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HomeMy WebLinkAbout2004 01-26 . � ; � , ��l� � � � ' � Massachusei!t� Deparfment of Enviranmen#at Prote�tion � i � Bureau of�esource Rrotectio�-Titte 5 ° � QEP ANRrovec� i�s�e�ti�n and 4��1 Fc�t�» for 't'i#�e � !/A ' Trea�en#and D�sposai Systems ' I - �4. � lla�io� - �,� i�1� � 1�-e--�i ° „ur,�,�„�,�c _ . � ,�. _ , , ..� , � � ��� � � ���� � � �� � � ` � � + ooinp�et,uss ' � a�h►�e t��osY ? t°"�'re ya„ ��� : c�-do ce^t � � u;s�+e re�m �-'�' ! �Y �lat'Gng resS of�mer,iF�i�Fes�r�t � "�..y `t=i�v��i�.i \ _ . � saeet�eax � � �' ' seace z� � (� )s�i� -�1�s3�aa. TeiephocK i�er i 8. Aes#�orized Service Provider _ ; _.-, � �1�9�u�dr ��u�r�tn�Pn�� .��ut�'�S , ,Ln� � . �F�, . �` q {���,'1!.'�� �+hr.� , �rQ��f�,c�-e. �2� d�.,�'r�s j �`�ro��?�S' -a�3v�. S`� � � ��e- !�'���%ts .S-l�.f"'�' i j ce�ea o�r�e c�r r�er � f ; C.-Facirc#yfSystetrs in�ormation ; � _G�tlla�` /UaRa��'c o �C�� ! ��a lr O� a�,��o a�t r� : , . ; En�tt Q�e SialL of ; ,,!!�� � Ap�roval Tyrpe:Q Generai[�Provisio�al�ii�ng 0 Rer�zedfal ; : t Se�on�Residenca—�ed less�6�.tye�[�Yes�No � ; �` ! - . � � �. Clp�rc�tin�rtn#orq�atio�r ; �_� . . - _�—�o� � � � .� �_ ' I �� y�-w. - - Rr�+rious n�e �.�e,E�tta ae� �pittg R�un+�nded ❑Yes��ic � � AA4 -S' ' v t�'/rD I �°�" � «� o oo,� i � T61A�M1•3nero2 � � �t ot 2 � . � , � , � � � ���� � V ' Massac�uset� Deparimet�t cf Et�viror�rr��rs#a! Protection ; , ; ; Bureau af Resc�ur�e Pratectio�t-T�ie 5 ' � D�P Appr�ved �nspec#ior� �nd Q�M Form far Ti#�e 5 #IA � � Tceatme�# and �isposal Systerr.� ' E. Samptic�g In#a�matia . 5��,-�:o�� ��,t : �ara��s�e� a�t �oo rss �rEv�c��� ; � � � � c � �4 I�_�--_ /tlf.�3 t2ch�Z t3ilter 3 ; Oes " tiat�anY,mairtt�tatu��er€cumed�pr�iptss ess�n�duc�r�g lhis utspertiorr. i /�-�' S'/� l,� 1 D e9ala,r- S✓vC�G�i'�1' s � �C �t.2. � �t1' �i-ti ff?t. /.��-�. : ; i Atotas and Camrnen#s: ' i ; i ; � ; , F. �e�catiot7 � t certify.!have insp�d#te�s+�rdge treaunent artd disposat system at#he adcfress aCave.have � compieGed ihis rep�rt and ttte at�achecf tec.haotagy ooerat�e ac�maintenar�c:e cEsecicii5#,and the ' �n t�e is �xatr�te,and cc�r►t�ete as�f the#'rcne of the ie�spec#ion. i am a ' se c in ce wittt 257 CMR 2_ / ! ...