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HomeMy WebLinkAboutMiscellaneous - 1312 SALEM STREET 12/13/2005 16-DEC-06 11:39AM FROM-JRENCPROD +15095547232 T®617 P.01/04 F°364 44 Commercial Street Raynham, MA 012767 Tel: (508) 880-0233 Fax: (508) 8807232 December 15,2045 '�E �FII i North Andover Board of Health 404 Osgood Strut North Andover,MA.01845 ���E C; G(AN N1 71 Attention: Board of Health Agent Reference: Home FAST Treatment Serial Number: 25855 Attached please find a copy of the Product Registration Report for the FAST Treatment System for work performed on 12/13/2005 at the home of Gay Neilson located at 1312 Salem Street,North Andover,MA. Also, attached is a copy of the fully executed Inspection&Effluent Testing AgTeement. If you have any questions or require additional information please do not hesitate to call. Sincerely, Manna.E, Callahan Enclosures 15-DEC-05 11 :39AM FROM-JRENGPROD +15088807232 T-617 P.02/04 F-364 am, P 3 R A T E 0 8450 Cole Parkway w Shawnee, KS 66227 m Phone 913-422-0707 m Fax: 912-422,0808 e-mail: ons" big ' obics.c m www iomicrobic+ .rom o 804-753-FAS�T(3278) �.J .!. i PROD I I ^ 1 Product Registration Report must be completed and returned to Bio-Microbics, Inc,in order to effect warranty. date of Stazt-U 1-63 bate Shipped to End User 11/15/05 Serial#25855 OWNER NAME Gay Neilson ADDRESS 1312 Salem Street CITY1STATEIZIP North Andover,MA 01845 PHONEIFAX 810-MICROBICS DISTRIBUTOR NAME Wastewater hvatment Services,Inc. ADDRESS 44 Commercial Street CITYISTATE/ZIP Raynh=4 MA 02767 PHONE/FAX 508-880-0233 FAX: 508-880-7232 INSTALLER NAME Sous 's Sewer ADDRESS P.O.Box 4158 CITY/STATE/ZIP Andover,MA 01810 PHONE/FAX 978-470-1400 CON§OL.TING ENGINEER if s licable . NAME New n land ET1 ineerin ADDRESS P.O.Box 535 CITY/STATEIZIP North Andover,MA 01845 PHONEIFAX 978-686-1768 Good Bad NA Good Bad NA EI-ECTRICAI_PANEI_(S) TREATMENT UNIT(S) Visual Alarm Operating ❑ J Air vent clear ❑ Audio Alarm Operating ® Septic tank level E, ❑ BLOW ER(S) Septic tank meets min.size Y L3 Wired for correct voltage ❑ Septic tank filled to [� ❑ operating level Inlet/outlet piped correctly Air Lift Operation Filter element installed [] Recirculation tube in place [ ❑ Blower hood secure ❑ Fasteners tight ❑ Blower works correctly ❑ WATER-TIGHT JOINTS Blower located within 100'of L) ILj Treatment unit to septic tank IL treatment unit 4 ❑ Air line clear L] Entrance tube to insert cover Air inlet screen clear ~❑ Insert to insert cover PEE Blower hood vents clear Li Discharge line connection :=' Title- factory Authorized personnel: Date: Firm: Wastewater Treatment Services Inc_ 15-DEC-05 11 :39AM FROM-AMPROD +15088807232 T-617 P.03/04 F-364 u,1•'gym-V; 11 14,dA FROM-AMPROD Ft:;ynhami, MA E'r9u:•c.►r►'►tlotasn items motk�e* C.;767 i,06iin;tbve0Infivi a, M94 9itdr,'1'o��tir�tGOtapaacSa; . ?llldt#?x{' L Tirl: (601,)831) 9t:,CS11i ialfe F'a ix: rnrspxrr > r.�Ecn E ? , aiio=at catered itlta by? ad'b w"r►'Wptew$iter'l�re�taaaent e►wrle ,lac.(her�;in c ll�s l WTS)a,°:� A►; 15-DEC-05 11 :40AM FROM-AMPROD +15088807282 T-617 P•04/04 F-864 II.S�VO'��'t! 11 14,IM rKUr�®�RGnur�u� ' All a me�tt�are rlor�-x fu�ciabl�s. �0�w?r Clt two., aQntrnt w3 .lxilled annually. P y ,;nsiau of s' with.this contract may'resuit ill I;U!,l' j',�(17a� �";p�x<;ir,'vc�•{c��p�� at1yV.�Ak':��.+�t��r�vise cam�+lY S• *I his r r unification of wrarl anties,at the electic i at'`►�V'1�' isa#�c611arign of ems�tx�66 io 4d( .�3; i.tt]�E�r t,l} j; �li�3it.a$ iot asiakale wlr, iut eke consent of WK'S and will remain in force u��al carp!led�, r ; Forth Andover,MP, I; 90 C0 " astern e�Treatin t knjLr:5, !(nc, :,• pd,by fie • 1 Alld es�: 44 Commercial Street i 1 Ss ctin Snret RaynhMt,MA 02767 Tele: (Sp$)880-0233 State: dip:_ Fax:(508) 880-7232 I ( ,;, A.d MA. 01945 G o v Effective Date o#'A �ernr�r :ejtTh0- 97R-6 5- 4 i1:101 imc Telephone: 1;1'�i' t l ut►derstartds that(1)A�11�UA�r�-ATE payment is for Gibe year c+nCY of thifl tw'o•ya)r ag�retrment t.tl'. is,1ltSIS ri,Fttt'id8blty and( ) ttnet'it DEl? JJ OWNER AVE READ AND D 1'S�ERSTAXM T ID'tee al f,)r the life of the VASrSyStCl� ,SjpT�e4 by DW R: r "'f1y �Test sarhple takezt 4 times year and he OWNER. OWNER responsible f)r prCM ling st�:lt$for ev, ip .,t&t4:and 1paal Agencies as Well as the ;tc ��l,ta1sle 4:cGnss to effluent tp ena��e a Drab sample to be taken for laboratory testa:ag lie��!;:rtted- AL CONDITION PER.LOCAL BOARD OF HEALTH (�or(l`I)if YES,pletss,; :�,tech aol�y �t ;'rr4t�t BODs,TSS (.)0 ther, t Ming: 918(kU0 Et�ere� t �ierat��asiued: iia *Engineer,Nov Enlrl�:x.,,:En$i�YCe�.46; r,sl,e,� >►IIe: 0 4,"86 " .pl sro vi31 Fnr E£fluerit Testio -� ' ��I�COV�f1 ,3 Si�,I18t1dTe