TRANSMITTA L of OMAH A LEA D SITE 

SOIL REMEDIATIO N FIL E FOLDE R 

SAID#: l^/)/ l . Date: J^-fj^/j2^& 

Address: ' 3:)^I £^dCr^u fj'/f)ji Jh/^ 

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Remediation Contractor: Coasta l Environmenta l Group _ Year: _2007_ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

m Video of property (DVD) • \ ^ 

W • Executive Suminary 

M EPA-provided property sketch 

M Signed Access Agreement for subject property 

D Signed Access Agreement(s) for adjacent property 

^ Restoration Agreement 

D Settlement documents (i.e., for damage or to replace plants, etc.) 

m . Confirmation data 

B^ Photographs bma \ ^ H// r itlgl %(A 

SZ As-built sketch 

W Satisfactory restoration signed by Property Owner 

m' Property close-out check list signed by EPA 1/^ 3 AP^ (3 7 

D Descriptionof areas not meeting ROD cleanup criteria 

D . Utility clearances 

W Property information fi-om Douglas County Assessor's Office 

D 

signature /Dat / Dee V 

40317125 

3 ,^ -,.JI 

Superfund 
X 

4 

^

/ ^

^

\%:)H 

33 a \ 60 creiaK-ten 

Final Report Property Check List (Please place with each file) 

Hard Copy Information 

--HT Property Check List 

Yl. Site Working Drawing Map 

yii. EPA originals Map 

J C Douglas County Assessor's Map 

^ ^ Property Contact Sheet 

Afjreement 

^^-K'Acccss Agreement 

...x2^Restoration Agreement 

Miscellaneous Documents 

^,YY^\x\'<i\ Map from the Field 

^SrTThange Orders |\\(./^^_ 

^^XR F Data 

- ^ Any emails or PO wrrespondences NX^J 

Property Completion 

1. Executive Summary 

2. AS BUILT 

,^i5^roperty Completion Agreement 

y^kw y buyout info or reimbursement info {V^ Qy 

^yS. Check or money order copies '^C A 

>r^P A Property Close Out Fonn 

.7<Attached Begin Video 

Electroni c Documentatio n 

Drawings 

j Y EPA original 

3 ^ Working Drawing 

.3. AS Built.vso 

4. AS Built.jpg 

Photos 

Begin Photos 

During/Excavation Photos 

Sod Photos 

30-Day Sod Photos 

Scanned Documents 

Final Documents 

Executive Summary 

 Videos 

 Begin Video 

 My Movie 

i 
t'^ ' A-­

'%•: . 

Property Access Checklist 

j Propc-ty ID: / ^ ^ / / D WORK STARTED ON: / / 1 

j Propc-t, Address ^: ^ | ^r^^.r/^ ^ n WORKCOMPELTED ON: . / / 

0 

Owner: \\X(1^ ^¥-^ s: 

.Address: 

Mfxq ^ Renter: 

Phone: 

Fax: 

Cell/Piificr 

Phone: ^^ j ^^^7"^ ^^^^ 1 .Additional Information: 

Fax: 

i Cell/Pauci 

J ^ Notification Letter 

"33 -Access .Agreement 

• ® Resioration Aureenieiit 

1 n Topsoil Sam|)linj; (if iipp'i'^'' ble) 

; CH Disposal Sampling (if applic abkO 

j O Garden Samplinj; (if applic; ihle) 

;J 0 l'tilit\ Clearance 

\ ^ \ ide<»/Photos (Before) 

1 ' H V ideo/Photos (Durin-:) 

i S Nideo/Photos (After) 

1 n Video/Photos (30-Da>) 

j S Pr<)|)ert\ Completion .Agreement 

1 • Final Report 

Air Monitoring ( as applicahle) 

i n Comm«nit> n Crew i On:

j Results: 

jj Hlj' Community Q Crcn On:

jl Results: 

I O Comnuinit} D Crew i On:

jj Results: 

'>(inl: _fj_l JY blSiuned: ^/i^)/ ^ 

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Called: ^ :X] (>1 

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Omaha Lead Site 
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Total Qu! Square Footage to be Excavated = 2484 it>e c^^-K- Property Classification: 800 Total iW^ i one Linear Footage to be Excavated = 38 

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Ed Creighton Avenue 

Legend 

Concrete 

Nort jhAr Arro i w Omaha Lead Site 

Omaha. Nebraska 

ZZ 

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Excavated Area 

Existing Structure 

Permanent Landscaping 

 Fence 

K 

Scale 

1 Inch = 20 feet or 1 grid = 5 x 5 ft 

Property Number OLS-18011 

Property Address 

3221 ED CREIGHTON AV 

o 

-

-

 Quadrant Boundary 

 Street Boundary 

Tree/Stirub 

{A l • HC5L F1 . 

