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HomeMy WebLinkAbout0025 TISQUANTUM ROAD - Health 25 TISQUANTUM RD. BARNSTABLE u r. y e ,x 1 h ,.:�N v ,... .. TI �, ..'ram: . ,r 't � � ' [ `➢s t ' :s I .. ➢ '� < `- ... � ., , .. , .,.. r m , ' a . 0 it .l - -. .. • i _ ' Cr � �; � �. 4➢ . .a •,.» .''i,.T {}i '�,' e "' _ r� �', V_ s'4 � a o. ➢� - �t.+-T ny ., .. - rc r - TOWN OF BARNSTABLE L�j iUJ��% 3 7LOCATIO �.��/S�i/Aa/nley X� SEWAGE # �- I VILLAGE 6dA-0 ASSESSOR'S MAP & LOT MOW INSTALLER'S NAME&PHONE NO. I���/7 Lf�iYTi��ii:�7X��i✓� ���f� SEPTIC TANK CAPACITY 130067-" LEACHING FACILITY: (type) irf*2r (sizeY NO.OF BEDROOMS C2 BUILDER OR OWNER T/ -.� //✓✓. "� �1✓� t ,1�'ir/1 PERMIIDATE: 1-1 6 Z-Pd I COMPLIANCE DATE: Z — I L- 0/ Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 6 No. � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS � 01pplication for Miopo,01 *paem Construction Permit Application for a Permit to Construct( )Repair`/Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. / Owner's Name,Address and/Tell.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 provision&Title�5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issu e Signe Date 48116 Application Approved by Date ,4 Application Disapproved for-the-following reasons i A Permit No. 2001 -0Z01 Date Issued Entered in computer:. k- THE COMMONWEALTH OF MASSACHUSETTS Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS Zlppficatibn for Mi5poeaf *p.5tern Construction Permit Application for a Permit to Construct( )Repair(\/Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. / Owner's Name,Address and Tel.No. /,} Assessor's Map/Parcel D / 7 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tell.No. Type of Building: 2 Dwelling No.of Bedrooms J Lot Size sq.ft. Garbage Grinder( ) Other Type.-of-Building, No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title r Size of Septic Tank Type of S.A.S. Description of Soil _ A Nature of Repairs or Alterations(Answer when-applicable) n/ 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 i Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issu thi_ldto a Signs ,, ° Date (� Application Approved by Date ✓ Application Disapproved for the following reasons I OF Permit No. �2 001 ' U 7 `+ Date Issued M ------------- ----------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of Compliance � ry THIS IS TO CERTIFY, that the On�site Sewage Dispal System Constructed( '-)--Repaired( )Upgraded( ) Abandoned( )by �� `o f -t,Z at Zs— l t I S c, a,, -A, 6, Nj Y�06 6Q has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No._;2CQ1 C:Z dated 1)/& 10 / Installer Designer The issuance of this permit shall nol be construed as a guarantee that the sys em w'll f ncti°�n4s design d. Date \ I Z -Zvv/ Inspector / /L r No. 9Vtl 1" �� —— — — Fee wy THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Migpogar *pgte Con!Aruction Permit Permission is hereby granted to Construct( )Repair(A)Upgrade( )Abandon( ) System located at cgs TC,_-)O uann u{-� j� . and as described in the above Application for Disposal System Construction Permit. The applicant recognizes 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. Date: Approved by ti � �D Town of Barnstable- P# 9 909 Department of Health,Safety,and Environmental Services �,►+E, Public Health Division Hate p0 v� 367 Main Street,Hyannis MA 02601 • BAnNBTABrE, 1 Y Y Date Scheduled Time d - 11A)tL Fee Pd._ ')d n•(Do Soil Suitability Assessment for Sewage Disposal Performed By: S'� 9Soni 2, AW,' ,e �, Witnessed By: 'Doman /r'!