## TRANSMITTA Lo f

OMAH A LEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R SAI D # : loiV b Dare : I ^ / '' ^ Address : Remediatio nContractor : Coasta l Environmenta i Group

_ Year : _200g } SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S Vide o ofpropert y (DVD ) 

# t / Executiv e Summary EPA-provide dpropert y sketc h dSigne dAcces s Agreemen t for subjec t property -B ' Signe dAcces s Agreement(s ) for adjacent property WRestoratio nAgreemen t -f

r Settlemen t document s (i.e. , for damag e o r t o replac e plants , etc. ) -B Confirmatio ndat a

[3 / Photograph s % '^ 9 V feCQWi^lWt K \\iy{!pO(mi< ^ 5

/ As-buil t sketc h M Satisfactory restoratio nsigne db y Property Owne r ^ Property close-ou t chec k lis t signe db y EPA —& Descriptio no f area s no t meetin g RO D cleanu p criteri a I w Utility clearance s d /

Property injormatio nfro mDougla s Coimt y Assessor' s Offic e D D D ^\\ 0 Signatur e I ­ ^^
­ ­ ­ 'Dat e 3005446 2 Superfun d• # • •


## Propert yAcces s Checklis t Propert y ID : ZOfhl' ^ Property Address : 32. 1 ?.Popd(»to n AVr t n D

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

# o^^r
- (iV\/xrlnW9 i ?^\pjti s Address :



## 32 1 ^ PoppWcP AAV G Phone ; Fax : 

# • (}oi)?^\i-\fi? M Celi/Page n Rente r Phone: Fax : Cell/Pftgen Additional Infonnation :

D Notificatio nLette r • Acces s Agreement D Restomtio nAgreemen t D Topsoil Samplin g (if applicable ) D Disposa l Samplhi g (if applicable ) D Garde nSamplin g (if applicable ) D Utilit y Clearanc e Q^ideo/Photo s (Before ) D Video/nioto s (During ) D Video^hoto s (After) D ^ Video/Photo s (30-Day ) 13 ^ Property Completio n Agreemm t t l Final Report Sent : / / Siened : / / Signed : / / / / / / / / Called : / / On:j2_//7 / 0 ^ On : / / On : / / On : / / Signed : /^/. Issued : / / ^ By : By : By : By : By : By : By : 

## ^r-OOw/z j //^£r//H ^ By : By : By : By : By : Ai r Monitorin g (a s applicable ) D Commnnit y D Crc n Results : On : / / By :

n Conunnnit y Resuhs : •Cre w On : / / By :

• Commnnlt y Results : QCre w On : / / By :
Omah a Lea d Sit eDougla s Cotmt yAccotm t I 

### ijlJbnM^o n 

## Pag e 1 of 2 Dougla s County , Nebrasic a Propert yRecor d - R123633000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t o f 52n d S t - ViewO H Ma p Informatio n i s vali d a s o f 2009-8- 3 Treasurer' s Ta xRepor t Ne wFeatur e -•->- » Aut o Sale s Searc h Owne r SHIELD S CHARLOTT E 321 2 POPPLETO N AV E OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumber : 363 3 000 0 1 2 Accoun t Type : Residentia l Parce l Number : 123633000 0 Parce l Address : 321 2 POPPLETO N AV OMAH AN E 68105-000 0 Lega l Description : HANSCO M PLAC E LOT1 4 BLOC K7 W 1 1 FTLT S 1 1 & 1 2 & E 2 9 FTLT S 1 3 & 4 0 X10 0 Vaiu e Informatio n 

### 200 9 200 8 200 7 

### 200 6 200 5 200 4 Lan d $5,200.0 0 $5,200.0 0 $5,200.0 0 $5,200.0 0 $5,200.0 0 $5,200.0 0 Improvemen t $88,600.0 0 $72,000.0 0 $72,000.0 0 $74,800.0 0 $74,800.0 0 $74,800.0 0 Tota l $93,800.0 0 $77,200.0 0 $77,200.0 0 $80,000.0 0 $80,000.0 0 $80,000.0 0 Saie s Informatio n Sale s Date : 

### 2008-06-0 9 Dee d Type : Price : Q C $0.0 0 BooJir : 200 8 Page : 05641 5 Grantor : VOLVOLK AALA N Grantee : SHIELD S CHARLOTT E Valid/Invalid : Exclusio n Reason : Invali d Famil ySal e Lan d Informatio n Acre s 0.0 9 S F 4000. 0 Unit s 

### 1.0 Dept h 100. 0 Widt h 40. 0 Vacan t N o Improvement Informatio n 

## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accoimtno=R12.. . 8/22/2009• • 

