HomeMy WebLinkAboutInspection - 121 RALEIGH TAVERN LANE 6/3/2005 aG C)YT1YYIf„nP"C ial h'Ga'et
Rap ham, MAC
0 767
del: (508) 880-0233
Fax: (508) 880-7232
June 3," 00
W RECEI IED
JU
E a,r
North Andover Board of Health HEAL_
27 Charles Street
North Aitlover, Mfg 01 845
Attention: Board of Health Agent
Reference: Home FAST Treatment
Serial Number: 24747
Attached please find a copy of the Product Registration Report for the FAST Treatment
System for work perfornned on 05/24/2005 at the home of Michele Harrison located at
121 Raleigh Tavern Lane, 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,
Donna L. Callahan
Enclosures
t � Q
e
fMC0RPOR.ATED
8450 Cole Parkway w Shawnee, KS 66227 m Phone 913-422-0707 w Fax: 912-422-0808
e-mail: 2n1ite2b1om1crobi0 com m 45Y.-btainlcrobics com m 800-753-FAST(3278)
PRODUCT REGISTRATION REPORT
Product Registrat bn Report must be completed and returned to Bio-Microbics, Inc. in order to effect warranty.
��
Date of Start-U ` `��� Date Shinned to End User 4/13/05
Serial #24747
OWNER
NAME Michele Harrison
ADDRESS 121 Ralei h Tavern Lane
CITY/STATE/ZIP North Andover,MA 01845
PHONE/FAX
810-MICROBICS DISTRIBUTOR
NAME Wastewater Treatment Services,Inc.
ADDRESS 44 Commercial Street
CITY/STATE/ZIP Ra MA 02767
PHONE/FAX 508-880-0233 FAX: 508-880-7232
NAME INSTALLER
John Souc
ADDRESS 830 Livingston Street
CITY/STATE/ZIP Tewksb ,MA 01876
PHONE/FAX 978470-1400
CONSULTING ENGINEER if applicable)
NAME New England En ineerin
ADDRESS P.O.Box 536
CITY/STATE/ZIP North Andover,MA 01845
PHONE/FAX 978-686-1768
ELECTRICAL PANEL(S) Good Bad NA Good Bad NA
Visual Alarm Operating TREATMENT UNITS)
\-0 ❑ O Air vent clear
Audio Alarm Operating ❑ ❑ Septic tank level 13\� ❑
BLOWER(S)
Septic tank meets min. size \m ❑
Wired for correct voltage [j Septic tank filled to
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
treatment unit ❑ ® Treatment unit to septic tank
Air line clear \ ❑ Entrance tube to insert cover
Air inlet screen clear ❑ ❑
® ❑ ❑
Blower hood vents clear Insert to insert cover
❑ Discharge line connection ❑
" s Factory Authorized Personnel:
Title: v
F
09-FEB-05 09:31AM FROM-JRENGPROD +15088807232 T-293 P 02/03 F-570
'11`14'lew(rCiw
44 Commerclal Street
Pleae cotnpkna all item nu teed® Raynham, MA
including duw sipatum, Mail 02767
sigmd original contmi to:
MiAtMater Treatment S=iccs.Inru Tel: (508) 880-0233
44 Corrowrcigl street Fax: (508) 880-7232
a mham�MA_Q7767
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 lev 4 times per year that this Agreement remains in effect,with the first
inspections beginning. d'. These inspections will include:
1) Testing of the sludge depth in the septic tank.
2) Inspection,power testing and clean/replace intake filter of the air blower.
3) Inspection of the alarm system.
4) Inspect overall condition of FAST' System.
5) Notification to OWNER of any problems encountered.
*6) Inspection of Septic Tank and Pump Chamber
*7) Inspection of pump and pump cycle
*8) Inspect/clean floats
9) 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. WT 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 property, or equipment failure.
