HomeMy WebLinkAboutMiscellaneous - 43 MILL ROAD 1/13/2005 44 C;,orrMierd of Street
R aphr:am, PEA
02707
..reo: (08) 880-0233
Fax: (508) 80-723
January 13, 2005
North Andover Board of Health
27 Charles Street
North Andover, MA 01845
Attention: Board of Health Agent
Reference: Home FAST Treatment
Serial Number: 24428
Attached please find a copy of the Product Registration Report for the FAST Treatment
System for work performed on 01/04/2005 at the home of Karl Kober located at 43 Mill
Road,North Andover, MA. Also, attached is a copy of the fully executed Inspection&
Effluent Testing Agreement.
If you have any questions or require additional information please do not hesitate to call.
Sincerely,
� f
Donna L. Callahan
Enclosures
W I Q
=PO INCORRATED
8450 Cole Parkway w Shawnee, KS 66227 w Phone 913-422-0707 ,m Fax: 912-422-0808
e-mail: onsiteObiomicrobics.com w www.biomicrobics.com W 800-753-FAST(3278)
PRODUCT REGISTRATION REPORT
Product Registration Report must be completed and returned to Bio-Microbics, Inc. in order to effect warranty.
Date of Start-U /" OJ Date Shipped to End User 11/10/04 Serial# 24428
OWNER
NAME Karl Kober
ADDRESS 43 Mill Road
CITY/STATE/ZIP North Andover,MA 01845
PHONE/FAX
BIO-MICROBICS DISTRIBUTOR
NAME rRaynharn,astewater Treatment Services,Inc.
ADDRESS Commercial Street
CITY/STATE/ZIP MA 02767
PHONE/FAX 8-880-0233 FAX: 508-880-7232
INSTALLER
NAME John Souc
ADDRESS 830 Livingston Street
CITY/STATE/ZIP Tewksbury,MA 01876
PHONE/FAX 978-470-1400
CONSULTING ENGINEER if applicable
NAME Benjamin Osgood )
s ood
ADDRESS P.O.Box 536
CITY/STATE/ZIP North Andover,MA 01845
PHONE/FAX 978-686-1768
Good Bad NA Good Bad NA
ELECTRICAL PANEL(S) TREATMENT UNIT(S)
Visual Alarm Operating ❑ Q Air vent clear �j Q
Audio Alarm Operating C3 C3 Septic tank level 7 Q
BLOWER(S) Septic tank meets min. size ( Q
Wired for correct voltage Q Septic tank filled to Q� Q
Inlet/outlet piped correctly operating level
[� ❑ 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 ❑� Q Q Treatment unit to septic tank ❑
treatment unit
Air line clear ❑ Entrance tube to insert cover ❑ ❑
Air inlet screen clear ❑ Insert to insert cover [� ❑
Blower hood vents clear Q ❑ Discharge line connection 9/ ❑
Factory Authorized Personnel: Title: <
Firm: Wastewater Treatment Services Inc. Date:
uu
` �a��u��nfcr ��eatinc�� c1L/'UCCE.S , � .
44 Commercial Street
Please complete all items marked• Raynham, MA
including three signatures. Mail 02787
signed original contract to:
"Vastawutcr Treatment ticrvice Inc
44 Commerci1l r t Tel: (508) 880-0233
&yallam.MA 02767 Fax: (508) 880-7232
INSPECTION AND EFFLUENT 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 OWNER which is described below.
Upon acceptance of this agreement at WTS's office, WTS will render the following services only:
Equipment will be inspected at lea�4 times per year that this Agreement remains in effect, with the first
inspections beginning — -off . These inspections will include:
1) Testing of the sludge depth in the septic tank.
1) Inspection, power testing and clean/replace intake filter of the air blower.
1) Inspection of the alarm system.
1) Inspect overall condition of FAST'System.
1) Notification to OWNER of any problems encountered.
1) 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 standard labor rates of$74.00 per hour.
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.
OWNER understands and agrees that WTS is not responsible for special, incidental or consequential
damages, including loss of time, injury to person or pruperty, or equipment failure.
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.
This is a two-year contract which will be billed annually. All payments are non-refundable. OWNER's
failure to pay invoices promptly or to otherwise comply with this contract may result in suspension of
service, cancellation of contract and/or nullification of warranties,at the election of WTS. This
agreement is not assignable without the consent of WTS and will remain in force until canceled by either
party through written notice.
MANUFACTURER MODEL NO. SERI 1. NO. LOCATION ANNUAL RATE
Bio-Microbics MicroFAST ���/ North Andover, MA 5390.00
EQUIPMENT OWN Wastewater Treatment Services Inc.
*Signed by OWNER;
Karl obey Signed: 6\�
'"Address:
43 Mill Road 44 Co ercial Street
Raynham,MA 02767
Tele: (508) 880-0233
*City: State: Zip: Fax: (508) 880-7232
North Andover MA 01845 l
Telephone 617-967-5298 Effective Date of Agreement / — y" 6
.Daytime Telephone:
OWNER understands that(1) ANNUAL RATE payment is for one year only of this two-year agreement
and is non-refundable; and (2) Curre
FOREGOING. n PEP Regulations require OWNER to maintain a service
agreement for the life of the FAST Ste A READ AND UNDERSTAND THE
*Signed by OWNER:
Effluent Testing
Effluent sample taken 4 times per year and delivered to a qualified testing lab for evaluation. Results
sent to State and local Agencies as well as the OWNER. OWNER is responsible for providing
acceptable access to effluent to enable a grab sample to be taken for laboratory testing performed.
PERMIT:
*(PLEASE CHECK ONE) ( ) GENERAL (A)REMEDIAL ( )PROVISIONAL
*SPECIAL CONDITIONS PER LOCAL BOARD OF HEALTH(Y) or(N)if YES,please attach copy of
permit
(X)pH, BOD5, TSS ( )Other:
*Cost for testing: $180.00
Operator assigned: Willia
Telephone: (50814 *Engineer: Benjamin Osgood
*Approval for Effluent Testing