HomeMy WebLinkAboutSeptic Tank - Septic Pumping Slip - 1980 TURNPIKE STREET 1/29/2026 <L ro Wn f A"1011�
Commonwealth of Massachusetts o
City/"Town0f North Andover 17do Ver
System Pumping Record 0 2026
Form 4
DEP has provided this form for use by local Boards of Health.Other forms may be used,4'tha,'jnjormation must be
substantially the same as that provided here.Before using this form,check with your local Board 664eail�=etermine the form
they use.The System Pumping Record must be submitted to the local Board of Health or other approving' 14
days from the pumping date in accordance with 310 CMR 15.351.
A. Facility Information
1. System Location:
1980 Turnpike Street
Address
North Andover MA 01845
Cityrrown State Zip Code
2. System Owner:
Affinity Realty Property Mana -ment Elm_q_qRa�re Industrial Condominiums.
Name
63 Atlantic Avenue
Address(if different from location)
BostonMA 02110
City/Town State Zip Code
9786949399
Telephone Number
B. Pumping Record
1. Date of Pumping 01/29/2026 2. Quantity Pumped: 3500.0000
Date Gallons
3. Component: FI cesspool(s) Septic Tank F—] Tight Tank F] Grease Trap
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. 1 inches of top solids. 1 inches of bottom sludge. 3500
gallons removed. Filter not present. Tank cannot be outfitted with filter. Septic system
serviced.
6. System Pumped By:
Jonathon—Colson
Name Vehicle License Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlborough, MA 01752
Company
7. Location where contents were disposed:
Greater Lawrence Sanitary District 240 Charles Street , North Andover, MA
Jonathon Colson 01/29/2026
Signature of Hauler Date
Signature of Receiving Facility(or attach facility receipt) Date
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