### TRANSMITTA Lo f OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R
SAID # : l^^KZDate : ZJ^bjrP } Address : 30E> b S ^' ^ SIT ' Remediatio nContractor : Coasta l Environmenta l Group

_Year : 200 8
SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S y Vide o o f property (DVD ) y Executiv e Summary D EPA-provide dproperty sketc h y Signe dAcces s Agreemen t fo r subjec t property QJiP C Signe dAcces s Agreement(s ) fo r adjacent property y Restoratio nAgreemen t |M) nSettlemen t document s (i.e. , fo r damag eo r t o replac eplants , etc. ) y Confirmatio ndat a G

/ 

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### •S-dcL D As-buil t sketc h y Satisfactory restoratio nsigne db y Property Owne r Q / Property close-ou t chec k lis t signe db y EP A KJft ' Descriptio no f area s no t meetin g RO D cleanu p criteri a y Utilit y clearance s y propert y informatio nfro mDougla s Count y Assessor' s Offic e

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### Propert yAcces s Checklis t Propert yID : m>-.\Qg ^ D WOR K STARTE D ON : / /_ Propert yAddress : go5^c^ , -Zl^^ ^- ^ D WOR K COMPELTE D ON : / /
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### Signed:/Z_//2/Q B ^y-Krt^, ^ B^Restoratio n Agreemen t 

### Signed : ^//^/O g B^Br.^w , O Topsoi l Samplin g (i f applicable ) 

### / / By : 1 1 DisposaJ Samplin g (i f ;)pplicable ) 

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### / / By : n Utilit yClearanc e 

### Called : iL/H/£iS L B3:l\/3l M B

^ Video/Photo s (Before ) 

## On : u_/r^a 2 ^y- ? ^ i G n D Video/Photo s (During ) 

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## CONTACT FOR M Propert y I D # Propert y Address : Initia l Contact : Secon dContact : Fina l Contact : Fina l Action :

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# \^^B a 3os u S-S^^
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### Dougla s County Accoun t In^^atio n Pag e 1 of 3
Dougla s County , Nebrask a Propert yRecor d - R194288000 0 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e ©scal e 0-5 0 f t wes t o f90t h S t - Vie wO n Ma p Informatio n i s vali d a s o f2008-11- 5 Treasurer' s Ta xRepor t Ne wFeatur e ->-•- •Aut o Sale s Searc h Owne r RISHLIN G JOSHU AL 305 6 S 3 3 S T OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumber : 428 8 000 0 1 9 Accoun t Type : Residentia l Parce l Number : 194288000 0 Parce l Address : 305 6 8 3 3 S T OMAH AN E 68105-000 0 Lega l Description : PARKVAL E LOT 2 BLOC K8 4 1 X 130 Valu e Informatio n Lan d Improvemen t Tota l 200 8 $5,900.0 0 $85,200.0 0 $91,100.0 0 200 7 $5,900.0 0 $85,200.0 0 $91,100.0 0 200 6 $5,900.0 0 $74,200.0 0 $80,100.0 0 200 5 $5,900.0 0 $74,200.0 0 $80,100.0 0 200 4 $5,900.0 0 $74,200.0 0 $80,100.0 0 200 3 $5,900.0 0 $55,800.0 0 $61,700.0 0 Sale s Informatio n Sale s Date : 2001-11-3 0 Dee d Type : W D Sooilr ; 219 8 Page : 41 9 Price : $85,000.0 0 Grantor : Grantee : Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 1995-12-1 4 Dee d Type : D Book : 202 3 Page : 67 7 Price : $ 55,000.0 0 Grantor :


### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl.
. . 11/17/200 8

### dougla s County Accoun t In^^atio n Pag e 2 of 3

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 2 5330. 0 

### 1.0 130. 0 41. 0 N o Improvemen t Informatio n Buildin g 1

•EwSttflW M •w
it : SecondRoo r 3S4.Q«|lt. „ Firs t Floc r Detache d 5280s q f t

sc rI 1 1/ 2 STOR YFlNtSHC D

CLIC KT O ENLARG E IMAG E CLIC KT O ENLARG E IMAG E Squar e Footage : 1024. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 1 1/ 2 Stor yFi 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 : 1. 0 Roo fCover : Compositio n Shingl e Bedrooms : 2. 0

