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HomeMy WebLinkAbout0206 LONG BEACH ROAD - Health 206 L®NG BEACH RD., CEN'fZRV.[LL A=206.001 z: l `���ae•%�«ci/��r- �7recr.�irrc�i.� 1�r�ric�.�; 'izc-. 44 Commercial Street Raynham, MA 02767 Tel: (508) 880-0233 r - Fax: (508) 880-7232 March 21, 2006 Richard McCourt 21 Jarris Avenue Hingham, MA 02043 Reference: 206 Long Beach Road. Centerville— Serial # BMR1006 Dear Mr. McCourt: Wastewater Treatment Services was at your site in March for service and/or service and testing and found your blower off and system not working as designed or permitted.- If this is a seasonal unit used 6 months or less, please notify your local Board of Health and ask that your status be changed from a year-round residence,to a seasonal residence. Please forward a copy of your request along with any response you receive to our office for our records. Thank you in advance for your cooperation. Sincerely, 1�A�ialm � e6pet Service Manager k i�'41 Cc: Barnstable Board of Health Massachusetts DEP - 44 Commercial Street Raynham, MA 02767 Tel: (508) 880-0233 Fax: (508) 880-7232 February 9, 2005 Barnstable Board of Health 200 Main Street Hyannis, MA 02601 Attention: Health Agent Reference: Single Home FAST® Treatment System Serial Number: BMR1006 Attached please find the Field Inspection& Service Report for services performed on 12/14/2004 at the property of Richard McCourt located at 206 Long Beach Road- Centerville, MA. Please call if you have any questions or require additional information. Sincerely, Wastewater Treatment Services, Inc. Service Department Enclosures '> Copy to: Richard McCourt = Massachusetts DEP •• E>n� CID Inn LlMassachusetts 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 4329 Important: Richard McCourt When filling out Owner forms on the computer,use 206 Long Beach Road only the tab key Facility Street Address to move your Centerville cursor-do not 02632 use the return City Zip key. Mailing address of owner, if different: 21 Jarris Avenue Street Address/PO Box: Hingham MA 02043 `BQ1' City State Zip (617 269 2330 ext. Telephone Number B. Authorized Service Provider Wastewater Treatment Services, Inc. O&M Firm 44 Commercial Street Street Address Raynham MA 02767 City State Zip (508)—880-0223 ext. Telephone Number Michael Dillen 11173 Certified Operator Name Certification Number C. Facility/System Information BMR1006 Bio-Microbics, Inc. MicroFAST Single HomeFAST DEP ID Manufacturer's Name&ID .9 09/11/1996 Installation Date Start of Operation Approval Type:_General _Provisional _Piloting X Remedial Seasonal Residence—used less than 6 mo./year:_Yes X No D. Operating Information 12/14/2004 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended _Yes X No Color: Odor: Effluent Description DEPMicroFASTnew.doc-2/9/o5 Page 1 of 2 LlMassachusetts Department of Environmental Protection -`" Bureau of Resource Protection - Title 5 DEP Approved Inspection and 0&M Form for Title 5 I/A Treatment and Disposal Systems - 4329 E. Sampling Information Samples Taken:_ Influent _Effluent Parameters sampled:_pH_BOD—TSS_TN_Other(list below) Other 1 Other 2 Other 3 Description of any maintenance performed since previous inspection &during this inspection: Notes and Comments: Also tested: , , , . Unit off for the season. F. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, 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. Michael Dillen 12/14/2004 Operator Signature Date System owner must submit this report, technology 0&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 Piloting & Provisional Use- General Use—by September 31 st of each year for the within 30 days of inspection 30th of each year for the previous calendar year date previous 12 months Department of Environmental Protection Attention: Title 5 Program One Winter Street, 61h Floor Boston. MA 02108 DEPMicroFASTnew.doc•2/9/05 Page 2 of 2 1 INCORPORATED 8450 Cole Parkway m Shawnee, KS 66227 m Phone 913-422-0707 m Fax: 912-422-0808 4329 e-mail: onsite(ftiomicrobics.com m www.biomicrobics.com m 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT . For Bio-Microbics Single Home FAST® System INSTALLATION AUTHORIZED SERVICE PROVIDER 206 Long Beach Road Installaticn Address Centerville,MA 02632 Name Wastewater T reatryient Services,inc. Owner Name Richard McCourt Street Mail Address: Mail Address 44 Commercial Street 21 Jams Avenue Raynham, MA 02767 Hingham,MA 02043 City State Zip 508-880-0233 508-880-7232 Phone 617 269 2330 Fax e-mail Phone Fax e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pump out Sin Ie HomeFAST.9 BMR1006 09/11/1996 09/01/2002 EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating if resent Blower(s) Air Inlet Filter Clean Blower Hood Vents Clear Excessive Noise Excessive Vibration Treatment unit(s) Unusual Odor Pum out Required: X Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LIMIT RESULT Estimated Daily Flow 4 Bedrooms H Standard Units Color Temperature Odor Comments: Unit off for the season. TECHNICIAN SERVICE DATE Michael Dillen 12/14/2004 Vases 9rwti7w"jave 44 Commercial Street Raynham, MA 02767 Tel: (508) 880-0233 Fax: (508) 880-7232 July 6, 2005 2 Barnstable Board of Health Qn µ i Xa 200 Main Street Hyannis, MA 02601 Attention: Health Agent -� : Reference: Single Home FAST® Treatment System c.a CO Serial Number: BMR1006 --j M Attached please find the Field Inspection& Service Report and test results for services performed on 06/07/2005 at the property of Richard McCourt locate at 206 ong eac a - Centervi e, - -�aa1T i you have any questions or require additional information. Sincerely, Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: Richard McCourt Massachusetts DEP Environmental Chemistry Site Assessment Environmental Services Quality Assurance Services Analytical B� ` ce Site Sampling C O R P R A T T 0n* Data Auditing Wastewater Treatment Services, Inc. CERTIFICATE OF ANALYSIS 44 Commercial Street REPORTED: 06/20/2005 Raynham, MA 02767 ORDER#: G0572048 COLLECTED BY: M.Dillen SAMPLE DATE: 6/7/2005 TIME: 15:00 DATE RECEIVED: 6/8/2005 LOCATION: 206 Long Beach Rd., Centerville, MA SAMPLE ID: McCourt Grab(BMR1006) DESCRIPTION: WATER RESULTS OF ANALYSIS Test Parameters LAB-m#: 0572048-01 BOD SM 5210B 06/09/2005 H mg/L 4 5.3 p SM 4500 H+B 06/08/2005 S.U. 1 0-14 S mg/I" olids, Suspended SM 2540 D 06/09/2005 6.8 :L:::�4 6.5 — NA=Not Applicable ND=Not Detected Less Than Approved B : bb '*' = Detection Limit b Mana ate mom"'? JUN 1 1 JUN 2 t fos Analytical Balance Corp., 422 West Grove Street, Middleboro, MA 02346 Ph: 508-946-2225 Massachusetts Department of Environmental Protection Ll Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems 4329 A. Installation Important: Richard McCourt When filling out Owner forms on the computer,use 206 Long Beach Road only the tab key Facility Street Address to move your Centerville cursor-do not 02632 use the return city Zip key. Mailing address of owner, if different: VQ 21 Jarris Avenue Street Address/PO Box: Hingham MA 02043 City State (617 269 2330 ext. zip Telephone Number B. Authorized Service Provider Wastewater Treatment Services, Inc. O&M Firm 44 Commercial Street Street Address Raynham MA 02767 City State Zip (508)—880-0223 ext. Telephone Number Michael Dillen 11173 Certified Operator Name Certification Number C. Facility/System Information BMR1006 Bio-Microbics, Inc. Single HomeFAST.9 DEP ID Manufacturer's Name&ID Model Name&Number 09/11/1996 Installation.Date Start of Operation Approval Type:_General _Provisional _Piloting X Remedial Seasonal Residence—used less than 6 mo./year:_Yes X No D. Operating Information 06/07/2005 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended _Yes X No Color: Clear Odor: None Effluent Description DEPMicroFASTnew.doc-7/6/05 Page 1 of 2 f LlMassachusetts 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 4329 E. Sampling Information Samples Taken:—Influent X Effluent Parameters sampled: X pH X BOD X TSS—TN—Other(list below) Other 1 Other 2 Other 3 Description of any maintenance performed since previous inspection &during this inspection: Cleaned Filter,,,Splash Recycle, Notes and Comments: Also tested: , , , . Alarm inside-not accessible. F. Certification I certify:.I have inspected the sewage treatment and disposal system at the address above, 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. Michael Dillen 06/07/2005 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 Piloting &Provisional Use- General Use—by September 31St of each year for the within 30 days of inspection 30th of each year for the previous calendar year date previous 12 months Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston. MA 02108 DEPMicroFASTnew.doc•7isio5 Page 2 of 2 I MiNc o R P 0 MRA T E 0 8450 Cole Parkway Shawnee, KS 66227 m Phone 913-422-0707 w Fax: 912-422-0808 4329 e-mail: onsite(W-biomicrobics.com m www.biomicrobics.com m 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTALLATION AUTHORIZED SERVICE,PROVIDER 206 Long Beach Road Installation Address Centerville,MA 02632 Name Wastewater Treatment Services,Inc. Owner Name Richard McCourt Street Mail Address: Mail Address 44 Commercial Street 21 Janis Avenue Raynham, MA 02767 Hingham,MA 02043 City State Zip 508-880-0233 508-880-7232 Phone 617 269 2330 Fax e-mail Phone Fax e-mail INSTALI;ATION INFORl1!1ATION Model No. Serial No. Date of Installation Date of last pump out Single HomeFAST.9 BMR1006 09/11/1996 09/01/2002 EQUIPMENT.UIPMENT YES N PERF S < Electrical Panel (s)QRIyIEI),AND CQTvfiyl�'F Visual Alarm Operating Au dio Alarm Operating g if resent -Blower(s) Air Inlet Filter Clean X Blower Hood Vents Clear X Excessive Noise X Excessive Vibration X Treatment unit(s) Unusual Odor Pum out Re uired: X Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LIMIT RESULT Estimated Daily Flow 4 Bedrooms H Standard Units Color Clear Temperature Odor None Comments: Alarm inside-not accessible. TECHNICIAN SERVICE DATE Michael Dillen 06/07/2005 II s- 44 Commercial Street Raynham, MA 02767 r ' Tel: (508) 880-0233 Fax: (508) 880-7232, May 6, 2004 RECEIVED MAY 112004 Barnstable Board of Health TOWN OF BARNSTABLE 200 Main Street HEALTH DEPT. Hyannis, MA 02601 Attention: "., Health Agent Reference: Single Home FAST®Treatment System Serial Number: BMR1006 Attached please find the Field Inspection& Service Report. We attempted service on 03/18/2004 at the property of Richard McCourt located at 206 Long Beach Road - Centerville, MA; however, the system was turned off. Please call if you have any questions or require additional information. Sincerely, Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: Richard McCourt Massachusetts DEP Massachusetts Department of Environmental Protection Bureau of Resource Protection Title 5 DEP A rove�d�lnspection�and OW Form forrTitle '5,1/A pP Treatment and Disposal Systems 2737 Ll A. Installation Important: Richard McCourt When filling out Owner forms on the computer,use 206 Long Beach Road only the tab key Facility Street Address to move your Centerville cursor-do not 02632 use the return city Zip key. Mailing address of owner, if different: 'Q 21 Jarris Avenue Street Address/PO Box: Hingham MA 02043 mod"' City State Zip (617 269 2330 ext. Telephone Number B. Authorized Service Provider Wastewater Treatment Services, Inc. O&M Firm 44 Commercial Street Street Address Raynham MA 02767 City State Zip (508)—880-0223 ext. Telephone Number Joan Peterson 9166 Certified Operator Name Certification Number C. Facility/System Information BMR1006 Bio-Microbics, Inc. Single HomeFAST.9 DEP ID Manufacturer's Name&ID Model Name&Number 09/11/1996 Installation Date Start of Operation Approval Type:_General _Provisional _Piloting X Remedial Seasonal Residence—used less than 6 mo./year:_Yes X No D. Operating Information 03/18/2004 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended _Yes X No Color: Odor: Effluent Description DEPMicroFASTnew.doc•6/6/04 Page 1 of 2 Massachusetts Department of Environmental Protection 4 f.,:Bureau of Resource Protection Title D E P s,��s`sC.t� :.,a h a 7 Approved Insi�"e'ction-arty O&M fo`irlm"folrLl t { Treatment and Disposal Systems E. Sampling Information Samples Taken:_Influent _Effluent Parameters sampled:_pH_BOD_TSS_TN_Other(list below) Other 1 Other 2 Other 3 Description of any maintenance performed since previous inspection &during this inspection: Notes and Comments: Unable to service-power off. F. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have completed this report and the attached technologyoperation and P 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. Joan Peterson 03/18/2004 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 Piloting& Provisional Use- General Use by September 31 st of each year for the within 30 days of inspection 30th of each year for the previous calendar year date previous 12 months Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston. MA 02108 DEPMicroFASTnew.doc•5/6104 Page 2 of 2 4 4 INCORPORATED 8450 Cole Parkway m Shawnee, KS 66227 Phone 913-422-0707 w Fax: 912-422-0808 2737 e-mail: onsite(cDbiomicrobics.com m www.biomicrobics.com m 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FASTO System INSTALLATION AUTHORIZED SERVICE PROVIDER 206 Long Beach Road Installation Address Centerville,MA 02632 Name Wastewater Treatment Services,Inc. Owner Name Richard McCourt Street Mail Address: Mail Address 44 Commercial Street 21 Jams Avenue Raynham, MA 02767 Hingham,MA 02043 City State Zip 508-880-0233 508-880-7232 Phone 617 269 2330 Fax e-mail Phone Fax e-mail INS.TALLAT ION;INFORMATION. r' Model No. Serial No. Date of Installation Date of last pump out Single HomeFAST.9 BMR1006 09/11/1996 EQUIPMENT YES .,. NO. .:. MAINTENANCE PERFORMED,AND COMMENTS Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating if resent Blower(s) Air Inlet Filter Clean X Blower Hood Vents Clear X Excessive Noise X Excessive Vibration X Treatment unit(s) Unusual Odor Pum out Required: X Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LIMIT RESULT Estimated Daily Flow 4 Bedrooms H Standard Units Color Temperature Odor Comments: Unable to service-power off. TECHNICIAN SERVICE DATE Joan Peterson 03/18/2004 Jff v&ws,, Ylic. 44 Commercial Street Raynham, MA 02767 Tel: (508) 880-0233 - Fax: (508) 880-7232 July 30, 2004 Barnstable Board of Health 200 Main Street Hyannis, MA 02601 Attention: •'HealthAgent Reference: Single Home FAST® Treatment System Serial Number: BMR1006 Attached please find the Field Inspection& Service Report and test results(as required) for services performed on 07/12/2004 at the property of Richard McCourt located at 206 Long Beach Road - Centerville, MA. Please call if you have any questions or require additional information. Sincerely, Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: Richard McCourt Massachusetts DEP Environmental Crr2mistry rr Environmental Services Site Assessment Anal ic(,�,1 gcC� Site Sampling Quality Assurance Services Data Auditing G 0 R P O R A T T 0 N CERTIFICATE OF ANALYSIS Wastewater Treatment Services, Inc. 44 Commercial Street REPORTED: 07/21/2004 Raynham, MA 02767 ORDER#: G0461176 COLLECTED BY: M. Dillen SAMPLE DATE: 7/12%2004 TIME: 15:45 DATE RECEIVED: 7/13/2004 LOCATION: 206 Long Beach Rd. Centerville,MA SAMPLE ID: McCourt BMR1006 Grab DESCRIPTION: WATER RESULTS OF ANALYSIS � z n v +fi � Test Parameters LAB-M: 0461I76-01 BOD SM 5210B 07/14/2004 mg/L 4 14.8 I pH SM 4500 H+B 07/13/2004 S.U. 0-14 7.7 Solids,Suspended SM 2540 D 07/16/2004 mg/L 4 12.0 NA=Not Applicable ND=Not Detected Less Than Approved By: = *' = Detection Limit La Mana;er Date Page 1 of l Analytical Balance Corp., 422 West Grove Street, Middleboro, MA 02346 Ph: 508-946-2225 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 2737 A. Installation Important: Richard McCourt When filling out Owner forms on the computer,use 206 Long Beach Road only the tab key Facility Street Address to move your Centerville cursor-do not 02632 use the return City Zip key. Mailing address of owner, if different: 21 Jarris Avenue Street Address/PO Box: Hingham MA 02043 City State Zip (617 269 2330 ext. Telephone Number B. Authorized Service Provider Wastewater Treatment Services, Inc. O&M Firm 44 Commercial Street Street Address Raynham MA 02767 City State Zip (508)—880-0223 ext. Telephone Number Michael Dillen 11173 Certified Operator Name Certification Number C. Facility/System Information BMR1006 Bio-Microbics, Inc. Single HomeFAST.9 DEP ID Manufacturer's Name&ID Model Name&Number 09/11/1996 Installation Date Start of Operation Approval Type:_General _Provisional _Piloting X Remedial Seasonal Residence—used less than 6 mo./year:_Yes X No D. Operating Information 07/12/2004 Inspection Date Previous Inspection Date 11 Sludge Depth(to be checked yearly) Pumping Recommended _Yes X No Color: Clear Odor: None Effluent Description DEPMicroFASTnew.doc•7/30/04 Page 1 of 2 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 2737 E. Sampling Information Samples Taken:— Influent X Effluent Parameters sampled:X pH X BOD X TSS—TN—Other(list below) Other 1 Other 2 Other 3 Description of any maintenance performed since previous inspection &during this inspection: Cleaned Filter,,,Splash Recycle, Notes and Comments: F. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, 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. Michael Dillen 07/12/2004 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 Piloting & Provisional Use- General Use—by September 31s`of each year for the within 30 days of inspection 30th of each year for the previous calendar year date previous 12 months Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6`h Floor Boston. MA 02108 DEPMicroFASTnew.doc-7/30/04 Page 2 of 2 I 1 INCORPORATED 8450 Cole Parkway m Shawnee, KS 66227 m Phone 913-422-0707 m Fax: 912-422-0808 2737 e-mail: onsite(ftiomicrobics.com m www.biomicrobics.com m 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTALLATION AUTHORIZED SERVICE PROVIDER. 206 Lop_g Beach Road Installation Address Centerville,MA 02632 Name Wastewater Treatment Services,Inc. Owner Name Richard McCourt Street Mail Address: Mail Address 44 Commercial Street 21 Jams Avenue Raynham, MA 02767 Hingham,MA 02043 City State Zip 508-880-0233 508-880-7232 Phone 617 269 2330 Fax e-mail Phone Fax e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pump out Single HomeFAST.9 BMR1006 09/11/1996 09/01/2002 EQUIPMENT ;YES NO MAINTENANCE PERFORMED AND;CONIIviENTS Electrical Panel(s) Visual Alarm Operating X Audio Alarm Operating X if resent Blower(s) Air Inlet Filter Clean X Blower Hood Vents Clear X Excessive Noise X Excessive Vibration X Treatment unit(s) Unusual Odor Pum out Required: X Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LIMIT RESULT Estimated Daily Flow 4 Bedrooms H Standard Units Color Clear Temperature Odor None Comments: TECHNICIAN SERVICE DATE Michael Dillen 07/12/2004 tea. 91-w&ne1ztJ& ,, Yw. 44 Commercial Street Raynham, MA 02767 Tel: (508) 880-0233 Fax: (508) 880-7232 September 29, 2004 Barnstable Board of Health 200 Main Street Hyannis, MA 02601 Attention: Health Agent Reference: Single Home FAST® Treatment System Serial Number: BMR1006 Attached please find the Field Inspection & Service Report(as required)for services performed on 09/20/2004 at the property of Richard McCourt located at 206 Long Beach Road - Centerville, MA. Please call if you have any questions or require additional information. S+J Sincerely, " Wastewater Treatment Services, Inc. Service Department Cf; ` : N Enclosures Copy to: Richard McCourt Massachusetts DEP ;, LlMassachusetts 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 2737 A. Installation Important: Richard McCourt When filling out Owner forms on the computer,use 206 Long Beach Road only the tab key Facility Street Address to move your Centerville 02632 cursor-do not use the return City ZIP key. Mailing address of owner, if different: VQ 21 Jarris Avenue Street Address/PO Box: Hingham MA 02043 City State Zip (617 269 2330 ext. Telephone Number B. Authorized Service Provider Wastewater Treatment Services, Inc. O&M Firm 44 Commercial Street Street Address Raynham MA 02767 City State Zip (508)—880-0223 ext. Telephone Number Michael Dillen 11173 Certified Operator Name Certification Number C. Facility/System Information BMR1006 Bio-Microbics, Inc. Single HomeFAST .9 DEP ID Manufacturer's Name&ID Model Name&Number 09/11/1996 Installation Date Start of Operation Approval Type:_General _Provisional _Piloting X Remedial Seasonal Residence—used less than 6 mo./year:_Yes X No D. Operating Information 09/20/2004 Inspection Date Previous Inspection Date 11 Sludge Depth(to be checked yearly) Pumping Recommended _Yes X No Color: N/A Odor: None Effluent Description DEPMicroFASTnew.doc•9/29/04 Page 1 of 2 LlMassachusetts 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 2737 E. Sampling Information Samples Taken:_Influent _Effluent Parameters sampled:_pH_BOD—TSS_TN_Other(list below) Other 1 Other 2 Other 3 Description of any maintenance performed since previous inspection &during this inspection: Cleaned Filter,,,Splash Recycle, Notes and Comments: F. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, 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. Michael Dillen 09/20/2004 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 Piloting & Provisional Use- General Use—by September 31 st of each year for the within 30 days of inspection 30th of each year for the previous calendar year date previous 12 months Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston. MA 02108 DEPMicroFASTnew.doc-9/29/04 Page 2 of 2 ' M M I MOR INCPORATED 8450 Cole Parkway w Shawnee, KS 66227 m Phone 913-422-0707 m Fax: 912-422-0808 2737 e-mail: onsiteC�biomicrobics.com u;www.biomicrobics.com w 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTALLATION AUTHORIZED SERVICE PROVIDER 206 Long Beach Road Installation Address Centerville,MA 02632 Name Wastewater Treatment Services,Inc. Owner Name Richard McCourt Street Mail Address: Mail Address 44 Commercial Street 21 Jams Avenue Raynham, MA 02767 Hingham,MA 02043 City State Zip 508-880-0233 508-880-7232 Phone 617 269 2330 Fax e-mail Phone Fax e-mail °INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pump out Single HomeFAST.9 BMR1006 09/11/1996 09/01/2002 vNENANC ERORvEDNCOV1ENTSNO.E UIPMENT _. .. Electrical Panel(s) Visual Alarm Operating X Audio Alarm Operating X if resent Blower(s) Air Inlet Filter Clean X Blower Hood Vents Clear X Excessive Noise X Excessive Vibration X Treatment unit(s) Unusual Odor Pum out Required: X Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LIMIT RESULT Estimated Daily Flow 4 Bedrooms H Standard Units Color N/A LTemperature Odor None Comments: TECHNICIAN SERVICE DATE Michael Dillen 09/20/2004 44 Commercial Street Raynham, MA 02767 Tel: (508) 880-0233 Fax: (508) 880-7232 January 6, 2003 Barnstable Board of Health PO Box 534 Hyannis, MA 02601 Attention: Health Agent r Reference: Single Home FAST® Treatment System Serial Number: BMR1006 Attached please find the Field Inspection& Service Report. We attempted service on 12/13/2002 at the property of Richard McCourt located at 206 Long Beach Road - Centerville, MA; however, the system was turned off for the winter. Please call if you have any questions or require additional information. Sincerely, Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: Richard McCourt i _ 1 ` COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 03108 617.393.5500 DEP Approved Inspection and O&NI Form for Title 5 UA Treatment and Disposal Systems Installation Authorized Service Provider Installation Address: O&M Firm: 206 Long Beach Rd.: Centerville MA Owner Name: Mail Address: Richard McCourt 44 commercial street,Raynham,MA 02767 Mail Address: 21 Jams Ave. T81:(508)880.0233 Fax:(508)880.7232 Hingham,MA 02043 Telephone No.: Telephone No.: 6172692330 Certi fied Operator dame: DEP No.: M&.No.: BMR1006 Cert.No.: Model No.: Installation Date: Start of Operation: Micro SST 9111/96 Approval Type: (Circle) Seasonal sidence—used less than 6 mo./year: (Circle) General Provisional Piloting <RZedia Yes No Operating Information Previous Inspection Date: Inspection Date: Sludge Depth:(to be checked yearly) Pumping Recommended(Circle) Yes No I Effluent Description: Attach copy of certified lab results. Check all that are required Samples:Influent Effluent Parameters: pH BOD TSS TN . Other Other Other Description of Overall System Condition: Description of any Maintenance Performed since Previous Inspection and During this Inspection: Notes and Comments: I certify: I have inspected the sewage treatment and disposal system at the address above, have completed this report and the attached manufacturer's 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 CNIR 2.00. 3�L naL k)-4 I,'-E3 L)Q Operator Signature D to System owner must submit Remedial Use—by January 31"of Department of Environmental this report, manufacturer's each year for the previous calendar Protection O&M checklist, and any year Attn: Title 5 Program required sampling results Piloting& Provisional Use- within One Winter Street, 61" Floor to the local Board of Health 30 days of inspection date General Use-by September 30'°of Boston, NIA 02108 and DEP as follows for each year for the previous 12 months each inspection performed: 5/1i01 INCORPORATED 8450 Cole Parkway■ Shawnee, KS 66227■Phone 913-422-0707■ Fax: 912-422-0808 e-mail: onsite .biomicrobics.com ■www.biomicrobics.com ■ 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT WiMM For Bio-Microbics Single Home FAST® System IIVSTAL}{}I,:ATIO�NJ 206 Long Beach Rd. Installation Address Centerville,MA Owner Name Richard McCourt Mail Address 21 Jams Ave. 44 comfflem i 8deot;Raymam;MA 02767 Hingham, MA 02043 Tot(Ws)8804M.;:Fax(sos)88O.= city State Zip Phone Fax e-mail 508-880-7232 — - Phone Fax e-mail NO MW Model No. Serial No. Date of Installation Date of last pumpout BMR1006 9/11/96 Electrical Panel(s) Visual Alarm tin Audio Alarm Operating 'jU�I�P�ME'l a if resent Blower(s) Air Inlet Filter Clean Blower Hood Vents Clear Excessive Noise Excessive Vibration Treatment unit(s) Unusual Odor Pum out Required: Primary Settling Zone Aerobic Treatment Zone EFFLUENT(options]) L 3M RESULT Estimated Daily Flow 4 Bedrooms H Standard Units 6-9 S.U. Color Clear Temperature Odor Slightly musty odor not septic) T CHNICIA SIGNATURE SERVICE DATE 1 44 Commercial Street Raynham, MA 02767 Tel; (508) 880-0233' Fax: (508),880-7232 'March 14 2003 r RECEIVE MAR 1 8 2003 Barnstable Board of Health TOWN OF BARNSTABLE HEALTH DEPT. 200 Main Street Hyannis, MA 02601 Attention' Health,Agent Reference: Single Home FAST® Treatment System Serial Number: BMR1006 Attached please find the Field Inspection& Service Report. We attempted service on 03/05/2003 at the property of Richard McCourt located at 206 Long Beach Road- Centerville, MA; however, the system was turned off for the winter. Please call if you have any questions or require additional information. Sincerely, Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: Richard McCourt COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS " DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 617.293.5500 DEP Approved Inspection and O&NI Form for Title 5 UA Treatment and Disposal Systems Installation Authorized Service Provider Installation Address: O&M Firm: 206 Long Beach Rd.: Centerville Owner Name: KAA Mail Address: Richard McCourt 44 Commerda)Street,Raynham,MA 02767 Mail Address: Richard Jarris Ave. Tel:(508)880.0233 Fax:(508)880•7232 Hingham,MA 02043 Telephone No.. Telephone No.: 6172692330 Certified Operator name: DEP No.: Mfr.No.: Cert.No.: r BMR1006 l Model No.: Installation Date:mrao i�sr Start of Operation: I Approval Type: (Circle) Seasonal sidence-used less than 6 mo./year: (Circle) General Provisional Piloting Remedia Yes No Operating Information Previous Inspection Date: Inspection D te: Sludge Depth:(to be checked yearly) Pumping Recommended(circle) i Yes No Effluent Description: Attach copy of certified lab results. Cheek all that are required Samples: Influent Effluent Parameters: pH BOD TSS TN Other Other Other Description of Overall System Condition: Description of any Maintenance Performed since Previous Inspection and During this Inspection: Notes and Comments: D I certify: I have inspected the sewage treatment and disposal system at the address above, have completed this report and the attached manufacturer's 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 ate System owner roust submit Remedial Use-by January 3 1"of Department of Environmental this report, manufacturer's each year for the previous calendar Protection O&M checklist,and any year Attn: Title S Program required sampling results Piloting& Provisional Use - within One Winter Street, 61' Floor to the local Board of Health 30 days of inspection date s Boston, .NIA 02108 and DEP as follows for General Use-by September 30 of each inspection performed: each year for the previous 12 months 5/1i01 1 INCORPORATED 8450 Cole Parkway■ Shawnee, KS 66227■Phone 913-422-0707■ Fax: 912-422-0808 e-mail: onsite ,biomicrobics.com a www.biomicrobics.com . 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTALLATION AUTHORIZED SERVICE PROVIDER 206 Long Beach Rd. Installation Address Centerville MA Owner Name Richard McCourt ��� `�� `f �� `� i Mail Address 21 Jams Ave. 44 comrwmlAl west.Aaynnam MA 02767 Hingham, MA 02043 Tel:(508)8W-OM. Fax(508)880-7= city State Zip _ Phone Fax e-mail 508-880-7232 4 Phone Fax e-mail '1NSTA,I:IAT�ON: IJFORMATION d Model No. Serial No. Date of Installation Date of last pumpout BMR1006 9/11/96 E UIPMENT, '.. DES, " .' NO i" MAiIFENIANCE PERIIURMED AND CO Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating if resent Blower(s) Air Inlet Filter Clean Blower Hood Vents Clear Excessive Noise Excessive Vibration Treatment unit(s) Unusual Odor Pum out Required: Primary SettlingZone Aerobic Treatment Zone EFFLUENT(optional) LEWr RESULT Estimated Daily Flow 4 Bedrooms H Standard Units 6-9 S.U. Color Clear Temperature Odor Slightly musty odor (not septic) ECHNICIA SIGNATURE SERVICE DATE CA 44 Commercial Street Raynham, MA 02767 Tel: (508) 880-0233 __Fax: (508) 880-7232 June 18, 2003 J U N 19 2001 TOWN Oi-bi;' blABLE I HEALTH DEFT. Barnstable Board of Health 200 Main Street Hyannis, MA 02601 Attention: Health Agent Reference: Single Home FAST° Treatment System Serial Number: BMR1006 Attached please find the Field Inspection& Service Report. We attempted service and testing on 06/12/2003 at the property of Richard McCourt located at 206 Long Beach Road - Centerville, MA; however, the system was turned off and the home unoccupied. Please call if you have any questions or require additional information. Sincerely, Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: Richard McCourt Massachusetts DEP COMMONWEALTH OF MASSACHUSETTS r f ' EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS -t t DEPARTMENT OF ENVIRONMENTAL, PROTECTION ONE WINTER STREET, BOSTON. MA 02108 617.292.5500 DEP Approved Inspection and O&NI Form for Title 5 UA Treatment and Disposal Systems Installation Authorized Service Provider Installation Address: 206 Long Beach Rd.: O&M Firm: Centerville Owner Name: �a� `��eatine�Gef�ruict� �it� Nlail Address: Richard McCourt 44 commercial Street,Raynham,MA 02767 Mail Address: 21 Jams Ave. TO(508)eso-OM Fax:(soa)sea7232 Hingham,MA 02043 Telephone No.: Telephone No.: 6172692330 Certified Operator Name: DEP No.: Mfr. No.: BMR1006 Cert.No.: Model No.: Installation Date: Start of Operation: Micro FAST 1 —7 9/11/96 Approval Type: (Circle) Seasonal sidence—used less than 6 mo./year: (Circle) . General Provisional Piloting Remedia Yes No Operating Information Previous Inspection Date: T ection Date: Sludge Depth:(to be checked yearly) Pumping Recommended(Circle) Yes No Effluent Description: Attach copy of certified lab results. Check all that are required Samples: Influent Effluent Parameters: pH BOD TSS TN Other Other Other Description of Overall System Condition: Description of any Maintenance Performed since Previous Inspection and During this Inspection: Notes and Comments: — I certify: I have inspected the sewage treatment and disposal system at the address above, have completed this report and the attached manufacturer's 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 CNIR 2.00. �. Operator Srg�iatur a e System owner must submit Remedial Use—by January 3 1"of Department of Environmental this report, manufacturer's each year for the previous calendar Protection O&M checklist,and any year Attn: Title S Program required sampling results Piloting& Provisional Use - within One Winter Street, 61h Floor to the local Board of Health 30 days of inspection date Boston, NIA 02108 and DEP as follows for General Use—by September 30 of each year for the previous 12 months each inspection performed: INCORPORATED 8450 Cole Parkway■ Shawnee, KS 66227■Phone 913-422-0707■ Fax: 912-422-0808 e-mail: onsite(ftiomicrobics.com ■www.biomicrobics.com ■ 800-753-FAST'3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System 9:�irEsy,1. ✓ > t Fri "v. r„d '" an N `7"sh.n..A�sv"`&b.'