Loading...
HomeMy WebLinkAbout0024 DOGWOOD LANE - Health LtuDogwood Lane. P 040 081 It --- - - - - -- - -- --- - - - i is Div.+`•-T.. ,• "' .:- � v ��SYS Al ` ' 3'Fk. +�tat xa pex , J }� - r CO MMOnweatth of:Mosso-chuselts Executtve Office of Er Wonmental Affairs - .John Grad-- - - - D.E.P.-Title V Septic Inspector @partment Of P.O. Box 2119 - Environmental Protection Teaticket,MA 61536. /(508) 564-6813 - Rr r SUBSURFACE SEWAGE--DISPOSAL SYSTEM`INSPECTION"FORM- PART A — --- CERTIFICATION ' _ yam. A -.. tzt* -Property Address:-24 Dogwood Lane Cotult Address of Owner: Date of Inspection:811219s *�. (If different) ' Name of Inspector:John Graci Rosa Mary Calssle Company Name,Address and Telephone Number: CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and Complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems; The system: r X_ Passes _ Conditionally Passes — Needs Further valuation By the Local Approving Authority Fails Inspector's Signature: Date:. 8113196 The System Inspector.shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this . inspections. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority.. INSPECTION SUMMARY: Check A. B,C, or D: A) SYSTEM PASSES: X I have not found any information which indicates that the system violates any of the failure criteria defined as in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B] SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair, passes inspection. Indicate yes,no,or not determined(Y, N,or ND). Describe basis of determination in all instances. If 'not determined",explain why not.) The septic tank is metal, cracked, structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised iviw95) One Winter Street • Boston,Massachusetts 02108 • FAX(617)556-1049 . Telephone(617)292-5500 J - .:.bq SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION.FORM PART A_ I CERTIFICATION (continued) - Property-Address: 24 Dogwood Lane Cotuit Owner: Rosa Mary Calssle } Date of Inspection:8112196 Sewage backup or-breakout or high static water level observed in the di5tribution_bo)Os due to a broken, - settled or uneven distribution box. The system will pass inspection if(with.approval of the Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced The system required pumping more than-four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed Cl FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the . system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT.THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh: 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT.PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface of water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone 1 of a public water supply well: The system has a septic tank and soil absorption system and is within 50 feet of a private waterl supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria volatile organic compounds indicates that the well is free from pollution for that facility and the presence of ammonia nitrogen and nitrate nitrogen is 9 g equal or less than 5 ppm. 3) OTHER D] SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be :contacted to determine what will be necessary to correct the failure. Backup of sewage in facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters-due'to an overloaded or clogged cesspool. _ SAS is in hydraulic failure. (revised 11115195) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM,` CERTIFIGATION_(contlnued). _ Property Address: 24 Dogwood Lane Cotult -Owner: Rosa MaryCalssle - Date of.Inspection:.&12196 D]'SYSTEM FAILS(continued) - - Static liquid level in the_distribution box above outlet invert due to'an overloaded or clogged SAS or cesspool Liquid depth in cesspool is less than 6"below invert or available volume is Tess than 1/2 day flow. - _ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Numbers of times-pumped - - — Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy.is within a Zone 1 of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool -or privy is less than 100 feet but greater than 50 feet from a private water supply well with no, acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and:nitrate nitrogen. E] LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria: - The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area (IWPA)or a mapped Zone II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 11115195) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM, PART B CHECLIST Property Address: 24 Dogwood Lane Cotuit Owner: Rosa MaryCalssle Date of inspection:V12196 Check if the following have been done: - x Pumping information was requested