-tJ ENTERED - hwbdocuments.env.nm.gov AFB/KAFB4562.pdf · '-tJ ENTERED From: Kunkel, ... -U '' D,,-/v{ c-.t>.un'l.-S'ti ~ .s/i.,, . / /')j l:M 1-;U>.J"/ ~'//,A.I/ 21·'1 ... rJJu."

'-tJ ENTERED From: Kunkel, Tara S [mailto:tara [email protected]] Sent: Tuesday, January 24, 2017 4:27 PM To: [email protected]; Burke, Bruce <[email protected]>; CLARK, SCOTI C GS-12 USAF AFMC 377 MSG/CEIR ([email protected]) <[email protected]>; Agnew, Diane, NMENV <[email protected]>; Kieling, John, NMENV <[email protected]>; Koster van Groos, Paul <[email protected]>; Lachance, Caitlin Q <[email protected]>; Lavorgna, Graig <[email protected]>; LYNNES, KATHRYN D HQE USAF AFMC 377 MSG/SAF/IEE <[email protected]> ([email protected]) <[email protected]>; Matt Ellender ([email protected])([email protected]) <[email protected]>; McBride, Randy <[email protected]>; McQuillan, Dennis, NMENV <[email protected]>; Roberts, Kathryn, NMENV <[email protected]>; Romalia, Kathleen <[email protected]>; Simpler, TrentSPA([email protected]) <[email protected]>; [email protected] Subject: KAFB-106MW2 completion diagram for NMED approval and status 1-24-17 Importance: High

Hi Diane and All,

Please find attached the proposed construction diagram for KAFB-106MW2 for NMED approval and the compiled, QCed draft borehole log to total depth.

On-site activities for Tuesday (1/24/2017): Drilled and advanced 11 % drive casing to total depth {557 feet bgs) at KAFB-106MW2. Performed borehole straightness test with ShurShot device, borehole passed with a measurement of 86.8 degrees.

Please find attached a site photo showing drill cuttings being deposited into a roll-off bin.

Anticipated activities for Wednesday {1/25/2017) : Prep materials for well installation. Begin well installation at KAFB-106MW2 after receiving NMED approval.

Please let me know if there are any questions!

Respectfully, Tara

Tara S. Kunkel Geologist Federal Services Tel: + l 505 :262 8906 Cell: +l 50.5 967 9.521 Tara. Kunkel @CBIFederalServices.com

CB& I 2440 Louisiana Blvd. NE Su.ite 300 Albuquerque. NM 87110, USA

KAFB4562

I 11111111Ill\1111111111Ill\111111\\\11\\\I \\I\ \II\

Well Completion Diagram Approval Form Well ID# /(A,C/f - /tJ&, /11 'W2

4 ft. x 4 fl . Concrete Pad

13-3/8-inch Borehole

(ftBGS) .2/fO'

11-3/4-inch Borehole -----<M

Bentonite Chips ----~

Top of Screen (ft BGS) -/- ~.)

35 ft. Screen -----fti-11==!

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Top of Cement High Solids ; _.1

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Bentonite Grout (ft BGS) --'-''"' •V;._

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500433_03-050100_M

Visual Classification of Soils Shaw Environmental & Infrastructure, Inc.

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c.;4.w' r.' ~t 2.JJ Notes:

Drilling Contractor: _C/rt,;1<.ddt:.. l)RAfl .. Drilling Equlpment:_.¥ee/ .:S'rar §t?k C'/I

Driller: __ L!:f!fa A- C:>rer.:--?

Form Number; 252_3 Rn Ol·~Ml

I I I I

I I I I

Project Number: .5 oo 4-3 3 Boring Number:,b~F'Lf--/t)GA1 W,1.

Elevation: Enginee(/Geologist: ),r;:fh A« r Dli· Drilling Methods: ,A fi? c //


Project Name: /<'AF.I?-~ ,;~ - }3-.{'TZf:J Coordinates: Date: J- ."'.Z. '-' •• !''$ GWL: Depth Date/Time: Date Started: / -;J.a ~;-7

Depth Date/Time: Date Completed: Page: 8 of

0 » c .0 uu 0 E Q) c: - '.+;:; » ..._ Q) LL - (J

Description (/) ~ ~ (/) -::::i Remarks

(/') ro (/) I- ~~ Cl) c .._.. () ~o c (/) 0 :::>

() ()

t? l----+---~--+---1-----------------l-'~~~''/+-----l----+------------t

;> .... 1.r-

1:r.r

Notes:

Drilling Contractor: _ _,,,C."-' o--~-':r._c.._··a_A_· c> ________ _

Drilling Equipment: :;~ee/ .. -;.:.r4', .fc? /.! c:' 1-1 I

Driller: /1-1 <.:it/~· c;;rel!?/2 r),R·.· · l\f1 ~-· t'\ Form Number: 252_3

Re·1. 01-2\·t~

Project Number: ')'Clo 4-7.'?

