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HomeMy WebLinkAboutLab Test Results - 151 RALEIGH TAVERN LANE 9/29/2015 1 44 Commercial Street Raynham, MA 02767 Tel: (508)880-0233 Fax: (508)880-7232 October 16, 2014 r North Andover Board of Health 1600 Osgood Street North Andover, MA 01845 Attention: Health Agent Reference: FAST Wastewater Treatment System- Serial Number: MCF215 Attached please find the Field Inspection& Service Report with field test results for services performed on 10-9-14 at the property of David Pinson located at 151 Raleigh Tavern Lane,North Andover, MA. Please call if you have any questions or require additional information. Sincerely, Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: David Pinson Massachusetts DEP x n ""H,>* C�0 H P 0 H p 'r E 0 8450 Cole Parkway, Shawnee, KS 66227, Phone 913-422-0707, Fax 913-422-0808 e-mail:onsite(o),biomicrobics.com, www.biomicrobics.com, 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST'System 22663 INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address: 151 Raleigh Tavern Lane Name:Wastewater Treatment Services,Inc. North Andover,MA 01845 Owner Name:David Pinson Mail Address: 151 Raleigh Tavern Lane Mail Address: 44 Commercial Street North Andover,MA 01845 Raynham,MA 02767 Phone: 508 880-0233 Fax:(508)880-7232 e-mail: i Phone:978-681-6468-Home Fax: e-mail: ( ) � INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pump out MicroFAST.5 MCF215 9/21/1998 7/1/2008 EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS Electrical Panel(s) Visual Alarm Operating N/A Audio Alarm Operating (if present) Blower(s) Air Inlet Filter Clean x Blower Hood Vents Clear x Excessive Noise x Excessive Vibration x Treatment unit(s) Unusual Odor x Pumpout Required x Primary Settling Zone 9 Aerobic Treatment Zone 9 EFFLUENT(optional) : LIMIT RESULT Estimated Daily Flow 440 gpd pH(Standard Units) 7 Color Clear Temperature 69 Odor Earthy Comments:Pumps and floats were inspected and are operational.Alarm not accessible. TECHNICIAN SERVICE DATE David Zavelle 10-9-14 Massachusetts Department of Environmental Protection LINBureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems 22663 A. Installation David Pinson Owner 151 Raleigh Tavern Lane Facility Street Address North Andover 01845 City Zip Mailing address of owner, if different: 151 Raleigh Tavern Lane Street Address/PO Box: North Andover MA 01845 City State Zip 978-681-6468- Home Telephone Number B. Authorized Service Provider Wastewater Treatment Services Inc. O&M Firm 44 Commercial Street Street Address 02767 Raynham MA City State ZIP 508-880-0233 Telephone Number David Zavelle 12920 Certified Operator Name Certification Number C. Facility/System Information MCF215 Bio-Microbics Inc. MicroFAST .5 DEP ID Manufacturer ID Model Number 9/21/1998 9/21/1998 Installation Date Start of Operation Approval Type: [] General [] Provisional [] Piloting [x] Remedial [] General Denite Seasonal Residence—used less than 6 mo./year: []Yes [x] No D. Operating Information 10-9-14 Inspection Date Previous Inspection Date 91) Pumping Recommended []Yes [x] No Sludge Depth(to be checked yearly) 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and ®&M Form for Title 5 I/A Treatment and Disposal Systems 22663 E. Field Testing Field Inspection: Color: [] gray [] brown [x] clear [] turbid [] Other (specify): Odor: [] musty [x]earthy [] moldy [] offensive []turbid Effluent Solids: [x] no []some pH 7 SU DO 5.21 mg/L Turbidity 7.10 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: 440 gpd Parameters sampled: Influent: [] pH [] BOD [] CBOD []TSS []TKN [] Nitrate [] Nitrite [] Phosphorus [] Spec. Cond. []Ammonia []Alkalinity [] Oil Grease []VOC [] Fecal Coliform Effluent: [] pH [] BOD [] CBOD []TSS []TKN [] Nitrate [] Nitrite [] Phosphorus [j Spec. Cond. []Ammonia []Alkalinity [] Oil Grease []VOC [] Fecal Coliform G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Cleaned Filter Checked Splash Recycle Pump(s) Inspected Float(s) Inspected Notes and Comments: Pumps and floats were inspected and are operational.Alarm not accessible. 2 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 22663 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. 