HomeMy WebLinkAboutSeptic Pumping Slip - 48 Sunset Rock Rd - 11/20/2024 - Septic Pumping Slip - 48 SUNSET ROCK ROAD 11/20/2024 Commonwealth of Massachusetts
City/TownOf 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:
48 Sunset Rock Road,
Address
North Andover MA 01845
City/Town State ZjD Code
2. System Owner:
Ma,r_qaux Crabtree ..........
Name
48 Sunset Rock Road,
Address(if different from location)
North Andover MA 01845
City/Town State Zip Code
4134461876
Telephone Number
B. Pumping Record
11/20/2024 1500.0000
1. Date of Pumping Date 2. Quantity Pumped: Gallons
3. Component: Cesspool(s) RX Septic Tank Tight Tank R Grease Trap
n Other(describe):
4. Effluent Tee Filter present? R Yes f�' No If yes,was it cleaned? F]Yes R No
t^1
5. Observed condition of component pumped:
Cover was accessed and properly secured. Septic system serviced. Filter not
present. Tank cannot be outfitted with filter. 150 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 using boost next
pumping. Adding treatment between now and then will improve the health of your
6. System Pumped By:
Robert Herrick
-Nam`e— Vehicle
- ....................... --ic-1e Licen
se
Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlb�912ugh_,_..MA 01752
Company
7. Location where contents were disposed:
Greater Lawrence Sanitary District : 240 Charles Street North Andover, MA
Robert Herrick 11/2 0/2 0 2 4
§i6n-atu-r-e-of-H-a-u-le'r,--------—------------------------------- Date
Signature of Receiving—Facility(or--attach—facility-"r-ecei—pt) —Date
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