HomeMy WebLinkAboutVALLI VUE ESTATES #2 BLK 1 LT 44 ) [ IMUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME PHQNr~ ! [] NEW
MAILING ADDRESS
LOCATION NO, OF ~EDROOMS
' Z DISTANCE TO: Well Dwelling PERMIT NO.
O ~ ( Manufacturer Material Liquid capacity m gallons
O Well Foundation Nearest lot line PERMIT NO.
Length Width De~th ~ PERMIT NO.
~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot llne
" ~ DISTANCE TO: Building foundation Sewer llne Septic tan~[ ~O Absorption ~(~) ~
OTHER
PIPE MATERIALS
INSTALLER -
REMARKS
APPROVED DATE LEGAL
72-£ 3~78)
F Li~J' ,. I
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THE L.!:EI'qGTH [:,I MENS I ON ~ E; THE I_.E.t",!6TI-! ( ~ N FE-.'E'.T) OF 'THE Ti-;:Ei",!E:FI OFi'. DP. Fi:t_' NFi EI..D.
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GROLIi'..ID FII',I[:, THE E=OTTOM OF THE E,';-::E:I::I'v'FITION (I!",I FEET::'.
'T't'IEF.~:E IS t".!O SET !,.I!DTH F'Ot~:
'I"HE GF'.I:::I'v'EL. I::,EF'TH ZE; THE M!'NIMLIM i)EPTH DF GF'.';'.RVEL BE'T'NEEN THE C)LITFI:-C.L F:'!PE
F:Ii",II) THE E~Erf'T()Ft OF:' THE IE',:',;CFIVFITI ON
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t?,!:::IfZ:i<;F::'];!._LING OF FIl'-,!"r' ..'~::: fE. tl 14ZTHfJ~I...FI' FINFtL II~4:!!;F':'ECTZOhl FII",![:, F:IF'I:::'F';:CCv'F:IL E, TH];S
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Erl'l'!E:~[;]: F;i:E);!LI_T. RE:MENT.':_'; l'lFl"r' RF'I:::'L"r'. SF'ECIFICR"I'IOt".IS FIt"JD E:ONS-FF~:UCTZCff',! DIF!Gtc~:FiIfi:'3
Ft'v'FtlL..RE:t.E 'TO INSURE; PI;~'.CIF'd]~};~'.
i (;;IEF,i'.TiF::'"¢ 'T'HI::IT
;i.: ii; !:;II"i Ft:::II'"tlLIF:If4: H'm'TH FI-.IE I;;%C!UIR[EM, E.'!'-,FF5 FOt:;~: Ot~,!.....Si'FE S!E[,IEt;]:5 t::ilx![;, !.,.IIELIJ_:.i; F!::};
FOF;'.TH E:V THE MUI'.,I];C]:!::'RLIT'¢ Ch'::' F:INC:HE~:R(]iE.
;;;::: ! HILL Ii'.,ISTFII.!. THE S"r'S'['I~!;M !N FIC:C;:OFi:DI::hNCE !.,.I!TH -Fl..IF!i; E:ODE~E;.
i;: I UI'.,t[)E!:,~'.STFiN[:, TI~,F1T THE OI'.,!.....S]:TE ::!i;!:Ef.,.IE!:;~: SV%TEM r'IFI'T' !:;;'.E;C!I..I!RE iEi'-,!LF!.r,i:GEMEi'.4-!' IF THE
F;i:EiE,!DE;NC!.:_' )iS REi'"IO[::,ELED TO ];I'..IC:[.I. JDE f'IOF;:E "ll..IRIq d.
~GRE:"~FR ANCHORAGE AREA Bor'~UGH
Department ;~3~n~irs~er~ntal G~uality
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOC^T,ON:-~ : '~'~:":,LEGALDESCR,PT,ON:/:~-:. :~ /'/ ~ ~'¥ : /
SEPTIC TANK:
DISTANCE (c~/~/~//~ /~ O
FROM WELL MANUFACTURER
NUMBER OF
COMPARTMENTS
INSIDE LENGTH
INSIDE WIDTH
LIQUID DEPTH
LIQUID CAPACITY I,-~ Ch GALLONS.
