HomeMy WebLinkAboutInspection - 369 SALEM STREET 5/13/2003 ........................ .......
44 C=nelrdal Sheet
Ray'Oiarn, MA
02767
Tek (508) 880-0233
Fax: (508) 880.723
May 13, 2003
North Andover Board of Health
27 Charles Street
North Andover, MA 01845
Attention: Health Agent
Reference: Single Home FAST Treatment System
Serial Number: SHF13
Attached please find the Field Inspection & Service Report(as required) for services
performed on 05/06/2003 at the property of Amit Banerji located at 369 Salem Street -
North Andover, MA.
Please call if you have any questions or require additional information,
Sincerely,
Wastewater Treatment Services, Inc.
Service Department
Enclosures
Copy to: Amit Banerji
Massachusetts DEP
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL, AFFAIRS
DEPARTMENT OF ENvIRONMENTAL PROTECTION
ONE WINTER STREET, BOSTON, MA 02108 617.292.5500
DEP Approved Inspection and O&NI Form for Title 5 UA Treatment and Disposal Systems
Installation Authorized Service Provider
(nstallation Address: 369 Salem Street, O&M Firm:
North Andover
MA Yyizr�e�uater ✓�reatnien.G Jrruier�, ,Iir,�
Owner Name: Mail Address: �-
Amit Banerji
369 Salem Street Commercial Street,Raynhem,MA 02767
Mail address: North Andover,MA 01845 Tel:(508)980-0233 Fax:(508)880.7232 j
9785579154 Telephone No.: __
Certified Operatof Nama:
Telephone No.:
DEP No.: Mfr. No.: Cart.No.:
i
Model No.: Installation Date: Start of Operation:
PA i cro FR 5 7- 1 9/4/98
Approval Type: (Circle) Seasonal 'deuce—used less than 6 mo./year: (Circle)
General Provisional Piloting Remedial Yes No
Operating Information
Previous Inspection Date: Inspection Date: Sludge Depth:(to be checked yearly) Pumping Recommended(Circle)
r Yes No
Effluent Description: Attach copy of certified lab results.
Check all that are required
C G Samples: Influent __ Effluent
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: C,
6 l�
3' , Ps
Notes and Corrtnlerts:
I certify: I have inspected the sewage trea ent and disposal system at the address above, have completed this report and the
attached 7tes op [ion d m tenance checklist, and the information reported is true, accurate, and complete as
of the timctio . I am Ma chusetts certified operator in accordance with 257 CMR 2.00.
or Slgw&mre Date
System own r must submit Remedial Use-by January 3 l"of Department of Environmental
this report, manufacturer's each year for the previous calendar Protection
O&M checklist, and any year Attn: Title 5 Program
Piloting & Provisional Use - within
required sampling results One Winter Street, 6'" Floor
to the local Board of Health 30 days of inspection date Boston, L*YIA 02108
and DEP as follows for General Use—by September 30'h of
each year for the previous 12 months
each inspection performed:
511101
a.
�r
e ' Q
INCORPORATED
8450 Cole Parkway ■ Shawnee, KS 66227 u Phone 913-422-0707® Fax: 912-422-0808
e-mail: gnsiteAbiorn1crobics com a www.blomicrobics.com ■ 800-753-FAST(3278)
FIELD INSPECTION & SERVICE REPORT
For Bio-Microbics Single Home FAST® System
a x _ rE v'`a 9l Y•4,Y1nfr?: rr1 1,:�. §Y,+i i d � M, ilp•sY' • 'rW1.M1.u-111}x ?(�Y� z}1a� ?Y '.F
INSTALL 'T0ION
,, UTI-�ORIZE SERVICE PRbV�ID
.. .,.... _.:y..,:.n .a/i.t'a�k»'h+ra»Y±Jr _ v,,.y w;m.lJ'AV ...;.v.,kJ, •w.+i,.....+,..•.«vi,.. a-.ia..cua .dw l�'�rta.R+.-.., 7 t3:
369 Salem Street w
Installation Address North Andover,MA 01845
Owner Name Amit Banerji
Mail Address 369 Salem Street ..44 commercial street,Raynham,MA 02767
North Andover, MA 01845 Tel•(508)880-0233 Fax:(508)880-7232
city State ..Zip
9785579154 _ 508-880-7232
Phone Fax e-mail Phone Fax
e-mail
�`� �' ����L� �1����_ Q�•N`z�1VF`C�.RI�A�p.��`�� -'��.� � . s>.,,:z� ., a
Model No. Serial No. Date of Installation Date of last pumpout
SBF13 9/4/98
�E. I11t t•} Qfi 'itrra�rrtj
Electrical Panel(s)
Visual Alarm Operating
Audio Alarm Operating
if resent
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(options]) LEMaT RESULT
Estimated Daily Flow 4 Bedrooms
H(Standard Units) 6-9 S.U.
Color Clear
Temperature
Odor Slightly
musty odor
(not se tic)
TE CHMCfAN SIGNATURE SERVICE DATE