HomeMy WebLinkAboutSeptic Tank - Septic Pumping Slip - 740 SHARPNERS POND ROAD 7/10/2025 Commonwealth of Massachusetts To Wn Of Nolth And
Over
City/TownOf North Andover
System Pumping Record AU& 112025
Form 4
DEP has provided this form for use by local Boards of Health.Other forms may be used,b i ion must be
1,' q substantially the same as that provided here.Before using this form,check with your local Boar 001ttl a Oermine the form
they use.The System Pumping Record must be submitted to the local Board of Health or other approving a 14
days from the pumping date in accordance with 310 CMR 15.351.
A. Facility Information
1. System Location:
740 Sharpners Pond Road
Address
North Andover MA 01845
City/Town State
2. System Owner:
David Barbato
Name
740 Sharpners Pond Road
Address(if different from location)
North Andover MA 01845
Cityrrown State Zip Code
6174701720
Telephone Number
B. Pumping Record
1. Date of Pumping Date—07/10/2025 2. Quantity Pumped: 0.0000
3. Component: Cesspool(s) [X—] Septic Tank F-]Tight Tank Grease Trap
F� Other(describe):
4. Effluent Tee Filter present? Yes RX No If yes, was it cleaned? F-]Yes F-] No
5. Observed condition of component pumped:
Unable to service. Recommend a riser as it's a 2 to 3 feet dig will remove
service call if customer buys riser. I did dig down 4 times to locate but was
unsuccessful.
6. System Pumped By:
Marcus Lark
Name Vehicle License Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlborouqh, MA 01752
Company
7. Location where contents were disposed:
07/10/2025
Signature of Hauler Date
-§iigmit�ue R-ke'ceiviing- Fa--d1-it-y-(o-r a-ft--a--c-h-faci—lity-r-ec—eipt-) Date
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