HomeMy WebLinkAboutDunkin Donuts-Grease Trap - Septic Pumping Slip - 535 CHICKERING ROAD 1/24/2025 Commonwealth of Massachusetts To Wn Of North 4 ndo Ver
City/Town of North Andover FE8 5 2025
I System Pumping Record "ea"' 0ePRertrn0jjt
Form 4
DEP has provided this form for use by local Boards of Health.Other forms may be used,but the information mus
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:
535 Chickering Road
Address
North Andover MA 01845
City/Town State Zip Code
2. System Owner:
Cafua Management Company, LLC
Name
280 Merrimack Street
Address(if different from location)
Methuen MA 01844
City/Town State Zip Code
9786822382 x743
Telephone Number
B. Pumping Record
1. Date of Pumping 01/24/2025 2. Quantity Pumped: 100.0000
Date Gallons
3. Component: F-] cesspool(s) Septic Tank Tight Tank F7V1 Grease Trap
VNI
F] Other(describe):
4. Effluent Tee Filter present? [—]Yes RX No If yes,was it cleaned? F-1 Yes F] No
5. Observed condition of component pumped:
3 Bay Sink. 1 inches of grease on top. 8 inches of water. 1 inches of bottom
sludge. 20 gallons removed. Inlet baffle/tee is not intact - outlet baffle/tee is
intact. Recommend inlet repair. Gasket is in good condition. Walls/bottom of trap
in good condition. System is at proper working level. Left 0 bottles of drain
master. 10inches 20 gallons. Recommend Plumbing. Inlet tee is needed gray plastic
6. System Pumped By:
Robbie Hall I
Name Vehicle License Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlborough, MA 01752
Company
7. Location where contents were disposed:
Inside Grease - NEMO Yard: 54 Knox Trail, Acton, MA 01720
Robbie Hall 1 01/24/2025
Signature of Hauler Date
Signature of Receiving Facility(or attach facility receipt) Date
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