### Dougla s County Accoun t I :

i^^o n Pag e 2 of 2
Buildin g 1 

## TW O STORY ":^OY.I :
1?l30sq Y

Tsi r

flnunl-n « fW * *

^ -Id a Lwn ^ Ara a ' ^ CLIC KTO ENLARG E IMAG E CLIC KTO ENLARG E IMAG E Squar e Footage : 2068. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Goo d

Buil t As : 2 Stor y Cond o Squar e Footage : 0. 0

HVAC : Force d Ai r Rooms : 6. 0 Exterior : Fram e Viny l Units : 2. 0 Interior : Drywal l Baths : 2. 0 Roo f Cover : ! Compositio n Shingl e Bedrooms : 4. 0

Roo f Type : Gambre l Stories : 1. 5 

### Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 Yea rBuil t Yea r Remodele d Percen t Remodele d Adjuste d Yea r Buil t Physica l Ag e 189 0 200 7 0 % 191 3 9 6 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 1172. 0 Basemen t Fai rFinis h 720. 0 Fixtur e Additiona l Fixture s 1. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 2. 0 Porc h Sla b Roo f Cei l 72. 0 Porc h Sla b Roo f Cei l 178. 0 Use r 2 ap t con v 1. 0 Use r code i 25tomode l 1. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R12. . . 8/22/200 9• • • •


## CONTACT FOR M Propert y I D # 20^\ ^ Propert y Address : 

# 22jr LpQpp\e.'k3 n/^v e Initial Contact : Date : Time : Action : Secon dContact : Date : Time : Action : Fina l Contact : Date : Time : Action : Fina l Action : Transmi t to EP A D Other Action : D

Comment : Owner Comment (s) : Site Coordinato r Comment (s) :" > • • • • Pag e 1 of 2

Creat e Anothe rTiclce t ] Bacl < t o Irt h Interne t | ' [ Sen d Emai l |

• YOU RTICKE T NUMBE RI S 2362525 . Origina l Cal l Date : 9/12/0 9 Time : 6:2 7 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date ; 9/16/0 9 Time : 7:1 5 a m State : N E County : DOUGLA S Place : OMAH A Address : 321 2 Street : POPPLETO NAV E Twp : 15 NRng : 13 E Sect-Qtr : 28-NW 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 : (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 h o f Excavation : 4f t ront : Y Rear : Involve s Tunnelin g o r Horizont ; ves : N CXCAT V LEVEL S MUD0 2 QLNNEI F
Servic e Areambe r UtiUt y Typ e CXCAT V CO X COMMUNICATIONS , IN C HEID I Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7 Day : 877366834 4 LEVEL S LEVEL S COMMUNICATIONS , LL C N A Alt : Emerg : 877366834 4 Day : 402504782 3 MUD0 2 METROPOLITA N UnLITIE S DISTRIC T SAND Y Alt : Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFICSEWE RRO N Alt : 402444516 1 Emerg : 402444516 0

http://virww.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 9/12/200 9

## Pag e 2 of 2 • • • •


### 0PPDGPR 6 OMAH A PUBLI C POWE RDISTRIC T N A 

## Day : 406728934 3

Alt : 406207149 4 

## Emerg : 888728934 3 QLNNEI FQWES T LOCA LNETWOR K

N A 

## Day : 406728934 3

Alt : 406207149 4 

## Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.. . 9/12/200 9

## 2051 3 OLS# : 2051 3 

# As-Buil t Drawin g ^ Dat e Excavated:9/26/0 9 Dat e USEP ASigne d Off : 10/23/0 9 C OASTA L 

# Omah aLea dSuperfun dSit e Are a Sodden : 106 2 sof t

Owne rName : ALA N AVOVOLK A Address : 321 2 POPPLETO N A V

Phone : H : W : Sampl e Numbe r RYASCPXA-2051 3 RYBSCPXA-2051 3 RYCSCPXA-2051 3 RYDSCPXA-2051 3 RDZSCPXA-2051 3 RGZ3CPXA-2051 3

Omah aLea dSit e

Concret e KZ/j J Are a replace d wit h So d ' ' 

### Contrac t # : EP-R7-07-0 5 Exterio rPain t Nort h Arro w Sit e Sketc h Omah a Lea d Sit e Q-'SSo d • Poo r [~ 1 No t pain t 

# t

Firm : Date : Time : Sample s Collecte d T'B . P^'T ^ (A^S> 0 ^V - \J> M VC a '. ^A3 ' ^r- ^ Sample s Analyze d XR F Unit : O 1 \ Book n ^