/ z4A1D/ q's ;::. T,( : ATION �4 C}+L+'NCZZII,:tNtbRh!IJ. xXcN Location AddressZ$ - Owner's Name e��Wv G',¢/-�sySG� eAl Address OU 37 Assessor's Map/Parcel: 3SZ—/,� Engineer's Name 57-&r73O,r; NEW CONSTRUCTION ✓ REPAIR r/ Telephone l( /—.5ro-f.4'LS-l3e7 . Land Use S'iov6urt Ly r Slopes("/") /°7o Surface Stones iyu wig Distances from: Open Water Body NV,9. n Possible Wet Area A lq R Drinking Water Well Al/9 n t Drainage Way N/a n Property Line -To' n Other n SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) N - ...................._..--- -Y 411sryc - - . .. DWELLING ` • zo r y 77/'�/ �Aj 6i�y 30. Tisv,q,V 7-v,y Parent material(geologic) Depth to Bedrock Depth to Groundwater: Standing Water in I lole: Weeping from Pit Face Estimated Seasonal High Groundwater nm�crtnnrrrA�rrori rnrt$�csorrA ,rrYrrvAcYrr�r Method Used. Depth Observed standing in obs.hole: in. Depth to soil mottles: Depth to weeping from side of obs.hole: in. Groundwater Adjustment R Index Well N _ ._. _._ Reading Date:,. __ Index Well level Adj.factor _ Adj.Groundwater Level q..: Observation Hole Hl ' � Time at 9" Depth of Perc(�pToM, 7 rr Time at 6" LL { Start Pre-soak Time© r S /_/:, 7 Time(9"-6") End Pre-soak Rate Min./Inch <��►'l,.tl ��/ �2„7�� /� Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Copy: Applicant Observation Hole Data To Be Completed on 13acic � -`+ DEED O� Depth from p Soil Hor Deizon Soil Te cture Soil Coloe SoiF '" ' Surface(m.) Other (USDA) (Munsell) Mottling (Structure,Stoncs,Doulderes. ' c y Cz N /O C�'f'''-��'" G4 `LT�A P�,2cy_� �✓�-�',e DELI' OBSERVATION DOLE LOG Hole# Depth from Soil Horizon Soil lecture Soil Color Soil Surface(in.) Other (USDA) (Munsell) Mottling (Structure,Stones,lloulderes. 0 DE ' C713SRVAT>YOf tI() C LOB flnle# Depth from Soil Horizon Soil 1exturc Soil Color Soil Surface(in.) Other (USDA) (Munsell) Mottling (Structure,Stoncs,Doulderes. 77 DEEP OBSERVATION E.LOG Mule# Depth from Soil Flo rizon Soil Texture Soil Color Soil Olhcr Surface(in.) USDA (USDA) (Munsell) Willing (Structure,Stones,Uouldcres. e ,Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes Within 500 year boundary No— Yes Within 100 year flood boundary No_ Yes Dentlt of Naturally Occurring Pervious Malrrial Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption p system? If not,what is the depth of naturally occurring pervious material? Certification I certify that on (date)I have passed the soil evaluator examination approved by(lie 1 Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMIZ 15.017. Signature Dale rr TOWN OF BARNSTABLE LO'bATION .�� s l/�f vim+ �a a� SEWAGE # VILLAG ESSOR'S M2P & LOT-5-- ,V 41' . CRAIG MEDEIROS INSTALLER'S NAME PHONE NO. 78 LINDEN'ST. HY Nl , MA OZW1 �`�.3•-o�� SEPTIC TANK CAPACITY .5��_n LEACHING FACILITY:(type) � % ' `� (size) X NO. OF BEDROOMS PRIVATE-,WELL OR( t BLIC WATEO BUILDER OR OWNERe DATE PERMIT ISSUED: / i y DATE COMPLIANCE ISSUED• ✓/�//, VARIANCE.GRANTED: Yes No L/ 1 > �� - . � � �/� / .. � � _'_ _ ,_� � 9 i �. Q� i � � --�� � � G',cr. i6 �7 �3 ® . � 3� � � �C/ , Ir e� ASSESSORS MAP N0:IZ cc� PARCEL NO: 0 No....`. .�. .... Fss...sa. v.............. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE . VVftrafiun for Diipuua1 Workii Tunitrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair (V(an Individual Sewage Disposal System at: Z �S l/ h�7�'�/►'v� �oa� --.........4. .. .... .................................. ll.. ti g.��i��x. fi!. ........................................ Location- dres .1.(.�...`�� ... .'��� way c:..'... ��1�Jb�! .. ....../. . 5 �./Q T'v l°vt Lo t r.! :t'!!4. 1�� �� r /� Ow er f _Xress� J n a -- ............ .. ... Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—T e of Building No. of persons............................ Showers 0.ai YP g ---------------------------• P ( ) Cafeteria Otherfixtures ------------------------------------------------------------------------------------------------------------------------ W Design Flow............................................gallons 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..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation 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........................ Description of Soil l`% �Irt2 e.� ---:� -�rJ�..... x ------- ----- . U -------------------------------•-------....---------------- --------------....------------.....----------------------------•----------------•-----------•------------....----------......._------------. ------- ---------------------------------------------------------------------------------------------------- U Natu - f Repairs or Alterat' —Ans r when applicable.__ __._..7. e.1- .� ��±!'__._...._.`_ ." 1 '/....---- ----- ---.-9........ �, � ::::::. :::.: Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the T system in operation until a Certificate of Complian e•has en issued by the b and of health. � . Signed ........................................ -- -------- 9 Application Approved By ....... ............ Date Application Disapproved for the following reasons- -------------------- ------------------------------------------------ ..------------. --------------------------- -- ----- ------................................................................................. Date Permit No. 95..: .... ........................... Issued .. -- e Date Fle No...1.s... .... Fims....3.2............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Diopmal Works Tonitrnrtion Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (.Vran Individual Sewage Disposal System at: ��_ �—��d .-^ Location-Addre�T � �-� yor..-Lot f0 Fr �. }j ' �� �O�wner •Address � At C�-O% !"lLy w ".� � l� S� /�J�t! M` ....... .....i............................................................... ............................................................f-----------------------•--•--------- Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a Other—Type of Building ..........._ No. of persons ....................... Showers a YP g ---------------- P ( ) — Cafeteria ( ) Otherfixtures ------------------------•--------...------------•-----.-----•-------------••--••--•-•--------••••------•----•--•-•---•........--•------............... W Design Flow..............................................gallons 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. it Seepage Pit No-_------------------ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z • Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date.........................................z Test Pit No. I................minutes per inch Dept i of Test Pit............_....... Depth to ground water........................ Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--.---_____---_--------. Description of Soil."=- . ---------------- x ------------ U Nature-of Repairs or Alterations—An�swer when applicable _ d ............//_ _ _m__ �_ /1..._j .......S n lr ! ? -� n `J-9_rt G t r! l rl.� � it Agreement: The undersigned agrees to install th'e aforedescribed Individual Sewage Disposal Systemin accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complian e-has been issued by the board of health. YSgned --�-, .................................... ; fe Application Approved B ' . - ..-.......... . - - --- -------Y ...'�................ Date Application Disapproved for the following reasons- ----- - ---------------------- ----------------------------------------- -------------------- - ----------------------- ------- ----------------------------- ---- --------=---------------------------- ----- - --------------------- -- --- ---- - Permit No. /3... Issued --- -5........�te_----- .-......_....-...--.-Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE �" C�>ex-�t�tctt#e of C�um�It�xrue THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ' ) Y...................:..... ------------------------......................------....-----------...--------.............-------------------------........--------------------------- .......................................................... .....--------------...........---.......e--...... has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. --. ar ......................... dated ..... 5.....---------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUAR NTEE THAT THE SYSTEM WILL FUNCTION SAJIS,FTORY. DATE ` '' --------------------------------------------- Inspector THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No....... _5-_' 0 TOWN OF BARNSTABLE . 00 .............. FEE........................ i oo 1 urkii Tonstr ion rruti L-,) iC 1 - i?G, � Permission is hereby granted----- ------- ----------- 1•---�'�--j-----•-..... '---•�-5-�.n-----------......---------....-•---•--..........•.. to Construct ( ) or Repair (__�)`an Individual Sewage Disposal System ' at No.. >- r -� �, �� � �,..¢ r_,...... -•------ Street --.--•>---.�••� •- -- n ,� as shown on the application for Disposal Works Construction Permit N-o.. � ___._. Dated.l �.�...�...........! 1 -- -----•••--------------•---- Board of Health DATE.................. `-� •------------------------------••--- FORM 36508 HOBBS✓f WARREN.INC..PUBLISHERS FROM :cl Dam ~rn:j i neer i n g inc FAX NO. :15083629880 Aug. 02 2007 12:35PM F:1 11:02AM BARNSTABLE BOARD OF HEALTH N0.551 P.1%.. `OWN OF 13ARMABLE l LOCAnON &ACim# Zeal-D Z d' ASSESS OR`S MAP & [.qT 11 ° C TANK WA CM U0,OF BEDROOMS--Le-9 BLTHZER OR ' 1MTDAs'13• CM0LIANM DAT.E: , s UPMEt on Distance Botw=the. lldar,-'i n=AdJulted OMmdwata Table Md Bottom of lAwhing Fesdlity mat ' h1vatz Water Supply Weil and Legebigg Fjoiisty (If guy wells moist Rake or with i"20.0 fwt of 1=hj�g facility) _ Edge of Wadand and Feet �. iu�►(��y wotla�ds Esc wsidlin 360 feet of leaebins facUityy t Fash®d by t I ' �, �� _ I J A .. L,. •� .I ..I.. .. I t 1 I,ii, . ,pt �li!.1.1 n i�`. ,,;L.i jn ,C''ell � fo'7;�y,�.. 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OF BEDROOMS- PERMITDATE: COMPLIANCE DATE: i Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply,Well and Leaching Facility (If any wells exist j on site or withid200 feet of leaching facility) Feet Edge of Wetland and Leaching_Facility(If any wetlands exist- within 300 feet of leaching facility) Feet i Furnished by lk 1" I tf 6 A-e �( .. 