Roo fType : Gabl e 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 191 6 0 % 191 6 9 2 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Fenc e Chai n Lin k 1. 0 Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 624. 0 Fixtur e Bas e Fixture s 1. 0 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl.
. . 11/17/200 8

### Dougla s County Accoun t In^^atio n Pag e 3 of 3

Fixture Garag e Porc h Porc h Use r Bat h Ful l Detache d En d Soli d Wal l En d Soli d Wal l Atti cFul l Finis h 1. 0 528. 0 270. 0 208. 0 384. 0



### http://douglasne.mapping-onIine.coin/DouglasCoNe/static/accountinfo.jsp?accountno=Rl.
. . 11/17/200 8

### Pag e 1 of 2

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



### • YOU RTICKE TNUMBE RI S 2178349
. Origina l Cal l Date : 11/19/0 8 Time : 10:0 5 a mOp : ELIZABETH1879 0 Wor k t o Begi n Date : 11/21/0 8 Time : 10:3 0 a m State : N E County : DOUGLA S Place : OMAH A Address : 3 05 6 Street : S 33R D S T Twp : 15 NRng : 13 E Sect-Qtr : 33-NW 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 ho f Excavation : 4 f t Corne r Lot : NFront : Y Rear : Y Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N CXCAT V MUD0 2 OMAHACO F 0PPDGPR 6 QLNNEI F QWEST 2
Servic e Are a Contac t Phon e Numbe r Utilit y Typ e 

### Day : 402934046 9 CXCAT V CO XCOMMUNICATIONS , IN C 

### HEID IAlt : 402934046 9 Emerg : 402932975 7 Day : 402504782 3 MUD0 2 METROPOLITA NUTILITIE S DISTRIC TSAND Y Alt : 

### Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFIC,SEWE R 

### RO NAlt : 402444516 1 Emerg : 402444516 0 Day : 406728934 3 OPPDGPR 6 OMAH APUBLI C POWE RDISTRIC T 

### N AAlt : 888728934 3 Emerg : 406728934 3 Day : 406728934 3


### http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT.
. . 11/19/200 8

### Pag e 2 of 2

QLNN E1 FQWES TLOCA LNETWOR K N A 

### Alt : Emerg : 888728934 3
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### SAR A Day :

Alt : 800283423 7 303992192 6 Emerg : 800283423 7

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT.
. . 11/19/200 8

### 1448 2 

# As-Buil t Drawin g C OAST AL 

# Omah aLea dSuperfun dSit e ENVIRONHENTA L CROUP , IN C

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# ENTERE D Dat e Excavated:11/24/0 8 Dat e USEP ASigne d Off : 1/14/0 9 Are a Sodde d 189 8 sq ft

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## 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 : ^QS^^ ^ 'R,s^^^(;^ ^ Daytim e Phone : ^4^2- ' 2 0 §' - 7 " ^ ? 9 

## 402- 7 (4- 1 g'i- 9
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# yyj o 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 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 tjegins
. 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 unit ! th e wor k ha s bee n satisfactoril ycompleted
. Th e Granto rals o agree s to :
Pag e 1 o f2^^^••• ^ COASTA L ENVIItONHFMlA l C I 0 U r, IN C



### •Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; • Remov e flowe rbulb s o rplant s tha t th e Granto ro rth e Grantor' s tenan t ma ywis h t o save ; • Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , a s necessarysubsequen t t o a n initia l waterin g perio d b yEPA ; •Abid e b yhealt h an d safet yguidanc e provide d b yEPA ; •I fth e propert yi s rented , assis t EP Ai n obtainin g tenan t approva l fo racces s t o th e propert yt o perfor m th e work
. •Allo wvideotapin g and/o rphotographin g o fth e property
. AGREEMEN TNO TT O INTERFER E 

### Th e Granto ragree s no t t o interfer e o rtampe rwit h an yo fth e wor k activities , o rwit h an y o fth e wor k done , o rwit h th e equipmen t use d o n hi s property , o rt o undertak e an y action s regardin g th e us e o fsai d propert ywhic h vwjul 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 (712 ) 352-018 8 -jclQlgran l Q i d o no t gran t acces s t o mypropertie s I gran t access t o mypropertie s



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.