of the owner,occupant, and Board of.Health. - x_ None of-the system components have been pumped for at least two weeks and the and the system has been receiving normal flow rates during that period. .Large volumes of water have not been introduced into the system recently or as part of this ' inspection: n1aAs built plans have been obtained and examined. Note if they are not available with NIA. X The facility or dwelling was inspected for signs of sewage back-up. X The system does not receive non-sanitary or industrial waste flow:' x The site was inspected for signs of breakout. X All system components, excluding the Soil Absorption System,have been located on the site. X The septic tang:manholes were uncovered,opened, and the interior of the septic tank was inspected for condition of baffles or tees material of construction;dimensions, depth of liquid, depth of sludge, depth of scum. X The size and location of the.Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. , X The facility owner(and occupants,.if different from owner)were provided with information on the proper maintenance of.Sub- Surface Disposal System. (revised 11115195) " 4 SUBSURFACE SEWAGE-DISPOSAL SYSTEM INSPECTION FORM PART:G- SYSTEM-INFORMATION Property Address 24 Dogwood Lane Cotult Owner: Rosa MaryCalssle_ Date of Inspection:8112196 - - A _ FLOW CONDITIONS _ RESIDENTIAL: Design flow: 330 gallons - - - . _ Number of bedrooms: 3 r _ _"__.. Number of current residents: t Garbage grinder(yes or no): Na- Laundry connected to system(yes or no):`Yes Seasonal use(yes or no): No Water meter readings,if available, nla Last date of occupancy: n1a COMMERCIAL/INDUSTRIAL: Type of establishment: Na Design flow:a• gallons/day Grease trap present:(yes or no) No ; Industrial Waste Holding Tank present: (yes or no) No Non-sanitary waste discharged to the Title 5 system: (yes or no) No Water meter readings,if available: n1a Last date of occupancy: rya OTHER: (Describe) Na Last date of occupancy: GENERAL.INFORMATION PUMPING RECORDS and source of information: System has not been pumped in the last two years. System pumped as part of inspection: (yes or no)No If yes,volume pumped: 0 gallons Reason for pumping: n/a TYPE OF SYSTEM X Septic tank/distribution box/soil.absorptions system Single cesspool Overflow cesspool,. Privy Shared system(yes or no) ( if yes, attach previous inspection records, if any) Other(explain) APPROXIMATE AGE.of all components,date installed(if known)and source information: 1988 Sewage odors detected when arriving at the site: (yes or no) No (revised 11115195) 5 t SUBSURFACE.SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATIOW(contlnued) - Property Address: 24 Dogwood lane Cotuit - - - OWnef: Rosa MaryCalssle - Date of Inspection:8112/96 _ SEPTIC TANK:-X -- - (locate on site plan) - - Depth below grade: 2' - Material of construction:X con6reate_metal FRP other(explain) Dimensions: L 8'6'H 5'7"W 4'10'. Sludge depth:5. Distance from top of sludge to bottom of outlet tee or baffle: 22' - - Scum thickness:6' - Distance from top of scum to top of outlet tee or baffle:2' Distance form bottom of scum to bottom of outlet tee or baffle: o Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural-integrity, evidence of leakage, etc.) Septic tank and all components are structurally sound.Recommend pumping system every two years for maintenance. GREASE TRAP: (locate on site plan) Depth below grade: nla Material of construction: concrete_metal_FRP_other(explain) Dimensions: n1a Scum thickness:nta Distance from top of scum to top of outlet tee or baffle:n/a Distance from bottom of scum to bottom of outlet tee or baffle: n1a Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) Na (revised 11115195) 6 � ti- � �.a:'s tit - ,:t-.T _•� - - - SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM` PART C SYSTEM INFORMATION(continued) =- - Property Address: 24 Dogwood Lane cotult - Owner: Rosa MaryCalssie -" Date of Inspection:.112196 TIGHT OR HOLDING TANK: - (locate-on-site plan) Depth below grade: n1a_ -- - Material of construction: concrete_metal_FRP_other(explain) - Dimensions: n1a Capacity:- n1a gallons - Design flow: n1a gallons/day Alarm level: n1a Comments: (condition of inlet tee,condition of alarm and float switches, etc.) Na DISTRIBUTION BOX: (locate on site plan) - Depth of liquid level above outlet invert: n1a Comments: (note if level and distribution is equal;evidence of solids carryover, evidence of leakage into or out of box etc.) Na PUMP CHAMBER: (locate on site plan) Pumps in working order.