HomeMy WebLinkAbout006-1011-10-100
PRIVA.-= S=V6'AG=
INSPECTION REPORT a-ran z
GENERAL INFORMATION 3acc =,ar t_ we
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I'nrtr, 4rr':p.. F _ t p l T. _ ~„r :`n I °dGe 5;. t,G
7--)'V%!N OF C U(.O,♦~ill
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TANK INFORMATION ELEb`AThON DATA
Vp~
r. Iben~hrrari.
30
lAr:rma' 11.ic;:.
Qol~4l,0r4 .515- 91.13
TANK SETBACK INFORMATION
a
. 7/00 33- 13.30 ~VA-00
I_:_anq .-9ao9rl~tar. i is•01- 94.30
- - Fo ..44.30
r-.n alr ^li ' Fr+ Sv-iet I Ii/ 93,}0
PUM' SIP ON INFORP It.TION 1 10 9klO
5-1
1`46 ~.wo, v- G.w 93.7
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13-
SOf_ ABSORPTION SYSTEN,
bSU TF°_4:Tr :vidy -';vF. / tvc "1 T rnnc/-' .7 .1-N; JNS cau- ]a :aur C ~
L'lldaKSIJN£. ! ...Y~
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IN-O?Idr.'IJN" _ _ _ _ ':nhM3EF'. Pe
UN- hnmr rvl:mn.- S
DIS7RI3U7ION SYSTEM klU jx
I r oic ~ I_ r.,.
Y r b
SOIL COVER x ?rmnurr: Svraocm. only zx MDuna 'jr A'-Sraae Svstom.c Dm
ofr 1 I ; atl.:,.e I -¢r o I.- - u V::: ,a
be.l' 'I x to I 4 mo r np - - - -
COMMENTS: pnauce o7_ ;:.r_r.r.le. > e>5l. _r. nsoe r r'. -r&
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LDcatior.
Go G~~ e
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31aG -curer ICn;ltl. _ 11 etw't-•a d L.. 0"
amoun'. C+-COe• t1Z dI~ O•x+Ci
?lur r t rU rtCJ.ll E.. _ IIYE _ N!' I -I V j
1/\✓/'-~~-/_ `
JsE fr rn tam allitional ini, ~ Ftlar I Al
SflN- fa~~
- `3 ~I rl 'J u 9 Z~~$ dlrly and Illllld'nys llivisioll S % • C / C %X
r<J 111 r,~ 2111 Vill, WI l AVn, P.O. I Ina 7'It17 :;anifaryl'tmlil Nm lrr(hl 111, nfin -hy(-,)
Moolisoll, M 53707-1162
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fwl i Shll~: "loIIinI Nm Jmf
u)11nty f'l'1(1n[ Appllrrllliul
In acrnrdiol'.- rr ilh ' IN I.PI(t) a I:. A•hu. C in I nl Ln.: I' nn 1 I(r. ap,anpl L:I r. I: n nnumnlnl un:1
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Ihc I I pnI m nI I \ I I, oil 11, o I I, III i I ':.n I 1 l t. it f I xnm nm you pruv.:. m:Iy I , III m•nuvlnly ~1 tJ9 ` 1 i~
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1. Appliv Ifuol I'll IIIn Illou III nI. 111 1.1 ! All lu In l'IIU1111I1
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1;;111! 3 19' I x vncl'.' Mv14 ;:Jdl cn: y1 r/ U/ Ra :r I I it un ,
Cry. Shot lap Call 1111 NLnhu NI /
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JI(I,. .•1'ype prltuil io (Iio'rlf u11 Ihnl npplY) Lord
IN Or 2 Ihl nil)•1. p,rlh r• -N,.olb ln111ednu„II.~ ``I Wo.
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of.