Boring Number:kllr.IJ - IO'G/11 w.:z Elevation:

Drilling Methods: A!? C #


Project Name: kA Fi5 - Ra ,,n1 d - 13-.5' Tc ) ';? Coordinates: ~ Date: I -· .1 .-'J .- J 7 GWL: Depth Date/Time: Date Started: I - 2 ~ .~ /7

Depth Date/Time: Date Completed:

Page: CJ of

0 >. c: .0 "O 0 0 E e? c,...... :;::; >. ::I Q) LL -0

Description (/) Ul ]? (/) -::i Remarks Q) '-

(/) ~ :g t:. 5:t> (.) ~o

c (/) 0 ::::> u ()

1----1---t--- +----+-- --------------+---l-----1-- -1-L.J.+/.' .... ~· -~,t:-7 . ....,..., r.: - ,,,.:_ ~ ~· ..,.....

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c ,<v

rc:.r.. \ .,,, r----r----t-- - +-- -+--------__..J,..-"'-".;;._,.J-----·1- -+-----1---+-- ··-·---------1

c':::/c,Y • "l-!o Jl.~1,,l:: I. B -nHo:.r It/ YR V'.z.

Notes:

Drilling Contractor: Cd ..s-c4' ~e ~~~----------··-

Drilling Equipment: 5Ree/ 57ar I

Driller: /'P1'artt 6r-ee/7

t-·~-----------------~--------------------------1

.. ' --· .: .. ,

Form Number: 252_3 Rt'l. 01 ·21·1l


Project Number: ,5 ~, "/ tJ-33 Project Name: k'A F B- 'ft ~A;"d- L_=:_5·7c.··/:;, Boring Number: /\APB ~· /tJG//1VV2 .. Coordinates: ' Date: / - ;{,t.J .. / 7 Elevation: GWL: Depth Date/Time: Date Started: I - 2 tJ ,_; 7 Engine~ologist'.' /, iB~A.it ,.~ · Depth Date/Time: Date Completed:

Drilling Methods: ,,,CJ/? C'/--1 Page: / O of

Q ' >- c: .0 'O 0 0 E Q) c: ,...... - '-8 >- '.:; .!!! LL

Description (/) (/) .!!? Cf) Q) 2 Remarks (/) m ~ c. ~1;) (.) ~o c: (/) 0 ::::>

(.) u

t---+---t---+---+----------------11----jl-----f-··--···-t------------t

-~ SIJ r~ j!#.l.~,1r/, /~,.. .. , j,,_JS~4-/i/l> - "· :;·~/.) dr11l,,.· - :,>/I t -2,")·- '/ f_',r p \ ' /;J J:.-!.rD ;;ih! JS'" :Yit '1

l'o/f.>I': JY.r,?,, ·· Rrv,,1;, 7 •-1~/t' ~--//~· \"' ,-, Prrv~ /:~,,;,," l'./Jl Z 3~,., .~/- l=~·- _ ' ' ,:i''t';r.or ;.). .. '/1 •. !::. v,~ JI !<;"

r---~--1---t---+-""'-2 ~·7.4>-.........,~~~:· 4-~~l,___-~,'1~·~~~~~·~~'--47'-~·.,L.....<i..~~~~~u-'--""1'~--1---~----l--~1;~.q~v~~~£~_~,~n~~;~~7~0t~-'"b .ZB.~ frI o /r ,~ - ~I"-, r; ../.,/,,.,./ ,,.,,.,./) c '"' '"y;,,.,,.

r:· ~ ;. '( ' ._~ ·-J

,__ _ _, __ __,I----+--- c,,lr ! t?ro.wl'l 7..fvl? S/9'--1----+-----1---1---+-'IJ~"'-=-·()_,_p.;'-~- ~"' +' LJ /1'J.u,f,·., . ., -r,.., f' · -"'O

