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Miscellaneous - 1600 OSGOOD STREET 4/30/2018 (76)
1600 Osgood Street Building-#70 i I i E i - Date..1.Q.. l l t�............... OF r10RTI�,h ?; co TOWN OF NORTH ANDOVER 9 PERMIT FOR WIRING �Bs�cMusst Thiscertifies that ................... . ....................................................................................... has permission to perform . e. ........................,..... D. ..... ................jn......................... "wiring in the building of.... ..... _9�r7...CA.......... �01 \cam os � - . �t ............................................. ��� ��orth Andover,Mass. Fee. Z Lic.No. N.b..... "I.................... ... . ....... .... ..... E CMC AL INSPECTOR Check# \DZ l onrmo ewsatth o�///aaaac�usalfa Official Use Onlv Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ev. 1/07] leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: Alorf j o olo y el- To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 1600 OSTodj arA M I tau.Y44.d--flff-70 Owner or Tenant Li S 7' to (� t S i i C�, S Telephone No.(5-00 S`Z,y - Owner's Address 1600 05&000 L4�/ v Q' Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters V Number of Feeders and Ampacity / Location and Nature of Proposed Electrical Work: eelola1, z J, g.Oc M-4 fi e,— Completion rCo letion of the following table may be waived by the Inspector of Wires. Na of Recessed Luminaires No.of Cc&-Swp.(Paddle)Fans No.of Total Transformers KVA Na of Lumigsd Outlets No.of Hot Tubs Generators KVA Na of Luminaires Swimming Pool Abgrnove ❑ In-d. ❑ BatteryUnit0.oftssency g — Na of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones Na of Switches No.of Gas Burners o.o on an Total hiffiafing Devices J Na of Ranges No.of Air Cond. Tons No. of Alerting Devices -� Na of Waste Disposers eat umber ons -IKW No. oSelf-Contained To F Detection/Alerting Devices fi Na of Dishwashers SpacelArea Heating KW Local❑ Monntecc'pd'l El Other } No.of D Heating Apphances KW stems: Dryers No.of Devices or Equivalent No.ofater , o.o o.of Data Wiring: Heaters signs Ballasts No.of Devices or Equivalent Na Hydromassage Bathtubs No.of Motors Total HP Telecommunications niugg: No.of Devices or E Vi'vn ent OTHER Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. j CHECK ONE: INSURANCE a] BOND ❑ OTHER ❑ (Specify:) 1 certify,under the pains and penalties of perjury,that the information on this application is true and conWlete. t FIRM NAME: 1,7,oe W,ye" r Lr C'eh c/ P t` LIC. NO.: FS_10 /yD Licensee: )OX,1,,;PDd _ ea ,if Signatu - LIC. NO.: (lfappltcable,ente exempt"in the license number line.) `� Z Bus. Tel. No.: Address: 99 ' g-7- Lofvtl/ ori 4 Alt.Tel.No.: 'Per M.G.L.c. 147,_s. -61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally o required by law. By my signature below, I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent J 0 Signature Telephone No. PERMIT FEE: S 1Z Y :COMMONWEALTH OF MASSACHUSETTS BOA D'of ELECTRICIANS 1 ISSUES,. THE FOLLOWING LICENSE AS A REG JOURNEXMAN ELECTRICIiAN PH:tL1PPE THIBEAULT 1 AIM" f 99 EPPING ST 't LOWELL MA 01852 48x9 t' 50440 E 07(3l/16':050219 F The Commonwealth of Massachusetts Department of.IndustrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/ContractorsfElectricians/Plumbers Applicant Information �,�// �/ Please Print Ledbly Name(Business/Organization/Individual): � 7_4b�4u!T Lv iCfni renel e'/ipfl Address:_ ?f �,v► 'v► r ST City/State/Zip:_ ai ef re- Phone#: 6?78� ��s=G 605; Are you an employer?Check the appropriate box: Type.of project(required): 1. ] I am a 4 employer with . ❑ I am a general contractor and I ` --� 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors7 ❑Remodeling 2.ElI am a sole proprietor or partner- listed on the attached sheet.x • ship and'have no employees These sub-contractors have 8. ❑Demolition working for mein any capacity. workers'comp.insurance. 9, E]Building addition _ [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.I]Electrical repairs or additions 3,❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions t myself.[No workers'comp. c.152,§1(4),and we have no 12.❑Roofrepairs insurance required.]► employees.fNo workers' comp.insurance required.] 1311 Other *Any applicant that checks box#1 must also fill out the section below showingtheir workers'compensation policy information. 7 Homeowners who submit this affidavit indicating they tie doing allwork and then hire outside contractors must submit anew affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees: Below is the policy anal job site information. Insurance Company Name:, Cp V I `t -�k S P,blicy#or Self-ins.Lic.#: Expiration Date: Jop Site Address:_ /G00 D Se er>e✓ S t City/State/Zip:Ze, �o d/fin Attach a,copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one=year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certlo under the pains andpena1des o perjury that the information provided above is true and correct. Si ature: Date: /D/O —CJ Phone#: 7 9-15--660 ? [OfJf1claluseonly. Do not write in this area,to be completed by c4 or town official. City or Town: Permit/License# Issuing Authority(circle ane): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - - Contact Person: Phone#: Information and ffnst r ueflon's Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employeiis defined as"an individual,partnership,association,corporation or other legal entity,or any two or more Of the foregoing engaged in a j oint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. however the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required" Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and