SEEPAGE PIT:
NUMBER OF PITS
LINING MATERIAL
BUILDING FOUNDATION
CRIB SIZE: DIAMETER DEPTH DISTANCE FROM: WELL/~0 t'~' ~" '
, NEAREST LOT LINE~~/ ['/~ TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA} //~//'~ ~ SQ. FT.
WELL:
TYPE (~)~////~ CONSTRUCTION
BUILDING NEAREST
FOUNDATION __ LOT LINE
DEPTH DISTANCE FROM:
NEAREST SEPTIC SEEPAGE
SEWER LINE TANK SYSTEM
CESSPOOL
OTHER SOURCES
APPROVED DISAPPROVED REMARKS
DISTANCES:
PIPE MATERIAL: - ,~ ~'~
LOT SLOPE: //~' '(-~/~-
Form No. EQ-031
DIAGRAM OF SYSTEM
~REaTER ANCHORAGE Area Borough
DEPARTMENT OF ENVIRONMENTAL QUALITY .
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
NAME Of APPLICANT
PERMIT NO.
]NSTALLATION LOCATION ~'~/'/~/~ ~/~ ~ /~//L) ~/~f:::~
INSTALLATION OF: SEPTIC TANK ~ SEEPAGE PIT ~ , DRAIN FIELD OTHER
FINANCED THROUGH
SOIL TEST RESULTS
TO BE INSTALLED BY
NOTE= THIS PERMIT IS NOT VALID WITHOUT BOIL TEST
COMPLETION DATE ANTICIPATED -~.~ J'~'/~./~_ /~3
FINAL INSPEC:TION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE /2~0 TYPE~-~) ~C' O~-~;Z~SEEPAGE AREA SIZE TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
/
SEPTIC TANK TO SEEPAGE PIT WALL
,~ /
· DRA~N FIELD
/S-/
SEPTIC TANK
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN F [ ~ D ~
WATER MAIN TO SEPTIC TANK
SEPTIC TANK, ~ -~// ., SEEPAGE PIT
SEePAge Pit ~0// ., DRAIN FIELD
, ALSO CONSIDER AREA WELLS.
/~) /., DRAIN FIELD / ~--~/
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURJ3ED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
Bl~AVEL BACKFILL
CONFORM TO BOROUGh REGULATIONS REGARDING INSTALLATION.
DIAGRAM OF SYBTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO, 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
~EAT~R ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVTRONMENTAL QUALITY
..~.~a~&~A~o~op.~" 3330 "C" Street
o~yf6~m~ ~u~u,, A N C H 0 R A G E, A L A S KA 99503
Performed For~g~
Legal Description: Lot_WV
This Form Reports Soils Log_~
Soil Test Must Be. Logged To 4'
Depth
Feet Soil Characteristics
Case #
~Lr~~$ Dated Performed
Block / Subdivision
Percolation Test
Below Proposed Seepage System
Was Ground Water Encountered?
If Yes, At What Depth?
e%
Reading
Date
Gross Time
Net
Percolation Rate Minute
Proposed Installation: Seepage Pit x
7~ Depth~-~-
Depth of Inlet_~p,m~
COMMENTS:
Time
Depth to H20 Net Drop
Drain Field
)ottom of--Pit OP Trench.
Test Performed BY
Date Certified BY:
Date:~
MUNICIPALITY OF ANCHORAGE
DMSION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information
Application Date
(a) Legal Description (include lot, block, subdivision, section, township, range)
Loe~tion (add~ess or directions)
IOn5-
(b) Applicants Nam~:~.~ MO?~(k~A Telephone ~
(c) Applicant is (check one) Lending Institution ~; Owner/~ailder ~;
2. ~ of l~esidence
Single-Family
Multi-Family
Othe~ (describe)
Number of ~edrccms
3 o Wate= Sup~
Individual Wetl~ Coi~munity~ Public~-~,
Note: If coq~unity ~11 system, must have w~itten confirmation f~cm tJ~e State
Department of Envi=onn~ntal Conservation attesting to the legality and status.