10-9-14 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 31 th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston, MA 02108 3 w� 44 Commercial Street t Raynham,MA 02767 Tel: (508)880-0233 Fax: (508)880-7232 May 6, 2014 North Andover Board of Health �" y °� � efl,t 1600 Osgood Street North Andover, MA 01845 . Attention: Health Agent Reference: FAST'Wastewater Treatment System - Serial Number: MCF215 r Attached please find the Field Inspection & Service Report with field4est results for services performed on 4/21/14 at the property of David Pinson locatd at 151 Raleigh Tavern Lane, North Andover, MA. Please call if you have any questions or require additional information. Sincerely, Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: David Pinson Massachusetts DEP 3 & f 4 a .t T 1 .0 8450 Cole Parkway, Shawnee, KS 66227, Phone 913-422-0707, Fax 913-422-0808 e-mail:onsite[@biomicrobics.com, www.biomicrobics.com, 800-753-FAST(3278) FIELD INSPECTI®N & SERVICE REPORT For Bio-Microbics Single Home FAST'System INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address: 151 Raleigh Tavern Lane Name:Wastewater Treatment Services,Inc. North Andover,MAO 1845 Owner Name:David Pinson Mail Address: 151 Raleigh Tavern Lane Mail Address: 44 Commercial Street North Andover,MAO 1845 Raynham,MA 02767 Phone:978-681-6468-Home Fax: e-mail: Phone:(508)880-0233 Fax:(508)880-7232 e-mail: INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pump out MicroFAST.5 MCF215 9/21/1998 7/1/2008 EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS Electrical Panel(s) Visual Alarm Operating x Audio Alarm Operating x (if present) Blower(s) Air Inlet Filter Clean x Blower Hood Vents Clear x Excessive Noise x Excessive Vibration x Treatment unit(s) Unusual Odor x Pumpout Required x Primary Settling Zone 16" Aerobic Treatment Zone 18" EFFLUENT(optional) LIMIT RESULT Estimated Daily Flow 440 gpd pH(Standard Units) 7 Color Clear Temperature Odor Musty Comments:System needs to be pumped. TECHNICIAN SERVICE DATE Richard Arruda 4/21/14 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 David Pinson Owner 151 Raleigh Tavern Lane Facility Street Address North Andover ) 01845 City > Zip Mailing address of owner, it different: 151 Raleigh Tavern Lane — Street Address/PO Box: North Andover MA 01845 City State Zip 978-681-6468 - Home Telephone Number B. Authorized Service Provider Wastewater Treatment Services Inc. O&M Firm 44 Commercial Street Street Address Raynham MA 02767 City State Zip 508-880-0233 Telephone Number Richard Arruda 16922 Certified Operator Name Certification Number C. Facility/System Information MCF215 Bio-Microbics Inc. MicroFAST .5 DEP ID Manufacturer ID Model Number 9/21/1998 9/21/1998 Installation Date Start of Operation Approval Type: [] General [] Provisional [] Piloting [x] Remedial (] General Denite Seasonal Residence—used less than 6 mo./year: [ ]Yes [x] No D. Operating Information 4/21/14 Inspection Date Previous Inspection Date 16" Pumping Recommended [x]Yes [) No Sludge Depth(to be checked yearly) 1 Massachusetts Department of Environmental Protection LlBureau of Resource Protection -Title 5 DEP Approved Inspection and ®&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: [] gray [] brown [x] clear [] turbid [] Other(specify): Odor: [x] musty [] earthy [] moldy [] offensive [] turbid Effluent Solids: [x] no [] some pH 7 SU DO 7.88 mg/L Turbidity 11.61 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: 440 gpd Parameters sampled: Influent: [] pH [] BOD [ ] CBOD []TSS []TKN [ ] Nitrate [] Nitrite [ ] Phosphorus [] Spec. Cond. []Ammonia []Alkalinity [] Oil Grease []VOC [] Fecal Coliform Effluent: [] pH [ ] BOD [] CBOD []TSS []TKN [] Nitrate [ ] Nitrite [ ] Phosphorus [] Spec. Cond. [ ]Ammonia [ ]Alkalinity [] Oil Grease []VOC [] Fecal Coliform G. Inspection and Maintenance Description of any maintenance performed since previous inspection & during this inspection: Cleaned Filter Checked Splash Recycle Notes and Comments: System needs to be pumped. 2 _ Massachusetts Department of Environmental Protection 1 Bureau of Resource Protection -Title 5 I roved DEP Ap Inspection and ®&M Form for Title 5 I/A - p Ll p p 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. 