## TRANSMITTALo f

OMAHALEA D SIT E SOILREMEDIATIO NFIL EFOLDE R
SAID# ' 

# 1<U \ ^^ Ul l l Date 

## Address ^^ K 'jb^t ^ 4 f Remediatio nConliactor : Coasta l Environmenta l Grou p Year : _2010ARRA
_ 

### SOI LREMEDIATIO N PROPERT V FIL EFOLDE RDOCUMENT S 

# i/ Vide o o f property (DVD ) Executiv e Summar y EPA-provide dproperl y sketc h / 

### Signe dAcces s Agreement fo r subjec l property Signe dAcces s Agreement(s ) fo r adjacent property Restoratio nAgreement Settlemen t document s (i.e. , fo r damag e or to replac e plants , etc. ) Confirmatio ndata Photograph s \ k ^Cfi(\l(^0 ^ \QCQ^V^Tl ^ ^ io ^ As-buil l sketc h Satisfactory restoratio nsigne db y Property Owner Property close-ou l check lis l signe db y EP A Descriplio no f area s not meetin g RO D cleanu p criteri a Utility clearance s 

# t / Property infonnatio nfro mDougla s County Assessor' s Offic e

Date 3021893 3 

# I I Superfun d

# vv Propert yAcces s Checklis t PropertylD : <^S ? / | Propert y Address : '^^]C:;

­ C^ j 

## S(UJ ^ D DWOR K STARTE D WOR K COMPE LIE D ON : ON : / // /
I Owner : fI'M 

# klyO ^

Address : - ^ 

## QyTO/JA^, rr O lgB\ \ Phone ; (o'bO-tO^lt ^ Fax : Renter : Phone : Fax : CeU/Pager : Additiona l Information : CeU/Pager :

nNotificatio nLette r I Acces s Agreemen t -'Restoratio nAgreemen t Topsoi l SampUn g (i f appUcable ) nDisposal Samplin g (i f applicable ) Q Garde nSampUn g (i f applicable ) Q UtiUt y Clearanc e 

# m Video/Photo s (Before ) D Video/Photo s (During ) D Video/Photo s (After ) D Video/Photo s (30-Day ) [~ | Propert y Completio nAgreemen t Sent : / / By : Signed : M jL^I I H °y' ^

V^-c V Signed : / O 1 ^ I Q By : w,o« ^ / / By : / / By : / / By : CaUed : \ x /\/ v » By : VV/>>A Q 

## On : _li2ny i L O By : v^'o*

- On : / / By : On : / / By : On : / / By : Signed : / /
. By : v»:>i^> ^

nFina l Repor t Issued : / By : Ai r Monitoriu K (a s appUcable )
• Conununit y • Cre w Results : On : / / 

### By : 1

• Communit y Results : • Cre w On : / / By :

• Communit y Results : O Cre w On : / / By :

Omah a Lead Stte

### Dougla s Cotmty Accoimt I;

i^j^ion Pag e 1 of 2 

# n
Dougla s County , Nebrask a Propert yRecor d - R164144000 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 HYD E FRE D 351 8 CHARLE S S T OMAH AN E 68111-OOO O Propert yInformatio n Ke yNumber : 414 4 000 0 1 6 Accoun t Type : Residentia l Parce l Number : 164144000 0 Parce l Address : 351 5 SEWAR D S T OMAH AN E 68111-000 0 Lega l Description : LOWE S AD D LO T4 BLOC KQ W1/ 2 3 0 X 127. 5 Valu e Informatio n Lan d //nprove/ne/i f Tota l 201 0 $500.0 0 $0.0 0 $500.0 0 200 9 $500.0 0 $0.0 0 $500.0 0 200 8 $500.0 0 $0.0 0 $500.0 0 200 7 $500.0 0 $0.0 0 $500.0 0 200 6 $500.0 0 $0.0 0 $500.0 0 200 5 $500.0 0 $0.0 0 $500.0 0 

### Sho wAl l Transaction s

Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.0 8 3810. 0 0. 0 127. 0 30. 0 Ye s



