HomeMy WebLinkAbout0092 BAYBERRY WAY - Health 92.BAYBERRY WAY
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Osterville.
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THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Appliratiou flar Uiipuoul Workii Tonotrurtinn Vamit
yG 1l Application is hereby made for a Permit to Construct ( v� or Repair ( ) an Individual Sewage Disposal
System at:
Y WSoo
•Location•Address _••• -- .---- •----or.Lot No.
-------- -- --- ------ ---------------- .............
Owner Address
W dot.? ........
Installer Address
QType of Building Size Lot............................ . feet
UDwelling—No. of Bedrooms................ ......................Expansion Attic ( ) Garbage Grin r
p, Other—Type of Building ____________________________ No of persons............................ Showers ( , ) — Cafeter )
a
Q Other fixlures .
W
Design Flow................ ......._ ...•-__gallons per person per day. Total daily flow.....................3g...0...........gallons.
WSeptic Tank—Liquid capacity1... -gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No. .................... Width......u............ Total Length..............4....... Total leaching area....................sq. ft.
Seepage Pit No-----------I........ Diameter.........g....... Depth below inlet.._...---....... Total leaching area.. ..sq. ft.
Z Other Distribution box (vl� Dosi tank ( ) A I /�
Percolation Test Results Performed by.- )Q1 .�... ..h1` . ............
Il°- P06:ADate.....-'2r7� -0�'3............
a Test Pit No. 1.......L—_._.minutes per inch Depth of Test Pit-------- .__. Depth to ground water.......--..............
f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a ---------------•----------•------ •------••----•---•••....------•---------------•----•-•-•---.........-••...----••-----•--------.....................................................
0 Description of Soil---------------•---------------------------------------•--•--------. ---------•-------•--------•--•--•---•---•--------•---- ......................................
x =
.
w
VNature 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 TI'i U 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.
ed ..........................-................................................... /ate
......
.......
Application Approved BY---• ------- --------*.....-•-• ...
Application Disapproved r th ollowing reasons:------•-••-----•------•---•-----•-------------•-•--•----•-------------------------------------------....---•-•--
...............•----•----------------••-•-•--•-•----••••-----.....----•----------•-----------------------
Date
PermitNo......................................................... Issued---•------••-----•----------------••---...--•-•--•-•--•-
Date
s No..l?.. ° 0,b F�s...,1 ............_
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
,� ��
..--
...................... ---------'--=-------.........................
Appliration for Uispoiial Workg Tomitrnrtinn ramit
Application is hereby made for a Permit to Construct O or Repair ( ) an Individual Sewage Disposal
System at:
.... - - -- ---------- ............................................. .......--•-•-------••••--'•-••--••----•-'••'---------•---..._...............................---••-
Location-Address or Lot No.
iA
caner ......•---------------••..-_--. Address.
Installer Address
Q Type of Building �'9 Size Lot..........................C. feet
Dwelling—No. of Bedrooms................. ......... .Expansion Attic ( ) Garbage GrinOther—T e of Buildin No. of ersons............................ Showers — Cafee
a' Other fixtures ..............................................
W
Design Flow................ ......................... per person per day. Total daily flow.............................................gallons.
WSeptic Tank—Liquid capacity ....?. .gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No..................... Width..................... Total Length.......... Total leaching area.....................sq. ft.
Seepage Pit No-----------I......... Diameter._______`'.__..__. Depth below inlet......rn......... Total leaching area.'_--t.fa.sq. ft.
Z Other Distribution box Dosing tank ( )
'-' Percolation Test Results Performed by. '-:_-----r:----_! - ' 7
C - ;
a . -•-'••-'-- - = Date-----
,� Test Pit No. I.......?. -_...minutes per inch Depth of Test Pit-------- %::._.. Depth to ground water.......
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-___.______-.-_--_.____-
a ••-•---••--••••••-•-•-•••-••••-•-•-•••••--•---••--•--•---•-•-•--••••-••...........•--•••••••••---•-•'•••--•••••••••--•••-••.._....-•-......-•-•-•-•---•---•-
0 Description of Soil--••••-•••••......•• •---••...................••--•----------•-••-�••----�......-----•------••••-•-••---•---•-•--•--••-----•--•-•-••••--•--•-••••--•-......._._.•...
t ,-. �... lI..., r..- I-- ..1'�
W •••••-----------------------•-•-----...............-----------•••-•-••-••.............•••-••._......----•--•...•----------------............••-•----•-•-••••-••--•-..__..........-•-•••--------•--......
