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HomeMy WebLinkAboutInspection - 333 RALEIGH TAVERN LANE 1/1/2004 ..................................................................................................................................................................................................................................................... 44 Go�'nniwdal Street Rapharii, MA 02. 0.7 'rei. (508) 880-0233 ax: (1508) 880-7232 May 19, 2004 North Andover Board of Health 27 Charles Street North Andover, MA 01845 Attention: Health Agent Reference: Single Home FAST@ Treatment System Serial Number: MCF156 Attached please find the Field Inspection& Service Report (as required) for services performed qg-0,511,112004,at the property of Thomas Shea located at 333 Raleigh Tavern Lane -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 Shea Massachusetts DEP Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Li Approved Inspection and O&M Form for Title 1/A Treatment and Disposal Systems 3033 A. Installation Important: Thomas Shea When filling out Owner forms on the computer,use 333 Raleigh Tavern Lane only the tab key Facility Street Address to move your North Andover 01845 cursor-do not City Zip use the return key. Mailing address-of owner, if different: 333 Raleigh Tavern Lane Street Address/PO Box: North Andover MA 01845 n City State Zip (978 262 8674 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 MCF156 Bio-Microbics, Inc. MicroFAST .5 DEP ID Manufacturer's Name&ID Model Name&Number 11/05/1998 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 05/11/2004 -- Inspection Date Previous Inspection Date 20.0" Pumping Recommended X Yes No Sludge Depth(to be checked yearly) — Color: N/A Odor: None — Effluent Description Page 1 of 2 DEPMicroFASTnew.doc•5/19/04 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title.5 DEP Approved Inspection and OM Form for Title`5 I/A Treatment and Disposal Systems 3033 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: t F. Certification 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 05/11/2004 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 30 of each year for the previous calendar year date previous 12 months Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6`h Floor Boston. MA 02108 Page 2 of 2 DEPMicroFASTnew.doc•5/19/04 U4WI 8450 Cole Parkway Shawnee, KS 66227 Phone 913-422-0707 m Fax: 912-422-0808 3033 e-mail: onsiteCED b iomicrobics.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 333 Raleigh Tavern Lane Installation Address North Andover,MA 01845 Name Wastewater Treatment Services,Inc. Owner Name Thomas Shea Street Mail Address: Mail Address 44 Commercial Street 333 Raleigh Tavern Lane Raynham, MA 02767 North Andover,MA 01845 City State Zip 508-880-0233 508-880-7232 Phone 978 262 8674 Fax e-mail Phone Fax e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pump out MicroFAST.5 MCF156 11/05/1998 EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS Electrical Panel(s) Visual Alarm Operating 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 Required: X Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LIMIT RESULT Estimated Daily Flow 3 Bedrooms H Standard Units Color N/A Temperature Odor None Comments: TECHNICIAN_v _ SERVICE DATE Michael Dillen 05/11/2004 ",/,( , ........... 44 CWTO'viercial Street .................. ............. Flaynhan't, MA 02767 TeL (1508) 880-0233 Fax:: (5C)8) 8801232 November 18, 2004 O Y,' 9 North Andover Board of Health 27 Charles Street North Andover, MA 01945 Attention: Health Agent Reference: Single Home FAST@ Treatment System Serial Number: MCF156 Attached please find the Field Inspection & Service Report (as required) for services performed on 11/11/2004 at the property of Thomas Shea located at3'3 3 Raleigh Tavern Lane -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 Shea Massachusetts DEP Massachusetts Department of Environmental Protection Bureau of Resource Protection Title 5 DEP A r©u� Ins ectian aI3M Form fQr Tie I/ Pp , Treatment and DIsposa�' ysems 3033 A. Installation Important: Thomas Shea When filling out Owner forms on the computer,use 333 Raleigh Tavern Lane only the tab key Facility Street Address to move your North Andover 01845 cursor-do not City Zip use the return key. Mailing address of owner, if different: 4� 333 Raleigh Tavern Lane Street Address/PO Box: North Andover MA 01845 ----__—_- R""' City State Zip (978 262 8674 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 MCF156 Bio-Microbics, Inc. MicroFAST .5 DEP ID Manufacturer's Name&ID Model Name&Number 11/05/1998 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 11/11/2004 — 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•11/18/04 Page 1 of 2 Massachusetts Department of Environmental protection Bureau of Resoufce Prptectjon -Title 5 , . . DAP ppl ova � to C i©lr 'and NV'14-F0 far Title 5 I/A Tw•ea�im®nt anc����g�,bsal Syst �ns 3033 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: Alarm inside - not accessible. 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 11/11/2004 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 31 st 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•11/18/04 Page 2 of 2 z ii�P` 0 A ATE O 8450 Cole Parkway Shawnee, KS 66227 moPhone 913-422-0707 tu Fax: 912-422-0808 3033 e-mail: onsite(d)-biomicrobics.com G www.biomicrobics.com o 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FASTO System INSTALLATION AUTHORIZED SERVICE PROVIDER 333 Raleigh Tavern Lane Installation Address North Andover,MA 01845 Name Wastewater Treatment Services,Inc. Owner Name Thomas Shea Street Mail Address: Mail Address 44 Commercial Street 333 Raleigh Tavern Lane Raynham, MA 02767 North Andover,MA 01 845 City State Zip 508-880-0233 508-880-7232 Phone 978 262 8674 Fax e-mail Phone Fax e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pump out MicroFAST.5 MCF156 11/05/1998 06/01/2004 EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating 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 Required: X Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LIMIT RESULT Estimated Daily Flow 3 Bedrooms H Standard Units) Color N/A Temperature Odor None Comments: Alarm inside-not accessible. TECHNICIAN SERVICE DATE Michael Dillen 11/11/2004