### http://douglasne.mapping-online.eom/DouglasCoNe/static/accoimtinfo. j sp?accoimtno= R164..
. 9/2/201 0I 

### 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 2630920
. Origina l Cal l Date : 11/01/1 0 Wor k t o Begi n Date : 11/03/1 0 Time : 10:5 8 a m Time : 11:3 0 a m Op : ELIZABETH1879 0
State : N E Address : 351 5 County : DOUGLA S Street : SEWAR D S T Place : OMAH A Twp : Twp : 15 NRng : 13 E Rng : Sect-Qtr : 16-NW,17-N E 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 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 : Y Involve s Tionneling 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 Contact 

### Phon e Numbe r UtiUt y Typ e
CXCAT V CO X COMMUNICATIONS , IN C HEID I 

### Day : 402934046 9 Ah : 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 Ah : Emerg : 402504797 0

OMAHACO FCIT Y O FOMAHA-TRAFFICSEWE RRICHA'RAFFI C 

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

### Pag e 2 of 2

OPPDGPR 5 OMAH APUBLI C POWE RDISTRIC T ELM LOCATIN G 

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

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

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 11/1/201 0

### 2581 1 

# As-Buil t Drawin g COASTA L 

# Omah aLea dSuperfun dSit e ENVIRONHENTA L GROUP , IN C OLS# : 2581 1 Dat e Excavated : 11/4/201 0 Dat e USEP ASigne d Off : 11/30/20 r Are a Sodden : 74 0 s a f t Exteno rPain t Omah a Lea d Sit e inn«r r •Goo d Stt e Sketc h •Poor Samplin g Address : 351 S SEWAR D S T Q^o t pain t Lea d Sampl e Sample s Collecte d Sampl e Numbe r LA B Concentratio n Collecte d Firm : PET«

- DT, CI
. RYASCPXA-2581 1 F l 2.85 " pp m 

# n Date : nllfilo i RYBSCPXA-25ei 1 F 2 332
. oo m 

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## . A ^ Legend : F l = Fron t Left , F 2 = Fron t Right , B 1 = Bac k Left , B 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , P Z = Pla y Al l quadrant s ar

e a

s viewa d from th e street , facin g proper wALLEV



### 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 Grou p Inc .\ . V 

# 2581 1 

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### Omah a Lea d Sit e •Goo d 

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COASTA I IMTItONMINTA I C I 0 U P > H C 

## Consen t fo rAcces s T o Propeft 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 : ^ ^;= ^

i / Daytim e Phone : ^30-^OS7 ^ Owner' s Name : f-^^^ fHi^dt ,

Addres s o fPropert y 

## 55V5 ^ ^^of dy^ ^ covere d b ythi s Agreement : 

### PURPOS E O F RESPONS E ACTIVITIE S 

### Th e EP Ai s requestin g acces s t o c:ollect 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 i 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 rais o agree s to :

Pag e 1 o f2V^^-< ^ COASTA L



### « 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 necessar ysubsequen 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
. c^

Allo wvideotapin g and/o rphotographin g o fth e property
. AGREEMEN T NOTT O 

### INTERFERE 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 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 Q I d o no t gran t acces s t o mypropertie s 

# .^y,>^,^ ^ «>'<1-< 0 ^ Signatur e ^ ^=;*^ ^ '^ Date Signature Date

Q I woul d lik e t o b e presen t durin g an ysamplin g tha t I s required
.

Page 2 o f2

### ^ COA S T AL GROUP , 

## Restoratio n Agreemen t The purpos e ofthi s agreemen t i s to provide amutua l agreemen t a s to condition s ofth e propert y prior to remediationactivities
. Thi s will als o serve a s documentationfo r

the purpos e of assuring tha t restoration activitie s ar e completedto the satisfactionof the propert y owne r an dthe UnitedState s Environmenta l ProtectionAgency (EPA)
.

Propert y ID : Z-S'^ H Propert y Address : ^S'^IS ' ^^:^o<?<c< r " ^ Owner : 

## fre. A Phone : 

# Alo , ^ ^ 

### O

nthe attacheddiagram(s ) indicat e area(s ) to excavate , surface structure s an dlandscapin g feature s an d acces s location(s ) t o b e usedby the contractors . Indicat e distances , depths , materia l types , etc . Photographicall y an dVideographicall y docimien t the existing condition s ofth e propert y an dthe basemen ti

f necessary . 

