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WATERLOO BIOFILTER SYSTEM
ROUTINE INSPECTION
ADDRESS: 300 Lon Pond Drive Yarmouth OWNER: Garramone
�
DATE: October 7, 2015 OPERATOR: Mario Rosa
SYSTEM STATUS
Septic Tank
I Effluent Filter: Cleaned
Scum Depth: 1"(Measured on 10l07/15)
Sludge Depth: 5"(Measured on 10/07/15)
Pump Chamber ',
Pump H-O-A Setting: Auto ',
' Pump Cycle Timer: 30 seconds on, 8 minutes 30 seconds off
Elapsed Time Meter: 90,600 minutes
Event Counter: 150,884
� High Level Alarm Count: 19
Low Level Alarm Count: 127
� Exercise Pump: Yes
Test&Clean Floats: O.k.
Tank Condition: Good
Waterloo Biofilter Chamber Recirculating Pump Disposal Pump
Pump H-O-A Setting: Auto Auto '
Pump Cycle Timer: 2 minutes on, 12 minutes off On Demand
Elapsed Time Meter: 94,771 minutes 169.81 hours
Event Counter: 100,001 2,115
High Level Alarm Count: 25 0
Exercise Pump: Normal Normal
' Test&Clean Floats: Yes Yes
Tank Condition: Good
Foam Medium Condition: Light grey
Spray Nozzles: Clean
UV Treatment
Check Light: Workin�
Clean Light: Clean
Effluent Quality
' Visual Inspection: Clear, no odor
� Sample: pH=6.5,Dissolved Oxv�en= 10.4 m��L,,Turbidity=0.57 NTU
;
Comments: Sampled from the Waterloo Biofilter(a� 12:45 p.m. Flushed laterals in SAS.
Signature:
++���'�������� '��i�� Certificate# 15652
PO Box 825, Ipswich, MA 01938• 978-356-0779 ■ Fax 978-356-5500 • www.clearwaterindustries.com
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; Massachusetts Department of Environmental Protection
I - 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 Barbara Garramone
filling out forms Owner
on the computer,
use only the tab 300 Long Pond Drive
key to move your Facility Street Address
cursor-do not Yarmouth 02675
use the return C�ty Zip
key.
,�
Mailing address of owner, if different:
� Street Address/PO Box:
�tron
City State Z�P
( ) - @Xt.
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
C. Facility/System Information
DEP ID Manufacturer ID Model Number
September 12 2005 April 1, 2006
Installation Date Start of Operation
Approval Type: ❑ General � Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: � Yes ❑ No
D. Operating Information
October 7, 2015 June 18, 2015
Inspection Date Previous Inspection Date
Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes � No
t5aiom.doc•rev. 11-07-05 Page 1 of 3
____.__ ___ .
i . 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 tnspection:
Color: ❑ gray ❑ brown � clear ❑ turbid
❑ Other(specify):
Odor: ❑ musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid
Effluent Solids: ❑ no ❑ some
H 6.5 SU p� 10.4 mg/L Turbidit �57 NTU
p 6 to 9 2 or greater Y 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 s stems or s stems with a desi n flow of 2000 d and reater, and General Use
Y Y 9 9p 9
nitrogen reducing systems:
gpd
Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS �TN ❑ 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. Effluent sample to test for Total Nitrogen.
t5aiom.doc•rev.11-07-05 Page 2 of 3
i •
', Massachusetts Department of Environmental Protection
� . Bureau of Resource Protection - Title 5
i
DEP 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.
'i������,���,��� October 7, 2015
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 3151 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 30t"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
t5aiom.doc•rev. 11-07-05 Page 3 of 3
,
� • NORTHEAST ENVIRONMENTAL LABORATORY, INC.
� �
41 DAYTON STREET, DANVERS, MA 01923-1015 • 978.777.4442
MASSACHu5ETT5 DEP NO. M-MA123
Clear Water Industries SO/15/15
P.O. Box 825 Report# 42061
Ipswich, MA 01938
Result MDL Method Analyzed By Lab Cert.*
�
j NEL# A10480: 300 Long Pond Drive Yarmouth Waterloo Effluent collected SO/07/15 at 12:45 by MR and received at NEL
10/08/15 at 08:10 by KC.