Phone numbers)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the r members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage, Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials -Please be sure that-the affidavit is-complete-andprintecl legibly: The"Departin erit liar provided a space at the botEom ` of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to Min the permit/license number which will be used as a reference number. lu addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: Thi C oRmalthofMiassarl?motts M-partment of Induddai Moldeats • �f�ice ofIntvesti�a�ip_�n� 600 Wasbingtou Streit Boston,MA.021.1.1 TQL#61.7-7274900 at 406 or 1-877 MASS.AFF, Revised 5-26-05 Fax#617-727-7749 Weston Solutions,Inc. / 45 Constitution Avenue,Suite 100 ® Concord, /New Hampshire 03301 603-656-5400•Fax 603-656-5401 www.westonsolutions.com The Trusted Integrator for Sustainable Solutions 5 May 2010 MAY 10 2010 Ms. Orit Goldstein, President TOWN OF NORTH�W VER 1600 Osgood Street, LLC � pq� I 1600 Osgood Street North Andover, MA 01845 Re: Notification of Class C-2 Response Action Outcome Buildings 70/71 and 30 Area 1600 Osgood Street North Andover, Massachusetts RTN: 3-0174 Dear Ms. Goldstein: This notice is being provided to you as required by the Massachusetts Contingency Plan (MCP) and the notification requirement of 310 CMR 40.1406. The MCP is a regulation that specifies requirements for investigation and cleanup of hazardous materials that are released to the environment in the Commonwealth of Massachusetts. On behalf of Alcatel-Lucent USA, Inc., Weston Solutions, Inc., (WESTON®) is addressing the release of hazardous materials at the 1600 Osgood Street property in North Andover. This property is also known as the former Merrimack Valley Works (MVW). The subject of this notification is the Buildings 70/71 and 30 Area, a portion of the MVW that is currently owned by 1600 Osgood Street, LLC. Cleanup of the environmental contaminants in the Building 70/71 and 30 Area is tracked by the Massachusetts Department of Environmental Protection (MassDEP) under Release Tracking Number(RTN) 3-0174. The MVW has historically been used for manufacture of telecommunications equipment, and releases of hazardous materials occurred in the Building 70/71 and 30 Area. The extent of the Disposal Site is shown on the attached figure. Over the years, chemicals used in the manufacturing process have been released to the soil and groundwater in the vicinity of Buildings 70/71 and 30. Site characterization and remediation activities commenced at the Building 70/71 and 30 Area in 1986. WESTON has been working with MassDEP since September 2003, when we commenced work at the site, to verify the extent of contamination and clean up the site in accordance with the MCP. G TROJECTS\1 1621039\Building_70_7]AAO\ClassC RAO\Public Notice\Notification Letter docx t Ms. Orit Goldstein 1600 Osgood St. LLC -2- 5 May 2010 The principal contaminants found at the Building 70/71 and 30 Area are as follows: ■ Soil: Trichloroethene (TCE), toluene, 1,1,1-trichloroethane (1 I 1 TCA), tetrachloroethene (PCE), xylenes, and cis-1,2-dichloroethene (cDCE). ■ Groundwater: TCE, I I ITCA, cDCE, 1,1-dichloroethene, PCE, and vinyl chloride. ■ Indoor Air: TCE, toluene, Freon-11, Freon-12, methyl ethyl ketone, acetone, and ethylbenzene. Following extensive investigation and remediation activities at the site, an MCP Method 3 risk assessment has been conducted. The results of the risk assessment demonstrate that there is no substantial hazard, as defined by the MCP, and that a Class C-2 Response Action Outcome (RAO) (temporary solution) can be submitted to MassDEP. As required by the MCP, the Class C-2 RAO was submitted to MassDEP on 1 May 2010. A copy of the RAO Conclusions is attached to this letter. Complete copies of the various environmental reports and submittals prepared for the Building 70/71 and 30 Area have previously been submitted to you and can also be viewed at the Town of North Andover Board of Health and Selectmen's offices. We are continuing our remediation activities at 1600 Osgood Street, and expect to meet the requirements for, and submit, a Class A RAO (permanent solution) for the Building 70/71 and 30 Area within the next 12 months. If you have any questions regarding this letter or any of our remediation activities at 1600 Osgood Street, please contact me at (603) 656-5412. Very truly yours, W STON SOLUTIONS, INC. Frederick R. S E. Project Manager cc: North.Andover Board of Health, North Andover Selectman's Office F. Lilley, Golder Associates G. Fisher, Lucent Technologies MassDEP BWSC G NROJECTS\I 1621039\Building_70_71\RAO\Class C RAOTublic Notice\Notification Lener do" 1 Response Action Outcome Report Former Lucent Buildings 70/71 and 30 Merrimack Valley Works ' North Andover,Massachusetts • • 6. CONCLUSIONS The Disposal Site is located within the former MVW at 1600 Osgood St. in North Andover, Massachusetts as shown on Figures 1 and 2. A release of hazardous materials was discovered at the Disposal Site in 1986 relating to the storage and use of industrial solvents at a large communications equipment manufacturing complex. Comprehensive response actions have been conducted at the Disposal Site under RTN 3-0174 since 1986 to assess the source, nature, and extent of contamination and to remediate contamination identified such that a condition of NSR exists for current and foreseeable future uses. Buildings 70/71 and 30 occupy the center of the 168-acre MVW property. The buildings are large, multi-story steel and concrete manufacturing