## TRANSMITTALof OMAHALEAD SIT E SOI LREMEDIATIO NFIL EFOLDE R

SAID# : lyy^J y Date : _ Address : ^^\\ < l^nV^fif ^ ^ < Remediatio nContractor : Coasta l Environmenta l Group

_Year : 200 8
SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S 0 Vide o o f property (DVD ) 1 H ^ ^/l^^n:lyv ^ 0 Executiv e Summary EPA-provide dproperty sketc h Signe dAcces s Agreemen t for subjec t property <& • Signe dAcces s Agreement(s ) for adjacent property p ' Restoratio nAgreemen t 0 Settlemen t document s (i.e. , for damag e o r t o replac e plants , etc. )

- & Confinnatio ndat a Photograph s jf^i^^lo ^ ^ fU ^ bcC^^r(U ^ ^ 

### As-buil t sketc h
^ Satisfactory restoratio nsigne db y Property Owne r UProperty close-ou t chec k lis t signe db y EPA -S ~ Descriptio no f area s no t meetin g RO D cleanu p criteri a Utility clearance s ^ / 

### Property informatio nfro mDougla s Coimt y Assessor' s Offic e

Superfun d\



### Propert yAcces s Checklis t Propert , ID : 2-'6 M Xl " D WOR K STARTED ON : / / D WOR K COMPELTE D ON : Properl yAddre» : y^\\f ^ DaVenfiDT ^
Rente r Owner : H\(^hCtC^ \ CD^

. Address : Phone : 

## "SavYut P«.\ : Cell/Pager : Phone : l^y ^ - -]5 C ^ Additiona l Inl'nrmittion : Fax : Ccll/Pager
.
D Notifieatio n Lette r Sent : / / By : H i Accesj fAgreemen t 

### Signed: JI/]3_/t] ^ B> = ^hiAMe ^ H ) Restoratio n Agreemen t 

### Signed: J2/]3./Q9

. ^ yV^^hPtAHj i D Topsoi l Semplin g (i f applicublc ) / / By : D Disposa l Samplin g (i f applicable ) / / By : D Garde n Samplin g (i f applicable ) / / By : • ^ ll| i lif yClearanc e 

### Called : 7_/2j/£ 4 

## B>:7/5^/f7 9 [5

^ Video/Photo s (Before ) 

### On-.Z.'JH'(2 S 

## ">• •Vcn-h/r\ / D Video/Pholo s (During ) On : / / By : ' D Video/Pholo s (After ) On : / / By : D Video/Photo s (30-DJI> ) On : / / By : D Propert yCompletio n Ajjreemen t Signed :/ / By : D Fina l Repor t Issued : / / By : Ai rMonitorint ! (* s applicable )

D Communit yO Cre w On : / / By : 

# 1 Results : D Community ' D Cre w On : / / By : Results :

n Communit ) D Cre w On : / / By : 

# 1 Resulb :

Omah a Lea d Sit e

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

Comment : Owne r Commen t (s) :
Sit e Coordinato r Commen t (s) : CONTAC T FOR M l_7^^1.1
_ 

# ^\^' ^ V^v^yvyoH Date : Time : Action :

Date : Time : Action : Date ; Time ; Action ; Transmi t to EP AD Othe r Action : D

### Dougla s County Accoimt InfornM^o n Pag e 1 of 3 rnM^ o
Dougla s County , Nebrask a Propert yRecor d - R131545000 2 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-5 0 ft wes t o f52n d S t - ViewOf l Ma p Informatio n i s vali d a s o f2009-6-1 6 Treasurer' s Ta xRepor t Ne wFeatur e ->••"•Aut o Sale s Searc h Owne r CO E MICHAE L D
311 5 DAVENPOR TS T# 7 OMAH AN E 68131-000 0 Propert yInformatio n Ke yNumber : 154 5 000 2 1 3 Accoun t Type : Multipl e Com m Parce l Number : 131545000 2 Parce l Address : 311 5 DAVENPOR TS T OMAH AN E 68131-000 0 Lega l Description : HILLSID E ADD- 1 LO T1 0 BLOC K6 LOT S 9 & 1 0 BL K6 IRRE G Valu e Informatio n Lan d Improvemen t Tota l 

