## TRANSMITTALo f

OMAHALEA D SITE SOILREMEDIATIO NFIL EFOLDER
SA1D # 

# : jM i Date : ^ fK/ M Address : Ho ^ ^ ^^^ ^ ^ < Remediatio nContractor : Coasta l Environmenta l Grou p Year : 2010ARR A
SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S / Vide o o f property (DVD ) Executiv e Summary EPA-provide dproperty sketc h 

# 1 y Signe dAcces s Agreemen t fo r subjec t property Signe dAcces s Agreement(s ) fo r adjacent property 

# 7 Restoratio nAgreement Settlemen t document s (i.e. , fo r damag e or to replac e plants , etc. ) Confirmatio ndat a Photograph s T K 0) 0 <^/^TW V 

### \tS ° (y^<^^\*x^ \^a ^ As-buil t sketc h Satisfactory restoratio nsigne db y Property Owner Property close-ou t chec k lis t signe db y EPA Descriptio no f area s no t meetin g RO D cleanu p criteri a Utilit yclearance s 

# c

/ Property informatio nfromDougla s County Assessor' s Office



# - 1 Kh

# s

Propert yAcces s Checklis t Property ID : QjQ^' ^ D WORK STARTE D Property Address : yiQ qc ^ ^ ^ g::;-|
. D WORK COMPELTED
Renter : Owner 

# Enn/fui L Fj^idyj o Address : Phone :



## F>^ ^ ^ ^0^" ^ Fax : Cell/Pager : 

# umo i ^ 

### Additional Information :



## ''"""^M/Zr: ) Qc^)n? ) Fax : Cell/Pager : D NotificationLette r Sent : / / By : I V Acces s Agreement Signed : £_/^/JC > By : ^ Restoratio nAgreement Signed : & U / /j O By : Q Topsoil Sampling (i f applicable ) / / By : nDisposa l Samplin g (i f applicable ) / / By : D Garde nSamplin g (i f applicable ) / / By : ' ^ UtiUt y Clearanc e CaUed:rOW"3Lb/\ o 

### ^y

- Cfbl^fw ^ ^ Video/Photo s (Before ) 

### On: S 1^ 1 I O By : nVideo/Photo s (During ) On : / 7 By : nVideo/Photo s (After ) On : / / By : D Video/Photo s (30-Day ) On : / / By : Q Property Completio nAgreement Signed : / / By : nFinal Report Issued : / / By : Air Monitorin g (a s applicable ) O Communit y • Cre w On : / / By : Results :

• Conmiunit y C ] Cre w On : 7 / By : Results : [~

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

Omah a Lea d Sit e

## Dougla s Count y Accoun t I:

n||Matio n Pag e 1 of 4
Dougla s County , Nebrask a Propert yRecor d - R123490000 0 Informatio n i s vali d a s o f2010-8-1 6 Ne wFeatur e " ^ • ^ r > Owne r ELIZOND O ENRIQU E 542 6 S 2 0 S T OMAH AN E 68107-000 0 Propert yInformatio n Ke yNumber : 349 0 000 0 1 2 Accoun t Type : Residentia l Parce l Number : 123490000 0 Parce l Address : 110 9 S 2 8 S T OMAH AN E 68105-000 0 Lega l Description : HANSCO M PLAC E LO T2 2 BLOC K1 N 4 0 FT4 0 X 15 0 Valu e Informatio n Lan d Improvemen t 201 0 $4,600.0 0 $54,100.0 0 200 9 $4,600.0 0 $56,400.0 0 200 8 $4,600.0 0 $56,400.0 0 200 7 $4,600.0 0 $56,400.0 0 200 6 $4,600.0 0 $54,600.0 0 200 5 $4,600.0 0 $54,600.0 0 Sale s Informatio n Sale s Date : 1999-11-1 2 Dee d Type : D Book : 213 8 Price : $ 38,950.0 0 Grantor : Grantee : Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 1999-05-1 4 Dee d Type : D Book : 212 2 Price : $ 20,000.0 0 Grantor : Prin t Reoor t Vie wInteractiv e GI S Maf i

Treasurer' s Ta xReoor t Subdivisio n Sale s Searc h

Tota l $ 58,700.0 0 $ 61,000.0 0 $ 61,000.0 0 $ 61,000.0 0 $ 59,200.0 0 $ 59,200.0 0

