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Home My WebLink AboutInspection - 100 RALEIGH TAVERN LANE 11/12/2004 .................... 4d, ('.w�nwwia� S�ftee� llklyllh,'Rfl, MA 02767 TeL (508) 880-023,3 Fax (508) 880 7232 November 12, 2004 t No 004 North Andover Board of Health 27 Charles Street North ..Am dover, MA 0184.5 Attention: Board of Health Agent Reference: Home FAST Treatment Serial Number: 24277 Attached please find a copy of the Product Registration Report for the FAST Treatment System for work performed on 11/11/2004 at the home of Brian Arsnow located at I 00_ Raleigh Tavern Lane, North Andover, MA. Also, attached is a copy of the fully executed T-n§-Vee'ti -En"t Testing Agreement, If you have any questions or require additional information please do not hesitate to call. Sincerely, Donflia L. Callahan Enclosures ri 11111,1111 !A K-10M INCORPORATED 8450 Cole Parkway m Shawnee, KS 66227 zu Phone 913-422-0707 zu Fax: 912-422-0808 e-mail: onsite .biomicrobics.com w www.blomicrobics.com w 800-753-FAST(3278) PRODUCT REGISTRATION REPORT Product Registration Report must be completed and returned to Bio-Microbics, Inc. in order to effect warranty. Date of Start-U p Date Shipped to End User 10/28/04 Serial # 24277 OWNER NAME Brian Arsnow ADDRESS 100 Raleigh Tavern Lane CITY/STATE/ZIP North Andover,MA 01845 PHONE/FAX BIO-MICROBICS DISTRIBUTOR NAME Wastewater Treatment Services,Inc. ADDRESS 44 Commercial Street CITY/STATE/ZIP Raynharn, MA 02767 PHONE/FAX 508-880-0233 FAX: 508-880-7232 INSTALLER NAME John Soucy ADDRESS 78 North Broadway CITY/STATE/ZIP Salem,NH 03079 PHONE/FAX 978-470-1400 CONSULTING ENGINEER if applicable) NAME Benjamin Osgood ADDRESS P.O.Box 536 CITY/STATE/ZIP North Andover,MA 01845 PHONE/FAX 978-686-1768 Good Bad NA Good Bad NA ELECTRICAL PANEL UT S) TREATMENT UNITS) Visual Alarm Operating ❑ ❑ Air vent clear ❑ Audio Alarm Operating ❑ ❑ Septic tank level Q BLOWER(S) Septic tank meets min. size Q Wired for correct voltage ❑ Septic tank filled to ❑ operating level Inlet/outlet piped correctly Q/ Q Air Lift Operation Q Filter element installed LJ ❑ Recirculation tube in place ❑ Blower hood secure ❑ Fasteners tight Q Blower works correctly ❑ WATER-TIGHT JOINTS Blower located within 100'of [� Q Q Treatment unit to septic tank ❑ treatment unit Air line clear ❑ Entrance tube to insert cover [ ❑ ❑ Air inlet screen clear ,Q'j' ❑ Insert to insert cover ❑ Blower hood vents clear ❑ Discharge line connection ❑ Factory Authorized Personnel Title: Firm: Wastewater Treatment Services Inc. Date: i/ /; / d y Oct 06 04 01 : 19p p. 2 �`�a��ecvatcr ,-'r�rG stG t Jeroe�r-, two. 44 Commercial Street Please complete all items marked• Raynham, MA including three signatures. Mail 02767 signed original contract to: wastgmter Treatment Servi_rc ttic as Conarmrcial Sircet Tel: (508) 880-0233 Raynham,MA 02767 Fax: (508) 880-7232 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 wil l be inspec ed at least 4 times per year that this Agreement remains in effect, with the first inspections beginning /'0 . These inspections will include: 1) Testing of the sludge depth in the septic tank 1) Inspection,power testing and clean/replace intake filter of the air blower. 1) Inspection of the alarm system. 1) Inspect overall condition of FAST*System. 1) Notification to OWNER of any problems encountered. 1) 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. 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. 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 WTS to be necessary or appropriate for WTS to perform its duties hereunder. pot 06 04 01 : 19P p• 3 This is a two-year contract which will be billed annually. All payments are non-refundable. OWNER'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 ANNUAL RATE Bio-Microbics MicroFAST .,I North Andover,MA $390.00 EQUIPMENT OWN Wastewater Treatment Services,Inc. *Signed by OWNER: Brian &Lucy Arsnow , Signed: ^ Qt tp *Address: L�U� 100 Raleigh Tavern Lane . 44 Commercial Street Raynham,MA 02767 Tele: (508) 880-0233 *City: State: Zip: Fax: (508) 880-7232 North Andover MA --01-845 _ Telephone 617-439-4876 X14 Effective Date of Agreement Daytime Telephone; Telephone: L.U � OWNER understands that(1)ANNUAL RATE payment is for one year only of this two-year agreement and is non-refundable; and (2) Current DEP Regulations require OWNER to maintain a service agreement for the life of the FAST®System. I HAVE READ AND UNDERSTAND THE FOREGOING. *Signed by OWNER: Effluent Testing 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(N) if YES,please attach copy of permit ;t (X) pH,BODs,TSS O Other: Aj 2 Cost for testing: $180.00/Visit � Operator assigned: William Everett Telephone: (508)400-3868 *Engineer: Benjamin Osgood *Approval for Effluent Testing >' r< Homeowner's Signature � ;", AMA•IVSp 2o,wp " I o