HomeMy WebLinkAboutMiscellaneous - 50 STONECLEAVE ROAD 4/30/2018 50 gTONECLEAVE ROA17 i d
C,ti
IN C-R.4ULZ� 1 2Z-73-
� a S GI151? �
r/ of
10 L& 145cy
14 5--f3 �v' .�� � �Y l�zl
0� �s..1 s -
I „ r r
A
' C �
/ I
i
9 � �
s���jII1l:-°moi
A
Ex S7'/NC -
y
a
rn
n
HP Fax K1220xi Log for
NORTH ANDOVER
9786889542
May 12 2005 11:04am
Last Transaction
Date TimeTune Identification Duration Pages Res 1
May 12 11:03am Fax Sent 819783715211 0:31 1 OK
C,lu
7
Es r3i'_: ...
/V 78'
-5--,?? 7'
0 145%Lj
V'
C)
Iry fa
7 A t-A
av� A-
14-5-25,
Z-I&r 05
it�ik-!
-Y
rn
1.5 7//v
111A1
/5
O
49
c C,
kh6
-MOS
As iN GloovAl
'?*JJ A A 1!;l-7 8'
r-
Nd C
9�9Q �� �j'� �'p ii � � ���
CIA
76
2,q
,5x 1.5 T11V
4L�
1
I 5'
r r/I•;5�Jr>1ti�r1 'Iv'�S��11i,b(,I JI, rj� 1�'11�11��h' 1''`1(Zk(G'1�`(����1,t����Ll Iil,�l
7t , NI ,i-�4 „ A' -1
i
. I..,. r� � 111 ,II`,. r.l •,1 11 1 ', � ,
1.
r,m
(.
T
STCM �.
f�
h :
loyc
I
I �� �, ' 't -111 •,, ��..
' ✓ ''^r�l.l'';�1 1'!'I !4'`11.,1- � ') !i.' ,;.� �`' � � —_ .-.__.._-�-
�VAMTITY � I � I f�
r i r:' ,f 7 I F'\ ��AC'•(�55' 'pfrl�41u y 1 , t•i�• . . � � 'C�1��-'�--Y/"
�r�,r•kt�',ill{yY �l,!'r'4(r
sCPTIC'
YFS
O.F.SER;YICEI ': ROUTINE. EMER0E�,0r
1 t �•�' LL-5' ��' i'1.�C�..
LEACHFICL0 1? Uri
`504101' C V Y0yC, R � I -
I• U '(y� i 1 ,l- r � ----^--�--tom I� �l .,
• l Y l
it S I l' r1"PUM ('CO''OY
`.15'I ,`541 liY l
, (, .V'•.!y, 1 ..I I. 1 ..{Ir�� '.1. {I• .., � ... ..
r,l; 1i ., 1.5VI ' 1 ;,L'�d.,11,.. ..11. �J1.;' •.,
j , 1
.rf'.vl
1(
l. f.
�`U,� I'A N,I'S �.I .F,CI VI
t , r 're a•� ' F ,
Commonwealth of Massachusetts �` 4•
City/ToWh. of NORTH ANDOVER MASSACHUSETTS
\\)
System Pumping Record
Form 4
PEVED ED'
DEP has provided this form for use by local Boards of Health. The System Pumping F ecord mu:
be submitted to the local Board of Health or other approvinauthOK 6 2006
A. Facility Information TOWN OF NORTHANDOVER
Important. HEALTH DEPARTMENT
When filling out. 1. System LocationL,n
forms the
computeto r,useyq�
only the tab key Address
to move your
cursor-do not
use the return Clty/Town , • _ St to
key. Zi
-- -
p Code
2. System Owner:
Address(if different from location) - -- - - - _-
State — Zip C de
Telephone Number
6.. Pumping Record
. Date.of Pum in ,.. �� �
p g Date 2. Quantity Pumped:
Gallons
3. Type of system: ❑ Cesspool(s) Septic Tank
--. � ❑ Tight Tank
❑ Other(describe):
4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No
r.
