* 

## TRANSMITTALo f

OMAHALEAD SIT E SOI LREMEDIATIO NFIL EFOLDE R
SAI D #: 2^70 ^Date: Address : l//ol 2 Cf.^Yh] ^ 5 + Remediatio nContractor : Coasta l Environmenta l Group

_Year : _2010ARRA

_
SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S WVide o ofpropert y (DVD ) Q ^ Executiv e Summary Qy EPA-provide dproperty slcetc h B

— Signe dAcces s Agreemen t fo r subjec t property
. ^^

—Signe dAcces s Agreement(s ) fo r adjacent property -•^r Restoratio nAgreemen t "^j^

—Settlemen t document s (i.e. , fo r damag e o r to replac e plants , etc. ) ''^y Confirmatio ndat a O

­ Photograph s if e ^^Alte* ^ ^ (x(yP(\IPc^(yi A^ 4(7 ^ \B'' ^ As-buil t sketc h "B " Satisfactory restoratio nsigne db y Property Owne r vQ

- Property close-ou t chec k lis t signe db y EP A •^ ^ Descriptio nofarea s no t meetin g RO D cleanup criteri a 'QyUtility clearance s Qy ^ Property informatio nfro mDougla s County Assessor' s Offic e D

3026102 3 

# • II I 

# I Superfun d

## Propert yAcces s Checklis t Property ID : 

# ^'4o ^ Property Addresit ; ) i ' i 2 , CIAJ ^ 'Z^I^ ^ D D

WOR K STARTE D WORKCOMPELTE D ON : ON : _ / / /_ /


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D NotificationLette r I^!}^cces s Agreement pNRestoratio nAgreement D Topsoil Samplin g (if applicable ) D Disposa l Samplin g (if applicable ) Q Garde nSamplin g (if applicable ) 1 D Utilit y Clearanc e 1 D Video/Photo s (Before ) 1 D Video/Photo s (During ) 1 D Video/Photo s (After) D Video/Photo s (30-Day) D Property CompletionAgreement D I<'ina l Report Sent : / / 

### Signed : ^/^//£ ) 

## si^tA'

. jni i£ l ui > 1 1 1 1 1 1 Called : / / On : / / On : / / On : / / On : / / Signed : / / Issued : / / By : By : By : By : By : By : By : By : By : By : By : By : By : Ai r Monitorin g (a s applicable ) C l Communit y • Cre w Rcsidts : O n / / By :

nCommunit y Results : Q Crew On : / / By :

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Omah a Lea d Sit e

### Dougla s County Accoxin t Infoacatio n Pag e 1 of 2 xaaoa :
Dougla s County , Nebrask a Propert yRecor d - R174457000 0 Prin t Reoor t Vie wInteractiv e GI S Ma o Infonnatio n i s vali d a s o f2010-8-3 0 Treasurer' s Ta xReoor t Ne wFeatur e - ^ ^

-r ^

Subdivisio n Sale s Searc h Owne r NIKOLA S MICHAE L E
P 0 BOX 455 4 OMAH AN E 68104-000 0 Propert yInformatio n Ke yNumber : 445 7 000 0 1 7 Accoun t Type : Residentia l Parce l Number : 174457000 0 Parce l Address : 161 2 CORB YS T OMAH AN E 68110-000 0 Lega l Description : MILLAR D & CALDWELL' S AD D LO T2 0 BLOC K0 W5 0 F T5 0 X 86.62 5 Valu e Informatio n Lan d Improvemen t 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 Sale s Informatio n Sale s Date : 1999-07-1 6 Dee d Type : D Boolr : 213 3 Page : 34 7 Price : $150.0 0 Grantor : Grantee : Valid/Invalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.0 9 4300. 0 0. 0 86. 0 50. 0 Ye s



### http://douglasne.mapping-online.com/DouglasCoNe/static/acco\mtinfo.jsp?accountno=R l 7..

. 9/15/201 0

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• YOU RTICKE T NUMBE RI S 2700077

. Origina l Cal l Date : 3/31/1 1 Time : 1:2 0 p m Op : ALFONSO1879 0 Wor k t o Begi n Date : 4/04/1 1 Time : 1:4 5 pm State : N E County : DOUGLA S Place : OMAHA Address : 161 2 Street : CORB Y S T Twp : 15 NRng : 13 E Sect-Qtr : 10-SE-S W 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 AND T O TH E PEDESTAL Remarks : FA X AL L CLEAR S TO : (402)934-281 1 : PLEAS E INCLUD E AL L EASEMENT S Compan y: COASTA L ENVIRONMENTA L SERVIC E Contac t Name : ALFONS O Phone : (402)934-283 7
Wor k Bein g Don e For : Coasta l Dept h o f Excavation : 4f t Corne r Lot : NFront : Y Rear ; Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N CXCATV MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C



