HomeMy WebLinkAboutLobster Tail Grease Trap - Septic Pumping Slip - 1081 OSGOOD STREET 12/22/2025 Commonwealth ofMassachusetts
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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 within14
days from the pumping date in accordance with 31OCMR15.351.
A. Facility Information
1. System Location:
1081 Osgood Street
Address
North Andover MA 0I845
City/Town State Zip Code
2. System Owner:
Lobster Tail
Name
1081 Osgood Street
Address(if different from
North Andover MA 01845
ug^/mvn Zip Code
6038905555
Telephone Number
B. Pumping
Record
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12/22/2025 I8O O00O
1. DmteofPurnpinQ 2 Quantity ^
oaoa ' ' Gallons
3. Component [—� Cemepoo|(o) [—1 Septic Tank F—|Tight Tank 'Grease Trap
Other(describe):
L_] ` '�
4. Effluent Tee Filter present? [—1 Yes ��| No |f yes, was itcleaned? R Yes F—lNV
5. Observed condition of component purnped-
3 Bay Sink. 6 inches of grease on top. 2 inches of water. 6 inches of bottom
sludge. 40 gallons removed. Both baffles/tees are intact. Gasket is in good
condition. Walls/bottom of trap in good condition. System is at proper working
level. Left 8 bottles of drain master. 1eiooueo 40gall000. eoe Logs Signed.
Recommend Drain Cleaning. oc for preventive maintenance on pipes and floor drains.
6. System Pumped By:
Robbie BaIl
Nome Vehicle License Number
Wind River Environmental, 46 Lizotte Drive Suite I000 Marlborough, MA 01752
Company
7. Location where contents were disposed:
Inside Grease - NEMO Yazd: 54 Knox Trail, Acton, M& 01720
Robbie Hall
l2/22/2025
Signature ufHauler Date
Signature o[Receiving Facility(or attach facility receipt) Data
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