UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13G
Under the Securities Exchange Act of 1934
(Amendment No. ________)*
ASAHI/AMERICA, INC.
(Name of Issuer)
COMMON STOCK
(Title of Class of Securities)
04338D106
(CUSIP Number)
*The remainder of this cover page shall be filled out for a reporting person's
initial filing on this form with respect to the subject class of securities, and
for any subsequent amendment containing information which would alter the
disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be deemed
to be "filed" for the purpose of Section 18 of the Securities Exchange Act of
1934 ("Act") or otherwise subject to the liabilities of that section of the Act
but shall be subject to all other provisions of the Act (however, see the
Notes).
*SEE INSTRUCTIONS BEFORE FILLING OUT!
Page 1 of 6 pages
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CUSIP No. 04338D106 13G Page 2 of 6 Pages
- --------------------------------------------------------------------------------
1 NAME OF REPORTING PERSON
S.S. or I.R.S. IDENTIFICATION NUMBER OF ABOVE PERSON
Nannette S. Lewis
- --------------------------------------------------------------------------------
2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
(a) |_|
(b) |X|
- --------------------------------------------------------------------------------
3 SEC USE ONLY
- --------------------------------------------------------------------------------
4 CITIZENSHIP OR PLACE OF ORGANIZATION
United States of America
- --------------------------------------------------------------------------------
5 SOLE VOTING POWER
NUMBER OF
0
SHARES
-------------------------------------------------------------
BENEFICIALLY 6 SHARED VOTING POWER
OWNED BY 993,935
EACH -------------------------------------------------------------
7 SOLE DISPOSITIVE POWER
REPORTING
0
PERSON
-------------------------------------------------------------
WITH 8 SHARED DISPOSITIVE POWER
993,935
- --------------------------------------------------------------------------------
9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
993,935
- --------------------------------------------------------------------------------
10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES*
- --------------------------------------------------------------------------------
11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
30%
- --------------------------------------------------------------------------------
12 TYPE OF REPORTING PERSON*
IN
- --------------------------------------------------------------------------------
*SEE INSTRUCTIONS BEFORE FILLING OUT!
Page 2 of 6 pages
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Item 1(a). Name of Issuer
Asahi/America, Inc.
Item 1(b). Address of Issuer's Principal Office
19 Green Street
Malden, MA 02148
Item 2(a). Name of Person Filing
Nannette S. Lewis
Item 2(b). Address of Principal Business Office, or if none, Residence
c/o Asahi/America, Inc.
19 Green Street
Malden, MA 02148
Item 2(c). Citizenship
United States
Item 2(d). Title of Class of Securities
Common Stock
Item 2(e). CUSIP Number
04338D106
Item 3. If this statement is filed pursuant to Rules 13d-1(b), or
13d-2(b), check whether the person filing is a:
(a)[ ] Broker or Dealer registered under Section 15 of the Act
(b)[ ] Bank as defined in section 3(a)(6) of the Act.
(c)[ ] Insurance Company as defined in section 3(a)(19) of the Act.
(d)[ ] Investment Company registered under section 8 of the
Investment Company Act.
(e)[ ] Investment Adviser registered under section 203 of the
Investment Advisers Act of 1940.
(f)[ ] Employee Benefit Plan, pension Fund which is subject to the
provisions of the Employee Retirement Income Security Act
Page 3 of 6 pages
<PAGE>
of 1974 or Endowment Fund: see section 240.13d-
1(b)(1)(ii)(F).
(g)[ ] Parent Holding company, in accordance with section
240.13d-1(b)(ii)(G) (Note: See Item 7)
(h)[ ] Group, in accordance with section 240.13d-1(b)(1)(ii)(H).
Item 4. Ownership
If the percent of the class owned, as of December 31 of the year
covered by the statement, or as of the last day of any month
described in Rule 13d-1(b)(2), if applicable, exceeds five
percent, provide the following information as of that date and
identify those shares which there is a right to acquire.
(a) Amount Beneficially Owned: 993,935*
(b) Percent of Class: 30%
(c) Number of shares as to which such persons has:
(i) sole power to vote or to direct the vote: -0-
(ii) shared power to vote or to direct the vote: -993,935-
(iii)sole power to dispose or to direct the
disposition of: -0-
(iv) shared power to dispose or to direct the
disposition of: -993,935-
NOTE: Represents shares beneficially owned by Mrs. Lewis' spouse,
including an option and right of first refusal to purchase
207,257 shares owned by Wells Fargo Bank, N.A. as executor of the
estate of Alan Baker. Mrs. Lewis disclaims beneficial ownership
in all of these shares.
Item 5. Ownership of Five Percent or Less of a Class.
If this statement is being filed to report the fact that as of
the date hereof the reporting person has ceased to be the
beneficial owner of more than five percent of the class of
securities, check the following [ ].
Item 6. Ownership of More than Five Percent on Behalf of Another Person.
Page 4 of 6 pages
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If any other person is known to have the right to receive or the
power to direct the receipt of dividends from, or the proceeds
from the sale of, such securities, a statement to that effect
should be included in response to this item and, if such interest
relates to more than five percent of the class, such person
should be identified. A listing of the shareholders of an
investment company registered under the Investment Company Act
off 1940 or the beneficiaries of employee benefit plan, pension
fund or endowment fund is not required.
Inapplicable
Item 7. Identification and Classification of the Subsidiary Which
Acquired the Security Being Reported on By the Parent Holding
Company.
If a parent holding company has filed this schedule, pursuant to
Rule 13d-1(b)(ii)(G), so indicate under Item 3(g) and attach an
exhibit stating the identity and Item 3 classification of the
relevant subsidiary. If a parent holding company has filed this
schedule pursuant to Rule 13d-1(c), attach an exhibit stating the
identification of the relevant subsidiary.
Inapplicable
Item 8. Identification and Classification of Members of the Group.
If a parent holding company has filed this schedule, pursuant to
Rule 13d-1(b)(ii)(H), so indicate under Item 3(b) and attach an
exhibit stating the identity and Item 3 classification of each
member of the group. If a group has filed this schedule pursuant
to Rule 13d-1(c), attach an exhibit stating the identity of each
member of the group.
Inapplicable
Item 9. Notice of Dissolution of Group.
Inapplicable
Item 10. Certification.
Inapplicable
Page 5 of 6 pages
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SIGNATURE
After reasonable inquiry and to the best of my knowledge and belief, I
certify that the information set forth in this statement is true, complete and
correct.
Date: February 6, 1997
Signature: /s/ Nannette S. Lewis
-----------------------------
Name/Title: Nannette S. Lewis