�e y , �} f ! . System awner rnust submit this r�o,�t„t�c;-�nafogy O&M c:��ckiist,�d any requirac samccing�=_suirs ' E�the locai baard ef�ea�and D��s c�tows fior each iRspE:cbon perfo�med: i . f ` Remediat Use— Jan ' 3'i�`af eact�year fi�or� Pifo�g b Pravisionat Use- Ge�nera!i3sa—by Septem6er `• within 30 days of inspecticzn 30 at each year fior the � P�ic�us caisndar year daEe � ; previous t2 months , � Department of Et3viromnentaf Protec�an i � A�iort: Tt'�le�P� f �} C�ne VYurter Str+ee�,6°1 F#oof � Sa�or�.II�A 02't08 � � � . • ; . TStAOM1•�28to2 � Papa 2 oi 2 , - � , # i I , � ` '°` ' �� � 1� � � � �� � SINGUZAIIt 5I"sRVICE CHECI�LiST � Ewittt same Qiter :�c fiiEer a�sighc a�ail�ran ciea�t wata ia�it unul thc SESI NU. 6.�. j �+ac flows oac o€the tiole in DATE UF �ICE:_„'�/_�la�f �,��.�� : �YI�PERFiJRMED BY:�""� azr ho�and agitatc witls air. ��} �eP agitat�8'Nith ciran � I.aeatfon Work!�Ifd uerformed � vuatec s2o�irly IIowing tt�il dte ; e�titfng wattr'ss drar. . { , �',rst Reemve�etc cover,cl�cic Fisish hosing dawn fitter � chamber f�n�rmat water le�ad .f ScraPe hoQger Check s€n�tge depth aRer ascco�d year�operatiou Apply fihri�ant to fxlter f3ange = � St�ud Ytcanove�ete sOve[' . ' � . chsa�ber Placc fiius in pla�ce,t�li 1 vrith ti c�n water and sit�ic it Conlird Opea aad s�ta"C{31yT .; oe�tcr positioa � . T�a out locking tabs,rePlace `� � fdtacuvts' Ssc� Chak aic$ow tbmugh aerar,or . _ chamiber ,S"3 p Ragvras con�te wva- . � � Ei�1ng aerrcv�aad tifc au Ferst Raplace coaaete covea - � c�mber Checic foa'�ro�n�bbar pads . 5ecaad Phtg i1t aesatQr' j � C�edc fdr vwar ot p�ab�� � V . C�edt wica insiser fv�,�fin3+ C�'vrite so ic is aot in ca�act [�i#needed �naaythiag ` W�off aesam�'puc it bach • �{���vu . Hook ug amF.ae�;cLeck Coa�`ol Puc switc4 ua"AUTf)' � /� : mF CIgtCAt v1C�2h�I11N11Rg. � [pi[Q' � r i ��c 3• j ���� Third Re�faire c�ncce�e co�a�sd .� cE�amber re�va tit�er to� Read a�d:+ecoi+d�our ma� � 11em itt biaslc Io�g t�s Faprr I.earc aot�ce of serv�e w8h �!� A_ �{ v�+ork owp� �� IOstsii pomp sud start pacIIpit�g � fmm;Hlcer to first chau�tbcr. - 1�1ac in�fxtc aaq : . Lift f�[wrah mpc ss �r�r p�ob�m � �3= . IudicatC if muy fUllow ttp iS i Lift omt f�tu�pwt it m wb �y ; G'lam d�e a�ts;ae af 6wer wim He s�,e m wmpkca fiie oa wazer,drain b�k oo fust ��n it W office � chamber . • �Sa .t+P�`e. t /j?G�t t7D� ; � �rio: • �rc�{�t� �►'�,� � _, �'"�al� �3 � ���n./ft/� I � f�v� ?b '7�i.t.S�4♦ � a,.-r+c f Ah 1�,I o ea�st+'�`�S dRlP��.T�� i � ► +0-� � i� ��fa r�NO.�� ,s'�r v� i � � �'e c..fi�'� �'U 1'� �0.4��� �a v o� � �� �'e �-�-�J . - � i � � � L t- ��¢...L �i� �Z--�— � ' x � � � , , �