?' � `� v e`JY�„ 'nk INSTALLA` TON i rs t 'AUTHORIZED SERVICE PROVIDER ' 206 Long Beach Rd. z Installation Address Centerville,MA Owner Name Richard McCourt Mail Address 21 Janis Ave. 44 Commercial Street,Raynham,MA 02767 Hingham, MA 02043 Tel:(508)8804= Fax(W8)880.7= city State Zip Phone Fax e-mail 508-880-7232 y Phone Fax e-mail - ;�. , Model No. Serial No Date of Installation Date of last pumpout BMR1006 9/11/96 E'..UIPMENT Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating if resent Blower(s) Air Inlet Filter Clean Blower Hood Vents Clear I Excessive Noise Excessive Vibration Treatment units Unusual Odor Pum out Required: Prim Settling. Zone Aerobic Treatment Zone EFFLUENT(optional) LINHT RESULT Estimated Daily Flow 4 Bedrooms H Standard Units) 6-9 S.U. Color Clear Temperature Odor Slightly musty odor not septic) I TEqMICIAN S N TURE SERVICE PATE ERE� Twf,elzt J&yt;P, Ylw, 003 44 Commercial Street Raynham, MA 02767 Tel: (508) 880-0233 Fax: (508) 880-7232 September 24, 2003 Barnstable Board of Health 200 Main Street Hyannis, MA 02601 Attention: Health Agent Reference: Single Home FAST° Treatment.System Serial Number: BMR1006- Attached please find the Field Inspection& Service Report. We attempted service on 09/18/2003 at the property of Richard McCourt located at 206 Long Beach Road - Centerville, MA; however, the unit was off at the breaker. Please call if you have any questions or require additional information. Sincerely, Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: Richard McCourt Massachusetts DEP 'COMMONWEALTH OF MASSACHUSETTS gut EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 617.292.5500 DEP Approved Inspection and O&NI Form for Title 5 UA Treatment and Disposal Systems Installation Authorized Service Provider Installation Address: O&M Firm: 206 Long Beach Rd.: Centerville hd Owner[Name: Y�a� 11ee�v, 5'� tilail Address: Richard McCourt 44 Commercial Street,Raynham,MA 02767 (ail Address: 21 Jarris Ave. Tel:(soe)eeo-ors Fax:(soe)wo-r2w Hingham,MA 02043 Tele hone No.: 6172692330 Certified Operator Name: Telephone No.: DEP No.: M K No.: BMR1006 Cent No.: f `t-�� moo r-�sr ✓ ,� /r'� G ��!!VV Model No.: c � Installation Date: Start of Operation: Approval Type: (Circle) _ Seasonal sidence-used less than 6 moJyear: (Circle) j General Provisional Piloting Remedia Yes No Operating Information Previous Inspection Date: Inspection Date: Sludge Depth:(to be checked yearly) Pumping Recommended(Circle) Yes No j Effluent Description: Attach copy of certified lab results. i Cheat all that are required Samples: Influent Effluent Parameters:.- .pH BOD TSS TN Other Other Other Description of Overall System Condition: Description of any Maintenance Performed since Previous Inspection and During this Inspection: VV✓ �0rr--- � Notes and Comments: I certify: I have inspected the sewage treatment and disposal system at the address above, have completed this report and the attached manufacturer's operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the i pectiont,I am a M certified operator in accordance with 257 C�iR .00. ot Operator Signature Date System owner must submit Remedial Use—by January 3 l"of Department of Environmental this report, manufacturer's each year for the previous calendar Protection O&M checklist,and any year Attn: Title 5 Program required sampling results Piloting& Provisional Use - within One Winter Street, 6'" Floor to the local Board of Health 3O days of inspection date Boston, ,NIA 0..2 108 General Use—by September 30'"of and DEP as follows for each inspection performed: each year for the previous I_ months 511i01 MIM 'M INCORPORATED 8450 Cole Parkway■ Shawnee, KS 66227■Phone 913-422-0707■ Fax: 912-422-0808 e-mail: onsite(M-biomicrobics.com a www.biomicrobics.com a 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System t.4 206 Long Beach Rd. Installation Address Centerville,MA Owner Name Richard McCourt Mail Address 21 Jarris Ave. 44 commer�fw b'aeeK Aarham.Ian 02767 Iimgham, MA 02043 TeL(We)880. Q33 -:Fax(We)a O-= city State Zip _ Phone Fax e-mail 508-880-7232 Phone Fax y e-mail Model No. Serial No. Date of Installation Date of last pumpout BMR1006 9/11/96 Electrical Panel (s)r w Visual Alarm Operating Audio Alarm Operating if resent /45 Q Blower(s) Air Inlet Filter Clean Blower Hood Vents Clear Excessive Noise Excessive Vibration Treatment unit(s) Unusual Odor Pum out Re aired• Prim Settlin• Zone Aerobic Treatment Zone EFFLUENT(optional) UNM RESULT Estimated Daily Flow 4 Bedrooms H Standard Units 6-9 S.U. Color Clear Temperature- Odor Slightly musty odor not se tic) TECHMCIAN SIGNA SERVI E DATE 44 Commercial Street Raynham, MA 02767 Tel: 08 880=0233 . I , ^► Fax: (508) 880-7232 4s VF[5 December 12,2003 � 2 2003 Barnstable Board of Health 200 Main Street Hyannis, MA 02601 Attention: Health�Agent Reference: Single Home FAST® Treatment System Serial Number: BMR1006 Attached please find the Field Inspection& Service Report. We attempted service on 12/08/2003 at the property of Richard McCourt located at 206 Long Beach Road - _�z Centerville, MA; however, the system was twined off for the winter, Please call if you have any questions or require additional information. Sincerely, Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: Richard McCourt Massachusetts DEP A y LlMassachusetts 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 2737 A. Installation Important: Richard McCourt When filling out Owner forms on the computer,use 206 Long Beach Road only the tab key Facility Street Address to move your Centerville 02632 cursor-do not use the return city Zip key. Mailing address of owner, if different: Q21 Jarris Avenue Street Address/PO Box: Hingham MA 02043 City State Zip (617 269 2330 ext. Telephone Number B. Authorized Service Provider Wastewater Treatment Services, Inc. 0&M Firm 44 Commercial Street Street Address Raynham MA 02767 City State Zip (508)—880-0223 ext. Telephone Number Michael Dillen 11173 Certified Operator Name Certification Number C. Facility/System Information BMR1006 Bio-Microbics, Inc. Single HomeFAST .9 DEP ID Manufacturer's Name&ID Model Name&Number 09/11/1996 Installation Date Start of Operation Approval Type: _General _Provisional _Piloting X Remedial Seasonal Residence—used less than 6 mo./year: _Yes X No D. Operating Information 12/08/2003 Inspection Date Previous Inspection Date 11 Sludge Depth(to be checked yearly) Pumping Recommended _Yes X No Color: N/A Odor: None Effluent Description DEPMicroFASTnew.doc•12/12/03 Page 1 of 2 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 2737 E. Sampling Information Samples Taken:_ Influent _Effluent Parameters sampled:_pH_BOD_TSS_TN_Other(list below) Other 1 Other 2 Other 3 Description of any maintenance performed since previous inspection & during this inspection: Notes and Comments: UNIT IS OFF FOR THE WINTER-1 F. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, 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. Michael Dillen 12/08/2003 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 Piloting & Provisional Use - General Use—by September 31 sc of each year for the within 30 days of inspection 30`h of each year for the previous calendar year date previous 12 months Department of Environmental Protection Attention: Title 5 Program One Winter Street, 61h Floor Boston. MA 02108 DEPMicroFASTnew.doc-12/12/03 Page 2 of 2 9 1 N r 0 R P 0 R A T E 0 8450 Cole Parkway Shawnee, KS 66227 w Phone 913-422-0707 m Fax: 912-422-0808 2737 e-mail: onsite(ftiomicrobics.com II www.biomicrobics.com M 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTALLATION AUTHORIZED SERVICE PROVIDER 206 Long Beach Road Installation Address CentervilleMA 02632 Name Wastewater Treatment Services,Inc. Owner Name Richard McCourt Street Mail Address: Mail Address 44 Commercial Street 21 Jams Avenue Raynham, MA 02767 Hingham,MA 02043 City State Zip 508-880-0233 508-880-7232 Phone 617 269 2330 Fax e-mail Phone Fax e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pump out Single HomeFAST.9 BMR1006 09/11/1996 EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS Electrical Panel(s) Visual Alarm Operating X Audio Alarm Operating X if resent Blower(s) Air Inlet Filter Clean X Blower Hood Vents Clear X Excessive Noise X Excessive Vibration X Treatment unit(s) Unusual Odor Pum out Required: X Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LIMIT RESULT Estimated Daily Flow 4 Bedrooms H Standard Units Color N/A Temperature Odor None Comments:- UNIT IS OFF-FOR THE WINTER TECHNICIAN F SERVICE DATE Michael Dillen 12/08/2003 44 Commercial Street Raynham, MA 02767 Tel: (508) 880-0233 � CF _ Fax: (508) 880-7232 February 12, 2002 FEB I Z® Z TOWN OwHEAL BARN rNBLe Barnstable Board of Health PO Box 534 Hyannis, MA 02601 Attention: Health Agent Reference: Single Home FAST° Treatment System Serial Number: BMR1006 Attached please fmd the Field Inspection& Service Report. We attempted service on 12/18/01 at the home of Richard McCourt located at 206 Long Beach Rd. - Centerville, MA; however, the system was off for the winter Please call if you have any questions or require additional information. S' erely, net M. Whitman Enclosures Copy to: Richard McCourt ._ �. LL., COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 617.292.5500 DEP Approved Inspection and O&M Form for Title 5 UA Treatment and Disposal Systems Installation Authorized Service Provider Installation address: 206 Long Beach Rd.: U&M Firm: Centerville MA �Uase:eurate�J�sttnenC�l�ruiet� 9n� Owner Name: Mail Address: Richard McCourt 44 Commercial Street,Raynham,MA 02767 [ail address: 21 Jams Ave. Tel:(508)880-0233 Fax:(508)880-7232 Hingham, MA 02043 Telephone No.: _ _ __ Telephone No.: 6172692330 Certified Operator Name: DEP No.: Mfi-. No.: BMR1006 Cert.No.: 91 i(P /^ Model No.: Installation Date: Start of Operation: m iao FASr Approval Type: (Circle) Seasonal sidence-used less than 6 mo.%year: (Circle) General Provisional Piloting Remedia Yes No Operating Information Previous Inspection Date: Inspection Date. Sludge Depth:(to be checked yearly) Pumping Recommended(Clyde) i Yes No � Effluent Description: Attach copy of certified lab results. Check all that are required Samples:Influent Effluent 1 Parameters: pH BOD TSS TN Other Other Other Description of Overall System Condition: Description of any Maintenance Performed since Previous Inspection and During this Inspection: i i Notes and Comments: I certify: I have inspected the sewage treatment and disposal system at the address above, have completed this report and the attached manufacturer's operation and maintenance checklist, and the information reported is true, accurate,and complete as of the time of the inspection, am a Massachusetts certified operator in accordance with 257 CNIR 2.00. P I /(:�/j Operator Signature ate System owner must submit Remedial Use—by January 3 1"of Department of Environmental this report, manufacturer's each year for the previous calendar Protection O&M checklist,and any year Attn: Title 5 Program required sampling results Piloting & Provisional Use- within One Winter Street, 61h Floor to the local Board of Health 30 days of inspection date Boston, NIA 02108 and DEP as follows for General Use-by September 30 of each inspection performed: each year for the previous 12 months 511r01 i IG Mill ax I N CORPORATED 8450 Cole Parkway■ Shawnee, KS 66227■Phone 913-422-0707■ Fax: 912-422-0808 e-mail: onsite(Mbiomicrobics.com a www.biomicrobics.com a 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTALLATION AUTHORIZED SERVICE PROVIDER . 206 Long Beach Rd. Installation Address Centerville,MA Owner Name Richard McCourt Mail Address 21 Jams Ave. 44 Commerdel street.Raynham,AAA 0¢767 Hingham, MA 02043 Tel:(soe)SW-MM. Fax(sos)880-7232 city State Zipj Phone Fax e-mail 508-880-7232 C� y Phone Fax r ri,.,,i, �;ZF,C.�, � ...:�, �T Del♦!�nyt` .J � e-mail _.X<.i � 4..,:. ..s:�►7� �Oif1�iU6'Y:l ,Vl`i Fry .�.0 �F 4 `������5 Model No. Serial No. Date of Installation Date of last pumpout BMR1006 9/11/96 EQUIPMENT. Electrical Panel(s)� � 4 Visual Alarm Operating Audio Alarm Operating if resent Blower(s) Air Inlet Filter Clean Blower Hood Vents Clear Excessive Noise Excessive.Vibraticn Treatment unit(s) Unusual Odor Pum out Required: Primary SettlingZone Aerobic Treatment Zone EFFLUENT(optional) LEWF RESULT Estimated Daily Flow 4 Bedrooms H Standard Units 6-9 S.U. Color Clear Temperature Odor Slightly musty odor not tic) 'TECHNICI GNATURE SERVICE QATE 44 Commercial Street Raynham, MA 02767 Tel: (508) 880-0233 Fax: (508) 880-7232 March 25, 2002 Barnstable Board of Health PO Box 534 Hyannis, MA 02601 Attention: Health Agent Reference: Single Home FAST® Treatment System Serial Number: BMR1006 Attached please find the Field Inspection& Service Report (as required) for services performed on 3/5/2002 at the home of Richard McCourt located at 206 Long Beach Rd. - Centerville, MA. Please call if you have any questions or require additional information. Pcerely, anet M. Whitman Enclosures RECEIVED Copy to: Richard McCourt APR 0 12002 TOWN OF BARNSTABLE ' HEALTH DEPT. r COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 617.292.5500 DEP Approved Inspection and O&NI Form for Title 5 VA Treatment and Disposal Systems Installation Authorized Service Provider Installation Address: O&M Firm: 206 Long Beach Rd.: Centerville Owner Name: Kl Vaf&� ',-w&ne",f&v"P, �n� r• Richard McCourt 44 Commercial Street,Raynham,MA 02767 Mail Address: 21 lards Ave. Tel:(508)880-0233 Fax:(508)880-7232 Hingham, MA 02043 Tt Telephone No.: 6172692330 Certified Operator-Name: _^ DEP No.: Mfr. No.: BMR1006 Cart.No.: d46 Model No.: Installation Date: Start of Operation: mkro r-W Approval Type: (Circle) Seasonal Usidence-used less than 6 mo./year: (Circle) General Provisional Piloting Remedia —7Yes No Operating Information Previous Inspection Date: Inspection Date: Sludge Depth:(to be checked year►y) Pumping Recommended(Circle) ' 3 S l Yes No I Effluent Description: Attach copy of certified lab results. Check all that are required (� Samples:Influent Effluent Parameters: pH BOD TSS TN Other Other Other Description of Overall System Condition: Description of any Maintenance Performed since Previous Inspection and During this Inspection: 6 oAD Notes and Comments: I certify: I have inspected the sewage treatment and disposal system at the address above, have completed this report and the attached manufacturer's 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 CNIR 2.00. 3 5/d Operator Signature Date System owner must submit Remedial Use-by January 31"of Department of Environmental this report, manufacturer's each year for the previous calendar Protection O&M checklist,and any year Attn: Title Program required sampling results Piloting 3c Provisional Use - within One Winter Street, 6'" Floor to the local Board of Health 30 days of inspection plate Boston, MA 02108 and DEP as follows for General Use-by September 30 of each year for the previous 12 months each inspection performed: 5/1i01 r. � I Q 1 N C 0 R P 0 R A 1 E 0 8450 Cole Parkway . Shawnee, KS 66227 a Phone 913422-0707 a Fax: 912422-0808 e-mail: onsite _biomicrobics.com ■www.biomicrobics.com . 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTALLATION AUTHORIZED SERVICE PROVIDER 206 Long Beach Rd. Installation Address Centerville, MA 1 Owner Name Richard McCourt fI Mail Address 21 Jarris Ave. `�a6G�uxrter,����rnenGcffuvrue�, 9n� Hingham, MA 02043 44 Commercial Street,Raynham,MA 02767 ! city State Zip Tel:(506)880.0233 Fax:(506)660.7232 Phone Fax e-mail *! TPhoney Fax e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pumpout BMR1006 9/11/96 EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS; Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating if resent 'A Blower(s) Air Inlet Filter Clean Blower 14--4)d Venn Clear Excessive Noise Excessive Vibration Treatment unit(s) Unusual Odor Pum out Required: Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LEWr RESULT Estimated Daily Flow 4 Bedrooms H(Standard Units) 6-9 S.U. Color Clear Temperature Odor Slightly musty odor (not se tic) TECHNICIAN SIGNATUR= SERVICE DATE 3 S r 44 Commercial Street Raynham, MA 02767 Tel: (508) 880-0233 Fax: (508) 880-7232 June 24, 2002 i Barnstable Board of Health P.O. Box 534 Hyannis, MA 02601 Attention: Health Agent Reference: Single Home FAST° Treatment System Serial Number: BMR1006 Attached please find the Field Inspection& Service Report and test results (as required) for services performed on 6/6/2002 at the home of Richard McCourt located at 206 Long Beach Road - Centerville, MA. Please call if you have any questions or require additional information. S' cerely, RECEIVED anet M. Whitman J U N 2 8 2002 SS ToWH ALTH:DEPTABLE Enclosures Copy to: Richard McCourt COMMONWEALTH OF MASSACHUSETTS f00 EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 617.292.5500 DEP Approved Inspection and O&NI Form for Title 5 UA Treatment and Disposal Systems Installation Authorized Service Provider Installa(iun Address: U&Ni Firm: 206 Long Beach Rd.: Centerville NIA Owner Name: N �l�G yrreatinertG�u�vice�, Richard McCourt Mail.Address: 21 Jams Ave. 44 Commercial Street,Raynham,MA 02767 Hingham, MA 02043 T Tel:(508)880-0233 Fax:(508)880.7232 Telephone No.: 6172692330 Certitica operator oiwnc. DEP No.: Mfr. No.: BMR1006 Cert.No.: Model No.: Installation Date: Start of Operation: mia-o FAST Approval Type: (Circle) Seasonal sidence-used less than 6 mo./year: (Circle) General Provisional Piloting Remedia Yes No Operating Information Previous Inspection Date: Inspection Da Sludge Depth:(to be checked yearly) Pumpin commended(Circle) Yes (No) I Effluent Description: Attach copy of certified lab results. Check all that are required / Samples:Influent Effluent y \ Parameters: OD SS TN J Other Other Other Description of Overall System Condition: Description of any Maintenance Performed since Previous Inspection and During this Inspection: Notes and Comments: I certify: I have inspected the sewage treatment and disposal system at the address above, have completed this report and the attached manufacturer's operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the ' pection. 