IS the well adequate for the number of kedrccms specified in this H~k (Y/N)
4. Sewage Disposal
Onsite ~. Public ~ Core,unity ~ Holding Tank ~
Is t~he wastewater disposal system adequate for the miu~be~ of be. drocms (.Y/N)
[Page 1 of 2]
2-15-84
5. Enginee~in~ Fi~mt P~oviding Inspections, Tests, Data and Information
I certify that I have checked, verified, o~ conformed to all MOA HAA C~idelin~s in
effect on the date of this inspection°
Name of Fi~m
Address
Date_
6._DHEP Approval
Approved for
( ENGINEER SEAL)
Telephone
Approved ~ Disapproved ~ Conditional
Te~ms of Conditional Approval
Tne Municipality of Anchorage Depa~trrent of Health and Environn~ntal P~otection dces
not guarantee the continued satisfactory performance of the water supply and/c~ the
wastewater disposal system° This approval indicates that, as of th~ validation date
shcwn abo~e, based on the data and infc~mation furnished by an engir~er registered in
the State of Alaska, the water supply and wastewater disposal system is safe and func-
tional for the number of bedrooms and type of structure indicated°
( D~EP SEAL)
'"' ')' Ltl
{] Tc',,j)h~j,Od~ ['~] Hot~nod your call [.] Game
A o ~ELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (~iAA)
CHECKLIST - FEBRUARY 1984
A
Well Classification
Well Log P~esent (Y/N)
Total Depth caSed to
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances f~cm Well:
To Septic/~olding Tank on Lot
To Nearest Edge of Absol?ption Field on Lot
To Nearest Public Sewer Line
C leancut/Manhole
Wate~ Sample Collected By
Water Sample Test Pesults
Legal Description
Date Completed Yield
Depth of G~outing
Pump_ Set At
Sanitary Seal on Casing (Y/N)
Depression A~ound Wellhead (Y/N)
; On. Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewe= Service Line on LOt
; Date
B. SEPTIC/HOLDING TANK DATA
Date 'Installed ~)/'L,~____ size I~ ~O No. of Cu,va~tm~nts __J
Standpipes (Y/N) ~ Air-tight Caps (Y/N) ~ Foundation Cleanout (Y/N)
Depression ove~ Tank (Y/N) '~ Date Last Pumped ~L~ 19gq
Pumping/Maintenanos Contract ~ File (Y~) ~/~; fo~
Holding Ta~ High-Wate~ ~a~ (Y~) ~Y/~ ~ Holdir~ Tank Pe~t (Y~)
~p~ation Distan~s ~ ~ptic~olding Ta~:
To Water-Supply ~11 ~, ~ TO ~ilding F~jndati~
To ~o~y Li~ ~ ~ To Dis~sal Field
To ~te~ ~ Li~ ~O To S~e~, Po~, ~e, ~ ~jor ~aina~
Course
Corm~nts
[Page 1 of 2] 2-15-84
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata ~ O
Date Installed ~fT~ Length of Field
Width of Field 5" Depth of Field ~
Gravel Bed Thickness
Square Feet of Absorption Area ~/~.. Standpipes P~esent (Y/N)
Depression over Field (Y/N) ~ Date of Last Adequacy Test
Results of Last Adequacy Test ~.,V~_~,~ ~'~ ~ ~_
Separation Distance from Absorption Field:
To Wate=-Supply Well C.~ , ~%~v' To P~operty Line
To Building Foundation ~ ] ~ To Existing o¢ A~ System cn
Lot ~ ; On Adjoining Lots --70
To Water~;¢Line [OOT To Cutbank(if present)
To Stream/Pond/Lake/o~ Majo~ D~ainage Course
To [/¢iveway, Pa~king A~ea, o~ Vehicle Sto~age A~ea ~ ~
Type of System Design
C~'¢ents
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested fo~
Electrical Codes(Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles du~ing Adequacy Test.
Meets MOA
Comments
** Check Permitted Bed~ocm Rating Against HAA Request
I certify that I have checked, verified, o~ conformed to all MOA HAA Guidelines in effect
on the date of this inspection. ~..~t~.%~
compan~ I ~o~ ~o.~t-~-o~l ~,...4¢~__~tE~s
~.,~-~. ',..v · · ,~9.~,,~ :4 ·" '/'/~
...
"I,,,'P~,.~,.;;: ~',, ,',
[Page 2 of 2] ,~..~/.~,,~,~. ~-~"
2-15-84
MUNiCiPAL
MUNICIPALITY OF ANCHORAGE DEPT.