3 Q� { u a '�D - : � � v N O off WS-382-4541 fax 508 382-9N80 Bamsfabk Harbor down cape engineering, inc. Locus i us {rj CML ENGINEERS LAND SURWYORS 939 Main Street — YARMOUTHPORT, MASS. a ZONING SUMMARY ZONING DISTRICT: RF-1 n MIN. LOT SIZE a 43,560 S.F. � R°ut MIN. FRONT SETBACK 30' 6q MIN. SIDE SETBACK 15' e� MIN. REAR SETBACK 15' � LOCUS MAP SCALE 1"=2000't ASSESSORS MAP 352 PARCEL 15 LOCUS IS WITHIN FEMA FLOOD ZONE C LOT 14 i 10,069 SFt a ��sg PROP. STAIR S FOR BASEMENT ACCESS PATIO / EXISTING / DWELLING / 0 / .. / PROP. ADDITION / 7 \\ R=l 9 ti OWNER OF • RECORD DOUGLAS & DIANNE LANGELANO 25 TISQUANTUM ROAD CUMMAQUID SITE PLAN SHOWING PROPOSED ADDITION REFERENCES AT �c 7 353G ' 25 TISQUANTUM ROAD CUMMAQUID PREPARED FOR N OF�S�cti ARNE �N M/M D. LANGELAND ti H <. - OJALA N JANUARY 29, 2008 i No.2 48 aCOT Scale:t"=20' ARNE i h!D�TE P.L.S. 0 10 20 30 40 50 FEET _._..............._..._.._.........._—_...............---....._ r TOWN e.*ar•su. puss dU$ETT3 ice''''.. .....«........ ......... ..•T EL..�G S,D ,. TOP OF FOUNDATION CONCRr1c COVERS •• Fi...0 3 s"o J 12 `` / j'♦ 4"CAST' IRON 91� T'r• '" -_ ••r• .,rr f , .,ri r ' rC.E'•% Z Z.SO ' �j .,r..y.. •rr ,r OR SCHEDULE 40 ri 4 SCHEDULE 40 P.V.C. (ONLY) ' ' LEACHING TRENCH ( / )REO. t . ►.i RV.C. P'.PE MIN. - 2 PIPE- MIN. s- MlN • i/811-- Ile WASHED STONE 35'� MAX. 4 Jf, PITCH 1/4 PER 14"PE2 z4" 2.!--4,z/24 sp i• IVVE.RT L._! Ec.zo.68 .,_ , ;•• EL Zz:���,... GAS BAFP1,.E- a►. INVERT INVERT r SEPTIC TANK �s• ���z! z3 _... INVERT IS-op ' - .Zo.�O - ,+ • ;'o .... . ... GAL.. INVE^'Zi• t DIST, • • EL. �..�. E1...2�.•. •. BOX ;�`�90• STA N DA R D (7e2�) 3/4"+I�/�lT� s '' •' s"CRUSHED sx'oNE !N INFILTRATOR WASHED STONE scr/�G,4y •% :. 43 P.- PR FI LE OGROUND WATER TABLE• '• ' ' ,�.�5�-Ssoas •ti►�p .�sz ,�A,��-�. �s . SOIL L0� • SEWAGE • DISPOSAL S�r STEM DATA ��Z04 e.. T I m- . 'JAI. . NO SCALE TEST XOL E I TEST i HOLE 2ELEV. VLEV. � DDESIGNDDATAIs ��.,.• �i.r„i :.:fir,,. ! !=C «: 'J i l Sga/2r/ C.esM v N 5R*+py Z04 tf I�!V .:.. �'. :-:i..CQ I..,S .. . . .. ~. . . It A .a v�d(a R ,a y n i4• �zarg3 /x" 4a,Z'.cso TOTAL ESTIMATED FLOW . .. :33:'. . . .. GALLONS/DAY 12. • X4,./oy Co y ` " SgrrDY 404" hY2 �/8 8 140y,¢ 6/6 ,f T- 3/�' BOIiOM LEACHING , AREA 43���.... SQ.ri.linENCH • CO/�RS� a '''� _f/ L}gRSec' Sgr/A _ .r 7•s'ye �v. r ,,oya A LEACHING aAREAJQ.i 1.f t tt:IIC}i ram_ SIDE. LcA.r . + n a ro .. . ... �yR 414 SY/D GAR.,AG: DISPOSAL .// /'. t50f AREA INCREASE)Z ?ec. /Yo Sp 4� . hevr . . • . . • y� �P¢ / ya WTOTAL LEACHING AREA .�07. . . . � 84• � 3ir� y / 1 �•%,/0 7,c PERCOLATION PATE*. PER INCH 3��► t uq'I Sri sws�� 111 ✓sao LCS 1x� 1 Z.y:'' C y$' ,h , �. _�� W s�tT, r�,-,' 3 S14�1&, L'EACI-IING AREA P:.� PERCOLATION RATE .��.�3� SQ.r IC., P. ' i,rj_s ; .1 ► v ,Aye 4/f C L� �lGay.rrG72 C -- -= ;- ---- t �- t A86'- .«o //7'� APPROVED . . . . . . . . . . . . . .. BOARD OF HEALTH GROUND 'ev nao s�Ts 11 C 1 '. U j . .. ..WATER EN O td rR=cO DATE ... . . v is L�, ,! - AGENT 0.1 INSPEnC OR W.M.NES.S.ED B . Dove !'b/ L0•7: / 2S o . ... ... '�. . . . . . . . . .. BOARD Or rZALT H p 1 ! u 1 l o f ST�ToN /2; •f�r�tc. ';5.. ENGINEER 09pA?>7o,t ! C ; D T I / J f� • . 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