HomeMy WebLinkAboutSeptic Tank - Septic Pumping Slip - 315 BERRY STREET 3/19/2025 Commonwealth of Massachusetts
Of North Andover
City/Town of North Andover APR - 3 2025
.......... n System Pumping Record
Form 4
may be used,but iWrr"
DEP has provided this form for use by local Boards of Health..Other forms thd S
substantially the same as that provided here.Before using this form,check with your local Board of Health to determine hQ> rm
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:
_3_l5 BeEEy Street_
Address
North Andover MA 01845
City/Town
2. System Owner:
Michael Santangelo
Name
315 Berry Street
Address(if different from location)
North Andover MA 01845
City/Town State Zip Code
7819537304
Telephone Number
B. Pumping Record
1. Date of Pumping 03/19/2025 2. Quantity Pumped: 1500.0000
Date Gallons
3. Component: F]Cesspool(s) Septic Tank F-]Tight Tank F] Grease Trap
141nd
Other(describe):
4. Effluent Tee Filter present? []Yes No If yes,was it cleaned? R Yes R No
5. Observed condition of component pumped:
Cover was accessed and properly secured. Septic system serviced. Filter not
present. Tank cannot be outfitted with filter. 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.
6. System Pumped By:
Marcus Lark
Name Vehicle License Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlborough, MA 01752
Company
7. Location where contents were disposed:
Greater Lawrence Sanitary District : 240 Charles Street , North Andover, MA
Marcus Lark 03/19/2025
Signature of Hauler Date
Signature of Receiving Facility(or attach facility receipt) Date
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