DEPARTMENT OF HEALTH & ENV RONMENTAL PROTECTI(~viRoNMENTAL
825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL ENGINEERING DIVISION MAR
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWE
)IRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) d~ys for processing.
1. PROPERTY OWNER
Merrill Lynch Relocation(matiuk Home)
PHONE
277-1553
MAILING ADDRESS
% Jack White Company, 3201 C Street 99503
PROPERTY RESIDENT (If different from above) PHONE
2. BUYER PHONE
vial LING A DDR ESS
3. LENDING INSTITUTION I PHONE
MAI LING ADDR ESS
4. REALTOR/AGENT I PHONE
Elliot Lawson % Jack White Company I 277-1553
MAILING ADDRESS
3201 C Street 99503
S. LEGAL DESCRIPTION
Lot 44 Block 1 Valli Vue Estates Subdivision #1
;TREET LOCATION
10115 Main Tree Drive
8. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One ~ Four [] Other__
~ SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY [] Three [] Six
7. WATER SUPPLY
[] INDIVI DUAL* * ATTACH WELL LOG. A well log is reqdired for all wells drilled
~ COMMUNITY since June 1975. For wells drilled prior to that date, give well
[] PUBLIC UTI LITY depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
**If individual/on-site, give installation date
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE pRocEssING CAN BE INITIATED.
72-010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
~ DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
1, TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2, WATER SUPPLY
[] INDIVIDUAL ~PTH OF WELL
[] COMMUNITY ~--ATE DRILLED
[] PUBLIC UTILITY
Connection Verified -~G RECEIVED
3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVI DUAL/ON -SITE ~'ATE INSTALLED
[]PUBLIC UTILITY ~ O'-7
Connection Verified
INSTALLER
[]Septic Tank or E~]Holding Tank '~'~ ~
Size: }~-,,~ IfTankishomemade SOILS RATING
give dimensions: ~ O
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
WELL TO: ewer Line
4. DISTANCES Septic/Holding Tank Absorption Area Nearest Lot Line
Absorption Area to nearest Lot Line
[] CONDITIONAL APPROVAL (letter must accompany certificate) ~
~DISAPPROVED
DATE BY (Title)
LEGAL DE8ORIPTION
72-010 (Rev, 3/78)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
2510 East Tudor Road, Anchorage, Alaska 99504 276-2221
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
MUNiCIPALiTY OF ANCHORAGE
DEPT. O~' j fAL'fFI &
ENVIRONMENTAL F,,C TECTION
MAR 2 3 979
RECEIVED
1. Type of Inspection: CMRO. VA FHA CONV zxx
2. Property Owner: MERRILL LYNCH RELOCATION MGT. INC. (~""[~,.1~,, ~,.~¢VCU ~
% Jack White Company ~
Mailing Address: 3201 C Street, Anchorage Day Phone: 277-1553 (Elliot Lawson)
3. Name of Buyer: Not yet sold .... just listing and home will be vacant
Mailing Address:
4. Name of Lending Institution:
Mailing Address:
5. Name of Realtor or Agent: Jack White Co.
99503
Mailing Address: 3201 c Street¢ Anchorage
6. Legal Description: Lot 44, Block 1, Vallivue #2
Location:
Day Phone:
Not ~et sold .... so no hew loan presently
Phone:
(attention: Elliot Lawson)
Phone: 277-1553
10115 Maintree Drive ..... directions: up O'Malley Road .... turn left
on Maintree .... go to 10115 Maintree (on corner)
7. Type of Facility to be Inspected:
8. Water Supply
Type of Supply:
If Individual, number of dwellings presently served
If Individual, depth of well n/a
9. Sewage Disposal System
Type of System:
If Individual, date of installation
Single- family No. Bdrms. 4
*Homeowners Assn. owns community water system
Public Utility. * Individual
Public Utility Individual (on-site)
unknown .... about 1973-4
XXXX
For access: contact Elliot Lawson 277-1553
Check for $40 enclosed
72-003(3/76)
May 9~ 1979
Merrill Lynch Relocation
% Js. ck ~ite Company
3201 C Street
Anchorage, Alaska 99503
Attention: ~liot Lawson
SubJect~ Lot 44 Block 1 Valli Vue Estates Subdivision ~2
The sewer system on the subject property failed to pass the
adequacy test that was p~rformed on ~y 3, 4, 5, 1979=-
Therefore~ before approval may be granted, there will need to
be an upgrade on the existing system. The upgrade will
inclu~le:
Thirty-five(35) feet of trench~ which should be connected
to the top of the seepage pit. A ten(10) foot solid
east iron pipe should separate th~ trench %Dd~eepage
pit. Six(6) feet of gravel backfill with a trench width
~ two to four feet.
