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Home My WebLink AboutMiscellaneous - 45 BRIDGES LANE 5/17/2005 44 Commercial Street Raynham, M 02°767 Tel: (508) 660-0230 Fax: (508) 680-7232 RE IVED June 3,2005 jUN 0 2005 TOWN OF HEALTH North Andover Board of Health 27 Charles Street North Andover,MA 01845 Attention: Board of Health Agent Reference: Home FAST Treatment Serial Number: 24751 Attached please find a copy of the Product Registration Report for the FAST Treatment System for work performed on 05/17/2005 at the home of Michael Koenig located at 45 Bridges Lane,North Andover, MA. Also, attached is a copy of the fully executed Inspection&Effluent Testing Agreement. If you have any questions or require additional information please do not hesitate to call. Sincerely, Donna L. Callahan Enclosures FA INCORPORATED 8450 Cole Parkway w Shawnee, KS 66227 m Phone 913-422-0707 w Fax: 912-422-0808 e-mail: onsite(o)blomicrobics com m www.biomlcrobics.com o 800-753-FAST(3278) PRODUCT REGISTRATION REPORT Product Registrati n Report must be completed and returned to Bio-Microbics, Inc. in order to effect warranty. Date of Start-Up /�/`�' Date Shi ed to End User 4/27/05 Serial#24751 OWNER N Michael Koeni 45 Brid es Lane North Andover,MA 01845 BIO-MICROBICS DISTRIBUTOR NAME Wastewater Treatment Services,Inc. ADDRESS 44 Commercial Street CITY/STATE/ZIP Ra am, MA 02767 PHONE/FAX 508-880-0233 FAX: 508-880-7232 INSTALLER NAME Kellet Landsca in ADDRESS 400 Salem Street CITY/STATE/ZIP L field,MA 01940 PHONE/FAX CONSULTING ENGINEER if a licable NAME New En land En i leering Services ADDRESS P.O.Box 536 CITY/STATE/ZIP N.Andover,MA 01845 PHONE/FAX 978-686-1768 ELECTRICAL PANEL(S) TREATMENT UNIT(S)Good Bad NA Good Bad NA Visual Alarm Operating Q C3 Air vent clear 13 Audio Alarm Operating �j ❑ 13 Septic tank level 173 BLOWERS) Septic tank meets min. size �Q ❑ Wired for correct voltage `21 ❑ Septic tank filled to Q Inlet/outlet piped correct) operating level p p y \0 ❑ Air Lift Operation ❑ Filter element installed \0 ❑ Recirculation tube in place ❑ Blower hood secure \10 ❑ Fasteners tight tJ Q Blower works correctly b ❑ WATER-TIGHT JOINTS Blower located within 100' of Q O Treatment unit to septic tank ] ❑ treatment unit Air line clear b Q Entrance tube to insert cover �j Q ❑ Air inlet screen clear Q Insert to insert cover �j ❑ Blower hood vents clear ❑ Discharge line connection �� ❑ Factory Authorized Personnel. Title: Firm: Wastewater Treatment Services Inc. Date: 5 1 U(-APR-05 09:5ZAM FROM-JRENGPROD r\utwiUU PAGE 01/02 +15066907232 T-740 P-01/02 F�381 P hMa 44"iPleft all iW=ffwrw tftgludi th y ®1TIM®fclal S na i , hRait Flaynham� MA t of ° signed orisieal eart�scc�: 02767 Tel: (sos) Sao-0233 Fax, (508) 880-7232 P C O Nb E)n'FLU)„NT TESTING AGR� Agreement entered into by and between Wastewater Treatment Services me the FAST'System OWNED,(herein called OWNER) For the inspection by WTS hof certain ll equipment and --of OWNER which is described below. qulpment Upon acceptance of this agreenlent at WTS's office, WTS will render the fo Ilowmg services only: -Equipment will be inspected at lean d times per year that this A.greoment remains in effea wi inspections beginning Zhcse inspections will include: th the first 1) Testing of the sludge depth in the septic tank, 2) Inspection,power testing and clean/replace intake filter of the air blower. 3) Inspection of the alam system. 