Nitrate 11.7 mg/L 0.02 300.0 SO/08/15 11:16 KC MA123 P, N
Nitrite < 0.2 mg/L 0.01 300.0 10/08/15 11:16 KC MA123 P
Total Kjeldahl Nitrogen < 1 mg/L 0.5 351.1 10/13/15 J)T CT008 N
Cert.* Lab performing analysis is certified for the parameter by MA-DEP in: P= potable water, N = non-potable water
�Qr.�. �
)ohn Lovatt
Laboretory Director
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� 2 5 2015
June 24, 2015 HEALTH DEpr
, Ms. Bazbaza Garramone
� 300 Long Pond Drive
Yarmouth, MA 02675
RE: Maintenance and Service Contract for the Waterloo Biofilter System located at
�n� T .�„a na^d n:i��e, Yurmcath
� Deaz Bazbara:
Clear Water Industries (CWI)proposes to provide the service and maintenance for the Waterloo
Biofilter System located at the above referenced property. The following maintenance and service
schedule is for the next two (2) yeazs of operation commencing upon receipt of signed contract and
Annual Cost received in full.
Scheduled Semi-Annual Service:
Annual Cost: 2 inspections and 2 field effluent testing @ $215 each = $430.00
2 Lab tests for TN @$100 per test =$200.00
$630.00
(Note: Access cover for all components must be at the ground surface.)
l. Check sludge and scum depth in the septic tank and clean the effluent filter as needed.
2. Check panel and alann system.
3. Check ejector pumps and float switches in both the Pump Chamber and the Waterloo Biofilter.
4. Check spray nozzles, fan and foam cubes in Waterloo Biofilter.
5. i ake c�iiuent �ai;iple as ,-eyuiicu by ;`viassnchusetis�.i.P. Sau;ple ,viii be anaiyzed for iiie
following:
*Total Nitrogen (TN =TKN +NO3 +NO2),
*Dissolved Oxygen,
*Turbidity,
and *pH.
6. Notify Client verbally of any problems encountered.
(Note: There may be instances when the high water alarm will sound. In the event of an alarm
condition, you aze requested to silence the audible alann and contact
CWI @ (978) 356-0779 for instruction and/or a follow-up field visit by a C WI personnel.
See unscheduled service costs.)
I have read and agree with the above Scope of work:
CWPs initial ��_ Owner's initial ��
PO Box 825, Ipswich, MA 01938 • 978-356-0779 • Fax 978-356-5500 •www.clearwaterindustries.com
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Page 2
Ms. Bazbara Garramone
June 24, 2015
Unscheduled service:
1. Unscheduled emergency service calls will be billed at the following hourly rates:
*Monday through Friday 7am— 5pm: $90
*Monday through Friday 12am— 7 am, 5 pm— 12pm: $150
*Saturday and Sunday: $150
with a minimum of a 2 hour charge.
2. If results of field effluent testing for pH, Dissolved Oxygen or Turbidity do not comply
with Massachusetts Department of Environmental Protection limits, additional testing for
Total Suspended Solids and Biochemical Oxygen Demand would need to be done at a
certified laboratory. Owner would be contact prior to additional testing. Additional
testing of above effluent would be $95.00 per sample. Additional sampling for nitrogen
effluent @ $195.00 per sample. Additional sampling would be necessary, if a high test
result in TN was obtained. Owner would be contact prior to any re-sampling.
Certified technician:
The service technician shall be a Massachusetts Certified Operator. The certified operator will
be David F. Clark, George F. Norris, Mazk S. Cottrell, Mazio Rosa or James Griffin.
Reporting requirements:
In accordance with DEP's Title V Regulations, CWI will file annual reports transmitting the data
from the semi annual insnections. as noted above, as well as a xeview ef an� ,.�nscheduled
service. CWI will also file semi annual reports with the home owner and the local Boazd of
Health. _ . _
Sincerely,
Cleaz Water Industries
'����
David F. Clark
Manager
Acceptance by Owner:
� li /.�-"
Barbaza Garramone Date
PO Box 825, Ipswich, MA 01938 • 978-356-0779 • Fax 978-356-5500 •www.clearwaterindustries.com
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JUL C16 Z015
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WATERLOO BIOFILTER SYSTEM
ROUTINE INSPECTION
ADDRESS: 300 Long Pond Drive.Yarmouth OWNER: Garramone
- DATE: June 18. 2015 OPERATOR: Mazk Cottrell
SYSTEM STATUS
Septic Tank
Effluent Filter: Cleaned
Scum Depth: I"(Measured on 10/31/141
Sludge Depth: 5"(Measured on 10/31/14)
Pump C6amber
Pump H-O-A Setting: Auto
Pump Cycle Timer: 30 seconds on, 8 minutes 30 seconds off
Elapsed Time Meter: 84371 minutes
Event Counter: 140.721
High Level Alarm Count: 19
Low Level Alarm Count: 125
Exercise Pump: Yes
Test&Clean Floats: O.k.
