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Home My WebLink AboutRecirculating Sand Filter System Routine - Inspection - 67 RALEIGH TAVERN LANE 10/14/2026 L Town of Nod Andover OCT42026 Health Department R�'CIRCULA TING SAN.�1.,�IL TER SYS TE'M F ROUTINE INSPECTION ` ADDRESS: 67 Raleigh-Tavern Lane North Andover OWNER: Hamann DATE: September 24 2026 OPERATOR: Mario Rosa SYSTEM STA T US Septic Tank Effluent Filter: 0.k. c leaned Scum Depth: 1 5'148" Sludge Depth I2"I48" (Measured on September 24, 2026) (See comments) 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: NIA (See comments) Tank Condition: NIA Sand Filter Sand Condition: Glean Diffusers Condition: Gleaned, flushed all three(3) Dosing Pump Clamber Pump H-0-A Setting: Auto Pump Cycle Timer: On Demand Alarm Selector: On Level Alarm: Normal Exercise Pump-, Yes Test& Glean Floats: NIA Tank Condition: NIA (See comments) Effluent Quality Visual Inspection: Clear, no odor Sample: PH = 7.0 Dissolved 0x en = 5.4 m IL Turbidity = 1.7.8 NTU Comments: Flushed all five 5 laterals in SAS on September 24 2026. Replaced three 3 Floats in recirculatin tank & re laced three 3 floats in the Dosing tank 9 time of maintenance visit. Customer had wholes stem um ed due to floatable solids on October 2 2026 b Stewart Septic Services. Signature: Certificate# 15652 PO Box 825,Ipswich,MA 01938 978-356-0779 w Fax 978-356-5500 w www.clearwaterindustries.cem Massachusetts Department of Environmental Protection e Bureau of Resource Protection - Title 5 ` RSF Syste Operat"ion Inspection Checki"Ist A. Installation & Service Information 67 Raleigh Tavern Lane September 24, 2026 Facility Street Address Date of Service North Andover Mario Rosa/Clear Water Industries City Operator/O&M Firm Inspect& note if13. Septic tank(s) pumping is required. Sludge Pumping Required: Yes 0 No ❑ E Sludge Depth: 1 2" Inspect&clean effluent tee Effluent tee filter: Yes ® No El If yes, inspect® &clean at least yearly filter. Clean as C. Recirculation tank necessary. Inspect for ® Check if sludge accumulating Pumping required: Yes Z No sludge. Odor problems: Yes ❑ No M If es description _. y � Inspect for D. Equalization tank (if installed) sludge. Ej Check if sludge accumulating Pumping required: Yes N No ❑ Inspect pumps Ew 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 N No ❑ allow proper operation of the Distribution pipes Flush: Yes N No❑ Brush: Yes ❑ No system. Check head loss in pipes o.k. Headtoss and comments G. Sample collection (Field Sample) Yes ® (Field Sample) No ❑ If yes: El BOD ❑ TSS N pH El TN N other--Dissolved oxygen &turbidity rsfcheck 10/7126 Page I of 1 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 Important:When Darrell Hamann filling out forms Owner on the computer, use only the tab 67 Raleigh Tavern Lane 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: Street Address/PO Box: ream 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 Mario Rosa 15652 Certified Operator Name Certification Number D. Facility/System Information DEP ID Manufacturer ID Model Number Installation Date Start of Operation Approval Type: ❑ General ❑ Provisional ❑ Piloting 0 Remedial Seasonal Residence—used less than 6 mo.lyear: ❑ Yes No D. operating Information September 24, 2026 October 30, 2025 Inspection Date Previous Inspection Date 12 Sludge Depth(to be checked yearly) Pumping Recommended Yes ❑ No 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: [I gray El brown 0 clear ❑ turbid El Other(specify): Odor: El musty El earthy El moldy El offensive El turbid Effluent Solids: ❑ no D some pH 7.0 SU D0 y 5.4 mg/L Turbidity 17.8 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: El 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 El BOD❑ CBOD El TSS [:1 TN [:1 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 [CEP 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. September 24, 2026 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 31 st 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 02103 t5aiom.doc•rev. 11--07-05 Page 3 of 3