h



## n t 1 0 ^
Readin g Sampl e are a 

## 4 5 i i 3 D F Z 45- ^

i Z ^ Dept h 

## 56 0 t ZA /3 "



# 4^6 

# ' - 3 b y

Averag e 

# (H ^ Ufrdy j RETES TAREA S Readin g Sampl e are a

—-— Dept h 

# ^ y > 

# yA Shot # 

## 14 3 

# m / ^ ^ Averag e
Shot #

Averag e
Shot #

Averag e

Shot #

# 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 AVERAG E ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

Supervise d B y 

## Certificat e o f Verificatio n

13 4 SOI L 2011-01-2 1 13:2 4 90.7 5 Fina l Avg o f 131-13 3 201 1 N 2 7 S T B l 13 " C.PADILL A CONFIRMATIO N CLEA R

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpil< e Billerica , MA0182 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 382.49 7 Supervise d By : 

## Certificat e o fVerificatio n

13 1 SOI L 2011-01-2 1 13:2 3 30.2 0 Fina l 2731 8 201 1 N2 7 S T B l 13 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r
± 28.61 8

# 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 399.36 0 Supervise d By : 

## Certificat e o fVerificatio n

13 2 SOI L 2011-01-2 1 13:2 3 30.2 6 Fina l 2731 8 201 1 N 2 7 S T B l 13 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r
± 28.74 4

# 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 415.29 1 Supervise d By : 

## Certificat e o fVerificatio n

13 3 SOI L 2011-01-2 1 13:2 4 30.2 9 Fina l 2731 8 201 1 N2 7 S T B l 13 " C.PADILL A CONFIRMATIO N CLEA R

Erro r
± 29.79 4

# 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 AVERAG E ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

Supervise d B y 

## Certificat e o fVerificatio n

13 8 SOI L 2011-01-2 1 13:2 7 90.7 1 Fina l Av g o f135-13 7 201 1 N 2 7 S T B 2 13 " C.PADILL A CONFIRMATIO N CLEA R

# 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 14.75 3 Supervise d By : 

## Certificat e o f Verificatio n

13 5 SOI L 2011-01-2 1 13:2 6 30.2 0 Fina l 2731 8 201 1 N 2 7 S T B 2 13 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r ± 9.78 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-3902 2 Readin g N o 13 6 Mod e SOI L Tim e 2011-01-2 1 13:2 7 Duratio n 30.2 2 Sequenc e Fina i Flag s BVI D 2731 8 ADDRES S 201 1 N 2 7 S T QUADRAN T B 2 DEPH T 13 " XR F TEC H C.PADILL A MIS C CONFIRMATIO N NOT E CLEA R

pp m ±Erro r P b 15.08 6 ±9.90 7 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 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 28.28 5 Supervise d By : 

## Certificat e o fVerificatio n

13 7 SOI L 2011-01-2 1 13:2 7 30.2 9 Fina l 2731 8 201 1 N 2 7 S T B 2 13 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r
± 11.03 2

# 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 AVERAG E ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

Supervise d B y 

## Certificat e o fVerificatio n

14 2 SOI L 2011-01-2 1 13:3 1 91.3 3 Fina l Avg of 139-14 1 201 1 N2 7 S T F 2 13 " C.PADILL A CONFIRMATIO N CLEA R

# 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 451.87 9 Supervise d By : 

## Certificat e o fVerificatio n

13 9 SOI L 2011-01-2 1 13:2 8 30.3 1 Fina l 2731 8 201 1 N 2 7 S T F 2 13 " C.PADILL A CONFIRMATIO N CLEA R

Erro r ± 30.45 3

# 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 457.52 4 Supervise d By : 

## Certificat e o fVerificatio n

14 0 SOI L 2011-01-2 1 13:3 0 30.6 9 Fina l 2731 8 201 1 N 2 7 S T F 2 13 " C.PADILL A CONFIRMATIO N CLEA R

Erro r
± 27.27 0

# 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 550.69 7 Supervise d By : 

## Certificat e o fVerificatio n

14 1 SOI L 2011-01-2 1 13:3 1 30.3 3 Fina l 2731 8 201 1 N 2 7 S T F 2 13 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r
± 34.97 3

# 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 AVERAG E ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

Supervise d B y 

## Certificat e o fVerificatio n

14 6 SOI L 2011-01-2 1 13:3 8 90.7 0 Fina l Av g o f143-14 5 201 1 N 2 7 S T E A 1 " C.PADILL A CONFIRMATIO N CLEA R

# 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 280.50 3 Supervise d By : 

## Certificat e o fVerificatio n

14 3 SOI L 2011-01-2 1 13:3 6 30.2 5 Fina l 2731 8 201 1 N 2 7 S T E A 1 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r
± 24.23 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 219.25 3 Supervise d By : 

## Certificat e o fVerificatio n

14 4 SOI L 2011-01-2 1 13:3 7 30.2 1 Fina l 2731 8 201 1 N 2 7 S T E A 1 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r
± 22.50 4

# 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 204.00 6 Supervise d By : 

## Certificat e o fVerificatio n

14 5 SOI L 2011-01-2 1 13:3 8 30.2 4 Fina l 2731 8 201 1 N 2 7 S T E A 1 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r 21.54 2

### / ^A/' % o ^^^Z I 

### \y^y ^ ^'IPBOT*' ^ 

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

. 

