HomeMy WebLinkAboutTitle V Inspection Report - 1312 SALEM STREET 10/2/2013 arrionwealth of Massachusetts.
Title 5 Off"Idal Inspection Form
Subsurface Sewage Disposal System Form m Not for Voluntary Assessments
1312 Salem Street
Property Address
Michael Cronin
Owner Owner's Name ---
require tion is North Andover Ma 01845 10/2/13
required for every
page. City/Town State Zip Code Crate of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important:When General Information
filling out forms
on the computer,
use only the tab 1. Inspector:
key to move your
cursor-do not Kevin Usilton
use the return Name of Inspector
key.
Wastewater Treatment Services
reb Company Name — --
44 Commercial Street
&A Company Address
Raynham Ma 02767 — ----
City/Town State Zip Code
508-880-0233 5113528
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5 (310 CMR 15.000).The system:
® Passes ❑ Conditionally Passes ❑ Fails
❑ Needs Farther E aluation by the Local Approving Authority
10/2/13
Insp eo for's Siditature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board
of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP. The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time.This inspection does not address how the system will perform in the future under
the same or different conditions of use.
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17
nmonwealth of Massachusetts
F Title 5 Official Inspection
o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
1312 Salem Street
�M
Property Address
Michael Cron an
Owner Owner's Name
information is North Andover Ma 01845 10/2/13
required for every
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
® 1 have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass"section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND(Explain below):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection -
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 1312 Salem Street -
Property Address
Michael Cronan -
Owner Owner's Name
information is North Andover Ma 01845 10/2/13
required for every
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes(cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The -
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR -
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17
Commonwealth of Massachusetts
F Title 5 Official Inspection r =
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M , 1312 Salem Street
Property Address
Michael Cron.an -
Owner Owner's Name
information is
required for every North Andover Ma 01845 10/2/13
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well**.
Method used to determine distance:
**This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must
be attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate"Yes" or"No"to each of the following for all inspections:
Yes No
El ® Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
El ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6°below invert or available volume is less
than '/day flow
l5ins•3f13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17
Commonwealth of Massachusetts
off IgMi�
Title 1 I Inspection Form -
Subsurface Sewage Disposal System Form ®Not for Voluntary Assessments
�M
1312 Salem Street -
Property Address
Michael Cronan
Owner Owner's Name
information is North Andover Ma 01845 10/2/13
required for every
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. -
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
El ® The system fails. I have determined that one or more of the above failure -
criteria exist as described in 310 CMR 15.303, therefore the system fails.The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the
questions in Section D.
Yes No
❑ ® the system is within 400 feet of a surface drinking water supply
❑ ® the system is within 200 feet of a tributary to a surface drinking water supply
El ® the system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area—IWPA)or a mapped Zone II of a public water supply well
If you have answered"yes"to any question in Section E the system is considered a significant threat,
or answered"yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
l5ins•3113 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 5 of W
Commonwealth of Massachusetts
f Title 5 Official Inspection
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
1312 Salem Street
M
Property Address
Michael Cronan -
Owner Owner's Name
information is North Andover Ma 01845 10/2/13
required for every
page. City/Town State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate"yes"or"no"as to each of the following:
Yes No
❑ ® Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
® ❑ Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
® ❑ Were as built plans of the system obtained and examined?(If they were not
available note as N/A)
® ❑ Was the facility,or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
® ❑ Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System(SAS)on the site has
been determined based on:
® ❑ Existing information. For example, a plan at the Board of Health.
® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable)[310 CMR 15.302(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms(design): 4 Number of bedrooms(actual): 4 -
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440gpd
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17
Commonwealth of Massachusetts
Title ii
a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
e w 1312 Salem Street -
Property Address
Michael Cronan ----
Owner Owner's Name
information is
required for every North Andover Ma 01845 10/2/13
page. City/Town State Zip Code Date of Inspection
D. System Information
Description:
The system is designed for a 4 bedroom house @ 440gpd with a 1500 gallon 2 compartment tank
with an I/A technology(FAST)system in the 2 nd compartment for treatment, the effluent then flows to
a 1000 gallon pump chamber by gravity. The effluent is pumped to a leaching field @ 9.5'Wx56'L
n/a
Number of current residents:
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ® Yes ❑ No
Seasonal use? ❑ Yes ® No
Water meter readings, if available(last 2 years usage (gP d))� 68gpd
Detail:
attached a copy of the water meter readings from the last 2 years, system is under the design flow.