## Servic e Are a Contac t 

## Phon e Numbe r Utilit y Typ e
CXCATV CO X COMMUNICATIONS , INC HEIDI Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7

MUDO l METROPOLITA NUTLLITES DISTRIC T SAND Y MUD Day : 402504782 3 Alt : Emerg : 402504797 0

OMAHACO F CITY O FOMAHA

TRAFFICSEWE R RICH/TRAFFIC Day : 402444719 7 

## Ah : 402444516 1 Emerg : 402444516 0

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# Omah aLea dSuperfun dSit e OLS# : 2970 8 Dat e Excavated : 4/7/201 1 

## 2970 8
Exterio rPain t Nortt i Antr « Omah a Lea d Sit e Owne rName : MICHAE L E NIKOLA S •Goo d SH e Sketc h Address : 161 2 CORBYS T •Poo r

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# lili i 2970 8 Exterio rPaint Nortt i AncT H Owne rName : MICHAE L E NIKOLA S Omah a Lea d Sit e •Goo d Address : 161 2 CORB YS TSit e Sketc h •Poo r Phone : »- 402-578-115 1 W : 402-571-972 6 

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# Consen t fo fAccess

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RIGH TO F ENTR YT O PREMISE S 

### Granto r(th e propertyowner) 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 reprissentatives , 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 priemises : "^J^^^floSy ^

Owner' s Name : Daytim e Phone : 

# V\vcW V )JlVx6W 5 

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Addres s o fPropert y covere d b ythi s Agreement : 

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PURPOS E O F RESPONS E ACTIVrriE S 

### Th e EP Ai s requestin g acces s t o collect soi l sample s an d remove soi l tha t contain s elevate d concentration s o f lea d an d ma ypos e a healt h hazard

. Th e area{s ) wil i 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 restorie 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 f Coasta l Environmenta l Group , contracte d byUSEPA , wil l contact th e Grarito rin-perso n t o discus s th e wor k t o b e performed , th e Granto rwil l have a n opportunityt 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 EPAtha t th e property 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 , confractors an d subcontractors th e righ t t o ente rth e property , a t al i 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 effect unti l th e wor k has bee n satisfactoril ycompleted

. Th e Granto rals o agree s to :

Pag e 1 o f2

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COASTA L

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### e Remov e obstaiction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; e 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 ; cAbid 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

. e Allo wvideotapin g and/o rphotographin g o fth e properly

. AGREEf^ENTNO TT 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
©ig r D I d o no t gran t acces s t o mypropertie s I gran t acces s t o mypropertie s 

# ^ y ^ 

# ^ ^ Signature Dat l 

### Signature Dat e

n I woul d iik e t o b e presen t durin g an ysamplin g ths t i s required

.

Page 2 o f2COASTA L CROUP , IMC

. 

## 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 documentatio 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 Environmental Protectio nAgenc y (EPA)

.

Property ID:^^^; ^ Property Address : /^/ ^ Cs>r^ y O^vner : \\,^ K JJU^^ s Phone : O nth e attache ddiagram(s ) indicate area(s ) t o excavate , surfac e structure s an dlandscapin g feature s an d acces s location(s ) t o b e use db y th e contractors
. Indicate distances , depths , material types , etc
. Photographicall y an dVideographicall y document th e existin g condition s ofth e property an dth e basement if 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 rretu m o fthes e item s i s th e Owner' s responsibility

. Item : 

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### /Lyi^t^ty y Item :
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### Landscap e Inventor y Ite m Quantit y Uni t Condition/Type/Specie s Pre-existin g property area , Quadrant s that wil l b e excavated , that i s covere dwit hgrass . Numbe r o f tree s > 2 inc h Eac h 

# b i trunk diamete r Numbe r o f tree s < = 2 inc h Eac h 

# -h- ^ trunk diamete r Numbe r o f Sprinkle r Zones , Contro l Valves , Eac h 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 Eac h area . Square Fee t Attac hasketc ho f relativ e size s an dlocations

. Agree dupo nvalu e o f plan t material s no t to b e replace db v contractor
. Not e thi s vaiu e wil l b e use dt o issu e aplan t vouche r t o th e propert y owner . Easemen t Area , t o b e Eac h excavate d 

# ud_^ani^

_ Pag e 2 of

.COASTA L ENV I RONM C NTA L CROUP , INC

.