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11.-I HI...... I Lra:.v:l For it Itcvixiou II --u.nl'I'loul III. I.uni'Iluu..li:IhINuv 1J..II'myiulle l'runilNunlorand!1111¢!soul-
II Iuu: I.xlnuJmn Iluucr N)b /l
Iv.'1'ype u( I'OA4 1 -yslcuJ( nnquuunJJDI yiu:: (Cheep 111111m1:II1111y)
1J I I I u.. I I f I n I l I L I r I III I on ri f l At Goole hlaund> 2q w I fsnoal•le nil (I IJa I I I in. 11,11 Iil IIdI :uil '~r~ r 1 1
CI II I I r. HIM' I-Ian n „I""- I Iu,;.:, III u.-vo. I«IIo:d $7 GT N y^ICY~`-~
V. IIi p Il lhln InI 11 lLuufufolm11linn - - - Lilo JY I `)r5
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VL'Lud: pIIII f ry a 11,111- Nul tvln.wl'u luov _
IulkoI I Cnllnm I I hn L: I ' _
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1'Lnul Pl our. (19uLL) _ I'hu LLr n,.inLUlun: \IIfMl 11 ;TJw dI I Illl:a ur Ih~nePlum6n-
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I'houhnf's Addmns G;ucnl, Cilj, )l lute, 7.iil Cot')
VLLI nimtI-I •pnlhu nlUseOnly
A, p nv : I qI 14x.111! Pen bal., innun h :nin • I,ud til,;nohll-
I ~ tlt I u I:a'Iluli'II ~
I.\. (uudd~l'i '111111(•.'~f~[t,IEy"111 "J:11,(i~:ILlpluS'ul ,~a\ (~dC ~ 6dts1 Vie
ultiper.::: cell MI all be' - .1c 's ' _ `t•_` - 1
n per i-nar.ayemen' Wan P
2 Al a!1WAL MI -an s mac! L V r! d,
a per llgicr itclr J rd::nr _ I~ V~r!Y\ Sa;lg ~ r1a(izm~ 5 3 Yb~4
All- hInrn yllalrp6uI 'fl pem 1 I.... lalh.I:nnufY only uu 1 ~Inl Lxctl m11u Il buh vLl aL..I:
I'M nialJ(IJ. 11,11) 4.~ -ol..~`cIA Pb` -1GL2. , 'V'y !I Z'r rf-l•"~~
D r iJr>UQ<__ . JD : 1 "N.tl nL~ SYV'l/..
CONVFN IIONAI COMPONI N I DFSI(N
Res denlial application
INI )LX AND 1 I R F PA(X
Pagr I Index . n i'I~ilr~
Pme-
I aye L P nt Phan Name:. ..f 2dr~ _ - -
' 1 / tr•Cl SI In- it
t' A . 3 ~r g & r'f0 5 ~I t.1i~n Owner's
I' iq, 1 Nltr f S(•t c '
Nanu;: r,
- -
F' iciF 7 P 1 li i[el~ I I•nalrni lrlOn i ~
- Owrlef .s 7
Address: ~X-7,3 j 2, 14t7
I'.il) i pll : l nl h t1 un{ i rn c I and `I /
kP.:~chnvi L Soil lum, t - - - -
l -59o 7
Legal I-)escription: /~,L= • j .3 J N /(a G✓
Subdivi siun: - - I_ot
Totvn: C4/ d
County:
PilwL.i ICU
Designer/Plumber:
- - License
t ic.Inahn'e:_- - Date:
t-urnn'Ienrs
Rc I,.Iwd pur-,ndnt iu nIP In ldounri bun P,rl••uipnon componciit fvldnnal Iw Pi)"%, h Lrlion .U
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Soil Absorption System Cross Section
r WC'
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F.;h!:duie 4p I n[tI C:L:!1P
Pvc V,,11 Yiae \~l (i~D~r p_
'.^th Veil
Le: u:hi'x7 111 ( ~ c~
CFimbcr
'Y- - System LI^va`.i r
i
Soil Absorption System Plan View
ft
j- -
3-« ~r.i~((f(#~(11I~Il]1(lI[IIIDIII(1(([IIIIIII1»i~~IJllillllll(~(lL[[III(((~11~I~I1_}F~I1 I eachin i rench 1
5 fl Vent Or Observation Pipe Chamber -
1` I
(I111111((ilf(I~f1lllI~iiiillll(ill(iffl~Il11J111Iii1ili(1(!1LiII]11illlllll~ii[Iilh
n.uia
( Trench 2 ( 1leadei
Lcachind Chamber S tecifications
'Aanufacturcr And -Iodel i = t<
F.ISA Rating ~?O__ sq ftperch, tuber Soil AID Pl;c-attun Rate ~gpdisq ft
gpd Design Flow ; Soil Application Rase U LISA 15
Chambers
3 9 rt v s c( cltan.Lr.r.; r:ar.h, r• fb, - tr
Page --of_ _
~.'I„ INSTALLATION INSTRUCTIONS
PL-5251PL-625 FILTER
INSTALLATION INSTRUCTIONS i -
~ II )!.(~~U~S ~(I I 1 I) ~ nllh oln:nlnll 1J1)~I~. I ~ il~ i.
