System Pumping Records RECEIVED 01/27/2017 03:50PM 9787450343 Salem Health Dept
01/27/2017 15:43 9782814869 WINDRIVER PAGE 03/07
0207078334 071]Ed2004
Comigonweolth of Massachusetts Form 4--System Pumping Record 5%
cr..
I' Massachusetts
s' 5N5tetn Pumping Record
System owner system Location
Jones Larry frim s.ry itr_mt,
411 Lafayette Street 411 Laf,^yev:tn.
Salem, Tim, 01970 Salem, KA, 131910
(E08)-847-7682 6c (SC8)-8+e7^ ?rB r
jonag Barry
Type' Emergen :`i Routine
Cesspool: No Yes Septic Tank: No Yes=
Dote of Pumping: V Quantity Pumped' Gallons
System Pumped ay: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at:
Salem-MA-
Date: Pumper Signature:
Condition of System/Other Comments
® Pnnedon m�uedp.W Dep Approved Form-32/07/95
RECEIVED 07/27/2016 11:40AM 9787450343 Salem Health Dept
07/27/2016 11:35 9782814869 WINDRIVER PAGE 06/06
n^nRn�A4na 07/0812004
Commonwealth of Massachusetts Form 4—System Pumping Record 920%
Massachusetts
System Pumping Record
System Owner System Location
ConcaA Lewis Primary Home
411 Lafayette Street 411 Lafayette Street
Salem, MA, 01970 Salem, NIA, 01970
(508)-878-0753 x (508)-878^0753 x
Conrad Lewis
Type: Emergen Routine
Cesspool: No 1 yes Septic Tank: No —Yvs�
Dote of Pumping: Quantity Pumped: /�]C L r ollons
System Pumped 8y: Wind River Environmentol,LLC Permit#:
Contents Transferred to:
Contents Disposed at:
�Ote: Pumper Signature:
=ondition of System/Other Comments
F3 �2382
C
M-WR '
b$WiCh, MA.
F4ineaanuys�wuer Dep Approved Form-32/07/95
IMPORTANT MESSAGE
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FOR 969 hey' or L.0.r
DATE/ 1 LPTIME 91 L/O A.
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v AREA CODE NUMBER EXTENSION
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AREA CODE NUMBER TIME TO CALL
TELEPHONED PLEASE CALL X
CAME TO SEE YOU WILL CALL AGAIN
WANTS TO SEE YOU RUSH.
RETURNED YOUR CALL WILL/FAX TO YOU
MESSAGE Tho-rP WaUAO Ci/ r1� he .
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91,-oet- ana she is r vesfinq
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SIGNED S, n k
FORM 4009
MADE IN U.S.A.
ROTES
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A7/18/2E13 11: 42 9782814869 WINDRIVER PAGE 07/08
. !'M ,,.."-:"tlknnn�nnq(.,ga .. 07tnB17fltld
Commonwealth of Massachusetts Form 4--System Pumping Record.U%
Massachusetts
5ystem Pumping Record "
System OWner System Location
Conrad Lewis Primary Home
411 Lafayette Street 411 Lafayette Street
Salem, MA, 01970 Salem, tdA, 01970
(506)-678-0753 x (508)-878-0753 x
Conrad Lewis
Type: Emergen I Routine
Cesspool: No Yes Septic Tank: No O YasE�]
Dote of Pumping: a cr•�� Quantity Pumped:—. L Gallons
System Pumped By: Wind River Environmental,LLC - Permit#:
Contents Transferred to:
Contents Disposed at:
bate: Pumper Signature:
�onditlon of System/Other Comments
�L
SB-S.D.
ck, ME.
