HomeMy WebLinkAboutSeptic - Septic Pumping Slip - 336 SHARPNERS POND ROAD 2/18/2025 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 15351.
A. Facility Information
1. System Location:
336 Sharpers Pond Road klArth over
Address 1UW11 kil
North Andover MA 01845
-City/To WW---- State 4
2. System Owner:
Kael n Sackett
Name Heali De arulillt;1116
336 Sharpners Pond Road
��dres�C�—different from location)
North Andover MA 01845
Cityrrown State Zip Code
5124361576
Telephone Number
B. Pumping Record
1. Date of Pumping 02/18/2025 2. Quantity Pumped: 1500.0000
Date Gallons
3. Component: F1 Cesspool(s) Septic Tank F-]Tight Tank R Grease Trap
Other(describe):
4. Effluent Tee Filter present? RX Yes n No If yes,was it cleaned? Yes [—] No
5. Observed condition of component pumped:
Cover was accessed and properly secured. Septic system serviced. Filter is present
and was cleaned. 1500 gallons removed. Light sludge on bottom of tank. Moderate
amount of 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.
6. System Pumped By:
Marcus Lark ......----
Name Vehicle License Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Mar1boroRqh,--MA 01752
Company
7. Location where contents were disposed:
Greater Lawrence Sanitary District 240 Charles Street North Andover, MA
Marcus Lark 02/18/2025
Signature of Hauler Date
.......................
Signature of Receiving Facility(or attach facility receipt) Date
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