HomeMy WebLinkAboutGrease Trap - Septic Pumping Slip - 700 CHICKERING ROAD 4/7/2026 Commonwealth of Massachusetts
City/Town0f 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:
.70.0___C_hicker i nq Road ............................................ -------...........
Address
North Andover MA 01845
Cityfrcvwn -zip
2. System Owner:
Ashland Farm at North Andover IG Ashland Farm at North Andover
Name
700 Chickerinc Road
Address(if different from location)
North Andover MA 01845
............
City/Town State Zip Code
9786831300
.........___------
Telephone Number
B. Pumping Record
0 4 0 7 2 0 2 6 100.0000
1. Date of Pumping _.__._.____ 2. Quantity Pumped:
Date Gallons
3. Component: F] cesspool(s) F] septic Tank Tight Tank NJ Grease Trap
F-1 Other(describe):
4. Effluent Tee Filter present? n Yes Z No If yes, was it cleaned? n Yes F] No
5. Observed condition of component pumped:
Kitchen. 4 inches of grease on top. 8 inches of water. 4 inches of bottom sludge. FOG 50%. 50
gallons removed. Both baffle/tees are not intact. Recommend inlet/outlet repair. Gasket is ill
bad condition - Recommend replacing gasket. Grease trap needs 1 bolt replaced. Walls/bottom
of trap are in need of repair. Recommend Trap Repair/Replace. System is at proper working
level. Left 0 bottles of drain master. BOH Logs Signed. Recommend Drain Cleaning. Recommend
Inside Grease Trap Replacement. Trap outlet baffle is rotted out as seen in pictures
6. System Pumped By:
Robbie Hall
_ -----------W
Vehicle License Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlborough, MA 01752
dompe n'y..................... .............. ..Marlborough,....
7. Location where contents were disposed:
Inside Grease NEMO Yard: 54 Knox Trail, Acton, MA 01720
------------------ .................... ..........___.____._.._............
Robbie Hall 04/07/2026
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Signature of Hauler Date
.................... .........................
Signature of Receiving Facility(or attach facility receipt) Date
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