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BOX 7
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Rev . 3/86 PUTNAM COUNTY DEPARTMENT OF HEALTH •• `'�✓.� �—"� -
Division of Environmental Health Services, Carmel, N.Y. 10512
�\ Englneer Most Provide
"D P.Cm.D. Permit N `
l�
CERTIFICA F CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM OT��Sc�
Town or V
Located at lE i �� Tax Map
Owner /applicant Name�°�` /v�L Sabdivlslo�L -Lot H �D
Mailing Address J Date Permit.Issaed
Separate Sewerage. System built by °S/� fr�T IC 6 Y 6 rz9ji S Address r�Z22 197 , i:IAJ /' A H- r/Uy
Consisting of Galion Septic Tank and 0 L +
Water Supply: /Public Supply From /► Address
or: Y Private Supply Drilled by r%l /� lL Address O� �l i l LS /yy
Building Type )&5 / -Vou T- /ki Has.Eroslon Control Been Completed?
Number of, Bedrooms Has Garbage Grinder Been installed? A)
Other Requirements
I certify that the system(s) as listed serving the above premises were constructed essentially as shown on the plans of the completed work ( copies
of which are attached), and in accordance with the standards, rules and reg ations, in accordance ai th filed plan, and the permit issued by the
Putnam County Department of Health. -
Date % Certified by P.E.�j� R,A.
Address ?✓ J ` 0� /A License No.
Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary
conditions resulting from such usage. Approval of the separate sewerage system shall become null and void as soon as a pub(': sanitary Sewer becomes
available and the approval of the private'waier supply shall become null void when a .public water Supply becomes available. Such approvals are
subject to modifications or change when, in the Judgment of the'C, is /ihler��(off� /MMaeit ch revocation, modification or change Is necessary,
Date �� [' q 8Y " —" M�g /v"� Title ��
n.
l C��O�l. TTTIITT
�;
�c
W ��4
WL' LL liVl'lt LL11VLY 1 \lal Vitl
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
PUTNAM COUNTY DEPARTMENT OF HEALTH
Office Use Only
WELL LOCATION
STREET ADDRESS: WNW Y TAX MO flUNig a b'y"
'S Se
WELL OWNER
NAME: AOORESS: �� p
CaA) -C_ / LL 5 Ip !A) , )9dC,1�2
081VATE
❑ PUBLIC
USE OF WELL
1 - primary
2 - secondary
ESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND.IHEAT PUMP ❑-ABANDONED
❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify)
❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑
MOUNT OF USE
YIELD SOUGHT gpm. /N0. PEOPLE SERVED __Y_1 EST. OF DAILY USAGE gal.
REASON FOR
DRILLING
SUPPLY ' 0 PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION
f3 REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL
DEPTH DATA
' WELL DEPTH ft-
STATIC WATER LEVEL ft.
DATE MEASURED
DRILLING
EQUIPMENT
❑ ROTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG
❑ WELL POINT BLE PERCUSSION ❑ OTHER (specify):
WELL TYPE
❑ SCREENED gl- �N END CASING.' ❑ OPEN HOLE IN BEDROCK ❑ OTHER
TOTAL LENGTH tt.
MATERIALS: EL O PLASTIC D OTHER
CASING
LENGTH .BELOW GRADE tL
JOINTS:. ❑ WELDED BEADED ❑ OTHER
DETAILS
DIAMETER in..
SEAL: ENT GROUT O BENTONITE ❑OTHER
WEIGHT
PER FOOT (b. /ft.
DRIVE SHOE S O NO
UNER: OYES
SCREEN
DIAMETER .(in)
'SLOT SIZE
LENGTH
(ft)
DEPTH TO SCREEN (ft)
DEVELOPED?
DETAILS
FIRST
O YES ONO
HOURS
SECOND
GRAVEL PACK
❑ YES
❑ NO
RAVE
SIZE .
DIA ER
OF PA in.
T
DE ft.
80
DEPTH it.
WELL YIELD TEST It detailed pumping
c
METHOD: O PUMPED to tests were done is in-
O CO M ESSED AIR formation attached?