Tank Condition: Good
Waterloo Biofilter Chamber Recirculating Pump Disposal Pump
Pump H-O-A Setting: Auto Auto
Pump Cycle Timer: 2 minutes on. 12 minutes off On Demand
Elapsed Time Meter. 89,056 minutes 163.54 hours
Event Counter: 94.473 1,978
High Level Alazm Count: 23 0
Exercise Pump: Normal Normal
Test&Clean Floats: Yes Yes
Tank Condition: Good
Foam Medium Condition: Li tg_�t grey
Spray Nozzles: C]ean
UV Treatment
Check Light: Working
Clean Light: Clean
Eftluent Quality
Visual Inspection: Clear, no odor
Sample: pH=6.5.Dissolved Oxy�en= 7 95 mg/L Turbidity=0 69 NTU
Comments: Samnled from the Waterloo Biofilter Ca� 7:30 a.m. Flushed laterals in SAS on ]0/31/14
Signature: ��� '�--2���7jO" Certificate# 11739
� PO Box 825, Ipswich, MA 01938• 978-356-0779 • Fax 978-356-5500 • www.cleanvaterindustries.com
Massachusetts Department of Environmental Protection
� Bureau of Resource Protection - Title 5
� DEP Approved Inspection and 08�M Form for Title 5 I/A
Treatment and Disposal Systems
A. Installation
imPonanr. Barbara Garramone
When filling out p�yner
forms on the
wmputer,use 300 Long Pond Drive
only the tab key Facility Street Address
to move your Yafmouth 02675
cursor-do not Cily Zip
use the return
key. Mailing address of owner, if different:
�u--�
I� StreetAddresslPOBox:
"°'" City State Zip
( ) - BXt.
Telephone Number
B. Authorized Service Provider
Clear Waterindustries
OSM Firtn
P.O. Box 825
St2et Address
Ipswich MA 01938
City State Zip
(978) 356-0779 e#.
Telephone Number
Mark Cottrell 11739
Certified Operator Name Cert�cation Number
C. Facility/System Information
DEP ID Manutadurer ID Model Number
September 12, 2005 April 1, 2006
Installation Date Start of Operation
Approval Type: ❑ Generai � Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: � Yes ❑ No
D. Operating information
June 18, 2015 October 31, 2014
Inspection Date Previous Inspeclion Date
5"
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
Fieid Inspection:
Color: ❑ gray ❑ brown � clear ❑turbid
❑ Other(specify):
Odor: ❑ musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid
Effluent Solids: ❑ no ❑ some
PH 6.5 SU D0 7.95 mg/L Turbidity 0.69 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 � Effiuent
Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use
nitrogen reducing systems:
9Pd
Parameters sampled: ❑ pH ❑ BOD � CBOD ❑ TSS � TN ❑ 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. EfFluent sample to test for Total Nitro en.
t5aiom.doc•rev. 11-07-OS Page 2 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
H. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
conducted the required Field Testing andlor 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.
�,� <� �
1��� � ` June18 2015
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 pertormed:
Remedial Use—by January 31s`of each year for the previous calendar year
Piloting Use-within 45 days of inspection date
Provisional Use—by March 31'"of each year for the previous 12 months
General Use—by September 30'"of each year for the previous 12 months
Send to:
Department of Environmental Protection
Attention: Title 5 Pro�gram
One Winter Street, 6` Floor
Boston, MA 02108
t5aiom.doc•rev.11-07-05 Page 3 of 3
/ ,
NORTHEAST ENVIRONMENTAL LABORATORY, INC.
"r
41 DAYTON STREET, DANVERS, MA 07923-1O1S •97$.777.4442
Ma55aCFiu5ETT5 DEP NO. M-MA723
Clear Water Industries 06/26/15
P.O. Box 825 Report# 41289
Ipswich, MA 01938
Result MDL Method Analyzed By Lab Cert.'
NEL# A08050: 300 Long Pond Drive Yarmouth Waterloo Effiuent collected 06/18/15 at 07:30 by MC and received at NEL
06/19/SS at OS:03 by KC.
Ni[rate 14.8 mg/L 0.02 300.0 06/19/15 KC MA123 P, N
Ni[rite < 0.2 mg/L 0.01 300.0 06/19/15 KC MAI23 P
To[al Kjeldahl Nitrogen < 1 mg/L 0.5 351.1 06/25/15 JJT CT006 N
Cert.* Lab pertorming analysis is certified for[he parame[er by MA-DEP in: P= po[able water, N = non-potable water
�
John Lovatt
Laboratory Direc[or