1 am a Massachusetts certified operator in accordance with 257 CNIR 2.00. MI" Op for Signature Date System owner must submit Remedial Use-by January 3 l"of Department of Environmental this report, manufacturer's each ,year for the previous calendar protection O&M checklist,and any year Attn: Title S Program required sampling results Piloting& Provisional Use - within One Winter Street, 6'" Floor to the local Board of Health 34 days of inspection date General Use-by September 30'"of Boston, .NIA 02 108 and DEP as follows for each year for the previous 12 months each inspection performed: 5/1;01 �MN 11M 14=1 O RPORATEO 8450 Cole Parkway a Shawnee, KS 66227■Phone 913-422-0707. Fax: 912-422-0808 e-mail: onsiteftbiomicrobics.com■www.biomicrobics.com a 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTALLATION AUTHORIZED SERVICE PROVIDER 206 Long Beach Rd. Installation Address Centerville,MA - - Owner Name Richard McCourt Mail Address 21 Janis Ave. �� !e�uat ,�reirtiiiereG�urrice� �i Hingham, MA 02043 j Cl State Zi 44 Commercial Street,Raynham,MA 02767, Tel:(508)880-0233 _.Fax:(5W)880-7232 U Phone Fax e-mail f �* y Phone Fax e-mail INSTAU ATION INFORMATION �. fib; Model No. Serial No. Date of Installation Date of last pumpout BMR1006 9/11/96 UIPMENT YES NO >✓h°iRVTENANCE,PERFORMEI),AND CON111T1TSa Electrical Panels Visual Alarm Operating Audio Alarm Operating if resent Blower(s) Air Inlet Filter Clean U Blower Hood Vents Clear Excessive Noise Excessive Vibration Treatment unit(s) Unusual Odor Pum out Required: Prim Settling Zone Aerobic Treatment Zone EFFLUENT(optional) Lu4m RESULT Estimated Daily Flow 4 Bedrooms H Standard Units) 6-9 S.U. Color Clear Temperature Odor Slightly V musty odor not septic) TE HNICIAN S1,GN TUBE SERVI E DATE i � x� Environmental Chemistry Environmental Services Site Assessment Quality Assurance Services Analvtic" l*Balmce Datta Auditing C O R P O R "1' I O 1\' Wastewater Treatment Services, Inc. CERTIFICATE OF ANALYSIS 44 Commercial Street REPORTED: 06/18/2002 Raynham, MA 02767 ORDER#: G0236168 COLLECTED BY: J. Peterson SAMPLE DATE: 6/6/2002 TIME: 11:45 DATE RECEIVED: 6/6/2002 LOCATION: Centerville, MA(BMR 1006) SAMPLE ID: McCourt Grab DESCRIPTION: WATER RESULTS OF ANALYSIS Test Parameters LA&ID#: 0236168-01 BOD SM 5210B 06/07/2002 mg/L 4 12.4 pH SM 4500 H+B 06/07/2002 S.U. 0-14 6.9 Solids, Suspended SM 2540 D 06/13/2002 mg/L 4 15.0 NA=Not Applicable ND=Not Detected Approved By: = Less Than * = Lab anager / Date Detection Limit Analytical Balance Corp., 422 West Grove Street, Middleboro, MA 02346 Ph: 508-946-2225 Page I of l ;I RECEIVEn S F P 1 9 2002 44 Commercial Street aynham, MA TU, _.6TABLE 0 767 HLHL i H DEPT. Tel: (508) 880-0233 Fax: (508) 880-7232 September 12, 2002 Barnstable Board of Health P.O. Box 534 Hyannis, MA 02601 Attention: Health Agent x" Reference: Single Home FAST® Treatment System Serial Number: BMR1006 Attached please find t ield Inspection& Service Report (as required) for services performed on 9/4/2V the property of Richard McCourt located at 206 Long Beach Road -Centerville, Please call if you have any questions or require additional information. Si3jQerely, a � et M. Whitman Enclosures Copy to: Richard McCourt COMMONWEALTH OF MASSACHUSETTS _. EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, 80STON, MA 02108 617.292.5500 DEP Approved Inspection And O&NI Form for Title 5 VA Treatment and Disposal Systems Installation Authorized Service Provider Installation Address: O&M Firm: 206 Long Beach Rd.: Centerville II Owner Name: Mail Address: �a� oie &n6,zbtr&-Vice&, 9rr�Mail Address: `---- Richard McCourt 44 Commercial street,Raynham,MA o27s7 I 21 Jarris Ave. Tel:(soa)880 0233 Fax:(508)8e0 7232 Hingham, MA 02043 Telephone No.: j 6172692330 Certified Operator dame: Telephone No.: 12 DEP No.: Mfi. No.: BMR1006 Cert.No.: III-Z, Model No.: Installation Date: Stan of Operation: M icro F4ST Approval Type: Circle pp yP (. 9/11/96 Seasonal sidence-used less than 6 mo./year: (Circle) i General Provisional Piloting Remedia Yes No Operating Information Previous Inspection Date: Inspection D te: Sludge Depth:(to be checked yearly) JRwnping= Recommended(Circle) Ye No Effluent Description: Attach copy of certified lab results. Check all that are required Samples:Influent Effluent Parameters: pH BOD TSS TN Other Other Other Description of Overall System Condition: Description of any Maintenance Performed since Previous Inspection and During this Inspection: �l�, L Ci�,i✓�d �L-9L.� � Notes and Comments: I certify: I have inspected the sewage treatment and disposal system at the address above, have completed this report and the attached manufacturer's operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I aqi a Massachusetts certified operator in accordance with 257 CNIR 2.00. - Operator / � Signature Date System owner must submit Remedial Use-by January 3 1"of Department of Environmental this report, manufacturer's each year for the previous calendar Protection O&M checklist,and any year Attn: Title 5 Program required sampling results Piloting& Provisional Use • within One Winter Street, 61" Floor to the local Board of Health 34 days of inspection date General Use-by September 30'"of Boston, iv[A 02108 and DEP as follows for each inspection performed: each year for the previous I. months 511r01 � ' Q INCORPORATED i. 8450 Cole Parkway■ Shawnee, KS 66227■Phone 913-422-0707■ Fax: 912-422-0808 e-mail: onsite(ftiomicrobics.com .www.biomicrobics.com ■ 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System WSTALLATION AUTHORIZED SERVICE PROVIDER 206 Long Beach Rd. Installation Address Centerville, MA Nam.. �a�te uatei� Owner Name Richard McCourt Stree; Mail Address 21 Janis Ave. Mail co sn' ^ Hingham, MA 02043 Tel:.(509)880-0233 Fa-*it )880 7232 cityState Zipcity - St_i�14' Phone Fax e-mail 508-880-7232 4 y Phone Fax e-mail .INST :LATION INFORMATION ��Yy'a Model No. Serial No. Date of Installation Date of last pumpout BMR1006 9/11/96 EQUIPMENT Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating if resent J�'lil Blower(s) Air Inlet Filter Clean Blower Hood Vents Clear Excessive Noise Excessive Vibration Treatment unit(s) Unusual Odor Pum out Required: Primary SettlingZone Aerobic Treatment Zone EFFLUENT(optional) 1A3W RESULT Estimated Daily Flow 4 Bedrooms H Standard Units) 6-9 S.U. Color Clear Temperature Odor Slightly musty odor not septic) .✓� car� LC/b TECHMCIAN SIGNA SERVI E PATE J&R SALES & SERVICE, INC. April 3, 2001 Barnstable Board of Health PO Box 534 Hyannis, MA 02601 Attention: Health Agent Reference: Single Home FAST°Treatment System Serial Number: BMR1006 Attached please find the Field Inspection& Service Report and test results(as required) for services performed on 3/20/01 at the home of Richard McCourt located at 206 Long Beach Rd. - Centerville, MA. Please call if you have any questions or require additional information. S' cerely, anet M. Whitman Enclosures Copy to: Richard McCourt 44 CommexialSt. Raynham,MA 02767 Tele.508 823.9566 Fax 508-880 7232 'e Environmental Chemistry Environmental Services Site Assessment Site Sampling Quality Assurance Services Analvtica Balance Data Auditing C 0 R ' P O R � A .0 1 0 1\' CERTIFICATE OF ANALYSIS J&R Sales & Service REPORTED: 3/28/2001 44 Commercial Street Raynham, MA 02767 ORDER #: G0122321 COLLECTED BY: J. Peterson SAMPLE DATE: 3/20/2001 TIME: 1 1:15 DATE RECEIVED: 3/20/2001 LOCATION: Centerville, MA (BMR 1006) SAMPLE ID: McCourt Grab DESCRIPTION: WATER RESULTS OF ANALYSIS ' r x Test Parameters LAB-Ina: 0122321-0I �BOD-- SM 5210B -- 3/21/2001 -- — mg/L ---- 4 -- 1 ---- 14.6----- IPH SM 4500 H+B 3/20/2001 S.U. 0-14 8.3 --- iSolids, Suspended SM 2540 D-----�3/27/2001—�--- mg%L------------2-- ----- ----- 18 NA=Not Applicable -- -------------- ------ ------- ------- ND=Not Detected Approved B : = Less Than A pp y Lab /ager / at *' = Detection Limit Analytical Balance Corp., 422 West Grove Street, Middleboro, MA 02346 Ph: 508-946-2225 Page: 1 c2dINA1111t Q I N C. 0 R P 0 R A T E 0 8450.Cole Parkway■ Shawnee, KS 66227 .Phone 913-422-0707■ Fax: 912-422-0808 e-mail: onsite-biomicrobics.com a www.biomicrobics.com . 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTALLATION AUTHORIZED SERVICE PROVIDER 206 Long Beach Rd. Installation Address Centerville. MA Name J&R Sales&Service, Inc. Owner Name Richard McCourt Street Mail Address 21 Jarris Ave. Mail Address 44 Commercial Street Hingham, MA 02043 Raynham, MA 02767 City State Zip City State Zip Phone Fax e-mail 508-823-9655 508-880-7232 Phone Fax e-mail INSTALLATION INFORMATION I Model No. Serial No. Date of Installation Date of last pumpout i BMR1006 9/11/96 EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating yUl9 if resent) Blower(s) Air Inlet Filter Clean l/ Blower Hood Vents Clear Excessive Noise U Excessive Vibraticca Treatment unit(s) Unusual Odor (� Pum out Required: Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LEVITT RESULT Estimated Daily Flow 4 Bedrooms H(Standard Units) 6-9 S.U. Color Clear Temperature Odor Slightly Ll musty odor (not septic) TE HNICIAN S TURE SER ICE QATE r S ® T B`E J&R SALES & SERVICE, INC. August 1, 2001 Barnstable Board of Health PO Box 534 Hyannis, MA 02601 Attention: Health Agent Reference: Single Home FAST° Treatment System Serial Number: BMR1006 Attached please find the Field Inspection& Service Report and test results(as required) for services performed on 6/26/01 at the home of Richard McCourt located at 206 Long Beach Rd. - Centerville, MA. Please call if you have any questions or require additional information. S' rely, _ez J et M. Whitman Enclosures Copy to: Richard McCourt 44 Commercial St. Baynham,MA 02767 Tale.508-823.9566 Fax 508.880 7232 ,r 1 Q 1 INCORPORATE O 8450.Cole Parkway a Shawnee, KS 6=7 .Phone 913-422-0707 . Fax: 912-422-0808 e-mail: onsit -,bicmicrobics,com .www.biomicmbim.com . 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTALLATION AUTHORIZED SERVICE PROVIDER 206 Long Beach Rd Installation Address Centerville. MA Name AR Sales&Service. Inc. Owner Name Richard McCourt Street Mail Address 21 Jams Ave. Mail Address 44 Commercial Street Hingham, MA 02043 Raynham, MA 02767 City State Zip City State Zip Phone Fax e-mail 508-823-9655 508-880-7232 Phone Fax e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pumpout BMR1006 9/11/96 EQUIPMENT YES NO MAINTENANCE PERFORMED AND CONM ENTS Electrical Panels) Visual Alarm Operating Audio Alarm Operating if resent) Blower(s) Air Inlet Filter Clean V Blower Hood Vents Clear Excessive Noise Excessive Vibration L/ Treatment unit(s) Unusual Odor Pum out Required: Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LEWr RESULT Estimated Daily Flow a Bedrooms H(Standard Units) 6-9 S.U. Color Clear Tem erature Odor Slightly musty odor (not septic) CHNICIA IG ATURE SERVICE DATE Environmental Chemistry r� Environmental Services Site Assessment AnaV4j'cal Balance Site Sampling Quality Assurance Services Data Auditing C: 0 R R A l' I O 1\T CERTIFICATE OF ANALYSIS J&R Sales& Service REPORTED: 7/6/2001 44 Commercial Street Raynham, MA 02767 ORDER#: G0125477 COLLECTED BY: J. Peterson SAMPLE DATE: 6/26/2001 TIME: 10:30 DATE RECEIVED: 6/26/2001 LOCATION: Centerville BMR-1006 SAMPLE ID: McCourt grab DESCRIPTION: WATER RESULTS OF ANALYSIS Test Parameters LA&ID#: 0125477-01 BOD SM 5210B 6/28/2001 mg/L 4 <4.0 IpH SM 4500 H+B 6/27/2001 S.U. 0-14 7.8 Solids, Suspended SM 2540 D 7/3/2001 mg/L 2 <2.0 NA=Not Applicable ND=Not Detected Approved By: <' = Less Than #, Manage / Date = Detection Limit Analytical Balance Corp., 422 West Grove Street, Middleboro, MA 02346 Ph: 508-946-2225 Page: 1 Aug4st`107,2001 J&R SALES SERVICE, INC. Division of Water Pollution Control AUG 212001 Department of Environmental Protection ABLE One Winter Street—6`h Floor TOWN of BARN HEALTH DEPT. Boston, MA 02108 Attention: Ms. Natalie Brown Subject: Request for Testing Reduction FAST Treatment System Reference: Serial Number BMR1006 206 Long Beach Rd. - Centerville, MA Dear Ms. Brown: Attached please find the results for two additional quarters of testing as requested per Mr. Langley's letter of denial ate September 2.1,2000., The testing was performed at the property of Richard McCourt, 206 Long Beach Rd., Centerville, MA. As the operator of this system we are requesting the testing requirements be reduced or eliminated for this unit. Please forward a copy of your decision to our office. Thank you. S _ erely, anet M. Whitman cc: Barnstable Board of Health Homeowner Mailing Address: Richard McCourt 21 Jarris Ave. Hingham, MA 44 Commercial St. Raynham,MA 02767 Tele.508 823 9566 Fax 508 860 7232 W .. w J&R SALES & SERVICE, INC. September 21, 2001 RECEIVE® Barnstable Board of Health SEP 2 7 2001 PO BOX 534 TOWN OF BARNSTABLE HEALTH DEPT. Hyannis, MA 02601 Attention: Health Agent Reference: Single Home FAST°Treatment System Serial Number: BMR1006 Attached please find the Field Inspection& Service Report (as required) for services performed on 9/4/01 at the home of Richard McCourt located at 206 Long Beach Rd. - Centerville,MA. Please call if you have any questions or require additional information. S' erely, anet M. Whitman Enclosures Copy to: Richard McCourt 44 Commercial St. Raynham,MA 02767 Tole.508 823.9566 Fax 508.880-7232 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 617.292.5500 DEP Approved Inspection and O&NI Form for Title 5 UA Treatment and Disposal Systems Installation Authorized Service Provider Installation Address: O&;NI Firm: U10 I 206 Long Beach Rd.: Centerville J & R Sales & Service, Inc. Owner Name: Mail Address: 44 Camiercial Street Richard McCourt Mail Address: Raynham, Ma 02767 21 Jarris Ave. Hingham, MA 02043 Telephone No.: 0 23-9566 Telephone No.: 6172692330 Certified Operator Name: ::2� DEP No.: Mfr. No.: BMR1006 Can.No.: Model No.: Installation Date: Start of Operation: m ia-o F*ST 9/11/96 Approval Type: (Circle) Seasonal A4,sidence-used less than 6 mo./year: (Circle) General Provisional Piloting Remedia Yes <No Operating Information Previous Inspection Date: Inspection Date: Sludge Depth:(to be checked yearly) Pumping Recommended(Circle) Yes No Effluent Description: Attach copy of certified lab results. Check all that are required Samples: Influent Effluent Parameters: pH BOD TSS TN Other Other Other Description of Overall System Condition: Description of any Maintenance Performed since Previous Inspection and During this Inspection: Notes and Comments: I certify: I have inspected the sewage treatment and disposal system at the address above, have completed this report and the attached manufacturer's 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 CNIR 2.00. r Operator Signature Date System owner must submit Remedial Use-by January 3 I"of Department of Environmental this report, manufacturer's each year for the previous calendar Protection O&M checklist,and any year Attn: Title 5 Program required sampling results Piloting & Provisional Use - within One Winter Street, 61" Floor to the local Board of Health 3O days of inspection date General Use-by September 30'"of Boston, ,NIA 02108 and DEP as follows for each inspection performed: each year for the previous 12 months 511i01 ag]=, o R P o R A r E u 8450 Cole Parkway . Shawnee, KS 66227 .Phone 913-422-0707. Fax: 912-422-0808 e-mail: onsite _biomicrobics.com n www.biomicrobics.com . 