HomeMy WebLinkAboutGrease Trap - Septic Pumping Slip - 757 TURNPIKE STREET 12/4/2025 Commonwealth of Massachusetts
City/TownOf North Andover
System Pumping Record
Form 4
DEP has provided this form for use by local Boards of Health.Other forms may be used,but the information must be
substantially the same as that provided here.Before using this form,check with your local Board of Health to determine 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:
757 Turnpike Street
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Address
North Andover MA 01845
City/Town
2. System Owner:
c/o Ahold
Name
1385 Hancock Street
Address(if different from location)
.......... MA 02169
............City/Town State Zip Code
7 0 4 6.3 382 5
Telephone Number
B. Pumping Record
1. Date of Pumping -12/04/2025 2a#e . Quantity Pumped: 4000.0000
----------------- -dei]ion—s
3. Component: Cesspool(s) F] septic Tank n Tight Tank Grease Trap
Other(describe):
4. Effluent Tee Filter present? n Yes nX No If yes,was it cleaned? F]Yes n No
5. Observed condition of component pumped:
Cover was accessed and properly secured. Grease Tank system serviced. Filter not
present. Tank cannot be outfitted with filter. 4000 gallons removed. 1 inches of
bottom sludge. 2 inches of grease on top. 40 inches of water. System is at proper
working level. Both baffles/tees are intact. Main line is clear.
6. System Pumped By:
Jonathon Colson
.............. ---—-------------------
Name Vehicle License Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlborouqh, MA 01752
bom,---pan y ...........—
7. Location where contents were disposed:
MEMO Yard: 54 Knox Trail, Acton, MA 01720
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Jonathon Colson 12/04/2025
'Sina�iure-of—Hauler --Date .........
Signature of Receiving Facility(or attach facility receipt) Date
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