OWNER agrees that WTS may enter OWNER.'s property and have acceptable access to all areas
deemed by W17S to be necessary or appropriate for WTS to perform its duties hereunder.
TIUV0000444 03/03 F®570
This is a two-year contract which will be billed annually. All payments are non-refundable. R'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. SERIAL NO. LOCATION A_ NNUAL RATE
Bio-Microbics MicroFAST aW7 517 North Andover,MA $390.00
EO MEIVT OWNEE Wastewater Treatment Services,Yne.
*Signed by OWNER.-
Michelle Harrison Signed:
*Address: 9
121 Raleigh Tavern Lane 44 Commercial Street
Rayr:han M—A.02767
Tele: (508)823.9564
*City: State: Zip: Fax: (508) 880-7232
North Andover MA 01845 .-�
Telephone 978-794-9526 Effective Date of Agreement
Daytime'Telephone,
OWNER understands that(1)ANNUAL RATE payment is for one year only of this two-year agreement
and is nonrefundable; and(2)Current DEP Regulations require OWNER to maintain a service agreement for
the life of the FAST'System. I RApp VE READ AND UNDERSTAND FOREGOING.
Signed by OWNER: 'e P
Effluent Testin
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 ( X)REMEDIAL, ( )PROVISIONAL
*SPECIAL CONDITIONS PER LOCAL BOARD OF HEALTH(Y)or(I)if YES,please attach copy of permit
(X)pH,BOD5,TSS ( )Total Nitrogen ( X )Other per Local Board of Health.
*Distal Pressure&Inspection
of pump,floats,septic&purnp
chamber.
Cost for Testing: $180.00/Visit
Testing of Distal Pressure Sl.S0.00/yisit
Total $330.00/Visit
Operator assigned: William Everett
Telephone: ��(5508)400-3868 *Engineer: New England Engineering
*Approval for Effluent Testinp- V— iO.(���i L�V—
Homeowner Signature
NEW ENGLAND ENGINEERING SERVICES
INC
EDw wkW u� µ mmwiwwmm u
FE
February 15, 2004 w�
Michelle Harrison
121 Raleigh Tavern Lane
North Andover, MA 01845
Dear Michelle,
Enclosed is a maintenance contract for the Fast System that is part of the septic system
design at 121 Raleigh Tavern Lane. You need to sign it and return it to Wastewater
Treatment Services, Inc. with the 1710.00 dollar fee for the first years testing,
If you have any questions please don't hesitate to contact this office.
Sincerely,
Benj ;in C. (Z d, Jr.,PE
President
CC:North Andover Board of Health
60 BEECHWOOD DRIVE-NORTH ANDOVER, MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099
09-FE®-05 09:31AM FROM-AEUPROD +15088807232 T-293 P-01/03 F-570
Yw-
44 Commercial Street
Raynham, MA
02757
Tel: (508) 880-0233
Fax: (508) 880-7232
February 9,2005
Mr. Ben Osgood
New England Engineering
P.O. Box 536
North Andover,MA 01$45
Subject: FAST Treatment System
121 Raleigh Tavern Lane,North Andover,Massachusetts
Dear Mr. Osgood:
Enclosed is the Inspection&Testing Agreement for the FAST Treatment System to be
located at 121 Raleigh Tavern Lane,North Andover,Massachusetts.
The annual maintenance cost of this agreement is $390.00/per year. The cost for the
first year's testing is$1,320.00. Both will need to be paid in advance to Wastewater
Treatment Services Inc. and returned with the signed Inspection &Testin
A reetnent to our Ra nham office 13rior to the order being rocessed.
Thank you for your order and we look forward to working with you. if you should
require any additional information please do not hesitate to call or write.
Sincerely,
Donna L. Callahan
Please make check payable to:
Wastewater Treatment Services,Inc.
