HomeMy WebLinkAboutGREAT LAND ESTATES #2 BLK 1 LT 7
Municipality of Anchorage Page I. of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: ~---~ ~"~'~l'~'~}''' PIDNumber: ~:)/-~( [ ;;;~[t~:' .
~'~"'~,~'""l~-~t...-- ¢'-~"¢'(_~'-.~,_, ~.,~e~aterSystem: ~New ~Upgrade
Address:
~ ~. ~~~ ~, ~. ABSORPTION FIELD
o ~~~,~ ~,.~, ~.~s: ~ Deep Trench ~ Shallow Trench ~Bed ~Mound ~Other
LEGAL DESCRIPTION so,,,~,,,~: ~.~GPD/Sq. Ft. Total Depth from original grade: /~ ~
Subdivision: Depth to pipe bottom from original grad~ Gravel depth beneath pipe
Township: Range: ~ Section: ~ilJ added above original grade: Gravel length:
~ I / Ft. Ft.
WELL: ~ New ~ Upgrade ~rave[~ ~~/ Numbe~of lines: Oistancebe~eenlines:
Ft. ~ "' Ft.
~f;a~A,B,C): Total Depth: Cased To: Total absorption area~ _~ ~ipe material:
· Ft. Ft. - ,-~SQ. Ft.
Yield:S~M ,~mp Se, a~: ,t. Ca,~,, ,~ A~o~ ~ro,nd:~. TAN K
SEPARATION DISTANCES ~pti~ ~ Holding ~ S.T.E.P.
TO Septic Absorption Lift Holding Public/Private M~nufacture[: Capacity in gallons:
~ Material: Numbe~padments:
Su~a~ew~te~ 1¢¢'~ i~¢ ~ ~ -- LIFT STATION
LineL°t (~ ¢ ~ I ~ ~ ~ Size in gallons: ~ Manufacturer: ~~
Foundation ~/
Cu~ain ~ ~ ~ ~ ~ ~ . Pump~l lElectricallnspectionspedormedby:
.-- Drain
Remarks: ~~ ~~ BENCH MARK
Location and Description:
ENG~~L
-, ~: ~ *~,
S & S ENGINEERING . ,..,ac ~~,~-,,
inspeotions performed by: 17034 EEule River L~ Road' N°'~es' 1st~"~'~ ~' ~*~ ~
2nd - P,_ .
Department of Health and Human Services approval t;~.., .~'~
Reviewed and approved by: ~ Date: *~%~ ~-~- "-~--
/
72-013 (1/91) MOA 2§
Per'nit No. '~[/~/~-~1'~-'~1'' Page '"~----- of ~
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
~C-4~r~- ~" ~ ~-~0/
72-013 A (2/91) MOA 25
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW920174
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:FEDERAL NATIONAL
OWNER ADDRESS:135 N. LOSROBLES AVE. 300
PASADENA, CA. 91101-1758
DATE ISSUED: 7/09/92
EXPIRATION DATE: 7/09/93
PARCEL ID:05113118
LEGAL DESCRIPTION: GREAT LAND ESTATES #2 BLK
LT 7
LOT SIZE: 87120 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAACS0).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
THIS UPGRADE MUST BE INSTALLED IN ACCORDANCE WITH THE
APPROVED ENGINEER'S DESIGN DATED 7/1/92. THE EXISTING TRENCH
MUST BE PROPERLY ABANDONED.
RECEIVED BY: Q ~(~ DATE:
ISSUED BY: ~ J DATE:
/
June 27, 1992
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL iNSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOl L TEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
iNSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
Anchorage, Alaska 99501
REFERENCE: Great Land Estates unit No. II, Block 1, Lot 7
Request you issue a permit to upgrade the septic system
serving the referenced property.
A test hole was excavated and a percolation test performed in
the area of the proposed upgrade. The ground water monitoring
tube within the hole has been checked and water was found at
15.5'. Attached is the proposed upgrade design.
We do not anticipate any adverse effects on neighboring
properties by the installation of the proposed septic upgrade.
If you have any questions or require additional information
for your review, please contact us.
sincerely,
RJS/LSU/lsu
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
/"= 50'
SCALE i
GREAT
t
/
/
/
UPGRADE
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
6-
7
8
9
12
13
14
15
16
17
18
19
2O
Township, Range, Section:
SLOPE
WAS GROUND WATER
ENCOUNTERED?
