21 CEDARCREST AVENUE SYSTEM PUMPING RECORDS RECEIVED 01/27/2017 03:50PM 9787450343 Salem Health Dept
01/27/2017 15:43 9782814869 WINDRIVER PAGE 01/07
0207077587 ca�iinata
Commonwealth of Massachusetts Form 4--System Pumping Record B"
Massachusetts
System Pumping Record
System owner System Location
8erne_t's Garage Parnett'.s viZ% o2.
21 Cedar Creat; Avenue_ r,u.;•-
21 Cedar �..- ,. h-,r,'tua
Salea-a, MA, 01970 Salem, M, 03.910
(97B)-468-4011 x (978)-468-011. ---
Don Burnett
Type: Emerges Routine
Cesspool: No yes Septic Tank: No = YesD::I—
Date of Pumping:( (.a Quantity Pumped: Q?oU Gallons
System Pumped By: Wind River Environmental,LLC Permit#.
Contents Transferred to:
Contents Disposed at:
Dote: Pumper Signature:
Condition of System/Other Comments
G�
Haverhill WWTP
40 S Porter St
Bradford, a
(9719) 3:74 2882
rnmeao�,uyu�e , Dep Approved Form-12/07/95
02/12/2016 15:06 9782814869 WINDRIVER PAGE 02/14
Q�''�7�?��t>S'7't GAJ/1',f207sd
Commonwealth of Massachusetts Form 4--System Pumping Record `
Massachusetts
System Pumping Record
System Owner System Location
5ernett,F Garage Bernett's Garage
a1 Cedar Crest Avenue 21 Cedar Creat Avenue
salen, Yb:, 0n?0 S.Saez, InA, 01970
(978)-469-4011 z s9713)-469-4011 x
Dan Burnet;.
Type: Emergent Routine
Cesspool: No Yes Septic Tank: No Yes=
Date of Pumping: /11/S lly— Quantity Pumped: Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at: . " &F.&DS.E,S.D.
ALk Swt�..� It
Date: J Pumper Signature:
Condition of System/Other Comments —
Panmaavmc�c��apaFer Dep Approved Form-12/07/95
09/05/2014 14:14 9782814869 WINDRIVER PAGE 02/03
i S
Commonwealth of Massachusetts Form 4--System Pumping Record
Massachusetts
System Pumping Record
System Owner System Location
E<rne tt's Becnett's GaNage; :j
21 Leeflz t r4 i 7,ce 21 cedar,crebt•AV4
salea:, Nit, 01U70•--,.. MA,�61970
078)-,168- 407.3. % / r `_;•-' -
Bernett's Gac.aga
Type: Emergen Routine
Cesspool: No Yes Septic Tank: No Yes
Date of Pumping: P-12 _�C� Quantity Pumped:_Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at:
Date: Pumper 5ignoture: '!/
Condition of System/Other Comments
Se
` C
® Pdmal opmoyebd w�r Dep Approved Form-12/07/95