buildings with concrete slab floors and no basement. The facility has been used for the manufacture of electronic communications equipment since the mid-1950s. Buildings 70 and 71 are currently vacant and Building 30 is about 40% occupied by various commercial businesses. Large volumes of industrial solvents were used in the manufacturing process and were delivered to the site in railroad tanks, stored in 10 USTs ranging in size from 500 to 10,000 gallons. The solvents were transferred into 55-gallon drums and 5-gallon pails for transportation and use around the facility. Solvents used included TCE, 1,1,1-TCA, Varsol, toluene, and methylene chloride. Solvents were discovered in groundwater beneath the site in 1986 and MassDEP was notified of the release. Since 1986, extensive site characterization activities have been performed to determine the source, nature, and extent of contamination. More than 1,500 environmental samples have been collected and submitted for laboratory analysis, including over 1,200 groundwater samples, 250 indoor air samples, and 50 soil samples. In addition, extensive field screening of soil samples was performed with a PID to assess the lateral and vertical extent of soil impacts. Two sources of contamination have been identified at the Disposal Site: the former solvent USTs and pumping system at Building 70/71, and a former floor drain within Building 30 (see Figure 2). At least one of the USTs failed and solvents were released to the adjacent soils. It is G:\PROJECTS\11621039\BUILDING 70 71\RAO\CLASS CRAG\BLDG 70 CLASS C RAO.DOCX 6-1 28 APRIL 2010 Response Action Outcome Report Former Lucent Buildings 70/71 and 30 Merrimack Valley Works North Andover,Massachusetts • CONCLUSIONS also believed that other incidental spills occurred in this area related to pumping of large volumes of solvents from the rail cars into the USTs. The source of contamination at Building 30 was determined to be a floor drain within a maintenance room where waste solvents used for parts cleaning and degreasing were discharged. Contaminants identified in soil, groundwater, and indoor air in the vicinity of the release areas were predominantly solvents including TCE, 1,1,1-TCA, toluene, and their associated breakdown products. Concentrations at the source areas were initially very high, with maximum TICE concentrations in groundwater of 2,200,000 µg/L at Building 70/71 and 140,000 pg/L at Building 30. Soil contamination was found to be very limited at Building 30, extending no more than 30 ft from the former floor drain. Soil contamination at Building 70/71 is largely limited to the former UST area; which is now beneath Building 71. Low concentrations of VOCs are found in indoor air within all three buildings. Groundwater contamination associated with the two release areas extends downgradient to the northwest towards the Merrimack River; which is the regional groundwater discharge point. Contaminant concentrations in groundwater decrease rapidly in the downgradient direction, dropping below the GW-3 MCP standards more than 1,000 ft from the river. Following discovery of the Building 70/71 source area, the 10 USTs were removed along with approximately 300 cubic yards of contaminated soil. Confirmation samples collected from the excavation bottom and sidewalls verify that all soils exceeding GW-3/S-3 criteria were removed. Similarly, at Building 30, the floor drain was removed along with a small amount of impacted soils. Access limited the amount of soil that could be removed from this area, and an SVE system was constructed to treat the remaining contamination. An SVE system was also constructed at Building 70/71 to help mitigate VOCs volatilizing from the impacted groundwater and migrating into indoor air. As a result of these activities, all uncontrolled sources have been eliminated or controlled. A groundwater extraction and treatment system was installed at Building 51, which is downgradient of Building 70/71, to limit migration of contaminants towards the Merrimack River and a Potentially Productive Aquifer located in that area. A second groundwater extraction GAPROJECTS\11621039\BUILDING_70_71\RAO\CLASS C RAO\BLDG_70_CLASS_C_RAO.DOCX 6-2 28 APRIL 2010 Response Action Outcome Report Former Lucent Buildings 70/71 and 30 ' Merrimack Valley Works North Andover,Massachusetts • • CONCLUSIONS and treatment system was installed in the Building 70/71 source area to treat the contaminant source area. An air sparging system was installed at the Building 30 source area to address groundwater contamination there. The two source area groundwater treatment systems were replaced by ISCO in 2003 in order to accelerate remediation of the source areas. Two ISCO injections were performed at Building 30, reducing TCE concentrations in groundwater from 140,000 µg/L to 150 µg/L in 2 years. The more extensive groundwater contamination at Building 70/71 has required 11 ISCO injections, but the average TCE concentration has been reduced from over 200,000 µg2 to less than 15,000 µg/L, indicating a substantial reduction in contaminant mass. One small area of elevated TCE and 1,1,1-TCA concentrations persists along the eastern side of Buildings 70/71. The SVE systems at Buildings 70/71 and 30 were operated for 6 years before and during the ISCO program. As the ISCO program reduced groundwater contaminant concentrations, (groundwater contaminants are the source of VOCs in indoor air) the SVE systems were transitioned to pulsed operation and then shut down altogether, based on careful monitoring of indoor impacts. Because all three buildings are