HomeMy WebLinkAboutAshland Farm-Grease Trap - Septic Pumping Slip - 700 CHICKERING ROAD 2/19/2025 'own Of N
Commonwealth of Massachusetts orth Andover
City/TownOf North Andover
System Pumping Record MAR 4, 02
Form 4
DEP has provided this form for use by local Boards of Health.Other forms may be used b t the information must be
substantially the same as that provided here.Before using this form,check with your l=;0K yeo to ine the form
they use.The System Pumping Record must be submitted to the local Board of Health or other approV1'n=ifff"etjt
days from the pumping date in accordance with 310 CMR 15.351.
A. Facility Information
1. System Location:
700 Chickerinq Road
Address
North Andover MA 01845
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2. System Owner:
Ashland Farm at North Andover_............. ------ ...........
Name
700 Chickerinq Road
Address(if different"o location)
North Andover MA 01845
City/Town State Zip Code
9786831300
Telephone Number
B. Pumping Record
1. Date of Pumping 02/19/2025 2. Quantity Pumped: 100.0000
Date 6-WI—ons
3. Component: F-1 Cesspool(s) R Septic Tank F]Tight Tank Grease Trap
Other(describe):
4. Effluent Tee Filter present? F-]Yes a No If yes,was it cleaned? F-]Yes [_1 No
5. Observed condition of component pumped:
3 Bay Sink. 8 inches of grease on top. 4 inches of water. 4 inches of bottom
sludge. 50 gallons removed. Gasket is in good condition. Walls/bottom of trap in
good condition. System is at proper working level. Silicone applied to trap cover.
Left 0 bottles of drain master.
6. System Pumped By:
Amauary Leon I
Name Vehicle License Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlborough, A 01752
7. Location where contents were disposed:
Inside Grease - NEMO Yard: 54 Knox Trail, Acton, MA 01720
..................
Liam Brown 0 2/19/2 0 2
--------........
Signature of Hauler Date
Signature off Receiving Facility—(or attach faicilfty-r—ece-i p Date
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