F2 

81 

Post Excavation Concentrations (ppm) 

B2 Play Area 

DZ Easement 

Garden Other 

DesCTiption of post excavation areas: Fl, front yard left-hand quadrant; F2, front yard right-hand quadrant; Bl, backyard left-hand quadrant; B2, backyard right-hand quadrant; 

DZ, dnp zone (1-3 foot area of soil around the foundation of the house). 
Total Quadrj jouare Footage to be Excavated = 2484 

Property Classification: 800 p Total Drij | e Linear Footage to be Excavated = 38 

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Legen d NorthArrow Omaha Lead Site 

^Y \ Concrete Omaha, Nebraska 

[Yy \ Excavated Area N Property Number 

OLS-18011 

txisting btoiciure Scale 

R^ Permanent Landscaping 1 Inch = 20 feet or 1 grid = 5 x 5 ft Property Address 

3221 ED CREIGHTON AV • Fence 

Quadrant Boundary Post Excavation Concentrations (ppm) 

Fl 82 Plav Area 

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DUUII 

hrub 

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B1 G art 

DZ 

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DesCTiption of post excavation areas: Fl . front yard left-hand quadrant; F2. front yard right-hand quadrant; Bl . backyard left-hand quadrant; B2. badcyard right-hand quadrant; 

DZ, drip zone (1-3 foot area of soil around the foundation of the house) 

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^ \ ^ . $ ; ^ ^ ^ ^ \s^ > ^ $ ^ sN\ ^ ' 0 icV J 
18011 

Omaha Lead Site Owner Name: WILLIAM E BRENNAN 

Site Sketch Address: 3221 ED CREIGHTON AV 

Phone: H: W: 

Sampl Lead Sample e Number LAB Concentration Collected 

RYASCPXA-18011 F1 ^ 7 ^ ppm \ ^ n 

RYBSCPXA-18011 F2 ^^y - ppm D 

RYCSCPXA 18011 .m . ppm D D 

RYDSCPiXA 18011 -B2 ^ ppm D D 

RDZSCPXA-18011 DZ /^^ ^ ppm 2f n 

Lab RYBSCPLA-18011 " ppm D D 

Result 713 ppm ppm D D 

Number of Samples = : 31 \ 

ENTERED 

SEP 0 2 Z004 

Y 

Privc 

.33.^.1 

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Exterior Paint North Arrov*; 

• Good 

• Poor 4/ 

^^HoX paint 

Samples Collected 

Firm: F^?^ 06>/t> C 

Date: j;-.^^-^> ^ 

Time: iy.O'=r 

Samples Analyzed 

XRF Unit: ^/ - Book 

Date ^-"0 -

Time /=^y ^ 

Staff: Zy^T^^^i ^ 

\S> U^tlc^^tCTl\ A,ve 

Omaha Lead Site 46130 
Douglas County Page 1 of2 

Douglas County, Nebraska Property Record ­ R2403210000 

Information is valid as of 2007-7-19 

Values not finalized until after Board of Equalization 

Print Report 

View on Map 

Owner 

BRENNAN WILLIAM E 

ETAL 

3221 ED CREIGHTON AVE 

OMAHA NE 68105-0000 

Property Informatio n 

Key Number: 03210000 24 

Account Type:

Parcel Number:

 Residential 

 2403210000 

Parcel Address: 

Legal Description:

3221 ED CREIGHTON AV 

OMAHA NE 68105-0000 

 VIRGINIA PU\CE LOT 16 BLOCK 2 W1/2 56.31 X 63.62 

Value Informatio n 

2007 

2006 

2005 

2004 

2003 

2002 

Land 

$4,800.00 

$4,800.00 

$4,800.00 

$4,800.00 

$4,800.00 

$0.00 

Improvement 

$108,400.00 

$88,100.00 

$88,100.00 

$88,100.00 

$62,000.00 

$0.00 

Total 

$113,200.00 

$92,900.00 

$92,900.00 

$92,900.00 

$66,800.00 

$0.00 

Sales Informatio n 

Date Type Book Page Price 

Land Informatio n 

Acres

0.08 

 SF 

3520.0 

FF 

64.0 

Units 

1.0 

Depth 

55.0 

Width 

64.0 

Vacant 

No 

Land Attributes 

Attribute Attribute Description 

Improvemen t Informatio n 

Building 1 

http://douglasne.mapping-online.coin/DougIasCoNe/static/accountinfo.jsp?accountno=R240... 8/3/2007 
Douglas County Page 2 of2 

