HomeMy WebLinkAboutSeptic Tank - Septic Pumping Slip - 505 GREAT POND ROAD 7/31/2026 Commonwealth of Massachusetts Town of North Andover
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System Pumping Record
Form4 Health Dep
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DEP �as;)rovideci mis form ror use * loca-I Boards of Heal&,- ct'he!-t errns may '0,
information m- ust,be substntiety te same asittlat provided here. Before using tis form, ch-eck wit your
local Board of Health to determins,thelorrn t-hey use. -F!*ie System Pumping Record must be submitted t
the I oca I Board e, Heath or ottrl er a o o rcv�r g auth o rt y vit-h in I A days fro n. t-he p u m p 1 n g rl ate 1 n
accordance With 310 CMR i 5.351.
k Facility Information
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B. Pumping Record
Date of Pumoing an` Pumpe--4:1.1ti 1.1 o M S
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Tank -rank 7
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4. Efruent Tee FNtsr present-.) yes TNO
Ve-s, V 7 No
Cie=-ned? Yes
5. Ob s"Ved con^i, or, of
6
in' l
n, r. � LI of this estmated
.wL -L*16 time ofr;Dumpinia� Nnt re's C-MSibi teyorld the dge.jtVVe.
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Service
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