Sump pump? ❑ Yes ® No
current
Last date of occupancy: Date
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
l5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17
Commonwealth of Massachusetts
Title I I I Inspection Form - _
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
5 1312 Salem Street
�M
Property Address
Michael Cronan
Owner Owner's Name
information is
required for every North Andover Ma 01845 10/2/13
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
n/a
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
Source of information:
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
❑ Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
® Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner)and a copy of latest
inspection of the I/A system by system operator under contract -
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17
Commonwealth of Massachusetts
F Title 5 Official Inspection
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�M 1312 Salem Street
Property Address
Michael Cronhn
Owner Owner's Name
information is
required for every North Andover Ma 01845 10/2/13
page. City/town State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known)and source of information:
7 years
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
3+'
Depth below grade: feet
Material of construction:
❑cast iron ®40 PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments (on condition of joints,venting, evidence of leakage, etc.):
All piping looks good, no signs of leakage and venting is good.
Septic Tank(locate on site plan):
COT
Depth below grade: feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
The septic tank has access covers to grade over the inlet tee and the baffle wall, as well as the FAST
system observation port.
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
1500 gallon
Dimensions:
17"/15"
Sludge depth:
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17
Commonwealth of Massachusetts
F Title 5 Official l i -
a Subsurface Sewage Disposal System Form Not for Voluntary Assessments
1312 Salem Street
Property Address -
Michael Cronan -
Owner Owner's Name
information is
required for every North Andover Ma 01845 10/2/13
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank(cont.)
Distance from top of sludge to bottom of outlet tee or baffle
Scum thickness
4"
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
How were dimensions determined? sludge judge
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage,etc.):
The inlet tee is in good condition and the structural integrity of the septic tank looks good, no signs
of leakage or infiltration. The baffle wall that separates the 2 compartments is in good condition. The
2nd compartment has a FAST system with a built-in outlet tee and the liquid level is at operating level
for a FAST system. Pumping reccomendations were made due to the scum layer in the settling
compartment and the level of sludge in the 2nd compartment.
Grease Trap(locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness -
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle - -
Date of last pumping: Date
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17
Commonwealth of Massachusetts
Title Official Inspection r
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M <° 1312 Salem Street _
Property Address
Michael Crona_n -
Owner Owner's Name
information is
required for every North Andover Ma 01845 10/2/13
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain):
Dimensions:
Capacity: gallons -
Design Flow:
gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
*Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No =
l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17
Commonwealth of Massachusetts
F Title 5 Official i -Form
Subsurface Sewage Disposal System Form m Not for Voluntary Assessments
1312 Salem Street -
Property Address
Michael Cronan - -
Owner Owner's Name
information is North Andover Ma 01845 10/2/13
required for every
page. City/rown State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box(if present must be opened) (locate on site plan): _
Depth of liquid level above outlet invert
Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
Pump Chamber(locate on site plan):
Pumps in Working order: ® Yes ❑ No*
Alarms in working order: ® Yes ❑ No* - -
Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.):
The 1000 gallon pump chamber is in good condition and there are no signs of leakage or infiltration.
The chamber consists of 1 pump and 3 floats. The components were tested during the inspection
and are working as intended
*If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17
Commonwealth of Massachusetts
Official Title 5 i ° -
a Subsurface Sewage Disposal System Forma Not for Voluntary Assessments
1312 Salem Street -
Property Address
Michael Cronan -_ -
Owner Owner's Name
information is
required for every North Andover Ma 01845 10/2/13
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
❑ leaching chambers number:
❑ leaching galleries number:
® leaching trenches number, length:
3 @56,
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
No signs of hydraulic failure, the vegetation looks normal. No signs of ponding or damp soils.
