HomeMy WebLinkAboutMiscellaneous - 45 BRIDGES LANE 1/14/2016 (3) 44 Commercial Street
Raynham, MA,
027617
Tel: (508) 880-0233
Fax: (508) 880-7232
March 6, 2006
MAR ... 0 2006 �
North Andover Board of Health C�Arr )° 4'. { '.��/�.=�'
4f_ .
400 Osgood Street '" "
North Andover, MA 01845
Attention: Health Agent
Reference: FAST Wastewater Treatment System
Serial Number: 24751
Attached please find the Field Inspection& Service Report with field test results for
services performed on 02/14/2006 at the property of Michael Fox located at 45 Bridges
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: Michael Fox
Massachusetts DEP
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and 0&M Form for Title 5 I/A
Treatment and Disposal Systems
A. Installation 6778
Important: Michael Fox
When filling out Owner
forms on the
computer, use 45 Bridges Lane
only the tab key Facility Street Address
to move your North Andover 01845
cursor-do not Cit y
use the return Zip
key. Mailing address of owner, if different:
rab 45 Bridges Lane
Street Address/PO Box:
North Andover MA 01845
City State Zip
ext.
Telephone Number
B. Authorized Service Provider
Wastewater Treatment Services, Inc.
O&M Firm
r
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
24751 Bio-Microbics, Inc. MicroFAST .5
DEP ID Manufacturer ID Model Number
05/17/2005
Installation Date Start of Operation
Approval Type: 0 General 0 Provisional 0 Piloting ®Remedial
Seasonal Residence—used less than 6 mo./year: 0 Yes ®No
D. Operating Information
02/14/2006
Inspection Date Previous Inspection Date
6 Pumping Recommended 0 Yes ®No
DEPMicroFASTnew.doc-3/6/06 Page t of 3
Massachusetts Department of Environmental Protection
Ll ureau of Resource Protection - Title 5
DP Approved Inspection and ® M Form for Title I/A
Treatment and Disposal Systems
6778
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.
Michael Dillen 02/14/2006
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 st of each year for the previous 12 months
E
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
DEPMicroFASTnew.doc•3/6/06 Page 3 of 3
L421 r � �1 NCORP0RATE0
8450 Cole Parkway w Shawnee, KS 66227 m Phone 913-422-0707 zu Fax: 912-422-0808 6778
e-mail: onsite ftiomicrobics.com www.biomicrobics.com m 800-753-FAST(3278)
FIELD INSPECTION & SERVICE REPORT
For Bio-Microbics Single Home FASTO System
INSTALLATION AUTHORIZED SERVICE PROVIDER
45 Bridges Lane
Installation Address North Andover,MA 01845 Name Wastewater Treatment Services,Inc.
Owner Name Michael Fox Street
Mail Address: Mail Address 44 Commercial Street
45 Bridges Lane Raynham, MA 02767
North Andover,MA 01845 City State Zip
508-880-0233 508-880-7232
Phone Fax e-mail Phone Fax e-mail
INSTALLATION INFORMATION I
Model No. Serial No. Date of Installation Date of last pump out
MicroFAST.5 24751 05/17/2005
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 Dail Flow 440 gpd.
H Standard Units
Color Clear
-Temperature 50.0
Odor Earth
Comments:
TECHNICIAN SERVICE DATE
Michael Dillen 02/14/2006