Retainin g Wal l

F 2 = 270 PP M @ 9 "

461. W 

### Legen d Dri p Zon e Excavate d OOO I Quadrant s Excavate d Are a replace d wit h Are a lef t bar e Rock/Mulc h



### Coasta l Environmenta l Grou p Inc .• • 

## 2051 3

Omah aLeadSite 

## fOL i 4613 0

# r ^ 

# 0%r \a V 

# Z,^1d . 2051 3 Exterio rPain t Nort h Arro w 

### Omah a Lea d Sit e Owne rName : ALA N AVOVOLK A Q--Soo d 

### Sit e Sketc h Address : 321 2 POPPLETO N A V / \ 

### • Poo r Phone : H : W : Q No t pain t Sampl e Numbe r RYASCPXA-2051 3 RYBSCPXA-2051 3 RYCSCPXA-2051 3 RYDSCPXA-2051 3 RDZSCPXA-2051 3 ROZ3CPXA-2051 3 nPZOCPXA-2051 3 F l F 2 B l B 2 D Z 

### -6 Z Sampl e Collecte d Sannple s Collecte d 

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## 2051 3 Omah a Lea d Sit e Exterio rPain t Nort h Arro w Owne rName : ALA N AVOVOLK A Q-Soo d 

### Sit e Sicetci i Address : 321 2 POPPLETO N AV 

### • Poo r Phone : H : W : • Notpain t 

# T Sampl e Numbe r RYASCPXA-2051 3 RYBSCPXA-2051 3 RYCSCPXA-2051 3 RYDSCPXA-2051 3 RDZSCPXA-2051 3 ReZSCPXA-2001 8 RPZOGP)(A«2001 3

-.ic Sampl e Collecte d F l F 2 B 1 8 2 D Z -6 2 

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PBO"^ ^ cR 0 u r . > N C 

## Consen t fo rAcces s T o Prop6Ft 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 representath/es , 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 : 

# -^xl
- Gl'b ^ ^^KcvrloH ? ^ \ Addras s o f Propert y covere d b ythi s Agreement : 

# 321 2 PURPOS E O F RESPONS E 

### AcTivrriE 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 f lea 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 f Coasta 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 rvt/il 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 rvini i receiv e writte n documentatio n from 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 f performin 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 f 2

# f

V"^^'M*3=^ 'COASTA L

•>^ IKVmOhHIKTA t ^ i PRO" ^ C II O U rI R C


### « Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; cRemov e flowe rbulb s orplant s tha t th e Granto r orth e Grantor' s tenan t ma ywis h to save ; « Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , as necessar ysubsequen t to an initia l waterin g perio d byEPA ; «Abid e byhealt h an d safet yguidanc e provide d byEPA ; • If th e propert yis rented , assis t EP A in obtainin g tenan t approva l fo racces s to th e propert y to perfor m th e work . »Allo wvideotapin g and/o rphotographin g of th e property . AGREEMEN TNO T TO INTERFER E 

### Th e Granto ragree s no t to interfer e ortampe rwit h an y of th e wor k activities , orwit h an y of th e wor k done , orwit h th e equipmen t use d on hi s property , or to undertak e an y action s regardin g th e us e of sai d proF>ert ywhic h woul d ten d to endange rth e healt h or welfar e of th e Grantee s orth e environment , or to allo wother s to us e th e propert yin suc h a manner . Shoul d yo u hav e ari yquestion s abou t thi s program , pleas e contac t Coasta l Environmenta l Group , at (402 ) 991-119 9



## Ofg r D I do no t gran t acces s to mypropertie s gran t acces s to mypropertie s

Sianatur Signatur e e Dat Dat e e SignatureDate
D I woul d lik e to be presen t durin g an ysamplin g tha t is required .

Page 2 of 2

### -il ^ 

## '4 . COASTA L 

### Restoratao n Agreemen t Th e purpos e of thi s agreemen t i s to provide amutua l agreemen t a s t o condition s ofth e propert y prio r t

o remediatio nactivities . Thi s will als o serv e a s documentation fo r th e purpos e o f assuring tha t restoratio n activitie s are completedt o th e satisfactio n o f th e propert y owne r an dthe UnitedState s Environmenta l Protectio nAgenc y (EPA) . Propert y ID : ^pg , ^ Propert y AddrcM : ^„u^ , u 4 ^ o 4 WUc
­ O^gf ' <CUr\oH e ^h'.^\A < 

