HomeMy WebLinkAboutNinety Nine Grease Trap - Septic Pumping Slip - 267 CHICKERING ROAD 5/21/2026 Commonwealth of Massachusetts Town of No9�I*,i Andover
City/TownOf North Andover
System Pumping Record JUN 18 2026
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 local
'4�40=f0[m
they use.The System Pumping Record must be submitted to the local Board of Health or PteV196ein hi
days from the pumping date in accordance with 310 CMR 15.351
A. Facility Information
1. System Location:
267 Chickerijjq Road, Rte.-J-2.5.... .............................. ........... ...........--------......................
Address
North Andover MA 01845
...................... .............................. ...................
City/Town Zip cwe ------
2. System Owner:
.Ninesj�in,�__Restaurant OG/JET Ninety Nine� #.30004. ...................
Name
14A Gill Street
i-rom-lo,cat....-on i )-- ---------Address(if difFerent f
Woburn MA 01801
............................................ ..........
City/Town State Zip Code
6172428999
-------------------...... .............
Telephone Number
B. Pumping Record
05/21/2026 3500.0000
1. Date of Pumping i�_
Date 2. Quantity Pumped: Gallons
3. Component: Fj cesspool(s) � septic Tank R Tight Tank RX Grease Trap
E] Other(describe):
4. Effluent Tee Filter present? F]Yes RX No If yes,was it cleaned? n Yes F] No
5. Observed condition of component pumped:
Cover was accessed and properly secured. Main line is clear. Inlet baffle/tee is intact
outlet baffle/tee is not intact. Recommend outlet repair. System is at proper working level.
36 inches of water. 6 inches of grease on top. 2 inches of bottom sludge. FOG 18%. 3500
gallons removed. Filter not present. Tank cannot be outfitted with filter. Grease Tank system
serviced.
6. System Pumped By:
Robert Herrick
Name Vehicle-License-,--_ -,-Number,_
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlborough, MA01752
................... ------
Company
7. Location where contents were disposed:
Greater Lawrence Sanitary District : 240 Charles Street , North Andover, MA
--------------- ......................... .............
Robert Herrick 05/21/2026
................................................................................... ....... ---—------------- ..........................................................
Signature of Hauler Date
--.-I.,................. ............._....__.___.__.___................------------ ..............
Signature of Receiving Facility(or attach facility receipt) Date
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