largely vacant (Buildings 70 and 71 are completely vacant), the heating, ventilation, and air conditioning (HVAC) systems in these buildings are not operating, representing worst-case conditions for indoor air (no SVE operation, no HVAC operation, fully closed doors/windows). An MCP Method 3 Risk Characterization was performed using pertinent historical and more recent analytical data from the Disposal Site. A Data Usability Assessment was conducted to verify that the combination of CAM and non-CAM data used in the Method 3 Risk Characterization was representative of site conditions. The Human Health Risk Assessment was conducted based on a commercial/industrial risk scenario that included site workers and potential future construction workers. Based on the results of the Human Health and Environmental Risk Assessment, conditions at Buildings 70/71 and 30 do not pose a risk for any current or foreseeable future uses of the Disposal Site, provided that the property is restricted to commercial or industrial uses. The Stage I Environmental Screening Assessment indicates that conditions at the Disposal Site are unlikely to pose a risk to the environment. Because the risk G:\PROJECTS\11621039\BUILDING 70 71\RAO\CLASS C RAO\BLDG 70 CLASS C RAO.DOCX 6-3 28 APRIL 2010 J t Response Action Outcome Report Former Lucent Buildings 70/71 and 30 Merrimack Valley Works North Andover,Massachusetts • • CONCLUSIONS characterization is based on restricting uses of the property to commercial or industrials uses, an AUL has been recorded and submitted to MassDEP for this site. The AUL was developed to address other RTNs at the MVW in addition to this Disposal Site and as a result, it includes an area larger than the Disposal Site for RTN 3-0174. Comprehensive response actions were performed to characterize and remediate hazardous materials in soil, groundwater, and indoor at the Disposal Site. These response actions have significantly reduced contaminant concentrations at the Disposal Site, resulting in a condition of NSR, based on the results of a Method 3 Risk Characterization and Stage I Environmental Screening. Although remaining contaminant concentrations in soil, groundwater, and indoor air exceed background, the cost of reducing contaminant concentrations to below laboratory detection levels would be prohibitive and not justified, because there is NSR for current and foreseeable future uses of the Disposal Site. Although the average concentrations of individual contaminants within the source area are below their respective UCLs, TCE and 1,1,1-TCA concentrations in some monitoring wells and injection points still exceed the UCLs. The ISCO treatment of the Building 70/71 source area will be continued to further reduce contamination concentrations in an effort to provide additional protection of indoor air. It is feasible that additional application of ISCO will result in a Permanent Solution for the Disposal Site. As a result of the findings of the initial assessment activities, it has been shown that conditions at the Disposal Site meet the requirements of a Class C-2 RAO in accordance with 310 CMR 40.1045, provided that an AUL is recorded restricting future uses of the site consistent with the assumptions of the risk characterization. Continued semi-annual groundwater and indoor air monitoring in accordance with the Phase IV RIP is required to verify that impacts to indoor air are within risk thresholds. Renewed operation of the Building 70/71 and/or Building 30 SVE systems could be required if the monitoring indicates an increase in indoor air concentrations of VOCs above risk thresholds until a Permanent Solution is achieved. An AUL restricting future uses of a portion of the MVW that includes the Building 70/71 and 30 Disposal Site was recorded at the North Essex County Registry of Deeds on 31 July 2008, and submitted to MassDEP on 30 August 3008. This AUL is consistent with the assumptions of the G:\PROJECTS\11621039\BUILDING_70_71\RAO\CLASS C RAO\BLOG_70_CLASS_C_RAO.DOCX 6-4 28 APRIL 2010 t Response Action Outcome Report Former Lucent Buildings 70/71 and 30 WYAR Merrimack Valley Works North Andover,Massachusetts • • CONCLUSIONS risk characterization used to determine that a condition of NSR exists at the Disposal Site. A copy of the AUL is provided in Appendix D. G:\PROJECTS\11821039\BUILDING_70_71\RAO\CLASS C RAO\BLDG_70_CLASS_C_RAO.DOCX V-J 28 APRIL 2010 WASTEWATER TREATMENT \ .. .. ... ... PLANT .. .. DEIONIZED WATER TREATMENT PLANT BLDG - 53 SAND BED PARKING AREA SAND BO 8 G BED PTO2 f SURGE SAND �' ... TANK BED BLDG49 �ZF, Zp O BLDG 51® B 8G � -A G 3 SALT BUILDING 71 BLDG 2t::2L 70RA 34 -.... -.. .. . BUILDING 70 I i 1 1 BLDG FORMER SOLVENT USTs ARKING AREA a O O BLAG Axx BUILDING 30 a DISPOSAL SITE GRAPHIC SCALE CD BOUNDARY 200 100 0 100 200 a APPROXIMATE SCALE IN FEET PARKING AREA NOTE: BASE MAP DERIVED FROM CDM DRAWING TITLED /—FORMER MAINTENANCE "SITE PLAN" (FIGURE 2 OF CDM'S PHASE IV �l ROOM FLOOR DRAIN REMEDY IMPLEMENTATION PLAN, JANUARY 2001) r- 1 i 0 0 0 3 BUILDING 21 N BUILDING 20 • • CONCORD NEW HAMPSHIRE MERRIMACK VALLEY WORKS / NORTH ANDOVER, MASSACHUSETTS 0 0 N 3 / c� DISPOSAL SITE 0 BUILDINGS 30, 70, & 71 DRAWN DATE FIGURE NO. OSGOOD STREET BEG MAR 2010 2 CHECKED W.O. No. JS 11621.039.001 Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup BWSC122 This notice is related to: INFORMATIONAL NOTICE TO PROPERTY OWNERS Release Tracking Number - 174 As Required by 310 CMR 40.1406 of the Massachusetts Contingency Plan(MCP) A. DISPOSAL SITE ADDRESS: (associated with Release Tracking Number provided above) 1. street Address: Former Lucent Building 70/71 Area, 1600 Osgood Street North Andover 01845-0000 2. Cityrrown: 3. ZIP Code: B. THIS NOTICE IS BEING PROVIDED TO THE FOLLOWING PROPERTY OWNER: 1. Name of Property Owner: 1600 Osgood Street, LLC 2. Address of Property For Which This Notice is Being Provided Owned by Property Owner named in 61: 1600 Osgood Street a. Street Address: b. Cityrrown: North Andover c. ZIP Code: 01845-0000 C. THIS NOTICE IS BEING GIVEN: (check one) ❑ 1. Upon Completion of a Phase II Comprehensive Site Assessment. 