4) Inspect overall condition of FAST"System *) Notification to OWNER of any problems enca �r 6) .Inspection of Septic Tank and Pump Chamber wltered. '7) Ynspection of pump and pump cycle $) Inspect/clean floats 9) Service other than routine maintenance will be billed at an hourly rate,plus travel and arts, WTS shall notify the local Board of Health and Department p Within 24 Iaaurs Of system failure or alarm event ieludi g corrective measurles that Ooh b we iring OWNER will be billed standard VVTS charges for any parts used in repairs or maintenance. An have been taken. additional labor time will be billed to the OVVI-gE,at standard labor rates of$74.00 per y p hour. Emergency service betWeen regular inspections will be provided at standard labor rates during normal business hours;at time and one-half after 5:00 PM and on Saturdays, and at double time on Sundays and holidays. Emergency service charges will include a minimum fo WTS charges for parts,plus mileage and tmvrl charges, The ur(4)hours of labor, plus standard annual rate includes routine maintenance:, but does-not include repairs required for damages caused by abuse, accident,theft, acts of third p ersons forces of nature,or alterations made to the equipment. WTS shall not be responsible for failure to render the agreed services if caused by strikes, labor disputes, non-cooperation by OWNEX or other factors beyond the control of W s. OWNER understands and agrees that WTS is not responsible For special, incidental or consz u damages, including loss of time, injury to person or properly, or equipment failure. q ential OWNER agrees that WTS may enter OWNER's property and have acceptable access to all areas dezmed by WTS to be necessary or appropriate for WTS to perform it,duties hereunder, V(-ArMO Mb4AM FROM-MEMPROU -UL-1 ULNI PAGE 02/02 �16UU8f�Uf"LIZ I-MV V UZ/UZ h-�uj This is a two-YO"oonnwt which will be billed tall All a ' M pay involcea promptly or to othervvis®eon�ly with this contact y result n re�idable. 's failure cancellation Of Contract and/or nullification of warranties,at the eleclion of j'S This sagreement is riot assignable without the consent of WTS and will remain in force until canceled by either party through written nonce, MA7 ACTURE� MQn�L NO S O. Bio-1Vlicrobics Mic�roFAST LOCATION RATE fJ.�/ North Andover,MA $390.00 B-0 LT[�'MrN'T O R Wastewater Tr ent Services Inc, 'Signed by OWNER.. So Haug1� -e�, *Address: a l Signed: 4513ridge Lane 44 Commercial Street RaYnham,MA 02767 * Tele: (508) 823-9566 *City: State: Zip; flax: (508) 880-7232 North Andover MA 01845 Telephone Effective Date of Agreemen Daytime Telephone: OWNER understands that(1)ANNUAL RATE payment is for one year only of this two-year agreement and is non-refundable;and (2) Current DEp Regulations require OWNER to maintain a service agreement for the life of the FAST"System. I HAVE READ AND UNDERSTAND TIDE FOREGOING. "Signed by OWNER; Effluent Testin Effluent sample taken 4 times per year and delivered to a qualified testing lab for evaluation. Results sent to State and local Agencies as well as the OWNER. O'W1rIER is responsible for providing acceptable access to effluent to enable a grab sample to be taken for laboratory testing performed, ERM);T: *(PLEASE CYJECIc ONE) ( ) GENERAL ( X)REMEDIAL ( )PROVISIONAL *SPECIAL CONDITIONS PER LOCAL BOARD OF FMALTH('Y)or(1)if YES,please attach copy ofpemm r (X)PH,BOD5,TSS ( )Total Nitrogen ( X Other per Local Board of Realth: *Distal Pressure&Inspection Of pump, floats,septic&pump Cost for Test' � Sz80�00/Visat chamber ax, Testing of Distal Pre9sure $150.00/Visit Operator assigned: WYMam Everett Telephone; MM 400-3868 *Engineer: New England Engineering *Approval For Effluent Testing HOtDeo er ignature