HomeMy WebLinkAboutSeptic Tank - Septic Pumping Slip - 216 REA STREET 2/27/2026 Commonwealth of Massachusetts Town Of Kk)�h Andover
City/TownOf North Andover
MAR 16 2026
System Pumping Record
Form 4 He.11fil
99"ent
DEP has provided this form for use by local Boards of Health.Other forms may be used,but the in orm d
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:
216 Rea Street
Address
North Andover MA 01845
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City/Town State Zip Code
2. System Owner:
Daniel Hooley - Primary Home
Name
216 Rea Street
Address(if different from location)
North Andover MA 01845
City/Town State Zip Code
9786817623
Telephone Number
B. Pumping Record
1. Date of Pumping 02/27/2026 1500.0000
2. Quantity Pumped:
Date Gallons
3. Component: FI Cesspool(s) Septic Tank F-1 Tight Tank F-] Grease Trap
F-] Other(describe):
4. Effluent Tee Filter present? R Yes No If yes,was it cleaned? R Yes R 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 adding Treatment. Please visit
www.bookmyseptic.com to purchase online.
6. System Pumped By:
Marcus Lark
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Name Vehicle License Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlborough, MA 01752
Company
7. Location where contents were disposed:
HaverHill Disposal Site: 40 S. Porter Street, Bradford, MA 01835
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Marcus Lark 02/27/2026
Signature of Hauler Date
Signature of Receiving Facility(or attach facility receipt) Date
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