### 2009 $18,300.0 0 $97,900.0 0 $116,200.0 0 200 8 $18,300.0 0 $97,900.0 0 $116,200.0 0 200 7 $18,300.0 0 $82,300.0 0 $100,600.0 0 200 6 $18,300.0 0 $82,300.0 0 $100,600.0 0 200 5 $18,300.0 0 $82,300.0 0 $100,600.0 0 200 4 $18,300.0 0 $82,300.0 0 $100,600.0 0 Sale s Informatio n Sale s Date : 2000-07-2 7 Dee d Type : W D Sooilr ; 216 0 Page : 19 4 

### Price : $3,000.0 0 Grantor : Grantee : Valld/lnvalld : Invali d Exclusio n Reason : Sale s Date : 2000-07-2 7 Dee d Type : Book : 216 0 Page : 19 7 Price : $142,000.0 0 Grantor :


### http://douglasne.mapping-online.com/DouglasCoNe/static/accoimtinfo.jsp?accoimtno=Rl31.
. . 7/7/200 9•• • 

### Dougla s County Accoun t InfornM^o n Pag e 2 of 3 rnMgc
Grantee : Valid/Invalid : Vali d Exclusio n Reason : Multipl e 45 1 -Part i In t Vali d Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.2 6 11574. 0 1. 0 0. 0 0. 0 N o Improvemen t Informatio n Buildin g 1

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### „ CLIC KT O ENLARG E IMAG E Squar e Footage : 4760. 0 Percen t Complete : 100.0 % Perimete r 228. 0 Quality : Averag e Uni t Type : Condition : Fai r

Buil t As : Apartmen t < = 3 Storie s Cond o Squar e Footage : ' 0. 0

HVAC : i Force d Ai r Rooms : i 0. 0 Exterior : ; Masonr yCommo n Bric k Units : i 8. 0 Interior : Plaste r Baths : 0. 0 Roo fCover : ! Buil t U p Roc k Bedrooms : 0. 0

Roo fType : ; Flat Stories : 2. 0 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : : 0. 0 Yea r Percen t Adjuste d Yea r YearBuii t Physica l Ag e Remodele d Remodele d Buil t 191 0 191 0 9 9 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Porc h Ope n 50. 0 Ad d O n Porc h Ope n Uppe r 40. 0 Ad d O n Porc h Ope n Uppe r 40. 0 Ad d O n Porc h Ope n Uppe rDec k 40. 0


### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R l 31..
. 7/7/200 9

## Douglas Count y Accoun t Informanon Pag e 3 of 3 irnM^

Ad d O n Porc h Ope n Uppe rDec k 40. 0 Ad d O n Porc h Ope n Uppe rDec k 120. 0 Basemen t Bsmn t Bloc k 8 ft 2380. 0 Basemen t Finishe d 1190. 0



## http://douglasne,mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl31..
. 7/7/2009

### Pag e 1 of 2

" > Creat e Anothe rticke t Bac k t o Irt h Interne t I Sen d Emai l , |



### YOU RTICKE T NUMBE RI S 2349962
. Origina l Cal l Date : 8/26/0 9 Time : 9:5 1 a m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 8/28/0 9 Time : 10:1 5 a m State : N E County : DOUGLA S Place : OMAH A Address : 311 5 Street : DAVENPOR T S T Twp : 15 NRng : 13 E Sect-Qtr : 21-NW Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : LEA D REMEDTIATO N Locatio n o f Work : INCLUD E AL L EASEMENT S LOCAT E ENTIR E PROPERT Y Remarks : FAX 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 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 Number Utilit y Typ e Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , IN C HEIDI Alt : 402934046 9 Emerg : 402932975 7 Day : 877366834 4 LEVEL S LEVEL S COMMUNICATIONS , LL C N AAlt : Emerg : 877366834 4 Day : 402504782 3 MUDO l METROPOLITA NUTILITIES DISTRIC T SAND Y Alt : Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFICSEWE RRO NAlt : 402444516 1 Emerg : 402444516 0

