HomeMy WebLinkAboutSeptic Pumping Slip - 562 Turnpike St - Starbucks - 10/01/2024 - Septic Pumping Slip - 562 TURNPIKE STREET 10/1/2024 Commonwealth nfMassachusetts
C' Unf North Andover
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—� - Pumping�o Record
4
DEP has provided this form for use by local Boards nfHealth.Other forms may bm used,but the information must be
substantially the same am that provided here.Before using this form,check with your local Board o/Health m 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 inaccordance with 31DCmR1U51.
A. Facility Information
1. System Location:
562 Turnpike Street
mmress
North Andover MA 01845
CwTv~n State
2. System Owner:
3tazbocku
Name
85 Wells Avenue, Suite I18
rent from location)
Newton Center M� 02459
City/Town State Zip Code
5084775806
Telephone Number
B. Pumping Record
l0/0l/2024 lOO.0OUO
1 Date 2 Quantity Pumped:' Date ' � 8e||onm
3. Component: Cesspool(s) Septic Tank Tight Tank [X--j Grease Trap
F-] Other(descrbe):
4. Effluent Tee Filter present? F] Yes No If yes, was it cleaned? n Yes F� No
5. Observed condition of component pumped:
Cover was accessed and properly secured. Kitchen. 2 inches of grease on tog. 12
ioobee of water. 2 inches of bottom sludge. 25 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 O bottles of drain master. ona Logs
Signed.
6. System Pumped By:
zG AnthonyTrabucco
Nam� Vehicle License Number
Wind River Environmental, 46 Lizotte Drive, Suite lOOO Marlborough, M& 01752
Company
7. Location where contents were disposed:
Holbrook WRE Yard: 24 South Street, Holbrook, Ma 02343
IG Anthony Trabooco I0/01/2024
Giynam^aofHauler Dam
nammd Receiving Facility(or attach facility receipt) Date
t5fonn4.doc'11/12 System Pumping Record^Page 1m/