## Item s t o b e Remove d b yth e Owne rbefor e Start o f Remediation : Th e removal, storage , disposal , and/o rretum o f thes e item s i s th e Owner' s responsibility. Item :



## . yUot^
_ Hem : Kem : Hem :



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

# M ^ ^
Hem :
Hem :
Item :

Page l 

# •^J -

### k^ COA S T AL • NVinONHI N T * L O n O U P , IN C 

## Item s t o B e Remove d B y Contracto r Durin g Remediatio n an d Replace d Hem : 

# - S ^ Item : 

# S ^ Hem :
Hem :


## Landscap e Inventor y Item Quantity Unit ConditionH'ype/Specie s Pre-existin g property area , Quadrant s 

# B ( tbia t wil l b e excavated , that i s coveredwithgrass . Numbe r o f tree s > 2 inc h Eac h trunk diamete r ; Nimibe r o f tree s < = 2 inc h Eac h 

# £ r trun k diamete r Numbe r o f Sprinkle r Zones , Contro l Valves , Eac h Timers , Heads , etc . Attac hasketc her f th e 

### / ^ sprinkle r layout
. Numbe r o f an dsiz e o f eac hgarden/ flower be d Eac h area . Squar e Fee t Attac hasketc ho f relativ e 

# P

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 

# 0

use dt o issu e aplan t vouche r t o th e propert y owner . Easemen t Aiea , t o b e excavate d 

# ^O^ x Eac h 

# DenJt ^ /S-fe^^ ^
Pag e 2 of
. 

# 1COASTA L GROUP , IN C
AddKiona l Comment s / Instructions : Th e cit yo f Omah a ordinance s ma yprohib H yo 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 Agenc y(EPA ) ma yb e removing an d replacing 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 , t f thi s i s th e case , yo u shoul d understan d tha t thi s removing an d replacing o f soi i 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 wKhstandin g an yremova l o rreplacement o f soi l b yth e EP A I fyo u hav e an yquestio n abou t legalit yo f a certai n drivewa yo rparkin g area , yo u ma ycontac t th e cH yo f Omaha' s Plannin g Departmen t a t (402 ) 444-5150
. O Pleas e chec k thi s bo xi f yo u underetan d th e infonnatio n outline d above
. 

# ' ^ Q^u t 2^ 7 A V- y^^^' ^ 

# ce ^

G Chec k th e bo xi f Owne 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 f house , includin g foundatio n crack s o rfissures
.



# [Ei a nI d o no t agre e I agre e

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# IVli ^ M^W i

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

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Supervise d By : 9 3 SOI L 2011-01

­ 90.6 2 Fina l 

## Certificat e o fVerificatio n

2 5 14:4 9

Av g o f90-9 2 351 5 SEWAR D EA 1 " C.PADIL U 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 163.40 4 Supervise d By : 

## Certificat e o fVerificatio n

9 0 SOI L 2011-01-2 5 14:4 7 30.2 1 Fina l 2581 1 351 5 SEWAR D E A 1 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r ± 19.53 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 141.78 0 Supervise d By : 

## Certificat e o fVerificatio n

9 1 SOI L 2011-01-2 5 14:4 8 30.2 2 Fina l 2581 1 351 5 SEWAR D EA 1 " C.PADIL U CONFIRMATIO N CLEA R

± Erro r ± 18.58 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 149.64 8 Supervise d By : 

## Certificat e o fVerificatio n

9 2 SOI L 2011-01-2 5 14:4 9 30.1 9 Fina l 2581 1 351 5 SEWAR D E A 1 " C.PADIL U CONFIRMATIO N CLEA R

± Erro r ± 18.99 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

8 9 SOI L 2011-01-2 5 14:4 6 90.7 7 Fina l Av g o f86-8 8 351 5 SEWAR D B l 4 " C.PADIL U 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 305.97 2 Supervise d By : 

## Certificat e o fVerificatio n

8 6 SOI L 2011-01-2 5 14:4 5 30.2 2 Fina i 2581 1 351 5 SEWAR D B l 4 " C.PADIL U CONFIRMATIO N CLEA R

± Erro r ± 26.24 7

# 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 328.02 8 Supervise d By : 

## Certificat e o fVerificatio n

8 7 SOI L 2011-01

- 2 5 14:4 6 30.2 5 Fina l 2581 1 351 5 SEWAR D B l 4 " C.PADIL U CONFIRMATIO N CLEA R

± Erro r ± 26.98 6

# 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 387.47 8 Supervise d By : 

## Certificat e o fVerificatio n

8 8 SOI L 2011-01-2 5 14:4 6 30.3 0 Fina l 2581 1 351 5 SEWAR D B l 4 " C.PADIL U CONFIRMATIO N CLEA R

± Erro r ± 29.28 2

### ^^ jO k >& \ Omah Omah a a Lea d Site—Fixe d Pric e EP-R7-07-0 5

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Coasta l Environmenta l Grou p Inc
. ^ V j f www.coastaihazmat.co m ' ^

