HomeMy WebLinkAboutGrease Trap - Septic Pumping Slip - 700 CHICKERING ROAD 10/14/2025 Commonwealth of Massachusetts TOWn Of North over
City/Town0f North Andover
ri System Pumping Record
Form 4 OCT 14 2025
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 I I Bo d of Health to determine the form
they use,The System Pumping Record must be submitted to the local Board of HealtwQr within 14
days from the pumping date in accordance with 310 CIVIR 15.351.
A. Facility Information
1. System Location:
700 Chick!eri�pg__Road ------...................
Address
North Andover MA 01845
_sate....-------................ .......--------
2. System Owner:
Ashland Farm at North Andover
----....................... .............................. .............................................
Name
700 Chickering Road
.Address(if different from location) ------
North Andover MA 01845
City/Town State Zip Code
9786831300
Telephone Number
B. Pumping Record
09/29/2025 1000.0000
1. Date of Pumping Date ......... 2. Quantity Pumped: -G.a.I.I s on --.............---------------
3. Component: Cesspool(s) Septic Tank Tight Tank Grease Trap
F] Other(describe):
4. Effluent Tee Filter present? F1 Yes No If yes, was it cleaned? F]Yes F-1 No
5. Observed condition of component pumped:
Cover was accessed and properly secured. Grease 'rank system serviced. Filter not
present. Tank cannot be outfitted with filter. 1.000 gallons removed. 1 inches of
bottom sludge. 1 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
------- ,-e-h,i-"c"l--e en""-"L-i-"c'—NameV se Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlboroucth, MA 01752
........................
Company
7. Location where contents were disposed:
KENO Yard: 163 Western Ave, Gloucester, MA 01930
............
Robert Herrick 09/29/2025
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