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Home My WebLink AboutDEP Alternative Systems Annual Filing 2026 Tel: (508) 896-1706 | FAX: (508) 896-5109 | info@nsuwater.com | nsuwater.com Project Number: Regular Mail ☐ Pick up ☐ Express Mail ☐ Hand Deliver ☐ Certified Mail ☒ Green Card/RR ☒ - DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems (June and September 2025) - Singulair Service Check List (June and September 2025) Shipping Method: Description (including number of copies and date): Date: 10/28/26 Massachusetts Department of Environmental Protection Attention: Title 5 Program 100 Cambridge Street, Suite 900 Boston, MA 02114-2534 To: Remarks: Please find enclosed the DEP Inspection and O&M Forms and Singulair Service Check Lists for operation and maintenance conducted at the above referenced property. If you have any questions or require additional information, please contact us at your earliest convenience. Thank you. cc: Yarmouth Board of Health [via email] Kevin Morin, Property Owner [via email] Norweco [via email] Regarding: Morin Residence 17 Vermont Ave - West Yarmouth, MA 02673 K11361DA.S.IA.700 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 Natural Systems Utilities O&M Firm 1573 Main Street Street Address Brewster City MA State 02631 Zip (508) 896 - 1706 ext. Telephone Number Samantha Farrenkopf Certified Operator Name 13265 Certification Number C. Facility/System Information DEP ID Norweco Manufacturer ID Singulair 960-500 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 6.4.2025 Inspection Date 9/16/24 Previous Inspection Date 1st: 26" sludge, 1" scum 2nd: 10" sludge, 0" scum 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 6.98 SU 6 to 9 DO 6 mg/L 2 or greater Turbidity 4.25 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. Conduct effluent samples for field testing. Notes and Comments: Effluent quality passed field testing parameters. The recirculation pump has failed and replacement was 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 6.16.2025 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 Natural Systems Utilities O&M Firm 1573 Main Street Street Address Brewster City MA State 02631 Zip (508) 896 - 1706 ext. Telephone Number Samantha Farrenkopf Certified Operator Name 13265 Certification Number C. Facility/System Information DEP ID Norweco Manufacturer ID Singulair 960-500 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 9.2.2025 Inspection Date 6.4.2025 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 7.65 SU 6 to 9 DO 4 mg/L 2 or greater Turbidity 5.84 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: Complete replacement of the recirculation pump in August 2025. Conduct an operation and monitoring event on 9/3/25. 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 9.15.2025 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 INVOICE Payment Terms Net 30 Days REMIT TO: Natural Systems Utilities 170 Township Line Road Building C Hillsborough, NJ 08844 Kevin Morin 218 Tower Road Ludlow, MA 01056 Statement of Work: Invoice Number Invoice Date Invoice Amount Project Number Project Name Project Manager Client Ref. Number Customer Number Billing Representative INV-0001123344 12/08/25 715.74 K11361W2.L.21.319 Morin Risk, Kara MORIN Replace Recirculation Pump Line Description Contract Value Line Amount Percent Complete Amount Billable Previous Billed Amount Current Due Amount Replace Recirculation Pump $715.74 100.00%$715.74 $0.00 $715.74 Subtotal $715.74 $715.74 $0.00 $715.74 Subtotal Less Retainage Sales Tax Invoice Total: 715.74 0.00 0.00 715.74 Questions? Please contact your Project Manager. Please include this invoice # on your remittance, so that it can be applied to your account correctly.Invoice Term : Net 30 days