ILED O OTHER ; O YES ONO
�1�LL LOG 11 more detailed formation descriptions or sieve analyses
are available. please attach.
DEPTH FROM
SURFACE
water
Bear-
ing
Well
Dia-
meter
FORMATION DESCRIPTION
tooE,
ft.
ft.
WELL DEPTH
ft.
DURATION
hr. min.
DRAWOOWN
ft.
YIELD
gpm.
Surface
Of
WATER 0411AR TEMP.
QUALITY O CLOUDY HARDNESS
O COLORED ANALYZED? ES O NO
ANALYSIS ATTACHED? ES 0 NO
Cf
STORAGE TANK: TYPERg'A,4j &C
CAPACITY lI GAL. a�
PUMP INFORMATION
TYPE �i� CAPACITY Ai _&A
MAKER 46 DEPTH 00
MODEL U � VOLTAgA Z HP
WELL DRILLER NAMEn � GATE
✓b7 SIGf
ADDRESS o
C, .R � � /� a i8
1k represent that am wholly and completely responsible for the location,
workmanship, material, construction and drainage of the sewage disposal system
serving the above described property, and that it has -been constructed as shown on
the approved plan or approved amendment thereto,.and in accordance with the
standards, rules and regulations of the Putnam County Department of Health, and
hereby guarantee to the owner, his successors, heirs or assigns, to place in good
operating condition'any part of 'said system constructed by W which fails to
operate for a period _ of ;two years immediately : following the date of approval of the
"Certificate of Construction Compliance" for the sewage disposal system, or any
repairs made by W to such - system, except where the failure to operate properly is
caused by the willful or .negligent act of the occupant.of the building utilizing
the system.
The undersigned further agrees to accept as conclusive the determination of
the Director of the Division of Environmental Health Services of the Putnam County
Department of Health as to whether or not the failure of the system to oPer e was
caused by the willful or n ligent act of the occupant of the bui in t1 i ing
the system. , _ . �- �- ,
Dated this "0 day
- Signature
Title
,( y q � h��7 C
-D/1 (.),q d q / /i
Corporation Name (if Corp.)
oZ q v /Jo /4 J .e. .
Address N e j & u!'e, tl c A)
rev. 9/85
Corporation Name (if Corp.)
Yorktown' Medical Laboratory, Inc.
321 Kear Street
Yorktown Heights, N. Y. 10598
(914) 245 -3203
Director: Albert H. Padovani M. T. (ASCP)
F
Dennis Malanchuk
PO Box 313
Croton Falls, NY 10 -519
L J
LABORATORY REPORT ON THE QUALITY OF WATER
LAB N
Date Taken: Time: :: - 6 M
Date Rc' d : !S— Time:
�..
Date Reported:, SER 2n 1989
Collected By: Dennis Malanchuk
Referred By:
Sample L%cation: W d 3S
cr�\o,-eQ �lrY\Ca)n W11
Phone #
Phone # — I Sample Type:
Repeat Test? (check one)
INORGANIC NON- 'dETALS (mg /L)
MICROBIOLOGICAL (CFU /100mL)
_ Acidity
GENERAL BACTERIA
_ Alkalinity
Chloride
Standard Plate Count
_
Detergents, MBAS
_
:(CFU /1.OmL)
_
Hardness, Total
_ Nitrogen, Ammonia
MEMBRANE FILTRATION TECHNIQUE
_ Nitrogen, Nitrate
�,�
Phosphate, Total
Total Coliform
_ Sulfate
Sulfide
Fecal Coliform-
_
Sulfite
_
_
Fecal Streptococcus
METALS (mg /L)
MOST PROBABLE NUMBER TECHNIQUE
_ Copper
_ Iron
_ Total Coliform Index
Lead
_
Manganese
_ Fecal Coliform Index
Mercury
Sodium
KEY FO.R TERMINOLOGY
_
Zinc
_
N/A = Not Applicable
MISCELLANEOUS
LT = Less Than ( <)
GT = .Greater Than (>)
pH (units)
TNTC= Too numerous To Count
_
Color (units)
CON = Confluent ( =TNTC)
—
Odor (TON)
NR = Non- reactive
_
Turbidity (NTU)
_
..REMARKS /COMMENTS (For Lab Use)
Potable
_ Non - potable
_ STP INF
_ STP EFF
Other:
Sample Status:
(check each)
Outgoing
HNO3.