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Click to Enlarge Image 

Click to EnJa^rgeJmage 

Square Footage: 1568.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

Condo Square Footage: 0.0 

Built As: 2 1/2 Story Unfin Rooms: 7.0 

HVAC: Central Air to Air Units: 1.0 

Exterior: Frame Aluminum Baths: 1.0 

Interior: Drywall Bedrooms: 4.0 

Roof Cover: Composition Shingle Stories: 2.5 

Roof Type: Hip Foundation: Block 

Floorcover: Allowance Sprinkler Square Footage: 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1910 0 0% 1910 97 

Detail Type DetaiY Description Units 

Appliance Allowance 1.0 

Appliance Fireplace Masonry 1.0 

Basement Bsmnt Block 8 ft 752.0 

Basement Finished 400.0 

Fixture Additional Fixtures 1.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Porch Slab Roof Ceil 80.0 

Porch Slab Roof Ceil 80.0 

http://douglasne.mapping-online.coni/DouglasCoNe/static/accountinfo.jsp?accountno=R240... 8/3/2007 
Property ID #

Property 

Address: 

Initial Contact:

Second Contact:

Final Contact:

Final Action:

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

CONTACT FORM 

 / ft Q (| 

 Date: 7/z^7Time: ^f^Y Action: <^m-/y(/6r^ 

 Date: Time: Action: 

 Date: Time: Action: 

 Transmit to EPA D Other Action: D 
X 

'^^: : 

Omaha Lead Site—Fixed Price EP-R7-07-05 

V '•••• > 

Coastal Environmental Group Inc. 

www.coastalhazmat.com 

COASTA L ENVIKONMENTAL 

CROUP . IN C 

EXECUTIVE SUMMARY: 

18011—3221 ED CREIGHTON AVE 

No Issues or Concerns I I Issues/Concerns 

Detail Explanation: 
As-Built Drawing 

COAST

INVinONMENTA

A L L Omaha Lead Superfund Site « « O U P . IN C 

ll3bl Quaoanl square Footage to be Excawaieii - 2444 

Property cysaiteJon: 800 •RitaDH(}ZoneunearFoi)Oi|etoBeBcc3valefl-3g 

^" ^ .^=rCU^#: 18011 

7>-^ Date Excavated: 10/10/07 

Property Number '"" US'EPASijgrVed Off: 11/1 3/07 N OLS^IIOH 

Exssrq Ctrati.fs Pennanem Property Ad(*BSS LandEuiirg iinOi-zaibetarigiM •5x511 3221 ED CRaGHTON W •—•— • Fence 

QuaAant Bom&iy Post Excavation Concentrslions (ppm) 

Fl_ B2 PByVea SkE^BoundBty ^^i I HGL F2 DZ EaBsment 

|Q> iree'StiruD Bl Gamen ooier 

M rLMMWMH Hg«i»iiiHM»wnw.MmiiiiiiXMBdi|MiWnia,f f«i»m^«irinii n • •TMlMIM) 

Legen d 

Area no t Excavate d pyyj Dripzon e Excavate d £2<J3 Quadrants Excavate d 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group Inc . 
^ ^ EPA 

EPA Property Close Out Form 

Property #: 

Date/Time: 

Quads Excavated: 

MUL^ 

Contractor Group . 

cX^ 

ExcavatkoD General Yes No 

1. If necessary, were the correct quadrant(s) excavated and restored? y 

2. If necessary, were the correct areas of drip zone excavated and restored? y 

Grading Sod and Vegetation 

1 '• 

2. 

3. 

4. 

5. 

6. 

Does the grading around the perimeter ofthe house in excavated areas generally slope away 

from the house? 

Has sod been laid in all areas that were excavated? 

Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 

day time period) 

Are sodded areas generally firm and evenly graded? 

