HomeMy WebLinkAboutNinety Nine Grease Trap - Septic Pumping Slip - 267 CHICKERING ROAD 8/19/2026 Commonwealth of Massachusetts Town of'0q,",AndOver
City/TownOf North Andover
System Pumping Record SEP 2 2o26
Form 4
DEP has provided this form for use by local Boards of Health.Other forms may be used, b he information must be
substantially the same as that provided here.Before using this form,check with your local 04"ftlglo determine the form
they use.The System Pumping Record must be submitted to the local Board of Health or other app r QP61"ht
days from the pumping date in accordance with 310 CMIR 15.351.
A. Facility Information
1. System Location:
267 Chickering Road, Rte 125
...........
Address
North Andover MA 01845
Mate
2. System Owner:
Ninety Nine Restaurant - OG/JE,T Ninety Nine #30004
Name
14A Gill Street
........................... ----------......................... ...... .........
Address(if different from location)
Woburn MA 01801
City/Town State Zip Code
61724.28999
Telephone Number
B. Pumping Record
08/19/2026 3500. 0000
1. Date of Pumping ..be......................... 2. Quantity Pumped:
to Gallons
3. Component: Cesspool(s) F] septic Tank F]Tight Tank Grease Trap
Other(describe):
4. Effluent Tee Filter present? F] Yes RX 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. 36 inches of water. 5 inches of grease on top. 2 inches of
bottom sludge. FOG 16%. 3500 gallons removed. Filter not present. Tank cannot be outfitted
with filter. Grease Tank system serviced.
6. System Pumped By:
Robert Herrick
-Nmn�W..........------ -,Vehicle L,-ic—ens Number
--- —---------------
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlborough, MA 01752
Company
7. Location where contents were disposed:
NEMO Yard: 54 Knox Trail, Acton, MA 01720
Robert Herrick 08/19/2026
Signature of Hauler Date
............----...........................
Signature of Receiving Facility(or attach facility receipt) Date
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