HomeMy WebLinkAboutSeptic - Septic Pumping Slip - 980 OSGOOD STREET 2/14/2025 of
Commonwealth of Massachusetts TownNorth Andover
City/Town Of North Andover
System Pumping Record MAR - 4 2025
Form 4
DEP has provided this form for use by local Boards of Health.Other forms may be us d but t4 m tion must be a
substantially the same as that provided here.Before using this form,check with your W g form
approving
they use.The System Pumping Record must be submitted to the local Board of Health or other -oving m1fiv
days from the pumping date in accordance with 310 CMR 15.351.
A. Facility Information
1. System Location:
_2 82 Osgood Avenue _...
Address
North Andover MA 01845
_tgte
2. System Owner:
Vixxo - Various
Name
10 Columbus Boulevard 4th Floor
.......... ..................................
Address(if different from location)
Hartford CT 06106
City/Town-—"-' State ......... Zip-Code
5089875322
Telephone Number
B. Pumping Record
1. Date of Pumping 02/14/2025 2000.0000-- 2. Quantity Pumped:
Dat® Gallons
3. Component: F] cesspool(s) septic Tank Tight Tank Grease Trap
K-71
1AI Other(describe): Lift Station
4. Effluent Tee Filter present? F]Yes No If yes,was it cleaned? R Yes R No
1^1
5. Observed condition of component pumped:
There is a safety concern onsite that needs immediate follow up! . Cover was
accessed and properly secured. Lift Station system serviced. Filter not present.
Tank cannot be outfitted with filter. 2000 gallons removed. 1 inches of bottom
sludge. 1 inches of top solids. Recommend further evaluation due to tank levels.
Main line is not clear. Recommend drain cleaning. Recommend Drain Cleaning.
6. System Pumped By:
Jonathon Colson
Name Vehicle License Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlborouqh, -MA 01752
Company
7. Location where contents were disposed:
HaverHill Disposal Site: 40 S. Porter Street, Bradford, MA 01835
Jonathon Colson 0 2/14/2 0 2 5
Si --- -----------
nai6re-ofHauler Date
Signature of Receiving Facility(or attach facility receipt) Date
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