HomeMy WebLinkAboutSeptic Tank - Septic Pumping Slip - 141 REA STREET 3/23/2026 Town "'t
I\- Commonwealth of Massachusetts
City/Town0f North Andover APR 142026
System Pumping Record
Form 4 Ile-
DEP has provided this form for use by local Boards of Health.Other forms may be used,but theigi; X substantially the same as that provided here.Before using this form,check with your local Board of Health
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:
141 Rea Street
Address
North Andover MA 01845
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2. System Owner:
William Perry-.."_Primary--Primary Home
Name
141 Rea Street
Address(if d"r$ferent from location)
North Andover MA 01845
City/Town State Zip Code
9786188352
Telephone Number
B. Pumping Record
. Date of Pumping .03/23/2026 1000.0000
1
Date 2. Quantity Pumped: Gallons
3. Component: cesspool(s) M\7 Septic Tank Tight Tank Q Grease Trap
0 Other(describe):
4. Effluent Tee Filter present? F-]Yes No If yes, was it cleaned? F-1 Yes [--] 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.corri 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.
1000 gallons removed. Filter not present. Tank cannot be outfitted with filter. Septic system
serviced.
6. System Pumped By:
Jonathon Colson
-------------------
Name Vehicle License Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlborough, MA�017_52
Company
7. Location where contents were disposed:
Greater Lawrence Sanitary District : 240 Charles Street , North Andover, MA
Jonathon Colson 03/23/2026
Signature of Hauler Date
Signature of Receiving Facility(or attach facility receipt) Date
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