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

. I fyo 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

. Q Pleas e chec k thi s bo xi fyo u understan d th e informatio n outline d above

.

^

•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 rqf'house , includin g foundatio n crack s o rfissures

.


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e 16515.52 3 M n 592.89 6 Supervise d By : 

## Certificat e o fVerificatio n

7 7 SOI L 2011-04-0 8 11: : 1 1 48.3 5 Fina l 2970 8 161 2 CORBYS T B 2 4 " C.PADILL A CONFIRMATIO N CLEA R

Erro r 1 6.46 3 ± 13.07 3 ± 7.42 5 11.68 5 ± 5.02 5 \ 8.92 2 ± 13.62 1 4.80 6 ± 12.42 6

: 10.21 9 ± 17.97 3

1 71.40 1 24.91 5 61.36 6 140.38 8 ± 294.33 2 ± 86.52 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 BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m M o < LO D Z r 487.15 0 S r 192.45 3 U < LO D R b 61.52 8 T h 15.22 6 P b 167.98 9 S e < LO D A s < LO D H g < LO D Z n 157.77 1 

## w < LO D C u < LO D N i < LO D C o < LO D F e 15705.02 3 M n 768.72 5 Supervise d By : 

## Certificat e o fVerificatio n

7 8 SOI L 2011-04-0 8 11:1 3 30.5 2 Fina l 2970 8 161 2 CORB YS T B 2 4 " C.PADILL A CONFIRMATIO N CLEA R

Erro r 8.27 0 ± 16.75 6 ± 9.75 6 14.89 9 ± 6.46 9 ± 8.68 2 ± 18.62 0 5.92 3 24.51 4 12.24 6 ± 22.11 6 83.13 1 33.29 2 74.21 1 171.15 1 ± 369.33 2 ± 122.47 9

# 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 QUADRAN T DEPH T XR F TEC H MIS C NOT E

M o Z r S r U R b T h P b S e A s H g Z n 

## w C u N i C o F

e M n Super v se d By : \ y 

## Certificat e o fVerificatio n

7 5 SOI L 2011-04-0 8 11:0 8 91.5 5 Fina l «Av g o f72-7 4

161 2 CORBYS T B l 4 " C.PADILL A CONFIRMATIO N CLEA R

pp m
< LO D 503.69 6 ± 179.63 9 ±

< LO D 65.68 8 ± 15.52 6 ± 287.66 9 ±

< LO D < LO D < LO D 155.38 9 ±

< LO D < LO D • ^ < LO D / : < LO D y : 17046.881 / 

### ±



# y ^ Erro r 8.37 6 17.10 9

9.52 0 15.29 3 6.72 6 9.77 5 23.62 0

6.15 2 30.92 7 12.31 7 22.24 8 ^,--88:263- ^ 33.492 ^ 79r^ 3 /^5.10 9 

### / -"^

387.40 9 ^

110.02 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 BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m M o < LO D Z r 485.02 1 S r 180.34 4 U < LO D R b 67.07 9 T h 23.56 0 P b 229.65 5 S e < LO D A s < LO D H g < LO D Z n 167.27 2 W < LO D C u < LO D N i < LO D C o < LO D F

e 17868.93 8 M n 506.25 0 Supervise d By : 

## Certificat e o fVerificatio n

7 2 SOI L 2011-04-0 8 11:0 6 30.5 1 Fina l 2970 8 161 2 CORBYS T B l 4 " C.PADILL A CONFIRMATIO N CLEA R

Erro r 8.52 2 ± 17.01 0 ± 9.62 7 15.51 4 ± 6.84 6 ± 10.05 6 21.71 2

6.00 5 29.09 6 13.06 7 23.24 7 93.08 6 33.13 5 83.20 0 189.97 1 ± 400.22 7 ± 107.34 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 QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m M o < LO D Z r 521.31 8 S r 185.95 8 U < LO D R b 62.20 7 T h < LO D P b 242.39 7 S e < LO D A s < LO D H g < LO D Z n 140.51 5 

