HomeMy WebLinkAbout0106 KNOTTY PINE LANE - Health 106 KNOTTY PINE LANE
Centerville
A = 191 — 097
SMEAD
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UPC 12534
smead.com • Made in USA
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No. 1 Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:—{z
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ftplitation for Disposal 6pstem CDnstrurtion Permit
Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address& t No. /OCS /G.�r�I f/ /�ia,e Owner's Name,Address,and Tel.No.
LPri�d Vt p�e.
Assessor's Map/Parcel / _ C�r��`�r Y
Installer's Name,Address,and Tel.No. Designer's Name,Address,annd�Tel.No.
Do-961ci5 A �oC7t.LaJ .i f c Sng-y�,�7/ N N sue,^r l/�f9✓L
Type of Building: {
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building ryi��iv//q l No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) y!y® gpd Design flow provided gpd
Plan Date —1 U—! S" Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S. 3 5-00 R 4)JG-J C kc--" -e/S d-A
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) 4 Alev 1 .-'TjlCY A^Jy 13 17-00 gpf
( IK.^�)rrs t'0 ► LI 91 S toN
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Signed Date 3 —/
Application Approved by Date '3
Application Disapproved by Date
for the following reasons
Permit No. OQO 1 Date Issued �^
No. gC � "a
o 15 - V ' Fee
THE COMMONWEALTH OFWASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN'OF BARNSTABLE, MASSACHUSETTS Yes
applitationlor Disposal 6pstem Construction Permit
Application for a Permit to Construct( ) Repair("Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address(Sr�yt No. /Od le-brit// /�,✓ t Owner's Name,Address,and Tel.No.
e,v,.,�✓V, lI-e-
C�Y✓GbY✓
Assessor's Map/Parcel_ /,5?/
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
�cxJslc.S �4C yJ 5-0 /'l
8"yam'7/,3-
/
Type of Building:
Dwelling No.of Bedrooms �"� 1 Lot Size /S�J7�f sq.ft. Garbage Grinder( )
Other Type of Building /q / No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) /gyp gpd Design flow provided gpd
Plan Date 9- -/(l- / S Number of sheets 2 Revision Date
Title
Size of Septic Tank 15-y, "'V Type of S.A.S. 3 C ZloA� ert ��if� N�S►�wP
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) /1)5 tUP 4 A,-JU :3 .,"pp /l�j,j
t' 4"S ( U
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Signed Date H " 3 -/
Application Approved by L Date
Application Disapproved by Date
for the following reasons
Permit No. o Date Issued �"
15
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certifitate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( p.�Upgraded( )
Abandoned( )by �I 1r7.75 A i2)royj,J L NC
at /o(D V_ y 7,ti -P 1.,CAA)e �,c t-has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.<'6 1 S"6�l dated l 3 .5
Installer Designer
#bedrooms �-) Approved design flo t'� gpd
The issuance of thi perinit shall not be construed as a guarantee that the system will fo as desig4d.
Date C Inspector
--------------
No. r Fee V y
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION- BARNSTABLE, MASSACHUSETTS
Disposal bpstem onstrUttion �ermit
Permission is hereby granted to Construct( ) Repair( V Upgrade( ) Abandon( )
System located at ((Xo J( N y t v I�.ru-n RAJ J i&yl
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit. n C
Date 9- 3 Approved by v /
r
Town ®f Barnstable
b4' EPoya Regulatory Services
Richard V. Scali, Interim Director
ennrr asc,E, ,
Q �p Public Health Division
'Fo y Thomas McKean, Director
200 Main Street,11yannis,MA 02601
Off ce: 5 8-862-4644 Fax: 508-790-6304
Installer & Designer Certification Form
Date: ;Sewage Permit# f - ) Assessor's MapTarcel t 1 1 — CI "7
Y-A5. t1 d� B�a�,2 Inc
gn '
Designer:• Installer-,
—� ;-+-�'-�'+�°,�--6a��r�4S--mac,
C ? ,��o , 3c, x DNS"
-Ad4r�es : 1 2 .0,1 e, � C;ir<s e (c Address: 1
0 A 4 . i�rz,J,ti (v%,( was issued a permit to install a
(date) (installer)
se tic s}stem at 1 <<``n `+' �C'r`R �'� C�"'�` based on a design drawn by
� (address) I
Zvi, n-.ter ct r.ta,lC , dated
(designed) .