Page : 71 2

Page : 55 7



## http://douglasne.mapping-online.com/DouglasCoNe/static/accoimtinfo.jsp?accoimtno=Rl2..
. 8/20/201 0

### Dougla s County Accoun t Inji^tetio n Pag e 2 of4 

## ijjg^ t
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 3 6000. 0 

### 1.0 150. 0 40. 0 N o Lan d Attribute s Attribut e Attribut e Descriptio n Negativ e Influenc e Vie w Negativ e Influenc e Traffi c5 Improvemen t Informatio n Buildin g 1

SMhRaNC X 3:5 1 Firs t Floo r 7T0. 0 S a Fl
.

BtlT n W WH n 

## Ranc h CLIC KT O ENLARG E IMAG E CLIC KT O ENLARG E IMAG E Squar e Footage : 770. 0 Percen t Complete : 

### 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : Ranc h Cond o Squar e Footage : 0. 0

HVAC : Force d Ai r Rooms : 3. 0 Exterior : Fram e Sidin g Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 2. 0

Roo fType : Gabl e Stories : 

### 1. 0 Floorcover : Allowanc e Foundation : Bloc k Sprinlde rSquar e Footage : 0. 0 yea r Percen t Adjuste d Yea r Yea rBuil t Physica l Ag e Remodele d Remodele d Buil t 187 5 199 9 0 % 

### 193 7 7 3 Detai l Typ e Detai l Descriptio n Unit s 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R12.
. . 8/20/201 0

## Dougla s Coimt y Accoim t I t^l^atio n Pag e 3 of 4 

# m Applianc e Basemen t Basemen t Fixtur e Fixtur e Porc h Porc h Allowanc e Bsmn t Bloc k 8 ft Finishe d Bas e Fixture s Bat h Ful l Sla b Roo fCeilin g Sla b Roo fCeilin g 1. 0 770. 0 510. 0 1. 0 1. 0 208. 0 119. 0



## http://douglasne.mapping-online.com/DouglasCoNe/static/accoimtinfo.jsp7accountno-R12..
. 8/20/201 0Page l of 2

Creat e Anothe rTicke t Bac k t o Irth : Inteme t [•

_Sen d Emai l j


### YOURTICKE T NUMBE RI S 2577778
. Origina l Cal l Date : 8/26/1 0 Time : 2:3 8 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 8/30/1 0 Time : 3:1 5 p m State : N E Coimty : DOUGLA S Place : OMAH A Address : 110 9 Street : S 28T H S T Twp : 15 NRng : 13 E Sect-Qtr : 21-SE,28-N E Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : LEA D REMEDIATIO N Locatio n o f Work : LOCAT E ENTIR E PROPERTY , AL L EASEMENT S AN D T O TH E PEDESTA L Remarks : 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 Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V LEVEL 3 MUDO l MUD0 2 OMAHACO F 0PPDGPR 5 0PPDGPR 6 QLNNEI C QLNNEI F

Servic e Are a Contac t Phon e Number Utilit y Typ e
CXCAT V CO X COMMUNICATIONS , IN C HEIDI Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7

LEVEL S LEVEL3 COMMUNICATIONS , LL C N A Day : 877366834 4 Alt : Emerg : 877366834 4
MUDO l METROPOLITA N UTILITIES DISTRICT SAND Y 

### Day : 402504782 3 Alt : Emerg : 402504797 0

MUD0 2 METROPOLITA N UTILITIES DISTRIC T SAND Y 

### Day : 402504782 3 Alt : Emerg : 402504797 0

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 8/26/201 0

### Pag e 2 of 2

OMAHACO FCIT Y O FOMAHA-TRAFFICSEWE RRICH^-RAFFI C Day : 402444719 7

Alt : 402444516 1 Emerg : 402444516 0
OPPDGPR 5 OMAH APUBLI C POWE RDISTRIC T Day : 406728934 3

EL M LOCATIN GAlt : 406207149 4 Emerg : 888728934 3
OPPDGPR 6 OMAH APUBLI C POWE RDISTRIC T Day : 406728934 3

EL M LOCATIN GAlt : 406207149 4 Emerg : 888728934 3 QLNNEI C QWES T LOCA LNETWOR K Day : 406728934 3

EL M LOCATIN GAlt : 406207149 4 Emerg : 888728934 3 QLNNEI FQWES T LOCA LNETWOR K Day : 406728934 3

EL M LOCATIN GAlt : 406207149 4 Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 8/26/201 0OLS# : 2104 9 