UNature 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 TIT1E 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.
<ollowing
Si ed..... ------•--•-•----•----••-----•-•••-••-•--••••-•..............•--•-.....Application Approved By-• •••• ••-••'--------••------•-••••-•-•---•----•-•..........•..--
--------
Date
Application Disapproved r th reasons:--
--•-----•---•••--••••--.....•••-•------...-•'---------------•-•---••--••--'----•-•-.....••-••--•---•---'-----•••--•••••--••••••••-•--•-••-------'-•••-•-•-•••----------•••••---••••••--•--•-----•-•-'---
Date
PermitNo.................................................................. Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
_ BOARD OF HEALTH
..4.�.:.. .!......................OF.......!�......!...............!............+l.. .................................
(9rdifiratr of Toutpliatta
S CERTIFY, hat the Individual Sewage Disposal System constructed ( or Repaired ( )
by...�7,I
�< ._�..---'-••-•-.._ � .... -------------------------------------alij V
at.. ..............................' - -- ------- ----------- -----ate G
has been installed in accordance with the provisions of TTTI LE 5 of The State Sanitary id �s scribed in the
application for Disposal Works Construction Permit No.. �_S'............. dated.._.-_:..�.. . e;....................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WIL F CTION SATISFACTORY.
r
DATE......1'fl..- `-C---------------'-------•--•-•-....._..---•-•-•---..... Inspector... __. ...................•....................................................•.
THE COMMONWEALTH OF MASSACHUSETTS
__ --- BOARD OF HEALTH
C t . OF.. �f) r�'t l +.�(� �: .................................... d/D
No................ ....... FEE. ... .............
]ispo'ga - �vcn r ilan rrmi
Permissionis eby granted...-----�----------------------------"--.-----------•------•---•-----------...------------------------------........._................_.
to Constru Repair ( ) an d v' l &.wage Disposal System
atNo Gv2rs ------------------------------------•---------------•-----..............-•••••....•..........
Street
as shown on the application for Disposal Works Construction Permit No................... � 4_5...........................
................•----•-------'- •. �!*-�``- ------....-------••--•--....�
------- - ---
Boar of Health
,.DATE .•Z_ __ Y�
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
4
LOCATION SEWAG PERMIT N0.
Lg r �-� �a �►�-► v —Bar ����y �3-� � ��
VILLAGE
I N S T A LLER'S NAME i ADDRESS
YC-
I
t UILDER OR OWNER
c. Y
DATE PERMIT ISSUED
DATE COMPLIANCE , ISSUED
p
Z q
Q IA
I�
I �
�1W 6Lr-M, FAMI�`(
o GAq-5A6E
II u
I D/a►L FLOW _ ItoY, 3 = 330G-PO
II5EPTtG TA►•JW- - 330X15o%
U5c— 1000
015Po5AL PIT v6E 'I v o0 GAL.
I !j rMWALL 26ta n 1 JOS.R 00�3.
BOTTOM A2EA r �0 5 F• p.•- GAS f ; , t I` `:
50 5.17-
. x I• o R o G.P. loo-S li.l
r' d
a
o DE51GN 2 G.
'T T A 1- .�{- '
-ToTAI` DAIS-Y FLC>W = 330G.P0.
P GoLATION RATE ; 1" N 2MIN OP-La655
�3 f � I•{�,E `
r
� Pazop• Ta41L :
r la;•3 ra�.z � •'� i �
,� tN OF
of +T•N
RICH M ALAN yG laol
W. 9 y
A. . ,I t"1 o �•
(( � JONES 99 9 loo
BAXTER i
`I Zo
Na 240480 o. 5100
49 9
I &a� T
iI 4Nv
TOP FWD
°lot,o
I` NoL� 5-2-83 IFL.Coo
` El_=No y, . �rq�^� 1►'N' qS
LOW
loco INV.