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 8/26/200 9

### Pag e 2 of 2
•


### OPPDGPR 5 OMAH APUBLI C POWE RDISTRIC T N A Day : 406728934 3

Alt : 406207149 4 Emerg : 888728934 3 QLNNEI C QWES 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.
. . 8/26/200 9

# As-Buil t Drawin g ^ ^ COASTA L 

# Omah aLea dSuperfun dSit e
2342 2 Exterio rPain t Nort h ArTCT W Omah a Lea d Sit e n.«oo d Sit e Sketc h U l Poo r Samplin q Address : 311 5 DAVENPOR TS T Q No t pain t 

# r Sampl e Numbe r Lea d Sampl e Sample s Collecte d 

# I LA B Concentratio n Collecte d Firm : F M V&A S RVASCPXA-2342 2 F 1 p p m 

## 11 3 

# • Date : jp-Z.3-<^f o RVBSCPXA-2342 2 F 2 p p m 

# n Time : T^'-Z- o /yiv\ RVCSCPXA-2342 2 8 1 «0- 7 p p m 

# n Sample s Analyze d RVDSCPXA-2342 2 8 2 

## 25a , p p m 

## D RDZSCPXA-2342 2 D Z 

## qft f pp m 

## D XR F Unit : GSHryBook : 2.2. H RGZSCPXA-2342 2 G Z 

## 35< ^ p p m 

## D Date : 1 1 - 2. 0 -0 & RrZOCnXA-2342 2 P E pp m 

## D Time : Prr ^ Staff : Numbe ro f Sam p 

## msu ? Legend : F 1 = Fron t Left , F 2 = Fron t Right , 8 1 = Bac k Left , 8 2 = 8ac k Righ t D Z = Dri p Zone , G Z = Garden , P Z = Pla ; A H quadrant s ar e a a viewe d fro m th e street , facir> g propert y OLS# : 2342 2 Dat e Excavated : 8/31/0 9 NO V V 9 200 8 Dat e USEP ASigne d Off : 9/22/0 9 Are a Sodden : 70 2 s a f t
.



### Legen d Dri p Zon e Excavate d Concret e Quadrant s Excavate d Are areplace dwit 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
.

# NQVVp^^ f

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### [1 5 2fi l pp m pp m pp m pp m Sampl e Collecte d 

# I LA B 

### D D 

## n n Firm Dale : Time : Sarnple s Collecte d nAt>0A J fP-li-g?: ) T^'Z- u prv \

Samples Analyze d RDZSCPXA-2342 2 D Z pp m 

### D XR F Unit : CxSH n Book : 2.2 M RGZSCPXA-2342 2 G Z pp m 

### D Date : \ l ­ Z O -Of i RrgCiCPXA-2342 2 -P 2 pp m 

### D Time : -JO ^ Numbe ro f Sample s = |_u | | Q [ Staff : 

## r^L o Legend : F 1 = Fron t Lett , F 2 = Fron t Right , B 1 = Bac k Lett , 8 2 = Bac k Righ t D Z = Dri p Zone

. G Z = Garden , P Z = Pla ; A H quadrant s ar

e a

s viewe d fro m the street, facing propeft y 

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# i LA B Concentrafio n Collecte d Fir m fh ^ P0A J RVASCPXA-2342 2 F l pp m 11 3 D lO'Z-i'O h Dat e RVBSCPXA-2342 2 F 2 2s 7 pp m D ^•t o pr^ Tim e RVCSCPXA-2342 2 8 1 ^ flOl pp m D Sample s Analyze d RVDSCPXA-2342 2 8 2 2 5 CP pp m D RDZSCPXA-2342 2 D Z -^r9 fi I pp m D XR F Unit : GSH n Book : 2.2 ^ RGZSCPXA-2342 2 G Z ~ 3 5* ^ D pp m Dat e ; / - zo-of i RPZOCnXA-2342 2 P 2 ~ pp m D D Time : ' t ^ Staff : pr>Sb J Numbe ro fSample s = I fcy | | f ) | Legend : F l = Fron t Left , F 2 = Fron t Right , 8 1 = Bac k Left , B 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , P Z = Pla v Al l quadrant s ar e a s viewe d fro m til e street , facin g propert y ^,Vo : KDV ) 9Z0D 8