### Phone : '^yl-^TS ^ O

n th e attacheddiagram(s ) indicat e area(s ) to excavate , surface structure s an dlandscaping feature s an d acces s location(s ) to b e use dby th e contractors . Indicat e distances , depths , materia l types , etc . Photographically an dVideographicaJl y documen t th e existing condition s ofthe propert y an dthe basemen t i

f necessary . item s t o b e Remove db y th e Owne r befor e Star t o f Remediation : Item : 

# ^U \ rlcuJ- s ttem: ttem: 

### / ttem: 

### /



### item s t o b e Remove d b yth e Contracto rDurin g Remediatio n an d No t Replace d ttem: 

# JL^w^m^ ^ SSA/LJ L ttem: ^ Kem : ttem:
Pag e 

### 1o f2_

# '((T ^ COASTA L 

### Item s t o B e Remove dB y Contracto r Durinf l Remediatio nan dReplace d ttem: 

# ^ ^ ttem: 

# ^^-A - Item : ttem:



### Ite m Pre-existin g propen y area , tha t wil l b e excavated , tha t i s covere dwh hgrass . Numbe r o f tree s > 2 inc h tnui k diamete r Numbe r o f tree s < = 2 inc h trun k diamete r Numbe r o f Sprinkle r Zones , Contro l Valves , Timers , Heads , etc . Aiiat haskeicl r o l ilit r • .rr'Pkic i l;>v'.)u i Numbe r o f an dsiz e o f eac hgarden / flowe r Ije d area . Alliit h. 1 skcic ho l rcUitivf M/f S nii dloc;iiii'ti > Agree dupo n valu e o f plan t material s na t to b e replace db v contractor . Vol e Ihi ' \HI(I C wil l ti i i:si'L ' 10 \i:.\ni l filHii ! voiifln- T !( / th e |;ro|)cii > IM

< ner . Easemen t Area , t o b e excavate d 

# <>^^ \ D Z

Quantit y 

# n/ i 2

^ 

# f

^ 

# ^t ^ mo(o k

" F) . F 2

Landscap e Inventor y Uni t Quadrant s

Eac h Eac h

Fac h

Eacf a Squar e Fee t

S

Fjich 

### Condition/Type/Specie s

\e.\^sKC . XK^i^ ^ 

### Pag e 2
. . ^

## XL . COASTA L

* Additiona l Comment s / Instructions :



# Iw^r&A-\ - <: ^ Wo^^c—Hv xF \ cLvvcS } F2" ' <>^e^Hfi f 

# f^' S ^" ^ -F^ ^ ^ ^^^^ ^ ^H ^ Kil l ' Le^ . ^ , ^,, V S^o ^ cre. t <^,^ ^ 1 , •

^i^ot^f
- Tet^ia ^ TWV W
Q Chec k th e bo xi f Owne rdoe s not 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 t s not responsibl e fo ran ydamag e don e t o th e interio rof house , Includin g foundatio n crack s o rfissures . 

## BZi * agre e Q I d o no t agre e

Owner' s Signatnr e Date ' / Cmtractor' s Signature *" Dat e Pag e 3 of .BVID # '2 , 6^* 3 XR F PROPERT Y SAMPL E SHEE T Dat e Addres s ^2-/7 - Po p p/-c-H.v ^ 

### Aoi ^ Projec t Omah a lead ! FP 2n d yea ropilo n Sampl e tim e am/p m sampl e lengt h XRFID # 

## h7<<'fi' ^ 3 0 se c

Shot # Readin g Sampl e are a _Shot # Readin g Sampl e are a bampiea r 

# 7 a 

# sz ^ J 2 ^ 

# f^ / Dept h Dept h 

# m eg 4 

# -fm. / 3 ^ 

# L a d O Averag e /y-^/^Z ^ Averag e ^ ^ <i^lQ _ Shot # Readin g Sampl e are a Shot # Readin g Sampl e are a 

# 2 5 ^ ^ ^ ^ 

# I S ' 5 J=^ ^ 

# iLg l / Dept h 

### 'tifT-i^/ ^ Dept h

3 ^ ^ 

## V/? % i>tS ^ Averag e '^J^j ^ " ^ ^ ^ Averag e 

# /^jh/ ^ Shot # Readin g Sampl e are a Shot * Readin g Sampl e are a Dept h Dept h Averag e Averag e
RETES TAREA S Shot # Readin g Sampl e are a Shot * Readin g Sampl e are a Dept h Dept h Averag e Averag e la b sampl e # La b resul t Sampl e are a XR F AvQ . Signature . 