�I S✓ AV DUST. INJ. 56PT�G q�•a
2 l00o INY, tijuX1 91,40
1,L
I 4 LEA-Cu
T INV. Icn
NY •.#. ' .
1 /31I9uIIL
SA Lit, WASNGD ;
iI 6TvN6 ...
i GtirRTIFIGp p1_oT P>_AtJ
PR-oFILG LoGA-TIoN
g1' 13 L10• 5C-A,L �jGAI.E Iil �00 �AT'rc tJ'3'�3
o t,UA�� p>r P.N REF EiZE.N GE
1 tE ;X-T •tNA'T THE P 5NowN . {
NER6oI.l GOMP�.`r!5 YJITN"CHE SIo�L1tJ� . 'Zvo
A►JO SET GK 9-6Q0I9-EMENT!�, F 'C1-tomes
1oWN ANv 1S �VT I
LA
LOC, .T ED •WITNI 'T 6 GLo P tt-1 �� tzr LAI, 2G�O� I
GATES 3:
BAxTEIZe N`(E INC. '
R.EG I s-T E.Q6U ►.A W D 5 u?-Y
1 Tu15 PLAPI 1S NorT Bc•56n ob AN osT'ECZ.vit_I.E• ' .55• t
' IN,5T?_uMENT 5v12vEY �- -rNE 0$1r.6E75 Suou►.p
NoT DE V55,0'Td OETE•Rl^IN<✓ l cT �.IN1E.�j aPPLIGA►`JT' �j Z'�-S (4A / '�R;
No. ..... Fics............._...............
THEiOMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH..,
OF..........................................................................................
Application for Dispniittl Works Tonotrurtiun rrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
fir. ....�.. ...........�ZAAIAIb...... A)......... "-................................................................................
Lo 'on-Address or Lot No.
Owner Address
......_.. ,....... ............... ..... .................................•---......
Installer Address
Type of'Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder M)
P-4-, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
a' Other fixtures ------------
--•••-•...................
.............
W Design Flow..........._.e. .........................gallons per person per day. Total daily flow__._....29................._......gallons.
WSeptic Tank—Liquid capacityl:P...gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No. .................... Width.../............... Total Length.............. .... Total leaching area....................sq. ft.
Seepage Pit No...__Z... -.�2,-__.__.. Diameter....,_........... Depth below inlet..... _.......... Total leaching area.....sq. ft.
Other Distribution box ( ) Dosing tank ( )
'~ Percolation Test Results Performed by.........Fr—AX-T.ex.......................................... Date......5A110'-----------------
aTest Pit No. 1................minutes per inch Depth of Test Pit.... ."....... Depth to ground water.....&121........
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a ••••-•-•--••----•------------•-•••--•--•..............................•--•---•--•---•............._.........-••---•---..._...----.........••-•--......-•--••.
O Description of Soil--------..0.-?-"--4.V-�.......-2=' !)-• ........ .------..�i31!+i,�
x ...... _
.--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------••--•-
W --•-•-•----------- -----•-----------------•••----•-•--•••---------••----••••---•----•-•-•-•-----------••••-------------------•---••-•-•-•-...-••--•-•-•-••••••-•-••---•-------------••--•---•------•---
VNature 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 iITLL 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.
Signed........................•-•-..................-•----...._---••-----••--••-••.......... ................................
Date
ApplicationApproved By••-•••-••-••--•.........................................................•-•........_......_--•-•- .......................................
Date
Application Disapproved for the following reasons----------------------------------------------------------......................................................
..•••--••-•••--•----------------••-•-----••--•-•....----------•--•-•---•---•--•••-------•.............•----••-•••-------•-•---••---•-•-•--------•----------------•---•••---•---••---•••••....---•-----..
Date
PermitNo......................................................... Issued.......................................................
Date
...
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
8.....P�°'...................OF..........................
�rr�if irtt#r of f��ant Iittnrr
THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by......................e �.....•.-••••-----........•-----...-•••----•-••......-------•--••...-•-------•-•••--..._......__...•-•-•-------------•.......-----------•--.........-•--
Instal er
at............... .. - � ........t, e. .....--- C ....--------......-------------•-------•-------................--------
has been installed in accordance with the provisions of TIT JP 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No.---- 'ta......A............ dated................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.................... ----•.............•-•--. Inspector _...................................................