## w < LO D C u 42.59 4 N i < LO D C o < LO D Fe 16140.31 6 M n 647.79 9 Supervise d By : 

## Certificat e o fVerificatio n

7 3 SOI L 2011-04-0 8 11:0 7 30.5 2 Fina l 2970 8 161 2 CORBYS T B l 4 " C.PADILL A CONFIRMATIO N CLEA R

Erro r 8.37 3 ± 17.24 5 ± 9.61 3

: 15.08 2 ± 6.52 8 13.01 9 ± 21.85 0

: 6.39 7 : 28.03 0 : 13.03 4 ± 21.35 9 91.30 7 ± 23.23 1 77.09 0 : 179.39 3 ± 374.68 6 ± 115.59 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 QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m M o < LO D Z r 504.75 0 S r 172.61 5 U < LO D R b 67.77 7 T h < LO D P b 390.95 4 S e < LO D A s < LO D H g < LO D Z n 158.38 0 

## w < LO D C u < LO D N i < LO D C o < LO D Fe 17131.38 5 M n 507.48 6 Supervise d By : 

## Certificat e o fVerificatio n

7 4 SOI L 2011-04-0 8 11:0 8 30.5 2 Fina l 2970 8 161 2 CORBYS T B l 4 " C.PADILL A CONFIRMATIO N CLEA R

Erro r 8.23 4 d b 17.07 2 d 9.32 1 15.28 2 ± 6.80 4 15.88 3 ± 27.29 8 6.05 4 35.65 4 10.85 0 ± 22.14 0 80.39 6 32.22 3 78.39 8 185.96 4 ± 387.31 3 ± 107.12 4

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1 

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 7 1 Mod e SOI L Tim e 2011-04-0 8 11:0 5 Duratio n 91.5 7 Sequenc e Fina l Flag s AVERAG E Av g o f68-7 0 ADDRES S 161 2 CORBYS T QUADRAN T EA DEPH T 1 " XR F TEC H C.PADILU \ MIS C CONFIRMATIO N NOT E CLEA R

pp m Erro r M o Z r S r U R b T h P b S e A s H g Z n W C

u N i C o Fe M n Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1 

## Certificat e o fVerificatio n

6 8 SOI L 2011-04-0 8 11:0 3 30.5 3 Fina l 2970 8 161 2 CORBYS T EA 1 " C.PADILL A CONFIRMATIO N CLEA R

Erro r 8.01 4 ± 15.19 5 ± 9.11 8

: 14.63 2 ± 6.68 2 ± 9.64 1 ± 23.66 7 5.95 0 31.11 8 12.04 7 ± 30.01 4

* 92.63 9 ± 23.79 7

* 74.31 9 194.28 7 ± 403.91 2 ± 100.29 6 XL3t-3208 9 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

M o Z r S r U R b T h P b S e A s H q Z n 

### w C u N i C o F

e M n pp m
< LO D 398.12 5 170.35 4

< LO D 68.54 0 14.71 4 296.61 5

< LO D < LO D < LO D 317.02 6

< LO D 55.91 7 < LO D < LO D 19209.14 3

426.77 8 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 QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m M o < LO D Z r 376.59 7 S r 198.31 6 U < LO D R b 64.20 9 T h < LO D P b 230.20 5 S e < LO D A s < LO D H g < LO D Z n 250.02 1 

### w < LO D C u 33.23 7 N i < LO D C o < LO D Fe 18307.35 4 M n 399.03 4 Supervise d By : 

## Certificat e o fVerificatio n

6 9 SOI L 2011-04-0 8 11:0 4 30.5 3 Fina l 2970 8 161 2 CORBYS T EA 1 " C.PADILL A CONFIRMATIO N CLEA R

Erro r 7.57 8 ± 14.54 8 ± 9.56 1 14.52 3 ± 6.36 6 12.85 0 ± 20.57 4 5.52 9 ; 26.64 8 12.30 4 ± 26.19 8

* 85.40 7 ± 21.24 5 73.76 3 J 182.62 5 ± 384.54 5 ± 94.84 5

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1 

## Certificat e o fVerificatio n
XL3t-3208 9 Readin g N o 7 0 Mod e SOI L Tim e 2011-04-0 8 11:0 5 Duratio n 30.5 1 Sequenc e Fina l Flag s BVI D 2970 8 ADDRES S 161 2 CORBYS T QUADRAN T EA DEPH T 1 " XR F TEC H C.PADILL A MIS C CONFIRMATIO N NOT E CLEA R

pp m Erro r M o < LO D l 8.04 4 Z r 376.78 1 ± 15.07 6 S r 180.59 6 ± 9.50 3 U < LO D : 15.83 4 R b 63.32 8 ± 6.67 8 T h < LO D \ 14.39 4 P b 306.00 2 ± 24.32 9 S e < LO D 6.36 2 A s < LO D ; 32.54 2 H g < LO D : 13.35 5 Z n 336.79 8 ± 31.30 6 < LO D 96.05 7 