_ HC1
H2SO4
NaOH
ZnOAc
Na2S203.
Other:
Inncoming
NI LE 4 °C
_ GT 4 °C
pH LE 2
pH GE 9.
pH GE 12
Other.
THESE RESULTS INDICATE THAT THE WATER SAMPLE (WAS) (WASN'T) (N /A) OF A.
SATISFACTORY SANITARY QUALITY ACCORDING TO TH YORK STATE DRINKING WATER
STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME-OF COLLECTIO
THESE RESULTS INDICATE THAT THE WATER SAMPLE (DID.) (DIDN'T). /A) MEET THE
SATISFACTORY CHEMIC QUAL TY STANDARDS OF THE NEW YORK STAT D NKING WATER
CODES, FOR THE PA ME ERS TESTED, AT THE TIME OF COLLECTION.
Lx /� 2 /86(Rvsd7 /87)RWE
Albert H. Padovani, M.T. (ASCP), Director
IQ ir*F L��SrsC
'1'_CLI Cat=
FDIAL S
n _9-tad by
C
liffin
177.
1_ Qv�Cil C -- �L CL v_LC
SL;it�r' DISrCSrL A-PEA
G_ r j as ac=roL ed uh-mE
b Date o= plac--T--at
I
2:1 harrier er . IGZ'R wv =ra NIG_Dt"n_'d
C- P'� zr= i soil nct
d. -c` --r-e, bra _,. etc- , areate_r t'1cTi 15' f =CC[i SOS E--Ea
I
i
e- 1,0 ft f_=,-. WatCr ccnrSe/ Yet- antis -
c_ c t =:1 _°_= - 1,000 i
b- E= CL? c ter : ? '--tall i l=Ti e!
I
I
I
C. fc:, -,T =t -Cri
_
C_ i^, goo Cf= =rCLIL Within 10 Z__ cf dc,
e. L= 5"-R-T-L- -TCN BG', _ I
1 p � cuT e_ et s��.e e? evati cn - wa e^r t =_t=
pr0ta'y =' '' `' C v LIcst.
i jVi �.'c_ Mc _•� bcx arC _CinTL L CT1C1 ^�� wl!
f 1CTTCN F_ cam- I
I
.
L �T:C -� ^_ ? '=_rte - y� L'ancE1 i l s t=
D? S rCE c _nzsr L'. C_:C_r i �f
! /3G
E. 10 rte_ t ^ ^c,-- line - 20 L
i- -= - -�Tu Dim,_._ w
-.cn
i L-ct_-. c `` ch < 30 i_ ^cs _= Ca
E. Rccn
S. Size of c a el 31^- - 1 it diameter
lU . De1t7 C- in t_ e_zc 12"
1_ pie: = =cc = I
I I
h. F-DT- OR
Cv e_rf=lC- tank I
I
= 1lD e =5__Ti cc= =_=sIbL T.an'hcl°_ to crads
I
= F=rst Lf
6. C`yCle Tw.. _ by E °saa La Elea tRE
l
I I
cycle cer
-
b. r c-
G. car GCC'_z ea plans
b_
C. CasinC 18
(
d_ Grp : —Ca cr'C�i:C itic! ! ccCzCt =C! °_
jI,jI
a- E:7-x 'es prccez , y C. cU• ea
b piizes al ly hc.C.f i 1 i
C. vices f ��_'� witz ins' de of bcti I �-
d_ '= �`c =i11 Irat__a ccr_t in=_ stones < 4" in C= `rnat
e. C. —min d`_i ins--. led acccrdinc to plari - i
--i- --
-. C---tain Cr✓- cat =all &
C_ _.- ,cr -'_nQ C'" =_ = C..G ^.c?"C? cSvcV t -QTI C ��J c?"=�
1_ Qv�Cil C -- �L CL v_LC
I represent:.that 1 am wholly snqi completely _responsib.0tor✓tki'dpsign grid location of tits proposed,systern(s).; 1) that the aapaiate aiwage disposal. system
county'-Depwmmt -of Hdmlmk.• and that "ow"inplatibn thereof a "Certificate, of Construction Compliance" ptisractory to tho,Commitsioner of Mwlthwill
ti• 'wbMUted. to the Department, anil a wr'Itten •uarantei ;will be turn isfw0 the owner, hti tucgssat, heirs or fissions by the builder, that seid_bu{Wr will
