HomeMy WebLinkAboutSeptic Pumping Slip - 91 BOSTON STREET 12/18/2015 i
: - l l � ' P�h��r YrSAi:�}i�Jai�i j.�,tr�s lA 1h�,Y �✓{ ��r �S _ _. _'__-_-_ _...—. ---- - ;
A YON
OF N0RTHAPiD0VER
M PUMfN. C qCOPD
�l S I'6M UWN F,R & aL?DRESS SYSTEM LOCATION
WHal u: loft from Uf house)
r 7
7 -
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U UF'�PUMPINC ��' -` • QUANTITY f UMPQ, D 26j`
C,'I.�.il'UUL°°N0 /YFS SCPTIC' TANK: NO YES
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X,- TUKF'OF S E R Y I C f ROUTINE, �-'° EMERCEN'CY
r
U IJ,' TRY AT ION
C;UUD CUt U�l7'IQN, FULL 70 COYER
JAFFLUS IN VVACR _
tiU.OTS 4y ; < LEA HFICL D I� uN�ACK...
CXC�SSIY SO,h:IDS
FLOODED'
'0 U I 0,S' -CAARYO YC R ��JWHFft.(EX.PL,A.1N) --
10%
i
. ..i r.(t +�iJ 1,M Ji��J:y ) .i0.'�,.•,. ,
IS,TIZar�Srcll 2 D TO
'r OF NORTHarcDaVER
SYSTEM PUMPIM Ca�R.D ��� t
$.
M 0WNFR , ADDRESS w. SYSTEM LOCATION
' (ex mPIe; left front of hour) .
R.
c) . m}
r
U:�'i'E UFPUM1'INC; (QUANTITY PUMPED ,,
POOL; O YES SEPTIC TANK: N0 YES T^
NATURE OF SERVICE; ROUTINE EMERGENCY
()HSr-,R YATIONS;
GOOD CONDITION, PULL TO COYER
HRAYY CREASE BAFFLES IN I'I.,ACI:
HOOTS LEACHFIELD RUNBACK.,
EXCESSIVE SOLIDS FLOODED'
SOLIDS CARRYOVER IJ HER (EXPL,A.IN)
>'I`L PUM PC' t BY;
a a
UU.YlMF.NTS:
TRANS!'ERRED TO:
i
I
TOWN OF NORTH ANDOVER
SYSTEM PUMPING RECORD
r
til'STEM OWNER & ADDRESS SYSTEM LOCATION
(example; left front of Ouse)
OF PUMPINC: (QUANTITY PUMPED, „�� � �� CALLO'v)
C. 1:�,SPOOL: NO YES SEPTIC TANK: NO YES
,',ATURE OF SERVICE: ROUTINE EMERGENCY
UBSFRVATIONS,
GOOD CONDITION FULL TO COVER
HEAVY CREASE BAFFLES IN PL,AC1.
ROOTS LEACHFIELD RUNBACK
EXCESSIVE SOLIDS FLOODED
SOLIDS CARRYOVER �HER (EXPLAIN)
I
51 .E"I'LM PUMPED BY:
( U �IMENTS.
UNTI,'.NTS T) ANSFEIZI ED TO:
I
TOWN OF NORTH ANDOVER
SYSTEM PUMPING RECORD
DA'T'E:
Sl -STENI OWNER & ADDRESS SYSTEM LOCATION
(example: left front of liouse)
1).,\ l E 01" PUMPING: QUANTITY PUMPED `1,rk) GALLO.'v',
('I'SSPOOL: NO YES SEPTIC TANK: NO YES
N:\TURE OF SERVICE: ROUTINE EMERGENCY
13 S F'k\'AT]0 N S:
COOL) CO N 1)ITI 0 N FULL TO ("0 V I.,'I
HEAVY GRE,\SF BAFFLES IN PLACE
ROOTS LEACI-IFIELD RUNBACK
EXCESSIVE SOLIDS 4 FLOODED
SOLIDS CARRYOVER OTHER (EXPLAIN)
PUMPED BY:
Co 1,N I ENTS:
l
i
TOWN OF NORTH ANDOVER
SYSTEM PUMPING RECORD
1
DATE: ..: �... l
SYSTEM OWNER & ADDRESS SYSTEM LOCATION
(example: left front of house)
. f
DATE OF PUMPING: QUANTITY PUMPED GALLONS
i
CESSPOOL: NO � YES SEPTIC TANK: NO YES
NATURE OF SERVICE: ROUTINE EMERGENCY
OBSERVATIONS:
GOOD CONDITION FULL TO COVER
HEAVY GREASE BAFFLES IN PLACE
ROOTS LEACHFIELD RUNBACK
EXCESSIVE SOLIDS FLOODED
SOLIDS CARRYOVER OTHER (EXPLAIN)
SYSTEM PUMPED BY;
COMMENTS:
CONTENTS TRANSFERRED TO: ' �� ._.v. � M 4$r"°. m....
2001
FORM 4-SYSTEM PUMPING RECORD
CURRIEiN
SEPTIC & DRAIN SERVICE
107 FOREST STREET;MIDDLETON,MA 01949
(978) 774-2772
COMMONWEALTH OF MASSACHUSETTS
ve MASSACHUSETTS
VVIOTFAI P rlffPTVG RECORD
SYSTEM LOCATION:
0 u
� � .vos-f�� s
SYSTEM OWNER:
C� (I Yf "6 m vyl
DATE OF PUMPING: V QUANTITY PUMPED: oo GALLONS
CESSPOOL: NO YES SEPTIC TANK: NO 0 YES
SYSTEM PUMPED BY: 1"ITUIP-tvR SEPTIC & DRAIN SERVICE
CONTENTS TRANSFERRED TO: S, D
DATE:
q INSPECTOR:
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