Are the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day 

time period) 

Was the property graded such that water will not pool on the property? 

Yes 

Yw^ 

y 

y 

No 

7. Was damage to landscaping or plant materials avoided? ^ / 

Gates, Fences and Retaining Walls 

I. Do gates open and close freely? (Ifapplicable) 

Yes

H ^ 

 No 

2. Were all gates or fences taken down during restoration activities reinstalled? (Ifapplicable) /Jf3. Was damage to gates or fences avoided? (Ifapplicable) ^ 

4. Was damage to retaining walls avoided? (Ifapplicable) 1^ 

Foundation, Siding and Gutters 

I. Was damage to the siding or trim avoided? 

Yes

L / 

 No 

2. Was damage to the foundation avoided? t X 

3. Was damage to windows avoided? y 

4. Was damage to windows or door screens avoided? / / 

5. Was damage to downspouts or downspout extensions avoided? y 

Sidewalks and Driveways (C Concrete) 

1. Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 

Yes 

l y 

i X 

No 
Owners comments: 

Inspection notes: 

^ / ^ ^ ^ ^"" ^ 

Removal and restoration activates complete including the 30-day sod warranty: 

EPA Representativ. Date: 2^^ ^ 
i ,• •..,»• l )',.* ; 

... -i' 

Property Completion Agreement 

This agreement documents the completion of remedial activities performed on my properly. My 

signature will designate that 1 am satisfied with the restoration of my property, and that no items are in 

questions, now, or at any time in the future, except those items listed below, if any. 

Property ID: /^(J/ / 

Property Addre.s.s: ^^^ J ^ ^^^e/^/^/ ^ 

Owner: 

jrlA^7.U7J /^J6^M4A / 

Phone: 

" .^^/ <g^M / 

Restoration Items in Question: 

Item ' U/4c^^/i-^j^ f^o/0(-rx3/2-^>^h 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

I<—HHisi'ee restoration is completed, except as noted 

I do not agree restoration is completed 
PROPERTY CLEARANCE WORKSHEET 

Date I0-IU7 

Property ID ^\U{\ 

Property Project Omaha Lead - Fixed Price Address 3^^ / g p Cr^«^Vv^A 

Measurement XRF ID 

0107-51 Count/Time 

Field Shots 

Shot * Reading Sample Area 

Stiot # Reading Sample Area 

Tltp IVZ rzA' ^ 

ni>< S K/ W-fc ^ f ^ q-G 11'^ ^ 

df< 70 ^2. \-L-\H 

Sample Area r/?-5 

I n Situ 

Composite Composite Analytical 

Aliquot Composite Readings 

Lab Analytical 

Readinq Average 

(Dried & Spilt Sent (Bag) 

Number Results ? 1 

(Baq) Sieved) 

2 

^ < no 

3 

-irr- MA 

4 

J H - i^i XRF Corrected Value - > 

5 (use calibration chart or add 

2 0 % to value) 

•9-P' 

Sample Area f \ <V-C5 Pass/Fai l ? 

I n Situ Composite Composite Analytical 

Aliquot Composite Readings 

Lab Analytical 

Readinq Average 

(Dried & Spilt Sent (Bag) 

Number Results 1 4 $ ^ 

(Baq) Sieved) ? 

2 5^ <o 

3 < / ^'i ^ ^3 4 SS s-i XRF Corrected Value - > 

5 5Z (use calibration chart or add 

2 0 % to value) 

U 

Sample Area f^^'i ^ Pass/Fai l ? 

I n Situ Composite Composite Analytical 

Aliquot Composite Readings 

Lab Analytical Readinq Average 

(Dried & Spilt Sent (Bag) 

Number Results 1 

(Baq) Sieved) 7 to 

2 IflO ^V 

3 SI <ry 

5S 4 ^v 5-7 XRF Corrected Value - > 

5 sz (use calibration chart or add 

2 0 % to value) 

fc<) 

Sample Area DZ. I^-I'^ Pass/Fai l ? 

I n Situ Composite Composite Analytical 

Aliquot Composite Readings 

Lab Analytical Readinq Average 

(Dried & Spilt Sent (Bag) 

• > 

Number Results 1 

(Baq) Sieved) 

2 Ot- 12 ^ K i 

3 61 

4 

^H no XRF Corrected Value - > 

5 (use calibration chart or add 

2 0 % to value) 

Sample Area 

Pass/Fai l ? 