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COASTA L 

## Restoratio n Agreemen t Th e purpos e o f thi s agreement is t o provid e amutua l agreemen t a s t o condition s of the propert y prior t

o remediationactivities
. Thi s vvii l als o serv e as documentationfo r the purpos e o f assuring tha t restoration activitie s ar e completedt o the satisfactio no f th e propeit y owne r andthe UnitedState s Environmenta l ProtectionAgenc y (EPA)
. Propert y ID : /tjt/^p , Propert y Address:^(^,q ^ 5
. SV'" ^ S-f-
. Owner : 

# r£s^c(_ Q/\/<;/i jyc ^ IPhone : Jo ^ 1333 9
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nthe attache ddiagram(s ) indicat e area(s ) t o excavatedan ddept ho f excavation , locatio nof 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 dth e directiono f North
. Indicat e distances , depths , materia l types , etc . Indicat e digita l photo s b

y referencin g th e photo-lo g numbe r wit ha narro w indicating directiono f view
. Item s T o B e Remove d B yOwne rBefor e Star t O f(Remediation : (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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### % % ( ^ ^ COASTA L C R O U r. IN C 

### Item s To 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 : 

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### Item s T o B e Remove d ByContracto rDurin g Remediatio n An d Replace d (Us e additiona l sheet s a s necessary ) Item : 

# Soil - 

# ' N Item :
" ~~~~-- . 

# $.ny j y / - 

# 1^,9 - pr < ..//- / \ Item : 1 ^ Item : / Item : / Item : / Item : / Item : / Item : / Item : / Item : / Item : / Item : 

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

### Ite m 

## Quantity Uni t Condition/Type/Specie s 

# Ii i 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 Eac h trun k

diameter

Number o f tree s < = 2 inch Eac h trun k

diameter

Numbe r of Sprinkler Zones , Contro l Valves , Timers , Heads , etc . Eac h Attachasketcho f the sprinkler layout
.

Number of an dsize o f eac hgarden / flowe r bed area . Eac h Squar e Fee t Attachasketcho f relativ e size s an dlocations
.

Pag e 4 

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COASTA L IMvidONr^tMTA i c o o u r IN C 

### Ite m Quantit y Urii t Condition/Type/Specie s Agree dupo nvalu e o f plan t material s no t to be replace dbv contractor . Note thi s valu e will b e usedto issu e aplant vouche r to th e propert y owner . Agreeduponlist o f plan t material s tha t will be replace db y contractor . B e ver y specifi c an ddetailed
. Eac h Include asketchof wer e eachplant will b e placed b

y the contractor . Agreeduponare aof propert y t o b e replace d wit hgras s sod
. Include asketchof the area(s ) t o be replace dwit h gras s sod
. 

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. S F Include are a(s ) a sketchof the

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### D Chec k th e bo xi fOwne rdoe s no t wan t CE G t o documen t interio rfoundatio n wail s an d possibl e pre-existin g damage
. B ycheckin g tiiis boxCE G i s not responsibl e fo ran ydamag e don e t o th e interio ro fhouse , includin g foundatio n crack s o rfissures.



