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Home My WebLink AboutCorrespondence - 333 RALEIGH TAVERN LANE 8/26/2004 C.-f�"xaop"ceej,',, e.%c% 44 Comrnercial Street yriharrr, BONA 02767 Tel: (508) 880-0233 Fax: (508) 880-7232 September 17, 2004 2004 North Andover Board of Health T H 0 PAR' AENT 27 Charles Street North Andover, MA 01845 Attention: Health Agent Reference: Single Home FAST° Treatment System Serial Number: MCF156 Attached please find the Field Inspection & Service Report and test results (as required) for s r ces etfatm ed on 08/26/2004 at the property of Thomas Shea locat ''at 333 "°, Raleigh Tavern p a, ,F ri -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 Environmental Chemistry Environmental Services Site Assessment # Site Sampling Quality Assurance Services A'l't A4-ip li,*,R�ce Data Auditing , O R P a.+ R �+-�T 1 QI.,IN. Wastewater Treatment Services, Inc. CERTIFICATE OF ANALYSIS 44 Commercial Street REPORTED: 09/02/2004 Raynham, MA 02767 ORDER#: G0462984 COLLECTED BY: M.Dillen SAMPLE DATE: 8/26/2004 TIME: 11:00 DATE RECEIVED: 8/26/2004 LOCATION: 333 Raleigh Tavern,N.Andover, MA SAMPLE ID: Shea Grab(MCF156) DESCRIPTION: WATER RESULTS OF ANALYSIS Test Parameters LAB #: 0462984-01 BOD SM 5210B 08/27/2004 mg/L 4 17.2 pH SM 4500 H+B 08/26/2004 S.U. 0-14 7.0 Solids, Suspended SM 2540 D 08/31/2004 mg/L 4 13.5 NA=Not Applicable ND=Not Detected ,' Z 7 � <' = Less Than Approved By: La anager 1,J Date = Detection Limit Page 1 of 1 Analytical Balance Corp., 422 West Grove Street, Middleboro, MA 02346 Ph: 508-946-2225 Massachusetts Department of Environmental Protection Bureau of Resource Protection Title 5 DEP Approved Inspection and OW Form for Title 5 l/A Treatment and Disposal Systems 3033 A. Installation 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 man City 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 Manufacturers 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 08/26/2004 Inspection Date Previous Inspection Date U Sludge Depth(to be checked yearly) Pumping Recommended _Yes X No Color: Clear Odor: None Effluent Description DEPMicroFASTnew.doc•9/17/04 Page 1 of 2 Mae-sachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 ; DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems 3033 E. Sampling Information Samples Taken:_Influent X Effluent Parameters sampled: X pH X BOD X TSS_TN_Other(list below) Other 1 Other 2 Other 3 Description of any maintenance performed since previous inspection & during this inspection: Cleaned Filter,,,Splash Recycle, 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 08/26/2004 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 st 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•9i17/04 Page 2 of 2 QVINCORPORATED 8450 Cole Parkway Shawnee, KS 66227 m Phone 913-422-0707 Fax: 912-422-0808 3033 e-mail: onsite ftiomicrobics.com m www.biomicrobics.com m 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FASTO 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 T Date of last pump out MicroFAST.5 MCF156 11/05/1998 1 06/01/2004 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 Clear Temperature Odor None Comments: TECHNICIAN SERVICE DATE Michael Dillen 08/26/2004