HomeMy WebLinkAboutSeptic Pumping Slip -160 Candlestick - Septic Pumping Slip - 160 CANDLESTICK ROAD 9/24/2024 {
Commonwealth of Massachusetts
City/Town0f North Andover
QSystem Pumping Record
Form 4
w D P has provided this form for use by local Boards of Health.Other forms may be used,but the Information rust bo
substantially the same as that provided hare.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
. System Location:
160 Candlestick Road,
Address
Forth Andover MA 01845
City/Town state Zip Code
, System Owner:
Lee Salgad.,
Name
160 CandlestickRoad,
Address(if different from location)
North Andover 01845
City/Town State Zip Code
407 927
Teiephono Dumber
B. Pumping Record
09404 1000.0000
1. Cute of Pumping ]ate Quantity Pumped: Gallons
. Component: � Cesspool(s) 0 Septic Tank E] Tight Tank Grease Trap
Other(describe);
. Effluent Tee Filter pre ent? E]Yes M No If yes,was it cleaned? lies F No
. Observed condition of component runt pumped:
Cover was accessed and properly secured Septic system serviced. Recommend riser
due to depth of cover. Filter not present. Tank cannot be outfitted with ilter.
1000 gallons removed. Licht sludge on bottom of tank. Light top solids in tank.
System is at proper working level. Both baffles/tees are intact. Main line is
clear. Customer purchased a pre-paid repair item. Recommend using boost next
6. System Pumped By:
Jonathon Colson
Name Vehicle License Number
ber
Wind River Environmental, 46 Li of to Drive, Suite 1000, Marlborough, MA 01752
Company
'. Location where contents were disposed:
Greater Lawrence Sanitary Distract : 240 Charles Street , North Andover, MA
Jonathon Colson 09 4 024
Signature of Hauler Date
Signature of Receiving Facility or attach facility receipt) Dote
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