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTALLATION AUTHORIZED SERVICE PROVIDER 206 Long Beach Rd. Installation Address Centerville, MA Name AR Sales&Service, Inc. Owner Name Richard McCourt Street Mail Address 21 Jarris Ave. Mail Address 44 Commercial Street Hingham, MA 02043 Raynham, MA 02767 City State Zip Ci State Zip Phone Fax e-mail 508-823-9655 508-880-7232 Phone Fax e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pumpout BMR1006 9/11/96 EQUIPMENT YES NO MAINTENANCE PERFORMED AND CON*AENTS Electrical Panel(s) Visual Alarm Operating Iv IA Audio Alarm Operating N�0 if resent) Blower(s) Air Inlet Filter Clean Blower Hood Vents Clear Excessive Noise Excessive Vibration ,. Treatment unit(s) Unusual Odor L/ Pum out Required: Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LEWr RESULT Estimated Daily Flow 4 Bedrooms H(Standard Units) 6-9 S.U. Color Clear j Temperature II Odor Slightly musty odor (not septic) TECHNICIAN SIGNATURE =SERVICE DATE /,y J&R SALES & SERVICE, INC. March 15, 2000 Barnstable Board of Health PO Box 534 Hyannis, MA 02601 MqR y�� ` Attention: Health Agent "" x Reference: Single Home FAST° Treatment System ` 0z'° ' Serial Number: BMR1006 Attached please find the Field Inspection & Service Reports and Testing Results (as required) for services performed 03/13/2000 at the home of Richard McCourt located at 206 Long Beach Rd. -Hingham, MA. Please call if you have any questions or require additional information. Sincerely, , cam Candy Gayares attachments cc: kichard McCourt 44 Commercial St. Aaynham,MA 02767 Tele.508 823 9566 Fax 50B•BB0 7232 t F � I 1 I N C 0 R P 0 R A T E 0 8271 Melrose Drive - Lenexa, KS 66214 - Phone: 913-492-0707 - Fax: 913-492-0808 e-mail: onsite®biomicrobics.cam - www.biomicrobics.com - 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTA1.IrATIO1q- AUTfiORIZEDI SERUICSEROVIDER 206 I:ona L,eac.: ?. . Installation Address Centerville , "A Name AR Sales and Service Owner Name Ri.c. Ar IcCourt Street Mail Address _ , a r~'l s .:�.ve . Mail Address TJinQham, ""A 02n<<3 44 Commercial St. City State Zip City Rayner, MA S&;7677�0 (508) 823-9566 880-7232 Phone Fax e-mail Phone Fax e-mail .�-INSTAI;I;ATION.:INF..ORMATIOI�='•'- .: . :,; Model No.. Serial No. Date of Installation Date of last pumpout 5'invr1e Home B' `. E UIl'MElaT - '= s DES O qr.: '=MAIZ�z 1�A r Ep ox rrD.comr m_M. Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating (if present) Blower(s) Air inlet Filter Clean Blower Hood Vents Clear Excessive Noise Excessive Vibration I Tr�t units Unusual Odor Pumpout Required: Primary Settling Zone •—. Aerobic r;-eatment Zone v B rr_EE`tT u tionat) Ejavar. 77: ;.RESIII ? _.. . . Estimated Dailv Flow H(Standard Units) 6-9 S.U. Color Clear Temt)eranrre Odor Slightly musty odor not septic J OWNER SIGNATURE IMCENICIAN SIGNATURE SERVICE DATE: — c9'd J&R SALES & SERVICE, INC. June 13, 2000 Barnstable Board of Health PO Box 534 Hyannis, MA 02601 Attention: Health Agent Reference: Single Home FAST°Treatment System Serial Number: BMR1006 Attached please find the Field Inspection& Service Reports and Testing Results (as required) for services performed on 6/2/00 at the home of Richard McCourt located at 206 Long Beach Rd. - Centerville, MA. Please call if you have any questions or require additional information. Sincerely, Lillian Ferreira Enclosures cc: Richard McCourt 44 Commercial St. Aaynham,MA 02767 Tole.508 823 9566 Fax 508 880 7232 I I N C 0 R P 0 R A T E 0 8450,Cole Parkway ■ Shawnee, KS 66227 ■Phone 913-422-0707 . Fax: 912-422-0808 e-mail: onsiteCaDbiomicrobics.com .www.biomicrobics.com . 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTALLATION AUTHORIZED SERVICE PROVIDER 206 Long Beach Rd. Installation Address Centerville,MA Name J&R Sales&Service,Inc. Owner Name Richard McCourt Street Mail Address 21 Janis Ave. Mail Address 44 Commercial Street Hingham, MA 02043 Raynham, M 02767 CityState ZipCity A State Zip Phone Fax e-mail 508-823-9655 508-880-7232 Phone Fax e-mail INSTALLATION INFORMATION Model No. Serial No. I Date of Installation Date of last pumpout BMR1006 9/11/96 EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating if resent) Blower(s) Air Inlet Filter Clean Blower Hood Vents Clear Excessive Noise Excessive Vibration Treatment unit(s) Unusual Odor Pum out Required: Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LOM RESULT Estimated Daily Flow 4 Bedrooms H(Standard Units) 6-9 S.U. j Color Clear i Temperature Odor Slightly musty odor (not s tic) V jrE CHNICIAN SIGNATURE SERVICE.DATE 0-0 / J&R SALES &SERVICE, INC. August 2, 2000 Division of Water Pollution Control Department of Environmental Protection One Winter Street—6 h Floor Boston, MA 02108 Attention: Mr. Steve Corr Subject: Request for Testing Reduction FAST Treatment System Reference: Serial Number BMR1006 206 Long Beach Rd. - Centerville, MA Dear Mr. Corr: Attached please find the testing results for Richard McCourt located at.206 Long Beach Rd., Centerville, MA. I have spoken with Natalie Brown at your office who suggested we reapply:for red ugtion or elimination of testing at this location. The reason these samples are not recent is because we had suspended testing while waiting for redu tion approval from your office. Although we have not tested recently, we have been servicing this location as required. As the operator of this system we are requesting the testing requirements be reduced or eliminated for this unit. Please forward a copy of your decision to our office. Thank you. Sincerely, Lauren Dunlap cc: Barnstable Board of Health Richard McCourt Homeowner Mailing Address: Richard McCourt 21 Jarris Ave. Hingham, MA 02043 !AA Q1?67 I J&R SALES & SERVICE, INC. October 6, 2000 Barnstable Board of Health PO Box 534 Hyannis, MA 02601 Attention: Health Agent Reference: Single Home FAST° Treatment System Serial Number: BMR1006 Attached please find the Field Inspection& Service Report (as required) for services performed on 9/6/00 at the home of Richard McCourt located at 206 Long Beach Rd. - Centerville, MA. Please call if you have any questions or require additional information. erel y,,net M. Whitman Enclosures Cc:,Richard McCourt 44 Commercial St. Raynham,MA 02767 Tale.508.823.9566 Fax 508,880 7232 1 I N C 0 R P 0 R A T E 0 8450.Cole Parkway. Shawnee, KS 66227.Phone 913-422-0707■ Fax: 912-422-0808 e-mail: onsit biomicrobics.com .www.biomicrobies.com a 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FASTO System INSTALLATION AUTHORIZED SERVICE PROVIDER 206 Long Beach Rd. Installation Address Centerville, MA Name AR Sales& Service. Inc. Owner Name Richard McCourt Street Mail Address 21 Jarris Ave. Mail Address 44 Commercial Street Hingham, MA 02043 Raynham, MA 02767 City State Zip City State Zip Phone Fax e-mail 508-823-9655 508-880-7232 Phone Fax e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pumpout BMR 1006 9/11/96 EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating �t (if resent) Blowers Air Inlet Filter Clean Blower Hood Vents Clear Excessive Noise Excessive Vibration Treatment unit(s) Unusual Odor Pum out Required: Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LEVIIT RESULT Estimated Daily Flow 4 Bedrooms H(Standard Units) 6-9 S.U. Color Clear Temperature Odor Slightly musty odor (not septic) TECHNICIAN §JGNATURE SERVICE DATE C ;, ) COMMONWEALTH OF MASSACHUSETTS z EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 617-292-5500 y� 4+,4 Sv e ARGEO PAUL CELLUCCI BOB DURAND Governor Secretary JANE SWIFT LAUREN A.LISS Lieutenant Governor Commissioner November 9,2000 {Nancy Johnso�) "206 Long Beach road Centerville,MA 02632 F RE: Alternative On-Site Sewage Treatment Monitoring and Reporting Requirement 206 Long Beach road, Centerville DEP Facility No: bmr1006 Dear Ms.Johnson: ' The Department has received a letter from J&R Sales and Service,Inc.requesting reduction or elimination of quarterly monitoring and reporting of pH,BOD,and TSS on the effluent from the alternative on-site sewage disposal system at the above referenced facility. The Department,having reviewed the monitoring data for your system, denies the request to reduce effluent monitoring of the system.The Department's technology approval letters specify that the effluent from the FAST systems installed for Remedial Use must be monitored quarterly.There is no current sampling data for your system.Before the Department will review a request to reduce the monitoring and reporting requirements for your system,the Department requires that the system be sampled for two consecutive quarters. Moreover,the Department requires that the effluent concentration of both BOD and TSS for the four latest quarters average no greater than 30 mg/L in order for us to reduce sampling requirements. Should you have any questions regarding this matter,please contact Natalie Brown,of my staff,at (617)292-5658. Sincerely, Lealdon Langley,Director Watershed Permitting Program cc: J&R Sales and Service,Inc., 44 Commercial Street,Raynham,MA 02767 Centerville BOH DEP/SERO,B.Dudley This information is available in alternate format by calling our ADA Coordinator at(617)574-6872. i DEP on the World Wide Web: http://www.magnet.state.ma.us/dep ��«1 Printed on Recycled Paper I e COMMONWEALTH OF MASSACHUSETTS r(� EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET. BOSTON. MA 02109 617-292-»00 8 Nancy Johnsto � COXE WILLIAM F.WELD � TRU;DY cre Governor � )Secretary ARGEO PAUL CELLUCCI `1k�jAVID B.S7RUHS Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION F ��VV Commissioner CERTIFICATION S PART A �999 AV Property Address: 206 Leg Beach Rd.. , C tervillAodress of Owner: N. +' Date of Inspection: �'�' � (If different) Name of Inspector: Wm E Robinson Sr Z ] I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: Wm E Robinson Septic Service Mailing Address: PO BOX 1 089 , Cent ervi 1 1 e r MA 02632 Telephone Number;, 1 0 8 7 7 5—R 7 7 6 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sew e disposal systems. The system: _ Passes _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of i0,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: A] SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. C MENTS: B] S STEM CONDITIONALLY PASSES: One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Indic lite yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If "not determined", explain why not. _ The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 04/25/97) Page 1 of 10 DEP on the World Wide Web: http:ltwww.magnet.state.ma.us)dep ej Printed on Recycled Paper t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:206 Long Beach Rd.. , Centerville , MA Owner: Nancy Johnston Date of Inspection: B) SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed `\ pipets) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board;of Health). Describe observations: y� broken pipe(s) are replaced a ! obstruction is removed distribution box is levelled or replaced or The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipets) are replaced obstruction is removed C) URTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary'to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER (revised 04/25/97) Page 2 of 10 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 206 Long Beach Rd.. , Centerville , MA Owner: Nancy Johnston Date of Inspection: oZ„a/_�C/ Check if the following have been done: You must indicate either "Yes" or"No" as to each of the following: Yes No / Pumping information was provided by the owner, occupant, or Board of Health. _ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or / as part of this inspection. _ As built plans have been obtained and examined. Note if they are not available with N/A. _ The facility or dwelling was inspected for signs of sewage back-up. _ The system does not receive non-sanitary or industrial waste flow. V _ The site was inspected for signs of breakout. Z _ All system components, excluding the Soil Absorption System, have been located on the site. '✓ _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. Existing information. Ex. Plan at B.O.H. _ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) [15.302(3)(b)) (revised 04/25/97) Page 4 of 10 f j SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 206 Long Beach Rd. ,, Uenterville , NIA Owner: Nancy Johnston ` Date of Inspection: D) SYSTEM FAILS: You must indicate ei;-.er "Yes" or "No" as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes o Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _. Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LA GE SYSTEM FAILS: You ust indicate either "Yes" or "No" as to each of the following: The,following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Y s No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area- IWPA) or a mapped Zone II of a public water supply well) T owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program r gthrements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revimed 04/25/97) Page 3 of 10 `r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 206 Long Beach Rd . , Centerville , MA Owner: Nancy Johnston Date of Inspection: 2,-L/-17 FLOW CONDITIONS RESIDENTIAL: Design flow: b .p.d./bedroom for S.A.S. Number of bedrooms: `/ Number of current residents:Z_3 Garbage grinder (yes or no)::. n Laundry connected to system (yes or no): 3 Seasonal use (yes or no):Lo 1998 75, 000 gal Water meter readings, if available (last two (2) year usage (gpd): Sump Pump (yes or no):—de,,1A 1997 38, 000 gal Last date of occupancy:.L---'-1-7 `j COI MERCIAUINDUSTRIAL: Type of establishment: Desig flow: gallons/day Greas trap present: (yes or no)_ Industr al Waste Holding Tank present: (yes or no)_ Non-sa itary waste discharged to the Title 5 system: (yes or no)_ Water eter readings, if available: Las4de atof occupancy: OT (Describe) Lasof occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System pumped as part of inspection: (yes or no)A,C) If yes, volume pumped: gallons Reason for pumping: TYPE SYSTEM Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) I/A Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: 9 46 Sewage odors detected when arriving at the site: (yes or no)Atidl (rovisad 04/25/97) Page 5 of 10 e SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 206 Long Beach Rd.. , Centerville , MA Owner: Nancv Johnston Date of Inspection: 4—4 B ILDING SEWER: (Lo to on site plan) Depth below grade: Materi I of construction: _cast iron _40 PVC_other (explain)' Distan a from private water supply well or suction line , Diam er Com ents: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK:`Ll (locate on ¢ite plan) Depth below grader_ � Material of construction: c/concrete _metal _Fiberglass _Polyethylene _other(explain) If tank is metal, list age _ Is age confirmed by Certificate of Compliance _(Yes/No) t , Dimensions: d'6. OL f5 l Sludge depth: i Distance from top of sludge to bottom of outlet tee or bafflez— Scum thickness: Zi—!0 j, , Distance from top of scum to top of outlet tee or baffler ti, Distance from bottom of scum to bottom of outlet tee or baffle: How dimensions were determined: b & Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural I-, integrity, evidence of leakage, etc.) O—D J./ n !� � , L L� ig S O�rp � s E��4 4pel .tom GREA E TRAP: (locat on site plan) Depth low grade: Materia of construction: _concrete _metal _Fiberglass _Polyethylene _other(explain) Dimens ons: Scum t ickness: Distan a from top of scum to top of outlet tee or baffle: Dista a from bottom of scum to bottom of outlet tee or baffle: Date f last pumping: Co ments: (r mmendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural inte ity, evidence of leakage, etc.) (revised 04/25/97) Page 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) -Property Address: 206 Long Beach Rd`. , Centerville, MA Owner: Nancy Johnston Date of Inspection: a�y Q► TIG OR HOLDING TANK: (Tank must be pumped prior to, or at time, of inspection) (locate n site plan) Depth ow grade: Material f construction: _concrete _metal _Fiberglass _Polyethylene —other(explain) Dimensio s: Capacity: gallons Design f w: gallons/day Alarm I yel: Alarm in working order_ Yes; _ No Date of evious pumping: Comments (condition f inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert:_ Comments: (note if level and distribution is equal, evi ence of solids carryover, evidence of leakage into or out of box, etc.) PUMP AMBER:_ (locate o site plan) Pumps i working order: (Yes or No) Alarms working order (Yes or No) Comm ts: (note c ndition of pump chamber, condition of pumps and appurtenances, etc.) (revised 04/25/97) Page 7 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Addr�ss: 206 Longbeach Rd.I. , Centerville , MA Owner: ivancy Johnston Date of Inspection: ;_ -/-/-9 7 SOIL ABSORPTION SYSTEM (SAS):_ (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type. leaching pits, number:_ leaching chambers, number: leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of pondin ,.condition of vegetation, etc.) CES OOlS: _ Ilocat on site plan) Num r and configuration: Depth-op of liquid to inlet invert: Depth f solids layer: Depth f scum layer: Dime ions of cesspool: Mater' Is of construction: Indi ion of groundwater: inflow (cesspool must be pumped as part of inspection) C mments: In to condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRI Ilo to on site plan) Ma erials of construction: Dimensions: De th of solids- Co ments: In to condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (zavimad 04/25/97) Page 8 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 206 Longbeach Rd.. , Centerville , MA Owner: Nancy Johnston Date of Inspection:2-�Q SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) �a Lid c �3 yd- l (revised 04/25/97) Page 9 of 10 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) , Property Address: 206 Longbeach Rd.. , Centerville , MA Owner: Date of Inspection: g/ f� f� i Depth to Groundwater Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record •Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators, installers ,Use USGS Data Describe in your oow'n swords how you established the High Groundwater Elevation. (Must be completed) (revised 04/25/97) Page 10 of 10 i e' J&R SALES & SERVICE, INC. April 2, 1999 Barnstable Board of Health PO Box 534 Hyannis, NA 02601 Attention: Health Agent Reference: Single Home FAST®Treatment System Serial Number: BNR1006 Attached please find the Field Inspection& Service Reports and Testing Results(as required)for services performed on 3/25/99 at the home of Nancy Johnson located at 206 Long Beach Road. Please call if you have any questions or require additional information. Sincerely, Candy Gayares attachments cc: Nancy Johnson 44 Commercial Si. Raynham,MA 02767 Tole.50B.823-9566 Fax 50B•BBO-7232 e INCOflF"0"R-ATE0 - 8271 Melrose Drive •Lenexa, KS 66214 • Phone: 9.13-492-07-07 Fax: 913-492-0808. _ e-mail: onsite®biomicrobics.com • www.biomicrobics.com 800-753-FAST(3278) - -- Q4 - - _ FIELD INSPECTION & SERVICE IREPORT- For BZo-Microbics-Single Home-FAST®_SystenZ lIYSTALLATION A. ROR=SERVICE PROVIDER Installation Address ' Name lceFa c , Inc. .