HomeMy WebLinkAboutLots of Eats - Grease Trap - Septic Pumping Slip - 1211 OSGOOD STREET 4/7/2026 <C"N Commonwealth of Massachusetts
19) City/TownOf North Andover
System Pumping Record
Form 4
DEEP 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.
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A. Facility Information
1. System Location:
1211 s ootreet
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Address
North Andover MA 01845
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City/Town
2. System Owner:
Ap i et�aj.,_Lots Of Eats IG Lots Of Eat s A ha�k
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Name
1211 Osgood Street
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Address(if different from location)
North Andover MA 01845
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CityiTown State Zip Code
2072454878
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Telephone Number
B. Pumping Record
04/07/2026 200.0000
1. Date of Pumping ....................................... 2. Quantity Pumped:
Date Gallons
3. Component: F] Cesspool(s) F] septic Tank F]Tight Tank FXJ Grease Trap
Other(describe):
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4. Effluent Tee Filter present? n Yes Z No If yes,was it cleaned? F]Yes n No
5. Observed condition of component pumped:
3 Bay Sink. 4 inches of grease on top. 12 inches of water. 4 inches of bottom sludge. FOG
40%. 100 gallons removed. Both baffles/tees are intact, Gasket is in good condition.
Walls/bottom of trap in good condition. System is at proper working level. Left 0 bottles of
drain master. BOH Logs Signed. Recommend Drain Cleaning. Dc 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, Marlbor.oug MA 01752
Company
7. Location where contents were disposed:
Inside Grease - NEMO Yard: 54 Knox Trail, Acton, MA 01720
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Robbie Hall 04/07/2026
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Signature of Hauler Date
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-Signature of Receiving Facility(or attach facility receipt) Date
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