IF YES. AT WHAT
SITE PLAN
DEPTH? P
E
Depth to Wa(er ADer..~--,/ I ~:~!,~z
hloniloring? ~ 7~., Date: ,
Gross Net Depth to Net
Reading Date Time Time Water Drop
· (minutes/inch) 'PERC HOLE DIAMETER
TEST RUN BETWEEN ~ FT AND ~ FT
PERFORMED BY: I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
GREA,,'R ANCHORAGE AREA BOL.,GH
Department of Environmental Quality
3330 C $~reet
Anohorage, Alaska ggs03
I §PECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
MAILING ADDRESS ~).0. ~
LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE b
FROM WELL /-~
INSIDE LENGTH
MANUFACTURER~
MATERIAL
PHONE~>~~ ch/-~/c)?/
NUMBER OF
COMPARTMENTS
INSIDE WIDTH
LIQUID DEPTH
LIQUID CAPACITY [(~C~.) GALLONS.
TILE DRAIN FIELD:'~ ( ~
DISTANCE FROM WELL
NUMBER OF LINES }
ABSORPTION AREA % 4:~
DEPTH: TOP OF TILE TO FINISH GRADE
FOUNDATION
DISTANCE BETWEEN LINES
TOTAL LENGTH
NEAREST LOT LINE OF LINES
TRENCH WIDTH ¢¢/¢~¢iN. TOTAL EFFECTIVE
SQ, FT. LENGTH OF EACH LINE
DEPTH OF FILTER
MATERIAL BENEATH TILE
IN. ABOVE TILE ~ if IN.
Well:~)x
TYPE ~'~ ~
BUILDING
FOUNDATION
CONSTRUCTION
NEAREST NEAREST
LOT LINE__ SEWER LINE__
DEPTH
SEPTIC SEEPAGE
TANK SYSTEM
cESsPOOl.
OTHER SOURCES
APPROVED
DISAPPROVED
REMARKS
DISTANCE FROM:
DISTANCES:
INSTALLED BY:C~ /'~~'~
SEWER LINE DEPTH:
PIPE MATERIAL:~)~
LOT SLOPE:
REMARKS:
DIAGRAM OF SYSTEM
L,';:"' i3F;tE]i:::i'T' L,F'tNE:, E2!ii;'T
*l"HIi~: I....I~i:i",IG"I"H L":' :[ I'"lE:f',l:~!; :[ OJ",~ ]: :~:5 'l"l"ffi~: L. liii:i"~12iTH ':.' ]: F,I F:'I.:~:dEi:"t"::' (:IF:' "I'HE: "I'i:~:Iiii:F,ICH OF: [::'Fi:FI :1.' I'm,IF:` :1:
"i"Hiii.: E:,Ei:F:'TH 01::: I:::! 'T'I:;itE£NCH CII:~: I:::':[T :I:E!; THE: I:::, :[ :.'~;Ti::Ii'-,!CE!: [~!~ti~21"l.,.IZ[i~l'.,I THE '.'51...IFd:::F:ICE: OF:'
E!ii:;i:Oi..liqE:, F:liq[.'.', 'T'HE: EIi:TT'Ti:)r,1 OF' I"HE~ liC:-::C:I:::I',,,'FIT:!:C~N ,:::[l'.,l
"I'tlE: ~::il:~:l::l'v'[~::L. E:,i!~:F:'"I'H :1::~i; 'TH[ii: I',1]:NZHI...IH I)E:F:'TH OF' Gt:~:F:I',,,'I~:L li~E:"['l.,.ll~ii:l~i..'t'.,I THZ OIJTF:F:IL..L i:::' :[ I:::'E:
F:!t'.,I[::, 't"HZ E',OTTCIH O1::' '1"HE: E~: ::.:: C: Fi ',/ i::I T :[ i31'.,I ,:: ]: N I:::'E:IZT ::,.
