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HomeMy WebLinkAbout2008 Mar 20 - FAST Field Inspection & Service Report03/20/200B 19:59 5083855891 A000 StrLHtLK rr�ut e�� ers 4* ' IKew 9TtsI?t* Fm91x-,14LD NS 't CTIO & SERVICE REPORT F STa wastewater treatment Systems MST L"TION S. VICE PROVIDER - U•, 5irces /J.f. " �• IZ l� Mail AddressSR/►►� bV • Y 0 X� - 7.3 � Mail Andress 'lwnc fFa Fax �'7'?0TNSTALLATION INFORMATION Y~SexW No- Date of lustaUlilM I iiie u lad A ut Al r Audia Almm Op=dog Wer€sl - A r Jbta Nita ( }em E310wer Hod Vcuts r'tcac B x ct--,31 vc Noise M one RES-ULT � - Odor M1 ke. J''-'q L CeA-L— v L f / • I � �GI1rr � A 03/20/200B 19:59 50B3855891 ACCU SEPCHECK PAGE 03/08 IN Massachusetts Department of Environmental Protection I Bureau of Resource Protection - Title 5 t ; ( DEP Approved inspection and O&M Form for Tifier 511A Treatment and Disposal Systems -A. Insta##ation,, tmpwtant: q 4qWhen filling out Owner forme on the 'll computer, use only the tab key FarMy Street Address to move your q /Zoot ©—- cursor - do not City - - Zip use the return key. Mailing address of owner, if different: Street Address/PO Box: City ..— State ,...,._._,.__ Zip Telephone Number B. Auth rized Service Provi& . !� / f S-- O&M Firm n Street Addr City State p Telephone N r 4 s Certified Operator Name Gerb0cation Number C. Facility/System Information ba k1cro41c5 /i. c r20, WLIT IJlanuracturer ID Model Number �6)OX Instaltattao Date Start of Qparatian Approval Type' General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence — used teSS than 6 mo./year ❑ 4 Yes X No D. Qperati g Information Inspection date � ` r^� � Previous. inspection Date --- - -- Purnping Recommended ❑ Yes into Sludg® Depth to he choked YeartY) J t5aiom.doc - rev. 4 t-07-05 Page 1 of 3 03/20/200B 19:59 5063855891 ACCU SEPCHECK PAGE 04/08 MassachuseEts Department of Environmental Protection I Bureau of resource Protection - Title 5 LI? 'r': ; E3EP Approved Inspection and O&M Form for 'I"ifile 5 IlA Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ❑ clear turbid ❑ Other (specify" Odor. ❑ musty ❑ eartny moldy ❑ offensive ❑ turbid Effluent Solids: ❑ no ❑ s SU mar` NTU pH �w--_,�� ,- -- Turbidity. 6 t.a 2 or greater 40 or Eels Should a Remedial General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOO and TSS_ F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of nitrogen reducing systems: Parameters sampled: ❑ pH E❑ Other t gpd and greater, and General Use gpd C130D ❑ TSS ❑ TN ❑ Other (list below) ether 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous ins action & during this inspection: C hoc !�c�&vcr� --C�rciced Motes end Comments: I/V I Z' L- 5,.q t5aiom.doc • rev, 11-07-05 Page 2 or 3 03/20/200B 19:59 5063B55B91 ACCU SEPCHECK PAGE 05/08 Massachusetts Department of Environmental Protection Bureau of resource Protection - Title 5 DAP 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 operalpqrt accordance with 257 CMR 2.00. _ 3 -2- Operglor Signature date -- System owner must submit this report, technology O&M checklist, artd any required sampling results to the local board of health and DEP as follows for each Inspedion performed: Remedial Use — by January 31 ar 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 3e of each year for the previous 12 rnonths Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6r Floor Boston, MA 02108 t5aiom.doc • rev. 11-07-05 Page 3 of 3 03/20/2008 19:59 5083855891 ACCU SEPCHECK PAGE 06/08 ACCUSEPCHECK 17 NORTHSIDE VWF- S. Orals MA 02WO. phondrax: 60e-385-5921: ema:7oea►o'b"s@cwtcasinet IN$PEGT12N and S1ERVlGE AGREEMENT This Agreement is entered into by Joe Martins dba Accu Sepcheck and the EAST System OWNER (herein called UWNER), for the purpose Of setting fourth terms and conditions goveming Joe Martins dba Accu Sepcheck obligations to inspect D nnees equipment listed below. This is a one-year service agreement for the following atternativeAnnovative septic system: BIQ-Microbics FAST unit Upon acceptance of this agreement, Joe Martins Qdba ,,Accu Sepcheck will render the following services only: s l� Equipment will be inspected at every 9PA men , beginning in July 2005 and ending in January 2006. Inspections shall include: 3 A20.5 Al a,-C'k -100 Y Dec zoo r EACH VISIT: _k Ae— •ZoOP SePT o?0d S 1) Inspection of the system in accordance with manufacturees recommendation using the technology service sheet and MASS DEP Form. 2) Ffeld test for pH, temp, dissolved oxygen, and sample for tab Nesting for turbidity in accordance with Mass DEP regulations. Sample and test for SOD, TSS m t^ o S QP Q b y Y—A 0 Ij 3) Following recommended procedures of the manufacturer regarding care and regular replacement based on hours /years in service. 4) Access to cxxmponents shall be at grade. If not diggingllabor charges will be added at $r fhr. 5) Electrical shutoff access shall be provided to Accu Sepcheck by the Owner, such as open access to the breaker box, or outside shutoff. 6) Notify GINNER of any recommendations or problems encountered. 