### w C u 41.06 1 ± 23.17 1 N i < LO D 77.26 2 C o 245.64 1 ± 145.11 5 F

e 23347.22 5 ± 450.84 4 M n 479.11 2 ± 107.06 5 Supervise d By :X 

### f^QL' \ Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5

, J^^^ ' I Coasta l Environmenta l Grou p Inc

. ^^^^p * www.coastalhazmat.co m

"^"iPHOi* ^ COASTA L ENVIlONnENTA L C R 0 U f

. IM C 

# EXECUTIV ESUMMARY : BVID #29708-(161 2 CORB Y ST )
No Issue s o r Concern s [ ^ Issues/Concern s
Detai l Explanation : -DANGARVEY WALKE D TH EPROPERT Y O N04-21-1 1

## Propert yCompletio n Agreemen t
Thi s agreemen l documeni s lhe complclio n of remedial acliviiies peribiinedo n my properly

. My signaiur e wil l designal e ihai I amsatisfie dwilhthe re.'itoralio n of my properly , andtha ino ilem s ar e inquestions , now . or 31 an y lim e inthe future , excep i ihos e item s liste dbelow , ifan y Propert y ID : f^<^^ P Propcrf y Address : \ (o \y Owner : ^C^^QjJ j |/ ^ Phone : 

# ^^-IIS~ \ Restoratio n Item s in Question :

Item : Ilem : Item : Item : Item : Item :
Additiona l Comments :

rn- l xfirc c ic.^foralioni. s completed , excep t as note d [ I I ti o not ai;re c restoratio n i> complcie d

Owner' s Signatiirf
- Dati ^ ^^ itrarlor' s Signatur e

# ^ 1 EP APropert y Clos e Ou t For m Propert y #: d^9^S ^ Propert Propert y Address: ' • Addrt^:-^;^ ^ Datc/Tlne : Owner' s Name: , / ^ '/ , ^^-2y

- Quail s Excavated : Contracto r Grou p ("

. Excavatio nGenera l Yes No 1.

If neccssBiy , wer e th c correc i quadrant{s ) excavate dan drestored ? / 2.

If necessary , wer e th e correc t area s ofdri p zon e excavate dan drestored ? 

## y 1 Gradlo K So dan dVcgetalio n Ye s No 1 Doe s th e gradin g aroun dth e perimete r ofth e hous e inexcavate darea s generall y slop e awa y 

### y fromth e house ? 2.Ha s so dbeenlai d inall area s that wer e excavated ? 

# y_ 3.Doe s lh e sodappea r lo be generall y health y andgrowing ? (Onl y evaluat e if

inspecte d al a 30 

## ~y da y tim e period ) 4.Ar e sodde darea s genetall y firman devenl y graded ? 

# 'Z 5.Ar e thejoint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat e if

inspecte d at a

30 da y tim e period ) 

## y 6.Wa s the property grade dsuc hthat wate r wil l no t poo l onth e properry ? 

## y 7.Wa s damag e to landscapin g or plant material s avoided ? 

## y
Gates

. Fepce s an dRetainin g Wal b Ve s .N u I 1. Do gate s openan dclos e freely? (I f applicable ) / 2.Wer e al i gate s or fence s take ndow ndurin g restoratio nactivilie s reinsialled ? (I f applicable ) / 3.Wa s damag e to gate s or fence s avoided ? (Ifapplicable ) / 1.Wa s damag e to retainin g wall s avoided ? (Ifapplicable ) 

### y
Foundation , Sidiii K an dGutter s Ye s No 1.Wa s damag e to th e sidin g or tri mavoided ? / 2.Wa s damag e to th e foundatio navoided ? / 5.

Wa s damag e to window s avoided ? / 4 Wa s damag e to window s or doo r screen s avoided ? / 5.

Wa s damag e to downspout s or downspou t extension s avoided ? /
Sidewalk s an dDriveway s (Concrete ) Y c / t W No 1.Wa s damag e to drivewa y surface s avoided ? 2.Wa s damag e lo walkwa y surface s avoided ? 

# ~f

## Ort'tier s comments :

I ^ ^ 

## j Jn.spectio nno<es :

Removal andrestoratio nactivate s complete includin g the 30-da y sodwarranty :
EP ARepresenlaliv e Qo^^ ^ Date : I'^iL' L