PxIn,caunr<cvaNnnGrr Dep Approved Form-12/07/95
01/10/2014 14: 58 9782814869 WINDRIVER PAGE 01104
317fl fR�7� 4; 0710812004
Commonwealth of Massachusetts Form a--System Pumping Record*0%
Massachusetts
System Pumping Record
System Owner System Location
Conrad Lewis Primary Home
411 Lafayette Street, 411 Lafayette Street
Salem, MA, 01970 Salem, MA, 01970
(508)-878-0753 x (508)-678-0753 x
Conrad Lewis
Type: Emergen Routine
Cesspool: No Yes Septic Tonk: No yes
Date of Pumping: / l PJ - Quantity Pumped: 4!QPd_Gallons
System Pumped By: . Wind River Environmental,LLC Permit#:
Contents Transferred to: -
�'ontents Disposed at;
I
>ate! Ia`r (] ` Pumper Signature: ' 7
{NVIRUNMENIAL
,ondition of System/Other Comments
Lk
Drain Problems? We're Local&Fast
1.865-866-6214
Printed an rccvdedpaper Dep Approved Form-12/07/95
02/12/2016 15:06 9782814869 WINDRIVER PAGE 14/14
Commonwealth of Massachusetts Form 4—System Pumping Record y'
Massachusetts
u
System Pumping Record
System Owner System Location
cortrad Prlmary LiUmc^
%lI La;;awtte 5trcet 411 La Fayette Street
Salem, Ya, 01870 Salem, MAS, 01970
(508)-•678-0753 x (508)-978-0753 x
Conrad Lawi.s
Type: Emergent Routine
Cesspool: No Yes Septic Tank: No yesO
Date of Pumping: — Z,(� {� quantity Pumped: Jc_7 Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Corlents Disposed at:
Dote: Pumper Signature:
Condition of System/Other Comments r JC
® vdnan mi rccycmq raDep Approved Form-12/07/95
06/22/2015 23: 52 9782814859 WINDRI%'ER PAGE 03/09
:'261Y05-1 697 07/09f2001
Commonwealth of Massachusetts Form 4--System Pumping Record
iy'
Massachusetts
System Pumping Record
System Owner System Location
C•71112utl tewia PL-im.scy Eame
s71i. Lafa3fati:$ 411 LeLfayette stiY,�Gt
5ale!A; Pn� 01970 sz1riv01470
1508)i -878-0753 x (503)-978-0753 x
Conrad Lewis
Type: Emergen Routine
Cesspool: No _ yes k
Date of Pumping: r,c_/ Septic Tank: No Yes
Quantity Pumped: Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
:antents Disposed at:
)ate: Pumper Signature:
ij
rendition of System/Other Comments
x l�,
Frmcaonrec.c�cep�pDep Approved Form-12/07/95
01/10/2013 12:54 9782814869 WINDRIVER PAGE 02/04
MKIR17 U
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Commonwealth of Massachusetts Form 4--System Pumping Record i M%
Massachusetts
System Pumping Record
System Owner
System Location
� Primary Home
Conrad Lewis
911 Lafayette Street 411 Lafayette Street
Salem, MA, 01970 Salem, MA, 01970
(508)-878-0753 x (508)-878-0753 x
Conrad Lewis:
Type: Emergen Routine
cesspool: No Yes K
Septic Tank: No® Yes=
Date of Pumping: Quantity Pumped:`Gallons
system Pumped BY: Wind River Environmental,LLL Permit#:
Contents Transferred to:
Contents Disposed at: � .r�•
Salem. MA.
Date; Pumper 5i9
nature'
Condition of system/Other Comments
® vrinrcAonm.uc�aivepar Dep Approved Form-12/07/95
-ao�emesoa mmannnd
Commonwealth of Massachusetts Form 4--System Pumping Record.A%
Massachusetts
r System Pumping Record
System Owner � System Location -J
- —
Sed- P< 13
Conrad Lewis !i primary Home
911 Lafayettie Street 411 Lafayette Street
Salem, MA, 01970 Salem, MA, 01970
(508)-878-0753 x (508)-878-0753 x
Conrad Lewis
Type: _Emergent Routine
Cesspool: No- Yes Septic Tank: No �Yes
Date of Pumping:, C(_ /3— / y Quantity Pumped:_/�j�U Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at: [�
d.
Date: Pumper Signature:
n/
l X
Condition of System/Other Comments
It
® ventmo„�cyadra�r ',�Dep Approved Form- 12/07/95
0222024904 ir? 07108/2004 '
Commonwealth of Massachusetts Form 4--System Pumping Record
Massachusetts
System Pumping Record
System Owner System Location 5
Conrad Lewis Primary Rome CITY OF SA
411 Lafayette Street 411 Lafr.yette Street gO�OOF LEM
HEqL:
Salem, MA, 01970 Salem, MA, 01970
(508)-878-0753 x {508)-2'78-0753
Conrad Lewis
type: Emergent Routine
Cesspool: No Yes Septic Tank: No = Yes
Date of Pumping: —8—d4 Quantity Pumped: GO Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
,
"[ t
Contents Disposed at:
S-FSn
amem, MA.
