HomeMy WebLinkAboutSeptic Pumping Slip - 1211 Osgood St - Lots of Eats - 10/02/2024 - Septic Pumping Slip - 1211 OSGOOD STREET 10/2/2024 Commonwealth nfMassachusetts
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S���e00 �*uK��K�� RecordF System 4 Pumping
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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 31UCMR15351.
A. Facility Information
1. System Location:
1211
Address
North Andover MA 01845
2. System Owner:
ibk Lots Of Eats
Name
1211 Osgood Street
NorthAddress(if different from
Andover �A OIB45
City/Town State Zip Code
1078078343
Telephone Number
B~ Pump~ng Record
l0/U2/2O24 200.0000
1. Date ofPumping Da� 2. Quantity Pumped: Ga|lo-�
3. Component [—lCeeepoo|(e) F-7 septic Tank Fl Tight Tank Grease Trap
| Other(describe):
4. Effluent Tee Filter present? F—1 Yes F�� No |f yes, was itcleaned? F—lYeoE] No
5. Observed condition of component pumped-
Cover was accessed and properly secured. 3 Bay Sink. « inches of grease on top. 8
inches of water. A ioubeo of bottom sludge. 50 gallons removed. Both baffles/tees
are intact. Gasket is in good condition. Walls/bottom of trap in good condition.
System is at proper working level. Left 0 bottles of drain master. uoe Logo
Signed.
6. System Pumped By:
Raymond Saez
Name Vehicle License Number
Wind River Environmental., 46 Lizotte Drive, Suite 1000, Marlbo.L-2!Lah,---!!A- 01752
Company
7. Location where contents were disposed:
Water Solutions Group: 35 Mozzone Blvd Taunton, MA 02780
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Raymond Saez 10/02/2024
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Gignmmnmor Receiving Facility(or attach facility receipt) mm°
,5fbnn4.doo^11/12 System Pumping Record~Page 1 of