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Commonwealth of Massachusetts Form 4--System Pumping Record fix'
Massachusetts
System Pumping Record
Sys etj Owh ` System Location
Circle, K OG-Circle K #7502
4080 hest Jonathan Moore Pike 318 Highland Avenue
Columbus, IN, 47201 Salem, MA, 01970
(330)-630-6300. x 1841 (978)-745-8689 x
Manager
Type: Emergent Routine G � ;
Cesspool: No Yes Septrc Tank: No Yes e
Date of Pumping L - z — Z'L.. Quantity Pumped:Z�,'7 Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
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Contents Disposed at:
S.BAD.
Sallem. MA.
Date: Pumper Signature:
Condition of System/Other Comments
RIECEIVED
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® R n«onmcledP,pe, Dep Approved Form-12/07/95
Commonwealth of Massachusetts Form 4--System Pumping Record
Massachusetts
System Pumping Record
System Owner System Location
40130 Wont ;Pons't,`.:ar: ;rr•, ik< , ).f'. T1r;Pelanti 1s�r-.auw
C, l.umklas, Zft, C'li'r1"i SA-loot, W.", 01970;
.k 18411 (g7fxt-71S••3b73v x,
Type: Emergen Routine
Cesspool: h Yes .fep*ie Tank, No Yes
Date of Pumping: /��.�tl.r 1 J Quantity Pumped:oZi5k9b Gallons
System Pumped By: Wind River Envirohmentol,LLC Permit#:
Contents Transferred to:
Contents bisposed at:
S•B.,S.D.
...... Salem, MA.
Date: Pumper Signature: i. ._, ..�,7..)
Condition of 5ystem/Other Comments
® p,;nWQnnrcrickd�y+e� pep Approved Form-12/07/95
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Commonwealth of Massachusetts Form 4--System Pumping Record
Massachusetts
System Pumping Record
System Owner System Location
Circle K OG-Circle R ; 7502
4080 West Jonathan Moore Pike 318 Highland Avenue
Columbus, IN, 47201 Salem, MA, 01970
(330)-630-6300 x 1841 (978)-745-8689 x
Manager
Type: Emergent Routine
Cesspool: No Yes Fep"Tank: NNo,n' 1 Yes
Date of Pumping: S-, ��.I Quantity Pumped: 2 Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at:
Date: Pumper Signature:
Condition of System/Other Comments
'JUN n3 ?nil
H
® Pndmedonrecycled paper Dep Approved Form-12/07/95 -
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Commonwealth of Massachusetts Form 4--System Pumping Record 0%
Massachusetts
System Pumping Record
System Owner System Location
Circle X OG-Circle R #7502
4080 West Jonathan Moore Pike 318 Highland Avenue
Columbus, IH, 47201 Salem, MA, 01970
(330)-630-6300 x 1833 (978)-745-8689 x
Manager
Type: Eme_rgen Routine jo C4 6qs-c-
Cesspool: No l Yes Septic Tank: No Yes®
Date of Pumping: , �� �.�0O Quantity Pumped: o2QJo Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at:
S.E.S.D.
.
! Date: Pumper Signature: !`�✓
Condition of System/Other Comments
1 _ .
1
® PnntMonwycicdpaNr Dep Approved Form- 12/07/95
f i
Commonwealth of Massachusetts Form 4--System Pumping Record
Massachusetts
System Pumping Record
System Owner System Location
Circle K OG—Circle K #7502
4080 West Jonathan Moore Pike 318 Highland Avenue
Columbus, IN, 47201 Salem, MA, 01970
(330)-630-6300 x 1833 (978)-745-8689 x
Manager
Type: Emergenc Routine
Cesspool: No Yes Tank: No YesO
Date of Pumping: g_y( � Quantity Pumped: 0 60 Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
. . rr �VED
Contents Disposed at: SEP 13 2010
S.E.S.D.
Salem, MA.
Date: Pumper Signatu
Condition of System/Other Comments
® Ain�edonrecydedpaper Dep Approved Form-12/07/95
Commonwealth of Massachusetts Form 4--System Pumping Record
Massachusetts
System Pumping Record
System Owner System Location
Circle K OG—Circle K $7502
4080 West Jonathan Moore Pike 318 Highland Avenue
Columbus, IN, 47201 Salem, MA, 01970
(330) -Fi30-6300 x 1833 f978t-745-8689 x
Manager
Type: Emergent - Routine
Cesspool: No Yes 17'ye;Ui Tank: No Yes
Date of Pumping: Quantity Pumped:c94Wj Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at:
S.E.S.D.
Salem, MA.
Date: Pumper Sig Lure:
Condition of System/Other Comments
MAR -9 2010
® Noted onreeycledpaper Dep Approved Form-12/07/95
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Commonwealth of Massachusetts Form 4--System Pumping Record
Massachusetts
System Pumping Record
System Owner System Location
Circle K Circle K Grease #7502
4080 West Jonathan Moore Pike 318 Highland Avenue
Colisnbus, IN, 47201 Salem, MA, 01970
(330)-630-6300 x 1833 (978)-745-8689 x
Manacler
Type: Emergenc Routine ' e
Cesspool: No Yes Tank: No Yes
Date of Pumping �1.��7��C� Quantity Pumped: oZpt?p Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at:
Salem, MA.
Date: Pumper Signature: 7vV._.tXA.P57V
Condition of System/Other Comments
I
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4
® printed anrecycIedpaper Dep Approved Form-12/07/95
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DEC 3 2009
02:'07'';444 02MUMOU9
Commonwealth of Massachusetts Form 4--System Pumping Record
Massachusetts
System Pumping Record
System Owner
y System Location
W. r,` J�Q2r]Tri +u t•. •aea trtk ,3,'i `91�j!il ain� Av-Pn�.•
't U-XI . . H. 1 o.'Ait say M.A.
14 , ..;t„ '.. -
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Type: Emergenc Routine Gf�ati�
Cesspool: No Yes SepHeTank: No Yes
Date of Pumping: 3`�02—O Quantity Pumped: - Oa Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to: �u
0PIC4eNw
Contents Disposed at:
S.E.
S.D.
Salem, MA.
Date: Pumper Signature: �”"
Condition of System/Other Comments
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Dep Approved Form-12/07/95
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'RECEIVED
APR 0 6 2009
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ter:;'•,{{L� ;Ji= HEALTH