:~.: :[ F:IH i::'I:::II','I:[L..:[I:::Ii:;;t FI:I:TH 'l"H[i~:
F:'[::I[;~:"f"I...I i~!!:'.~.' THE: HI...IN]:C]:F'I:::IL:I:T'T'
;2: :[ I.,J :1: L.t.. :t: N':'~;TFILI.... THE: ~i~;"r':i~;TE:H :[ lq I::]C:COF.".[::'I:::INC:E:: !.,.i Z TH TH[ii: C:CiE:,E!:'.E;.
:'ii:: ): I...l?q[::,lii~:F;::i~;'T'l::ll"~[::, "I'HFIT -I-I-I1~: Oi",I""'~i;ZTEi: ~;Ei:!.,.ll!.':.l:;i: :i?'r".~;Tl:2:P'l I"ll:::l"r' F;:lii:(;!Ll:l:l';:[~: IZI",ILFIFi:GI~i:I"1I/~:I",!'T' :!:F' THE:
I:~: lili::ii; ]: £::, Z i"~~... I~: [::, "1" 0
2516 E. Tudor Road
Anchorage, Alaska 99507
276-2221
Pcrforlllcd For Mr. Pred Li~le ;)ate Pcrf)rll,.:J ,~../.lZ/.7.~
This form reports: Soils 1o9 ....... ~ ............ Percolation Lest
Dep
Feet
2 -
3-
4-'
5-
6-
7-
8-
L-
lO-
ll -
12 -
13-
14 -
OW ~ SW (110)
~w _ s~ (lie)
~w _ sw (zio)
6W - SW (110)
~w - sw (no)
~w - sw ~iio)
Fiat
Was ground water encountered? ~o
If yes, at what depth?
Regding [)aLe Gross Time Her Time Uepth.-lo warm' Net Drop
PercolaLion rate minute.
-Proposed ins iai la'~]i? "~'~ge P~ t Drain Fie Id
· I)ul)th of Inlet .................... . Oept[Fi~"bb~TO,hf"b'r"'t)i~ or tre,,ci, . ........................ [~.['_~.-~
COl,It.lENTS:
I'Q OiO (6/7't) Richard A. Drahn, P.E. Richard A. ~ahn, P.E.
A & L DRILLING COMPANY
BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE694-2588
LAND
OWNER OF
ADDRESS
LEGAL DESCRIPTION
DATE-Start.,
PERMIT NUMBER
DEPTH OF WELL
STATIC LEVEL OF WATER FT.
DRAW DOWN FT. / (bo
GALS. PER HR
KIND OF CASING
From '~.-' Ft. to
From .;5 Ft. to'
From ..,:. Ft. to
/Fl '2
From t f,0 Ft. to
From ~) ../: .~' Ft. to
KIND OF FORMATION:
From ~:)/? Ft. to ~ FcC
From ? ~' 'Y Ft. to ? q 4:
From __ Ft. to
From .:,)~?~ Ft. to '§ge,
From__ Ft. to Ft.
From Ft. to Ft.
From Ft. to Ft.
From Ft. to Ft.
From Ft. to Ft.
From__ Ft. to __Ft.
From__ Ft. to__Ft.
From__Ft. to Ft.
/_
Ft. /F~/:'~O~o~/-c- ~'oZ tO .
From Ft. to Ft.
From Ft. to_ Ft.
From__Ft. to Ft.
From Ft. to__Ft.
From Ft. to Fl.
From Ft. to Ft.
From Ft. to Ft.
From Ft. to Ft
From Ft. to Ft
From__Ft. to Ft
From Ft. to Ft
From Ft. to Ft.
From Ft. to Ft
From Ft. to. Ft.
From Ft. to Ft.
From Ft. to Ft.
From Ft. to : FI.
MISCL. INFORMATION:
DRILLER'S NAME
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519766.50
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
Complete legal description
Great Land Estates #2, Block !, Lot 7
Location (site address or directions) 20325 Greatland Drive
Property owner Federal National Mort. Assoc. Day phone
Mailing address 135 N. Losrobles Avenue #300, Pasadena, CA 91101
Lending agency
Mailing address ,.
Agent Virginia
Day phone
Day phone 694-4200
Address 16600 C_en~erfield Drive ¢~201
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
NOTE:
XX
, Eagle River, Alaska 99'577
Public water
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site x× . ,.
