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Commonwealth of Massachusetts Form 4--System Pumping Record
Massachusetts
System Pumping Record
Sys#em 0`wnerr nsu Sysfem Locution.W
Eursaw Oil Corp. Div of Alliance Energ P.:arpn Pantry
36 East Industrial Road 10 Paradise Road
Branf.w.d, �2T, on405 Salem, MA, 01970
BUu)--tl9y- i6V2 n (BOOL-899-B602 x
Dan
Type: Emergent Routine
Cesspool: No Yes Septic Tank: No Yes '
Date of Pumping: Quantity Pumped Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at:
S.E.S.D.
Salem, MA,
Date: Pumper Signature:
Condition of System/Other Comments -
i
MAR -9 jq%
® Pfim,do�.,yd�dr. r 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
Bursaw cit ; Cor p. D.iv oT Ai 1.i.Alzce GnNrq - P�unpn Pantry
35 Fast Industsi.al Poad 10 Paradise Road
Brantord, CT, 06405 Saleirt, MA, 01970
(800)- 899-8-02 x (800)-899-8602 x
Dan
Type: Emergent Routine /N
Cesspool: No Yes - No Yes®
Date of Pumping: Id Quantity Pumped: Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at:
S.E.S.D.
Salem, MA.
Date: Pumper Signature: �vv,/
Condition of System/Other Comments
® a;meao�aoy�iear, � Dep Approved Form-12/07/95
NED
NOV 0 6 2009 �
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rbk. 14 SYSTEM.PIU. RECORD
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Cog
9vistem�t'u, j ping Record
• ystcm «-ter z5yslem LocatioR
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Date of Pumping: �� Quantity Puniped�,�galJons _
Cesspool: NO Ek/ Yes ElSeptic Tank: ?N,o ❑ Yes
System Pumped by: 1 1�c License #:
Contents transferred to:
Date Inspector,
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FOR'%!4 SYSTEM PUNIPLNG RECORD
I
:.¢7 Purest St. p\C\
Middleton,MIA 01949
(.03) 774-2772 6 01 y\
Commonwealth of Massachusetts
�► , Massachusetts FEB 2 0 1996
.: Svsfem Pumping Record
stem «'ner System Jocation.
Date of Pumping: / - / 1 Quantity Purnped;/4�gallons
Cesspool: 1<o U Y Yes El Septic Tana:: No ❑ Yes
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Sy stem Pumped by: f License M.
Contents transferred to:
Date Inspector
FORh1*4'� SVSMM PLILPLIG RECORD
27 Forest Si. �p\� _
• �,.i� 'I.ton,"r.9A01989 GUD,P, .
774.2772 �\ �j\ r
ommon\sealth of Massachusetts FEB 2 0 1996
r MaSS8chus.e s i
Stem Pum-ping Record
System Owner )•s m Jocatioq.
Date of Pumping: �LL='_ Quantity Pumpedx�gallons
Cesspool: No IL.Y Yes � Septic Tank: No Yes
System Pumped by: `�1/ License #:
Contents transferred to:
Date Inspector