4/21/14 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 31st of each year for the previous calendar year Piloting Use -within 45 days of inspection date Provisional Use— by March 31 th of each year for the previous 12 months General Use— by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston, MA 02108 3 - I TREICEIVED 44 Commercial Street Raynham,MA I 02767 1 01 Tel: (508)880-0233 TOWN OF ORNI`IiA OL R Fax: (508)880-7232 EM..'nj DEPARTMENT ENT April 4, 2013 North Andover Board of Health 1600 Osgood Street North Andover, MA 01845 Attention: Health Agent Reference: FAST° Wastewater Treatment System.- Serial Number: MCF215 Attached please find the Field Inspection& Service Report with field test results for services performed on 3/7/13 at the property of David Pinson located at 151 Raleigh Tavern Lane,North Andover, MA. Please call if you have any questions or require additional information. Sincerely, eV �.2ca�i��c�,�/rtieea Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: David Pinson Massachusetts DEP Massachusetts Department of Environmental Protection LlBureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems 18538 A. Installation David Pinson = Owner 151 Raleigh Tavern Lane Facility Street Address North Andover 01845 City Zip Mailing address of owner, if different: 151 Raleigh Tavern Lane Street Address/PO Box: North Andover MA 01845 City State Zip 978-681-6468 - Home Telephone Number B. Authorized Service Provider Wastewater Treatment Services Inc. O&M Firm 44 Commercial Street Street Address Raynham MA 02767 City State Zip 508-880-0233 Telephone Number David Nix 15651 Certified Operator Name Certification Number C. Facility/System Information - MCF215 Bio-Microbics Inc. MicroFAST .5 DEP ID Manufacturer ID Model Number 9/21/1998 9/21/1998 Installation Date Start of Operation Approval Type: [] General [] Provisional [] Piloting [x] Remedial [] General Denite Seasonal Residence— used less than 6 mo./year: []Yes [x] No D. Operating Information 3/7/13 Inspection Date Previous Inspection Date 14" Pumping Recommended ( ]Yes [x] No Sludge Depth(to be checked yearly) 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 LlDEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems 18538 E. Field Testing Field Inspection: Color: [] gray [] brown [x] clear [] turbid [] Other(specify): Odor: [] musty [x] earthy [] moldy [] offensive [] turbid Effluent Solids: [x] no [] some pH 7 SU DO 6.62 mg/L Turbidity 8.25 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: 440 gpd Parameters sampled: Influent: [] pH [] BOD [] CBOD []TSS []TKN [ ] Nitrate [] Nitrite [] Phosphorus [] Spec. Cond. []Ammonia []Alkalinity [] Oil Grease []VOC [] Fecal Coliform Effluent: [] pH [ ] BOD [] CBOD []TSS []TKN [] Nitrate [] Nitrite [ ] Phosphorus [] Spec. Cond. []Ammonia []Alkalinity [] Oil Grease [] VOC [] Fecal Coliform _ G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Cleaned Filter Checked Splash Recycle Notes and Comments: Alarm not accessible. 2 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 LIDEP Approved Inspection and ®&M Form for Title 5 I/A Treatment and Disposal Systems 18538 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. -� 3/7/13 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 31st of each year for the previous calendar year Piloting Use -within 45 days of inspection date Provisional Use— by March 31 th of each year for the previous 12 months General Use— by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston, MA 02108 3 � � 1 ti C O R P O R vA'-T E;U 8450 Cole Parkway, Shawnee, KS 66227, Phone 913-422-0707, Fax 913-422-0808 = e-mail:onsite .biomicrobics.com, www.biomicrobics.com, 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST°System 18538 INSTALLATION '` AUTHORIZED SERVICE-PRO VIDER Installation Address: 151 Raleigh Tavern Lane Name:Wastewater Treatment Services,Inc. North Andover,MA 01845 Owner Name:David Pinson Mail Address: 151 Raleigh Tavern Lane Mail Address: 44 Commercial Street North Andover,MAO 1845 Raynham,MA 02767 Phone:978-681-6468-Home Fax: e-mail: Phone:(508)880-0233 Fax:(508)880-7232 e-mail: IN TAL'CATION,+INFORMATION Model No. Serial No. Date of Installation Date of last pump out MicroFAST.5 MCF215 9/21/1998 7/1/2008 EQUIPMENT YES NO' MAINTENANCE PERFORMED.AND COMMENTS. Electrical Panel(s) Visual