I n Situ 

Composite Composite Analytical Aliquot Composite Readings 

Lab Analytical Readinq Average 

(Dried & Spilt Sent (Bag) 

Number Results 1 (Baq) Sieved) 7 

2 

3 

4 

XRF Corrected Value —> 

5 (use calibration chart or add 

2 0 % to value) 

' rr;—r-' • ^ 

us t ADDIIIOHA L SHFFF S I F 

XRF Technician's Signiture HCFDFD j . ^ 
<( Total .1 Square Footage to be Excavated = 2484 J it>e cy(>^ ^ Property Total Ip Zone Unear Footage to be Excavated = 38 Classification: 800 itarWic 

I ^^ ^ H^.^V '/'' o\^Ua< p^^-/^ f 

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^ y , , , I '• 

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i^pW ^ e - -fr^ir 1 ! 

A r U 0, ,/UU<L£U i i .u_ 

DZ 

1045 ppm 

IW 

}£>-io)-­ ••656 

-ryT-;i.v4-:.4'--:t­

\M^^€-J^A£J^^ ^ 

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Ed; Creighton Avenue 

I -

I I -I 1 

• i - i 

Omaha Lead Site 

Concrete Omatia, Nebraska 

Excavated Area Property Number N OLS-18011 Existing Structure Scale 

Permanent Landscaping Property Addres s 1 Incti = 20 feet or 1 grid = 5 X 5 n 3221 E D CREIGHTO N AV Fence 

Quadrant Boundary Post Excavation Concentrations (ppm) 

B2 Play Area Street Boundary A / Y HGL 

O DZ Easement 

Tree/Shrub Garden Other 

Desaiption of post excavation areas: Fl , front yard left-hand quadrant: F2. front yard right-hand quadrant: B1 , badtyard leR-hand quadrant; B2. backyard right-hand quadrait, 

D2, df p zone (1-3 foot area of soil around the foundation of the house) 
„,^t 6 sr< . 

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# 

COASTA L 

" t PROt«-'=' 

ENVIRONMENTAL 

C B 0 U P . IN C 

Consent For Acces s To Property 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner) consents to and authorizes the United States 

Environmental Protection Agency (EPA) or its authorized representatives, collectively 

the Grantee, to enter and perform certain environmental response activities upon the 

following described premises: 

Owner'sName: -jJje^/^A-X J Daytime Phone: rp( J [ r ^ ^ ^ | 

Address of Property -^Z^ i et) <::feezQU_W^ /^ ^ 

covered by this 

Agreement: 

PURPOSE OF RESPONSE ACTIVITIES 

The EPA is requesting access to collect soil samples and remove soil that contains 

elevated concentrations of lead and may pose a health hazard. The area(s) will be 

excavated to remove contaminated soil. The removed contaminated soil will be 

replaced with clean materials and the area will be restored to its original condition. This 

work is being performed under the Omaha Lead Superfund Site remediation program. 

A representative of Coastal Environmental Group, contracted by USEPA, will contact 

the Grantor in-person to discuss the work to be performed, the Grantor will have an 

opportunity to review and approve the planned soil removal, and restoration work before 

it begins. Once the work is finished, the Grantor will be asked to review the work and 

confirm that it is complete and meets with the Grantor's approval. Upon completion, the 

Grantor will receive written documentation from EPA that the property has been 

remediated. 

ENVIRONMENTAL RESPONSE ACTIONS 

By signing this Access Agreement, the Grantor is granting the EPA, its employees, 

contractors and subcontractors the right to enter the property, at all reasonable times 

and with prior notice, for the sole purpose of performing the work. This access shall 

remain in effect until the work has been satisfactorily completed. The Grantor also 

agrees to: 

Page 1 of 2 
- • * 

C OASTA L ENVIRONHENTA L f t r CROU P I N C 

:. 1 

• Remove obstructions incfuding boats, trailers, vehicles, playscape items, wood 

piles, dog houses, etc; 

• Remove flower bulbs or plants that the Grantor or the Grantor's tenant may wish 

to save; 

• Water and maintain replacement vegetation, including fertilizer application, as 

necessary subsequent to an initial watering period by EPA; 

• Abide by health and safety guidance provided by EPA; 

• If the property is rented, assist EPA in obtaining tenant approval for access to the 

property to perform the work. 