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# I LA B Conceniratio n Collecte d Fir m RVASCPXA-2342 2 F 1 

## 11 3 pp m 

### D Dat e \0'li'O h RVBSCPXA-2342 2 F 2 

## 2R 1 pp m Tim e T-'-tO ; 

## n RYCSCPXA-2342 2 B 1 pp m Sample s Analyze d RVDSCPXA-2342 2 B 2 

### 250 > pp m 

### D RDZSCPXA-2342 2 D Z 

## n pp m XR F Unit : CtSt-i n Book : 22. H RGZSCPXA-2342 2 G Z 

### -3S q pp m 

## n Date : l l - 2. 0 -Of i RPZOCPXA-2342 2 -P Z pp m 

# • Time : & n Staff : Numbe ro fSample s = [ fc> | | (- ) | 

## mts( ^ Legend : F l = Fron t Left , F 2 • Fron t Right , B l = Bac k Left , 8 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , P Z = Pla i Al l quadrani s ar e a s viewe d fro m tti e street , facin g propert y



# 4^f t (^CH\ t

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### 2342 2 Omah a Lea d Sit e Exterio rPain t Nort h AiTo w Sit e SIcetc h msoo d [£ | Poo r Samplin g Address : 311 5 DAVENPOR TS T •No t pain t Sampl e Numt)e r Lea d Sampl e Sample s Collecte d 

# I U B Concenlraiio n Collecte d Finn : ftyl P^A J RYASCPXA-2342 2 F l pp m 

### D Date : |P

- Z.?>-/>h RYBSCPXA-2342 2 F 2 

### ^ pp m 

### D Time : l-'-Z- o pm RYCSCPXA-2342 2 B 1 

## ftp 

## 7 pp m 

### D Sample s Analyze d RYDSCPXA-2342 2 8 2 pp m 

### D RDZSCPXA-2342 2 D Z p p m 

### D XR F Untt : GSt4 n Book : 2.2 H RGZSCPXA-2342 2 G Z 

## 3g q pp m 

### D Date : l l - 2. 0 -Of e RPZaCPXA-2342 2 P E pp m 

## D D Time : Pi ^ Staff : __CQSL 2 Numbe r o

f Samples " I( y \| Q Legend : F l = Fron tLeft , F 2 = Fron tRight , B l = Bac k Left , B 2 = Bac k Righ tD Z " Dri p Zone , G Z - Gaiden , P Z = Pla ; Al l quadrants are a s viawad (nx n th e street , bdn g propert y |



### pqyct^fpr^
. Rc\-2<» S (.-leaal : IO-Sei>Ji 8COASTA L ENVIRONMENTA L ^ t PRO ^ Clour

. INC

. 

## 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 Nam e Daytim e Phone : 

# Mim^ LC6 ^ 4o 7

Addres s o fPropert y 

# 2 A ^ covere d b ythi s 

## l^A^e^^o^ 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 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 fCoastal 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 

### Bysignin g thi s Acces s Agreement , th e Granto ri s grantin g th e EPA , it s employees , contractor s an d subcontractors 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 :

Pag e 1 o f2COASTA L .<P * ENVIRONHENTA L CROUP , 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 wori cactivities , 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



# [J\ i gran t access t o m ypropertie s D I d o not gran t access t o m ypropertie s 

# 1 TKAJ

- ^ Signatur e Dat e Signatur e Dat e

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

.

Pag e 2 o f2C » H S T^ L



### Th e purpos e o f thi s agreement i s to provid e amutual agreement a s t o condition s ofth e propert y prior t

o remediatio nactivities
. Thi s will als o serv e a s documentatio nfo r th e purpos e of assurin g that restoratio n activitie s are complete dto th e satisfactio no f th e propert y owne r andth e UnitedState s Environmenta l Protectio nAgency (EPA)
. j Property IP : •'^J)^']f U

. Property Address : ^^g , 'P%V^€V^\;)OC V ^= ^ \Owner : 

## >KArMr \ Cr ^ p^o--

- lAV^-^2 ^ Onth e attache ddiagram(s ) indicat e area(s ) to excavate , surfac e structure s an dlandscaping feature s an d acces s location(s ) to b e usedby th e contractors . Indicat e distances , depths , materia l types , etc . Photographicall y an dVideographically document th e existin g condition s ofthe propert y andth e basemen t i

f necessary . 

