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Home My WebLink AboutDEP Approved - Inspection - 67 RALEIGH TAVERN LANE 10/30/2025 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Town Of North Andover Important:When Darrell Hamann filling out forms Owner on the computer, use only the tab 67 Raleigh Tavern Lane NOV 17 key to move your Facility Street Address cursor-do not North Andover 01845 use the return City Zip key. Mailing address of owner, if different: HUI] il❑Department VQ Street Address/PO Box: retrnn 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 Christopher Maskell 19580 Certified Operator Name Certification Number C. Facility/System Information DEP ID Manufacturer ID Model Number Installation Date Start of Operation Approval Type: 0 General El Provisional F-1 Piloting E Remedial Seasonal Residence—used less than 6 mo./year: El Yes 0 No D. Operating Information October 30, 2025 December 20, 2024 Inspection Date Previous Inspection Date 5" --- Pumping Recommended F1 Yes No Sludge Depth(to be checked yearly) 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/A 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 6.9 SU DO 5.8 mg/L Turbidity 15.50 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 5 I/A 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. Ot4t*V- October 30, 2025 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 315t of each year for the previous calendar year Piloting Use -within 45 days of inspection date Provisional Use—by March 311h of each year for the previous 12 months General Use—by September 301h 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 Town of NoO Andover NOV 17 2025 P � Department Health RECIRCULATING SAND FILTER SYSTEM ROUTINE INSPECTION ADDRESS: 67 Raleigh Tavern Lane, North Andover OWNER: Hamann DATE: October 30, 2025 OPERATOR: Christopher Maskell SYSTEM STATUS Septic Tank Effluent Filter: O.k. cleaned Scum Depth: 015/48" Sludge Depth 555/48" (Measured on October 30, 2025) 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 Sand Filter Sand Condition: Clean Diffusers Condition: Cleaned, flushed all three (3) 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 Effluent Quality Visual Inspection: Clear, no odor Sample: pH= 6.9, Dissolved Oxygen= 5.8 mg/L, Turbidity= 15.50 NTU Comments: Flushed all five (5) laterals in SAS on December 20, 2024. Signature: "" VV W )/ az&A Certificate 4 19580 PO Box 825, Ipswich,MA 01938. 978-356-0779 - Fax 978-356-5500 - www.clearwaterindustries.com Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 RSF System Operation and Maintenance Inspection Checklist A. Installation & Service Information 67 Raleigh Tavern Lane October 30, 2025 Facility Street Address Date of Service North Andover Christopher Maskell/Clear Water Industries City Operator/O&M Firm Inspect& note ifB. Septic tank(s) pumping is required. Sludge Pumping Required: Yes ❑ No ® ® Sludge Depth: 5" 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 ® 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 action(s) 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 and comments G. Sample Collection (Field Sample) Yes ® (Field Sample) No ❑ If yes: ❑ BOD ❑ TSS ® pH ❑ TN ® Other—Dissolved oxygen &turbidity Town of north Andover NOV 17 2025 rsfcheck• 11/3/25 Page 1 of 1 Health Department