4 ~h.1 iilGt rI'S.11n1S.'.,.fl~Itwff ~ ~ e ^i 1 (nn~
'J ~ ..e Y L 1~ ~ I ~ r 1 c iLyt~JI
p{,ti II J v
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Step 1: St. p L: (A) I. ocatr. Ill(, null,! of III,-, sepllc Lank. (A) N-low in;lallalion, Ilnee the Step 3:
Gle pi: Iha: hlter housiny on the
(It) Remove lank cover and YPumI1 lank Y (A) ut
filler houz:iny nn to fife 01.1110t pipe. Duffel n c.
it necessary . (U) Ivlol'u :;we Ihat the hou;:inr pi p
is positioned so tho filler can be l hion Ilrsul1 life tiler fe lifIlldye et lhu
ousing, making sure e filler
removed horn the lank fur corhidga k; properly aligned and
mauetr n,Inc, and servil corrlPlefcly inserted in the housing.
MAINTENANCE INSTRUCTIONS ~wLLYM=®-•
~'''~'.n >7 ill ~~,,eNbk ~i,~~~. ~;)~r• I u I~„•'-+`fr~i6r?. S!•H_>wi ~1, i~:ll~2rLf 1 °aia^~ 1-_ .n T[L:
I'
i
Step 1: Step 2:
1-oral, life nntlel of Ilie-se:plic lank. Step 3:
(A) Kcsnove lank cover and pump (A) Insert the litter rarh'idge back
< if necessary. Into Ill, the housiny maldny sure
- , , (R) Pull t l lillcr out ul the huusing, the tiller is properly alighed
l1;5E RUBBER G) GVCS 1 (c') 1-'use 011 the filrerovul the Seplic kvik. and completely inserted.
WI IFN CLtLANIN
G FII_I 1= I: J Makr. sure Al solids full baGr info the (fi) Replace septic lank cover
- - septie tank.
POWTS 0' rj[t;'S MANUAL & T11ANAGfMCNj PLAN
SY T'- 1 rl"ICI IIOIJS_ ❑ ^J.4
(IUN - u,r far l:_I .~rtr cc JFT/ 11 C:.4
troll^_1^_ - -
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- ~j9c^nt Ill nr P.lac,.i ,ctrl. I r
N
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,un :.nun O NA
of 1, ~n r r,
~.rrn dnr d IuJ r t il'1 i h}.)
: r.rn,tel ci Cl NA
ill n.L,el _
or`c nverY-' - - I
• , Pf t .all
evrrV:
.rnr ii!l.,l
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c,t n i`. rl 11-P 11a ,,~I, r,.IU^. -lr• Li ;e,:_ III
r
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till. l n I ul --J rcr'oY''y f1 I nr. > Pt J- rl n 1J ~r~r 1'
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rq Yl-IJ ,I - -d`pUlr 3-~!
rI 1 __r.,l~. Ir.1 r.. P(1,'ib II I.c mi a 1 _ f r: Ill'r~dni et;:n 7ur [F'u''i - n,
f It to ti I I hat F ' fill y
r_
Ir
r r,l Ih. t 1 is t`~ t 81+ i
n, r I ul -f > s nd t~ cnncr, f' l 1
Itl d to. clr r k 1 -r 1', rt'C❑ I. U'.
I ~..u: t u rl-. uie n ~I'ru I shidilrt I I a n, , m too o el ll'r ca~~,l cq
C rl n Int l Il.y n 1 tl d in r`'- 4 t.,:; 1 i" J it 3r,*? 10 it d:':zly a
it Pr. r:rill-) I ~1 b f!b .nt ml t 1. yr!.'.;. ,.p c.
ldinll f , QIwn^.
