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Preventative Septic and Drain, LLC
327 Asbury Street Date:ZOLI /
S. Hamilton,MA 01982 Technician:
978-468-9001
CUSTOMER SERVICE REPORT Hose length:
System Owner: Yv i S Job Site/Contact:
Address: / Address:
G --
Phone: 7 C/!l P one:
SYSTEM FUNCTION CHECK & PUMPING REPORT
Septic Tank: single ❑double compartment Filter present: ❑Yes o
El Cesspool: El overflow cesspool ❑ Cleaned ❑ Replaced ❑ Installed
Size of tank „s'G gal Type of filter:
Actual amount pumped gal Condition:
Scum layer(acceptable range 1-2") C;J in
Sludge depth(acceptable range 5-10") , " in Comments: , iD Tr
Li uid level 61�)Csr
❑Overflow Tank / ❑ Overflow Cesspool /
Size of tank gall
Actual amount pumped gal
Liquid level
Condition
YES NO
-Tank structure
We recommend that you pump your septic-
_ _ .
Breakout or ponding - - — - - - system-every:'
ystem every V 3 - 4 5 years.
co
Li uid level above inlet vert *Thank you for your continued patronage, we
Liquid level above outlet invert really appreciate your business! Our goal is to
Tee or Baffles missing or broken inlet
Tee or leave our customers satisfied and delighted by
Baffles missing or broken outlet providing exceptional service. Please call with
*YES indicates there is a problem,NO indicates there is no roblem any questions or concerns.
PREVENTATIVE MAINTENANCE PERFORMED
QTY. DESCRIPTION PRICE AMOUNT
Ar3 Z(
BOARD OF
TOTAL c�
-- _. Pa ent amt received $ ❑ Cash Check #: t/-2� $al:
For office use only please. ❑ Invoice entered ❑ Payment applied O'Pumping report sent to BOH
Date: Date: Date:_�J
02/12/2016 15:06 9782814869 WINDRIVER PAGE 09/14
02070668 e70 05!0112000
Commonwealth of Massachusetts Form A--System Pumping Record 6.260%
Massachusetts
System Pumping Record
r.
System Owner System Location
Zouris Barry 2rimary Uome
e Peter Road 6 Peter Road
Saris, VIA, 01970 Salem, MA, 01970
(97S)-742-6747 x (9743)-744-6747 x
Kouris Barry
Type: Emergen< Routine
Cesspool: No Yes
Septic lank: No Yes
Date of Pumping: ��� — (^1,. (� ��r
quantity Pumped: - Gallons
System Pumped 8y: Wind River Environmental,LLC Permit#:
Contents Transferred to.
Contents Disposed at:
R. +-ani.
Date: Pumper Signature:
:ondition of System/Other Comments
Dep Approved Form-12/07/95
12/09/2013 11:21 9782814869 WINDRIVER PAGE 09/11
Ann-MA A 61%A OFttIi 17007
Commonwealth of Massachusetts Form 4--System Pumping RecordliO%
Massachusetts
System Pumping Record
System Owner System Location
Itouris Harry Pr:imaxv Home
5 Peter Rd G Peter Rd
Salem, Nii.4, 01970 Salen, IIIA, 01979
(978)-744-6747 x (978)-794-6747 x i
XOutis Harry
Type: Emergen Routine
Cesspool: No Yes Septic Tank: No Yesi_ 1
Date of Pumping. 10 1/(f 13 Quantity Pumped: j CV0 Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at:
Date: J Pumper Signature: Z4 a�/ .
Condition of System/Other Comments
i
® Atn�ar.=)cledpewr Dep Approved Form-12/07/95
0207054474G�109 vO�Q
Commonwealth of Massachusetts Form 4--System Pumping Record
Massachusetts
System Pumping Record
System Owner system Location
Aaiae3s Barry Primary xAi me
6 Peter Road 6 Peter Road
Salem, P>A, 01970 Salem, MR, 01470
(976)-744-6747 x ()78)-749-6747 x
Aouris Harry
Type: Emergen Routine
Cesspool: Na Yes Septic Tank: No YeSL[�
We of Pumping: tt9,�I Quantity Pumped: ,_.Gallons
System Pumped 8y. Wind River Environmental,LLC Permit#;
Contents Transferred to:
Contents Disposed at:
n
bate: PumperPumper ignoture•
Condition of P,ystiun/O�{{ther��-Coomme,n___ts
Ftimcdonrecyc�otlpapa+ Dep Approved Form-12/07/98Z
OLl6Z(ZL
9T/90 MV8 N3RINGNIM 698tTGZBL6 ST:EZ PI
02/12/2013 13:29 9782814869
WINI?RIVER PAGE 73r`l33
i
- n�nsnnrnn« Harm Mnrtn
Commonwealth of Massachusetts Form 4—system Pumping Record 12M,4
Massachusetts
System Pumping Record
Sysr�ttf Ywner System Location
3ouria Parry Primary Fomes
6 Peter Rd 6 Peter aid
Salem, MA, 01970 Salem, .M>PS, 01970
(578)--744-6'747 Sc (978)-794-6747 x
Fauc3s &Ir=ry-
Type: Emergenc Routine
Cesspool: No - Yes u"' Septic Tank: No a Yes
Date of Pumping: /saQuantity Pumped: /W'047' Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at:
W. 5,G
5 mozzon f ? 1N6
�"ciu tsvl 1�1A
Date: Pumper Signature:
Condition of System/Other Comments ��
Dep approved Form-12/07/95
Commonwealth of Massachusetts Form 4--System Pumping Record E y,
Massachusetts
5ystem Pumping Record
system Owner System Location
Rd f�ci
MA. ';.197i1.
