HomeMy WebLinkAboutSeptic Tank - Septic Pumping Slip - 44 BRUIN HILL ROAD 10/14/2025 Town of Noll"I.M 1UV I-
Lo'\- Commonwealth of Massachusetts C 4
City/Town0f North Andover
System Pumping Record [)epa
Form 4
DP 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. Facility Information
1. System Location:
44 Bruin Hill Road
Address"I I
North Andover MA 01845
City/Town ZIP-Co.de...............
2. System Owner:
John Kell
j4irneR-.--.-.-----.-y ............................................. ...........
44 Bruin Hill Road
Address(if different from location)
North Andover MA 01845
..... ..... ............................................
City/Town State Zip Code
9-188355516
.......................................
Telephone Number
B. Pumping Record
09/05/2025 1500.0000
1. Date of Pumping -Date 2. Quantity Pumped- Gallons ..............
3. Component: Cesspool(s) RX Septic Tank F]Tight Tank R Grease Trap
R Other(describe):
........... ---------
4. Effluent Tee Filter present? E]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. Moderate
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. Recommend
using boost next pumping.
6. System Pumped By:
Michael Graham
...........
Name Vehicle License Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlborouqh, MA 01752
Company ..............................
7. Location where contents were disposed:
Greater Lawrence Sanitary District : 240 Charles Street , North Andover, MA
Michael Graham 09/05/2025
Signature of Hauler Date
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