### Stoms to b e Remove d b yth e Owne rbefoi cSts KofRemediation : I ii j .c-r.ovfi

. g'iOfcce , c-is/ObLl , i.:\Ktl:^i iEt.;f." i o. ' ttn..Vf e tifcmf cii - Lfii^

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. 

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## [tgiYtsj o B e RemovedE y Contracto r Durin g Remedtatioii an dReigtace d

Landscap e Inventory Item Quantity ' Unit Condition/Type/Specie s Pre-existin g propert y area , 

# 5' Quadrant s tha t wil l b e excavated , tha t i s covere dwit hgrass . Numbe r o f tree s > 2 inc h Eac h ^ trun k diamete r Numbe r o f tree s < = 2 inc h Eac h 

# 3 trun k diamete r Numbe r o f Sprinkle r Zones , Contro l Valves , Eac h Timers , Hearts , etc . 

# v ^

Aliac hr . skeicl i ul lli f iftMUt' i l;;u-.u ; Numbe r o f an dsiz e o f eac hgarden / flowe r be d Eac h area . Squar e Fee t ; Alliicl i ; i ski'icl i Cl l rfliiiiM ' iiZCf
. Hltc i l^>c;llillM. ^ Agree dupo nvalu e o f plan t material s no t t o b e replace db v contractor . S ••c: o !'-,: • . . l e • .j , b ' ^

• C'li-.-
. " • •(-
. '':•• • |-.."(:!i-' ' -
Easemen t Area , t o b e Eac h 

# V^ s UU^^l^'^ ^ \ excavate d
Pag e 2 of

.

### ' Additional Comment e / Instructions :


# 7^- 3 pi^y •/^v\]C Lf^^o^ ^ <^i^C^-l
b 0,^y^y < V ^ ­ \ 1 ­ Y^n\\^ ^ ­

ffi' Chec k th e boxi fOwne 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 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

.

\ ^ I agre e [ UI d o no * agre e

Owner' s Signsture Dale Contractor ^ Signatur e Dat e Pag e 3 of
.Dat e Projec t XRFID #

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# 5aD
. 

# 1sm . 5s ^ tl5A ^ Averag e

Shot # 

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Averag e la b sampl e # 

### BVID#i22M2 i XR F PROPERT YSAMPL E SHEE T 

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# ^7^8 ^ 3 0 se c Readin g Sampl e are a Shol # Readin g Sampleare a in'L.^\^\Z.'\< : 

### ^ .tl ^ 

### flL,.<^U4r\\.x ^ S nf.u:^tirt.q j Dept h Dept h 

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Readin g Sampl e are a Shot # Readin g Sampl e are a 

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

### Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 455 4 Mod e SOI L Tim e 2009-08-3 1 09:3 3 Duratio n 121.8 8 Sequenc e Fina l Flag s AVERAG E 

### Bai;Qfeft550-.455 3 i l ADDRES S 311 5 davenpor t s t QUAD/ZON E easemen t INSPECTO R VENTR Y DEPT H 1 SAMPL E TYP E CLEARANC E NOT E

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# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Blllerica , 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 102.91 1 Supervise d By : 

## Certificat e o fVerificatio n

455 0 SOI L 2009-08-3 1 09:3 1 30.5 6 Fina l 2342 2 311 5 davenpor t s t easemen t VENTR Y 1 CLEARANC E

± Erro r
± 12.35 4

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

## Certificat e o f Verificatio n XL3t-3208 9 Readin g N o 455 1 Mod e SOI L Tim e 2009-08-3 1 09:3 2 Duratio n 30.5 9 Sequenc e Fina l Flag s BVI D # 2342 2 ADDRES S 311 5 davenpor t 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 Pb 86.85 6 ±11.58 9 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Blllerica , 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 71.42 7 Supervise d By : 