pMce, iw food. oMia1MM ealdpbfl any.,p•rt it, _S aid ••!use• d {spow system dur{n� she paiO4 of two:(2) Pars Inimedietely followUlis the dote of tM iteu-
so" of im6agpovol of -;thi .Cert{fkat of Construction .Complliiici bf..the oiighial sysbm;o► any
pai' rs t " ' °ito; 2) that tls drilled'wNl "i6ribeA above
wo 7".01111,1101111% and that taw wail will;be insa . 1n , acOorgnee w tt
, s, r les a reoulii nsof 'the Putnam
COUnty O•p� • O h. _ - - .
OatsL i SifnaO P.E. �: R.A.
I1dd.ar Ar ri EL (i ' D 1 License hap
E. o
APPROVED FOR CONSTRUCTION Th s apor"ai axpireatwo yseis' /coin tM date Issued unless construction of th• building has boon undertaken and is
r"ocab_N-for cause or may be alnerlde0 or modified when consklerid necestary, by the Commisfioner of MNlik Any charge or alteration of construction
Rev.
ipuNer iw permit. Appr"rell for dhposel'of domfai(k sinNary s•�irsoa. s ejiat� w Wpp1y, only.
Z0/HB- Date SY ��� /"�—t TRW _r
r DEPARTMENT OF HEALTH
Division of Environmental Health Services
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914)
225 -3641
APPLICATION TO CONSTRUCT A WATER WELL
PCHD PERMIT #
WELL LOCATION
Street Address Town Vil a Cit Tax Grid Number
`' 'e/L�V� "L /� /LL �f-OJ� % T?S �,� p5-
WELL OWNER
' Mailin Ad rgss rivate
pe`l%�2 pw U /l .eT ,i�'1%Ea9� t Zs OPublic
TE OF WELL
primary
2 - secondary
RESIDENTIAL []PUBLIC SUPPLY O AIR /COND /HEAT PUMP O ABANDONED
® BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify
O INDUSTRIAL 0 INSTITUTIONAL O STAND -BY
AMOUNT OF USE
YIELD SOUGHT Ji gpm /# PEOPLE SERVED /EST. OF DAILY USAGE ) 0 gal
REASON FOR
DRILLING
IONEW SUPPLY O PROVIDE ADDITIONAL SUPPLY ® TEST /OBSERVATION
OREPLACE EXISTING SUPPLY ®DEEPEN EXISTING WELL
DETAILED
REASON FOR
DRILLING
2620 C�
WELL TYPE
LJDRILLED
DDRIVEN
®D6G ®GRAVEL
®OTHER
IS WELL SITE SUBJECT TO FLOODING? YES VI NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: CAEA
Lot No.
WATER WELL CONTRACTOR: Name TQ /�� 17E1�' Ilye� Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO
NAME OF PUBLIC WATER SUPPLY: /� �� TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: 014
LOCATION SKETCH SOURCES OF CONTAMINATION PROVIDED
REAR OF THIS APPLICATION 00 SEPARATE HEE
(date) signa, re)
PERMIT
TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted under the
provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and
provided that within thirty (30) days of the completion of water-well construction,
the applicant s.hall:
1. Pump the well until the water is clear.
2. Disinfect the well in accordance with the requirements of the Putnam
County Health Department attached to this permit.
3. Submit a Well Completion Report on a form provided by the Putnam County
Health Department.