certify that the septic system referenced above was installed substantially according to
e design, which may include minor approved changes such as lateral relocation of the
istribution box and/or septic tank. Strip out (if required) was inspected and the soils
ere found satisfactory.
certify that the septic system referenced above was installed with major changes (i.e.
eater than 10' lateral relocation of the SAS or any vertical relocation of any component
f the septic system) but in accordance with State & Local Regulations. Plan revision or
ertified as-built by designer to follow, Strip out (if required) was inspected and the soils
ere found satisfactory.
a?s^_�e�ey
certify that the system referenced above was construr��Z with the terms of
e IAA approval letters (if applicable)
PETER 'i-• cep
WENTEE `jt
v Civil. '
stal er's:Signa'lure) A� c��� `���s
esiper'-s Signature) (Affix Designer's Stamp Here)
P �,EA E RETURN TO_13ARNSTABLE PUBLIC HEALTH DIVISION. CERTZ'EtICATE
W C iVIPLIA.NCE TWILL NOT BE ISSUED UNTIL BOTH TIES FORM AND AS-
BUIL CARD ARE RECEIVED_.6Y THE BA.RINSTABLE I'U73L,IC HEA?�TI3I�)VISiON.
T a,-_Y 0 U
Q:�epticl esigner Certification Form Rev 8-14-13.doc
TOWN OF BARNSTABLE
LOCATION t o SEWAGE#
VILLAGE ASSESSOR'S MAP&PARCEL I c►1-O�J7
INSTALLER'S NAME&PHONE NO. - :)%V e&nx Ly,,%TW_ SC5f3-Ya0-�/S3y
SEPTIC TANK CAPACITYj5�►rvc II
LEACHING FACILITY:(type) SCX9 QrjL e kew6S(size) 12, 3)( 33S K2—
NO.OF BEDROOMS
OWNER f!
PERMIT DATE: L{ - "3-I S COMPLIANCE DATE:
Separation Distance Between the: N a N e Q t iPP«
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist on
site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BY
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OJT- SG,S 33
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fNE Town o Barnstable P#
�p 1
Department o� Regulatory Services
BARNSTABLE, Public H�alth Division Date f�
v� 1619,
9, 200 Main Strd�,et,H nis MA 02601 `
A�FD MAC a �
0
° i/
Date Scheduled r� Time Fee Pd,
Soil Suitability Assessment for Se eApos"�l
Performed By: {� ��c� i lc�ZC s "`y /S L��-Witnessed By:
LOCATION & GENERAL INFORMATION
Location Address I d ���� vt �` �� Owner's Name
Address �6 6 F �U77 y t J
Ce4 t 4-e itc ev /-'1-
Assessor's Map/Parcel: �. 'L — '7 i Engineer's Name,
NEW CONSTRUCTION II REPAIR Telephone# j e F —737 V 76 Kr
Land Use _ I�51�o`Q4it.��'� I Slopes(%) _ Z Surface Stones ✓Voi-e
Distances from: Open Water Body /J ft Possible,Wei Area /N ft Drinking Water Well -�![y7ft
Drainage Way_A)I)A- R Propertyi Line .� ft Other ft
I I
SKETCH: (Street name,dimensions of lot,exact locationslof test holes&Pere tests,locate wetlands in proximity to holes)
I �
I
I
I
Parent material(geologic) �11 l G�l v�/ Depth to BedrockG
Depth to Groundwater: Standing Water in Hole: I`' Weeping from Pit Face
1
Estimated Seasonal High Groundwater 1 i
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: i in. Depth to soil mottles:
Depth to weeping from side of obs.hole: in. Groundwater Adjustment R.