• Allow videotaping and/or photographing of the property. ; 

AGREEMENT NOT TO INTERFERE .-.,.:..:•.,:,;.:•- ; v.; _.•..; . 

The Grantor agrees not to interfere or tamper with any of the work activities, or with any 

of the work done, or with the equipment used on his property, or to undertake any 

actions regarding the use of said property which would tend to endanger the health or 

welfare of the Grantees or the environment, or to allow others to use the property in 

such a manner. 

Should you have any questions about this program, please contact Coastal 

Environmental Group, at (877) 234-6270. 

&f g grant access to my properties 

n I do not grant access to my properties 

Signature 

Date 

EH I would like to be present during any sampling that is required. 

Page 2 of 2 
COASTA L 

Restoration Agreement 

The purpose of this agreement is to provide a mutual agreement as to conditions ofthe property prior to 

remediation activities. This will also serve as documentation for the purpose of assuring that restoration 

activities are completed to the satisfaction ofthe property owner and the United States Environmental 

Protection Agency (EPA). 

Property ID: 

Property Address: ^^'^ ( ^bCvtA^guA^gVv 

Owner: y\/y(\ ^ 

Phone: 3^ f' hi;^^] ~ 

On the attached diagram(s) indicate area(s) to e.vcavated and depth of e.xcavation. location of ail known 

utilities, subsurface features, surface structures and landscaping features, access location(s) to be used by 

contractor, and the direction of North. Indicate distances, depths, material types, etc. indicate digital photos 

by referencing the photo-log number with an arrow indicating direction of view. 

Items To Be Remove d By Owner Before Start Of Remediation: 

(Use additional sheets as necessary) 

The removal, storage, disposal, and/or return of these items is the Owner's responsibility. 

Item: 

• 3AA^-C i -piA.-Kjr 5 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 1 of 
COASTA L 

Items To Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

Item: 5rvA^U^L^A^"^ 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 2 of. 
COASTA L 

Item: 

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

Item: 

Item ^ 

^"%(LGKUVJ !J[S)L.CM

Item:

 ^ ^ t>- ^ 

1 

Item: 

1 Item:

•1 i 

1 

Item: 

Item: 

Item: 

I • 

Item: 

Item: 

1 .

Item: 

 *t. ' 

Item: 

Item: 

/ ­ • • 

Page 3 of 
COASTA L 

Landscape Inventory 

(Use additional sheets as necessary) 

Item Quantity Unit Condition/Type/Species 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

i 

1 

Number of trees > 2 inch 

trunk diameter 

! 

1­1 

Number of trees <= 2 inch 

trunk diameter 

Number of Sprinkler 

Zones. Control Valves. 

Timers, Heads, etc. 

.^rtach a sketch of the 

sprinkler lasoui. 

Number of and size of 

each garden/ flower bed 

area. 

.Attach, a sketcli of relati\e 

sizes and locations, 

i 

^^^tz- Square feet 

11^^^ 

Each 

a Each 

Each 

& 

Each 

Square Feet 

1 

Page 4 of 
COASTA L 

Item 

Agreed upon value of 

plant materials not to be 

replaced bv contractor. 

Note this value will be 

used to issue a plant 

voucher to the property 

owner. 

Agreed upon list of plant 

materials that will be 

replaced by contractor. Be 

very specific and detailed, 

include a sketch of were 

each plant will be placed 

b_\ the contractor. 

Agreed upon area of 

property to be replaced 

with grass sod. 

Include a skeich oi' ihc 

area(s) to be replaced with 

gras,s sod. 

Area of City or County 

property to be landscaped 

per their requirements. 

Include a sketch of the 

area (s) 

Easement .Area, to be 

excavated 

Quantity Unit Condition/Type/Species 

0 $ 

Z^ 

Each 

Z^z-^ ' SF 

SF 

SF 

i 

i l 

Page 5 of 
COASTA L ENVIRONMENTA L 

G n O U P , INC . 

Additional Comments / Instructions: 

6X^4^ 

n Check the box if Owner does not want CEG to document interior foundation walls and possible 

pre-existing damage. By checking this box CEG is not responsible for any damage done to the 

interior of house, including foundation cracks or fissures. 

H^agn n I do not agree agree 

Ti ^ ^> J.j-yr . ^J^jJ^y^C ^ Cjl-.P^ ^ 9U/o7 

Owner's Sikjiature Date 7^ ontractor's Signature Date 

Page 6 of.