HomeMy WebLinkAboutSeptic Pumping Slip - 71 Johnny Cake - 10/14/24 - Septic Pumping Slip - 71 JOHNNY CAKE STREET 10/14/2024 Commonwealth of Massachusetts
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p 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:
71 Johnny Cake Street
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Address
North Andover MA 01845
City/Town -$tale.............................. Zip-C.P.d.e..........
2. System Owner:
Joe Mcqoldrick
.4 a.m..e —------------................................................................................. ----—----------------
71 Johnny Cake Street
Address(if different from location)
North Andover MA 01845
City/Town State Zip Code
9787642519
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Telephone Number
B. Pumping Record
1. Date of Pumping 10/14/2024......____ 2. Quantity Pumped: 1500.0000
DateGallons
3. Component: Cesspool(s) F7 Septic Tank F-]Tight Tank R Grease Trap
F] Other(describe):
..............
4. Effluent Tee Filter present? Yes o No If yes,was it cleaned? F-1 Yes F-1 No
5. Observed condition of component pumped:
Cover was accessed and properly secured. Septic system serviced. Filter not
present. Tank cannot be outfitted with filter. 1.500 gallons removed. Light 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. Recommend adding Treatment.
Please visit www.bookmyseptic.com to purchase online. None.
6, System Pumped By:
Jonathon Colson
v a_me_ Vehicle-L i-c-e n ve-Number
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Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlborough, -MA 01752
Company
7. Location where contents were disposed:
Greater Lawrence Sanitary District 240 Charles Street , North Andover, MA
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Jonathon Colson 1 0/14/2 0 2 4
Signature of--Hauler —-------- Date
_§ ---------- .......
Signature of Facility(or attach facility receipt) Date
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