(yes or'no) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) Na revised 11115/95 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C - - - -- --- SYSTEM INFORMATION (continued) -- _. Property Address: 24 Dogwood Lane Cotult - Owner: Rosa Mary Calssle -- - Date of Inspection:V12196 - SOIL ABSORPTION SYSTEM (SAS):X --------(locate on site plan;if possible;-excavation-not-required, but may be approximated by non-intrusive methods) If not determined to be present,-explain: . nla - Type: leaching pits, number: 1,000 gallon leach pit leaching chambers,number:nfa - - leaching galleries, number: nfa leaching trenches; number, length: nfa leaching fields, number, dimensions:nla overflow cesspool, number:n1a Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) The sas is structurally sound and functioning property.The leach pit has never had more than P of water in it CESSPOOLS: (locate on site plan) Number and configuration: nla Depth-top of liquid to inlet invert: nla Depth of solids layer: nfa Depth of scum layer: nla Dimensions of cesspool: nia Materials of construction: nla Indication of groundwater: nfa inflow(cesspool must be pumped as part of inspection) nla Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) nla 1, PRIVY: (locate on site plan) Materials of construction: nfa Dimensions: nla Depth of solids:.nfa Comments:(note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation;etc.) PrivyComments r (revised 1 111 519 5) yF#r +. 2,. ,, e`+y"x5.h.f,•, - ,g ?7f�-,.E .Fs' .t.%f`''�sY tj y '", ,3r'� 1 a.-., ':. .rr.ti.,.., � ._ t�. ..�F am�j a *a`:X`f-' •+„�•,`a.''s� �,. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM . PART C - SYSTEM INFORMATION (continued) Property Address:. 24 Dogwood Lane Cotuft Owner: Rosa Mary Calssle bate of Inspection:9112198 SKETCH OF SEWAGE DISPOSAL SYSTEM: -- include ties to at least two permanent references landmarks or benchmarks. locate all wells within.100' ry C AA $3' o At 21 E ` 1� . �b DEPTH TO GROUNDWATER Depth to groundwater:12 feet method of determination or approximation: USGS Maps and charts. (revised 11115195) 9 ,0, .. RECEIVED SEP 3 0 2002 COMMONWEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE EXE`C,.UTIVE, OFFICE OF ENVIRONMENTAL AFFAIR HEALTH DEPT. M Z DEPARTMENT OF ENVIRONMENTAL PROTECTION Z � _ h v 7 �0 ,,. TITLE 5 OFFICIAL INSPECTI©N FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE,SEWAGE DISPOSAL SYSTEM FORM s:a PART A �-: CERTIFICATION r1 t / o o' ' Property Address: 24 DOGW.00D;LANE, lJ COTUIT,MA 02635 "1 lJ Owner's Name: ROGER CAMPIAN, Owner's Address: 24 DOGWOOD LANE COTUIT, MA 02635 Date of Inspection: 9/10/02 Name of Inspector: (please prinit),',. I. %- GRACI Company Name: ;SEPTIC INSPE g CTIONS'' Mailing Address: R:D. BOX 2119 TEATICKET,MA.02536 Telephone Number: 508-564-6813'XAX 508-564-7270 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is lro§oy true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function andmain'tenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section F5i340mf Title 5(310 CMR 15.000). The system: X 11asses _ CoIly sses Nealuation by the Local Approving Authority ,�.Fa , Date: 9/10/02 Inspector's Signature: The system inspector shall suf this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this ine system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system ownerlshall,submit the report to the appropriate regional office of the DEP,The original should be sent to the system owner and copies,sent to the buyer, if applicable,and the approving authority. Notes and Comments 3'. `' SYSTEM PASSED TITLE V INSP,ECTION. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. ',I:;f ****This report only describes c0ii'ditions at the time of inspection and under the conditions of use at that lime.'Phis inspection does not address.how the,,syslem will perform in the future under the same or different conditions of use. Titlo 5 Incnortinn Form (,/I 5`110 Y() "" Page 2 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 24 DOGWOOD LANE COTUIT, MA 02635 Owner: ROGER CAMPIAN Date of Inspection: 9/10/02 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X 1 have not found any information which in that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: SYSTEM PASSED TITLE V INSPECTION. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. B. System Conditionally Passes: _ One or more system components�as described in the"Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement orrepair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y;N,ND),inl the for the following statements. If"not determined"please explain. n/a The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years oltt is available. i ND explain: n/a n/a Observation of sewage backitp,oribreak out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled ar unev'en d'Mribution box. System will pass inspection if(with approval of Board of Health): _ broken pipe(s)are replaced _ obstruction i's removed _ distribution box is leveled or replaced ND explain: n/a n/a The system required pumping'rnore'thari 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)'are replaced obstruction is removed ND explain: n/a Page 3 of I I 1! „i OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM : .. PART A s't.s CERTIFICATION(continued) Property Address: 24 DOGWOOD`LANE COTUIT,MA 02635 Owner- ROGER CAMPIAN " Date of Inspection: 9/10/02 '�' C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the,environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: ;t _ Cesspool or privy is within 50,feet'of:,y surface water _ Cesspool or privy is within 50 feet.of a bordering vegetated wetland or a salt marsh it . . 2. System will fail unless the Board of Health (and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic t t k and'soil'absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface:wa;er supply. _ The system has a septic tank!and SAS and the SAS is within a Zone I of a public water supply. _ The system has a septic tafWaiid SASS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance n/a y. t "This system passes if,the`well`water�analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates tHat the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal toor less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be a'ttachedtto tl is'form. q'rx !t r 3. Other: n/a f ,, it ' S Z Page 4 of 1 I OFFICIAL INSPECTIOMFORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 24 DOGWOOD LANE'COTUIT, MA 02635 Owner: ROGER CAMPIAN Date of Inspection: 9/10/02 D. System Failure Criteria applicable to.alAl systems: You must indicate"yes"or"no to.,each'of the.ollowing for alLinspections: Yes No X Backup of sewage intop­j;facility or system component due to overloaded or clogged SAS or cesspool 1. _ X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool h f^I i_ . ` _ X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than ''/z day flow X Required pumping more than,4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped ONE YEAR AGO BY OWNER. X Any portion of the SAS,cesspool or privy is below high ground water elevation. X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool ocprivy.is within a Zone I of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution-,from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm provided that no other failure criteria are triggered. A copy of the analysis must be attached to this forma (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the sysfemafail's::Tlie system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system`�the system must serve a facility with a design now of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large'systems in addition to the criteria above) yes no _ X the system is within 400 feerbf a surface drinking water supply X the system is within 200 feet of'z'trib6lary to a surface drinking water supply X the system is located in a'nitrogen'°sensitive area(interim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public Water supply well If you have answered"yes"to an;y question in Section E the system is considered a significant threat,or answered . q, ")'P5" In SPfli(ln n ah(l�'P lh?;litl'k?S1'*161-hits failed, The owner or nheratnr of any large system considered a significant threat under Section E or failed underSectioii U slha(i upgrade the system in accordance with 310 CMR I5.304. The system owner should contact the appropriate regional office of the Department. ,4, d Page 5 of 11 r i OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS E--SE SUBSURFACE--SEWAGE WAGE DISPOSAL SYSTEM INSPECTION FORM , y PART B CHECKLIST Property Address: 24 DOGWOOD LANE COTUIT,MA 02635 Owner: ROGER CAMPIAN Date of Inspection: 9/10/02 Check if the following have been do»e;'You must indicate"yes"or no as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health _ X Were any of the system components pumped out in the previous two weeks X _ Has the system received normal flows in the previous two week period'? X Have large volumes;of wateir,been,introduced to the system recently or as part of this inspection '? X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility.or 641Ping`i'nspecied for signs of sewage back up? X _ Was the site inspected for-signs of break out'? X _ Were all system components,excluding the SAS,located on site'? X _ Were the septic tank manhole's'uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid, depth of sludge and depth of scum ? X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systeihss`', The size and location of the,Soil Absorption System(SAS)on the site has been determined based on: �s I Yes no X _ Existing information. For example;"a plan at the Board of Health. X _ Determined in the field(if any of'tlie'tfailure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)], . .S oti.