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Home My WebLink AboutInspection - 67 RALEIGH TAVERN LANE 1/1/2012 IV—` I' � W RECIRCULATING SAND FILTER SYS"TE �, � ROUTINE INSPECTION ADDRESS: 67 Raleigh Tavern Lane, North Andover OWNER: Hamann DATE: June 5 2012 OPERATOR: Mark Cottrell SYSTEM STATUS Septic Tank Effluent Filter: 01- cleaned Scum Depth: 05/48" Sludge Depth 0 15/48" (Measured on November 15, 2011) Recirculating Pump Chamber Pump H-O-A Setting: Auto Pump Cycle Timer: 2 minutes on 15 minutes off Alarm Selector: On Level Alarm: Normal Exercise Pump: Yes Test& Clean Floats: O.k. cleaned Tank Condition: Good Dosing Pump Chamber Pump H-O-A Setting: Auto Pump Cycle Timer: On Demand Alarm Selector: On Level Alarm: Normal Exercise Pump: Yes Test& Clean Floats: O.k, cleaned Tank Condition: Good Sand Filter Sand Condition: Clean Diffusers Condition: Clear, flushed and brushed all (3) laterals Effluent Quality Visual Inspection: Clear, no odor Sample: pH= 7.0, Dissolved Oxygen =4.85 mg/L, Turbidity=4.56 NTU Comments: Flushed all five (5) laterals in SAS. Signature: Certificate # 11739 PO Box 825, Ipswich, MA 01938 - 978-356-0779 a Fax 978-356-5500 ® www.clearwaterindustries,com Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 KOF System Operation and l"Waintenance Inspection Checklist A. Installation & Service Information 67 Raleigh Tavern Lane June 5, 2012 Facility Street Address Date of Service North Andover Mark Cottrell/Clear Water Industries City Operator/O&M Firm Inspect& note B. Septic tank(s) if pumping is required. Sludge Pumping Required: Yes ❑ No X X Sludge Depth: 0" Inspect& clean effluent tee Effluent tee filter: Yes X No ❑ If yes, inspect X&clean at least yearly X filter. Clean as C. Recirculation tank necessary. Inspect for ❑ Check if sludge accumulating Pumping required: Yes ❑ No X sludge. Odor problems: Yes ❑ No X If yes,description Inspect for D. Equalization tank (if installed) sludge. ❑ Check if sludge accumulating Pumping required: Yes ❑ No ❑ Inspect pumps E. Pumps, switches, floats, alarm system &electrical switches, test X Pump Inspections (all units) as necessary. If problems,describe Run pumps in X Test pump alternator, or record hours Not applicable for this system manual mode. Hours of operation Record X Float switches 0.k. readings from Check all switches for operation meters & X Test alarm counters. If non-functioning,corrective action(s) Note if weeds & F. Recirculation Sand Filter debris are present on bed. X Inspect for ponding Ponding Present: Yes ❑ No X Clean/maintain bed surface to X Clean bed: Yes X No allow proper operation of the X Distribution pipes Flush: Yes X No Brush: Yes X No system. X Check head loss in pipes 0.k. Headloss and comments G. Sample Collection (Field Sample) Yes X No If yes: BOD TSS X pH ❑TN X Other- Dissolved Oxygen and Turbidity rsfcheck•6/7/12 Page 1 of 1 Ll Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/ reatment and Disposal Systems A. Installation Important: Darrell Hamann When filling out Owner forms on the computer, use 67 Raleigh Tavern Lane only the tab key Facility Street Address to move your North Andover 01845 cursor-do not use the return City Zip key. Mailing address of owner, if different: r� Street Address/PO Box: City State Zip ( ) - ext. Telephone Number B. Authorized Service Provider Clear Water Industries O&M Firm P.O. Box 825 Street Address Ipswich MA 01938 City State Zip (978) 356 -0779 ext. Telephone Number Mark Cottrell 11739 Certified Operator Name Certification Number C. Facility/System Information DEP ID Manufacturer ID Model Number Installation Date Start of Operation Approval Type: ❑ General ❑ Provisional ❑ Piloting ® Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information June 5, 2012 November 15, 2011 Inspection Date Previous Inspection Date 0" Sludge Depth(to be checked yearly) Pumping Recommended E] Yes ® No t5aiom.doc•rev. 11-07-05 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/ Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ❑ musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ❑ no ❑ some pH 7.0 SU DO 4.85 mg/L Turbidity 4.56 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection & during this inspection: Notes and Comments: Field sample was clear with no odor. t5aiom.doc•rev.11-07-05 Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title I/ Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, 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. June 5, 2012 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 31 st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31 t of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston, MA 02108 t5aiom.doc•rev. 11-07-05 Page 3 of 3 ✓ ° w AN RECIRCULATING SAND .FILTER SYSTEM ROUTINE INSPECTION ADDRESS: 67 Raleigh Tavern Lane North