.................. , ........................................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
-OF.....................................................................................
No... �.... L.
Disposal NvAii Tuno#rnrtion rrmit
Permissionis hereby granted.............- �E-9-—411...........................................................................................................
to Construct ( ) or Repair ( ) an Individual Sew a Disposal System
at No .... ----------------------
................ ,3._..
Street
as shown on the application for Disposal Works Construction Permit No.............. ....... Dated..........................................
� Board of Health
DATE------------------------------------------------•---•-•---.....--•-----.........
FORM 1255 A. M. SULKIN. INC., BOSTON
No......=s ......= - - FEs..............................
THE'iC'OMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.. ............. ....................OF.............................--...
Appliratiun for Uiipuual Workii Tumtrnrtiun Prrntit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at: /
----------------------------•••••••-•---•-•-_...--
Looa'on-Addr ss or Lot No.
................................
W Owner Address
........................................•-•-----...._.......
Installer Address
U Type of Building 13 Size Lot............................Sq. feet
., Dwelling—No. of Bedrooms.....................................:......Expansion Attic ( ) Garbage Grinder OW
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
d Other fixtures ------------------------------------------•-•••---.....
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity/.PP...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 ( ) Dosing tank ( )
aPercolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.....................--.
44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
04 -•--•-•-------------•......-•--------•-........-••-----......•-•---•........._..........................---•-••-------...•••....-••....._........•-•---......
0 Description of Soil---------.C.1....................................................435 ' i'lC 'ri4!v- -----------------------------•----•-•-----•-•-----•
x
w
x -------------- --.....------••------•---••-••---•--------•--•-•----•---------••-----•--•••-•----------•-•••••-••-•---•----•--•---•-•--•--•-•-••-------•--•--.....-•----......----•-•....•--------
U Nature of Repai-s or Alterations—Answer when applicable...............................................................................................
----------------------------•---•----•--------•-•-•-----------------•--•-•--•-•••-----------........•-•------...------••----•---••-------•--••••---•-••••--------•----•---......--------•••••••-•••--••-
Agreement:
The enders gned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 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.
Signed...................................................................................... ................................
Date
ApplicationApp-oved By----••----•-•--•------•-•-•-•.....................•-------••-•••---•-•---------........._••-----
Date
Application Disapproved for the following reasons-----------------------------•-----------------------•-------...-------------•--------•-•-------......---_•-•-•-
---------------•-•---•-----•--•-••--•--•---••---...•--••---...------•-•--•-•--•--•---•---------.....---••------------........_.........................................----------------------------••-
Date
PermitNo......................................................... Issued.--------------------------•--•-••----•--......._---••-
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................................OF..... .....................
(9rrtifiratr of Tuntplittnrr
THIS IS TO CERZIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
..-
� Instal �,�
at ... d`" L v ..._._ !_e ........ ��--�--`---•----------------------•----------•-•--•-----.............._........
has been installed in accordance with the provisions of TIT F 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No..--- '-�'-Z._Ar9.._......... dated................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY. �-�
DATE....... ��._.....� 4e,3---•----•---------------- Inspector......:-��%��.�-�"•------.........._.......-------•-----....--•---•---
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...........................................OF.....................................................................................
No... ... FEE........................
Rapouttl Works 'unutrnrtiun rrntit
Permission is hereby granted.......... - '• -----------....•-_---.._•---------------
to Construct ) or Repair ( ) an Individual Sewa ispo System
'
at No..-----•--- -----------------.............. ..... �.-� ----------------------------------------------•--•-••-•--
Street
as shown on the application for Disposal Works Construction Permit No............... Dated..........................................
...... ...
w "'V...................................................................
Board of Health
FORM 1255 A. M. SULKIN, INC., BOSTON ,
r-_
i
-
VILLAGE DATE.
APPLICANT 1"`•! �1 FEE
i (Non-refundat
ADDRESS TELEPHONE NO.
;ENGINEER -TELEPHONE NO.