-, l.a, t t � S Page 6 of 11 0,, OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE,SEWAGE DISPOSAL SYSTEM INSPECTION FORM i PART C SYSTEM INFORMATION Property Address: 24 DOGWOOD LANE COTUIT, MA 02635 Owner: ROGER CAMPIAN Date of Inspection: 9/10/02 FLOW`'CONDITIONS RESIDENTIAL Number of bedrooms(design):3 sr Number`of bedrooms(actual): 3 DESIGN flow based on 310 CMR 1`5.203,(for example: 110 gpd x#of bedrooms): 330 Number of current residents:2 Does residence have a garbage,grinder(yes or,no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or1 no)::NO a Seasonal use:(yes or no): NO Water meter readings, if available(1ast2 years usage(gpd)): nfa-» 0l 4D/WD Sump pump(yes or no): NO :e, OD 651 Last date of occupancy: n/a COMMERCIAL/INDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR 15 2Q3):11n/agpd Basis of design flow(seats/persons/sgft,etc.): n/a Grease trap present(yes or no): NO Industrial waste holding tank present(yes or no): NO Non-sanitary waste discharged to the Title 5 system(yes or no): NO, Water meter readings, if available: n/a Last date of occupancy/use: n/a OTHER(describe): n/a 1�} GENERAL INFORMATION Pumping Records , Source of information: ONE YEAR AGO BY OWNER Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: n/agallons =�1I'ow was quantity pumped determined? n/a Reason for pumping: n/a sit Ai: . TYPE OF SYSTEM r+ X Septic tank,distribution box,soil absorption system A¢ ' _Single cesspool _Overflow cesspool . _Privy `� � t _Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology ;Attach a,copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank Attach a copy of the DEP approval Other(describe): n/a ;! ; Approximate age of all componen4 date installed(if known)and source of information: IS 1'EAIIS III' OWNLIt Were sewage odors detected when arriving at lth'e site(yes or no): NO a. ,E Page 7 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE,SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 24 DOGWOOD LANE'COTUIT, MA 02635 Owner: ROGER CAMPIAN +_ Date of Inspection: 9/10/02 BUILDING SEWER(locate on site plan) ' j 4�'. _ Depth below grade:20" Materials of construction:_cast iron._A0•PVC Xother(explain): 20 PVC Distance from private water supply well or suction line: n/a Comments(on condition of joints,yenting,evidence of leakage,etc.): TOWN WATER z SEPTIC TANK: X(locate on site plan) Depth below grade: 14" Material of construction: Xconcrete_metal fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a is 49e c6nfir 6d by a Certificate of Compliance(yes or no):NO(attach a copy of certificate) Dimensions: 1000G L 8' 6" "5'°7"'W,4' 10"" ` Sludge depth: 2" Distance from top of sludge to.bottom of outlet tee or baffle:32" Scum thickness: 1" Distance from top of scum to t :p�61ti outlet tee or baffle:6" Distance from bottom of scum to.bottom`of outlet tee or baffle: 17" How were dimensions determined:' MEASURED Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage;"etc.): SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. «�` GREASE TRAP:_(locate on site plan) Depth below grade: n/a Material of construction: concrete, metal._fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a '-; Comments(on n pumping iecom5endatPi,e§ns,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage, n/a :� f Vill Page 8 of 11 f F OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY'ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 24 DOGWOOD LANE COTUIT,MA 02635 Owner: ROGER CAMPIANy Date of Inspection: 9/10/02 k TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction: concrete_metal fiberglass_polyethylene_other(explain)`. n/a Dimensions: n/a ?' y Capacity: n/a gallons r, Design Flow: n/a gallons/day 4 ti Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no): NO Date of last pumping: n/a #' Comments(condition of alarm and float switches,etc): n/a DISTRIBUTION BOX: X(if preseph;must be,opened)(locate on site plan) Depth of liquid level above outlet invert LEVEL WITH BOTTOM OF PIPE Comments(note if box is level and distrrbuion to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): s D-BOX IS STRUCTURALLY SOUND.