HomeMy WebLinkAboutSeptic Tank - Septic Pumping Slip - 34 WILLOW RIDGE ROAD 10/14/2025 Commonwealth of Massachusetts Town C,
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City/TownOf North Andover
System Pumping Record 0' .
Form 4
DEP has provided this form for use by local Boards of Health.Other forms may be used,but the inWfo must be
substantially the same as that provided here.Before using this form,check with your local aim to&et,§rrni6e 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:
34 Willow Ridge Road
Address
North Andover MA 01845
City/Town State Zip Code
2. System Owner:
Susan Garavanian
Name
34 Willow Ridge Road
-Address--(if different from location)
North Andover MA 01845
City/Town State Zip Code
9786857661
Telephone Number
B. Pumping Record
1. Date of Pumping 09/24/2025 2. Quantity Pumped: -1000.0000
Date 6—aii6ni—'-'---
3. Component: F]cesspool(s) Q 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:
Cover was accessed and properly secured. Septic system serviced. Recommend riser
due to depth of cover. Filter not present. Tank cannot be outfitted with filter.
1000 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. Cover broken talked to
6. System Pumped By:
Michael Graham
Name Vehicle License Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlborough, MA 01752
Company
7. Location where contents were disposed:
NENO Yard: 163 Western Ave, Gloucester, MA 01930
Michael Graham 09/24/2025
Signature-of--Hauler Date
Signature of Receiving Facility(or attach facility receipt) Date
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