HomeMy WebLinkAboutGrease Trap - Septic Pumping Slip - 315 TURNPIKE STREET 10/2/2023 Commonwealth of Massachusetts
u1ls City/Town Of North Andover
. System Pumping Record
Form 4
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
1. System Location:
315 Turnpike Street
Address
North Andover MA 01845
City/Town State Zip Code
2. System Owner:
Casella Organics
Name
283 Smith Road
Address(if different from location)
Chateaugay NY 12920
City/Town State Zip Code
6032905835
Telephone Number
B. Pumping Record
1. Date of Pumping 10/02/2023 2 Quantity Pumped: 3900.0000
Date Gallons
3. Component: Cesspool(s) Septic Tank Tight Tank a Grease Trap
Other (describe):
4. Effluent Tee Filter present? Yes ❑X No If yes, was it cleaned? Yes No
5. Observed condition of component pumped:
Normal water level. lin bottom sludge. lin top solids. Main line Not Applicable
No filter is present on the tank; current tank is not designed to be used with a
filter. Cover(s) secured. No 3rd party paperwork filled. Scheduled maintenance.
3900 Gallons
6. System Pumped By:
Kyle Lambert
Name Vehicle License Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlborough, MA 01752
Company
7. Location where contents were disposed:
Vanguard Renewables - Located in Haverhill: 1058 Boston Road, Haverhill, MA
10/02/2023
Signature of Hauler Date
Signature of Receiving Facility(or attach facility receipt) Date
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