HomeMy WebLinkAboutGrease Trap - Septic Pumping Slip - 700 CHICKERING ROAD 5/24/2025 Town of North Andover
Commonwealth of Massachusetts
City/Town of North Andover JU/V 3 2025
System Pumping Record
Form -kmcwtD
DEP has provided this form for use by local Boards of Health.Other forms may be used,but the a
substantially the same as that provided here.Before using this form,check with your local Board of Health to
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:
700 Chickering Road
Address
North Andover MA 01845
City/Town State Zip Code
2. System Owner: ;
Ashland Farm at North Andover
Name
700 Chickering Rpad
Address(if different from location)
North Andover MA 01845
City/Town State Zip Code
i.
9786831300
.y Telephone Number
B. Pumping Record
1. Date of Pumping ;R 05/24/2025 1000.0000
Date 2• Quantity Pumped: canons
3. Component: Cesspool(s) Septic Tank Tight Tank Grease Trap
Other(describe):
4. Effluent Tee Filter present? Yes N No If yes,was it cleaned? Ej Yes n No
5. Observed condition of component pumped:
Cover was accessed and properly secured. Grease Tank system serviced. Filter not
present. Tank cannot be outfitted with filter. 1000 gallons removed. 2 inches of
bottom sludge. 2 inches of grease on top. 48 inches of water. System is at proper
working level. Both baffles/tees are intact. Main line is clear.
6. System Pumped By:
Robert Herrick
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
Robert Herrick 05/24/2025
Signature of Hauler Date
Signature of Receiving Facility(or attach facility receipt) Date
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