`` w PUMP CHAMBER:_(locate on site plan) Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): n/a t � u i, 'Ah9laL.or4£% ' `a Page 9 of OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) . Property Address: 24 DOGWOOD LANE COTUIT,MA 02635 Owner: ROGER CAMPIAN Date of Inspection: 9/10/02 6 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a z Type 1000 GAL 6'X 6' leaching pits, number: 1 n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a x, leaching fields, number: n/a n/a r overflow cesspool, number: n/a n/a �; �.tnnovative/alternative system .Type/name of technology: n/a Comments(note condition of solla 1s'ign's of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): LEACH PIT IS STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.SYSTEM SHOWS NO SIGNS OF FAILURE.PIT HAD 1' OF LIQUID IN IT AT TIME OF INSPECTION.STAIN LINES INDICATE PIT HAS NEVER HAD MORE THAN 1;' OF LIQUID IN IT. BOTTOM IS AT 9 FT. CESSPOOLS: (cesspool must i'b$u nped as part of inspection)(locate on site plan) i . Number and configuration: n/a Depth—top of liquid to inlet invert: n/a ' Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a PRIVY: (locate on site plan) «' Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil;;signs of hydraulic failure, level of ponding,condition of vegetation,etc.): It 1JI, , n Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 24 DOGWOOD LANE COTUIT, MA 02635 Owner: ROGER CAMPIAN Date of Inspection: 9/10/02 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. 0 1 C13 A-0 Z� D 13A C6 �C3 (C gC S 40 S 4y .. �i:. .C I� F in Page 1 I of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 24 DOGWOOD LANE COTUIT, MA 02635 Owner: ROGER CAMPIAN Date of Inspection: 9/10/02 SITE EXAM _Slope _Surface water _Check cellar _Shallow wells Estimated depth to ground water 12+feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record- If checked,date of design plan reviewed: n/a YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local ekcavators, installers-(attach documentation) NO Accessed USGS database-explain: n/a You must describe how you established'Ehe h gh ground water elevation: HAND AUGER- 12+ FT. t r. 1 .. ' i � 145 LOCATION SEC1ACE PERMIT HO. 4 VILLAGE INSTA LLER'S NAME ADDRESS �A' Rwovziy 8 U I L D E 0 OR OWNER Y A W /2tf TAf DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 0 I� i k3q �o J G '�pgN,i i 3 5 915 C— NOZZ77 FPS....Via.......... THE COMMONWEALTH`OF ?AASSACHUSETTS BOAR® OF HEALTH ..."..........Zbwn.................OF.........Barnstable ......... . ......................................................... ApphrFation for Dhipvii al Morks Tonstrnr#iun ramit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: ...... t..13.... 00a--T,a�?e.............................. .. .Cotuit , Ma. Location•Address o Lot No ......................edar Acres Realty„Trust 24 Great Pond Drive, S. Yarmouth, Ma. _.... ........... -----••------•--••--•--- ...............................................---•-•--•----•------•---.._.._._......... Owner Address W same same a ........................................•-•-:..... .............................................. ....--••-....................-----•------......----••-•---...--••--............---................ Installer Address 21,275 d Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms._----3...................................Expansion Attic ( ) Garbage Grinder ( ) P4 Other—T e of Building No. of persons............................ Showers — Cafeteria P4 Other fixtures ................................. . W Design Flow..................5...........................gallons per person per day. Total daily flow....330 gallons. WSeptic Tank—Liquid capacity.1000 gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosin tank �-+ gNorman �rossman P.E. Sept. 16, 1982 Percolation Test Results Performed by................................................... ........ Date........................................ aTest Pit No. 1...2.---------minutes per inch Depth of Test Pit.......12 i....... Depth to ground water....riOn.. (T4 Test Pit No. 2................minutes per inch Depth of Test Pit................... Depth to ground water........................ P4 -----------------------------------------------------------•----•-...................--------------•......................................................... O Description of Soil---- 161--- -------------------•-------.----•-----•------------..-.-------.- x c, -------------------------------------------------------------- ----------- ------------ --....... ------- -------- -----•---------------------------------...................................... W --------------------------------------------------•-------------...------....