o
Date: `f//�� 8 4 Pumper Signature:
Condition of System/Other Comments
er
.I"
Dep Approved Form-12/07/95
Commonwealth of Massachusetts Form 4--System Pumping Record
Massachusetts
System Pumping Record
System Owner System Location
Conrad Lewis Primary Home
411 Lafayette Street 411 Lafayette Street
Salem, MA, 01970 Salem, HA, 01970
(508) -878-0753 x (508)-878-0753 x
Conrad Lewis
Type: Emergen Routine
Cesspool: No Yes ,�,p Septic Tank: No ® Yes
Date of Pumping: Quantity Pumped: /OOQ Gallons
System Pumped By: v Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at: S.E.S.D.
Salem, MA.
Date: Pumper Signature:727 X1;' J"�
Condition of System/Other Comments
Y
® Noted onrecydcdparcr Dep Approved Form- 12/07/95
Commonwealth of Massachusetts Form 4--System Pumping Record
Massachusetts
System Pumping Record
System Owner System Location
Conra(I Lewis Primary home
411 LdtdyeCte Street 411 Lrfdyette Street
Sd.Lem, MA, 01971) SmIera, MA, 019'/G
15GN1-HYH-G7�i x tH09}-878-0753 x
Conrad Lewis
Type: Emergent Routine
Cesspool: No O, Yes Septic Tank: No Yes
T Date of Pumping 10, aq-Q / Quantity Pumped: (/' Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at:
S.E.S.D.
.
i
Date: Pumper Signature:
Condition of System/Other Comments
'G I
® H;med..�,,knrwe. Dep Approved Form-12/07/95
�. II
,f
d
REGEVED
DEC -3 2009
Commonwealth of Massachusetts Form 4--System Pumping Record
Massachusetts
System Pumping Record
5y"stem'd4wnI'r" t ° uatom c IQe rl yyacem7 uuotea System Location
6LBUU-LYUUJ li
Conrad Lewis Primary Home
411 Lafayette Street 411 Lafayette Street
Salem, KA, 01970 Salem, MA, 01970
(508)-878-0753 x (508)-878-0753 x
Conrad Lewis
Type: Emergent Routine
Cesspool'. No es Septic Tank: No Y
Date of Pumping: ] Quantity Pumped:ICT60 Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at:
i
Date: Pumper Signature:
Condition of System/Other Comments
Dep Approved Form-12/07/95
tY�39(li t i in 07IM004
Commonwealth of Massachusetts Form 4--System Pumping Rd
Massachusetts
System Pumping Record
System Owner System Location
Conrad Lewis Pr:YmaYy�;liome.._.,
911 Laf<ayeLte Street 411 L:;iayette Strome
slam, MA, 01970 Salem, MA, 019*7U
t`08)-878-0'753 x {SOl3j-878--U`75? x
Conrad Lcwi-
Type, Emergent Routine
esspoo2umping' QuantityPumped:
No %�'J Yes Septic Tank: No Yes
Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at:
Date: Pumper Signature:
Condition of System/Other Comments
io
CITY OF SALEM
BOARD OF HEA! ;f1
Dep Approved Form-12/07/95
Form 4 -- System Pumping Record
Commomweakh of Mlassachusetss
Mlossadwsetts
System Pumping Record
System Owner System Location
.T .y, t.r - i arra y't t ra,t
I
Type: Em V=y Routine r-��
Cesspool: w Yes X Septic tank: VI
nk: w I Yes
Date of Pumping: �^ Quantity Pumped: O� 6 rallons
System Pumped By: Wind Rima Env#w menfn/, LLC Permit#:
Contents transfund to: ..
Contents Disposed at:
III
Dote: Pumper `.ngkature:
Condition of System/Other Comments
Dep Approved Form - 12/07/98
i I r% F1 11 11117711"D 561 Main Street.Hudson.Massachusetts 01749 E-Mail:
E N V I R O WMENTI 11 IV Law - LTelephone 978.281.4443 Facsimile 978.283.0780 I wrenvironmental.com
ENVI RO
i
r.