# As-Buil t Drawin g Dat e Excavated : 10/13/1 0 Dat e USEP ASigne d Off : 11/9/1 0 COASTA L 

# Omah aLea dSuperfun dSit e Are a Sodden : 216 0 s a f t

Name : /^i;, ^ .W - Omah a Lea d Sit e Date : V-^i'^ i Nort h Arro w Address : // ^

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- ^ 1COASTA l INVISONKII^TA l cI 0 u rI» ( c 

### Cons&Pi i to fkctc.a^ ^ T o Piopeil y RIGH TO F ENTR YT O PREMISE S 

### Granto i (th e propert yowner ) consent s t o an d authorize s th e Unite d State s Environmenta l Protectio n Agency(EPA ) o i it s authorize d representatives , collectivel y th e Grantee , t o ente ran d perfor m certai n environmenta l respons e activitie s upor \ th e followin g describe d premises :

Owner' s Name : £}vr^^i ^ C^^l^^ ^ Daytim e Phone : Q j ^

_S^Zog ^

Addres s o fPropert y covere d b ythi s 

# [XO^ i S -^ o S ^ 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 maypos 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 its 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 wor1 < i s finished , th e Granto rwil l b e aske d t o revie wth e wor k an d confin n tha t r 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 , Its 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 wor k 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 of2.„^«=<l«'4, , COAS1A i IKViaONHIKTA l C R O U fI ^ C 

### Remov e obstruction s includin g boats , trailers , vehicles , playscap e ilems , woo d piles , do g houses , etc ; Remov e flowe rbulb s o rplant s tha t th e Granto i o rth e Grantor' s tenan t maywis h t o save ; Wate ran d maintai n replacemen t vegetation , includin g ferlilize rapplication , a s necessary ' subsequen t t o a n initia l waterin g perio d b yEPA ; Abid e b yhealt h an d safet yguidanc e piovide d byEPA ; I fth e propert yi s rented , assis t EP Ai n obtainin g tenan t approva l fo i acces s t o th e property ' t o perfor m th e work
. Allo wvideotapin g and/o rphotographin g ofth e property
. AGREEMEN TNO TT O INTERFER E 

### Th e Granto ragree s not t o interfer e o rtampe rwit h an yo fth e wor k activities , o i wit 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 wothers t o us e th e propert yi n suc h a manner . Should yo u hav e an yquestion s abou t thi s program , pleas e contact Coasta l Environmenta l Group , a t (402 ) 991-119 9
I gran t access t o m ypropertie s O I d o no t grant acces s t o m ypropertie s

^ 

# nd^Q^-^l V
. ^ r>rr v Dat e Signatur e Dat e Signatur e
Q I woul d lik e f o be presen t durin g an ysamplin g tha t i s required
.

Pag e 2 o f2C O AS TAL • MVinOMHItiTA L C • O U P
. INC
. 

## Restoratio n Agreemen t Th e purpos e o f thi s agreemen t i s t o provid e amutual agreemen t a s t o condition s o f th e property prio r t o remediatio nactivities
. Thi s wil l als o serv e a s documeritatio nfor th e purpos e o f assurin g that restoratio n activitie s ar e complete dt o th e satisfactio no f th e property owne r an dth e Unite dState s Environmenta l Protectio nAgenc y (EPA)
.

Property ID : 2^1 0 M ^ Property Address : / 1 0 t X ^ Z O ^^ • Owner : j^f^^u cCUSAW Q 

### ^ ^ ^ ^ ^ ^ O nth e attache ddiagram(s ) indicat e area(s ) t o excavate , surfac e structure s andlandscapin g feature s an d acces s location(s ) t o b e use db y th e contractors . Indicat e distances , depths , material types , etc . Photographicall y an dVideographicall y document th e existin g condition s ofth e propert y an dth e basemen t i f necessary . item s t o b e Remove d b yth e Owne rbefor e Star t o fRemediation : Th e removal , storage , disposal , and/o rretur n o fthes e Item s I s th e Owner' s responslbiltty
. ttem:

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

## yU c '(Snr^ ^ ttem:
ttem:

Pag e 1 of
.