A permit must be issued prior to the upgrade f~ this office.
If there are any further questions, please contact this office
at 264-4720.
Sincerely,
Robert C. Pratt,
Associate op~clalist
P.E. 4303, North Star Street Anchorage,
NE'h PHC
~6-41~ 3
)R:
SOIL ABSORPTIO.N SYST~
.CRIPTION:
~ RECORDS
DRAINFIELD ~
ON
TEST ·
TELEPHONE: ~77
DATE OF .TESTS :' ,.,<--/:~ '
FILE:
ACCORDANCE WITH JML STANDARD PROCEDURE ACCEPTED BY
F ANCHORAGE, DEPT. OF ENVIRONMENTAL
~H THE FOLLOWING MODIFICATIONS:
QUALITY ON~
ON SYST~ (sAs) gC:O~eJl~.s -~,~rl~.. ~, FT
TA~ PLUS SAS , /
-~~ STEADY STATE , ,,/, ~ ~
PERF01%MED BY. ~
SUPERVISED .BY
J/gL
/ o~ ~
p.E. 4303 Nor~ Star Su~et
Anchorage, Alaska, 99503 907-279-8056 ·
P.E. 4303 North S~ar Street
Anchorage, Naska, 99503 907-279-80,(,(,(,(,(,(,(,(,(~
P.E. 4303 Norlb Star Street Anchorage, Alaska, 99503 907'279-8056 '
LEGAL DESCRIPTION: L~
METER READING GALLONS PUMPED · TIME
REFI,,':~RNCE ' · : ( GAT.TONS ) ( NET )
:::.: ,.. __ .. ,/:~.
..-: . .. , . . p,
:':_'h'>>. , : ~/~ j ' ,- ·
:>:,-: :~ -~ & / ~,~, . ~,-~:
. , ~ , '~ '
~ TO
FROM
.~l~ot ~awSen
'' ' Jack White Company
3201 C Street
Anchorage, Alaska 99503
SUBJECT LOt 44 Block 1 Valli VUe Estates ~1 ~ ~)ATE
MEBBAGE
Vatli Vue Estates is on a co~unity water system ~d is on a
monitored basis. _ne Chem ~b fee is applicable only i~ the residence
in on a individual well serving ~%at house alone. That is when
we must take a water sample for ~alysis.
I am scheduling Bob out on this one on Friday, March 30~ 1979 at
10:30 am. You will not have to be present, he will cheek for
standpipes and research the fite and we will let you know from there.
Any questions, oallo $1~--~k~o Ward ..........
REKY 264~4720
Redif~ · 4S 471 SEND PARTS 1 AND 3 WITH CARBON INTACT- PART 3 WILL BE RETURNED WITH REPLY
Poly Pak (50 sels) 4P471
March 30, 1979
Elliot Lawson
% Jack White Co~upany
3201 C Street
Anchorage, Alaska 99503
Subject: Lot 44 Block I Valli Vue Estates Subdivision
Approval for the individual sewer and water facilities
will not b~ granted until the following items have been
/]cqmpl~ted: .
/ (1) ~e septic tank i~ pumped with a receipt submitted to
(2) A four(4) inch cast iron cleanout be installed to tl~e
sDptie tank or l~aching ar~a.
(3) A percolation test be perfo~ed on the existinq leaching
area. This will determine if the system is adequate
acoording to National Standar¢~s. A list of ~rivate
finns who perfor~ the test is enclosed.
Notify this department 6~r a re--inspection when descrepaneies
have been corrected. If there areaany further questions,
please contact this office at 264-4720.
~ ~ncerel~ ~
Robert C. Pratt~ R~F~
A~sociate Specialist
RCP/lj~