'.:nt f:l fl,~ Ut°u~t i a'I 'y ) mere of th_ tanl: . r
coalanee 4,IAIA ch"IP:~
. te netif!.-nrnn Df th-.t.e~I rC9ul..rory avdmu~. or
in any t.mk ugnarc
dgu :~r,li l;cunt
t ,d Id, a Scp:aiJC g'.nric~n0 ppolnt;f and disVnced of in ac
1 e comhincd accu'nulnt:on of 51U
n '..nt
ill bo left)") r rlnllon
f tank shy lrr•.,alized
aLNn1e jll,;^rc, mec.h~niLal or I
a c,erC{icd S'UV:'1 ; FAait,tain"r
or ut pc`.atiris;raa;ru code.
rlv l^inq cf "flu" I
d In
^ . , II••. I,, f, rinnvcl Lr a„•1 i ; t••lr IN event
but not Intl u
includ n0 ' Lcnti,.ra,
1 1
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„„al r JI U. r
nl 1•
::h'l1 h? provided to
' 'f. t~ ~ : ~ YC> I" r 1W`?IC" ~nYl ,~j1(~ y~ 1 ~ +~'iS~l l ~ 4 *'~•t ~ ~ ?
` h, j tin +''r\ p7,~.nY PI l4"5 i ~1 1~7 r =Ha,( w] ~I t , tJ7' , Y: i ; 1' .r.:
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~y~)cy nfY r ,t:,ll 111 :L:; +a :fvr to
cu r anal .,,.mt I I~Z ~:'ca E I c.^..1 'K f 4 6''~~~ c.
llcr]hrr !It btc~nnr]%.
f.real/tlc,'i/In41c1]ru ~ zGO ~ 1
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IJ, u.irtu:cul C r1,,I.t l- (%a~~;rt ;:c r)
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17 tn`mti:~n' rJl Suitg (If'.Ir-hiry char rhr rt,)
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1 !1' ),H1 {lq: fry i#or cien~cn '
v 'vl
C U C~ .jtIlUC6 L) ~4 t:SGd - ~ I t l Uq~C ~ , 4 I
+ F lii '-iJ ~4
1V ~IrlN 511y 4,1-qY!•\lA t'llf Yf t~Y~ .lJk'i" J lY,..Y ii r'J~ ISj r1H > to fF lir YV!a'atfn I/ it1 lr. -A v c` {per
Ff .,off 1~ -'v't ~ ~ 1' 1 ! ~L~i'~ y /~t'.• ~ iY -.t I J ~I:~
~Y IJ. Irr~~ Yn' 'I I I Y." S t_1 `.j jl I Y - l I~ -
4,L>xv_ti~ ti♦~r!.r.~l.t , y~ S' i I V C '}pY I': r, I.t I •>F
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Iv~u .;I
;TART LIP AND OPERATION I
- - - - - -
I' .r now rcic:uuction, prior to usa nt Iho POW I S rflycf: to:atment t,nl:i:d fur till: presence of pairdiar; products or other chenllrads
dial may impede 1h P tmatlnent process Millar rlanolge the dispersal cl;llisl. If high conCOnrrations am detected havn the t ontenls
of the tankisl n:nmved by a sl:plage serviriug operator prior to usa.
&yst oil, !:l',-rl up :;h:df cut 11r,,:ur vvl,ua ;alit wiidi::c:ns :itu fucun at llf.: if t ill I ilI,VI::A ldcc.
Puliug power odt,j!;: i p,,,mp I elks uuly fill „lawn nonn.d hightaatef luvr.i:;, Winn r,ovvta is fe:~ln, cal Iho (.Xe"S W.1,l[1.Welol Will be
discharged to fl o. dispersra r:ragsl in or.e Inge dose, o•vuluadilig tiv: Co.lisl and Maly fdsult in till: backup or surface disrh alga of
u ff,u Pls. In avoid Iii:; s.malion hnvr. tlw coo,arts of u,e Imngl f.mk rcnlrlvt:d by lI Se(llaga Su1•t.l fipnrat.;t prior to restoring
1„rNcr In the Ctfllwjw' 11111111) of con Ulct a P1u,11ber or POL''IIS Nlainlainur In aslsl 111 Illanllally opelalillg Idle pill lip ntlldlofs to
n:r.mre normal I,:v1:Is •a:illln lnr. pump lank.
I.., rill dli've or park vr.F. I Gvul iinli: and dispersal e,.1L:. Do Fail ,ilea nt ,lark ovu,, or l,111L, .v'ra disturb er conlptct, the an;,,
av31Ln '15 feet down sluPa of ally mound or ai-qulda soil al; anq:tiup al::a.