Date of Issue: 19_Tr � ��`--
Date of Expiration: 19 ermlt Issuing fl
Permit is Non - Transferrable Rute copy: H.D. File
Yellow copy: Building Inspector
2/87 Pink Copy: Owner
Or'ancrP mnv! WP11 flrri l l Pr
PUTNAM COUNTY DEPARIFIXIT OF HEALTH
DIVISION OF •' O' ' 1N Y• HEALTH SERVICES
DESIGN DATA SHEET- SUBSUFACE S3gAGE DISPOSAL SYSTEM
FILE NO.
Owner ed41060A-14- CO 21p, Address ; `f p
/)oP-Tl4. og1%. ; O&W
P2BC#-EL( -E
Located at (Street) C aU)4LL fkiLL P--04-T?
Sec. _L Block
.. _ Co Lot A /
(indicate nearest cross street)
Municipality G A-r A)
Watershed
SOIL PEROO=ON TEST DATA RDQUT..RED TO BE SUS WITH APPLICATIONS
Date of Pre - Soaking. C0 /�� Date of Percolation Test
&
HOLE
NUMBER .. CLOCR TIME PERCOLATION
PERCOLATION
Run Elapse Depth to Water. Fran
Water Level
No. Time Ground Surface
In Inches.
Soil Rate
Start-Stop Min. Start Stop
Drop In
Min/In Drop
Inches Inches
Inches
1 i�ej -�. qo S
2 q1
4
5
1
3
4
5
E1
� - % (`
ME
a
m
NOTE'S: 1. Tests to be repeated at same depth until approximately equal 'soil rates
are obtained at each percolation test hole. All data to'be submitted
for review.
2. Depth measurements to be made fran top of hole.
rev. 9/85
14'
INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING EN00UNTERED
DEEP HOLE OBSERVATIONS MADE BY: DATE:
DESIGN
Soil Rate Used Min/1". Drop: S.D. Usable Area Provided '9000
No. of Bedrooms Septic Tank Capacity /a L5 0 gals. Type C.6 A-)C,
Absorption Area Provided By 40 0 L.F. x 24" width trench
Other
Name 45.Qc �ignature
Address 7J �C-A-Vpu�-p 7)P—iV6 SEAL
THIS SPACE FOR USE BY HEALTH DEPAMMDU ONLY:
Soil Rate Approved sq.ft/gal. Checked by
IZ7
N. C iq
CZ) 4
f1c,. 56 , 24
OFESS0
Date
TEST PIT. DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS EMXXRnERED
IN TEST HOLES
DEPTH
HOLE NO. j HOLE NO.
:HOLE NO.
RE -IVL�
G.L.
cNVIRONIMQOA��.
JIL
21
55A0 E?
3'
4'
51
61
71
81
91
10,
121
13'.
14'
INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING EN00UNTERED
DEEP HOLE OBSERVATIONS MADE BY: DATE:
DESIGN
Soil Rate Used Min/1". Drop: S.D. Usable Area Provided '9000
No. of Bedrooms Septic Tank Capacity /a L5 0 gals. Type C.6 A-)C,
Absorption Area Provided By 40 0 L.F. x 24" width trench
Other
Name 45.Qc �ignature
Address 7J �C-A-Vpu�-p 7)P—iV6 SEAL
THIS SPACE FOR USE BY HEALTH DEPAMMDU ONLY:
Soil Rate Approved sq.ft/gal. Checked by
IZ7
N. C iq
CZ) 4
f1c,. 56 , 24
OFESS0
Date
i
i
1
Putnam County Department of Health
Division of Environmental Sanitation
AFFIDAVIT - CORPORATE OWNER APPLICATION
FOR PERMIT APPLICATION SURMI'TTED• TO
PUTNAM COUNTY HEALTH DEPARTMENT
TO: Commissioner of Health.- In the matter of application for '
I+ ._._C1.'u• �S — ='� ---------- --- - -_ represent.
that .I am officer or employee of the corporation and am,-. authorized'
to act for Co, -•_n wa I ��!
