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Home My WebLink About- Title V Inspection Report - 67 RALEIGH TAVERN LANE 2/11/2019 RECIRCULATING SAND FILTER SYSTEM ROUTINE INSPECTION ADDRESS: 67 Raleigh Tavern Lane,North Andover OWNER: Hamann DATE: December 17 2018 OPERATOR: Mark Cottrell SYSTEM STATUS Septic Tank Effluent Filter: O.k. cleaned Scum Depth: 115/4813 Sludge Depth 9'/48)' 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. clean 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., clean Tank Condition: Good. Sand Filter Sand Condition: Clean Diffusers Condition: Clear, flushed all three 3 Effluent Quality Visual Inspection: Clear, no odor Sample: pH = 6.8, Dissolved Oxygen = 6.3 mg/L, Turbidity — 3.18 NTU Comments: Flushed all five (5) laterals in SAS on December 1.7, 2018. " Signature: Certificate # 11739 PO Box 825, Ipswich, MA 01938 ® 978-356-0779 ® Fax 978-356-5500 www.dearwaterindustries.com L7Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 1 -1 RSF System Operation and Maintenance Inspection Checklist A. Installation & Service Information 67 Raleigh Tavern Lane _..__ December 17, 2018 Facility Street Address Date of Service North Andover Mark Cottrell/Clear Water Industries City Operator/O&M Firm Inspect& noteif13. Septic tank(s) pumping is required. Sludge Pumping Required: Yes ❑ No ® ® Sludge Depth: 9" Inspect& clean effluent tee Effluent tee filter: Yes ® No ❑ If yes, inspect ® & clean at least yearly filter. Clean as C. Recirculation tank necessary. Inspect for ❑ Check if sludge accumulating Pumping required: Yes ❑ No sludge. Odor problems: Yes ❑ No E 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 ®Pump Inspections (all units) as necessary. If problems,describe Run pumps in ® Test pump alternator, or record hours Not applicable for this system manual mode. Hours of operation Record ® Float switches O.k. readings from Check all switches for operation meters & ® Test alarm counters. If non-functioning,corrective actions) Note if weeds & F. Recirculation Sand Filter debris are present on bed. Inspect for ponding Ponding Present: Yes ❑ No Clean/maintain bed surface to ® Clean bed: Yes ® No ❑ allow proper operation of the ® Distribution pipes Flush: Yes ® No ❑ Brush: Yes ❑ No system.. ® Check head loss in pipes O.k. _-- Headloss mm and coents G. Sample Collection (Field Sample) Yes ® (Field Sample) No ❑ i If yes: EI BOD ❑ TSS ® pH ❑ TN ® Other— Dissolved Oxygen, Turbidity I i rsfcheck• 1/2/19 Page 1 of 1 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M FormTitle If Treatment n isposal Systems A. Installation Important:when Darrell Hamann filling out forms Owner on the computer, g7 Raleigh use to move tab r Facility e gh Tavern Lane lei y y y Street Address cursor do not North Andover 01845 use the return —- Zi - -" key. C ity p O)Q Mailing address of owner, if different: ----------- 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 Opera kor Name Certification Number C. Facility/System Information DIE ID Manufacturer ID Model Number Installation Date Start of Operation Approval Type: ❑ General ❑ Provisional ❑ Piloting Z Remedial Seasonal Residence— used less than 6 mo./year: ❑ Yes ® No D. Operating Information December 17, 2018 December 15, 2017 Inspection Date Previous Inspection Date Sludge Depth(to be checked"-yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev. 11-07-05 Page 1 of 3 I I LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 ApprovedDEP Inspection and OW Formfor Title 5 I/ Treatment and Disposal Systems E. Field Tasting Field Inspection: Color: ❑ gray ❑ brown ❑ clear ❑ turbid ❑ Other(specify): Odor: ❑ musty ❑ earthy El moldy ❑ offensive ❑ turbid Effluent Solids: ❑ no ❑ some 6.8 SU 6L — 3.18 NTU pH 6 to_q.. DO .3 mg/2 or greater Turbidity 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: Parameters sampled: ❑ pH [ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(fist 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 LlMassachusetts [department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 II 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. December 17, 2018 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 31s'of each year for the previous calendar year Piloting Use -within 45 days of inspection date Provisional Use—by March 31'h of each year for the previous 12 months General Use—by September 30'h of each year for the previous 12 months Send to. Department of Environmental Protection Attention: Title 5 Program One Winter Street, 61h Floor Boston, MA 02108 t5aiom.doc•rev. 11-07-05 Page 3 of 3