HomeMy WebLinkAboutSeptic Pumping Letter - Correspondence - 370 GREAT POND ROAD 8/27/2020 a .
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North Andover Health Department
Community and Economic Development Division
Septic System Pumping Records
Date: 8/27/20
Address: 370 Great pond road.
Condition of system: Sewer pump chamber
Dear Owner:
Please note that a pumping record for your pump chamber dated 5/28/20 and received on 6/22/20
states that your sewer lift station had excess solids inside, including wipes and tampons. A
pumping record from 3/18/20 also noted that there was overflow from the cover. This indicates
that repairs may need to be performed on your current sewer lift system. Please have your
system inspected by a licensed Title 5 inspector within 30 days of receiving this letter.
Attached is a list of Title 5 septic inspectors that are permitted through the North Andover Health
Department, as well as a best practices pamphlet on caring for your septic system. If you have
any questions or concerns,please contact the Health Department at the phone number listed
below.
Thank you for taking the time to consider the impact this may have on your system as well as the
environment.
Sincerely,
Stephen Casey Jr.
Health Inspector
Office: (978) 688 9540
Enc: Title 5 inspectors List
Caring for your septic system
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North Andover Health Department, 120 Main St.
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
� Commonwealth of Massachusetts P -171' D
City/Town of No. Andover APR _ g 2020
System Pumping Record TOWN Orrt(�y�;t�Fr,r
Form 4 HEALTH DEPART)VaT
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DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use. The System Pumping Record must be submitted to
the local Board of Health or other approving authority within 14 days from the pumping date in
accordance with 310 CMR 15.351.
A. Facility Information
Important:When
filling out forms 1. Syste tion: �'�
on the computer, /S
use only the tab ✓// V
key to move your Address —
cursor-do not No. Andover MA 01845
use the return City/Town State J Zip Code
key.
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2. System wner:
Nam
Address(if different from location)
City/Town State Zip Code
Telephone Number
B. Pumping Record
1. Date of Pumping ate lY/ 2. Quantity Pumped: Gallons
-
3. Component: ❑ Cesspool(s) ❑ Septic Tank ❑ Tight Tank ❑ Grease Trap
Other(describe):
4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No
5. Observed condition of component pumped:
Q V`Q,P/o w 6 r-c,r�
6. System Pumped B : f /
y s J
Name Vehicle License Number
Stewart's Septic 58 So. Kimball St., Bradford,MA
Company
7. Location where contents were disposed:
20 So Mill 5t., Br ford,
J01
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Si nature of Hauler Date
Signature of Receiving Facility(or attach facility receipt) Date
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