-0wnerName 'Tan-ev Johnston Street -44 or. nercia -- treet -: . Mail Address 206 Lon Q Beach Road Mail Address - - - Centerville , MIA 02632 - _-City State ZipCitv:�aynharl State"<<?Zi 027 7 = 503-775-2700 508-823-9.56 Phone- Fax e-mail Phone ax e-mail --- LIl�TSTALLAZTON IlVEORNfaTIC}I � y Model No. Serial No. Date of Installation c Date of last pumpout TTU006 0 Electrical Panei(s Visual Alarm Operatingh/ Audio Alarm Operating _ (if present) Blower(s) Air Inlet Filter Clean v - Blower Hood Vents Clear v - excessive Noise v Excessive Vibration ✓ Treatment unit(s)- Unusual-Odor -: - Pumaout-Required: r =_-Prim SealingZone -Aerobic-Treatment Zone ✓ _ Estimated Dail Flow - - H Standard Units) 6-9 S.U. 'Color Clear Temperature - - Odor Slightly - = - musty odor --= _ not septic) 1NV 0NER SIGNATURE TEC IGNATURE ;.SERVICE DATE r J&R SALES & SERVICE, INC. June 9, 1999 Barnstable Board of Health PO Box 534 Hyannis, MA 02601 Attention: Health Agent Reference: Single Home FAST®Treatment System Serial Number: BMR 1006 Attached please fmd the Field Inspection& Service Reports and Testing Results(as required) for services performed on 6/7/99 at the home of Richard McCourt located at 206 Long Beach Rd.. Please call if you have any questions or require additional information. Sincerely, Candy Gayares attachments cc: Richard McCourt 44 Commercial St. Aaynham,MA 02767 Tele.508.823 9566 Fax 508 880.7232 INCORPORATED 8271 Melrose Drive -Lenexa, KS 66214 Phone: 913-492-0707 - Fax: 913-492-0808 e-mail: onsite®biomicrobics.com • www.biamicrobics.com - 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTALIrATION AUTH0R1=-SER.VICEPROUIDER 206 Long ,each ?. Installation Address Centerville , "'A Name J&R Sales and Service Owner Name Pic. ar '`cCcurt Street Mail Address 21. : arr!S :�.ve . Mail Address T-rineham, `-fA 02043 " Commercial St. City State Zip City Raynham, MA S&&7677j (508) 823-9566 880-7232 Phone Fax e-mail Phone Fax e-mail INSMkILLATION INFORMATION' Model.No. Serial No. Date of Installation Dace of last pumpout �7Si7�n,{�gle `-?ore B"+.`�•. �+�}����/�• E Q ViCl1'l1-rl.�l ... -y'T '£ YI-:.r7�' 4�' "`-' 4' �!`.•l .FL'l�AJ1�.CE-P�:.'�C Ql\1�iGLJ"Ci1�L�C.Q1Y11V ZS• -�.1 Electrical Panels Visual Alarm Ooeratin Audio Alarm Operating (if present) Blower(s) Air inlet Filter Clean Blower;food Vents Clear Excessive Noise Excessive Vibration Treatment unit(s) Unusual Odor Pumpout Required: Primary Settling Zone Aerobic Treatment Zone _J.2—FLUENT(optional) � . :.: RESUIii,. ..... . .. .... Z-stimated Dailv Flow H "Standard Units) 6-9 S.U. - Color Clear Temperature Odor Slightly musty odor not septic OWNER SIGNATURE :TECHNICIAN SIGNATURE :::;SERVICE DATE -7- r a t J&R SALES & SERVICE, INC. September 2, 1999 Division of Water Pollution Control Department of Environmental Protection One Winter Street—6 h Floor Boston, MA 02108 Attention: Mr. Steve Corr Subject: Request for Testing Reduction FAST Treatment System Reference: Richard McCourt Serial Number: BMR1006 Dear Mr. Corr: Attached please find the testing results for the first year of testing, four(4) samples, performed at the property of Richard McCourt located at 206 Long Beach Rd. Centerville, MA. As the operator of this system we are requested the testing requirements be reduced or eliminated for this unit. Please forward a copy of your decision to our office. Thank you. Sincerely, ones R. Dunlap cc: Richard McCourt Barnstable Board of Health 44 Commercial St. Haynham,MA 02767 Tele.508-823 9566 fax 508.880 7232 ANALYTICAL BALANCE CORP. 422 WEST GROVE STREET Environmental Chemistry MIDDLEBORO. MA 02346 Environmental Services Site Assessment 508-946.2225 Site Sampling Quality Assurance Services Fax 508-946-3335 Data Auditing J&R Engineered Services 18 July 1997 534 New State Highway Raynham, MA 02767 I COLLECTED BY: B. Everett SAMPLE DATE: 07/07/97 i TIME: 1230 hrs. DATE RECEIVED: 07/08/97 LOCATION: Johnston- Centerville (BMR 1006) SAMPLE ID: 97-07-5416 RESULTS OF ANALYSIS Fi4RAhETER AItALYTICAT. ) TE KNITS Al»;I` :.` RESFII�I' ; METHCiD ANAIrYZET7. ..<:LTMI ' Total Suspended Solids Std. Meth.,2540 D 07/14/97 mg/L 2.0 4.0 Biochemical Oxygen Std.Meth.,2510 B 07/09/97 mg/L 2.0 3.8 Demand Total Kjeldahl Nitrogen Hach Digesdahl/ 07/17/97 mg/L 1.0 3 Nesslerization Nitrogen-Nitrate Std. Meth.,4500-NO,-D 07/10/97 mg/L 0.50 8.31 Nitrogen-Ammonia Std. Meth.,4500-NH,-C 07/11/97 mg/L 0.10 0.33 'Standard Methods, 18`h edition 1992 Ladu6tory Manag /Date i i I Pbonly.fhrM t ANALYTICAL BALANCE CORP. 422 WEST GROVE STREET Environmental Chemistry MIDDLEBORO, MA 02346 Environmental Services Site Assessment 508-94.6-2225 Site Sampling Quality Assurance Services Fax 308-946-3335 Data Auditing J&R Engineered Services 16 July 1997 534 New State Highway Raynham,MA 02767 COLLECTED BY: B. Everett SAMPLE DATE: 07/01/97 TIME: 1300 hrs. DATE RECEIVED: 07/01/97 LOCATION: Johnston- Centerville (BMR 1016) SAMPLE ID: 97-07-5241 RESULTS OF ANALYSIS P ...:L ... .......: ; :..::.rh'I E ...:.. .... : .. ANA€..YZED...: ,:.. ... Total Suspended Solids Std.Meth.,2540 D 07/08/97 mg/L 2.0 4.0 Biochemical Oxygen Std.Meth.,2510 B 07/02/97 mg/L 2.0 8.0 Demand Total Kjeldahl Nitrogen Hach Digesdahl 07/I5/97 mg/L 1.0 4 Nitrogen-Nitrate Std. Meth.,4500-NO,-D 07/02/97 mg/L 1.00 6.92 Nitrogen-Ammonia Std. Meth.,4500-NH,-C 07/02/97 mg/L 0.10 0.42 'Standard Methods, 18'b edition 1992 La&&ory ManWr/Date Pbady.(mV95 ANALYTICAL BALANCE CORP. 422 WEST GROVE STREET Environmental Chemist MIDDLEBOR Chemistry O, MA 02346 Environmental Services Site Assessment 508-946-2225 Site Sampling Quality Assurance Services Fax 508-946-3335 Data Auditing 13 January 1998 J&R Engineered Services 44 Commercial St Raynham, MA 02767 i COLLECTED BY: B. Everett SAMPLE DATE: 1/5/98 TIME: 0900 hrs. DATE RECEIVED: 1/5/98 LOCATION: Johnston- Centerville (BMR 1006) SAMPLE ID: 98-01=00055 RESULTS OF ANALYSIS Farataeter Analyizcal Date units Det Result; Nteitiod* Anat zed Limit:; pH Std.Meth.,4500-H`B 1/6/98 ---- NIA 8.06 Total Suspended Solids Std. Meth.,2540 D 1/7/98 mg/L 2.0 15.0 Biochemical Oxygen Std. Meth.,5210B 1/7/98 mg/L 2.0 12.3 Demand NA=Not Applicable *Std.Methods, 18''edition, 1992 Ib3l4 ej LtaboratoWKhnager/Date Pbonlylffn195 ANALYTICAL BALANCE CORP. 422 WEST GROVE STREET ,41ronmental Chemistry MIDDLEBORO. MA 02346 Environmental Services .-Site Assessment 508-946-2225 Site Sampling Quality Assurance Services Fax 508-946.=S Data Auditing 20 August 1997 J&R Engineered Services 534 New State Highway Raynham, MA 02767 COLLECTED BY: B. Everett SAMPLE DATE: 08/11/97 TRVIE: 1400 hrs. DATE RECEIVED: 08/11/97 LOCATION: Johnston- Centerville (BMR 1006) SAMPLE ID: 97T08-6638 RESULTS OF ANALYSIS ?'::.<' P :..:;.;;.. ::.:..:.. YTIC.4�..::: ..:.:.:: }�SE ::;.....;UNITS DET....::.:;::.:.: >:>::...RE :... .......::..,.; ... :::.::.::: .......:. ... .::..:::::::::..: :::,.. :...::.::::::::.:::. SFJLT.:.::: ...... < ©D : ATYZED. : :. Total Suspended Solids Std.Meth.,2540 D 08/18/97 mg/L 2.0 42 Biochemical Oxygen Std.Meth.,5210B 08/13/97 mg/L 2.0 6.1 Demand Totai Kjeidahl Nitrogen Hach Digesdahl/ 08/19/97 mg/L 1.0 16 Nessierization Nitrogen-Nitrate Std.Meth.,4500-NO,-D 08/13/97 mg/L 0.50 7.22 Nitrogen-Ammonia Std.Meth.,4500-NH,-C 08/14/97 mg/L 0.10 11.3 'Standard Methods, 18°'edition, 1992 P ' ,Ck aboratory Mana er/Date PboWy.ftm95 I ANALYTICAL BALANCE CORP. 422 WEST GROVE STREET Environmental Chemistry MIDDLEBORO, MA 02346 Environmental Services Site Assessment 508-946.2225 Site Sampling QualityAssurance Services Fax 508-946-3335 Data Auditing 17 July 1998 J&R Engineered Services 44 Commercial Street Raynham, MA 02767 COLLECTED BY: B. Everett SAMPLE DATE: 7/07/98 TIME: 1000 DATE RECEIVED: 7/07/98 LOCATION: Johnson- BMR 1006 SAMPLE ID: 98-07-05713 Centerville, MA RESULTS OF ANALYSIS Farataeter .4nalyt cal Late UiiFts b.t l esuit lt�fettad Anal::zed LiitIt pH Std.Meth.,4500-H'B* 7/08/98 SU N/A 7.6 Total Suspended Solids Std. Meth.,2540 D* 7/13/98 mg/L 2.0 7.8 Biochemical Oxygen Std.Meth.,5210B* 7/13/98 mg/L 2.0 10.7 Demand *Std.Methods, 18`b edition, 1992. Labor.Wry Man ger/Date ANALYTICAL BALANCE CORP. 422 WEST GROVE STREET Environmental Chemistry MIDDLEBORO. MA 02346 Environmental Services Site Assessment 508-946-2225 Site Sampling Quality Assurance Services Fax 508-946-3335 Data Auditing 1 April 1998 J&R Engineered Services 44 Commercial St Raynham, MA 02767 COLLECTED BY: B. Everett SAMPLE DATE: 3/23/98 TIlVIE: 1030 hrs. DATE RECEIVED: 3/23/98 LOCATION: Johnston- Centerville (BMR 1006) SAMPLE ID: 98-03-02268 RESULTS OF ANALYSIS caL Date Knits Deb Kesutt Pieter::.;.:.;:..:;.;::.::::;:.: :.;:.;:.:.:.>:::::;:..Analrt� :.::...:.:.::....:. € 141eth :. a ,od »::»>:>:::;_»»:» ::»:An I pH Std.Meth.,4500-H`B 3/25/98 --- N/A 7.9 Total Suspended Solids Std.Meth.,2540 D 3/26/98 mg/L 2.0 5.2 Biochemical Oxygen Std.Meth.,5210B 3/25/98 mg/L 2.0 17.5 Demand NA=Not Applicable *Std.Methods, 18te edition, 1992 Labofatory Mana& Date Pbwiysrs F { == ..:. . ANALYTICAL BALANCE CORP. `{ 422 WEST GROVE STREET ' - ;-.,mental Chemistry MIDDLEBORO, MA 02346 Environmental ' Assessment ronmental Services 508-946-2225 Site Sam.rality Assurance Services Fax 508-946.3335 Sampling Data Auditing J&R Engineered Services 2 July 1997 534 New State Highway Raynham, MA 02767 COLLECTED BY: B. Everett SAMPLE DATE: 06/23/97 TIME: 1100 hrs. DATE RECEIVED: 06/24/97 LOCATION: Johnston- Centerville (BMR 1006) SAMPLE ID: 97-06-4946 i RESULTS OF ANALYSIS i RE1RAh�fETER ANALYTICAL: DATE MIrTHCID s ANA'LYZED ;: t.IMIT Total Suspended Solids Std. Meth.,2540 D 06/30/97 mg/L 2.0 6.2 Biochemical Oxygen Std.Meth.,2510 B 06/25/97 Demand mom- 2.0 10.7 Total Kjeldahl Nitrogen Hach Digesdahl 07/02/97 mg/L 1.0 3 Nitrogen-Nitrate Std. Meth.,4500-NO,-D 06/25/97 mg/L� 1.00 9.68 Nitrogen-Ammonia Std. Meth.,4500-NH3-C 06/25/97 mg/L 0.20 0.10 'Standard Methods, 13 'edition 1992 oratory� Mana�grDate a 7 PEonly.&M95 ENVIROTECH LABORATORIES, INC. ' MA CERT. NO.: M-MA 063 449 Rte. 130 Sandwich, MA 02563 508 (888-6460) 1-800-339-6460 FAX(508) 888-6446 September 24, 1998 J& R Sales and Service "Commercial Street Raynham, MA 02767 Location: Centerville Collection Date: 9/18/98 at 11:00 pm grab Sampled By: William Everett Lab ID#: 989481A-B Results of Analysis: Lab ID# 989481A 989481E Parameters Units Johnson Pessa Method MDL Date Analyzed, Total Suspended Solids mg/L 5.5 5.5 25400 1.7 9/21/98 BOO 5-day mg/L 6.0 5.7 521013 3.0 9/18/98 pH mg/L 7.31 7.33 4500 H+ NA 9/18/98 Bless than greater than By: � P'(su4h Rona d J. Saa Laboratory 0 rect r 1 J&R SALES & SERVICE, INC. September 15, 1999 Barnstable Board of Health PO Box 534 Hyannis, MA 02601 Attention: Health Agent Reference: Single Home FAST°Treatment System Serial Number: BMR1006 Attached please find the Field Inspection& Service Reports and Testing Results (as required) for services performed on 9/7/99 at the home of Richard McCourt located at 206TLong Beach Rd.. Please call if you have any questions or require additional information. Sincerely, Candy GVares attachments cc: Richard McCourt 44 Commercial St. Raynham,MA 02767 Tole.508 823.9566 Fax 508.880-7232 r i 9Q=1 ORPORATED 8271 Melrose Drive -Lenexa, KS 66214 - Phone: 913-492-0707 - Fax: 913-492-0808 e-mail: onsite®biomicrobics.com - www.biamicrobics.com - 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTAUATION AUTHORIZEII SER�ICEPROVIDER 0 Lone :'each ?. Installation Address Centerville , "A I Name J&R Sales and Service Owner Name Richard. ``cCourt Street Mail Address . arr, s ve . Mail Address TJinaha__m, "An2n43 44 Commercial St. City State Ziv City MA StQ7677 (508) 823-9566 880-7232 ?hone Fax e-mail Phone Fax e-mail INSTALIATrOM INE0RMATI0I4-. - Model No. Serial No. Date of Installation I Date of last pumpout Sinqrle '_ror is B­ 1 0 6 F". -EQUIPMENT --�=Nf:4IN1'El�ANC'EP�ORMEI7rAVD:GOIv1I�1�'TS Electrical Panels Visual Alarm Operating Audio Alarm Operating (if present) Blower(s) j Air inlet Filter Clean j Blower Hood Vents Clear Excessive Noise Excessive Vibration Treatment unit(s) Unusual Odor Pum riout Required: Primary Semling Zone Aerobic Treatment Zone ;r '7LUENT(optional lj�LJB EC; ,.: ':RESUI ' mated Dai1v Flow j L off(Standard Units) 6-9 S.U. Color Clear Temverature Odor Slightly musty odor not septic) OWNER SIGNATURE CHNICIAN SIGN ::._: : . SERVICE DATE j & R SALES & SERVICE, INC. December 17, 1998 Barnstable Board of Health PO Box 534 Hyannis, MA 02601 Attention: Health Agent Reference: Single Home FAST®Treatment System Serial Number: BMR 1006 Attached please find the Field Inspection& Service Reports and Testing Results(as required) for services performed on 12/7/98 at the home of Nancy Johnson located at 206 Long Beach Road. Please call if you have any questions or require additional information. Sincerely, Candy Gaya es attachments cc: Nancy Johnson 44 Commercial St. Raynham,MA 02767 Tel:508-823-9566 Fax:508-880-7232 ! a C O R P O R A T E 0 8271 Melrose Drive -Lenexa, KS 66214 -.Phone: 913-492-0707 - Fax: 913-492-0808 e-mail: onsite®biomicrobics.com www.biQmicrobics.com • 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTALLATI0? :. AUTHORIZED SERVICE PRQVIl?ER Installation Address Name J&R Sales & S ervi ce, Inc. Owner Name Nancv Johnston Street 44 CorinercialStreet Mail Address 206 Long Beach Road Mail Address Centerville, MIA 026-32 City State Zip Cie--a ham state,,�zi 027 7 503-775-2700 508-823-.9.56P Phone Fax e-mail Phone ax e-mail - L�FS 7ATELTATIONW.ORMATIKJI Model No. Serial No. Date of Installation Date of last pumpout B' 1006 Electrical Panels Visual Alarm Operating Audio Alarm Operating if present) Blower(s) Air Inlet Filter Clean Blower Hood Vents Clear Excessive Noise v Excessive Vibration Treatment unit(s) Unusual Odor v. Pum out Required: Primary Sealing Zone Aerobic Treatment Treatment Zone . - EIEIT�1f�T° Estimated Daily Flow H Standard Units) 6-9 S.U. Color Clear Temperature Odor Slightly musty odor not s tic) OWNER SIGNATURE TECHNICIAN ITNATURE SERVTCE DATE r J &R SALES & SERVICE, INC. December 28, 1999 Barnstable Board of Health PO Box 534 Hyannis, MA 02601 Attention: Health Agent Reference: Single Home FAST°Treatment System Serial Number: BMR1006 Attached please find the Field Inspection& Service Reports and Testing Results (as required) for services performed 12/22/99 at the home of Richard McCourt located at 206 Long Beach Rd.. Please call if you have any questions or require additional information. Sincerely, Barbara J. Rogers attachments cc: Richard McCourt 44 Commercial St. Raynham,MA 02767 Tele.508 823.9566 Fax 508.880.7232 INCORPORATED 8271 Melrose Orive -Lenexa, KS 66214 - Phone: 913-492-0707 - Fax: 913-492-0808 e-mail: onsite®biomicrobics.com - www.biamicrobics.com - 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTALLATION' AUTHORFZED SERVICE PROVIDER 206 Lona ?each InsmiladonAddress Centervi11e , '"A I Name J&R Sales and Service. Owner Name nic. ar ""Court Street Mail Address � J a.rr s Ave . Mail Address uinQham, "'A02�<<3 44 Commercial St. CityState Ziv City • MA 5767v (508) 823-9566 880-7232 Phone Fax e-mail Phone Fax e-mail 14S7, LT;AT TON..INE.ORMATION- ._ Model No. Serial No. Date of Installation Date of Iast pumpout ._MA>ZVTEl<rANC MR7-O *M.C.OM4& Ts !::4 Electrical Panel(s) Visual Alarm Overatin / Audio Alarm Operating (if present) Blower(s) Air inlet Filter Clean Blower Hood Vents Clear Excessive Noise Excessive Vibration I/ Treatment unit(s) Unusual Odor Pumvout Required: Primary Settling Zone Aerobic T:eatment Zone E.