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Home My WebLink AboutLab Test Results - 151 RALEIGH TAVERN LANE 9/29/2015 (4) _.m. ....�... . .._�..� .... ,..... ....�...�.. ..�,__.. .�,_.,, 44 Commercial Street Raynham, MA 02761 I'd: (506) 680-0230 Fax: (506) 880-7232 RECEIVED November 21, 2005 DEC ) 1 2005 TOWN OF NOUH ANDOVER North Andover Board of Health . ,,., 400 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 for services performed on 11/10/2005 at the property of Paul Antinori located at 151 Raleigh Tavern Lane m North Andover, MA. Please call if you have any questions or require additional information. Sincerely, Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: Paul Antinori 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 6112 A. Installation Important: Paul Antinori When filling out Owner forms on the computer,use 151 Raleigh Tavern Lane only the tab key Facility Street Address to move your North Andover 01845 cursor-do not use the return city Zip key. Mailing address of owner, if different: _Q 151 Raleigh Tavern Lane Street Address/PO Box: North Andover MA 01845 `d7R City State Zip (978 682 4271 ext. 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)—880-0223 ext. Telephone Number Michael Dillen 11173 Certified Operator Name Certification Number C. Facility/System Information MCF215 Bio-Microbics, Inc. MicroFAST .5 DEP ID Manufacturer's Name&ID Model Name&Number 09/21/1998 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 11/10/2005 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended _Yes X No Color: N/A Odor: None Effluent Description DEPMicroFASTnew.doc•11/21/05 Page 1 of 2 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 6112 E. Sampling Information Samples Taken:_ Influent _Effluent Parameters sampled:_pH_BOD_TSS—TN—Other(list below) Other 1 Other 2 Other 3 Description of any maintenance performed since previous inspection &during this inspection: Cleaned Filter,,,Splash Recycle, Notes and Comments: Also tested: F. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, 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. Michael Dillen 11/10/2005 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 Ilse—by January Piloting & Provisional Use- Oenerai use—by September 31 st of each year for the within 30 days of inspection 30th of each year for the previous calendar year date previous 12 months Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6'h Floor Boston. MA 02108 DEPMicroFASTnew.doc-11/21/05 Page 2 of 2 o � 1 1 , IN C0 R P 0 R A T E 0 8450 Cole Parkway m Shawnee, KS 66227 m Phone 913-422-0707 m Fax: 912-422-0808 6112 e-mail: onsite anbiomicrobics.com m www.biomicrobics.com m 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FASTO System INSTALLATION AUTHORIZED SERVICE PROVIDER 151 Raleigh Tavern Lane Installation Address North Andover,MA 01845 Name Wastewater Treatment Services,Inc. Owner Name Paul Antinori Street Mail Address: Mail Address 44 Commercial Street 151 Raleigh Tavern Lane Raynham, MA 02767 North Andover,MA 01845 City State Zip 508-880-0233 508-880-7232 Phone 978 682 4271 Fax e-mail Phone Fax e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pump out MicroFAST.5 MCF215 09/21/1998 EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating if resent Blower(s) Air Inlet Filter Clean X Blower Hood Vents Clear X Excessive Noise X Excessive Vibration X Treatment unit(s) Unusual Odor Pum out Required: X Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LIMIT RESULT Estimated Daily Flow 4 Bedrooms H Standard Units Color N/A —Temperature Odor None Comments: TECHNICIAN SERVICE DATE Michael Dillen 11/10/2005 tzwk""Ibulev- Y'o 44 (Dorrirnercial Street Rayrihain, MA 02767 TeL (508) 880-0233 Fax: (508) 880-7232 September 7, 2005 T V",f North Andover Board of Health 27 Charles Street North Andover, MA 01845 Attention: Health Agent Reference: Single Home FAST" Treatment System Serial Number: MCF215 Attached please find the Field Inspection & Service Report for services performed on 08/21/2005 at the property of Paul Antinori 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: Paul Antinori Massachusetts DEP 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 4297 A. Installation Important: _Paul Antinori When filling out Owner forms on the computer,use 151 Raleigh Tavern Lane only the tab key Facility Street Address to move your North Andover 01845 cursor-do not use the return City Zip key. Mailing address of owner, if different: 151 Raleigh Tavern Lane Street Address/PO Box: North Andover MA 01845 City State Zip (978 682 4271 ext. 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)—880-0223 ext. Telephone Number Kevin Usilton 12530 Certified Operator Name Certification Number C. Facility/System Information MCF215 Bio-Microbics, Inc. MicroFAST .5 DEP ID Manufacturer's Name&ID Model Name&Number 09/21/1998 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 08/21/2005 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended _Yes X No Color: Clear Odor: None Effluent Description DEPMicroFASTnew.doc•9n/o5 Page 1 oft 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 4297 E. Sampling Information Samples Taken:_ Influent _ Effluent Parameters sampled:_pH_BOD—TSS—TN_Other(list below) Other 1 Other 2 Other 3 Description of any maintenance performed since previous inspection & during this inspection: Cleaned Filter,,,Splash Recycle, Notes and Comments: Also tested: , , , . F. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, 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. Kevin Usilton 08/21/2005 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 Piloting & Provisional Use - General Use—by September 31St of each year for the within 30 days of inspection 30th of each year for the previous calendar year date previous 12 months Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston. MA 02108 DEPMicroFASTnew.doc•9/7/05 Page 2 of 2 INCORPORATED 8450 Cole Parkway m Shawnee, KS 66227 m Phone 913-422-0707 w Fax: 912-422-0808 4297 e-mail: onsiteabiomicrobics.com m www.biomicrobics,com m 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FASTO System INSTALLATION AUTHORIZED SERVICE PROVIDER 151 Raleigh Tavern Lane Installation Address North Andover,MA 01845 Name Wastewater Treatment Services,Inc. Owner Name Paul Antinori Street Mail Address: Mail Address 44 Commercial Street 151 Raleigh Tavern Lane Raynham, MA 02767 North Andover,MA 01845 City State Zip 508-880-0233 508-880-7232 Phone 978 682 4271 Fax e-mail Phone Fax e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pump out MicroFAST.5 MCF215 09/21/1998 EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS Electrical Panel s Visual Alarm Operating X Audio Alarm Operating X if resent Blower(s) Air Inlet Filter Clean X Blower Hood Vents Clear X Excessive Noise X Excessive Vibration X Treatment unit(s) Unusual Odor Pum out Required: X Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LIMIT RESULT Estimated Daily Flow 4 Bedrooms H Standard Units Color Clear Temperature Odor None Comments: TECHNICIAN SERVICE DATE Kevin Usilton 08/21/2005