Amount Due: $1,710.00
09-FEB-05 09:31AM FROM-JRENGPROD +15088807232 T-293 P.02/03 F-570
`�lu�r/c�rr��rlc�r � cul�j�cril. cJc.11y !ew
44 Commercial Street
Parham, MA
Please complete all items marked• 02767
including three signatures, Mail
signed original contract to;
7e1: {508) 880-0233
W
44 Qpmmcrcial S_tteft Fax: (508) 880-7232
ftmhum-MA 67
INSPECTION AND EFFLUENT TESTING AGREEMENT
Agreement entered into by and between Wastewater Treatment Serviees,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 least 4 times per year that this Agreement remains in effect,with the first
inspections beginning-. These inspections will include:
1) Testing of the sludge depth in the septic tank.
2) Inspection,power testing and clean/replace intake filter of the air blower.
3) Inspection of the alarm system.
4) Inspect overall condition of FAST"System.
5) Notification to OWNER of any problems encountered.
*b) Inspection of Septic Tank and Pump Chamber
*7) Inspection of pump and pump cycle
*8) Inspect/clean floats
9) 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-halt'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.
OWNED understands and agrees that WTS is not responsible for special, incidental or consequential
damages, including loss of time, injury to person or property,or equipment failure.
OWNED 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.
MAY-8-2005 18:47 FROM:SKYWORK'8 7813763320 70:919786851099 P:4/10
00-FEE-05 M 31AM FROM-JRENGPROD �Ib088U0i232� __
i-2U3 P.p3/U3 t-5�U
This is a two-year contract which will be billed azin lly. All payments are nom-rcfuuaable. O R's faure
to pay invoices promptly or TO o se comply with this contract may result in suspension of service,
onar-Olationl of contract and/or nullification of warranties,at the election of WTS. This agmermeznt is not
assignable without the consent of WTS and will remain in force until candled by either party through written
uodgc.
MAMA-CM 1V1 1 >vf.Nd. `RiAL NCI �.00ATI(�O*? At 3tIAlL RA's
Bio icrobics N icroPAST North Andover,MA $390.00
RQ OYM Wastewater Treatment Serwlres.InSI
R'Signedby OWNER
Michelle Harrison Signed:
*Address:
121 Raleigh T2LV s R Lane 44 Commercial Street
Raynfmn),MA 02767
Tole:(508)823-956£
*City: Stater, Zip: Fax: (508)880-7232
North Atndover 1KA 01945
T0lcpbooe_, 97$-794-9526 Effective Date ofAgreement
Daytitne Telephone:
OWNER understands that(1)ANNUAL RATE pay=nt is for one year only Of this two-yeas'agreement
and is non-rcfinzdable;and(2)Current DW Regulations require OWNER to maintain a seMce agreement for
the life of the FAsr system. I UAvE RrAD AND UNDERSTAND RSTAND FOREGOING.
-Signdd by OA MD ,G ,
ETUP-021 BIWA
Effluent saMle taken 4 ti=s per year and delivered to a qualified testing lab for cvalu on. Rzsults sent to
State and local Agencies as well as the OW I;d,. OWNER is responsible for providing acceptable access to
effluent to enable a grab sample to be taken for laboratory testing performed.
E
*(PLEASE C K ONE) ( )G ZAL ( 7i<) IAL ( )1sR1C.1'VXSJClI3AI.
"S?ECIAL COMMONS PER LOCAL BOARD OF HEALTH(Y)or(N)if YES,please arch copy 64"14it
(fit )pH, C>I7s,TSS ( Toua Niwozen ( X )other per Local Board of Health:
*Distal Pnssuxe 8c Inspection
of pump,floats,sqydc&p
chamber.
Cost for Testuagt $180.00/Visit
Testing of DisW lP`ressmv M.eor"sit
Total 5330.001vsit
opwator assigned: 'Wftllal4arrw LVeretl.
Telephone: a0 400-3868 *Ea&eer: New 7Wxngland cog
*Approval for Effluent T'e$;
Homcow nta mature ........
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