# ^caam . Prin t f ^ Uoj i M a Cocef(f s• • • •


### ^

Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5

I .. . . . ._ / v^ ^ \ . Coasta l Environmenta l Grou p Inc . M V*^^ ^

vinvw.coastalhazmat.co m ^ ^ XpROrt ^ COASTA L MVIIOMNEIITA L CIOUP , IN C 

# EXECUTIV ESUMMARY : BVID #20513-(321 2 POPPLETO NAVE ) No Issue s or Concern s | ^ Issues/Concern s Detai l Explanation : -COASTA L

TO DRO POF FADDITIONA LBAGS OFMULC H

TO PO.(COMPLETE D

ON 10/21/09 )4 

# ^%EP A EP A Propert y Clos e Ou t For m Property # : "ZPS B . . DfltcHlme : 

### — : Owi«r'iNanie:..£h.nrl0tt f _f)hl'<'^\G\ ^ , rnn^mctn r Crou p C*r^r^fa/>^ ^ Kf Wl^yPnTU'/V m» Quad s Eicavated ; )F\ , f 2 , D 7 Ye s N o Excavatio n Genera l 1 .IfnecessBiy , were th e correc t quadrant(s ) excavate dan drestored ? 2 .If necessary , were th e correc t area s ofdri p zone excavate dandrestored ? 

# y ' Ye s ,N o Gradin g So dan dVegctatto n 1 .IX>es th e gradin g aroun dth e perimcier ofth e hous e i nexcavate darea s generally slop e awa y 

# T7 f fromth e house ? 2 .Ha s so dbee nlai dinal l area s tha t wer e excavated ? 3 .Doe s th e sodappea r t o b e generally health y an dgrowing ? (Onl y evaluate if inspecte da t a3 0 

# y day time period ) ^ 4 .

Ar e soddedarea s generall y fir man devenly graded ? 5 .

Ar e th e joint s betwee nth e so dstrip s generally tight ? (Only evaluate if inspecte da t a3 0 da y C / tim e period) ___^_ _ 6 , Wa s the propert y grade dsuc htha t wale r will no t poo l o nth e propert}**] 

# IP ' 7 .Wa s danug e t o landscapin g o r plan l material s avoided ? 

# IP ^ Gates , Fence s an dRctaialn g Wall s Ve s N o I .D o gate s ope n an dclos e freely? (Ifapplicable ) 2 .Wer e all gate s or fence s takendow ndurin g restoralio nactivitie s reinstalled ? (Ifapplicable ) 3 .Wa s damag e t o gate s or fence s avoided ? (Ifapplicable ) 

# 17 ^
" ^ ^ 4 .Wa s damag e t o retainin g wall s avoided ? (Ifapplicable ) Foundation , Sidin g an dGntler s Ye s N o I .Wa s damag e t o th e sidin g o r tri mavoided ? 2 .Wa s damag e t o Ih e foundation avoided ? K ^ 3 .

Wa s damag e t o window s avoided ? Wa s damag e t o window s or doo r screen s avoided ? 5 .Wa s damage l o downspout s o r downspoul extension s avoided ? iy ' Sidewalk s an dDriveway s (Concrete ) Ye s N o 1 . Wa s damag e t o driveway surface s avoided ? 

### c x " 2 . Wa s damage t o walkwa y surface s avoided ? 

# -Z^' ^

## Owner s comments :

Inspectio nnotes :

Remova l an drestorationactivate s complete including th e 30-da y so dwarranty : EP A Representativ e Uov t \Sa££ . Date : /o/xi/o j

# L •


## Propert yCompletio n Agreemen t Thi s agrcemen i document s th e completio n of remedia l acliviiie s pcrloiinc d on mypioperty Mysignalur e wil l designat e tha t f

am satisfie d wil h Ih e restoralio n of myproperly , an d Iha l no item s arein queslions . now , or al anylim e in th e future , excep t those item s lisle d below , ifan y Propert y ID : 2(05lg > Propert y Address : -^^^i . Pr)pp\P.Vy n/W P 

## ^'"""'^"""'" ' :>7..\ Lyg^S A Owner : CYV^r\oVV ^ rSVlAtcL S 

### Phone : g^^ ^ Q^^y^ , ^^^< ^ Restoratio n Item s in Question : 

# "•- ^

fflulr.K Item : Item : Item : Item : Item : Additiona l Comments :



## D^e=^f^- \ c.9 r \0 ^^<^ ^

)MOIOU ^ 

## t^< 9 ^jc^lc i \\^ ^|0

I VT l agre e • Mtoralio n » completed , excep t as nolci i [_ | I do nn t «Kre cretloratio nis complete d

Owner' s Sipnahir gnahir r rDutc* ^ D«t c•' ^ Connirlor' s Signalnr cDal e