�'nLIJ l;`(T u tionall L Estimated Daily Flow H(Standard Units) 6-9 S.U. Color Clear Temoerature Odor Slightly / musty odor V not septic) OWNER SIGNATURE: TECHMC -SIG ATURE : ; SERVICE DATE ANALYTICAL BALANCE CORP. 422 WEST GROVE STREET Environmental Chemistry MIDDLEBORO, MA 02346 Environmental Services Site Assessment 508-946-2225 Site Sampling Quality Assurance Services Fax 508-946-3335 Data Auditing 13 January 1998 J&R Engineered Services 44 Commercial St Raynham, MA 02767 COLLECTED BY: B. Everett SAMPLE DATE: 1/5/98 ;TIME: 0900 hrs. DATE RECEIVED: 1/5/98 LOCATION: Johnston- Centerville (BMR 1006) SAMPLE ID: 98-01-00055 RESULTS OF ANALYSIS Parameter Analytical Date ;Units . Det Result Method Anal zed Lima pH Std.Meth.,4500-H+B 1/6/98 ----- N/A 8.06 Total Suspended Solids Std.Meth.,2540 D 1/7/98 mg/L 2.0 15.0 Biochemical Oxygen Std.Meth.,5210B 1/7/98 mg/L 2.0 12.3 Demand NA=Not Applicable Std.Methods, 18'edition, 1992 WaboratoWK4anager/Date Pbonly.Gm/95 ,I J&R SALES & SERVICE, INC. January 16, 1998 Town of Barnstable Board of Health PO Box 534 Hyannis, MA 02601 Re: Single Home FAST Serial#BMR1006 Attn.: Health Agent Attached please find the Test Results and the Field Inspection& Service Report for services performed on 1/5/98 at the home of Nancy Johnston located at 206 Long Beach Road. Sincerely, alto Cand �ares Y Y attachments (2) 44 Commercial St.. Aaynham,MA 02767 Tale.508 823.9566 Fax 508 880 7232 J RZINCURPIAATED 8271 Melrose Drive -Lenexa. KS 66214 - Phone: 913-492-0707 - Fax: 913-492-0808 e-mail: onsite®biomicrobics.com - www.biamicrobics.com - 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTA EAMN;. AUTHORIZED SERVICE PRQ TIDER Installation Address Name J&'-R Sales & Service, Inc. Owner Name Nancv Johnston Street oTrttlerci.a treet Mail Address 206 Lons Beach '.?o a d Mail Address Centerville, MIA 02632 City State Zip CitvF-aynhars State'`"�.Zi 027 7 508-775-2700 508-823-9.56 Phone Fax e-mail Phone ax e-mail - =gVSTAL c TIONINEORMATIdI Model No. Serial No. Date of Installation i Date of last putnpout TT,1006 -06 Electrical Panels Visual Alarm Operating Audio Alarm Operating if present) Blower(s) Air Inlet Filter Clean v Blower Hood Vents Clear Excessive Noise Excessive Vibration d Treatment unit(s) Unusual Odor Pum out Required: Primary Seating Zone Aerobic Treatment Zone tional t Estimated Daily Flow H Standard Units) 6-9 S.U. Color Clear ✓ Temperature Odor Slightly musty odor not septic) SERVICE DATE OWNER SIGNATURE TECHNICIAN SIGNATURE ANALYTICAL BALANCE CORP. 422 WEST GROVE STREET Environmental Chemistry MIDDLEBORO, MA 02346 Environmental Services Site Assessment 508-946-2225 Site Sampling Quality Assurance Services Fax 508-946-3335 Data Auditing 17 July 1998 J&R Engineered Services 44 Commercial Street Raynham, MA 02767 COLLECTED BY: B. Everett SAMPLE DATE: 7/07/98 TIME: 1000 DATE RECEIVED: 7/07/98 LOCATION: -Johnson-BMR 1006 SAMPLE ID: 98-07-05713 Centerville, MA RESULTS OF ANALYSIS Pat.rneter Analyrieal ' Date Units Det Result Method Anal zed I m�t pH Std.Meth.,4500-H+B* 7/08/98 SU N/A 7.6 Total Suspended Solids Std.Meth.,2540 D* 7/13/98 mg/L 2.0 7.8 Biochemical Oxygen Std.Meth.,5210B* 7/13/98 mg/L 2.0 10.7 Demand *Std.Methods, 18"edition, 1992. _ 7//1 AN o Labor Wry Man ger./Date INCORPO'RATE0 8271 Melrose Drive -Lenexa, KS 66214 - Phone: 913-492-0707 - Fax: 913-492-0808 e-mail: onsite®biomicrobics.com • www.biomicrobics.com - 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTAE.1r.4TION : ... AUTHORIZED SERVICE PRGVIDER_ Installation Address Name J&R Sales & Service , Inc, Owner Name Nancv -Johnston Street 44 Corimerc-12—altreet Mail Address 206 L on a. Beach .Road Mail Address Centerville, Y-A 02632 City State Zip CitvPaynham State"' ,Zip 027 7 508-775-2700 08-823-9566 Phone Fax e-mail Phone F ax e-mail - L M .L TION- NFORMtY,ON ._. Model No. Serial No. Date of Installation Date of last pumpout B",.,10 0 6 E.. Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating (if present) !� Blower(s) Air Inlet Filter Clean Blower Hood Vents Clear Excessive Noise Excessive Vibration Treatment unit(s) Unusual Odor Pum out Required: Primary Settling Zone Aerobic Treatment Zone -EMMUEN-':b 0tro - Estimated Daily Flow H Standard Units 6-9 S.U. Color Clear -Temperature Odor Slightly musty odor not septic) OWNER SIGNATURE TECHNICIAN SIGNATURE: SERVICE DATE -�_ — 7 — P I r ,a J&R SALES & SERVICE, INC. July 22, 1998 Barnstable Board of Health PO Box 534 Hyannis, MA 02601 Re: Single Home FAST Treatment Serial Number: BMR1006 Attention: Health Agent Attached please find the Field Inspection& Service Report and Testing Results(as required) for services performed on 7/7/98 at the home of Nancy Johnson located at 206 Long Beach Road. Please call if you have an questions or require additional information. any Sincerely, Candy Gayares attachments 44 Commercial St. 8aynham,MA 02767 Tele.508 623 9566 Fax 508 880-7232 ENVIROTECH LABORATORIES, INC. MA CERT. NO.: M-MA 063 449 Rte. 130 Sandwich, MA 02563 508 (888-6460) 1-800-339-6460 FAX(508) 888-6446 September 24, 1998 J & R Sales and Service 44 Commercial Street Raynham, MA 02767 Location: Centerville Collection Date: 9/18/98 at 11:00 pm grab Sampled By: William Everett Lab . 989481 A-B Results of Analysis: Lab ID# 989481A 989481B Parameters Units Johnson Pessa Method MDL Date Analyzed Total Suspended Solids mg/L 5.5 5.5 2540 D 1.7 9/21/98 BOD 5-day mg/L 6.0 5.7 5210 B 3.0 9/18/98 pH mg/L 7.31 7.33 4500 H+ NA 9/18/98 <=less than ->=greater than By: konald J. Saa Laboratory D rect r J & R SALES & SERVICE, INC. October 7, 1998, 1998 Barnstable Board of Health PO Box 534 Hyannis, MA 02601 Re: Single Home FAST Treatment Serial Number: BMR1006 Attention: Health Agent Attached please find the Field Inspection& Service Report and Testing Results(as required) for services performed on 9/18/98 at the home of Nancy Johnson located at 206 Long Beach Road. Please call if you have any questions or require additional information. Sincerely, (0"Iel Candy Gayares attachments 44 Commercial St. Aaynham,MA 02767 Tel:508-823-9566 Fax:508-880-7232 J&R SALES & SERVICE, INC. September 8, 1997 Town of Barnstable Board of Health PO Box 534 Hyannis, MA 02601 Re: Single Home FAST®Serial# BMR1006 Attn: Health Agent Attached please find the testing results and Field Inspection& Service Report for services performed on 8/11/97 at the home of Nancy Johnson located at Date Homeownds Name 206 Long Beach Road Address Sincerely, Candy Gayares 534 New State Highway Haynham,MA 02767 Tale.508 823 9566 Fax:508-880-7232 l Gaz_ � INCOHPORATED 8271 Melrose Drive-Lenexa, KS 66214- Phone: 913-492-0707-Fax: 913-492-0808 e-mail: onsite@biomicrobics.com -www.biomicrobics.com FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTAT,LATION AUTHORIZED,SERVICE PROVIDER Installation Address Name Owner Name Street Mail Address a&6 r4-o..�... Mail Address city State-09))%ip City State Zip 13�9� 57s o7>ae Phone Fax e-mail Phone Fax e-mail INSTALLATION`INFO.RME�iTION `' Model No. Serial No. Date of Installation Date of last pumpout E. U3P1yIEN'I° ` � '� ;' MAIN OItMED AND CO1GII�IEN'TS YES kI�O TEN•ANCE:'PERF Electrical Panel(s) Visual Alarm Operating ri Audio Alarm Operating (if resent) Blower s Air Inlet Filter Clean v Blower Hood Vents Clear v Excessive Noise �— Excessive Vibration Treatment unit(s) Unusual Odor A Pum out Required 1 E�I:.VENT=o tional I;IIVIIT RESU�,T j Estimated Daily Flow H(Standard Units) 6-9 S.U. Color Clear Temperature Odor Slightly musty odor (not septic) OWNER SIGNATURE;;': TECHNICIAN>SIGNATURE SERVICE DATE . 8 i I ANALYTICAL BALANCE CORP. 422 WEST GROVE STREET Environmental Chemistry MIDDLEBORO, MA 02346 Environmental Services Site Assessment 506-946-2225 Site Sampling Quality Assurance Services Fax 508-946-3335 Data Auditing 20 August 1997 J&R Engineered Services 534 New State Highway Raynham, MA 02767 COLLECTED BY: B. Everett SAMPLE DATE: 08/11/97 TIME: 1400 hrs. DATE RECEIVED: 08/11/97 LOCATION: Johnston - Centerville (BMR 1006) SAMPLE ID: 97,08-6638 RESULTS OF ANALYSIS PARAMETER..;:: ;;; : t NALY ICAL I}A1 E t11�lITS DET.: . ..::: RESULT...................... ANAL: 2ED LIMIT:: Total Suspended Solids Std.Meth.,2540 D 08/18/97 mg/L 2.0 4.2 Biochemical Oxygen Std.Meth.,5210B 08/13/97 mg/L 2.0 6.1 Demand Total Kjeldahl Nitrogen Hach Digesdahl/ 08/19/97 mg/L 1.0 16 Nesslerization Nitrogen-Nitrate Std. Meth.,4500-NO,-D 08/13/97 mg/L 0.50 7.22 Nitrogen-Ammonia Std.Meth.,4500-NH,-C 08/14/97 mg/L 0.10 11.3 'Standard Methods, 18'edition, 1992 aboratory Mana er/Date i i i Pbonly.fmJ95 — i J&R SALES & SERVICE, INC. July 17, 1997 Town of Barnstable Board of Health P.O. Box 534 Hyannis , MA 02601 Re: Single Home FASr Serial 9 BMR 1006 I Attn: Health Agent Attached please find the test result and work order for the services performed on 6/2 3/9 7 at the home of_ Nancy Johnson located at Date Homeowners Name 206 Long Beach Rd. /Centerville Sincerely, Candy Gayares 534 New State Highway 8aynham,MA 02767 Tale.508.823 9566 Fax:508-880-7232 t Qj ;l N C 0 R=PO R A T E0 8271 Melrose Drive-Lenexa. KS 66214 - Phone: 913-492-0707-Fax: 913-492-0808 I e-mail: onsite®biomicrobics.com -www.biamicrobics.com FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System .INSTALLATION - A=, O.'[;=SERVICE PROVIDER Installation Address o2l3G I Name J&R Sales and Service Owner Name Street Mail Address V Mail Address 534 New State Highway Ciry State ZiD City Ravnham StatCM Zit) 0276 - 7,11 >yS 'Z>sa 1 ;08/823-9566 508/880-7232 Phone Fax a-mail hone Fax e-mail :INSTALLATTONDNFORMATTON Model No. I Sezal'No. I Date of Installation Date of last pumpout -E =11v ,4PAI97ENANCE:PERFORNMD%AND C0N2A TS Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating (if oresent) I �/ Blower(s) I I Air Inlet Filter Clean ✓� I Blower Hood Vents Clear Excessive Noise v Excessive Vibration Treatment units) Unusual Odor v PumDout Reouired EPFI;UENT(oDttonal)r � T.T1vfi'F" "::_ .-RESIILT" �I Estimated Daily Flow _pH(Standard Units) 6-0 S.U. Color Clear Temperature Odor Slightly musty odor (not septic) .OWNER SIGNATi3RE TECHNICIAN'STGNATURE . z,_:SERVICE.DATE 5 i i , i I ANALYTICAL BALANCE CORP. 422 WEST GROVE STREET Environmental Chemistry MIDDLEBORO, MA 02346 Environmental Services Site Assessment 508-946-2225 Site Sampling Quality Assurance Services Fax 508-946-3335 Data Auditing 2 July 1997 J&R Engineered Services 534 New State Highway Raynham, MA 02767 COLLECTED BY: B. Everett SAMPLE DATE: 06/23/97 TIME: 1100 hrs. DATE RECEIVED: 06/24/97 LOCATION: Johnston- Centerville (BMR 1006) SAMPLE ID: 97-06-4946 RESULTS OF ANALYSIS PARAMETER ANALYTICAL DATE: UNITS DET RESULT METHOD' ANALYZED LIMIT Total Suspended Solids Std.Meth.,2540 D 06/30/97 mg/L 2.0 6.2 Biochemical Oxygen Std.Meth.,2510 B 06/25/97 mg/L 2.0 10.7 Demand Total Kjeldahl Nitrogen Hach Digesdahl 07/02/97 mg/L 1.0 3 Nitrogen-Nitrate Std.Meth.,4500-NO3-D 06/25/97 mg/L 1.00 9.68 Nitrogen-Ammonia Std. Meth.,4500-NH3-C 06/25/97 mg/L 0.20 0.10 'Standard Methods, 18'edition 1992 �► . ; -- oratory Manag r/Date Pbonly.fml/95 IMCOflP0RATE0 8271 Melrose Drive -Lenexa, KS 66214 - Phone: 913-492-0707 - Fax: 913-492T0808 e-mail: onsite®biomicrobics.com - www.biomicrobics.com - 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System _ - AlL. INSTALLATION`. . AUTHORIZED:SERVICE PRC}`T!I?ER Installation Address Name J&ti. Sales & Service, Inc. Owner Name Nancv Johnston Street 44 CoTmerc1aiStreet Mail Address 206 Lon? Beach Road Mail Address Centerville, MIA 02632 City State Zip CiryRaynham state',, zip 027 6 7 508-775-2700 508-823-9.56� Phone Fax e-mail Phone ax e-mail } IltFSTALL:4TION'INFORMA TO ,. T Model No. Serial No. Date of Installation i Date of last pumpout - B�T,1006 9/11/96 E~t�iP1 'r. :.� ._ �; :,-_:;_ _ S'""" Q✓�' ._� ;��MAtb4_TsEL�F�II�EEIavFD�.�N4 C©1r�BGIF1�'1,'S�"'�`` Electrical Panel(s) Visual Alarm Operatingr✓ Audio Alarm Operating �� (if resent) Blower(s) Air Inlet Filter Clean Blower Hood Vents Clear ev Excessive Noise Excessive Vibration Treatment unit(s) Unusual Odor .� Pum out Required: Primary Settling Zone Aerobic Treatme^.Zone ` T :b fional _ =tTa_S1tTT'L< '- Estimated Daily Flow H Standard Units) 6-9 S.U. Color Clear Temperature Odor Slightly musty odor (not septic) OWNER SIGNATURE "' TECHNICIAN SIGNATURE :`' VICE ' TE- PROFESSIONAL CIVIL ENGINEER, CUSTOM DESIGNER P.O. Box 781 Dennis, Massachusetts 02638 Telephone(506)365-6530 Fax(508)396-3063 May 22, 1996 Mr. Rob Gatewood Barnstable Conservation Commission 367 Main Street Hyannis, MA 02601 Re: 206 Long Beach Road, Centerville DEP File #SE 3-2884 Dear Rob, Enclosed, herewith, are 4 copies of the site plan for the above referenced project. As you can see; I have changed the proposed treatment plant from a Bioclere to a F.A.S.T. system. The concrete vault walls have been revised to provide better protection during flooding by extending them to the foundation. Also, the leaching system has been changed from pvc pipes to infiltators. I have reviewed these changes with Tom Mckean at the Board of Health and he sees no problem with this proposed design. Therefore, I request a modification of the "Order of Conditions" issued on 5/26/95 and to make this the new plan of record. Since Mr. Steve Wilson requested that I take over this project, I will be conducting the inspection and certification for Nancy Johnston. If you have any questions or comments, please contact me. Very truly yours, Craig R. Short CRS/gaw Enclosures cc: we McKean Nancy Johnston Ed Mogan Daniel D. O'Neill, P.L.S. Cb P.O.Box 307 West Hyannisport, Massachusetts 02672 (508) 771-7217 July l l th, 1495 Board of Health \ Town Hall 367 Main Street Hyannis, Massachusetts 02601 RE: Nancy Johnston 206 Long Beach Road Centerville Members of the Board; On January 6th, 1995 the Board granted approval to upgrade the septic system at the above noted address. At the time of the Board's approval the Dept. of Environmental Protection had not yet issued any approval of alternative systems as provided for in Section 15180 of the "new" Title V. Since then the D.E.P. has approved the Bioclere unit for general use in small flow situations such as single family homes and does not require a filing to obtain approval from the state. Therefore we are requesting that the Board revise its approval to reflect the fact that the Bioclere unit has a general use approval. We can meet with the Board at its convenience to discuss this matter further. Sincerely, yG��^c/ ����3Ih✓ Daniel D. O'Neill, P.L.S. Q �Y #�� 1 oft r cc: W. Johnston ! _ I�9 V " TOWN OF BARNSTABLE CF?NE TO OFFICE OF BMITM s BOARD OF HEALTH MAS& p, 00 1679. `� 367 MAIN STREET HYANNIS, MASS.02601 August 7, 1995 Daniel D. O'Neill, P.L.S. P. O. Box 307 36 Putter Lane West Hyannisport, MA 02647 A=206.001 Dear Mr. O'Neill: You are granted a variance from Part VIII: Section 10.00 of the Board of Health regulations on behalf of your client, Nancy Johnston, to install an "alternative" on-site sewage disposal system (bioclere unit) at 206 Long Beach Road, Centerville with the following conditions: (1) A maintenance agreement for the bioclere unit shall be submitted to the Board of Health rp for to obtaining a disposal works construction permit. (2) The wastewater effluent shall be monitored for the following parameter on a monthly basis for the first six months and quarterly thereafter for two years pH, BOD, Total suspended solids, Nitrate and Ammonia. If after this time (two and one-half years), the test results indicate that the bioclere unit is removing/reducing pollutants to the prescribed amounts, the monitoring can be ceased. Sincerely yours, lusan G. Ras R.S. Chairman Board of Health Town of Barnstable SGR/bcs biodlere P.O: BOX 781 CRAIG R. SHORT, P.E. DEN(dIS,MASSACHUSETTS 02638 Telephone(508)385-6530 Fax(508)398-3063 August 20, 1996 [RECEIVED k-ti. w Mr. Edward F. Barry, Health Inspector AUG °� 19 TOWN OF BARNSTABLE - 96 Health Department HEALTH D77T 367 Main Street OF BAR, Hyannis, MA 02601 , RE Locus: 206 Long Beach Road, Centerville Job #1-0795 Dear Board of Health:e lth: On August 07, 1996, I made my final on-site inspection of the installation of the septic system for the above referenced property. I found the system including the vault wall was installed in substantial compliance with the approved Plan by Daniel D. O'Neil dated 12/02/94 revised 04/29/96 by me. Very truly yours, Craig R.IWort, P.E. CC: Barnstable Conservation Commission CC: Ed Mogan CRS/cwk Fv : F C�IVp® oa�L? 3 1996 TaYfiy TOWN-OF BARNSTABLE / LOCATIONUI. G.v.,e 1� �iZ� SEWAGE # VILLAGE Cet Awu,Al, ASSESSOR'S MAP & LOTe4lG'`a6 ll INSTALLER'S NAME & PHONE NO.�-fQ �Vi���,� '7 7 5 2 1y SEPTIC TANK CAPACITY i 5 o Cam.. LEACHING FACILITY:(type) )� (size) NO. OF BEDROOMS d/ PRIVATE WELL OR PUBLIC WATERI�Seri BUILDER OR OWNER /(f,,.�.L.