DATE SCHEDULED ' �O
(Applicant's 'signature)
• F • ,
- SOIL._LOG
� - '•• - DATE •, _ - �._� TIME •. . .
SUB-DIVISION NAME " t _
EXPANSION AREA: I YES ✓ NO '`/ _-'i ��/ ENGINEER'? .
t TOWN WATER V PRIVATE WELL BOARD OF HE,
EXCAVATOR
SKETCE : : (Street-name,etc.-;dimensioris •'of _lot; -exact location --of- test _holes and l
y'---percolation -tests, locate 'wetlands in proximity to"test holes)
I— NOTES :
�.
IPERCOLATION RATE :
HOLE NO: ELEVATION: - --TEST HOLE NO: ELEVATION:
TEST —
2
r _
3
3
4 4 -
_ 5 6 -
I 6
I 7
7 r. ? _
8
!: 9 9
to
11 II
12 12
1
13
3
• 14 _ 14
15 15
16 16
FIELD LEACHING PITS
SUITABLE FOR SUB-SURFACE SEWAGE :. LEACHING
• `LEACHING TRENCHES
UNSUITABLE FOR SUB-SURFACE SEWAGE'. REASONS:
NOTE : ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION
E AND RETURNED TO BOARD OF HEALTH
ORIGINAL: COMPLETED IN ENTIRETY BY P . 1 -
ropy. R \ICIED BY APPLICANT
;I 51►JG�.C-. FAM��Y - � BCORnoM
IIii ►JO GAQBAG6 rj�NDE2.
II pA1LY F1_oW : ►lox
I SEPTIC, TA►JK = a30x15o% '•142i'G.P. q
u5E• ►000
015Po5AL PIT v6E 1000
,5 t DEh/ALL ARM-A. = 150 S.P I
k3 I
50TTOM AREAS .. �O.S,F•- GAK
5p 5.F x 1• 0 5o G.Po.
� l�o •s �
'T oT A 1- I>S.51 GN z .a 2
'TOTAL DA 11-Y FLDV4 - 33o G.P0..
j PE2cot_taT1oN RATE : I"IN 2MIN OP-LV=5! — -
�-
• PzoP rAN� /T
ICU
41
tN of bf �P�tH OF yq� Fir ArzeA
0 (f
T•N
RJCHARD o AIAN ca.l
w. �l l`1(a •O�j ... . fi.y_ "�
. X A JONES - '�---- -loo
g BAXTER a � qy.9 -
Na 24048 o. 5100
ST
Mo sua�
r
T�`�T RI&o2 Fe,= Ivv Top FNI)=1o1,o
NOL� S-2.83 F� ' Ioo
7^
S✓ l� 016T. INY. Ge►►.
BuX Ej6P7�C.
4 GAL..
LEACu
10A PIT I N Y. `�n,4
O AI 1 WIT 14 9't•2
r ..
I
S��o• WASucD
670 H
PLOT PL-AW
PRUFIL.r.= Loco-T_loN
. ;TL-`:rZv 1 L.l..1'-3
$1 13 N0. SCA,LL- SGALE IiI_ Coo �AT� rj"3'83
�.,o p• (�5�
l CERTIFY THAT THE SNoµ o
NE.R�aN GoMPLYS 1rJlTNZNE S►o�L►N� .. I � moo � '
Al C> 56'c GK R.6Q�►R.EMI:NT� OF •t1.1a L-
-TO W N O F�AJ2 45T fl0-C: A N'D 1 S aT
LOCATED WITNI T .E �Lo D P ►N (� I�� CLv;,:�� 1�U�1�
DAT E
6AXTE�Z.e 1.1`{E INC.
REG I ST E,zr"D't.A w D 5 u 7.Y Ic�(oeS
'T411S PLO•►J 1 07 NaT AN 03TE�VILL� • MAss.
• IN5•T-R,�MENT StJQv>�Y �'T►-1E oHF5ET5 6uou� cP.�T'
NoT DE VSED•td OETEpl^i►-IE LcT t�lt-lE.�j APPLt �,- `..- C<� IAC-T�� �R •
I
� y
d
2� 4-
za
WIA�1J0 EAR
FNGHARO
A.
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