--------------------------------------------------------------------------------------------------------------------•-•---- VNature of Repairs or Alterations—Answer when applicable .....................e. ..................................................................... ..............................•-----------•-•---•••-----•-•-----------------------•-•--........••••-••--••-•---•-•--•-•--•------•-------••-----------.....------•--•-------------------•-----......---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITfYL, 5 of the•State-Sanitary Code.—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss ed by the b r of h Ith. Si ed.-. . ....... ... . --- -- . ..................... ......�- ---- ate Application Approved !�-----------------------•-------......_..............-- ..1 ' Date Application Disapp ve r th following reasons:-•-•-•------•-•--•-•--••--•----••-------•--•----•-•-------•---•------- ...................................... ..................................... ------•-- -----------................-----------•.................. Date PermitNo......................................................... Issued-....................................................... Date NCO..&_:7 ............................. THE COMMONWEALTIH OF MASSACHUSETTS BOARD OF HEALTH ................Town................O F..........:Barnstable ..................................................... Appliration for Disposal Works Tonstrnrtinn Urrutit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: ................13._..IXxlwc.....................................................d :.._..._... .......cotui...-'--M�'....... ._...... --••--..........---•••................ Lo tion-Address or Lot No ........Cedar Acres racy TI'rust_._._.._..:. 24 Great Pond Drive, 5. Yarn=uth, Fla. --........-...................... -•-----•-••-••...... -------•--••-....-----•---- --•--....I._...•• ........._....---•----•--- Owner Address r� Sam same: ......................3 .... ---•---- ... Installer Address 275 Type of Building Size Lot......!....................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) �A4 Other—Type e of Building ....... No. of persons............................ Showers YP g ••--•-•------------=- P ( ) — Cafeteria ( ) Otherfixtures ------------------------------------------------------•••••--••--••--•--••-•••..................- W Design Flow................5..........................gallons per person per day. Total daily flow.....:_.....................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter----............ Depth................ xDisposal Trench—No..................... Width..:................. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No------------------_ Diameter.....--..--......... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( 0.4 Percolation Test Resul s Performed b 1*)n An Cowan P.E. Sept. 16, 1982 y .................•-••--.••... - r•. Date.. --•- 1.4 4 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........---...--........ r.X4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4+ -•••-••••••••••-••••-••••-•-••-••-•---••--••-•-•.....••-••--•-.....••-•..........................••.......................................................... O Description of Soil....(�,,1f3•"-...1CQZ,---16! 3V...subsoLlt...3V-14V-_saT ............................................................... W. V W ------------------------------------------------------------•-----------------------------------------------....----------------------------------•---------•-----....-------------••••••-••-••--....... U Nature of Repairs or Alterations—Answer when applicable................................................................................................ -------------------------------------------------------•------......------------••--.............-----•---....--------------------....------------------------------..................-•........--•••• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of:i Ll, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. tSl ed.....••••..........•-•--•--•--•-•----......--•.................•.......•-••_.......`•. •• te:.... \. Application Approved ....... .. .C-----••-------------------------•--.....------------...--------.....----- 2 y 4.. ................. Date Application Disapprove -r th/ following reasons-.....................................................-.......................................................... r / ... ••-•--••--•........••--•...............•••-----•--..................••- Date PermitNo......................................................... Issued---•-----•.............................