HomeMy WebLinkAboutAshland Farm Grease Trap - Septic Pumping Slip - 700 CHICKERING ROAD 6/11/2026 Town of Wh Andover,
Commonwealth of Massachusetts
City/TownOf North Andover JUL - 2 2026
System Pumping Record
Form 4
DEP has provided this form for use by local Boards of Health.Other forms may be used,bN9911thtiORPall men
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substantially the same as that provided here.Before using this form,check with your local Board of Health to determine the form
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:
70.0 Chhickkeri_ng Road
Address
North Andover MA 01845
City/Town
2. System Owner:
Ashland Farm at North Andover OG Ashland Farm at North Andover
KW -, -------
Name
700 Chickerin Road____g. ........................------- ........ ------
_Kd_jiaii(jff_d'_1i'6' i;nt from location)
North Andover MA 01845
..............
City/Town State Zip Code
9786831300
Telephone Number
B. Pumping Record
1, Date of Pumping 06/11/2026 ---- 2. Quantity Pumped: 1000.0000
Date Gallons
3. Component: Cesspool(s) Septic Tank R Tight Tank RX Grease Trap
F] Other(describe):
4. Effluent Tee Filter present? n Yes nX No If yes,was it cleaned? R Yes n No
5. Observed condition of component pumped:
Cover was accessed and properly secured. Main line is clear. Both baffles/tees are intact.
System is at proper working level.. 48 inches of water. 2 inches of grease on top. 2 inches of
bottom sludge. FOG 8% 1000 gallons removed. Filter not present. Tank cannot be outfitted
with filter. Grease Tank system serviced.
6. System Pumped By:
Michael Graham
---—-------------------
ame Vehicle License Number
Wind River Environmental, 46 l,izotte Drive, Suite 1000, Marlborough, MA 01752
Company" , _
7. Location where contents were disposed:
MEMO Yard: 54 Knox Trail, Acton, MA 01720
Michael Graham 06/11/2026
Signature of Hauler --Date
Y'6n__atu'r_eo"f---Receiving—Fac—ility(or a_ft_a_c`h_fa_c_i1_it'y_recaipt)___ -D—ate
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