Holding tank
Community on-site
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
NOTE:
72-025 (Rev. 1191) Front MOA ¢t21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm
Address
Engineer's signature
DHHS SIGNATURE
17034 Eagle River Loop Road No. 204
Approved for ~'~W~-~-'~' ~.,) bedrooms.
Phone
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
l f: , JIII;.Ji
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025 {Rev. 1/91) Back MOA #21
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: ~,~
A. WELL DATA
Well type'~'/~----',Vr~/~"~ If A, B, or C, attach ADEC letter.
Logprese~_.~N~ -~ ~'~"', - Date completed
Total depth
Sanitary se~N)
ADEC water system number
Cased to '~{-C~ ~ -Jr" Casing height Wires properly protected(~N)
FROM WELL LOG
Date of test I ~-I ~ I '~-~
Static water level l~'~j
Well flow
Pump level
AT INSPECTION
SEPARATION DISTANCES FROM WELL TO:
Septic/h~lding tank on lot 11 ~ /
Absorption field on lot [[ ~/
Public sewer main t,._[~::~ t-.[ ~
Sewer service line
o
; On adjacent lots
; On.adjacent lots
Public sewer manhole/cleanout
Petroleum tank ~..
WATER SAMPLE RESULTS:
Coliform ~
Date of sample: ;~'~1 :~'~1 ~
Nitrate
Collected by:
Other bacteria
B. SEPTIC/HOLDING TANK DATA
Date installed ~:~l~
High water alarm (Y
Date of pumping
Tank size
Foundation cleanou~N)
~ lCd/---Compartments ~
/ Depression (Y~ ~
Alarm tested (Y/N)
, Pumper
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Foundation
water main/SerViCe iine
Well(s) on lot Ill/
On adjacent lots
To property line I C)~ I Absorption field
Surface water/drainage ~ C,4:~ ~-Jr-
72-026 (Rev. 7/91) Front ! . ' CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
Meets MOA electrical code~s-(IC/N)
SEPARATION D.D.J.81~NCE FROM LIFT STATION TO:
Wetl on...~ On adjacent lots
D. ABSORPTION FIELD DATA
Manufacturer ~
Man~/N)
"Pump on" level a~---~ "Pump off" level at
Cycles tested
Date installed
Length ~ Width
Total absorption area
Depression over field(~)
Results (pass/fail) t'..L~-~
Peroxide treatment (past 12 months) (Y~)
Surface water
Soil rating ~-~' ~¢' ~'~P~/~::~-~-'~
Gravel thickness ~" /
Cleanouts present~)
Date of adequacy test
for ~
System type
Total depth
If yes, give date
bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Wellonlot II'~( On adjacent lots I~'-- Propertyline
To building foundation ~'~''3r~'~- To existing or abandoned system on lot
On adjacent lots '~2Z2Iq- Cutbank )x.J ~ Water main/service line
Surface water I ff_--~d~' ~
Driveway, parking/vehicle storage area
Curtain drain ,~h. JOi~-L~-~ ~r~Ol~J ·
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on th date of this inspection.
Signature
Engineer's Name
Date
$ & $ ENGINEERING
17034 F. agle River Loop Pearl
Eagle River, Alaska 09571
HAA Fee $
Date of Payment
Receipt Number
Waiver Fee: $
Date of Payment
Receipt Number
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
5633 B STREET ANCHORAGE, ALASKA99518 TELEPHONE (907) 562-2343
ANALYSIS RESULTS for INVOICE $ 56666
Chemlab gei.$ 92.3950 Sample $ 1 Matrix: WATER
FAX: (907) 561-5301
Client Sample ID
PWSID
Collected
Received
Preserved with
L7 B1 GREATLAND EST. Client Name :S & S ENGINEERING
UA Client Acct :SNSENGP
AUG 3 92 ~ 15:45 hrs. BPO$ :
AUG 4 92 @ 14:$0 hrs. Req$ :
AS REQUIRED Ordered By :g. SHAFER
POS :NONE RECEIVED
Analysis Completed : AUG 5 92
Laboratory Supervisor,: STEPHEN C. EDE
Send Reports to:
1)S & S ENGINEERING
Parameter Results /--~Units Method Allowable Limits
/ n~j/1 EPA 353.2 10
NITRATE-N 2.2 /
Sample ROUTINE SAMPLE COLLECTED BY: R.J.S.