2. Upon Submittal of a Response Action Outcome(i.e., Site Closure Report). ❑ 3. Upon Completion of Additional Investigation showing that Oil or Hazardous Material is not Present at the Property. D. DESCRIPTION OF OIL AND/OR HAZARDOUS MATERIAL PRESENT OR LIKELY TO BE PRESENT AT THE PROPERTY: (check all that apply) AFFECTED ENVIRONMENTAL MEDIA PRINCIPAL CHEMICAL(S)PRESENT 1. soil Trichloroethene, 111-Trichloroethane, Toluene 2. Groundwater Trichloroethene, 1,1,1-Trichloroethane, cis-1,2-DCE ❑ 3. Surface Water 4. Sediment 5. Indoor Air Trichloroethene, Toluene, Freon-11, Freon-12, MEK 6. Other (specify) E. ATTACHMENTS PROVIDED WITH THIS NOTICE.AS REQUIRED BY 310 CMR 40.1406: 1.A Copy of the Map Showing or a Description Describing the Area where the Oil and/or Hazardous is or is likely to be Present. 2.A Copv of the Phase II Completion Site Assessment or Response Action Outcome Conclusions. F. CONTACT INFORMATION RELATED TO THE PARTY PROVIDING THIS NOTICE: 1. Contact Name: Fred Symmes, Weston Solutions 2. street: 45 Constitution Ave. Concord NH 03301-5079 3. Cityrrown: 4. State: 5. ZIP Code: 6. Telephone: (603) 656-5412 7. Email: Fred.Symmes@westonsolutions.com Revised: 05/02/2006 Page 1 of 2 Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup BWSC122 This notice is related to: L71 INFORMATIONAL NOTICE TO PROPERTY OWNERS Release Tracking Number ' 3❑ - 174 As Required by 310 CMR 40.1406 of the Massachusetts Contingency Plan(MCP) MASSACHUSETTS REGULATIONS THAT REQUIRE THIS NOTICE This notice is being provided pursuant to the Massachusetts Contingency Plan and the notification requirement at 310 CMR 40.1406. The Massachusetts Contingency Plan is a state regulation that specifies requirements for parties who are taking actions to address releases of chemicals (oil or hazardous material) to the environment. THE PERSON(S) PROVIDING THIS NOTICE This notice has been sent to you by the party(ies) who is/are addressing a release of oil or hazardous material to the environment at the location listed in Section A on the reverse side of this form. PURPOSE OF THIS NOTICE Parties who are taking actions to respond to releases of oil or hazardous material to the environment are required by state regulations (referred to above) to notify the owners of property where the oil or hazardous material is or is likely to be present. These same parties are also required to notify property owners upon completion of actions to address the oil or hazardous material, or if additional investigations show that the oil or hazardous material is not, as previously suspected, present at a property. Section C on the reverse side of this form indicates the circumstance under which you are receiving this notice at this time. INFORMATION RELATED TO YOUR PROPERTY Section D on the reverse side of this form indicates the type(s) of oil or hazardous material that is or is likely to be present at your property, and the environmental medium (e.g., soil or groundwater) where it is or is likely to be present. Please note when an investigation indicates that the oil or hazardous material is or is likely to be present at your property, this does not mean that the oil or hazardous material is posing a health risk to you. Parties who are taking actions to address oil and hazardous material releases are required by state regulations to adequately investigate these releases and take necessary actions to ensure that affected properties meet standards that are protective of human health and the environment. ATTACHED MAP OR DESCRIPTION AND REPORT CONCLUSIONS The party providing this notice to you is required to attach a map or description that indicates the boundaries of the area where the oil or hazardous material is or is likely to be present, and the conclusions of the site investigation or closure report(Section E). These attachments should give you additional information about the nature and location of the oil or hazardous material with respect to your property. FOR MORE INFORMATION Information about the general process for addressing releases of oil or hazardous material under the Massachusetts Contingency Plan and related public involvement opportunities may be found at http://www.mass.gov/dep/cleanup/oview.htm. For more information regarding this notice, you may contact the party listed in Section F on the reverse side of this form. Information about the disposal site identified in Section A is also available in files at the Massachusetts Department of Environmental Protection. See http://mass.gov/dep/about/region/schedule.htm if you would like to make an appointment to see these files. Please reference the Release Tracking Number listed in the upper right hand corner on the reverse side of this form when making file review appointments. Revised: 05/02/2006 Page 2 of 2 Date.......... .... ....... TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACMUSEt This certifies that ......................... O� has permission to perform ..................... wiring in the building of. ........ ....... at , ..1A................ ...................... . .......North Andover, V. .......... Lic.No. .. .Fee . 10.1 I-MR. LECTRI-/ INSPECTOR . .. ...... Check # 76G2 SAP-vendor Pa nt SAP INV DOC NBR DATE REP NSR TEXT / P.O. NBR INV AMOUNT DEDUCT TYPE NET INVOICE CR 1901567254 081007 08102007PERMIT E2pay invoice 250.00 0.00 KR 250.00 w t l DATE 08/22/07 T01 BV-SAP 1 Alcatel•Lucent ID NO. 0010181571 CHECK NO. 1000484593 CHECK AMT. $250.00 Alcatel-Lucent Ball Labs Innovations You can now check the status of your invoices on the web. Visit http://scportal.lucent.com/invoice. Questions concerning your invoice(s) can be directed rtpr- u t UD U-t : U5p NUH I H ANDOVER 9786889542 P. 1 - " (..am nvnwea111r o f 1aa3:,,,CA tielld vu�ua� vx unly _r r Pcrmit No. _7Z,ION 2, i^ ;a �` ..iJ�J77cT rlmgrtC or �lrs �JsrVi C3j G. / Permit Fee Assigned a; Y BOARD OF FIRE PREVENTION REGULATIONS RGv. 111991 ►cave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK FOR INSTITUTIONAL" USE ONLY his form is fen use by institutions cmploying licensed electricians and others for which notice of electrical installations to the ,u:uc;pak i:rspecior of Wires is required for work on the premises of the institution. if you arc not an employing utstitution to C: t 1 I §S of tlrc Massachusetts General Laws,stop here. You cannot use this forst. Use the standard form only. �'L .i�l ,r'R!;v; i,Vl;�`1` URT1'P , 1ILLItV(-OlZrlf;lTlO,V) Date: $/O t) �jAoc C'itN. or�Tolti'n of: .yl�od�F�L_ To the ltrspectorof Wires: i d,is apphrmion the undersigned gives notice of the on-premises performance of electrical work by employees_ ;t;dr ss /�OD �S'9c3d o2` — Loca!i�rn :curl tiarirre of 4'ropuseJ Electrical \ti'urk: G���C'.t1L� ��i.tl/Q^���il�� C. 143 §3L of the irlassachusetts General Laws obliges those who perform electrical installations to give notice of j san-:e to the municipal Inspcctor of Wires. You may do so by filing this form upon each such occasion, or if so cocrtenr- plarcd in an annual permit fee schedule set by the municipality you may maintain a contemporaneous log of.such work, which shall be cxlubitcd to the Inspector of Wires during normal business hours without advance notice. Some municipali- I ties may set nominal fees for arurual permits and require individual permits for work above a stated magnitude. `Ke will �tk tl%s. form on each such occasion(check one): YES El NO P�_� rr-ti::. m One or more contemporaneous logs) (check one): YES ©ANO ❑ otrtiun is available where so contemplated by the municipality. In these cases, you must renew this application annually srt,nificant changes in cmploymcnt. Hov"ir:Y ;ndividual(s)will be responsible for the accuracy of the 10g(s), if maintained You agree that the log(s) will be is.rc;t'cd as indicated below. The coverage in any individual log must be for contiguous property except by arrangement with 1\ices. Attach supplementary sheets if required for additional log locations. Fl.o, cuverage, and location Nyhere it gill be maintained Res onsible erso S vv� ^ray ruaintain tlrc logs decLonically upon agreement Willi the Inspector of Wires. If you intend to apply for such a proc d;rc, i::rlicaic below•how the Inspeclor of Wires should access the log: };(_'v. !rt't!y electricians and/or system technicians(as licensed by the Board of State Examiners of Electricians) do you emplt al ri:atr faciGn-? Indicate the total number and also indicate the number of full-time equivalent staff that number includes: l;:cal c`cetriral unrl:luymenl: �pZ— lrttll-tinrc e+luivniertt electrical employment: �- m_: , hclpc;s or apprentices do you cmploy to assist your licensed staff,under their direct supervision(see C. r,..nlb:r must not exceed the ratio of one licensed individual to one unlicensed individual. Limited exceptions a t: t:�t vctera;:s(see St. 1962,c.582 §3 as amended by St. 1979,c. 156). Indicate the total number and also indicate the nut tx: of fell-r.ntc equivalcnt staff that number includes: ° :,:;,; rtcctrical cnrplL;n.enl: _ Full-time equivalent electrical employnietrt: wor?: for which notice to the Inspcctor of\Vires is required must be performed by licensed personnel. How vrch t crsoirs, not n:quircd to be licensed,do you have in your employ" Indicate the total number and also indicate the iii?-tinny eq i.aient staff that number includes: eicetrical errrploe•ntctrt: Full-lime equivalent electrical employnrent: ' t-:;it)ns o)-c defineit for these purposes as aur•person,Jirni.or corporation opernthig wider c. 141§3. (Please see reverse side for certifications and required signatut r U ,-,_i _. .- UF !YUK ! r. 1-1171-JUVLK JJ /Ubb8Jb4G P• G s - lustit dionai Permit Form,page 2 C- 1; PVOTE. Some institutions enter into contracts with contractors to perform ongoing electrical work at an institution, simil to institutional employees. If, by the terms of such a contract, you direct the performance of such work, include the nui I bcrs of such employees in this application. If the contractor directs such performance, of if the contract period is for tc than one year, application must be made by the contractor on the standard form for such work_ Do not include such c+ t pt to/ccs i+t this application. Please ei%'c your official title, such as "Director of the Physical Plant" or "Director of Facilities" or equivalent. In addii pro !dc a statement that substantiates your authority to hire electricians pursuant to c. 141 §3 for electrical work on the pt ises of your institution, and to establish priorities for the performance thereof. This form is not to be construed as a grar authority to direct any licensee of the Board of State E-xamincrs of Electricians to perform work in contravention of the rule said Board, or in contravention of the Massachusetts Electrical Code. Nle title is: (/��/��Q�f A M �vlltu+its to ac! for the aforementioned instil jufion is: �L� ��j ��� U� r �(.