' (namr of corporati n)
having offices atG1'lGh��e1�c� /a�z,�.��L���
�%r11��e._ewche�•�,, _ Whose officers -are
President,.. - - - - --
(Name an address}
Vice - President
^(Name and AddressT
Secretary— —
- - — — — — — -- _.•,•_ _ — . - ...
• — (Name and Address)
Treasjurer
- — (Name _ and Address) _ -
• Y
and that I= am-and will be individually responsible for. any or all aptor
of. the- corporation with respect to the approval requested and-all .sub- �
sequeit acts relating thereto. t
Sworn to before me. this day Signed jPsid
of 1989 Title t
J.
Notary Public'
60NNI�J. DAVIS
ke" Public, %Ate of Now York
OuteMssCanty ,
My Commission f Xpinm April 0,% 19 `LI
V
Corporate Seal
1
CF E--- I -H - DWISICI CF EIG =C�ZfL' F L- r, ��� �V--- S
L�T�> -Fi �L 'x? - ",rte cuj-p9 & c- --, u -FZC~ StS ;P—r- DISi -r��L
RAJ ";ti C - C'SNSZ"cl:'=NT ps�trT?' _� `
DCC'�fr:=
Peter :u =poi i c ticn
Ccr- rcratV Rescl ut -C-L
sat-- Vii=
Engineers
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CCr.=_stan� Pere
per` Eol=- cc-Ctn L CC
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Data Cn [)CS PI
R=tili I N� Dr 2 , - z C-N
D or J E^_x;T'!l=-rlc: /C-a1-2--r-,- I' pT = deta �
We_'1 E)E i1, S_r-,74cs Line if C',c='
Cvnst-uct�Cn NCt�`_' (C�_nGr.r -� -=1
Z�s_Cn Da =
per: s_rC ceep ras. - -=
T,vc -Fcct Ccr.L.CL rs {_s nC cc -- _CCS-J-
Driv°vv & S1CCG Cat
F,oL_r_fe::T_sr,C , Dr,,_cs (: ___�. :-E Cam`
Perc & Deen ecl_s C✓ =l
Rear= Sc ^_L= L__,7r- of pr_: _r eKza s--. c :
S -Cc
I_ Fes; Pit & D Box Slzc,�n &
House - No. C.E. Ee�r,-ati
Wells & S:SZS' s w /in 20.0 ft. of r coc_a�l
Proce_rLty Metas & Ecunl-1
HCllse Sew" ck Necessary . ('T_,' C:: � 1c t )
Hcuse Seier - 1 /4 "/f 4"0;�r,-e pi e
NO " ^^c' Ma—c- EEnr s 45° 4vi C_ = P_CL't
Fields
10' to P -L_, Drivc.vci, L_ =e 'r• �s,Tc_ Cr
20' to Fcund -a t.1Cn iVc11 c
100' to mil; 200' in D.I...C.D, 1=0'
100' tc Stream, Wkt=r- u =e, ka (!_^.c. E`:
13' to Dra i -- ur -- i r , Lea.dar, FcCt i 'lc
10'' t0 War=s Lin
50, irlt,
St-2c tic r-Zcz-
cf
a
IF
ScALE_�,
v�KY •. r "= 5�
FlNlSNED �>2Api;
WMOVABl.E 60VI:t2 <
e
r�o� C7-t P•) ,�
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o
4 h.-
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-to L. r. AP,, OKflT )ON
' OUTFL.OW
°.
P•v -G CT�PJ
fob HIGH t /41, MIN .
P
C� RYA I l.-
��rrr� T^NIL
G. I P
19,10 TO Ot 4"rlrrf THAT TH& y>✓WAGE�,.
�xi�TING a�iZ
1 POyAt. 5'C,aT 6 M WAS GON61flWOT6V A,57
2iOATPL.t7 ON THIS PLAN AN12 THAT T'Kei -
',_;!7TC,M VVAq INrrec4F.D 01 MC "fFotz
wA� oavEt?r✓O avirw •. Yr�"
+N�?TizVGT>✓17 1N A0C&iVW.+NGei KITH Alai
AN 17AkW K•VILi?h t lZ5I UtLAi'1pNy ,0P THI:
o/
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