HomeMy WebLinkAboutGrease Trap - Septic Pumping Slip - 315 SOUTH BRADFORD STREET 10/14/2025 Commonwealth of Massachusetts ro Wn of IVO[th�nuo ver
City/Town0f North Andover
OC7 4 �025
System Pumping Record
Form 4
DEP has provided this form for use by local Boards of Health.Other forms may be used,['bu ! n must be
substantially the same as that provided here.Before using this form,check with your local Board of He GP hoe nMthe form
they use.The System Pumping Record must be submitted to the local Board of Health or other approving au hon
✓
days from the pumping date in accordance with 310 CMR 15.351.
A. Facility Information
1. System Location:
315 South Bradford Street
Address
North Andover MA 01845
City/Town
2. System Owner:
Smolak Farms
.............. ............
Name
315 South Bradford
Address(if different from location)---'
North Andover MA 01845
............................. ...............
City/Town State Zip Code
9785002019
Telephone Number
B. Pumping Record
1, Date of Pumping 0 9/2 9/2 02 5._____ 2. Quantity Pumped: 100.0000 -------
DateGallons
3. Component: Cesspool(s) Septic Tank Tight Tank nX Grease Trap
R Other(describe):
4. Effluent Tee Filter present? F-]Yes FX-] No If yes,was it cleaned? F-] Yes R No
5. Observed condition of component pumped:
There is a safety concern onsite that needs immediate follow up! . Cover was
accessed and properly secured. 3 Bay Sink. 4 inches of grease on top. 6 inches of
water. 4 inches of bottom sludge. 40 gallons removed. Both baffles/tees are
intact. Gasket is starting to tear - Recommend replacing gasket. Walls/bottom of
trap in good condition. System is at proper working level. Left 0 bottles of drain
6. System Pumped By:
Walburt Wallace
""------------------------------------------------------- -- c I--U------ ' ---------Nama Vehia license Number
Wind Environmental, 46 Lizotte Drive, Suite 1.000, Marlborough, MA 01752
.................
Company
7. Location where contents were disposed:
Holbrook WRE Yard: 24 South Street, Holbrook, MA 02343
......................... .................... .................. ...............................................................................................................--.-.........
Wal.burt Wallace 09/29/2025
----------
Signature of Hauler Date
.............-—-——---------------------------------------- —— -----------—--—--------------------
Signature of Receiving Facility(or attach facility receipt) Date
t5form4.doc-11/12 System Pumping Record-Page 1 of 1