HomeMy WebLinkAboutSmolak Farms Grease Trap - Septic Pumping Slip - 315 SOUTH BRADFORD STREET 7/15/2026 Commonwealth nfMassachusetts
y�'| Vv~� (| ".��/ / umf
North Aodo,ez
System Pumping
Record
��������� u �����D��� "�������"��
F��00 x� x_ ��
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 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 within14
days from the pumping date in accordance with 31RCMR15.551.
A. Fac^U^tnx Information
1. System Location:
315 South Bradford Street
Address
North Aodove MA 0I845
City/Town State Zip Code
2. System Owner:
Smolak Farms - IG - Smolak Farms
Name
315 South Bradford
Address(if different from location)
Nortb Andover M8 01845
City/Town State Zip Code
9785002019
Telephone Number
B. Pumping Record
07/I5/�026 lO0'OU0O
1 Date 2 Quantity Pumped:' Date � � oo||mnm
3. Component: [—1 Cesspool(s) [-7 septic Tank Tight Tank Grease Trap
| | Other(describe):
4. Effluent Tee Filter present? [—|Yes No |f yes, xvasitdemned? [—lYesF] No
5. Observed condition of component pumped:
Cover was accessed and nrn»eclv secured. 3 Bay Sink. s inches of grease on ton. n inches of
water. s inches of bottom sludge. FOG 43w. *n gallons removed. Both baffles/tees are intact.
Gasket is in good condition. Walls/bottom of trap in good condition. System is at ezoeez
working level. Left n bottles of drain master. aoe Logs Signed.
O. Symbsnn Pumped By:
Robbie Ball
Name Vehicle License Number
Wind River-Environmental, 46 Lizotte Drive, Suite lOOU Marlbqr o � �A 01752
Company
7. Location where contents were disposed:
Suncook-Wastewater Treatment/ AIIeuotuwn Sewer Commission: 35 Caoalstreet
Robbie Hall 07/15/2026
Signature or*o�fe, Date
Signature of Receiving Facility(or attach facility receipt) Dova
t5form4.dou'11/12 System Pumping Record^Page 1nf1