FORMERLY R.B.STRONG y `
T= � " I
AUG „ 5 2004 s
CITY OF SALEM
BOARD OF HEALTH
August 3, 2004
Wind River Environmental
163 Western Ave.
Gloucester, MA 01930
Board of Health Administrator,
This package contains the dump slips for the Board of Health from the field office
located in Gloucester, MA. This is the work we have completed.
If you have any questions,please feel free to contact our Director of Field Operations, j
Brad Robertson, at 978-282-7315. 1
T ou, j> /Y1
Miss illian H. lam
i Form 4 -- System Pumping Record
Commomvea"of Massachusetts
Massachusetts
System Pundna Record
System Owner System location
'r,nr»d Lewis primary !iota,=
' 1 L.il)YPftr utreet 111 Lat.ayothn „Moot
S,aiem, MA, 01910 Salem, MA, 01 WN
(508) 818-0753 x (508) 878-0753 x
Crn r eri
Type: Emer e y Routine
Cesspool: No Yes Eld Septic tank: No FZYes
Date of Pumping: �� 1b Qua"Pumped: Gallons
System Pumped By: Wind River Environmental, Uc Permit#:
Contents transferred to:
Contents Disposed at: AUG 5 2004
�� S�
r l N OF SALEM
SGARD 0
i}
y
Date: D y Pamper Signature: A, U
Condition of System/Other Comments
Oep Approved Form - 12/07/95
Commonwealth of Massachusetts Porm4--System Pumping Record�pmlye`
Massachusetts
System Pumping Record
System Owner rr, System Location
4.11 Y,,If.y,4tTom(„
Type: Emergenc Routine
Cesspool: No yes Septic Tank: No Yes
Date of Pumping; 10 - 7,1 Il � � Quantity Pumped:/(YGallons
System Pumped By: _Wind River Environmental,LLC - Permit PA:
Contents Transferred to'. -
Contents Disposed at:
Date: , Pumper Signature:
Condition of system/Other Comments
1
® vrwAim,urrcinApat+:r Dep Approved Form-12/07/95
07/03%2012 15:05 9782814869 WINDRIVER PAGE 01104
Wind River Environmental
577 Main Street Suite 110
Hudson, MA 01749
July 3, 2012
Please find attached our disposal slips for the month of June. If you have
any questions or concerns please contact me.
Best regards,
Rachael Kane
Office Administrator
978-282-7315
163 Western Ave, Gloucester, Massachusetts 01930
ph 978-282-7315 fax 978-281-4869
e-mail jcoble(Pwrenvironmentol.com
07/03/2012 15:05 9782814869 WINDRIVER PAGE 02/04
f57tT7PS �i$9 07,(r2:•.2004
Commonwealth of Massachusetts Form 4--System Pumping Records 2W%
Massachusetts
System Pumping Record
System Owner System Location
Conrad Lewis Primary home
411 Lafayette Street 411 Lafayette Street
Salem, MA, 01970 Salem, MA, 07.970
;508)-878-0753 x {508)-876-0753 x
Conrad Lewis
Type: E 1111:1 Routine,
cesspool' No yes
Date of Pumping: Septic Tank: N_o� _�� Yes
�� �� 7 Quantity Pumped: Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
7ontents Disposed at:
S.E.S.D.
)ate: Pumper Signature:
:ondition of System/Other Comments �7lJOi�
® anmm an�ydw Mar Dep Approved Form-12/07/95
08/08/2014 14:35 9782814859 WINDRIU'ER PAGE 11/14
y q
'Ythel7te.170Rf1
M171nR�7[Ind
Commonwealth of Massachusetts Form a--System Pumping RecordlM%
Massachusetts di
System Pumping Record
System Owner System Location
Conrad Lewis Primacy Brame
921 Lafayette Street 411 Lafayette Street
Salem, 14A, 02970 Salem.,,:.Nl?,;.01970
(503)-B78-0753 x (60e)-878-0753 x
Conrad Lewis
Type: Emergent Routine
:esspool: No Yes G ; Septic Tank: No O yes=/—�
)ate of Pumping: 711Y
Quantity Pumped: /JZ�a Gallons
p
iystem Pumped By: Wind River Environmental,LLC Permit#:
:ontents Transferred to: .
ontents Disposed at:
,ate: Pumper Signature:
ondition of System/Other Comments --7
a
r.
Salem; INAA.
h�:c=d.,o mnd�er.. r Dep Approved Form-12/07/95