Index Well 0 — Reading Date: Index Well level Adj.factor Adj.Groundwater Level_
PERCOL-ATION TEST Date Time
Observation Time at 9" _
i
Depth of Pere Z O Time at 6"
c cq LG✓1 J
Start Pre-soak Time® 2 �J Time(9"-6")
� zs 1—Via....
End Pre-soak l..l S
Rate Min_/inch l S � f
a
t Site Suitability Assessment: Site Passed_� Site Fiiled: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back-----------
***If'percolation test is to be conducted within 100' of wetland, you must first notify the
I Barnstable Conservation Division at least ong (1) week prior to beginning,
QASEPTIC\PERCFORM.DOC
DEEP.OBSERVATION HOL�LOG Hole#
4th from Soil Horizon Soil Texture Soil Color Soil• Other
Surface(in.) (USDA) !(Mi nsell) Mottling '(Structure,Stones;Boulders.
Consiste vl
jib -3 c 43 5�---• ��
L -i2v 2,7-
DEEP OBSERVATION HOLE LOG Hole# '
pth from Soil Horizon Soil Texture Soii Color Soil Other
SS irface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
_ I ConsistencY.95.Gravel)
Z
i
i
DEEP OBSERVATION HOLE LUG Hole#
Depth from Soil Horizon Soil Texture Soil;Color Soil Other 1
Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders.
C i e t3. e I
i r
DEEP OBSERVATION HOLh LUG Hole#
Depth from Soil Horizon Soil Texture Soil Color boil Other
Surface(in,) (USDA) (Munsell) Mottling (Structure,Stones',Boulders,
Con s'
Fjood Insurance Ra te_N a P:
Above.500 year flood boundary No_ Yes-.( ,.
'`� i
Within 500 year boundary No JZ Yes
Within 100 year flood boundary No Yes
Tenth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervio s irlaterial exist in all areas observed throughout the
a ea proposed for the soil absorption system? 1" �1 1-
I'not, what is the depth of.naturally occurring pervious material?
i
C eftif_Cation
I cert' ify that on �����' q (date) I have passed the I soil evaluator examination approved by the
epartment of Environmental Protection and that the above analysis was performed by me consistent with .
e required trit'nm&expertise and experience described in:310 CMR 15.017.
Signature• l Date
I
Q:�.SBPTlC�PBRC:FORM.]?O C
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,4'
LEGEND N
103,27
BENCHMARK '-`
- 98 -- EXISTING CONTOUR
COR.IBULKHEAD x 100.98 EXISTING SPOT GRADE -10, Moon Moon P L ny
EL.=103.11 0 0 5
W EXISTING WATER SERVICE 'a L
s 3
103.2 _ _ G EXISTING GAS SERVICE �°c o °-
7----1� ---104,20 S 1 1'31'40" W --- m p v Mene sho Ln
`+' U UNDERGROUND WIRES a . C
X 104,17 1 � 51
x 101,41 g o
- x 11�5 TEST PIT Y N
102.83 / _ 33.5'-=►=10' t
\ r - --.-. ---.-.-1 BENCHMARK
7' $ LOCUS
44 G \ _' .PROPOSED S.A.S.. 02.82
c / 103,24
ton �n
\ / x N I• p p p �'_•,,:I ' Woodvale Ln Cor\e
10 .99 xv
103.
102.51 GARAGE 103.00
103,06 ,Q) LOCUS MAP
r ;..PAVED;:
EXISTING LEACH PITS NOT TO SCALE
BRZ. PATIO CONTRACTOR SHALL PUMP,
DRIVEWAY_::::;:;, : war FILL WITH SAND & ABANDON GENERAL NOTES:
;.:.: /
103,5 103.11
CN
00. a ":: ' ::''' p 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
N p 103,13
o',::: \ _ Z BOARD OF HEALTH AND THE DESIGN ENGINEER.
6. ,_
� 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
(aPPfOx'�-- - EX/STING O j/ OJo� OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
/ N LOCAL RULES AND REGULATIONS.
