HomeMy WebLinkAboutSeptic Tank - Septic Pumping Slip - 1024 TURNPIKE STREET 11/10/2025 �L Town Of North Andover
Commonwealth of Massachusetts
City/Town0f North Andover NOV 10 2025
System Pumping Record
Form 4
DEP has provided this form for use by local Boards of Health.Other forms may be used,but tt iawwtno
substantially the same as that provided here.Before using this form,check with your local Board of Healt tod=614*nt
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:
,1024Turnpike Street----' ........... ...........
Address ... .........
North Andover MA 01845
Ziii .................................................................................... ..............................
2. System Owner:
Mark —------ ..........
Name
1024 Turnpike Street
Address(if different from location)
North Andover MA 01845
City/Town State Zip Code
9173713201
.......... .......... .................
Telephone Number
B. Pumping Record
10/27/2025 1500.0000
1. Date of Pumping Date 2. Quantity Pumped: Gallons-.................................
3. Component: Cesspool(s) Septic Tank n Tight Tank F] Grease Trap
Other(describe):
........... .................
4. Effluent Tee Filter present? n Yes nX No If yes, was it cleaned? n Yes F] 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:
NENO Yard: 163 Western Ave, Gloucester, MA 01930
-...................------------- ................................................... ..................... ------...................................................................................
Michael Graham 10/27/2025
------------............................................... ------
Signature of Hauler Date
- - iur- --R",''- "-- -h ---- --- -,,---' ,- ------ -" --------------------------------------------------------------------------- ---------
Signae of Receiving Facility oraft ch facility raceipi) Date
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