.2(! ~ //.,,,,_,; /..,<>.<•//

/? ,_, ,,,.~f- ,,/,_,. f;>~·?'.r./ \;,. .. r -

Notes:

Driffing Contractor: C:::Z 'C ~-~-- -~~-------Drilling Equipment: _<:;,a eec/ S~ar

7

Driller: /4 a..rk {;r-d?<ErJ

r:-~;.;/~· '·~· .;."';~·,."°1 1:.· r1 i 1 b l ... .. ti _, Ii

r-:.·2"::'-.. I ·' /.!

u ~-~--·----... -_--_----------------~-------~------------=------.... --!

Form Number: 252_3 Rc-1 Ot-21- 13


Project Number: /;' CIO 4- ·"31 3 Project Name: /(,1 Fl? - }l~fa.id - [_<;· TC::)"':::1

,__Bori~g Number: lit'-1 F B ... Lo 6 /111 \lif.4'. Coordinates: Date: I -.,.2. .? , / 7 Elevation: GWL: Depth Date/Time: Date Started: l-2;;:;-/7 Enginee~Geologist) r. ;f,~Ac~ ,.c/$ Depth Daterrime: Date Completed:

Drilling Methods: AJf. c· J-1 Page: JI of

.... _ 0 ~ c:

Cl> ci c<l> c:- -.0 -0 0 - 0 a. E Cl> c ....... +:l ..c +.

_z ..... Q) >- s 2 u.. -0 a. "' a.o6 ~~ > Description (/) f/) .~ (/)

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Q) ~ E ID 0 3'-0 a. (.) CJ) m~1::- Vi O.._.. CQ a. -E &- u (/) ;::... al CG ::;?: 0 c f- (J)- en u 0

3'f/v ::> u

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,~ ~1- ,~,,,

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f;!,,, .. -~.,,, &-'4444 ~,.,,.:,,.R.:.. •. ~ I

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1)t> ;"°)~~ .. . .,., L0/',,

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315

·- ·--,,.,4- .I··' ·'J~ ·7 1 C'' J. 1: ,,.,1,.... IC> . :) ,. .J'! ~ "· I...,, _, .. .- C''LAJ/ 1(:-e;~ .. ~ t)_ ( -"' (!;?: I :i-i·<."J - './ . , ""· ~,

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:(.,;;. '7, __ <j:._.,./ - F;;.,:t. ~ C>aB.:0 ·~ . ' 0- ., )1_ ,, -Sf~ 'J ?"7 c:;.>l>VJl/~n;,,. • i. f-., .> ·I" ,

JC'"''"'/ ·~ ~· l.J. ;{,r;t>~,-r;/..

32.5'

Ci_'

-330 Notes: '

Drilling Contractor: (,'cz.rcct/C?

Drilling Equipment:._5ize ed ....... S'P·l'a r .. iCJ I< Cf/

Driller: /1'1a.r1l 6.n:e·"

fj "-~\ ! ,.,

[I ~J j • ' ... _, "'-t.tJ:.Y

,,.';!/..,, ... ~/ J'" fi" /,'7 ""-""/ ~ ~ ,..

~\ /.L . .,,.J'::-/ ,..,;.. ~'/:/'..!!.;.,-"

/) 1W" .~A

p~"~t1 tm . ) I ;·1 t'·r; .· fl \\ fj ~ b' -. \\

mln'lf m..~·· z.u

~·J ~ Form Number: 252_3

Re"l'. 01 ·21 - 13

r7


Project Number: ~t;·e;o .,~ 3 3 Project Name:k.,q P-8-l?aPJd- .tF-s· /c P 1--~~~~~-..,.---~~--~-t---~~-~~-~-~-'--7~~-.---~-~--~------~-~

Boring Number: A'A F' B - / t) t:./J1L'LI 2 Coordinates: " Date: l ~ .2 S' .- / 7 Elevation: . GWL: Depth Date/Time: Date Started: / - ;,:l ,CJ .. / 7 EngineQf[Geologisf) 7::- :P,c.,4.c;-,.~,&- Depth Date/Time: Date Completed:

Drilling Methods: ./-/ fi' [ ,,t-/ Page: I ;J,./ of

............ 0 c: Cl>

~-- ~z 0 0. .!: h.. .... Cl> .... 0. o6 (/)Cl> > 0. \),)

Ea> 30. 0 Q) ~ .Q E () a_ co 0. &-Cl) >- CO m r- Cl)-

330

34D

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Cl) co (/) f-(.) Q) c:: -Cl) ~ 0

(.) ::J

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Remarks

1t::-- .~ ...... ,,,,.,,, ,._,k·o;r_,,.;:.C"f"- fo{'q,6-?tt:::UJ, t' ~~.,~ ,.....