.cn 102.89 i
HOUSE 106 00
:t 1 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
IT.O.F.=103.9f N TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
I` DESIGN ENGINEER.
q`FO.. :' ' >' x 02.61 / 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
W 101.70 FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
102,51 .* x 102.�6 ENGINEER BEFORE CONSTRUCTION CONTINUES.
102,79 EXISTING SEPTIC TANK 5. ALL ELEVATIONS BASED ON ASSUMED DATUM.
[�.� "� '•;' . TOP OF TANK, EL.=101.77 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
�1 c
,k �' .,�:� :•, I INV.(OUT)=100.44.t THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
x 102.26 G I HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
.t... x 102.52
LOT 28 4� 7. WATER SUPPLIED BY TOWN WATER SERVICE.
--- :'io2.a9° 15,825tSF 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S.
9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
�.M�B-L-���--097- 101.82 AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE
DIRECTED BY THE APPROVING AUTHORITIES.
101.82 x
0 x 101,54 :` 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY
!�101,47 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
x 101.46 CONSTRUCTION.
11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS
x 100,3 IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND
100,71
p ' 72, REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3).
100;5:9..: 100.71
x 100,66 78P12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE
x 100,66 78. 1 •3 ' INSPECTED BY A LICENSED SOIL EVALUATOR PRIOR TO BACKFILL.
x b90E 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND
TCH BASIN- 11�31 4O E �_ OF IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY.
99.26 �P��� 04sS9C
100,35 == :�: ' ' �� PROPOSED SEPTIC SYSTEM UPGRADE PLAN
99,87 edge of pavementE 100,53 o PETER T. ✓'
100,08 99,59 M CIVIL EE 106 KNOTTY PINE LANE, CENTERVILLE, MA
' No. 35109
��p Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632
KNOTTY PINE LANE F E-/Sl- Engineering by: SCALE DRAWN JOB. NO.
OWNER OF RECORD S EN 9
CHEVALIER, RONALD N & NANCY Engineering Works, Inc. 1"=20' P.T.M. 105-15
106 KNOTTY PINE LANE 2ttal�� 12 West Crossfield Road, Forestdole, MA 02644 DATE
CHECKED SHEET N0.
CENTERVILLE, MA 02632 (508) 477-5313 2/10/15 P.T.M. 1 Of 2
- i
i
t NOTE: TO PREVENT BREAKOUT, THE PROPOSED \ BRZ.
FINISH GRADE SHALL NOT BE < EL:100.3 WAY G\GE
SEPTIC TANK FOR A DISTANCE OF 15 AROUND THE BACK OF HOUSE
INSTALL RISERS & COVERS OVER INLET PERIMETER OF THE S.A.S.
AND SET TO 6" OF FINISH GRADE. PROPOSED D-BOX PROPOSED S A.S."
T RISER & PROVIDE ONE ACCESS MANHOLE TO WITHIN 3"
INSTALL WATERTIGHT T.O.F. COVER SET TO 6" GRADE OF FINISH GRADE FOR INSPECTION PURPOSES
F.G. EL.=102.9f F.G. EL.=102.8t �S•
F.G. EL.=102.8t F.G. EL.=102.9t sO ��
MAINTAIN 2% GRADE (MIN.) OVER S.A.S. •2• �p
�tK.
L = 23' L = 13' fp�y
® S=1% (MIN.) ® S=1% (MIN.)
