HomeMy WebLinkAbout17 Vermont Ave - Yarmouth 2023 DEP Annual Filing
LETTER OF TRANSMITTAL
TO: DATE: JOB NUMBER:
REGARDING:
SHIPPING METHOD:
Regular Mail Pick Up Priority
Mail Hand Deliver
Express Mail Other
A NATURAL SYSTEMS UTILITIES COMPANY
LICENSED SITE PROFESSIONALS * ENVIRONMENTAL SCIENTISTS * GEOLOGISTS * ENGINEERS
1573 Main Street, Brewster, MA 02631 * 5088961706 * Fax 5088965106 * www.bennettea.com
BENNETT ENVIRONMENTAL ASSOCIATES, LLC.
Certified Mail Green Card/RR
COPIES DATE DESCRIPTION
For review and comment: For approval: As requested: For your use:
REMARKS:
FROM:
If enclosures are not as noted, kindly notify us at once
t5aiom.doc • rev. 04-11-13 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
A. Installation
Important: When
filling out forms
on the computer, use only the tab
key to move your
cursor - do not
use the return
key.
Kevin Morin
Owner
17 Vermont AVenue
Facility Street Address
West Yarmouth
City
02673
Zip
Mailing address of owner, if different:
218 Tower Road
Street Address/PO Box:
Ludlow
City
MA
State
01506
Zip
(617) 570 - 1332 ext.
Telephone Number
B. Authorized Service Provider
Bennett Environmental Associates, LLC
O&M Firm
1573 Main Street
Street Address
Brewster
City
MA
State
02631
Zip
(508) 896 - 1706 ext. 1140
Telephone Number
Brian Fortin
Certified Operator Name
15320
Certification Number
C. Facility/System Information
DEP ID
Norweco
Manufacturer ID
Singulair
Model Number
Unknown
Installation Date
Unknown
Start of Operation
Approval Type: General Provisional Piloting Remedial
Seasonal Residence – used less than 6 mo./year: Yes No
D. Operating Information
6/30/2022
Inspection Date
9/20/2022
Previous Inspection Date
Sludge Depth (to be checked yearly) Pumping Recommended Yes No
t5aiom.doc • rev. 04-11-13 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
E. Field Testing
Field Inspection:
Color: gray brown clear turbid
Other (specify):
Odor: musty earthy moldy offensive turbid
Effluent Solids: no some
pH 7.34 SU
6 to 9 DO 5.0 mg/L
2 or greater Turbidity 1.02 NTU
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 systems or systems with a design flow of 2000 gpd and greater, and General Use
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:
Conduct an operation and monitoring event. Collect effluent samples for field testing.
Notes and Comments:
All mechanical components of the system are operating correctly. Effluent quality passed field testing
parameters.
t5aiom.doc • rev. 04-11-13 Page 3 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 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.
Operator Signature
2/8/2023
Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health 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 31th of each year for the previous 12 months
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, 5th Floor
Boston, MA 02108
t5aiom.doc • rev. 04-11-13 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
A. Installation
Important: When
filling out forms
on the computer, use only the tab
key to move your
cursor - do not
use the return
key.
Kevin Morin
Owner
17 Vermont AVenue
Facility Street Address
West Yarmouth
City
02673
Zip
Mailing address of owner, if different:
218 Tower Road
Street Address/PO Box:
Ludlow
City
MA
State
01506
Zip
(617) 570 - 1332 ext.
Telephone Number
B. Authorized Service Provider
Bennett Environmental Associates, LLC
O&M Firm
1573 Main Street
Street Address
Brewster
City
MA
State
02631
Zip
(508) 896 - 1706 ext. 1140
Telephone Number
Brian Fortin
Certified Operator Name
15320
Certification Number
C. Facility/System Information
DEP ID
Norweco
Manufacturer ID
Singulair
Model Number
Unknown
Installation Date
Unknown
Start of Operation
Approval Type: General Provisional Piloting Remedial
Seasonal Residence – used less than 6 mo./year: Yes No
D. Operating Information
9/20/2022
Inspection Date
6/30/2022
Previous Inspection Date
12" sludge, 3" scum
Sludge Depth (to be checked yearly) Pumping Recommended Yes No
t5aiom.doc • rev. 04-11-13 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
E. Field Testing
Field Inspection:
Color: gray brown clear turbid
Other (specify):
Odor: musty earthy moldy offensive turbid
Effluent Solids: no some
pH 6.77 SU
6 to 9 DO 5.0 mg/L
2 or greater Turbidity 8.04 NTU
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 systems or systems with a design flow of 2000 gpd and greater, and General Use
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:
Conduct an operation and monitoring event. Collect effluent samples for field testing.
Notes and Comments:
All mechanical components of the system are operating correctly. Effluent quality passed field testing
parameters. Pumping of the septic tank is recommended.
t5aiom.doc • rev. 04-11-13 Page 3 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 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.
Operator Signature
2/8/2023
Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health 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 31th of each year for the previous 12 months
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, 5th Floor
Boston, MA 02108