## Certificat e o fVerificatio n

455 2 SOI L 2009-08-3 1 09:3 3 30.1 9 Fina l 2342 2 311 5 davenpor t s t easemen t VENTR Y 1 CLEARANC E

± Erro r 10.91 2

# 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 75.24 5 Supervise d By : 

## Certificat e o fVerificatio n

455 3 SOI L 2009-08-3 1 09:3 3 30.5 4 Fina l 2342 2 311 5 davenpor t s t easemen t VENTR Y 1 CLEARANC E

± Erro r
± 11.01 4

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

## Certificat e o fVerificatio n
XL3t-3208 9 Readin g N o 458 4 Mod e SOIL Tim e 2009-08-3 1 14:3 0 Duratio n 122.2 3 Sequenc e Fina l Flag s AVERAG E ADDRES S "311 5 davenpor t s t QUAD/ZON E B l INSPECTO R VENTR Y DEPT H 6 SAMPL E TYP E CLEARANC E NOT E

± Erro r P b ± Supervise d By : 

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# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Blllerica , 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 136.97 4 Supervise d By : 

## Certificat e o fVerificatio n

458 0 SOI L 2009-08-3 1 14:2 8 30.5 6 Fina l 2342 2 311 5 davenpor t s t B l VENTR Y 6 CLEARANC E

± Erro r
± 14.48 4

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Blllerica , 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 130.88 6 Supervise d By : 

## Certificat e o fVerificatio n

458 1 SOI L 2009-08-3 1 14:2 8 30.5 1 Fina l 2342 2 311 5 davenpor t s t B l VENTR Y 6 CLEARANC E

± Erro r
± 14.54 7

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Blllerica , 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 85.71 4 Supervise d By : 

## Certificat e o fVerificatio n

458 2 SOI L 2009-08-3 1 14:2 9 30.5 9 Fina l 2342 2 311 5 davenpor t s t B l VENTR Y 6 CLEARANC E

± Erro r
± 12.02 1

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Blllerica , 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 80.66 7 Supervise d By : 

## Certificat e o fVerificatio n

458 3 SOI L 2009-08-3 1 14:3 0 30.5 7 Fina l 2342 2 311 5 davenpor t s t B l VENTR Y 6 CLEARANC E

± Erro r
± 12.05 8

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

## Certificat e o f Verificatio n XL3t-3208 9 Readin g N o 458 9 Mod e SOI L Tim e 2009-08-3 1 14:3 3 Duratio n 122.3 2 Sequenc e Fina l Flag s AVERAG E Av g o t 4585-458 8 ADDRES S ^rrsTiavenpor t s t QUAD/ZON E D Z INSPECTO R VENTR Y DEPT H 1 3 SAMPL E TYP E CLEARANC E NOT E

pp m ±Erro r P b [ri67J22 ^ 

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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 fVerificatio n XL3t-3208 9 Readin g N o 458 5 Mod e SOI L Tim e 2009-08-3 1 14:3 1 Duratio n 30.0 8 Sequenc e Fina l Flag s BVI D # 2342 2 ADDRES S 311 5 davenpor t s t QUAD/ZON E D Z INSPECTO R VENTR Y DEPT H 1 3 SAMPL E TYP E CLEARANC E NOT E

pp m ±Erro r P b 51.22 8 ±9.70 5 Supervise d By :

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

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

pp m Pb 239.77 7 Supervise d By : 

## Certificat e o f Verificatio n

458 6 SOI L 2009-08-3 1 14:3 1 30.6 4 Fina l 2342 2 311 5 davenpor t s t D Z VENTR Y 1 3 CLEARANC E

± Erro r
± 19.03 8

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

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

pp m P b 151.78 0 Supervise d By : 

## Certificat e o fVerificatio n

458 7 SOI L 2009-08-3 1 14:3 2 30.6 4 Fina l 2342 2 311 5 davenpor t s t D Z VENTR Y 1 3 CLEARANC E

± Erro r
± 14.91 3

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Blllerica , 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 226.50 3 Supervise d By : 

## Certificat e o fVerificatio n

458 8 SOI L 2009-08-3 1 14:3 3 30.9 6 Fina l 2342 2 311 5 davenpor t s t D Z VENTR Y 1 3 CLEARANC E