4"SCH40 PVC 4"SCH40 PVC
6"
10,1 n
14" 8' BBBaE®a
EXISTING a8" uoulD aa6aaaa
LEVEL / O /
GAS BAFFLE INV.=100.10 PROPOSED INV.=99.93 4' EFFECTIVE WIDTH = 12.8'4,
INV.=100.44t D-BOX O /^�
EXISTING INV.=99.80
EXISTING SEPTIC TANK 3-500 GALLON LEACHING CHAMBERS /
SURROUNDED WITH STONE AS SHOWN 2 �\
H-10 RATED � v
TOP CONC. ELEV.=100.6t
BREAKOUT ELEV.=100.3
NOTES: INV. ELEV.=99.80 aaaa SEPTIC LAYOUT
a66a
"EFFEC
aaaa1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE BOTTOM ELEV.=97.80aaa aINVERTS, PRIOR TO INSTALLATION. 3 x 8.5'=25.5' 4'2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE 4' MIN. OF NATURALLY OCCURRINGVE LENGTH = 33.5'
ON A MECHANICALLY COMPACTED SIX INCH CRUSHED PERVIOUS MATERIAL
STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). 5' MIN. ABOVE GROUNDWATER LEACHING SYSTEM SECTION ®:EOED
® 0 ® ®®
3) INSTALL INLET & OUTLET TEES AS REQUIRED. BOTT. OF TP-1&2, EL.=92.8 _ ® ®®® ® ®®®® 33"
4) CONTRACTOR SHALL INSTALL A GAS BAFFLE ON 3/4" TO 1-1/2" DOUBLE N WPERI
® ®®® ® ®®®
THE OUTLET TEE. WASHED STONE z
3" LAYER OF 1/8" TO 1/2"
SEPTIC SYSTEM PROFILE ( DOUBLE WASHED STONE
OR APPROVED FILTER FABRIC) 1 O2"
DESIGN CRITERIA SOIL LOG 4" KNOCKOUT
DATE: FEBRUARY 9, 2015 (REF#14,633) 20" DIA. COVER
NUMBER OF BEDROOMS: 4 SOIL EVALUATOR: PETER McENTEE PE(SE#1542) / 58"
SOIL TEXTURAL CLASS: CLASS I WITNESS: DONNA MIORANDI R.S. HEALTH AGENT 4" KNOCKOUT 4" KNOCKOUT
DESIGN PERCOLATION RATE: <2 MIN/IN ELEV. TP-1 DEPTH ELEV. TP-2 DEPTH 0
(0.74 GPD/SF LOADING RATE) 102.8 A 0" 102.8 A 0"
DAILY FLOW: 440 GPD SANDY LOAM SANDY LOAM 4" KNOCKOUT
DESIGN FLOW: 440 GPD 10YR 4/2 10YR 4/2
GARBAGE GRINDER: NO 102.1 a 8" 102.1 B 8"
LEACHING AREA REQUIRED: (440 GPD) = 594.6 SF SANDY LOAM SANDY LOAM 500 GALLON CAPACITY, H-10 LOADING
.74 GPD/SF 100.3 10YR 5/4 30" 100.1 10YR 5/4 32„ CHAMBERS
EXISTING SEPTIC TANK: 1000 GALLON CAPACITY C PERC C
PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLETS M-C SAND 28"/40" M-C SAND
USE 3-500 GALLON LEACHING CHAMBERS IN SERIES 968 2.5Y 6/4 2.5Y 6/4 PROPOSED SEPTIC SYSTEM UPGRADE PLAN
SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES c 72 f9s s c 72 106 KNOTTY PINE LANE, CENTERVILLE, MA
SIDEWALL AREA: 2(12.8' + 33.5') X 2 = 185.2 SF MED. SAND 4 MED. SAND Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632
BOTTOM AREA: 12.8' x 33.5' = 428.8 SF 2.5Y 6/6 l 2.5Y 6/6
� Engineering by: SCALE DRAWN JOB. N0.
TOTAL AREA:..............................................................614.0 SF 92.8 120" Engineering Works Inc. NTS P.T.M. 105-15
120 ,92.8 g g ,
DESIGN FLOW PROVIDED: 0.74 GPD/SF(614.0 SF) = 454.4 GPD NO GROUNDWATER, PERC RATE: <2 MIN./IN. 12 West Crossfield Rood, Forestdole, MA 02644 ATE CHECKED SHEET NO.
(508) 477-5313 /10 1/ 5 P.T.M. 2 Of 2
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