5. Condition of System:
V ..
6. Sy em Pumped By:
ame -- -- —_- ._....
/� Vehicle License Number
Company
7. . Location where contents were disposed:
,��,__�____
Si ature of Hau Date- -
httpa/www.mass gov/dep/water/ pravals/t5forms.htm#inspect
t5form4.doc-06/03
System Pumping Record-Page 1 of 1
140 i {
•
d t
E 'l°1 r f x •;
r
3S57 AW
Gti�`I�C' SAM+�`t . ��� . • � ,` �;�
� , z.se �25 t 1q��, t4q�•255 t�$ � "� w
173 s r d3,%e sF d3r955 sF
IZ'p t v -d 00 Z�„ ROAD
i. Y.
- °��d 27 Z 28A4 29AA 3 31 r
�� k.�, • ?ate 1Z0 .
00 C
1 l ta•�
0
tv cpcc aN x {
�d 7 343 4� 5rso s F 1� �t �
�3 ., R.i
a �• a3 5ros� p SkoNt,q F• tAG eM""
yy
� ra
� kepor
O
Ac,
!qS- a .
• Si�.RtiY c . W a!� � ,
ras V FL' Aworef S-atj to ny
lam �n
twiOLJ
xv
'! Mts4 r
`91�_f tic S4. .,. `,�
-TO D
pt.t• o ,
TOWN OF NORTH ANDOVEP,
UA I't �j SYSTEM PUMPINU RBCOFJl
SYSTE VVNER ADpRESS SYSTEMLTON
/m d-
DATE.OF PVMMNq;_ �?�5-a ,QUANTITY PUMPED;
500c 1'Lnk. NU
NA rUKU OF SBRVICE, Rou'rINEMERUENC'Y_ MAY 0 6 2005
VbSBAVAT10NS;
TO aA�TH DEPART(UI TH 0 TER
000D CONDITION PULL. 'fU cova e�
142AYY OIilZA.38 BAFYLES IN PLACC.
Kom ^ LWHAIELD RUNBACK _i
B+XCBSSIVE SOLIDS FLOODED
10LtDCARRYOVER OTHER EXPLAIN
Syot.m PumpcJ by .. .G(. �7�.,....
VUMMBNTS,
uuN I'BN'I'S fKANSF'BRRtiU I'�i
ta�c p9�,1►s 140 . -
131t
A
t3G�•`j35 `.�
k ., _ ;143 }. }_ t,• ; "i '�f
214
POC
•� �s.GA 9�a�^ �jt�o-(�tNra 'Z�vy(''Cf•". �o�ZM�•SN `� � ',� .
Ocs06„
JAC �25 a t4�tt
l
i � e0i�'�' $ �(o l t; Ai/545SF �1389955t= 'd3�°'95E� 41
1lEtle �xj� �3 s 43 5 sF
tAGI
�p%QQ � 5p- 2� 28A z9 AA 3� 3t r 4r,p; ..
Q L�o�l .{
Q Q N 4.� � � t�,MQ_li W`�� LI t� � \S�I � •+��. "`•. � ..,a.. �•w I#1�°�a d� ��..
�116 ut QO �Gu�so�
�ptt)c � -ra�0 °O , � .
43 5roo SF.• S10NE�
F. tdG
t
" t4 SFO �1�t-�fa� ,.e: � � sa t ,, �•}
E� 6
All
zst QA9 . a
vVbG4
0
1
bk m i ..
X52 �,•� oj95 `' � �`�+,
r t'
«, 2G
• 4
�Ior � e
to b� ti�. : 1� ,a; ♦ �
e �
FRY FAjem
F
L•� 59,
eA L
f •�� �2Ca A' �G �`�f' }��yy;
MtTt7 � 4 �
Oman"
•�� 6� t?C � .c�'f
D