�/ Jt/.S'lT/l�� I ce rify, urnler the pains ane!penalties of perjrrrt',deal dee information on this applicaliun is true and complete. (Sienature) (Dated) M16 Z- (%vork tclephonc number) (extension) (facsimile number) 7tS 6 7/ 17-30 97,F69/ /0 SG 1 a i Date.F�?..F ?_�7..... NORTH of`"�� '•�"� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING 40 �sSACKU � This certifies that ....................................` ... ...:.. has permission to perform -: ....-- --'�'� wiring in the building of at.................................�...................((.. ................ ,North Andover,Mass. Fee .................... Lic.No.............. ....................................................... ... � ELECTRICAL INSPEC'fOR�'— Check # C3Q�d���7� ✓ 7 2 2 b.. Apr 01 05 04 : O5p NORTH ANDOVER 9786889542 p. 1 • (,omonweallh of /Y/amacht'oetL� vir�uai vac yr m �� 1'4 �� r rnc� �7 Pcrmtt No. © _ "ga-lmanl o1 yirs Ssrbics:j Permit Fee AssignedS?l 130ARD OF FIRE PREVENTION REGULATIONS Rev. 11!991 Icavcblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK FOR INSTITUTIONAL* USE ONLY !his form is for use by institutions employing licensed electricians and others for which notice of electrical installations to the .;;unicipal inspector of Wires is required for work on the premises of the institution. If you are not an employing umstitution to C. 1 J 1 §3 of the Nlassachuscus General Laws,stop here. You cannot use this forst. Use the standard form only. r'1LL.t L PR.I;VT f,V I;VA OVHP SILL hVrOltAlilTID,V) Date: o City or Town of: j� /r`�ay�£�C To the hispectotof Wires: i y ,Itis app11cat1 1onon the undersigned gives notice of the on-premises performance of electrical work by employees. Adurt�ss _ �C?C? ©S f• i_ocat nn and tiature of 1'rol used Electrical NN'ork: I NOTE: C. 143 §31- of the Massachusetts General Laws obliges those who perform electrical installations to give notice of `i sar;:e to the cmuoicipal Inspector of Wires. You may do so by filing this form upon each such occasion, or if so contem- plated in an annual perrrut fee schedule set by the municipality you may maintain a contemporaneous log of such work, which shall be exlubiced to the Inspector of Wires during normal business hours without advance notice. Some municipali- ties may set nominal fees for annual permits and require individual permits for work above a stated magnitude. `Ve will file this forni on cath such occasion(check onc): YES ❑ NO ®--, t c <<:iti m:iintairt one or more conteinporaneous log(s) (check one): YES ®/ NO ❑ i hc; option is available where so contemplated by the municipality. In these cases, you must renew-this application annually stgnificant clmanges in employment. l i:_; i.rik:':riti individuals)will be responsible for the accuracy of the log(s), if maintained. You agree that the log(s)evilbe tccacd as indicated below. The coverage in any individual log must be for contiguous property except by arrangement with ? st:-_tor 01 Wires. Attach supplementary sheets if required for additional log locatiats. ~ 1 Log coverage and location where it will be maintained Responsible person r You slay maintain lite logs electronically upon agreement with the Inspector of Wires. If you intend to apply for such a proc it cdicatr below how the Inspector of Wires should access the log: tiov +natty electricians and/or system icchnicians(as licensed by the Board of State Examiners of Electricians) do you empl, at ;ottr facillw? Indicate the total number and also indicate the number of full-time equivalent staff that number includes: i uta) eiccti ivA cnnployment: IZ - Full-time celttivnlcnt electrical employment: io.v t:aa; ; l;clpcs or apprentices do you employ to assist your licensed staff,under their direct supervision(see c. 141 §S)? -itis number inust nut exceed the ratio of one licensed individual to one unlicensed individual. Limited exceptions a a, f:t cleans(see St. 1962,c. 582§3 as amended by St. 1979, c. 156). Indicate the total number and also indicate the nut tx: of Gull-unit, equivalent staff that number includes: Gi =tai ctcctrical emplo; Apr L? 05 O4 : O5p NORTH ANDOVER 9786889542 p. 2 ' I Iustituiional Permit Form,page 2 NOTE: Some institutions enter into contracts with contractors to perform ongoing electrical work at an institution, simil to institutional employees. If, by the terms of such a contract, you direct the performance of such work, include the: nui bers of such employees in this application. If the contractor directs such performance, of if the contract period is for Ic than one year, application must be made by the contractor on the standard forst for such work. Do not include such et '�ployccs in tliis application. Plc"sc ui.c your official title, such as "Director of the Physical Plant" or "Director of Facilities" or equivalent. In addii provtdc a statement that substantiates your authority to hire electricians pursuant to c. 141 §3 for electrical work on the pi ices of your institution, and to establish priorities for the performance thereof. This form is not to be construed as a grar authority to direct any licensee of the Board of State Examiners of Electricians to perfomt work in contravention of the ruic said Board, or in co ravention of the Massachusetts Electrical Code. ;flyruthorit,y too act for the aforeincntioned institution is: t I cerriYy, under the pains and penalties ojperjun-,that the information on this application is trite and complete. (Signature) //a/Lvi4jw� (Dated) (Print nanic) Z uV7Q �t�f G(+Q/ (,.vork telephone numbcr)C],W/ /0-h(extcnsion) (facsimile number) • Date.. ...........9:...,........ �aORTFi °tt"`° :•1"° TOWN OF NORTH ANDOVER . p PERMIT FOR WIRING �sS�cMusE� r This certifies that vC& f �,4T� ............................................................................................ has permission to perform �--- -a 2- � -�--^� ......... .................... ................................... . wiring in the building of.. �- �� r.... - ........... ,North Andover,Mass. at. .................... ........G.............. Fee-�S�............ Lic.No, ��.. .. �.. ,�....-�:;��,�...................... ELECTRICAL I�ECTOR Check # 745 440 0604 M ai 09 07 03: 50p John V. Hickey 440-0604 P. 1 • mpr U L UZl U4: U5p NORI*H FiNDOVER $?8-6869542 P- 1 J6 —: (.orrsn+onmeal7n -1 Arla-MaChUdelb Permit Na. Vit"FI 7 Senn Cir:j Pcmtit Fee Assigned L4C)A.cZ[) OF FIRE*PREVENTION REGULATIONS cv. I I j991 (1,3,c blank) APPILICATIONFOR PERMIT TO PERFORM ELECTRICAL WORK' FOR INS L VTUT[ON AL* USE ONLY -j;ii s Form is:fqtjsc by iltshLuttomrIl Cpt-ying licensed electillciing, d 0IIlcfS:f0f---'�1)"nGt'cc OCICeftic I lrstajlotioit s to the ofw;rCs-is-req.t.med,forwork on tile Premises of the:institution. trybu are not an emP10019 111stitution to C. ffic Massachusetts Gcjjcr.31 mt.wvs.stoplicre. You camlo,tIsIt.tilis for,,,. Use the stziidard rorm Only. �?.P!,VT hV 1NK OR TYPE)AN L INFO -111TIO,V) Date: 0 res: ro 061)jspecloy C;tV (w7wvil of: PC-,r6rft%ugcc ofelectrical work by cmployccS. �Inlw2tton 111C %cd SivCS notice of(lie oft k 1-.ttttr6 or Prot(iscd.Elcaricn)Work: r ivc noticc of C 1-53.§3Lof`11hc assachuskitfGenieral Laws obliges those-tvhd pc fiofin c1carilcal k1stalla i0a to g Iijis,f r jf�t*conterilk- pal tn4pc.ddr d 'm by r ri c2ell. orwites. Yoit May S. filing I_ form such cl�4$iCln,0 111C,10 the..mulglici h W04 set by thejnumc�pstity you:may maintain a contcrnpoiranc-005 169 �latcd it, arl zilnilul oerrriicrce schedule shall lccxhlbi(eO tqdig lnspqctor Dr."ViTeS during normal hours without zdvarzen tic6- 'Somc rnunkc.'Patics trta'y set zbq e-a slu.ttstated: gnituo nomin.A.feCS(Or anPU4 .perp utidiqVic in crri its foe qrk YES 0 'W.'e:will rAk I'llis Corns oncarlisuch occasioh.tthoct 0_0 (check one):. YES 14 IN"i wl It nai 6.11 zill iowt or *tqrg cp-nic.l.,... .. . . . -this applkltion artniiatl) ;D. 1. coat. I. . i il:iaiity. In't cast you,rpuSt,xcjl-C%V 1�ptiort is-available wilcre so cottempIdIcd Uy the monle T, x- "Fican.IC.113tip i nilploymcntd m Sm I CS its c c& 'Yciu agree that"Ille 1.08(�)will Ix i nd the-acc.�rk.y.o r im�iogs),Jr cirage in an u in4Rvi4 al jog.must-be or.contiguous property except by arm gC11 c"I with. th. itidicatcd:below. Thc,coY for additionfillo":rocaudlis. ........... I 1) %:k1VCr2 e 2 Ild 10C—1tim,'IN %Tillbe llailitnined— "o o, 0 11 U.proC d lyrd.r,suc maintain."tic legs Cketa n elki.rc,il.4catt:below WY the lnsp;.dorp('wVtres sltvuld access the log abyst.lit ofElectrichns),d,Q.1yoU C.MP11. er,Ot'ftill.�tiitc,cqtjtv2lcnt Varriliat nunft2rincludes.. ca total ljj�i teilw t' and also.indicutellic PPMb. le Ii citsed Stu M under Alleir dired supery I s I otl ppreitlic;sAo YOU Cillpitly-to assIst your I Ir—11 U�C PCIE's-or,a icd indiv.jdual., Limited excie0tiolls 0; 'r,-One lipclls<4iltdividoutxo-ont itillicem hoiridkWIC iliellui -4i htimb-cr must-Out Mrc4W:Ilic rall" lndlcair�I)Wtotal number an a St.'11162,c.582§3 2SItliclided by St..1979.C. ti,.tttofT11izJmltmb0'i6d-o4cs: Full-lube equivnInCelectrical employnicill- employll?C111, nel. How ensed POSpill 4 e.."N"irrs:is.rt:4Lilrtdlllw(bc.p6rfdrnrtcd:byli'C workJor Mflcli�nobcc to the itspector:o e d to be licctisedu 11) do Yo .ave ill your 6niploy. 1rt dicut tile total riuniticr and also indicate."tic lit (N tZ t1l=linin c4tjivzldnt S:(z(f flut number inclums: orcarpordijoll opeA-011111S uittle).z. 141 fS. sec revels:side(or ccrtiricatkotjs and aq. 4iredsigontin ........... ............. 440 0604 May 09 07 03: 50p John V. Hickey 440-0604 p. 2 Hpr a U., >. 4 ;ti.b.n NU1i r ri FiNDOVEl2 3786889542 P. 2 t.ustinuiin, .l?ectnit Farn�,.jyagc 2 k ,vam Some institutions enter into contracts with contractors to perform ongoing.clectrieat work at an institution. zimil 1 to institutional employees. If.by the terms of-*such a contract,.you direct thc,perforn=ncc of such work,include the.ntu hers of such'erriployce3 in ibis.oppli alion. Ir tile ccatractor:disccts SUC13:perrorm ucc,of if tilt:contractperiod is ror is dian oitc.ycar.opOlicatiall must be,made by cetntractor oii the standard fomi for such work. 'Do not itichtde such Cl .ploycc3 ilt:;Itis applicuhiprt. Mea.sc givc your official titic, such as "Director of the Physical Plant" or."Director of Facilities" or equivalent. In ad.dit pruvldc a:sta.tcmcnt.that substantiates.your au.0I%ority to hire cl..ctrieiasu pursuattt.to c. 141. §$ for cfcttrical work.on the pi [ses oryour instiiution..alld.to establish priorities for the performance ahercor. This form.is nat 1p be c-alstrucd as a.grar authority to d ectan:y t:.crnscc o(thi:.f3oard.of State'Lxan-jncrs of Etcctriciam to perform work in comravention of theculc :ad Board.of in CU ltrav6llion of tflc Massachusctts Electrical Codc; 0%tv:. 0ior'il)-to act for tttc irarcuunLioncd linsitaitiutr W: L?tJyS 1 S�zt l�rx /7 041 e,� LV �I�'t�.i��h tT_e�It fs b�llasl�� fern,/i; unrler dre pains attJ pe11e7tirs of perjrtry,IIral:flreiufornralioie orrllris.applicalivrj ii! tie a»d corrinkre. /Ag(Sikriatue) I 4t u7✓`J�ct ,~varlr:acicpliunc umber)- (extctixion):. �facsimilr.ttuntacr) �4.3.3 L7 - dice,'Ye l0l9 In/j .