HomeMy WebLinkAboutSeptic Tank - Septic Pumping Slip - 129 FOREST STREET 1/8/2026 TO Wn Of Alorth 417doVer
L\ Commonwealth of Massachusetts
EW City/TownOf North Andover
System Pumping Record FEB 10 2026
Form 4
DEP has provided this form for use by local Boards of Health.Other forms may be used,bi jbq na�jqn must be
substantially the same as that provided here.Before using this form,check with your local B*oarCofHi)aW'P r ine the form
they use.The System Pumping Record must be submitted to the local Board of Health or other approving
days from the pumping date in accordance with 310 CMR 15.351.
A. Facility Information
1. System Location:
129 Forest Street
Address
North Andover MA 01845
City/Town State Zip Code
2. System Owner:
Paul Tricket - Primary Home
Name
129 Forest Street
Address(if different from location)
North Andover MA 01845
City/Town State Zip Code
9786973900
Telephone Number
B. Pumping Record
0 1 0 8/202 6 1500.0000
1. Date of Pumping Date 2. Quantity Pumped: Gall.ons
3. Component: FI Cesspool(s) Septic Tank Tight Tank Grease Trap
F] Other(describe):
4. Effluent Tee Filter present? R Yes RX No If yes, was it cleaned? R Yes R No
5. Observed condition of component pumped:
Cover was accessed and properly secured. Recommend adding Treatment. Please visit
www.bookmyseptic.com to purchase online. Main line is clear. Both baffles/tees are intact.
System is at proper working level. Moderate amount of top solids in tank. Heavy sludge on
bottom of tank. 1500 gallons removed. Filter not present. Tank cannot be outfitted with
filter. Septic system serviced.
6. System Pumped By:
Marcus Lark
Name Vehicle License Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlborough, MA 017�52
Company
7. Location where contents were disposed:
Greater Lawrence Sanitary District 240 Charles Street , North Andover, MA
Marcus Lark 01/08/2026
Signature of Hauler Date
Signature of Receiving Facility(or attach facility receipt) Date
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