5 HILTON ST j yr l �-oh Sr !°f�c
0207028884
Commonwealth of Massachusetts Form 4 System Pumping Record
Massachusetts
5ystem Pumping Record
System Owner 1 System Location
S.Ihwacltz
Type: Emergen Routine
Cesspool: No Yes
Date of Pumping: Quantity Pumped Gallons
System Pumped By: Wind River.EnvironmentcJ,LLC Permit#:
Contents Transferred to;
Contents Disposed at:
&E.S.D.
Salem Mk
Date: Pumper Signature:
Condition of System/Other Comments C e!)
b
Dep Approved Form.- 12/07/95
e,
1
Wind River Environmental
577 Main Street, Suite 110
Hudson, MA 01749
December S, 2011
Please find attached our disposal slips for the month of November. If you
have any questions or concerns please contact me.
Best regards,
Jamie Coble
Office Administrator
978-282-7315
163 Western Ave, Gloucester, Massachusetts 01930
ph 978-282-7315 fax 978-281-4869
e-mail ,jcobleVwrenvironmental.com
#, Commonwealth of Massachusetts Form 4--System Pumping Recorco- L
Massachusetts
System Pumping Record
System Owner System I-ocatlon
SC154Jct r'.�n! Jaib.lf 7:r„tf1.6�47 »C�..",fi$L,a °�.'�F;ll=]
5 .C3i.tLcrc'� S� ::� 5�i.ltrsn Sh.`.
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Salem, ilk, 1019,70 ;ys1om, NCA, 01.9' o
(�375).,,��r1_7t;2la v tigty,7 pmx.,._ rh�f1 .,
Type: Emen er Tie °
Rau n
9
Gess aol: No. Yes
p �/ Septic Tank: No Y
0
Date of Pumping: I
/6p Quantity Pumped:,, 7n Gallons
System Pumped 9y: Wind River Environmental,LLC Permit 30:
Contents Transferred to:
Contents Disposed at:
SI.S.D.
Salem.
Date: Pumper Signature:
Condition of System/Other.Comments
J
j
® rd�������yd�ac�n•r Dep Approved Form-12/07/95
5
Commonwealth of Massachusetts Form 4--System Pumping Record
Massachusetts
System Pumping Record
System Owner System Location
Schwartz Laurance Primacy Home
5 Hilton St. 5 Hilton St:
Saiem, MA, 01970 Salem, MA, 01970
(978)-745-7628 x (9781-745-7628 r.
SchwartzType: Emergent Routine n
((r
Cesspool: No Yes S;4�tcTank: No Yes
Date of Pumping: i'd-LI Quantity Pumped: rOryo Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at:
,i
i
Date: Pumper Signature:
Condition of System/Other Comments
Is
Printed onmycledPaper Dep Approved Form-12/07/95
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