Ituduction or elimination ill :h:: follotming 110111 Ill-, vvasm :•at:u stream clay fill;, .tvl: till, p,~I lonllencc and I:,olunll Ilw lily of thil
lit L•V I S. au ldliotit aL', ip,a:, Ciaa:IAte hulls; ,.nndums; cr.l(rn :::webs; rl I i, a::; nL
iwim ation drr,iu Emcip w.iwi; Imit alI equrcIIIu peoliogs; gasulinu, ct.n; If;
p einrin.1 prndncts; pesticides; s;,q:nary napkins; te:npnns; d1111 welter soyener brio.-:.
i i:ANDONMFN I'
°+!ron lho POW-; la's and.'or is pr.Irnannllly t'Ik-.n c;n of s.:rv:co Ihd .:b.pS sill 11 In: t.: l,cn - : - .c,: ;J !.t
pr pofly , nd -eal•y abandoned in cumplir,nru with rrlaplr.f Cwmn 83.33, :Nisccnsin Ad,11i11I,.. :Iiv- CLI-U::. ~
• All piping to tanks and pilti shell In: d~sr on uuiaed wild Llre ~ba,l rl:i❑::d pip,: oprlilimis se,drl1.
• 1113 COI1to111•; of all tanks and pit:: sh.ui u.: Lr41111va0 Edit pl,:pcriy dispusud of by a Suptdga `.*,lvol
• Ater pumping, all tanks and pill; droll hu uxcr,vatarl and Iuulrrond it fhoir covers removed and the void s,;ccu tiLad vdfih
:it .0, glavra or anuthcl iuml u+hd ur.lla dal.
l :olll HNGP.NCY PLAN
If Ile POL'JTS fails and cammi he repairoll Ihu ItAcivAng measures havn heel, nI ueml by taken, to plovido a Code compliant
t r.placemurt systanl:
II A suitable ruplarenu:ill ales ho:; burn evaluon:d and Inay bu utilin:d rill Ihu lunation ill it n:placenlenl soil abeolplion
system. the nlplauamant army shuuld be. pfntt;clad front disn«Lanrc and compaction and sllould not be infringed upon btu
wiloired setbacks from existing doll pluposed structuln, tut hues and wc11u. FaIIUIn In rioturt LLu it;PhIrl:menl araa wit',
result in 11111 need fill .t cove :"if and sill evaluation Ili establish a sutabla mplardment al::a. Replace11a:nt systsnls must
craupfy with tho n,lc:: ill offocr at that lima.
I I A suitable wplat;um it area is nut uvailablu due to salback and/of soil Iimitalions. Ranrinp advances in I'OW I S
turhnrlogy a holdin.f tank may bo inotallod as a tact iauurt lu replarn the failed POWTS.
LI Tho silo has not Lunn rvalualed to idoidit•y a guilt la repiauolncnl a1e.1. Upon Iailow of the POWTS a soil and :Ac
evafualion most bu pelfnn'wd Ill Inflate a anlllahh: rupldeuln:all alua. II oo mplecnno:nt area is available a holding l::ir.k
may fill installed as a last n:sull to replat:u Ilse failed f'OL'U I S.
I I Mnnnd and ;a -grade Sail ibumlloon uysn:ni. ,nay 1.;: 1::r:nnclnlcu:d il Ldace Inllov lg re11luval of file biomat at the
inliltralive : urtaru. Rrx:onstructiuos (if such Sysiuns must comply :v:III Ilia rules ill to feel of 1h:t lieut.
WARNING;->
SEPTIC, 1 IROP AND OTHER Hit ATNIr_NT 1ANKS MAY CONTAIN LETHAL GASSES ANDJUR INMIFFICIIkNl OXY61 N. 00 NOT
LNILII A SEPTIC, PINUP OR OTHER 1RFAIMI-NI IANIC 11NW.R ANY CIRCUMS-I'ANCL-S. UEA"FN MAY RESULT. RESCUE OF A
PERSON I ROM Till-. IN [LMOR Or A TANK MAY RF OR I ICI11. 1 OR IMOOSSIBLE.
iIODITIONAV COMMENTS
rPOW 151NS 1-ALI Ell VOW I t: MAIN I AINI-B
Nam Nli
e
Phon/f. ,X~'S Gi17------ if11.1
SEI' IAGE SERVICING OVERATOR II'11M1'I'111 LOCAL Rr.Gl11 ATORY All 111Oai11 Y ,
Noon
Phony - - - J _ I hot _7y.~s~(--mod - ~`lf9 U
rl,ic docurnmd wn. droned III r, 1Pl a W1.1 will, r.l 1.:pluf I'„nun D:i.2: !-.IILI(1lidla I Ord <ia.!:lO). 1:11 r,. (:il, 6J..: ,m:.n CJr ~:n avatlYC Cod..
