HomeMy WebLinkAboutGrease Trap - Septic Pumping Slip - 1081 OSGOOD STREET 4/7/2026 Commonwealth of Massachusetts
City/Town of 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:
j 0 8 I_gp_qoqqStreet —---------------
Address
North Andover MA 01845
............
City/Town ....................
2. System Owner:
Lobster Tail - IG - Lobster Tail
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-1081 Osgood .§treet
Address(if different from location)
North Andover MA 01845
City/Town State Zip Code
6038905555
Telephone Number
B. Pumping Record
04/07/2026 100.0000
1, Date of Pumping ............. 2. Quantity Pumped:
Date Gallons
3. Component: F] Cesspooi(s) R Septic Tank E]Tight Tank FACrease Trap
R 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:
3 Bay Sink. 4 inches of grease on top. 6 inches of water. 4 inches of bottom sludge. FOG 57%.
40 gallons removed. Both baffles/tees are intact. Gasket is in good condition. Walls/bottorn
of trap in good condition. System is at proper working level. Left 0 bottles of drain master.
BOH Logs Signed. Recommend Drain Cleaning. Do for preventive maintenance on pipes and floor
drains recommended to have do pm lines 2-3times a year to assure proper flow.
6. System Pumped By:
Robbie Hall
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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:
Inside Grease - NEMO Yard: 54 Knox Trail, Acton, MA 01720
Robbie Hall 04/07/2026
-Signature- --'`---o f--Aa"u-i e-r............. --Date ............
-of Receiving e'"iv I n"'g-Facility- ---- -'(-o-r-aiia-c-h-facility-- -1" receipt)' "'------------ —Da-t'e----"'--- --------------------------
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