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer -
Dimensions of cesspool
Materials of construction _
Indication of groundwater inflow ❑ Yes ❑ No
l5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
1312 Salem Street _
�M -
Property Address
Michael Cronan
Owner Owner's Name
information is
required for every North Andover Ma 01845 10/2/13
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.): -
Privy(locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
Commonwealth of Massachusetts
Title ii al Inspection Form = -
a Subsurface Sewage Disposal System Form o Not for Voluntary Assessments
M 1312 Salem Street _
Property Address
Michael Cron an _
Owner Owner's Name
information is
required for every North Andover Ma 01845 10/2/13
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate -
where public water supply enters the building. Check one of the boxes below:
❑ hand-sketch in the area below
® drawing attached separately
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17
Commonwealth of Massachusetts
= Title 5 Official l i _
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
GSM
1312 Salem Street
Property Address
Michael Cron an -
Owner Owner's Name
information is North Andover Ma 01845 10/2/13
required for every
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope
® Surface water
® Check cellar
® Shallow wells
Estimated depth to high ground water: feet
Please indicate all methods used to determine the high ground water elevation:
® Obtained from system design plans on record
If checked, date of design plan reviewed: 2005 Date
❑ Observed site(abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health -explain:
❑ Checked with local excavators, installers-(attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
Established ground water from the design plan on record with the Board of Health
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17
Commonwealth of Massachusetts
Title 5 Official
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
;M 1312 Salem Street
Property Addresp
Michael Cron,an
Owner Owner's Name
information is every North Andover
required for eve Ma 01845 10/2/13
page. Cityrrown State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary:A, B, C, D, or E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed
® System Information—Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
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Summary Record Card generated on 10/7/201310:03:32 AM by Maureen McAuley page 1
Town of North Andover
Tax trap # 210-106.A-0160-0000.0 -
Parcel Id 17304
1312 SALEM STREET
MICHAEL & JENNIFER CRONAN
1312 SALEM STREET
NORTH ANDOVER, MA 01845
Class 101 Single Family Property Type 1 Residential
Zoning2 1 Residential Zoning3 1 Residential
Size Total 3.7 Acres
FY 2014
UB Malling Index
Name/Address Type Loan Number Active/Inact. From Until
MICHAEL&JENNIFER CRONAN Owner
1312 SALEM STREET
NORTH ANDOVER,MA 01845
NEILSEN Previous Customer Inactive 6/4/2010
1312 SALEM STREET
N.ANDOVER,MA
01845
UB Account Maint.
Account No Cycle Occupant Name ActivelInactive
Bldg Id.17408.0-1312 SALEM STREET Last Billing Date 10/2/2013
3170078 03 Cycle 03 Active
UB Services Maint.
Account No.3170078
Service Code Rate Charge Multiplier/Users
MISCFEE ADMIN FEE 0.635/8 7.82 1/
WTR WATER 01 ALL METER SIZE 342.40 /1
UB Meter Maintenance
Account No.3170078
Serial No Status Location Brand Type Size YTD Cons
33605600 a Active ERT HH b Badger w Water 0.63 0.63 549
Date Reading Code Consumption Posted Date Variance
9/10/2013 639 a Actual 68 10/15/2013 62%
6/11/2013 571 a Actual 42 7/2412013 183% —
3/12/2013 529 a Actual 15 4/22/2013 -65%
12/10/2012 514 a Actual 42 1/9/2013 -52%
9/12/2012 472 a Actual 91 10/15/2012 63%
6/11/2012 381 a Actual 54 7/16/2012 238%
3/13/2012 327 a Actual 16 4/14/2012 1%
12/1412011 311 a Actual 16 1/17/2012 -12%
9/14/2011 295 a Actual 20 10/13/2011 -6%
6/6/2011 275 a Actual 19 7/2012011 12%
3/9/2011 256 a Actual 17 4/13/2011 -7%
12/10/2010 239 a Actual 19 1/12/2011 6%
9/8/2010 220 a Actual 20 10/1512010 156%
5/27/2010 200 f Final Bill 6 5/27/2010 32%
3/8/2010 194 a Actual 5 4/1412010 -35%
12110/2009 189 a Actual 8 1/12/2010 -58%
9/9/2009 181 a Actual 20 10/15/2009 92%
6/412009 161 a Actual 9 7/20/2009 -26%
3/12/2009 152 a Actual 14 4/29/2009 -2%
1215/2008 138 aActual 13 1/20/2009 -21%
9/8/2008 125 a Actual 18 10/10/2008 -5%
6/4/2008 107 a Actual 17 7/16/2008 17%
3/10/2008 90 a Actual 15 4/11/2008 -17%
12/12/2007 75 a Actual 20 1/22/2008 4%
9/4/2007 55 a Actual 16 10/12/2007 -4%
6/14/2007 39 a Actual 19 7/20/2007 55%
44 Commercial Street
Raynham, MA
02767
Tel: (508) 880.0233
Fax: (508) 880-7232
L
INSPECTION AND TESTING AGREEMENT - -
Agreement entered into by and between Wastewater Treatment Services,Inc. (herein called WTS)and the
FAST'System OWNER(herein called OWNER) for the inspection by WTS of certain equipment of OW(VER
which is described below.
