HomeMy WebLinkAboutInspection - 445 BOSTON STREET 11/4/2004 aphain, 10A
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I,el: (508) 880..02
Fax: ( Ofd) 880-72,32
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November 4, 2004
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North Andover Board of Health
27 Charles Street
North Andover, MA 01.845
Attention: Health Agent
Reference: Single Home FAST° Treatment System
Serial Number: 21762
Attached please find the Field Inspection & Service Report (as required) for services
performed on 10/29/2004 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
Bureau of Resource Protection - Title 5
DEP Ll
Approved Inspection and O&M Form for Title 5 I/
Treatment and Disposal Systems
3234
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
Michael Dillen 11173
Certified Operator Name Certification Number
C. Facility/System Information
21762 Bio-Microbics, Inc. MicroFAST .5
DEP ID Manufacturer's Name&ID Model Name&Number
01/06/21003
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
10/29/2004 _
Inspection Date Previous Inspection Date
Sludge Depth(to be checked yearly) Pumping Recommended _Yes X No
Color: N/A Odor: None
Effluent Description
DEPMicroFASTnew.doc-11/4/04 Page 1 of 2
Massachusetts Department of Environmental Protection
\' Bureau of Resource Protection o Title 5
DEP Approved lns
pp pection a�tt�, O&M Form for Title I/A
1°reatment and Disposal Systems
3234
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:
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 10/29/2004
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
31st 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 •11/4/04 Page 2 of 2
WU=1NC0RP084TF1)
8450 Cole Parkway Shawnee, KS 66227 m,Phone 913-422-0707 m Fax: 912-422-0808 3234
e-mail: onsite(a)biomicrobics.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
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
EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS
Electrical Panel(s)
Visual Alarm O eratiIg 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 Re uired: X
Primary Settling Zone
Aerobic Treatment Zone
EFFLUENT(optional) LIMIT RESULT
Estimated Daily Flow 4 Bedrooms
H(Standard Units)
Color N/A
Temperature
Odor None
Comments:
TECHNICIAN SERVICE DATE
Michael Dillen 10/29/2004