HomeMy WebLinkAboutSeptic Tank - Septic Pumping Slip - 1555 TURNPIKE STREET 5/8/2026 Commonwealth of Massachusetts ToWn Of'V011 Andover
City/TownOf North Andover
System Pumping Record JUN1 8 20
Form 4 26
DEP has provided this form for use by local Boards of Health.Other forms may be used, the information must be
substantially the same as that provided here.Before using this form,check with your local ,P%a:to determine the form
they use.The System Pumping Record must be submitted to the local Board of Health or other In 14
days from the pumping date in accordance with 310 CMR 15.351. ei7t
A. Facility Information
1. System Location:
.1555 Turn.k-e street, ..................
Address
North Andover MA 01845
....... ..... .........................
City/Town
2. System Owner:
Debbie Limas - .'rimer Home
Name ---------------------
1.555 Turnpike Street
1.;k� different'- '--fr-o-m-i o--c-a--t-icn-) '-'-- ---------------
North Andover MA 01845
City/Town State dip Code
9783170770
.......... ...............
Telephone Number
B. Pumping Record
05/08/2026 1500.0000
1. Date of Pumping ........... 2Date . Quantity Pumped: -Gallons
3. Component: Cesspool(s) FXJ Septic Tank F]Tight Tank ❑Grease Trap
R Other(describe):
4. Effluent Tee Filter present? n Yes ® No If yes, was it cleaned? n Yes Ej No
5. Observed condition of component pumped:
Cover was accessed and properly secured. Septic system serviced. Recommend riser due to depth
of cover. Filter not present. Tank cannot be outfitted with filter. 1500 gallons removed.
Light sludge on bottom of tank. Light, top solids in tank. System is at proper working level.
Both baffl.es/tees are intact. Unable to test main line.
6, System Pumped By:
Jonathon Colson
-..- -11---l----------------- ............... .......... ...................
Name Vehicle License Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlboro MA 01752
Company........... ---------------------------------
7. Location where contents were disposed:
Greater Lawrence Sanitary District : 240 Charles Street , North Andover, MA
........... ....................... ......... ................ .................. -------.............
Jonathon Colson 05/08/2026
-§ign-a-t u-re—o-fkau'ie-r Date
-
—----------1--.-I....................... ...............
Signature of Receiving Facility(or attach facility receipt) Date
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