%Pi.ote 6 COASTA L INVItONMIHTA l C 1 0 U r, IN C 

# EXECUTIV ESUMMARY : BVID #25811-(351 5 Sewar dSt )
No Issue s or Concern s | ^ Issues/Concern s Detail Explanation : -DA NGARVE Y WALKE D TH EPROPERT Y

ON11/30/1 0

## EP APropert y Clos e Ou t For m 

# 5r/5 ^ 3^ujctd<^ r Proptrt y# : 

# ^^1 1 Propert yAddress: * • Date/Time : Owner' s Name;
. /4
. Quad s Excavated ; ^ | Contracto rGrou p Excavatio nGenera l 1
.I f necessaiy , wer e th e correc t quadrant(s ) excavate dan dreslored ? 2
.I f necessary , wer e th e correc l area s ofdri p zon e excavate dao drestored ? Gradln s So dan dVcffetatlo a 1 Doe s th e gradin g aroun dth e perimete r ofth e hous e inexcavate darea s generall y slop e away fromth e house ? 2
. Ha s so dbee nlai di nal l area s that wer e excavated ? 3
. Doc s th e so dappea r t o b e generall y health y an dgrowing ? (Onl y evaluat e i f inspecte da t a3 0 da y tim e period ) 4
. Ar e sodde darea s generall y firman devenl y graded ? 5
. Ar e th e joint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat e i f inspecte da t a3 0 da y tim e period ) 6
. Wa s th e propeit y grade dsuc hthat wate r wil l no t poo l onth e property ? 7
. Wa s damag e t o landscapin g o r plant maierial s avoided ? Gates , Fence s an d RcuhilD s Wall s 1
. O o gates ope n an d clos e freely? (Ifapplicable ) 2 , Wer e al l gate s o rfences take n dow n durin g restoralio n aclivilie s reinsialied ? (I fapplicable ) 3
. Wa s damage t o gate s o rfences avoided ? ( 1 fapplicable ) 4 Wa s damage t o retainin g wall s avoided ? ( 1 fapplicable ) Foundation , Sidingan dGatttn t .Wa s damag e t o th e sidin g o r tri mavoided ? 2
.Wa s damag e t o th e foundatio navoided ? 3
. Wa s damag e t o window s avoided ? 4 Wa s damag e t o window s o r doo r screen s avoided ? 5
.

Wa s damag e t o downspout s o r downspou i extension s avoided ' Sidewalk s an d Driveway s (Concrete ) 1
. Wa s danng e t o drivewa y surface s avoided ? 2 , Wa s damag e t o walkwa y surface s avoided ? Yes N o ^ / Ye s N o / / / 

# y / / 

## J Ve

s No / / 

# J y Ye s N o / / / 

## y / 1 Ye s N o

## Ort'oer s comments :

1 _^^_ ^ . __^_
_ 

## n!n.*!pectionnotes :

Removal andrestoratio nactivate s complete includin g the 30-da y so dwarranty : EP ARepresentativ e ^ J ^ Date : uhojio

## Propert yCompletio n Agreemen t Thi s agreemen t documenl s th e compiclio n ofremedia l aclivme s perloime d o n mypioperi yM ysignalui e wil l designat e Iha t I a m satisfie d wil h th e restoratio n o fm yproperly , an d lha ( n o item s ar e i n questions , now , o ra l an ylim e i n th e fuluie , excep l thos e ilem s liste d below , i fan y

Propert y ID : ^ ^ / | Propert yAddress : ^5~[< ^ SeoQC^ ^ ^ Owner : 

## f=7Ml Phone : / ^ ^Q- ^ ^^^' f L J Restoratio n item s i n Question :

Item : Item :

• •••unU^w aI • Wll
. UUJI
. Item : Item : Item : Item : Additiona l Comments :

I Hgrc c(c^tomlio n i t complcCed , rxccp l a s nole d [_ j I d o no t A|>re crestoratio n i; ; complele d



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