HomeMy WebLinkAboutSeptic Tank - Septic Pumping Slip - 475 FOSTER STREET 11/7/2025 CCommonwealt of Massachusetts Town of NmhAndover
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SystemPumping Record 2Q
w Form 4
DE P has Provided this foal fof use, by local Bowds of
lforrrlr lion rnusl e suhsf�lflli�,111y 111e sr�r7le �1s Ihs1 provided f7erE, Refore using this ortlr, check with your
local Board of Health Io de(erfnirle the form they use The Systern Por-nping Record nitjs1 be submilIe,d to
the local Board of McEflth or olh(f' approww'.) authority within 14 days from 'he purnping date in
accordance with 310 CMR 15 :351. ,r._W.
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(flung out loans 1 System I_oc ' ()) n.
on the computer,
use only fho lab
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B, Purnping Record
1, Date of f-)urnping C7<!e l 4 --- -- 2 C)uantity Pumped'
:3 Corn.>r,7rrc n( Cesspool(s) Septic Tank Tight Tank Carey+sE Trap
L-� Other (describe) �
A. F ftdu(,rlt ( r; � F filter e�sF�,n1"' [ ) Yes Vo If ,,:,, was it cla> nec1"1
5. Qbservpd condition of component purrrped:
---- __ --- - _ :_ _ ---- .
6 `.>y Iefr7 irnped C3y
Da Mass1AA9S� Mass 1AD31!
N a m G - .......... -_--___..._
.,„r VE Vehicle t.Ict,r7se Number
Baieson E nlefp(ises Inc,
company ....
7 I.. c,alioti wit ae 1ter 'vvefr disposed
S-ig naIu-( 06 fia I t e 0 1 a
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