HomeMy WebLinkAboutSeptic Tank - Septic Pumping Slip - 74 SHERWOOD DRIVE 3/16/2026 Commonwealth of Massachusetts Town of Nofth Andover
City/TownOf North Andover APR 14 2026
System Pumping Record
Form 4
VI) DEP has provided this form for use by local Boards of Health.Other forms may be used,b Htaa"a Q I substantially the same as that provided here.Before using this form,check with your local Board of Health No4etetinreqhRe q&
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:
74 Sherwood Drive
Address
North Andover MA 01845
......................
City/Town ZPAQW9
2. System Owner:
Dena Davis - Dena Duprey
.................. ........
Name
74 Sherwood Drive
Address location)
North Andover MA 01845
Chy,fi State Zip Code
3392252426
Telephone Number
B. Pumping Record
03/16/2026 1500.0000
1. Date of Pumping Date 2. Quantity Pumped: Gallons
3. Component: Cesspool(s) RA Septic Tank Tight Tank Grease Trap
Other(describe):
4. Effluent Tee Filter present? 1-1 Yes RX No If yes, was it cleaned? R Yes R 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. Main line is clear. Both baffles/tees are intact.
System is at proper working level. Light top solids in tank. Light sludge on bottom of tank.
1500 gallons removed. Filter not present. Tank cannot be outfitted with filter. Septic system
serviced.
6. System Pumped By:
Jonathon Colson
Vehicle License Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlborough, MA 01752
Company
7. Location where contents were disposed:
KENO Yard: 163 Western Ave, Gloucester, MA 01930
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Jonathon Colson 03/16/2026
Signature of Hauler Date
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Signature of Receiving Facility(or attach facility receipt) Date
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