~~ z <.4''-f~. ;,_ h1- ... :;~ . ., ~"-•:J<''/~.,:...µ_'.c:.>"",,,_~,<:! .. CZ'"':+' - --i----1----ltlja A~YAc'! /'1. ,.~ .;~ kJ....-.,,,, f;: c:,,..,,v./ -r;,.,,, *· r-&~~; ,,..., '_\' -- ?-.. ' 7 .

/~ ;, '>"s-' i.~r ,,;, r -

3.50

Notes:

Drilling Contractor: Ca.s-·c c~ ~& Drilling Equipment: -<~eec/ .... Srt-ar .So/<: Cl-/

I Driller: ./J1 cu ,~ 6 -,,. e e 11

Form Number: 252_3 Rtr1. 01·21-13


Project Number: .SDD 'f 33 Project Name: I< AFR - .R,...l .a 1 ~ - E .. S "1-c· /J Boring Number: }</.)!.:' E ,... /06Jl'llN'.2 Coordinates: /

Elevation: GWL: Depth Date/Time:

Enginee((G'eofogist)r. ;,p,,:,t;cc rd's- Depth Date/Time: ·-

Drilling Methods: ARc~J

.... ,..... 0 Q) 0 c: <IJ ~ .......

..0 ,...._ 0 0. E .c ·~

_z ~~

Q) >. a ~, a.od > Description (/) Q) ~ E <JJ 0

.Q E 0 Cl) Cl .. co a. ~-..._. (/) >. co ro 0

(/) i:- Cl)-

.J(;o :::>

.:/,,,. fi, ,. ·'« :/--' V/,•H · - ,,.~ ./., .1 · ,_J'./f-A/. fl ~ .

wJ·-rA Gr,vv y / /°:.Jw) A~t qh ) . 1 .P .,? .::~.:)~ ,·.=~~ ;?60 " ,.-;r ........ ,_____

s-,,,,,, 365

'37~

··-37.S

3 7? / ro3 ,\"r,.V.?//-c,r~,~ / -~.>l- /i/ .,_/;) ' ~ ...... ,-~ . # Gr~c~,~ / . (7,,,/} ·- q/

. .1-r CJl.;~"·, .; o c?T' ·7 j~·- / 7 tf, • t .. ·f ...Jt....J-,# "bJ: • '.PO

380

3l?S

-·

" • J

390 Notes:

Drilling Contractor: Cafe q o/e

Drilling Equipment: JJ., ~ t?e/ __ -~';tee: r _'i?> K C"/-1 -)

Driller: />'7' ~,-A:_L2 ,...&~a

Date: / ·_Jyv// Date Started: / - ::21> --/7 Date Completed:

Page: /3 of

>. c: "C (.) 0 Q) c: ,..... _13 :; 2 u. Cf) -~ Cl) - :J Remarks Q) ....

~ ~ t:, ~iii ~o c

0 0 0

----·

l.4oh.:.: L,1,~ ~t.{t >J"i .... \:;...L±t:.. <Y • ~ •

u.,, c"" lt!,:h1/•~ <.! I ·"'

A'e 1fl., a .. ,, c' /~"/ ,v,f/

~~,:U. "t;:,,.,,,.,,.,.-y-/,;,1'1 (:} //r:) J

PLl>.:&. dJ P.f-'3:.1 c<V P. •r ,,..,

~ ~ .. ,~ > .. /~ ---~· /

/(ct////l#/•'!"'/,,.,;.~·· ,y

//;f, ~.t.Y7?.r ~ //<P-1""' .b.:J.y1,,.J //,•/!•

----····

D RA =r Form Number: 252_3

Rev 01·21·13

I I

I

I

I


Project Number: $001-33 Project Name: KAF B·- tf 0.,.,,.~- E S/t'/C Boring Number: kl) F B. Jt/5;/11 w "J Coordinates:

