HomeMy WebLinkAboutInspection - 151 RALEIGH TAVERN LANE 5/16/2002 fC,TC.,/C:�,4-f. , t._t✓(fr5..f.
44 Doruii'ierc,al h'eef
F�layiiharii, MA
02767
Tel: (5040 880-.0233
Rix: (508) 880-7232
May 23, 2002
North Andover Board of Health
27 Charles Street
North Andover, MA 01845
Attention: Health Agent
Reference: Single Home FAST® Treatment System
Serial Number: MCF215
Attached please find the Field Inspection& Service Report (as required) for services
performed on 5/16/2002 at the home of Paul Antinori located at 151 Raleigh Tavern Lane
-North Andover, MA.
Please call if you have any questions or require additional information.
S' cerely,
net M. Whitman
Enclosures
Copy to: Paul Antinori
% 1
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
ONE WINTER STREET, BOSTON, MA 0'2108 617.292.5500
DEP Approved inspection and_O&h[ Norm for Title 5 UA Treatment and Disposal Systems
Installation Authorized Service Provider
Installation Address: O&NI Firm:
151 Raleigh Tavern Lane:
North Andover
4�asrecoatrr��eatmerr�Iurxcea%, �ieo.MA Owner Name: Ntail Address:
Paul Antinori 44 Commercial Street,Raynham,MA 02767
Tel:(508)880-0233 Fax:(508)880.7232
Nail.Address: 151 Raleigh Tavern Lane
North Andover,MA 01845 Telephone No. - - -
Telephone No.:
9786824271 Certified Operator Name: / ��� l
DEP N°.: Mfr. No.: MCF215 cart.No.: Il 7 3
Model No.: Installation Date: Start of Operation:
M(Cro FOS7-
9/21/98
Approval Type: (Circle) Seasonal 'deuce-used less than 6 mo./year: (Circle)
General Provisional Piloting Remedial Yes No
Operating Information I
Previous Inspection Date: Inspection.Date: Sludge Depth:(to be checked yearly) Pumping Recommended(Circle) I
Yes No
Effluent Description: Attach copy of certified.lab results. I'
Check all that are required
Samples:Influent Effluent
r,4 Parameters: pH BOD TSS TN
Other Other Other
Description of Overall System Condition: Description of any Maintenance Performed since Previous Inspection
and During this Inspection:
I
Notes and Comments:
I certify: I have inspected the sewage treatment and disposal system at the address above, have completed this report and the
attached manufacturer's operation and maintenance checklist, and the information reported is true, accurate, and complete as
of the time of the ' spection. I am a ,Massachusetts certified operator in accordance with 257 CMR 2.00.
�x �/wok
Operator Signature Date
System owner must submit Remedial Use-by January 3 l"of Department of Environmental
this report, manufacturer's each year for the previous calendar Protection
0&;*VI checklist, and any year Attn: Title 5 Program
required sampling results Piloting & Provisional Use - within One Winter Street, 6`" Floor
to the local Board of Health 3O days of inspection date Boston, �.*V[.A 02108
General Use -by September 30''of
and DEP as follows for each year for the previous 12 months
each inspection performed:
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I N C 0 R P 0 R A T E 0
8450 Cole Parkway ■ Shawnee, KS 66227 .Phone 913-422-0707. Fax: 912-422-0808
e-mail: onsite0lbiomicrobics.com .www.biomicrobics.com n 800-753-FAST(3278)
FIELD INSPECTION & SERVICE REPORT
For Bio-Microbics Single Home FASTS System
INSTALLATION AUTHORIZED SERVICE PROVIDER
151 Raleigh Tavern Lane
Installation Address North Andover,MA 01845 4�asGrcuat�Jai eabneirG cl�rvnce� 9rz�
Owner Name Paul Antinori
Mail Address 151 Raleigh Tavern Lane 44 commercial street,Raynham,MA 02767
North Andover, MA 01845 Tel:(508)880-0233 Fax:(508)880-7232
—9ty State Zip
9786824271 _ _ 508-880-7232
Phone Fax e-mail Phone Fax e-mail
AL,I ATION1Nk'ORT.4TIQN '' r
Model No. Serial No. Date of Installation Date of last pumpout
MCF215 9/21/98
E UIPM1rNT .R ;AND CD_
_.
Electrical Panel(s)
Visual Alarm Operating
Audio Alarm Operating
if present)N
L
Blower(s)
Air Inlet Filter Clean
Blower Hood Vents Clear
Excessive Noise
Excessive Vibration
Treatment unit(s)
Unusual Odor
Pum out Required:
Primary Settling Zone
Aerobic Treatment Zone
EFFLUENT(optional) LEVM RESULT
Estimated Dailv Flow 4 Bedrooms
H(Standard Units) 6-9 S.U.
Color Clear
Temperature
Odor Slightly
musty odor
(not se tic)
TECHNICIAN SIGNAT SERVI E DA E
S