Upon acceptance of this agreement at WTS's office,WTS will render the following services only:
Equipment will be inspecte�atJl'eaast 1 time per year that this Agreement remains in effect,with the first _
inspections beginning I 1 1 111 These inspections will include:
1) Testing of the sludge depth in the septic tank.
2) Inspection,power testing and clean/replace intake filter of the air blower.
3) Inspection of the alarm system.
4) Inspect overall condition of FAST'System.
i
5) Notification to OWNER of any problems encountered.
6) Service other than routine maintenance will be billed at an hourly rate,plus travel and parts.
WTS shall notify the local Board of Health and Department of Environmental Protection in writing within 24
hours of a system failure or alarm event including corrective measures that have been taken.
OWNER will be billed standard WTS charges for any parts used in repairs or maintenance. Any additional labor
time will be billed to the OWNER at our current labor rates of$78.00.
Emergency service between regular inspections will be provided at standard labor rates during normal business
hours; at time and one-half after 5:00 PM and.on.Saturdays; and at double time on Sundays and holidays.
Emergency service charges will include a minimum four(4)hours of labor, plus standard WTS charges for parts,
plus mileage and travel charges. The annual rate includes routine maintenance,but does not include repairs
required for damages caused by abuse,accident,theft, acts of third persons, forces of nature,or alterations made to
the equipment. WTS shall not be responsible for failure to render the agreed services if caused by strikes,labor
disputes,non-cooperation by OWNER,or other factors beyond the control of WTS.
rf
OWNER agrees that WTS may enter OWNER's property and have acceptable access to all areas deemed by
WTS to be necessary or appropriate for WTS to perform its duties hereunder.
Current WTS practice is to send OWNER approximately 10 days before expiration of the term of the current
contract an invoice for one year of service. It is OWNER's responsibility to timely return the payment. WTS must
receive the payment before expiration of the current contract year to assure continuous contract coverage. Failure
to return payment may result in suspension of service, cancellation of the contract and/or nullification of
warranties, at the election of WTS.
1
OWNER may not assign this contract without the prior written consent of WTS. It will remain in force until a
party cancels by written notice to the other at the address given herein. -
MANUFACTURER MODEL NO. SERIAL NO. LOCATION ANNUAL RATE PERMIT
Bio-Microbics MicroFAST 25855 North Andover, MA $400.00 Remedial
Includes(2)Field Tests
EQUIPMENT OWNER ) Wastewater Treatment Services Inc.
*Signed by OWNER: )
Michael &Jennifer Cronan Sig i;;d:
*Address:
1312 Salem Street 44 Commercial Street
Raynham,MA 02767
Tele: (508) 880-0233
*City: State: Zip: Fax: (508) 880-7232
North Andov ) MA. 01845
Telephone_ 5r - `(� — �- � Effective Date of Agreement /O
E-mail address: IrIC
OWNER understands that(1) ANNUAL RATE payment is for one year only commencing on the effective date set
forth above and is non-refundable; and(2) Current DEP Regulations require OWNER to maintain a service
agreement for the life AofliejFA 'Sy stem. T HAVE READ AND UNDERSTAND THE FOREGOING.
/'*Signed by OWNER
Field Testing _
Onsite testing performed twice per year will be used to demonstrate that the systems are operating at a secondary
treatment standard of 30 mg/L of BOD5 and TSS. The following will be performed:
1) Visual examination of the effluent for color, turbidity and effluent solids.
2) Effluent pH to detennine if the waste water is between 6 and 9 standard units.
3) Dissolved Oxygen. .2m._^-../L or i-nore, to ensure that the systeim is o "ratin'-7.
4) Turbidity, less than or equal to 40 NTU.
If the effluent does not meet effluent quality standards, a grab sample will be collected for laboratory analysis.
Results sent to state and local Agencies as well as the'OWNER. OWNER is responsible for providing acceptable
access to effluent for field testing and/or to enable a grab sample to be taken for laboratory testing perfoniied. If
such laboratory sample is required, OWNER will be responsible for charges incurred. IF REQUIRED,THE
COST FOR THIS ADDITIONAL TESTING W L �190.00/VISIT.
*Approval for Additional Testing if Required
wner's Signature
Operator assigned: Michael Moreau _
Telephone: (508)989-274,4