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HomeMy WebLinkAboutInspection - 445 BOSTON STREET 4/26/2005 ........... 44 Cotnmerdal Sheot Raphavii, MA L/102767 Tel: (508) 880-0233 Fax: (508) 880-7232 RE C April 26, 2005 MAY 4 N05 HEALI H 1)EF"(0�'l NALNVT ................ North Andover Board of Health 27 Charles Street North Andover, MA 01845 Attention: Health Agent Reference: Single Home FAST" Treatment System Serial Number: 21762 Attached please find the Field Inspection& Service Report for services performed on 04/11/2005 at the property of Thomas Connolly located at 445 Boston Street-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 Connolly Massachusetts DEP Massachusetts Department of Environmental Protection LA Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems 5069 A. Installation Important: Thomas Connolly When filling out Owner forms on the computer,use 445 Boston Street only the tab key Facility Street Address to move your North Andover 01845 cursor-do not use the return City Zip key. Mailing address of owner, if different: 445 Boston Street Street Address/PO Box: North Andover MA 01845 City State Zip (978 975 7694 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 Kevin Usilton 12530 Certified Operator Name Certification Number C. Facility/System Information 21762 Bio-Microbics, Inc. MicroFAST .5 DEP ID Manufacturer's Name&ID Model Name&Number 01/06/2003 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 04/11/2005 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended _Yes X No Color: Clear Odor: None Effluent Description DEPMicroFASTnew.doc-4/26/05 Page 1 of 2 Massachusetts Department of Environmental Protection Ll Bureau of Resource Protection - Title 5 EP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems -- 5069 E. Sampling Information 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: Cleaned Filter,,,Splash Recycle, Notes and Comments: Also tested: , , , . 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. Kevin Usilton 04/11/2005 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 30`h 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-4/26/05 Page 2 of 2 LU INCORPORATED 8450 Cole Parkway w Shawnee, KS 66227 w Phone 913-422-0707 ro Fax: 912-422-0808 5069 e-mail: onsite(cDbiomicrobics.com u,www.biomicrobics.com w 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FASTO System INSTALLATION AUTHORIZED SERVICE PROVIDER 445 Boston Street Installation Address North Andover,MA 01845 Name Wastewater Treatment Services,Inc. Owner Name Thomas Connolly Street Mail Address: Mail Address 44 Commercial Street 445 Boston Street Raynham, MA 02767 North Andover,MA 01845 City State Zip 508-880-0233 508-880-7232 Phone 978 975 7694 Fax e-mail Phone Fax e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pump out MicroFAST 5 21762 01/06/2003 Mai YES NO MAINTENANCE PERFORMED AND COMMENTS Panel(s) Opera X 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 4 Bedrooms H Standard Units Color Clear Temperature Odor None Comments: TECHNICIAN SERVICE DATE Kevin Usilton 04/11/2005