Remarks:
1 Te~ts Performed ' See Special Inetruction~ Above UA~Unavailable
ND~ None Detected "See Sample Remarks Above
NA: Not Analyzed LT-Less Than, GT=Greater Than
~SGS Member of the SGS Group <SociOtO Gdndrale de Surveillance)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS; Complete all parts on page 1, Incomplete requests will not be processed, Please allow ten (10) days for processing,
I PHONE
1. PROPERTY OWNER
FRED & DOROTt{Y LI~'ILE N/A
MAI LING ADDRESS
N/A
PROPERTY RESIDENT (If different from above)
FRED B. & JOYCE B. ARVIDSON
2. BUYER
PHONE
688-2160
PHONE
FP~D B. & JOYCE B. ARVIik~ON
688-2160
VlAI LING ADDRESS
3. LENDING INSTITUTION
PETEI~S CI~.F~ OR C/O tlUC&IES THORSN}~SS 509 WEST THIRD iNCH. AK.
IPHONE
279-7511
PEOPELS BANK & TRUST
MAILING ADDRESS
POUCH 7007, ANCHROAGE, ALASKA
4. REALTOR/AGENT
99501
PHONE
N/A
MAILING ADDRESS
5. LEGAL DESCRIPTION
LOT 7~ BLK. 1, GP~ATIAND ESTATES
STREET LOCATION
6. TYPE OF RESIDENCE
[] SINGLE FAMILY
[] MULTIPLE FAMILY
NUMBER OF BEDROOMS
[] One [] Four
[] Two [] Five
[~ Three [] Six
[] Other
7. WATER SUPPLY
~]~-~ IN~.IVIDUAL*
[] COMMUNITY
[] PUBLIC UTILITY
* ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE*~'
[] PUBLIC UTILITY
~*lf individual/on-site, give installation date
If system is over two (2) years old an adequacy test is required
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE ~ROCESSING CAN BE INITIATED.
72-010{3178)
· MUNICIPALiTy OF ANcH
~... DEPT· OF HEA... 0,~,~
N,v,c~'~IAL PROTECTION
P, ECEIVED
(SL/~ '^oU) 0
(o],eolJO.~o~ ^uedLuoo0e ~,snu.i Jo~:lOl) -IVAOUddV qVNOIJJ(INO0
SIAIOO U CI3 t:] UO3 (]3 AO>'hJdV
QaAOUddV$~
SIN3W~O3 '9
~3H.LO [~
eaJV uo!ldJOs(I ~ue~. §u!plo;l/o!lda$
~v~~-~t/''O''¥~/L ~VIU3J.V~
:O J_ qq3~
S3ON'VJ. SIO 17
V_:l H¥' NOIJ_dUOSSV qV I O J_
U3Uf-LLDVd f/NVV~ )lNYJ. JO 3el/L/
gN IJ. VJ3 S91OS
Oag~VISNI BIVQ
U3~I~nN J. IJAIH3 d
C]3AI303U 90'1
Q3'11 Iua -3J. VO
T13M 30 II~LcI3Cl
U3B~NN /l~13d
XIS ~] UNO-J [] OM J_ [~]
3AI-3 [] 33UH/ [] 3NO []
................. :suo!suoLu!p
apeuJatuoq s! >JUe/Jl ~C)0~-:az!s
>lLleJ. 6U!PlOlt [] JO ~ue/
pa!ii.laA uo!~oauuoo
A±I9 I.LIq O l1 ~ f-lei [~]
3±1S' NO/IVFK]IAIQNI ~
IAJ3.LSAS 9¥SOdSIO 39V~3S 'g
i)o!j!J,')A uopaauuo3
Ali'] I±R DIg~]Rcl []
A.LI N F~INLNOD E]
9VRQIAIONI ~
AqddCIS U3/¥~
A-I ItAIV-I qldligrlN
A9 IB¥:J 399NIS
33N3C]I$3U JO 3dA.L '
SINOOIJa3tt .-lO tl31]lAIl'lN
:SNOLLOaUIG
3£V0
3VgI.L
Cl3AI303W 3±Va
A-INO 3Sfl 1¥131:JJO UOJ ~tCIIS SIH.L