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Dept h Dept h Averag e Averag e 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 Avg
. Signatur e ^ ' Prin l /// ' < o/t^ S if ­

# 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 171.50 6 Supervise d By : 

## Certificat e o fVerificatio n

430 5 SOI L 2008-11-2 4 11:3 8 32.3 4 Fina l 1448 2 305 6 s 3 3 S t B l Ventr y 6 CLEARANC E

± Erro r ± 16.14 7

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 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 243.59 7 Supervise d By : 

## Certificat e o fVerificatio n

430 6 SOI L 2008-11-2 4 11:3 8 31.0 0 Fina l 1448 2 305 6 s 3 3 s t B l Ventr y 6 CLEARANC E

± Erro r ± 19.31 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 143.87 1 Supervise d By : 

## Certificat e o fVerificatio n

430 7 SOI L 2008-11-2 4 11:3 9 30.5 9 Fina l 1448 2 305 6 s 3 3 s t B l Ventr y 6 CLEARANC E

± Erro r ± 14.97 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 166.21 8 Supervise d By : 

## Certificat e o fVerificatio n

430 8 SOI L 2008-11-2 4 11:4 0 30.6 2 Fina l 1448 2 305 6 s 3 3 s t B l Ventr y 6 CLEARANC E

± Erro r ± 16.18 8

# 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 430 9 Mod e SOI L Tim e 2008-11-2 4 11:4 0 Duratio n 124.5 5 Sequenc e Fina l Flag s AVERAG E Av g o f4305-430 8 ADDRES S 305 6 s 3 3 S t QUAD/ZON E iB l INSPECTO R Ventr y DEPT H 1- 6 SAMPL E TYP E CLEARANC E NOT E

pp m ± Erro r P b 181.29 8 ± 16.65 5 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 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 77.03 5 Supervise d By : 

## Certificat e o fVerificatio n

431 0 SOI L 2008-11-2 4 11:4 1 30.5 4 Fina l 1448 2 305 6 s 3 3 s t easemen t Ventr y 1 CLEARANC E

± Erro r ± 11.49 2

# 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 431 1 Mod e SOI L Tim e 2008-11-2 4 11:4 2 Duratio n 30.5 3 Sequenc e Fina l Flag s BVI D # 1448 2 ADDRES S 305 6 s 3 3 s t 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 78.09 3 ±11.33 1 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-3208 9 Readin g N o 431 2 Mod e SOI L Tim e 2008-11-2 4 11:4 2 Duratio n 30.5 6 Sequenc e Fina l Flag s BVI D # 1448 2 ADDRES S 305 6 s 3 3 s t 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 90.36 6 ±12.09 9 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 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 90.53 7 Supervise d By : 

## Certificat e o fVerificatio n

431 3 SOI L 2008-11-2 4 11:4 3 30.5 0 Fina l 1448 2 305 6 s 3 3 s t easemen t Ventr y 1 CLEARANC E

± Erro r ± 12.20 2

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 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 TYP E NOT E 

## Certificat e o fVerificatio n

431 4 SOI L 2008-11-2 4 11:4 3 122.1 3 Fina l tAv g o f4310-431 3

305 6 s 3 3 s t " easemen t Ventr y ; 1 CLEARANC E

pp m ± Erro r P b ^4.00 8 ± 11.78 1 Supervise d By :

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

. •^ www.coastalhazmat.co m VpHO^" ^ COASTA L ENVHtONHENTA L GROUP , INC
. 

# EXECUTIV ESUMMARY : BVID #1448 2 - (305 6 S 3 3 ST ) 'xl No Issue s o r Concern s [] ] Issues/Concern s Detai l Explanation :

# >^^EP A EP APropert ) Clos e Ou t For m Prop«rt > P : \,L\L\fpyS ) Proptrt yAddrcM : 3D|S C 0 S - 3 3 o t Dtle/riroe : Owner' s Namt : t5vr^ P-^^^-^^^-^ ^ "RcUZr^^t ^^9 ^ Qu«d 5 E»c»v«lfd : ^ 1 Conlrsrto rCrou p Qtsy^ S.'Vt.'-J ^ "^^xA r Q <-N>AJ^'^'^ H
LxcivBtlo n Gencn l Ye s N o 1 I fnecessi^ , wer t ih t conrc l quadrani(s ) cxcavalt d an d reslored ? y 2 I fnecessary , wer e th e correc t area s o fdri p zon e excavaie d an d restored ' 

# it\ CradlD KSo d an d VctcUlio D Ve s N o 1 Doe s th e gradin g aroun d ih e perimele ro fth e hous e i n excavate d area s generall yslop e awa y s y from Ih e house ? 2
. Ha s so d bee n lai d i ral l area s Iha t wer e excavated ? 