± Erro r
± 18.55 5v 

## f\A ^

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

. V j ^ www.coa8talhazmat.co m ^-"t^oit" ^ COASTA L Clo u p . m c 

# EXECUTIV ESUMMARY : BVID #23422-(311 5 DAVENPORT ST )
No Issue s o r Concern s Q Issues/Concern s
Detail Explanation : -COASTA LTO REPAI RYAR D O NTH EN ECORNE RDAMAGE D B Y EQUIPMENT.(COMPLETE D 9/20/09 )^ 

# EP APropert y Clos e Ou t For m Propert y AddTM«r.3}iiJ^VfiWL ^ Datc/Tlmc : Owner' s Name ; .^jj^jOjifl^/CTg

. Contracto rGrou p /^jfVr^ATgv^viVnAmflVVl \ OrOOf

. Quad s Excavated : Ye s /N o Excavatio nGenera l 1
.If necessaiy , were th e correc t quadrant(s ) excavate dandrestored ? i — 2
.I f necessary , were th e correc t area s ofdri p zone excavate dandrestored ? 

# c y Ye s JN o Gradln £So dan dVegetetio n 1
.Doe s the gradin g aroun dthe perimeter ofth e hous e i nexcavate darea s generally slop e awa y 

# M fromthe house ? 2
.Ha s sodbee nlai di nall area s tha t wer e excavated ? 3
.Doe s th e sodappear t

o b e generally healthy an dgrowing ? (Only evaluate if inspecteda t a3 0 day tun e period ) 4
.

Are soddedarea s generally finnan devenl y graded ? 5
.

Ar c th e joint s betwee nth e so dstrip s generally tight ? (Only evaluate if inspecte da t a3 0 da y tim e period) 6
.Wa s the propert y grade dsuchtha t wate r wil l no t poo l o nthe property ? 

# ly' ' 7
.

Wa s damage t o landscapin g o r plan t material s avoided ? 

# -i? '
Gates , Fence s an dRetainin g Wall s Ye 5 N o 1
.D o gate s ope nan dclos e freely? (Ifapplicable ) 2
.Were all gate s or fence s taice ndow ndurin g restoratio nactivitie s reinstalled ? (Ifapplicable ) 

# 7? ^ 3
.Wa s damage t o gate s or fence s avoided ? (Ifapplicable ) 4
.Wa s damage t o retainin g wail s avoided ? (Ifapplicable ) 

# T; ^
Foundation , Sidin g an dGmier s Ye s .N o t .Wa s damage t o th e sidin g or trimavoided ? LX ^ 2
.Wa s damage to the foundationavoided ? 

# I'
Wa s damage to window s avoided ? 4
.Wa s damage to window s o r door screen s avoided ? 

## I/ " 5
.Wa s damage t o downspout s or downspoul extension s avoided ? 

# u^ Sidewalk s an dDriveway s (Concrete ) Ye s » r 1
.Wa s damage to drivewa y surface s avoided ? 2
.

Wa s damage t o walkwa y surface s avoided ?

## 0>»'ner s comments :

Inspectio nnotes :

Remova l an drestorationactivate s complet e including the 30-da y so dwarranry : EP ARepresentativ e Uc ^ IJ A^^J LDate : ^ %> ( 0 ^

# L Propert yCompletio n Agreemen t
ihi s agreemen l documeni s lhe complclio no i remedial acliviiie s perloime do nm y pioperl y M y signalur e will designal e llia l I amsatisfie dwit hlhe rc«!toraliono f m y property , andtha t n o item s ar e i nquestions , now , o r ai any lime i nthe future , excep t ihos e item s liste dbelow , t f an y Propert y fD : ^ ^H^ Z Propert y Address : ^;^ ^ P^^^^^^^ f ^ A Owner : ]fl^.^^^ i ^ Phon e •LB ' lC»-{ < {H31]H15-'7^1 H Restoratio nItem s inQuestion :

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

## io./^(^fex i ^ y e^tcipme^-h , ^fAS 3

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J I rto no l ji(»re c rcjuomtio ni s complete d 

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