HomeMy WebLinkAboutCorrespondence - 333 RALEIGH TAVERN LANE 2/16/2004 44 Cornr�ierci l Sti-eet
Raphwn, ESA
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Tel: (505) 880-0233
Fax: (50 8) 880-7202
February 23, 2004
North Andover Board of Health
27 Charles Street
North Andover, MA 01845
Attention: Health Agent
Reference: Single Home FAST`S Treatment System
Serial Number: MCF156
Attached please find the Field Inspection& Service Report (as required) for services
performed on 02/16/2004 at the property of Thomas Shea located at 333 Raleigh Tavern
Lane-North Andover, MA.
Please call if you have any questions or require additional information.
Sincerely,
Wastewater Treatment Services, Inc.
Service Department
Enclosures
Copy to: Thomas Shea
Massachusetts DEP
i
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/
Treatment and Disposal Systems
A. Installation 3033
Important: Thomas Shea
When filling out Owner
forms on the
computer,use 333 Raleigh Tavern Lane
only the tab key Facility Street Address
to move your North Andover
cursor-do not 01845
use the return City Zip
key. Mailing address of owner, if different:
� 333 Raleigh Tavern Lane
Street Address/PO Box.
North Andover MA 01845
C�h State Zip
(978 262 8674 ext.
Telephone Number
B. Authorized Service Provider
Wastewater Treatment Services, Inc.
O&M Firm
44 Commercial Street
Street Address
Raynham MA 02767
City State Zip
(508)—880-0223 ext.
Telephone Number
Michael Dillen 11173
Certified Operator Name Certification Number
C. Facility/System Information
MCF156 Bio-Microbics, Inc. MicroFAST .5
DEP ID Manufacturer's Name&ID Model Name&Number
11/05/1998
Installation Date Start of Operation
Approval Type:_General _Provisional _Piloting X Remedial
Seasonal Residence—used less than 6 mo./year:_Yes X No
D. Operating Information
02/16/2004
Inspection Date Previous Inspection Date
Sludge Depth(to be checked yearly) Pumping Recommended _Yes X No
Color: N/A Odor: Process
Effluent Description
DEPMicroFASTnew.doc •2/23/04 Page 1 of 2
Massachusetts Department of Environmental protection
Bureau of Resource Protection - `title 5
DEP Approved Ins toon and Form for
Title I/
Treatment and Disposal Systems
E. Sampling Information 3033
Samples Taken:_ Influent Effluent
Parameters sampled:_pH_BOD_TSS_TN_Other (list below)
Other 1 Other 2
Other 3
Description of any maintenance performed since previous inspection & during this inspection:
Notes and Comments:
F. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
completed this report and the attached technology operation and maintenance checklist, and the
information reported is true, accurate, and complete as of the time of the inspection. I am a
Massachusetts certified operator in accordance with 257 CMR 2.00.
Michael Dillen 02/16/2004
Operator Signature Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use—by January Piloting & Provisional Use - General Use—by September
31 s'of each year for the within 30 days of inspection 30th of each year for the
previous calendar year date previous 12 months
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 6th Floor
Boston. MA 02108
DEPMicroFASTnew.doc•2/23/04 Page 2 of 2
MOR 94m;l
8450 Cole Parkway w Shawnee, KS 66227 w Phone 913-422-0707 m Fax: 912-422-0808 3033
e-mail: onsite(a)biomicrobics.com n www.biomicrobics.com m 800-753-FAST(3278)
FIELD INSPECTION & SERVICE REPORT
For Bio-Microbics Single Home FAST® System
INSTALLATION AUTHORIZED SERVICE PROVIDER
333 Raleigh Tavern Lane
Installation Address North Andover,MA 01845 Name Wastewater Treatment Services,Inc.
Owner Name Thomas Shea Street
Mail Address: Mail Address 44 Commercial Street
333 Raleigh Tavern Lane Raynham, MA 02767
North Andover,MA 01845 City State Zip
508-880-0233 508-880-7232
Phone 978 262 8674 Fax e-mail Phone Fax e-mail
INSTALLATION INFORMATION
Model No. Serial No. Date of Installation Date of last pump out
MicroFAST.5 MCF156 11/05/1998
EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS
Electrical Panel(s)
Visual Alarm Operating X
Audio Alarm Operating X
if resent
Blower(s)
Air Inlet Filter Clean X
Blower Hood Vents Clear X
Excessive Noise X
Excessive Vibration X
Treatment unit(s)
Unusual Odor
Pum out Required: X
Primary Settling Zone
Aerobic Treatment Zone
EFFLUENT(optional) LIMIT RESULT
Estimated Daily Flow 3 Bedrooms
H Standard Units)
Color N/A
Temperature
Odor Process
Comments:
TECHNICIAN SERVICE DATE
Michael Dillen 02/16/2004