HomeMy WebLinkAboutSeptic Tank - Septic Pumping Slip - 247A FARNUM STREET 4/17/2026 <L Commonwealth of Massachusetts
City/TownOf 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 twat 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:
247a Farnum Street
Address
North Andover MA 01845
City/Town 3jatg_--- Zip Cade
2. System Owner:
Donald Skifter - Primary Home
Name
247a Farnum Street
Address(if different from location)
North Andover MA 01845
Cityrrown State Zip Code
6176862994
Telephone Number
B. Pumping Record
1. Date of Pumping 04/17/2026 2. Quantity Pumped: 1500.0000
Date 'dellons
3. Component: F] Cesspool(s) N Septic Tank ❑Tight Tank F-1 Grease Trap
r-1 Other(describe):
4. Effluent Tee Filter present? n Yes No If yes,was it cleaned? F]Yes R No
5. Observed condition of component pumped:
Cover was accessed and properly secured. Septic system serviced. Filter not present. Tank can
be outfitted with filter - Sold Onsite. 1500 gallons removed. Light sludge on bottom of tank.
Light top solids in tank. System is at proper working level. Both baffles/tees are intact.
Main line is clear. 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.
6. System Pumped By:
Jonathon Colson
Name Vehicle License Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlbo.roucfh,,, MA 01752
Company
7. Location where contents were disposed:
NENO Yard: 163 Western Ave, Gloucester, MA 01930
Jonathon Colson 04/17/2026
Signature of Hauler Date
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