Type: Emerges Routine.
Cesspool: No Yes' Septic Tank: No Yesu -
—
bateofPumpingt q)„�1f quantity Pumped: 0CX7 Gallons
System Pumped By: f Wind River Environmeirtal,LLL' Permit#:
Contents Tronsf erred to:
Contents Disposed at,
$8IM. MA•
Date: Pumper Signature:
Condition of 5ystem/Other Comments
j
® nmeaon yckdpape Oep Approved Form-12/07/95
Commonwealth of Massachusetts Form 4--System Pumping Record
Massachusetts
System Pumping Record
System Owner System Location
Kouris Harry Primary Home
6 Peter Rd 6 Peter. Rd
Salem, MA, 01970 Salem, MA, 01970
(976)-744-6747 x (976)-744-6747 x
Kouris Harry
Type: Emergenc Routine
Cesspool: No Yes Septic Tank: No Yes
Date of Pumping: q— 1p _O(� Quantity Pumped: fQQ() Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
tj 5'
O oFN�_,
Contents Disposed at:
S.E.S.D.
a ®m, MA.
0
Date: Pumper Signature: �—
Condition of System/Other Comments
..f
II
I
® v,;ndedonrecycled pa ,. Dep Approved Form-12/07/95
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Massac huset&ts 01749 I E- ail:
E N Vd R ON M E N�7n L :�+`«.¢ Telephone.978.281.4443 Facsimile 978.2830780 �wremironmental Corr
FORMERIY.R.B.STRONG
AUG 52004
CITY OF SALEM
BOARD OF HEALTH
August 3, 2004 t'
Wind River Environmental
163 Western Ave.
Gloucester, MA 01930
Board of Health Administrator,
This package contains the dump slips for the Board of Health from the field office
located in Gloucester, MA. This is the work we have completed.
If you have any questions,please feel free to contact our Director of Field Operations, /
Brad Robertson, at 978-282-7315. C C�
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1hou,
ian H. lam
10
Form 4 -- System Pumping Record
Commonwealth of Maswdwwtss
Massachusetts C E �..a
System Pamoina Record x: � •. �
AUG „ 52004
SYSMUT oNme' System Location BOARD OF HEALTH
^z sr P,i 6 F'•;-mr Fd
'$;-7#d-6711 s
. ....:.... .. .": :
"Type: Emergenky Routine
Cesspool: Ido V Yes Septic tank: w Yes E
Date of Pumping: Quantity Pum: Gallons
System Pumped By: Wind Rirer EftwMnenta/, LLC Permit#:
Contents transferred to:
Contents Disposed at:
SES P
Date: Pumper Signature:
Condition of System/Other Comments
Dep Approved Form - 12/07/95
FOP-M 4- SYSTEM PUMPING RECORD
CURRIER
SEPTIC & DRAIN SERVICE
��� �
107 FOREST STREET; MIDDLETON, MA 01949
(978) 774-2772
242000
CITY
HE O H DEPTEMH
COMM//ONWEALTH OF MASSACHUSETTS
S Lq t e _,MASSACHUSETTS
SYSTEM, PUMPING RECO"
SYSTEM OWNER: SYSTEM LOCATION:
FE
l
DATE OF PUMPING: ✓ / ' �1 QUANTITY PUMPED: b C) GALLONS
CESSPOOL: NO [ ES SEPTIC TANK: NO YES
SYSTEM PUMPED BY: CURRIER SEPTIC & DRAIN SERVICE
--ONTENTS TRANSFERRED TO: -s ,S -'
I 1 ,
ATE: INSPECTOR: vz t.-t. C
t