. Date: l-..i ;« .J7

Elevation: GWL: Depth Date/Time: Date Started: I -..le; -/7 Enginee~eologist) r: R,- °'c-,,AAt .... ~ Depth Date/Time: Date Completed:

Drilling Methods: A:Rt"# Page: 14- of Jq .... _

0 > c: 0 c: <ll ~-

.0 "O (J .Q

li ~z 0 a. E Q) c: -a.c(! ~~

Q) >. s .l!! LL.. -0 > Cl) -::::i E a> 8 Description Cl) .!!l (fJ

~ti Remarks 0 a. Cl) l1l en t-ro c. -E £- CD c: -en >- CXl l1l () :?: 0 c: t- (J)- (f) () 0

:J"!CJ :::> ()

.. l tf.f,. 7';) .3 '} 7 ·' iAle/l · .·r~> ./,,_/ ..S°'A/Y /:;:> ~ .. _,.,.,,,,; ....

··N·..41. /...~~ 0 fr"'....r\ "

.A..r- ~ / .. ,,,,.. ? r'?' ~ ,..,, ?t:"c/ ~

39!i

... l<~JJ,,., !.>,.,., .... ~ 17.LJ

} 'f .• ~ t:L.a //..,.,,_ 6;.- 1/ -r-., <'1,--~t; • , /!11 .!:, :.. .://,)/ -. _,, ~ /-:Z.~-/

4-(XJ ·~ ~ (;> 7r 4- ?:nr/. // ··l/J& "

?9 "7 ' . .,._,., 4- j 7 .- Wt- JI - .; ,~J~ .. ;

<'A rV ,.., vv/rlt ("',,'2., .. / Is w) AT a..A~ I . L .

ar r. .:J i_-:? n. ?~a, 4-o " . /1-!or"' -~-,;-If-

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..Si.,. Ke11~.a..., c..;; l!l5'1r

e

7

~ .... ~_,.,. / _ _,,~.:::~ ..... e? 1;),Y ~ I

4..2 () Notes:

Drilling Contractor: C~scq~

-~eet:Y' D Drilling Equipment: _'::~r s·ek Cfl I '

/.-1,.:,, .... ~- 6, I." #,It Driller:

• ...

•,r

A }, l~J

I

/::> J ll.Z 0 C) LILIA'! l!J/ BZ ' #

't'- e;--~~,,f!..

t.,.v, -,.,? - J-= /j/r'~

;tx~• ".7,;,·.:·."a

r~ i r Form Number: 252_3

R4:1v,01·21- 13


Project Number: 500 <'i-.3'3 Project Name: f<AFft- Kd~ipl- e.s/~? Boring Number:/<AFl.3' - /L%MLiV.2 Coordinates:

, Date: /-,2.c;;.-17

Elevation: GWL: Depth Date/Time: Date Started: /-2a ·-17 EngineetfGeologist'.) r. ~;.A~ r pt!.- Depth Date/Time: Date Completed:

Drilling Methods: A RC J.I Page: 15 of 11 ............ 0 >- c: 0 c: Q) C:-..-..

..a "C (..) 0

1~ .l!:!Z 0 a. E Q) c: - :;::;

'- ~ >- 5 $ LI.. -0 a. olS Cl) Q)

Description (f) Cl).!!! en Q) 2 Remarks E Q) ~a. 8 .Q E (f) m <II I- ~ii5 m a. &- (.) Q) c: - c: (f) >- IIlm en :::!!: 0 0 r- en- (.) (.) "9-20 ::::>

<f.-17 ' t-o <tZ::> ?rv,,qjj..,..,,, __ db,? <.d _,,/' ..... ->w vr'sw) - ~·

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4-1. 5 9a? J<?rlot'- T-•1'1 .2 f,j ;'.;)C?l'.>lP, tl)r,~,r1·4-~ ~~,w /01° {/

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/;~--'/:J C:,(~ y.:,.l.&..~j A ~ . .... J,Y~ '/...z.. • - S' , . r->..:. ,,,•.ff . ~ 0 .,.... _ -j- -J· fi.~ , j), ,,, //p,J ... A p ~,,,,...,....