Alarm Operating N/A Audio Alarm Operating (if present) Blower(s) Air Inlet Filter Clean x Blower Hood Vents Clear x Excessive Noise x Excessive Vibration x - Treatment unit(s) Unusual Odor x Pumpout Required x Primary Settling Zone 14" Aerobic Treatment Zone 16" EFFLUENT(optional) LIMIT " RESULT Estimated Daily Flow 440 gpd pH(Standard Units) 7 Color Clear Temperature Odor Earthy - Comments:Alarm not accessible. TECHNICIAN SERVICE DATE David Nix 3/7/13 i i 44 Commercial Street „ Raynham,MA 02767 Tel: (508)880-0233 Fax; (508)880-7232 RECEIVED October 1, 2012 (1'`` ; TOWN OF NORTH Ao A °r�� �rM North Andover Board of Health 1600 Osgood Street North Andover, MA 01845 Attention: Health Agent Reference: FAST'Wastewater Treatment System- Serial Number: MCl?215 '4N Attached please find the Field Inspection & Service Report vrr th field test results for services performed on 9/13/12 at the property of David Pi son located at 151 Raleigh Tavern Lane,North Andover, MA. Please call if you have any questions or require additional information. Sincerely, Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: David Pinson Massachusetts DEP Massachusetts Department of Environmental Protection Ll Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems 18538 A. Installation David Pinson Owner 151 Raleigh Tavern Lane Facility Street Address North Andover 01845 = City Zip Mailing address of owner, if different: 151 Raleigh Tavern Lane Street Address/PO Box: North Andover MA 01845 City State Zip 978-681-6468 - Home Telephone Number B. Authorized Service Provider Wastewater Treatment Services Inc. O&M Firm 44 Commercial Street Street Address Raynham MA 02767 City State Zip 508-880-0233 Telephone Number David Nix 15651 Certified Operator Name Certification Number C. Facility/System Information MCF215 Bio-Microbics Inc. MicroFAST.5 DEP ID Manufacturer ID Model Number 9/21/1998 9/21/1998 Installation Date Start of Operation Approval Type: [] General [] Provisional [] Piloting [x] Remedial Seasonal Residence—used less than 6 mo./year: []Yes [x] No D. Operating Information 9/13/12 Inspection Date Previous Inspection Date 15" Pumping Recommended []Yes [x] No Sludge Depth(to be checked yearly) 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 - 18538 E. Field Testing Field Inspection: Color: [] gray [] brown [x] clear []turbid [] Other(specify): Odor: [J musty [x] earthy [] moldy [] offensive []turbid Effluent Solids: [x] no []some pH 7 SU DO 6.05 mg/L Turbidity 4,39 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: 440 gpd Parameters sampled: Influent: [] pH [] BOD [] CBOD []TSS []TKN [] Nitrate [] Nitrite [] Phosphorus [] Spec. Cond. []Ammonia []Alkalinity [] Oil Grease []VOC [] Fecal Coliform Effluent: [] pH [] BOD [] CBOD []TSS []TKN [] Nitrate [] Nitrite [] Phosphorus [] Spec. Cond. []Ammonia []Alkalinity [] Oil Grease []VOC [] Fecal Coliform G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Cleaned Filter Checked Splash Recycle Notes and Comments: Alarm not accessible. 2 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 18538 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. 9/13/12 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 31st of each year for the previous calendar year Piloting Use -within 45 days of inspection date Provisional Use— by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston, MA 02108 3 is e i q}tea a £ Flt 111 C 0 R P O R AT E D 8450 Cole Parkway, Shawnee, KS 66227, Phone 913-422-0707, Fax 913-422-0808 e-mail:onsite .biomicrobics.com, www.biomicrobics.com, 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Micr'obics Single Home FAST°System 18538 _ INSTALLATION- AUTHORIZED SERVICE4'ROVIDER :_ Installation Address: 151 Raleigh Tavern Lane Name:Wastewater Treatment Services,Inc. North Andover,MA 01845 Owner Name:David Pinson Mail Address: 151 Raleigh Tavern Lane Mail Address: 44 Commercial Street North Andover,MA 01845 Raynham,MA 02767 Phone:978-681-6468-Home Fax: e-mail: Phone:(508)880-0233 Fax:(508)880-7232 e-mail: INSTALLATION INFORMATION , - Model No. Serial No. Date of Installation Date of last pump out MicroFAST.5 MCF215 9/21/1998 7/1/2008 EQUIPMENT YES NO MAINTENANCI PERFORMED AND COMMENTS Electrical Panel(s) Visual Alarm Operating N/A Audio Alarm