7) If applicable: Invoicing on a quarterly basis for inspection and serVroe only to be paid within 30 days from date of invoice. Inspection or service work to be paid in full within 30 days. 8) Must receive a signed purchase order frorrr OWNER prior to any work being performed other than that.covered by this Inspection Agreement_ Service other than routine maintenance will be billed at an bourty rate plus travel time and material. 9) Owner shall notify operator of any alarm conditions, blockages or service such as pumping performed on this unit Joe Martins dba Accu Sepcheck shall notify the local board of health and the Department of Environment Protection in writing within 24 hours of a system failure or alarm event including corrective measures that have been taken_ It is understood that by this Agreement Joe Martins dba Accu Sepcheck is not obligated to supply any parts. Parts will cost additionally. Any additional labor time will be billed to the OWNER at standard labor rates of $''/hour. Emergency service between regular inspections will be provided at standard rates for labor during normal business hours, after 5:00 PM and on Saturdays time and one-half, and double: time on Sundays and holidays, minimum $100 plus standard charges for parts plus mileage and travel charges. The agreement does not include expenses to repair damage caused by abuse, accident, theft, acts of a thlyd person, forces of nature. or altering of the equipment by owners. Joe Martins dba Accu Sepcheck shall not be responsible for failure to render the service for causes beyond its control, including strikes and labor disputes. 03/20/200B 19:59 5083B55891 ACCU SEPCHECK PAGE 07/OB OWNER understands and agrees that Joe Martins dba Accu Sepcheck is not responsible for special or consequential damages, including loss of time, injury to person of property unit or equipment failure. This- agreement is not assignable without the consent of Joe ,Martins dba Accu Sepcheck and will remain in force until canceled by either party through written notice. Cancellation or re -assignment by either party will prompt Joe Martins dba Accu Sepcheck, in the case of cancellation by Joe Martins dba Accu Sepcheck, to notify the Board of Health within ten (10) wonting days of such cancellation. or in the case of cancellation .or re -assignment by the owner, the owner to notify the'Board of Health with ten (10) woridng days of such cancellation or re. -assignment. Failure; operate of operation, or alarm event of system: Should the system fail to opte .because of equipment failure, or have an alarm event or a failure to operate due to.human intervention, it is the responsibility of Joe Martins dba Accu 5epchock to notify the local Board of Health and the DEP in writing within 24 hours and to take corrective actions as soon as possible, preferably m thin'24 hours of the event or notice. This is a one-year seNjce contract to be billed annually in compliance with State regulations_ Failure to comply will result in cancellation and nullification of any warranties.. MANUFACTURER MODEL NO. SERIAL NO. LOCATION ANNUALRATE EgU1pWgnt Qwr�er l Sign Print Mau Telephone: Site address: Signed bye 17 Northside Ddve S. Dennis, MA 02660 Tel. 509-385-5891 Fay(: 608--385-6891 Email: joemartins@comcast.net Effective date of agreement:. 03/20/2006 19:59 50B3855B91 ACCU SEPCHECK PAGE 08/09 ffluapt 'Testing Effluent sample taken monthly for the first three months of operation and quarterly thereafter. a Muent samples. Samples shall be delivered to a qualified testing lab for evaluation and with results being sent to the owner, local Board of Health and Massachusetts DEP_ Owner is responsible for providing acceptable access to effluent to enable a grab sample to be taken for laboratory testing performed: PERMIT *(PLEASE CHECK ONE) 41LOCAL )GENERAL ( ) REMEDIAL ( ) PROVISIONAL_ *SPECIAL CONDITIONS BOARD OF HEALTH (Y) or (N) if YES, please attach copy of permit '. Effluent TeslingoSS ` 0 q, Ammonia, Nitrate, TKN, Total N, Conductivity, Other,,,_ZL O#Uent Testing Cost: 1 ! x �•-fP� 4A a,y a dos letidtnt'S Effluent Testing: pH, TSS, BOD, Ammonia, Nitrate, TKN, Phosphorous and Fecal Coiiform, Total Coliform ��teuE�flfluent Testing Cost: $ / Operator assigned:'3eo Telephone X: .Z i Z License .S-a S-7 Engineer: �Approval for Effluent Testin rban' -1(1� G4eck cc i - srrQ 7 S- 2.3-71 f (' r06- Un l - /Dt�- s:ee 7— to e J)e c- raf 0 w IE Fp) fMAR 2 12008 ir SO HEALTH UFH DEPT. FIELD INSPECTION &- SIERVi-CE RE PORT FAST,q, wastewater treatment sv,,sten,,,.s ........... . ..... ............ V NS'FAUON - - --------- -- 4VICE PROVIDER ,I tv Suite ztp ------------- 01wric. ---- - ------------- how., 7 90 ��aasf� y1'e. T INS ALIA'FION INFOW .. . ......... .. I,.-,., — I.. - I..... I - .4 . AMN we oflias1, alit, mon 1 14t, nflu,.-t Ali cro - e�ijdk? Alarm Opers-liog . .... . . ... �,C� io uke F LIM >s1S� stirs S L; 0 -Nf,,'R -1C' ATUNL� NV '� f—S N .. ............ - ..... .... ... 1614- NIAIN FX A10 I S t . . ..... . ... ... . ..... ------ -- - - ------- ,e eKelzile an a' WIA-t .A:, S111i VIC r?! Poo No -56' 1,,Js zoo 01 AaWqAQ NTQ tQQnn67Qnc Yva VV:nT Qnn7/n7/on f 7 N (.) rth,,;;k.to f)r S Dennis, foLA �mo) ernail. fax VuEg[Eu WEE ED MAR 2 1 2008 HEALTH DEPT. . ......... . . -------- --- 760 -9 -------- ----- ----------- 0 plesse Cl pmea.se 1�-Vpv El 1140:tLSt 14.eCyCte TOOP Aaaads HIS VRROOVZROC YVA cc:ol sooz/oz/co