HomeMy WebLinkAboutSeptic Tank - Septic Pumping Slip - 25 OGUNQUIT ROAD 5/1/2026 Tovin of North Andover
� M Coil-m—iorwvealth of Massachusetts
,.0 MAY 2026� Ity� CW � C �System F' ur Ir F €:cord
r / For rtI a lth Department
DEP has provided this fart°n for ose, toy local Goards of Health, Other fears rriay be used, but If)(,
inform ahon r,nust f)e substranh ally lhle> Banc;,, r,3s k-i al provided here. Before using Ihis form, check with yc
local Board of Health to de(r rrnin, (tart-n lhey use. The Systern Puf-nping Record must be submitted
the local Board of `rleaitl'h or otl'rr'( approving 4iu f ocity within 14 days fron) tie purnping vale in
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B, PUr-nping Record
1 Date of f'urral>In9 � 2. C)uaanlity Pumped:
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3. .. Cess goof s rfUr cnC n< EI rig tit Tank
(�._� Grease Trap
C)lf_ter (describe) _, ___ _...... -
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4. Effluent Tee f=iltei I)rawsenl ? �._� Yes [_�yfvoIf yes, was it cleaned? [ ) Ye:> 7
5. Observed concli(ion of (,,,ornponen pumped:
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4�Irl'rlped I"YL) 1neMVMass 1Al�,95; ., Mass 1A(-)317fir, (,V(,r +'�&c, tJur' 7e.rBri EI)IerpIISP s, InI'
Ilsorl vw .. e onConts Were C)1spe,1°,t'd
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