HomeMy WebLinkAboutSeptic - Septic Pumping Slip - 370 CANDLESTICK ROAD 6/5/2025 Commonwealth of Massachusetts
City/Town of North Andover
Iwo 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 15.351.
A. Faci l ity Information
1 System Location:
370 Candlestick Road
Address
North Andover MA 01845
City/Town State Zip Code
2. System Owner:
Kenneth Delatorre
Name
370 Candlestick Road
Address(if different from location)
North Andover MA 01845
City/Town State Zip Code
6177178634
Telephone Number
B. Pumping Record
1. Date of Pumping 06/05/2025 2. Quantity Pumped: 1500.0000
Date Gallons
3. Component: Cesspool(s) Z septic Tank Tight Tank Grease Trap
r-] Other(describe):
4. Effluent Tee Filter present? �Yes Z No If yes, was it cleaned? Yes F1 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. Moderate
sludge on bottom of tank. Heavy 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, Marlborough, MA 01752
Company
7. Location where contents were disposed:
HaverHill Disposal Site: 40 S. Porter Street, Bradford, MA 01835
Marcus Lark 06/05/2025
Signature of Hauler Date
Signature of Receiving Facility(or attach facility receipt) Date
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