HomeMy WebLinkAboutSeptic Tank - Septic Pumping Slip - 314 REA STREET 10/14/2025 rOW/7 of 4 70fo V
Commonwealth of Massachusetts /
lr
City/TownOf North Andover
System Pumping Record CTO
Form 4
DEP,hps,provided this form for use by local Boards of Health.Other forms may be used,but the inform,pUbU94
substantially the same as that provided here.Before using this form,check with your local Board of Health to date 'OS
they use.The System Pumping Record must be submitted to the local Board of Health or other approving authority within"14917t
days from the pumping date in accordance with 310 CMR 15.351
A. Facility Information
1. System Location:
314 Rea Street,
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Address
North Andover MA 01845
dFWfow`n- ---- ------ - ..41
2. System Owner:
Sara Ouellette
Name
314 Rea Street,
Address(if different from location
North Andover MA 01845
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City/town State Zip Code
9082680697
Telephone Number
B. Pumping Record
09/22/2025 1500.0000
1. Date of Pumping 2Date . Quantity Pumped:
Gallons
3. Component: F] Cesspool(s) Septic Tank F]Tight Tank F-1 Grease Trap
Other(describe):
4. Effluent Tee Filter present? FAYes R No If yes, was it cleaned? Yes n No
5. Observed condition of component pumped:
Cover was accessed and properly secured. Septic system serviced. Filter is present.
and was cleaned. 1.500 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 adding Treatment. Please visit
www.bookmyseptic.com to purchase online.
6. System Pumped By:
Marcus Lark
---- - --------------------------------------------------- ""-- --"es--- b---Name Vehiclel1cneNumer -
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 09/22/2025
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Signature of Hauler Date
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§ignatureof Recai vingFacility(oraftachfacilityreceipt) Date
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