HomeMy WebLinkAboutSeptic Tank - Septic Pumping Slip - 80 CAMPBELL ROAD 4/16/2026 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:
...................
Address
North Andover MA 01845
Gityrrown
2. System Owner:
Alan Nihill
Name
80 Campbell Road
Address(if different from
North Andover MA 01845
City/Town StateI Code
3399333355
Telephone Number
B. Pumping Record
1. Date of Pumping 04/16/2026 2. Quantity Pumped: 1000.0000
ba—te. ....... -Gallons
3. Component: F] cesspool(s) RX Septic Tank R Tight Tank Grease Trap
F] Other(describe):
4. Effluent Tee Filter present? 0Yes Z No If yes, was it cleaned? F]Yes n No
5. Observed condition of component pumped:
Cover was accessed and properly secured. Recommend using boost next pumping. Adding
treatment between now and then will improve the health of your system. Please visit
www.bookmyseptic.com to purchase online. Unable to test main line. Both baffles/tees are
intact. System is at proper working level. Light top solids in tank. Light sludge on bottom
of tank. 1,000 gallons removed. Filter not present. Tank cannot be outfitted with filter.
Septic system serviced.
6. System Pumped By:
Jonathon Colson
Name Vehicle
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlboroug , MA 01-752
6om�an—y ------------------------- ft...............................
7. Location where contents were disposed:
HaverHill Disposal Site: 40 S. Porter Street, Bradford, MA 01835
................
Jonathon Colson 04/16/2026
-.—........................... ..............
Signature of Hauler Date
-.-1-11-11.1--...................----............................. ..................
Signature of Receiving Facility(or attach facility receipt) Date
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