## Item s t o B e Remove d B yContracto rDurin g Remediatio n an d Replace d Item :
ttem: 

# ^^ ^ ^l.-K L

Landscap e Inventor y Item Pre-existin g property area , that wil l b e excavated , tha t i s coveredwithgrass . Numbe r o f tree s > 2 inc h trunk diamete r Numbe r o f tree s < = 2 inc h trunk diamete r Numbe r o f Sprinkle r Zones , Contro l Valves , Timers , Heads , etc . Attac hasketc ho f th e sprinkle r layout
. Numbe r o f an dsiz e o f eac hgarden/ flower be d area . Attac hasketc ho f relativ e 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 wil l b e use dt o issu e aplan t vouche r t o th e propert y 

## Quantity 

# P2jl*> Z 

# H 

# y \ 

# y F Unit Condition/Type/Specie s Quadrant s
Eac h
Eac h

Eac h

Eac h Squar e Fee t

$

owner . Easemen t Area , to b e Eac h excavate d 

### /// ^
Pag e 2 of
.C O A5 TAL • MViaOMHBNTAI
. O • O U P
. IMC
.
Additiona l Comment s / Instructions : Th e cit yo fOmah a ordinance s ma yprohibi t 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 removin g an d replacin g soi l underlyin 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 . I fthi s i s th e case , yo u shoul d understan d tha t thi s removin g an d replacin g o fsoi l 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 fyo u us e a grave l o rdir t are a a s a drivewa yo rparkin g area , no t withstandin g an yremova l o rreplacemen t o fsoi l b yth e EPA
. tt yo u hav e an yquestio n abou t legalit yo fa certai n drivewa yo rparkin g area , yo u ma ycontac t th e cit yo fOmaha' s Plannin g Departmen t a t (402 ) 444-5150
. r~ | Pleas e chec k thi s bo xi fyo u understan d th e informatio n outline d above
. 

# ^CjLr\fC^V/ ^ ^ Wr
. h)c\ioe
.

Chec k th e bo xi fOwne 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 fhouse , includin g foundatio n crack s o rfissures
.



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

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Supervise d B y 

## Certificat e o fVerificatio n

2 8 SOI L 2011-01-1 9 10:5 2 91.1 1 Fina l Av g o f25-2 7 110 8 S 2 8 S T B 2 8 " C.PADILL A 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 193.01 5 Supervise d By : 

## Certificat e o f Verificatio n

2 5 SOIL 2011-01-1 9 10:5 1 30.6 7 Fina l 2104 9 110 8 S 2 8 S T B 2 8 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r ± 18.61 0

# 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 228.30 3 Supervise d By : 

## Certificat e o fVerificatio n

2 6 SOI L 2011-01-1 9 10:5 2 30.2 5 Fina l 2104 9 110 8 S 2 8 S T B 2 8 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r ± 22.71 9

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

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pp m P b 192.03 7 Supervise d By : 

## Certificat e o fVerificatio n

2 7 SOI L 2011-01-1 9 10:5 2 30.1 9 Fina l 2104 9 110 8 S 2 8 S T B 2 8 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r ± 21.41 5

# 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 By : 

## Certificat e o fVerificatio n

2 4 SOI L 2011-01-1 9 10:4 6 90.6 5 Fina l Av g o f21-2 3 110 8 S 2 8 S T F 2 6 " C.PADILL A 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 124.88 6 Supervise d By : 

## Certificat e o fVerificatio n

2 1 SOI L 2011-01-1 9 10:4 5 30.1 6 Fina l 2104 9 110 8 S 2 8 S T F 2 6 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r ± 18.24 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 133.91 2 Supervise d By : 

## Certificat e o fVerificatio n

2 2 SOI L 2011-01-1 9 10:4 5 30.2 9 Final 2104 9 110 8 S 2 8 S T F 2 6 " C.PADILL A CONFIRMATIO N CLEA R

Erro r ± 18.57 8

# 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 130.91 6 Supervise d By : 

## Certificat e o fVerificatio n

2 3 SOI L 2011-01-1 9 10:4 6 30.2 0 Fina l 2104 9 110 8 S 2 8 S T F 2 6 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r ± 18.57 8