ST. CROIS COI NT's'
SEP E !C T S%IK MAINTENANCE AGREEMENT
AND
ONfiNF.RSIIIP CERTIFICATION FORM
Utcner 3uver too ~S~la_~-'£ f"~~~C~ I f~C(S -L
\iaihng Address J~ ITL,v r ' FUYk y _5
Property Address ~ J11 ~ ~~Z~~ 0 E r ~C~Yk )
1\'crilic;u ion rcquilwi lioro PI rnniq.,\. tin 1)cpuri t>`ii tit li,r ncttcananletion -
('Ih'State tt_.) Parcel Identification Number
LEGAL DESCRIPTION
Property Location U ~Ll_ 5 , Sec. lL , T N R (p N', "fond of _
Subdi\isionPlat__ rt`~C CQ I Lot Ti,
Certified Sun e) Map # Volume Pa-e
il'arrnnh Deed
(before 2 _00?)Vplume i u_ e
\pce huux ❑cr,~n1 Loa lace, idc:u TlmLlc c,0r.~
S : S I EM 1i %i N': G.N.INCE AND OWNER CERTIFIC AhIC'~_\
hnPruPer 11,e:utd tnonaeoance,d'Your,cgNic sc,ptm meld re,na in it. „m:amr Grl:nc :u h::n,li: .v~.tr,. Pa~•vi
n liutrn.wcc n+u,i,a ul'punyting tan the,epuc t ink ever, three crag. or unnter, iiller.frd. he :1 ficcn,ed pumper. 11,1L Ii: Ir.t, 11;,,
In . r'r ran al~ll'l Ih: fialciloll of the Septic hall, a5 a treatment sin^c in the w:a,ie dl,po,ul .t.sican On71cr Irlailllellat ,t
,IIII are,pecrfie'f in §SPS. ;N33 52( 1) and in Chapter i - sr. Cn,ix Count; Sanrurrv Oidina Tice.
I he property o•sucr agces to Submit to SI Croix C•uuntr Plannine & /pain^_ DCparanent a certfiicatitm fbnu, sieved be life
aco n! Ir; a nmslcr plumber, juume}-mar. plumher..CSIriCICd pf:nubcr or a hc~jtsed pumper redfbina that (I ) the ern site
s)b!em i, ill proper operation condition and w alier inslIcction and pumping (il neecsurpl, the septic lank
Than I " 11111 ot•,Indee.
I.:ca, the mlder,wned haee read the abuse aeyiremcms and agree to ncuntain the pncalc set,:agc dnpu,al ,\,tem it ith me
,Inndnr<is set firth, herein. a, o,I h\' the Dcpannlenr of "afetc \nd Protesmonal Setiwes and the Depailnrenl of Nanual Rc,ouree,
titre of lCixun,In ( Certifinah,I:) !at 1!1o that puns <efaic .%Stem It,!; heen nwfntained nnl,t be eompl.Ted and ref timed to they t
e ~nuv\• I'lam»oe R Zoning Depaill I fn 30 day, of the three sear expiration dale-
I ive certifi• that Till ,falement, r "ITT, firm are True II, the hest of lit% brv kntn%lcd.,e
i,;op:7rtp Jeserif><J ahnec, be eMae ufa .r:nrarr~ dyed recorded Ill Rc^_i,te; 01'!),'e111
I IIN.cc
Numb4v- of bedromns
C &
S it ATLIRF. OF' APPLICA\ 15) DATE
:\ov inlbrtnation that is misrrpre,enleti mac resuh in the salrilaa} permit bein aecuked 11 the Plantim!t . Zoning 1 c-partnivil -
Include oilb III], appf icauoll a recoadal ::mtanlc eked It"Ill lilt. Rr~_i,TC: -I Decd, ( )flies :md a am•. u;.. tit, ccnilicd ,tir:ec plop if
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' Please print all informatro I -J I'' - -'t~ L
.oral it l n. • u Pr Ac c:_p. l.an' < . /Z •r
Prop '.f'.aho,
Jo~\N PeAef5ou I_LC. I NE1<N ,;GS - 1 kJ~
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