Operating (if present) Blower(s) Air Inlet Filter Clean x Blower Hood Vents Clear x Excessive Noise x Excessive Vibration x Treatment unit(s) Unusual Odor x Pumpout Required x Primary Settling Zone 15" Aerobic Treatment Zone 15" EFF (ophon 2l)i LIMIT 'RESULT LUENT, Estimated Daily Flow 440 gpd pH(Standard Units) 7 Color Clear Temperature Odor Earthy Comments:Alarm not accessible. TECHNICIAN SERVICE DATE' David Nix 9/13/12 44 Commercial Street J AP R `wo °?131 Raynham, MA 02767 Tel: (508)880-0233 Fax: (508)880-7232 April 12, 2010 North Andover Board of Health 1600 Osgood Street North Andover, MA 01845 Attention: Health Agent Reference: FAST' Wastewater Treatment System - Serial Number: MCF215 Attached please find the Field Inspection& Service Report with fie test results for services performed on 4-14-09 at the property of David Pinson to ted at 151 Raleigh Tavern Lane, North Andover, MA. Please call if ou have an questions or require additional information Y Y q 9 n. Sincerely, Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: David Pinson Massachusetts DEP Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 1/A Treatment and Disposal Systems 11098 A. Installation David Pinson Owner 151 Raleigh Tavern Lane Facility Street Address North Andover 01845 City Zip Mailing address of owner, if different: 151 Raleigh Tavern Lane Street Address/PO Box: North Andover MA 01845 City State Zip 978-681-6468 - Home Telephone Number S. Authorized Service Provider Wastewater Treatment Services Inc. O&M Firm 44 Commercial Street Street Address Raynham MA 02767 City State Zip 508-880-0233 Telephone Number David Zavelle 12920 Certified Operator Name Certification Number C. Facility/System Information MCF215 Bio-Microbics Inc. MicroFAST .5 DEP ID Manufacturer ID Model Number 9/21/1998 9/21/1998 Installation Date Start of Operation Approval Type: [] General [) Provisional [] Piloting [x] Remedial Seasonal Residence—used less than 6 mo./year: []Yes [x] No D. Operating Information 4-14-09 Inspection Date Previous Inspection Date Pumping Recommended []Yes [x] No Sludge Depth(to be checked yearly) 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Ll Treatment and Disposal Systems 11098 E. Field Testing Field Inspection: Color: gray brown [x] clear 0 turbid Other (specify): Odor: musty [x] earthy 0 moldy 0 offensive p turbid Effluent Solids: [x] no [] some pH 6.5 S DO 7.57 mg/L Turbidity 4.39 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: 440 gpd Parameters sampled: [] pH [] BOD [] CBOD [] TSS []TKN [] Nitrate [] Nitrite (] Phosphorus [] Spec. Cond. []Ammonia []Alkalinity [] Oil Grease []VOC [] Fecal Coliform G. Inspection and Maintenance__.. ,`. r Description of any maintenance performed since pre�'ious inspection &during this inspection: Cleaned Filter Checked Splash Recycle Notes and Comments: 2 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 11098 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. L 4-14-09 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 31 th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston, MA 02108 3 wool N 8450 Cole Parkway, Shawnee, KS 66227, Phone 913-422-0707, Fax 913-422-0808 e-mail:onsite .biomicrobics.com, www.biomicrobics.com, 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FASP System 11098 INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address: 151 Raleigh Tavern Lane Name:Wastewater Treatment Services,Inc. North Andover,MA 01845 Owner Name:David Pinson Mail Address: 151 Raleigh Tavern Lane Mail Address: 44 Commercial Street North Andover,MAO 1845 Raynham,MA 02767 Phone:978-681-6468-Home Fax: e-mail: Phone:(508)880-0233 Fax:(508)880-7232 e-mail: INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pump out MicroFAST.5 MCF215 9/21/1998 EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS Electrical Panel(s) Visual Alarm Operating x Audio Alarm Operating x (if present) Blower(s) Air Inlet Filter Clean x Blower Hood Vents Clear x Excessive Noise x Excessive Vibration x Treatment unit(s) Unusual Odor x Pumpout Required x Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LIMIT RESULT Estimated Daily Flow 440 gpd PH(Standard Units) 6.5 Color Clear Temperature 51 Odor Earthy Comments: TECHNICIAN SERVICE DATE David Zavelle 4-14-09