## /^ O \ Omah a Lea d Site—Fixe d Pric e EP-R7-67-0 5 I ^^^ ^

I Coasta l Environmenta l Grou p Inc
. S!y^y ^ www.coastalhazmat.co m ^PHOt*" ^ COASTA L ENVmONHINTA l « • 0 U P , I N C 

# EXECUTIV ESUMMARY : BVID #21049-(110 9 S 2 8 ST )

~x \No Issue s o r Concern s Q Issues/Concern s Detail Explanation : -DANGARVE Y WALKE D TH EPROPERT Y O N9/16/201 0

# ^ 1 EP APropert y Clos e Ou t For m Propert y» : Propert y Addrcsr
. 

## 11DQ_ 1 Date/Time : 

### 9liili o Owner' s Nametl^iQD ^ Quad s Excavated : Contracto r Grou p CV^i Excavatio nGenera l I
.I f neccssuy , wer e th e correc t qtiadrantd ) excavate dan drestored ? 2
.I f necessaiy , wer e th e correc t area s ofdri p zon e excavaie dan drestored ? Gradin g So dan dVegetatio B I Doe s Ihe gradin g aroun dth e perimete r ofth e hous e i ncKcavaie darea s generall y slop e awa y firomth e house ? 2
.Ha s so dbeenlai dmal l area s that wer e excavated ? 3
.Doe 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 a} 0 da y tun e period ) 4
.At e sodde darea s generall y firman devenl y graded ? 5
. . Aji e th e joint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat e if inspecte da t a3 0 da y tim e period ) 6
. Wa s th e property grade dsuc hthat wate r wil l not poo l onth e property' ' I 7
. Wa s danug e t o landscBpin g o r plan t material s avoided ? Gates , Fencc aan dRcUtnip g Wal b { 1
. O o gate s ope nan dclos e freely? (t f applicable ) 2
.Wer e al l gate s o r fence s take ndow ndurin g restoratio nactivitie s reinstalled ? (I I applicable ) 3
.Wa s damag e t o gate s or fence s avoided ? ( I f applicable ) <l

.Wa s damag e t o retainin g wall s avoided ? (Ifapplicable ) FouDdatioD , Sidin g an dGnlier s \
. Wa s danng e t o th e sidin g o r tri mavoided ? 2
.Wa s damag e t o th e foundatio navoided ? Wa s damag e l 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 l o downspout s o r downspou t extension s avoided ? Sidewalk s an dDriveway s (Concrete ) 1
. Wa s damag e l o drivewa y surface s avoided ? 2 , Wa s damag e t o walkway surface s avoided ? Yes N o / y Ye s ^ o 

### y
y 

# y l

y
y 

### y Vc s N o 

### y y y Ve s N o 

# y y 

## y " y y Ye s N o /

## OM'ocr s comments :

inspectio nnotes :

Removal andresloratio nactivate s cornplel e includin g the 30-da y sodwarranry : F.P ARepresentativ e J^c ^ ^0 ^ Date: ^ lb^li°..
_

# i r

Propert yCompletio n Agreemen t
I hi s agreemen i docuinenl s Ihe completio no t remedia l acliviiie s perroime donm y properl y M y signalui e wil l designat e tha t I amsatisfie dwithth e re.<;toraliono f my property , an dlhal n o item s ar e i nquestion s nov^ , o r a

t an y lime i nth e future , excep t thos e item s liste dbelow , if an y Propert y ID : ^]})U ^ Propert y Address : ^^Q Q Q ^ i3D_St l 

# Q""" ' F^r<V|iiP v El'2on^ n !!n : lf?lQ?-^^s^52 l Restoratio n Item s i n Question :

Item : Item : Item : Item : Item :

= = Item :
Additiona l Comments :

I nyrr c icstoralio ni s complcled , rxccp l a s nnler i > [ I I rio no l aurf c rrsioratio nis complclcr i 

# y,^;s. ^fziyjiTTii o ffi-N'i'^ fiy/trjjiM- yy,- )
Owner'.* : Signatur e Dal e Conl i arlor' s Signalur c Dal e