# y 3
. Doe s th e so d appea rt o b e generall yhealth yan d growing' ' (Onl yevaluat e i finspecie d at a 3 0 da ylim e period ) 

### y A Ar e sodde d area s generall yfir m an d evenl ygraded' ' ^ 5 Ar e th e joint s berwce n Ih e so d stnp s generall ytight ? (Onl yevaluat e i fmspecie d a i a 3 0 da y y tim e period ) 6 Wa s th e properr ygrade d suc h tha t wate rwil l no t poo l o n th e propeny' ' 

### y 7 Wa s damag e t o landscapin g o rplan i material s avoided' ' 1 y Galtt
. FePCC Tan d ReUinin g W«ll i \t* , N o I D o gale s ope n an d clos e fre«ly' ' (Ifapplicable ) 2 Wer e al l gate s o rfence s take n dow n durin g resloralio n activiiie s reinstalled' ' (I fapplicable ) 

# i i 3 Wa s damtg e t o gate s o rfence s avoided ? (Ifapplicable ) 4 Wa s damag e t o retainin g wall s avoided ? (Ifapplicable ) 

## f/A Fouod i ition , SidiB Kan d Cutler s Ye s N o 1 Wa s damig e t o th e sidin g o rtri m avoided ? l y 2 Wa s damag e t o th e foundatio n avoided ? 

## y 3 Wa s damag e t o window s avoided' ' 

# y 4 VV'a s damag e t o window s o rdoo rscreen s avoided' ' 

### y 5 Wa s damag e l o dowTispoui s o rdownspou l exiension s avoided ? y Sidewalk a an d Driveway s (CoDcrelt ) Ve s N o Wa s damag e l o drivewa ysurface s avoided' ' 

## y 2Wa i damag e l o walkwa ysurface s avoided' ' 

### y

### O »Der s comments :

Inspectio nnotes :

Remova l an d resloralio n aclivale s complel e incluciin g ih e 30-(Ja yso d warrant y ^//^/^ ; FP ARenrp^pnt;iliv p HQW

## Propert yCompletio n Agreemen t
'ilii s agretiinen i clocumenl s th e complclio n o f remedia l activiiie s perromie d o n m yproperty
. M ysignatur e wil l designat e Iha t I a m sati,sJie d will i tli e restoratio n o f m yproperly , an d tha t n o itcm. s ar e i n question.s , now . o ra t an ytim e i n th e fiiliire , excep t thos e ilem. s liste d below , ifany
.

Ovvncr : J ^ OjS^yjo ^ R\S^\\ ' WC V
._ PJjonc ; -^ ~ Restoratio n Item s i n Question :

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


# L

I agre e re.stomtio n i, \ completed , excep t a s note d I I I il o no l aerc cresloratio n i s complete d
/ 

# iJzojo ^ ^x ^ ,,iH-y i r' s Signnliir c z^ ) Dal e Contractor' s .SijJiuatiice ' Dal e

# Q \ ^ ^

l•./l>^ ' 

# RESTORATIO NCHANG EORDE R OMAH ALEA D Propert y ID #/ VVS^ ^ Propert y Addres s 3 ^ -^ ^ S ^ \S~ ^ Owne r Name ~^O^r\{jc ^ i\'sUlinc ^ Dat e / / /^^/o 9 Comment s 7^k<

- OU- hConc\r<yr < u/^^lk ^ o n-j-J —

Owne r Signatu n