### www.c0astaiha2mat.co m COASTA L INyiaONMINTA l ca o u r , INC ' 

# EXECUTIV ESUMMARY : BVID #27318-(201 1 N2 7 ST )
No Issue s o r Concern s Q Issues/Concern s
Detail Explanation :

### ^L > 

## EP APropert y Clos e Ou t For m Propert y #: 2'^'^ l SZ PropertyAddre« : 7fft J A l ZK^T^V T Date/Time : Name:,/ , [ij&ijftfZ^. ^ ^ ^ Owner' s Wame;
. /^
. . / V Quad s Excavattd : p ( Z\Z^ ^ Y yi y Contracto r Crou p ZJDO ^ Ye s IS o Excavatio nGeneral 1.

If necessBiy
. wer e tiie correct quadrant(s ) excavatedan drestored ? 

# J 2.

If necessary , wer e (lie correct areas ofdri p zon e excavaledan drestored ? / Gradin g So dan dVegetettow Yes No I Doe s the grading aroundthe perimete r of ttie lious e inexcavatedarea s generall y slope awa y / fromthe house ? 2.

Ha s sodbee nlaid inall area s tha t wer e excavated ? / 3.Doe s the so dappea r to be generally IteaJlli y an dgrowing ? (Only evaluat e ifinspecte d at a

30 / day tim e period)
____ ^ ­ 4.

Are sodde darea s generally llr man devenl y graded ? / 5.Are th e joint s t>etwee nth e so dstrip s generall y tight ? (Only evaluat e if

inspecte d

at ^

30 da y time period ) 

# y 6.Wa s th e propert y gradedsuc htha t wale r wil l no t poo l onth e property ? / 7.

Wa s damag e lo landscaping or plan t material s avoided ? / Gates
. Fence s andRetainin g Wal b Yes No 1.

Do gate s ope nan dclos e freely? (Ifapplicable ) 

# 7 / 2.

Were all gate sor fence s take ndow nduring restorationactivitie s reinsulied ? (I f applicable) 3.Wa s damag eto gate sor fence s avoided ? (I f applicable) / 4.

Wa s damag eto teuiining wall s avoided ? (Ifapplicable ) / Foundation , Sidin g an d Gutler a Ye s .N o t.Wa s damag e to th e sidin g ortri m avoided ? 

# J 2.

Wa s damag e to Ih e foundatio n avoided ? / .*

.

Wa s damag e to window s avoided ? / 4Wa s damag e to window s ordoo rscreen s avoided ? / 5.Wa s damag e lo downspout s ordownspou i extension s avoided ? 

# J
Sidewalk s an d Driveway s (Concrete ) Yes
. No I. Wa s damag eto drivevra y surface s avoided ? 

# -A 2. Wa s damag e to walkwa y surface s avoided ? 

# T

## Ort'Der s comments :

[inspectio nnoies :

Removal andrestoratio nactivate s complel e includin g th e 30-da y so dwarranty : EP ARepresentiitiv e Bun^ ^ Date : IZ/J/J Q " ^

## Propert yCompletio n Agreemen t
ihi s agreemen t documenl s th e compiclio n o l remedia l activitie s perloime d o n myproperl yM ysignature wil l designat e iha l I a m satisfie d wit h tli e restoralio n o fm yproperly , an d tha i n o ilem s ar e i n questions , novi' , o ra l an ylim e i n th e fuluie , except Ihos e ilem s liste d below , i fan y

PropertylD : Z-l^^ZiS Z Propert yAddress : ^ ^ / / A t ZT^^Zt ^ Owner : ^.fijui t 'S ^ Phone : 

# li ^ 

# 3 ^

Restoratio n Item s i n Question :

Item : Item : 1 iiem :

' Item :

Item : Item :

PZ ' 1 »urc crestoralio n i % completed , excep t a s nole d \Z i ) ti o no t flfjrecrestoratio n i s complete d

vnrr' s SigMtnr r(|pf>t cCo^VfaTlor' s Sicnaturc? 'Date 1