•------•--••_... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............. .............OF...........Barnstable............................................... (9rdifirate of Tnntpliattrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.. Installer at.....:.. .............. _._.._._ ..... • -• ........-----•-••••.------..----•- � has been installed in accord nce with the provisions of TIm F 5 of The State Sanitary Code ;p de ribed in the application for Disposal Works Construction Permit No..•it--7- 2 r -•- --••...... dated....e l Y---�Z............••--- THE ISSO1 CE OF THIS CERTIFICATE SHALL NOT BE CONST ED AS A GUARANTEE THAT THE SYSTEM IL FU TION SATISFACTORY. DATE...l .1..°�... -------------•---•-••-----. Inspector... ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH man Barnstable �S .....OF.................................. .... 4 No...................•----• FEE.... ............... Disposal Vorks �Mtynrdation rrmit Cedar Acres Permissiovis hereby granted............................................................................................................................................... to Construct. (131 �qr Re�aiar ;n ui& ��rage Disposal System atNo. ......• ..... ...........----•.......................... .. ......... St eet i as shown on the application for Disposal Works Construction Perm�t No. ............... Dated._12..-.�'._.y.... ............ -` ry JJ �.t�L c . `; ...... ........ ... --------•-................._. Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS - i c� t -114 �E#jcr-AIL f�l�TEg (D--Ai-'L EL" 5"O 10 A" ME^.WJ SEm. Lo1 r— - - - G>11.T12M P1 1�1.ItE PI'TCl-1 ALL L.IWE45 A Mi4j,"Vt4 cis ►/l5'��T rr ut.r t`E S5 t�7'1-I�c @�t3 E 3•PEGa 1F 1 ED. Ati.L Pt PIES To r1w)D td TK4E SYSTEM SHA-L.1_ �• __ ----------- d. � _" � r � - !.►E u►sT lRb�.! � �c.,�i�out.� Ao P J c ®-- AIL. SEPTIC TAJJK5, P►ST2,5t_TTic. eo)cr A► o // //�� //jj�' L-VokG"I►JEa Prr'- SHALL g1E DES1Gr.lET> i"-olZ ll l`� © Do 1� - �.D �ll4FEEL- Id�D�.JC-tS • .it+t r ��yCL�SSp►ii`' (D— RENb✓E Au_ Ur.1`,x��TA3L.E NIATEiZiAlr 0E►.1Era71-I O go U ® 0 O -r- IrJ�/EOr E►..EVAT10.JS OF LEAC_�4 t..lt1 prTS Foe Aoo& 1'01i,4 1 % 1 I - L ` __ _ O O O �l J� ® A 1??+�uS of ) M.)O �KPtL-L \,J tTV1 CL1ry-peVe i 1 f7 c IC -MT _ s_e....►o A.-I p eEz eAoJE.L_ T-10 t O O ® �1 `1 `J TH£ ri r�t1�7 A r _ k � hICSI"IF�E.T� WHE.rJ THG. �ySTEr•� 1S NEAR;,, 0 00 VJ �J ® 1� �MOLETIOr.1 A..�O P�to2 TO b�►.C+GFiL.Lt.1iw ez ya.l.raC.� V \ O-- ursl,Ee.� oTNEie:�tSE I.soTED, A- 5Y5T�►/' O c coMPbK1ErJTS s►#�►.LL $E Ir.►STP.��.cc� rwl h f A4C0C-D.m..,ICC W ITV4 T ITL_E aF T�+GL '5TAT6 TV P 14C A L DI STQtbuTl G" 1501C_ O t0' CoaF AtisO Arty �L c2u�, { - WH lGN MAtY , / ` ,J �t /�� / UpT T® a /i/tJ if��`� iC c� Ai;�: bGAL r ---- T ►DOTE s sretdLrr�p.� e� P.►.1� 1 - T,yPsc^L- IQW C,..� SF.?T►G ►T 6sE V_A7�/�N QE,uFoet�a scrric by A LC,C&jj PCEC. ST' ►JoT -b SC-A-L..E. Sc^4_E CMt- `cQL�AI-. I g s Tar1KS RiltuFcaEC:ED Tt ou4Naar P1F,e«A T/O A/ .Q/�TZ` = //�Jvn /i�c iJ WITH ELF�CTR-1L WEL.(,1E0 Vlr2e W!'T'1'r ss et rArio�t 5 6 ' ;-S/ r� � !�, ' 24 -►1� 1EM>sEL70ED StL 2o�s ,� MC Tr¢s A4CICWS a MAN11•10L.L:J TO y' SGrrw- TA t►t AM D L,rs►+t~LI N.� t*m s 11 bo'rTo►•i. Cc* tb 4000 rlx. -mt.T Ta tsar 1N+LT LW TO la.A1CAdM ��O fl�ALry scr,c� trNtyN sri'..�ae. �vl ��5!✓��`% Pam' -Fop rWCKAT, Z' F 66.L I5►k 't)1�LAo F I taI►SN 6 Q�t�C F Isi m* 61tA D! CG xr- �tt.I1St•i GiCI►tE- '� x U/CC 171KKs, <IVliC`�r�Cst, � LEA.CHra~1G � ' I pqppv r � ' �w ,- 1wiAC1CFtLL Z L or �" �sT•arlr[ A • 0 O• ® p p •. .• ` 'of 1«#.R a • »�. 5nt s>. O 4 t 1 ';o,� b.►� • O •Q ` ,gyp tT eev.l�ccrp cld.�c. plSc� >,3oK O 00 m '. �rIG ?A.ry m O O sitm of— EUEv . -- t I /-I �J���f — TYP l CA L S E�uwCsE' SNSTE M >PCCP f I L..E O j _ Nor Ta sc�.Lr� LEACNIN6s PIS l� , La7 `rr � r I �k + F I f ;..ice — EX�lT G'owvrout PR OPO 5ED D WE L L I KI& LO CAT I O N GN I > OES/GN C.�2/TE!/� ''- � /�.Ie�R��iav Gavfd'!.r! /�zN il�;�,4Ss�641, RO �ti= PROP05�D SEWd4C6L D15POSAL 5Y5TE.M it/vM�E� pF dEO.LC7bM S �= - �.�. �E.I'/'tT `.-IPA Env off, BERL �© -----T -t 1 t -� Pwoe• OT�L�/ �� E. �', i �q }- O �// �^ � •�---' "'.� +, f�E,CS4/r/S �,C QfO.['Oail�! .�..... � RAYMOND �� C�.��_ G X./�1_J 6►Attays � ir[.�v oEe r _ _ PEA - 4 _ A�e64 QEQIJ/.Cfl� /5Yi m Oa3�.[-IIGCTipu PT. 1,U y� �/� (r 1 � /� CAS • \ , /RCN//1/6 1��/ � rl 1Yi�ti.J � LAC // /G AFf XOV6I Jw PROPOSED LEACHIMCG Pt .S.f�PL{G.�.A{T . Ekt�►li'71E�: :s r -r U,. ND Ky� R.l� J 100% EX PAKIs{ON ,:�/OE-'xCJ'7�GC. /�it?��'9 '•,- ��, Z�x<f� �Zi $� - .�'7 7�/�� �u\\;�}No.198i y `,, v>16•A41t: � DIA1'�: ,30770 ✓' A"A'I/Cot?T OAJ /V0, /.3 7. _ ,`�����.a� E�'' l wlr co" OV, Am* ev. r lwa