-""77:~-" .5' /,;_ 7" ( ~ ,,; '.)_,,, "h .,_ o> ~~i.""' ('.Cl It:-77 :- ........ ~,-.- ~/-~1 .1/ ~-!" ( !!. ,. (' R.,,. - ;. )

1440 ,t) /1?.1'-. ,. ~

,,

'!':~~ · Ir- d'i-,t ' {J/~11-c.-..L../ ~.A,v~ 6-.v) p /,/"')';:"I),/ --- t() f?;;.

uL..,,.., 6,,.,u,. " /?C. .. ,, tt:J YA' S/2 'ti- <: ~..t.. -9'rJ ,.:Z, <d,,/ - h '- • ~ /,;.!Y/l"Tc? W/;,~" /)-~,& ~;:::

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•• - ~C!i'.IA i't

5 " .... ~

4- .SO Notes:

Drilling Contractor: Ca.;cad~

Drilling Equipment: ,S'p~e/ .S'rar SOK Sf~·~

() m -c~r C"/-1 • . i'

I u '· . ~ Driller: _/7//~,,.,(- ?/"-el!'-"'

ntJ ~ Form Number: 252_3

Rev 0 1-21 -13

2. 7

Project Number: 5 e:J O 4- 3 3 Boring Number: k4,cB-Jt::>~ M W.Z


Project Name: /<AFB - Ra_,,,:ef- c-srcp Coordinates:

, Date: /-.,.??--/?

Elevation: GWL: Depth Datemme: Date Started: J ·-.,?0-17 Enginea(/Geologist: ) T. ;;e.;.A'~r/s- Depth Datemme: Date Completed:

Drilling Methods: ARCH Page: I~ of I?

0 c:&- :8 :>. c: !:'- E

"C <..> 0 - ~z o..._ Q) c - :;::; £ i-. a.aa

(I) :>. 5 $LL -U a.<»

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q.50 ::) () ()

4-..'.J~:J' ·f.:J .,,_,i /~- o,,../,.. .• ;._.,...,.,,,1 .. ./ ·"' bt.-

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Drilling Contractor: Ca s·c ~.:;;/~ :--~·

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Form Number: 252_ 3 Rf'Y. 01 -21-13


Project Number: .sao4-.J3 Project Name:kA FB ·~ J( dp/;.;/- ~S" rc;o Boring Number:kAFi>'"- /O,fitW2 Coordinates:

r Date: J - ).Cl- - /7

Elevation: GWL: Depth Date/Time: Date Started: J _: ,:z. c:> ~/7

Engineec[Geologist:7 r. ~iAu~ Depth Date/Time: Date Completed:

Drilling Methods: Aire')/ Page: 17 of 1 7' .... _

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!,'/{) Notes:

Drilling Contractor: Ca.src·~Je

Drilling Equipment: S,,ee/ S.7P,r , St/I< Driller: /'1tf-f r J.,J 6.re~/J

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Form Number: 252_3 Rev. 01 -21-13


Project Number: $009-33 Project Name: KA/:=-8-Rc:tA) a/ - GSTt:? Boring Number: /<APR -/Ot;Mw;Z Coordinates:

, Date: ) -i,.:;..-r7

Elevation: GWL: Depth Datemme: Date Started: I - J..,:;--/'7 Engineel(Geologisf: · ,-: ;B.e,h' Depth Date/Time: Date Completed:

Drilling Methods: Al?CH Page: JR of /9

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Drilling Contractor: ~~

Drilling Equipment: v~er ~t3?r 5oJ< CH FT Driller: ./"1<.itr,{' 6r"2e,.,, ~

---Form Number: 252_3

Re~, 0 1 -21 - 13

Project Number: _'IC>CJ/f-33

Boring Number: l<AFl3'-}r/6MW' 2 Elevation:

EngineeefGeologist,;) ~ 1?J (: )a rc:b'


Project Name: /<'AF 8- R aL) 1'c/- ESTc :P' Coordinates:

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Date: i -_2-.;--17 GWL: Depth Date/Time: Date Started: j -,7..~

Depth Datemme: Date Completed:

Drilling Methods: /IRC}/ Page: 19' of 17 ... _

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Notes:

Drilling Contractor: . Ca-Jeez~

Drilling Equipment: .>jeee/.5~1'<::<'r

Driller: fi/,' ct. ,. ,{· .6 .Le.::::4

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Form Number: 252_3 Rn. 01-21 · 13

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Documents

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