HomeMy WebLinkAboutLobster Trail Grease Trap - Septic Pumping Slip - 1081 OSGOOD STREET 8/6/2026 Commonwealth of Massachusetts Town Of North Andover
City/TownOf North Andover SEP 2 2026
System Pumping Record
Form 4
DEP has provided this form for use by local Boards of Health.Other forms may be used,but th�[ "
substantially the same as that provided here. Before using this form,check with your local Boa -f---ftn2tAA99Ment
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:
1081 Osgood Street ........... .................
Address
North Andover MA 01845
State
2. System Owner:
Lobster Tail - IG Lobster Tail
Name
1981--.Osgood Street ........
-Address I(if different from location)
North Andover MA 01845
City/Town State Zip Code
6038905555
..........
Telephone Number
B. Pumping Record
1. Date of Pumping 0 8 0 6 2 0 2 6 2. Quantity Pumped: 10O.U00...........
Date Gallons
3. Component: Fj Cesspool(s) F] septic Tank R Tight Tank Grease Trap
F] Other(describe):
...........
4. Effluent Tee Filter present? [--]Yes nX No If yes,was it cleaned? [--]Yes F-] No
5. Observed condition of component pumped:
Cover was accessed and properly secured. 3 Bay Sink. 4 inches of grease on top. 6 inches of
water. 4 inches of bottom sludge. FOG 57%. 40 gallons removed. Both baffles/tees are intact.
Left 0 bottles of drain master. System is at proper working level. Walls/bottom of trap in
good condition. Gasket is in good condition. BOH Logs Signed.
6. System Pumped By:
Robbie Hall
-............. ------
Name Vehicle License Number
Wind River Environmental, 46 Lizotte Drive, Suite 1000, Marlb�r��uljL___MA 01752
Company
7. Location where contents were disposed:
Suncook Wastewater Treatment / Allenstown Sewer Commission: 35 Canal Street
.......... ............ .................................
Robbie Hall 08/06/2026
Signature of Hauler Date
Signature of Receiving Facility(or attach facility receipt) Date
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