� ��l►Ks F� DATE PERMIT ISSUED: /��&�'" DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No r y=,� i `�` � _ � "n, ; , ,G r . . . �, ----�—� ,,�.._._era' � , .. THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA Fee ;rr JEALTH OF MASSACHUSETTS TOWN OF BARNSTABLE, MASSACHUSETTS igozat *Pgtem com5truction j3ermit ' .t to Construct( )or Repair( )an On-site Sewage Disposal System at: Owner's Name,Addrej and Tel.N4 r 1jwK`� vk-,Zv� C.GwYWJ��� ylU �S [liK (�CQ CCrt�G✓LA- U, Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. o cj c.1 -7 �-�v v S-�C�1.�, 1„J (l S o S v 214 '-1+1,t i.. CC��w�� 3L 1�kI-�.. CJ� ah�nrc -av�•� -77/ 72-17 Type of Building: Dwelling No.of Bedrooms '--I . Garbage Grinder( ) Other Type of Building L7uycy �Ccs,,� ` O. of Persons Showers(-) Cafeteria( ) Other Fixtures Design FlowY �w _ gallons per day. Calculated daily flow gallons. Plan Date j4 1 5 5 Number of sheets Revision Date Title I / Description of Soil SOP &_(fig ; rhea S-&. ,D — Nature of Repairs or Alterations(Answer when applicable) 4, 'Lc1 WC�7l f a(-EerAZhOle, Date last inspected: Agreement: DESIGNING ENGINEER MUST SUPERVISE INSTALLATION AND CERTIFY IN WRITING The undersigned agrees to ensure the construction and maintenance of the afor2 cgVSM WA$v9jS s"tSNRICT in accordance with the provisions of Title 5 of the Environmental Code and not to pU=MRE)AbM nT(qJ&M until a Certifi- cate of Compliance has been issued by this Board of Health. Signed Date Application Approved by Application Disapproved for the following reasons Permit No. � ��lJ �� Date Issued THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS DESIGNING ENGINEER MUST SUPERVISE INSTALLATION AND CERTIFY IN WRITING Certificate of Complia ntOE SYSTEM WAS INSTALLED IN STRICT ACCORDANCE TD per, THIS IS TO C TIFY,that the On-site Sewage Disposal System installed(i",_or repaired/replaced( )on by ��A,;' for as has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated/� P P Y Use of this system is conditioned on compliance with the provisions t forth be ow: T � 'M ��.:,�gp{',�„"rpt'f'r"c•1��i,'+Vi.�i%FRr/f+jF.r;•�'"M•w .. ..� _ .. ... h. • _ .3� s No. J" t 47 C� • - —� L ��/ L.'. Fee ` THE COMMONWEALTH OF MASSACHUSETTS — - PUBLIC HEALTH DIVISION- TOWN OF BARNSTABLE, MASSACHUSETTS _ -W A Yiratfon 'forigo�aYp�terrt Cori6tructior� erri�it j Application is hereby made for a Permit to Construct( )or Repair( )an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Addres and Tel.NQ i at�Co Ce... r.i,' yrvA 114fS LG�c )Z Q Cc„Je,11 R Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. MoejG� -71 �7Vv �c?t,, LJ, (ISo,_-a SLj214 7'�/ 7;Z/7 `ttt•�- (.. Cc��;.v�ttti .3L f�.Nr C.}�f G„�.t --V Type of Building: Dwelling No. of Bedrooms. Garbage Grinder( ) Other Type of Building i aoQ i ec,Q,,_L__.o. of Persons Showers(- ) Cafeteria( ) Other Fixtures Design Flow `'f Ny gallons per day. Calculated daily flow gallons. Plan Date 4_2� 3/) 5 5- Number of sheets Revision Date Title Description of Soil a- 7vf2 .S "- G�c� tlleiowsk: S:'3-G&,4- Nature of Repairs or Alterations(Answer when applicable) !_. v r-R- IG� S`" s� J c r Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site_ sewage disposal system ,�-in-_accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- '^' cate of Compliance has been issued by this Board of Health. r Signed Date r Application Approved by i Application Disapproved for the following reasons ..7 ","� 4 Permit No. �} Date Issued __ -__ _=_—— ------_ -__== _------- THE COMMONWEALTH OF MASSACHUSETTS \� PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Certificate of Compliance - THIS IS TO CERTIFY,that the On-site Sewage Disposal System"installed(40'�or repaired/replaced( .)on by 70C�-lfAfA<, ,jr f d,,/�A/ for. as has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. , dated/R Use of this system is conditioned on compliance with the"provisions t forth below: No. / b Fee/ l THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 'Wi5po5al *pMem Con5truction Vermit ,Permission is hereby granted to •7 'I � to construct(G-)repair( ) an On-site Sewage System located at ;` Yoh' and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction must be completed within two years of the date below. Date: Z Approved by r , t G 14. (b Daniel D. O'Neill, P.L.S. P.O.Box 307 711 West Hyannisport, Massachusetts 02672 �i L }" (508) 771-7217 JulI 11th, 1005 y Board of Health - .4 Town Hall 367 Main Street Hyannis, Massachusetts 02601 ' 4 . . i RE: Nancy Johnston r 206 Long Beach Road Centerville Members of the Board; { On January 6th, 1995 the Board granted approval to upgrade the septic system at5 the above noted address. At the time of the Board's approval the Dept. of Environmental Protection had not yet issued any approval of alternative systems as provided for in Section 15.280 of the "new" Title V. i Since then the D.E.P. has approved the Bioclere unit for general use in small flow situations such as single family homes and does not require a filing to obtain approval from the state. Therefore we are requesting that the Board revise its approval to reflect the fact that the Bioclere unit has a general use approval. We can meet with the Board at its convenience to discuss this matter further. t i Sincerely, Daniel D. O'Neill, P.L.& r "S tJ cc: W. Johnston 9� s s x F i Si gle Home FAY. r Sewage System Available for residential and light commercial applications t , ,y V s, • b. i� r a y. A Typical installation � � 3 of Single-Home FAST, 4. Single-Home FAST on-site sewage treatment systems offer the clear advantage of the Fixed Activated ' I Sludge Treatment process which has proven l superior for more than 20 years. Under very stringent regulatory requirements, the FAST process is recognized and accepted worldwide. Seal of the National Sanitation FoundationNS The SCIENCO/FAST Single-Home FAST is an NSF International Standard 40,Class 1 Certified Unit and meets or exceeds all EPA requirements. ANSI ACCREDITED IMCO/ O Tlie Advantages Are Clear.TM TM Check PASTO First for Dependable, Economical Treatment As an aerobic process with 100% Compare FAST®'s Treatment Cost submerged, open media, FAST® is the Efficiencies! For treatment of organic simplest and most reliable of the fixed wastewater, nothing can beat a film biological processes. , FAST® System. . Compared to Trickling Filters,FAST®avoids filter flies, Waste Strength media clogging,odors and problems with media wetting - and effluent recycle.FAST®is less susceptible to heat Method too mg/1 t,000 mg/1 loss and process suppression from cold weather. Cents/Gallon Cents/Gallon Compared to Rotating Biological Contractors t (RBCs),FAST°has no drive unit,no moving parts and FAST, System 003{w0.10¢/gal °'.010 .'l).40�/galV. no bearings and shafts that can break as'a result of Carbon Absorption 0.50- 1.000/gal. 5.00-10.000/gal. unpredictable and fluctuating biomass loads.FAST® eliminates odor problems and does not need to be Chemical Treatment 0.60- 1.300/gal. 6.00-12.000/gal covered to avoid cold weather problems.FAST®'s Hauling 6.00-50.00¢lgal. 6.00-50.00¢/gal. rectangular media allows more treatment capacity in equivalent space than RBC. Compared to Biological Aerated Filters(BAF), t FAST°features simpler operation and controls,does not Proven Treatment Efficiencies for require primary clarification and media backwash. FAST®is not subject to septic conditions and odor. Industrial Applications! Application Influent %BOD BOD,(mg/1) Removal .Check FAST®'s Important Benefits! Cheese Factory 2,000 80+ Long sludge age...Eliminates the need for sludge Soft Drink Plant 1,000 90+ reseeding after short flow interruption as in the case of conventional activated sludge;more tolerant of toxic Transport Washdown 800 94 shock. + Reduced loading of clarifier...Increases the settling Fragrance/Flavor Operation 2,200 90 rate in the clarifier and improves performance. Creosote Plant 1,200 80 • Nitrification...Reduces conventional aeration volume and operating cost. Compact,factory-built design...Lower installed — - --- costs,less space,fully inspected and proven prior to shipping. J&R ENGINEERED PRODUCTS,INC. Optional design for complete portability...Easily 271 Leonard steer Tele.508 823 9566 moved from site to site. Raynham,MA 02767 Fax 508 880 7232 14040 Santa Fe Trail Drive Lenexa,Kansas 66215 Smith&Loveless,Inc. Telex:42282(SMITLOVLS LENX) ©Smith&Loveless,Inc.1988 FAX:(913)888-2173 Printed U.S.". Solutions for a World of Water Problems 1ENCO/F45r How Si*ng1e=..H' ome bq�* W . or S (EAST = Fixed Activated Sludge Treatment) The Single-Home Fast process consists of a primary settling zone and an aerobic biological zone.Treatment is given by "friendly"bacteria that live,naturally in domestic sewage. An ideal environment is created in the aerobic zone so the bacteria may flourish. Solids are trapped in the primary zone where they settle. In the aerobic zone, the bacteria colony attaches itself to the surface of a submerged media bed and.feeds on the sewage as it circulates. The two zone system will treat the wastewater produced during both high usage peaks as well as low usage periods and still maintain healthy bacteria. The FAST Sewage Treatment System is designed to process the waste produced by typical family activities(bath, laundry, kitchen;etc.),ranging from two(2) to nine(9)members. This equates to a daily flow rate of up to 900 gallons of wastewater. F k ' ® The Single-Home FAST unit is a 4'x 4'x 6'module designed to be aesthetically pleasing to the 0. 0 0 0 surroundings and still offer ease of maintenance and service. _ — t=- ® Power Required: 120v,60 Hz. _ PRIMARY = _ .The Single-Home FAST is uaran- SETTLING- g ome $ —_— ZONE _ teed to be free of defects in mate- " — — rial or workmanship for a period of r _ — two years from date of installation. - SOLIDS COLLECTION ZONE TOWN OF BARNSTABLE V LOCATION4 SEWAGE # qS'/56 b VILLAGE ASSESSOR'S MAP & LOTeo:1,0 INSTALLER'S NAME 6i PHONE NO. rj M o��,� 7,7 SEPTIC TANK CAPACITY i 9bo G.. LEACHING FACILITY:(type) )2. (size) t 4l'x y 3 NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER SI.Z BUILDER OR OWNER /(fG, ,,�c..7 �� �s 1-rr•- DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: ' / r' �` ;P115, VARIANCE GRANTED: Yes No 1 Al ENVIROTECH LABORATORIES, INC. �t.,. MA Cert. No.: M-MA 063 449 Rte. 130 • Sandwich,MA 02563 (508)888-6460 - 1-800-339-6460 FAX(508)888-6446 December 5, 1995 ;b Mr. Ed Mogan 442 Bay Road. Centerville, MA 02632 re: Bioclere Monitoring Program Envirotech Laboratories will sample and perform analysis on effluent from the Bioclere waste treatment system that will be located at house owned by Will & Nancy Johnson at 206 Long Beach Rd. Centerville, MA. COST FOR ANALYSIS: Parameter Cost/Test pH $ 8 .00 BOD 35 .00 Total Suspended Solids 15.00 Nitrate-N 15 .00 Ammonia-N 15.00 GRAB Sampling $50.00 TOTAL COST PER SAMPLING* $88.00 *Monthly for First six (6) months. Quarterly after six (6) months. �rltechEn L oratories , Inc. Rold J. ari Edward Mo an LaboratoryS irector SEPTIC PUMPING AND'INSTALLATION 350 Maid St •, W. Yarmouth, MA 02673.• 775-2800 Heating'&Plumbing Fire SpnnWrs December 7,1995 Mr.`& Mrs.°Will Johnston 410 Nyes Neck Road Centerville MA 02632 Dear Mr. & Mrs..-Johnston: A&B Canco is licensed by the Barnstable Board of.Health in accordance with G.L.C. IIIS.31A and 31.0 CMR15:502. It has-been requested of us by Mr. Ed Mogan, Custom Builder,that we inspect the eptic tank annually and pump,it if necessary. A&B Canco would be pleased to do so, but we are unable to test effluent samples quarterly for pH,-BOD5 'and total suspended solids. For this, a class 2 certification is required and we do not employ a class 2'certified operator. Please feel free to call me at (508)775-2800 if you have any questions. Respectfully;. melt T Dubuque 1d_4�r�� General Manager 4- ETD:era q I , .. a ' �� .'r-.,u�..-r•:�U ar P; _ �'� it �,. ..Ii li 1^�� r ! .fTti.`I-f i°- "4/+�5� O� - f�/ esPsanr�(F'�-•Ga=4- -.+s-,�-a`� � 1 f -!_•01JS"'r2UG:Tldl�l`� `i- /.0 q��it.,wrR(RfN1ot'< <�' � v, � � --�I---�I � i ' L M BA / I ; __ ; _..___. w..roo«rs •r.r-+ 4e.ecG � G1M IN! J i w<J�`✓p�.` "�I � — �J . 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I I I . � 1. - � I DEEDED OR ZONING,REGULATIONS.' OWNER \APPLICANT IS TO' - �l � I 1-� �I TEST DATE - I .'' WATER 'LEVEL . ,� � 1. I �� I �I "I I I 'i ­l­ . I . � - . - �- I -0.4 1 r ,� 3.6 1 1 1 .7 I .. :�l 'I � , -, . I � I ,01-� I I ' ' I --- , ---- , . . 1. I - �I 11 . I � I I I - I I 11 , ' � - , � , �­ I i .� I ­I '. � I � I . I I .� .1� I ­ � - I . . � I � ' ­ . . I I . I I ­ ,.., . . 11 � I I I - E AUTHORITY. ­ I I I I � � � 1. ,r 1.11 � r, ­ . I � � 11 I I - 11 11 1. . 4.3 1 1 -1 . .HIGH :WATER ' I I .. :.1 . I I I � . I I I OBTAIN;.SUCH DETERMINATION �FROM ,APOROPRIAT , �', . . ­ ' ' . ' �:` --I '. 1. � -, , � I I I . � - � I 1. � . I� . I . I I � � 1. � I I � � 11 � I � ' ' I I - . � I I I 1. 1 . . 1. �. I . . INDEX WELL, ., , � � � .. . � ". I I I I " � . � Lj=:l ' I I , I .1 � .. � . I �1� I 1, - ­ I I.. I � � .. I,� 1, I , --..;- , , ." � 1. �- . ­ � :­.� ­ I I' ll . � ,� � . I . -C:= ,' ,,�.P-=­-_X;:;Z!�.,3.1 NGVD. . ­ I I I - I 11 I -1 I � � I . I.. � . I . 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Q 7 L OF; FOUNDATION T .TOP ELEVATION I I!, V D, Im vc v&N1 4* ry .,SCHEDULE 40 P.V.C, PIPE IN PITCH l/ PER FT. M 10 N rz 0 LOW S CONCRETE COVER _H ............ _F I E E -7-1 ELEV. 'ASSESSORS MA0,206, PARCEL 1 Ltvt.L A 'ELEV. mv. LOCATION MAP 7-9:3 C L tv',17.1 L.�.ELEV- P 5E D 'L r- V,=-I v I^/>,Z- .8ox 'TION 7s ISTRIBU x .4,3 Ll TO BE WATER 1ESTED IF 1500 - GALLON MORE THAN ONE OUTLET� SEPTIC TANK S., 'OUTLET TEE 8 OW OW . NE - CALCULATION ' LIOUID DEPTH IN SEPTIC TAW DEPTH. OF ' EL FL 14 IN NOTES 4 FEET CHES . . DESIGN� LEGEND:q 5 FEET '12 INCHES O D'E.P. BUSH 6 FEET 24 INCHES 1. 'ALL WORKMANSHIP. AND"MATERIALS .SHALL CONFORM OR 'MEE TITLE.-5. AND""THE TOWN -'RULE§ AND NUMBER OF.:BEDROOMS REGULATIONS .F GARBAGE UNIT OR THE SUBSURFACE DISPOSAL .OF SEWAGE. DISPOSAL _Q� I I �I I . I . , 1 9 I I 1 1 9 -L � IIJ I I I q .: 11.9. 1 ESTimATED FLOW SEWAGE 'DISPOSAL SYSTEM PROFILE TOTAL-, TO r-AL /DAY X 2. ALL �COVERS 'TO ,SANITARY UNITS SHALL 13E BROUGHT GAL./BR /bAY' 00L �DAY CESSP NOT� TO:SCALE WITHIN 6, OF nNISHED 'GRADE. RED SEP11C JANK ,CAPAC �GAL.) Ity REQUI wv 'DAY ACTUALT SIZE",OF, SEPTICJANK�� WATER GATE m 3. EXISTING :AND FINAL.GRADES SHALL REMAIN ESSEN11ALLY THE 'SAME.". z 0 V-� L;Lwl tt� 'A ' -ker^ LEACHfNJG -ARE REOUIREMENTS CAS GATE C E N T'E R VI LLE.., R I VER 4. ALL COMPONENTS OFTHE SANITARY SYSTEM SHALL BE CAPABLE OF" WITHSTANDING H-�-10 LOADING UNLESS THEYL ARE UNDER.-'OR WI THIN "AREA �CED ELECTRIC -GAL�/S.F.l 10 FT. .OF­DRIVES`­OR PARKING AREAS. H-201OADING' -SHALL BE EXISTING SlONEWALL ,, SPOT ELEV. lie Y go 4 ' E OR WITHIN 10 FT. "DRIVES OR .PARKING .AREAS�.'�D.P.W. LIC. #1735 A LEACHING, CAPACITY �'FLOW NOV. 19, '1935 5. ANY MASONERY UNITS USED TO BRING COVERS TOORADE SHALL RF-SER%'E--.,I,-F-ACH'INC,,CAPACiTY.'.* ALo/DAY 0.2 EYISTING DOCK BE MORTARED IN PLACE. DEQE­FILE # SE3-2528. , 2 3.8 BEEN MADE AS TO COMPLIANCE WITH b 6. NO DETERMINATION HAS WATER 'LEVEL'' A JUS MENT 7�: -0.4 -LEVEL 3.7 DEEDED OR ZONING REGUL-ATI.ONS., .OWNER \APPLICANT ISJO , TEST 'DA WATER' -,APPARANT HIGH WATE OBTAIN SUCH' DETERMINATION, FROM APPROPRIATE AUTHORITY. INDEX 3.8 .:WATER LEVEL, RANGE ZONE 4.0 .0 1NDEX WE L TION, 'SEE BOOK AGE 4.3 -0.6 -7. FOR FIELD NOTE INFORMA P TO W EL ATER..LEVEL'.FOR. N C-'l N FOR MONTH OF: i M,,V _41�!= 101 Fix<�m�-_fjff.4VIAL 7 3.7. WATE L ADJUSTMENT',' 6.7 0 DEPTH: T ;HIG 4.1 NING .'AREA: . lia-, 4. Z 0 WWAER, 2.9 FRONT SETBACK MIN. FEET 5 46 LEGEND 'o v3sA e LIGHT:' MIN. SIDE BFEET :E)dS*nNG:'SPOT ELEVATION X"Oo. xx�� Paz 4.0 N MIN. 'REAR SETBACK FEET . EXISTING CONTOUR 4.1 O.'a FINAL, SPOT. ELEVATIC 4.0 e. 0 __00.0 io nNAL`�CONTOUR 3.5 SOIL LOCATION' LOPE' �5 PERCOLATION : SOIL9 TEST E 04.3 _-EL VA ON ]!!�loop TEST TOWN',WATER w 4.1 DATE OF SOIL 40 _�3 Am 1.5 -T sEm BOXr 9 STORY,W\F, .6 -0.7 TEST BY DISTRIBUTION 13 WITNESSED BY.. tl PRIMARY LEACHING 'PIT r 0 .if TE r RESERVE EACHING PERCOLATION, RA Ymdbn--MIN./INCH PIT' * 3.7 OBSERVATION :HOLE --J 0.P. .6 �p r OBSERVATION HOLE I 4.2 45 _ , - �W6, J CAS 7 EL ELEV.= A 4.S_N& V C�y EV. FENCE 3.Q IZ 4.3 -0.00 0.00 SHED 4.5 wy cd ISSUE rvpsoil I r . r 1 46 3.7 47' 33 IBY DESC UPTION -BITUMEN DATE Atr PAVEMENT W i NO.- L44 7 4.3'. �-PROROSED_.-SE' "n c,, k 3.9 S P(,;RA E m at,r ju 'POR" DECK 0.6 4.3 3 8 8'7 p w, A, i i; e L a A 'BOTTOM OF, TEST HOLE, BOTTOM OF r TEST HOLE 'N �fi 3 ON- OR WATER ELEVA11ON Zlf .3.9 OR WATER ELEVATI 0.9 EXISTING 8 DOCK r(2 F CS DH R V Or CRAIG � ,SCALE TH,- TOP FNDN 12.0 NGVD. 0 ED F ,4EAL orivrn%l 'ARCEL�2 f 0 NEI L 4.2 E IVI L -D IEL�,D,,� VEyo .O*NER ,OFA' P AL, AGENT No.27483 DANIEL M. PACKARD ov PARCEL .3 " FIRST FLOOR D A TIE ROPESSIbN LA6 `tUR R 7 JjjU VD ,P 10. wv 6.05 NG OWN '307- DEED .43�6`PG.15 'BOX SK E RD: urrtR LAN MARJORIE D. CHITTIM - 02 72r,, !��­,': .HYANNISPO MA S' CLUSTER WEST PERMIT IRT, 1 PG 210 -;,�771 �-:7217 DEED BK. '191 .5