Andover OWNER: Hamann DATE: December 11, 2012 OPERATOR: Mark: Cottrell SYSTEM STATUS Septic 'Tanis Effluent Filter: O.k. cleaned Scum Depth: 0"/48" Sludge Depth 0"/48" (Measured on November-15, 2011) Recirculating Pump Chamber , Pump H-O-A Setting: Auto Pump Cycle Timer: 2 minutes on 15 minutes off Alarm Selector: On Level Alarm: Normal Exercise Pump: Yes Test & Clean Floats: O.k. cleaned Tank Condition: Good Dosing Pump Chamber Pump H-O-A Setting: Auto Pump Cycle Timer: On Demand Alarm Selector: On Level Alarm: Normal Exercise Pump: Yes Test & Clean Floats: O.k. cleaned Tank Condition: Good Sand Filter Sand Condition: Clean Diffusers Condition: Clear, flushed and brushed all (3) laterals Effluent Quality Visual Inspection: Clear, no odor Sample: pH= 6.9, Dissolved Oxygen= 5.2 mg/L Turbidity =4.22 N I'U Comments: Flushed all five (5) laterals in SAS on June 5 2012 Signature: r= Certificate # 11739 PO Box 825, Ipswich, MA 01938 ® 978-356-0779 d Fax 978-356-5500 ® www.clearwaterindustries.com Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 ion and Maintenance Inspection Checklist A. Installation & Service Information 67 Raleigh Tavern Lane December 11, 2012 Facility Street Address Date of Service North Andover Mark Cottrell/Clear Water Industries City Operator/O&M Firm Inspect& note B. Septic tank(s) if pumping is required. Sludge Pumping Required: Yes ❑ No X X Sludge Depth: 0" Inspect& clean effluent tee Effluent tee filter: Yes X No ❑ If yes, inspect X & clean at least yearly X filter. Clean as C. Recirculation tank necessary. Inspect for ❑ Check if sludge accumulating Pumping required: Yes ❑ No X sludge. Odor problems: Yes ❑ No X If yes,description Inspect for D. Equalization tank (if installed) sludge. ❑ Check if sludge accumulating Pumping required: Yes ❑ No ❑ Inspect pumps E. pumps, switches, floats, alarm system & electrical switches, test X Pump Inspections (all units) as necessary. If problems,describe Run pumps in X Test pump alternator, or record hours Not applicable licable for this system _ manual mode. Hours of operation Record X Float switches 0.k. readings s & X Test alarm from meteCheck all switches for operation meter counters. If non-functioning,corrective action(s) Note if weeds & Recirculation and Filter debris are present on bed. X Inspect for ponding Ponding Present: Yes ❑ No X Clean/maintain bed surface to X Clean bed: Yes X No allow proper operation of the X Distribution pipes Flush: Yes X No Brush: Yes X No system. X Check head loss in pipes O.k. _ Headloss and comments G. Sample Collection (Field ample) Yes X No If yes: BOD TSS X pH ❑TN X Other- Dissolved Oxygen and Turbidity rsfcheck• 12/19/12 Page 1 of 1 Massachusetts Department of Environmental Protection LAI DEP Bureau of Resource Protection - Title 5 Approved Inspection and O&M Form for Title 5 I/ Treatment and Disposal Systems A. Installation Important: Darrell Hamann When filling out Owner forms on the computer, use 67 Raleigh Tavern Lane only the tab key Facility Street Address to move your North Andover cursor-do not 01845 use the return City Zip key. Mailing address of owner, if different: Street Address/PO Box: retwn City State Zip ( ) - ext. Telephone Number B. Authorized Service Provider Clear Water Industries O&M Firm P.O. Box 825 Street Address Ipswich MA 01938 City State Zip (978) 356 -0779 ext Telephone Number Mark Cottrell 11739 Certified Operator Name Certification Number C. Facility/System Information DEP ID Manufacturer ID Model Number Installation Date Start of Operation Approval Type: ❑ General ❑ Provisional ❑ Piloting ® Remedial Seasonal Residence— used less than 6 mo./year: ❑ Yes ® No D. Operating Information December 11, 2012 June 5, 2012 Inspection Date Previous Inspection Date 0" Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev.11-07-05 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/ Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ❑ musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ❑ no ❑ some pH 6 to 9 U DO 2.2 greatC� Le- Turbidity . o2lN U Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection & during this inspection: Notes and Comments: Field sample was clear with no odor. t5aiom.doc•rev. 11-07-05 Page 2 of 3 Massachusetts Department of Environmental Protection l� Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/ Treatment and Disposal Systems H. Certification certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, 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. December 11, 2012 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 31st of each year for the previous calendar year Piloting Use -within 45 days of inspection date Provisional Use—by March 31 t of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston, MA 02108 t5aionn.doc•rev. 11-07-05 Page 3 of 3