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33 APPLEBY ROAD - Septic - System pumping records BK 2000 BIG-KINETIC" WASTEWATER MANAGEMENT SYSTEM _ Visit us on the worldwide web at NORWECACOM What type of treatment systems are used in your area? ❑ Aerobic Systems ❑ Septic Tanks ❑ Sand Filters What are the typical disposal methods used in your area? 1 t ❑ Surface Discharge ❑ Subsurface Discharge i Name Company = ' Address y City State Zip Phone(_) Fax(_) Email Web Address ❑ 1 would also like to learn about ❑ 1 would also like to learn about Norweco Treatment Plants. - Norweco Chemical Products. TODAY'S ANSWER FOR THE PROTECTION OF TOMORROW'S ENVIRONMENT sw n ®MMI NORWECO,INC.220 REPUBLIC STREET NORWALK,OHIO U.S.A.448571196 PHONE:(419)6684471 FAX:(419)6133-5440w n"w .wm NO POSTAGE NECESSARY IF MAILED IN THE UNITED STATES BUSINESS REPLY MAIL FIRST CLASS MAIL PERMIT NO. 7 NORWALK, OHIO POSTAGE WILL BE PAID BY ADDRESSEE NORWECO, INC. PO Box 410 Norwalk, OH 44857-9932 Commonwealth of Massachusetts Salem, Massachusetts System Pumpin¢Record System Owner & Address: Michael Clukey 33 Appleby Road Salem, Ma 01970 Location of system: Rear Date of Pumping: November 9, 2011 I` Type of system: Septic TankOV N ry J O Gallons Pumped: 1000 gallons e� rOFSA 2011 System humped by: Service Pumping& Drain Co., Inc. 5 Hallberg Park North Reading, MA 01864 License#: BHP-2010-0358 License#: BHP-2010-0357 Contents transferred to: Fitchburg Treatment Plant Date: November..9, 201.1 •m -w - .. •q!Pumping Technician :,PD " This is PROPRIETARY and CONFIDENTIAL information that may be used only by the Board of Health for regulatory purposes Commonwealth of Massachusetts Salem, Massachusetts System Pumping Record System Owner & address: Michael Clukey 33 Appleby Road Salem, Ma 01970 Location of system: Rear Date of Pumping: October 19, 2009 Type of system: Septic Gallons Pumped: 1000 gallons System pumped by: Service Pumping& Drain Co., Inc. 5 Hallberg Park North Reading, MA 01864 License #: BHP 2009-0388 and BHP-2009-0387 Contents transferred to: Fitchburg Treatment Plant Date:`i.Octobet19;2008 � ,,';,;,t `a N. ;�P&rAPumpingTechnician: PK This is PROPRIETARY and CONFIDENTIAL information that may be used only by the Board of Health for regulatory purposes Commonwealth of Massachusetts Salem, Massachusetts System Pumping Record System Owner& address: John Collins RECEIVE 33 Appleby RoadMAY 2 12007 Salem, MA ';RTY OF Si?LEM Location of system: Rear 3ur,ZD OF HEALTH Date of Pumping: April 27, 2007 Type of system: Septic tank Gallons Pumped: 1000 gallons System pumped by: Service Pumping & Drain Co., Inc. 5 Hallberg Park North Reading, MA 01864 License#: BHP 2007-0255, BHP 2007-0254 Contents transferred to: Fitchburg Treatment Plant Date: April 27, 2007.,,,,'"—Z% Pumping Techniciaw,MW This is PROPRIETARY and CONFIDENTIAL information that may be used only by the Board of Health for regulatory purposes tV > ; vt eT FORM 4-SYSTEM PUMPING RECORD a �t 107 F0 �u '+ � �ft- w*t- PD�, JUN 6 9999 4^+^3rs <e kl. XY CITY OF SHI t HEALTH DEPT I i TH OF MASSACHUSETTS tc r= try uf} MASSACHUSETTS - 4 t ��SYSTEM*PUMPING RECORD • - ,K `� IPM SYS OWNER.* H s �� [ r 4 M SYSTEM LOCATION: �y s � ' A Cr +r?,p a ty'�"yy� .it• t -_ �(/.�f,�/�C/C �,�- 'Ceti o wl ip yg yt, 9 Ya = c. � u ti.�q✓y F' FY',Y�. .'� , Vim, �t+d rte {?? r / - k 3' TIT x `QUANY PUMPED � a W. �qq i ' G41,tdQNS ,•� W. 1 ��v+ ��, j t ` v.� vat � F r '[ �. I ANO z fiSEPTIC T r YES ANK: � . PUMPER k '$X CURRIER`SEPTIC& DRAIN SERVICE )A � Y 4 ' t ' INSPECTOR w eater r�--}• �F div# s ti ? .m s v � �+co�+t w. r`�^• & Nt *��'ci � 3,0 +�rt � +�!'',� A4 2?* t' .w^W. .fir t .. ,M• �y }�.� it ..,�''„ �;��• �+• ' aI� / 1�`i`t^.�` r.k ,i �5,`s. t °P .b1 I t d`yJ`rAp`� " t ,.a m.r y: ' t Commonwealth of Massachusetts Salem, Massachusetts System Pumpine Record System Owner & address: John Collins ;,' ( n --7�33 Appleby Road I' I] Salem, MA V MAY 2 a 200 Location of system: Rear CITY OF SALEM Date of Pumping: April 24, 2006 BOARD OF HEALTH Type of system: Septic tank Gallons Pumped: 1000 gallons System pumped by: Service Pumping &Drain Co., Inc. License #: 012-04 0 Contents transferred to: Fitchburg Treatment Plant Date: April 24, 2006 .. Pumping Technician: CC This is PROPRIETARY and CONFIDENTIAL information that may be used only by the Board of Health for regulatory purposes PORTANT MESSAGE FOR DATE �U TIME M OF '�- -G4� .XLLrO PHONE AREA CODE NUMBER EXTENSION ❑ FAX ❑ MOBILE AREA CODE NUMBER TIME TO CALL TELEPHONED PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU ` RUSH RETURNED YOUR CALL WILL FAX TO YOU MESSAGE C CSO q� 6S SIGNED FORM 4009 wrops. MAOE IN U.S.A. ca CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH e 120 WASHINGTON . - - SALEM, MA 01970i11 _ TEL. 97B-741-1800 FAX 978-745-0343 STANLEY LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 6'j 60�(A[t T October 30, 2001 John Collins & Susan Sanderson 0� 33 Appleby Road Salem, MA. 01970 Dear Sir/ Madam: In accordance with the State Environmental Code Title V: Minimum Requirements for / the Subsurface Disposal of Sanitary Sewage, whenever a septic tank or cesspool is pumped, its condition shall be noted on a system pumping form approved by the DEP, and the results shall be submitted to the local Board of Health. The Salem Board of Health has no records regarding system pumping for your property located at 33 Appleby Road, Salem. Please forward the following information to this office upon receipt of this letter: - copy of the three (3) most recent system pumping records. - Name, address, and phone number of company used to pump tank. I thank you for your anticipated cooperation in this matter. If you have any questions please call me at 978-741-1800. Sincerely, Jeffrey Vaughan Sr. Sanitarian I ✓ �� CG��s _J, �- �� F?OU-06-2001 14:50 FROM: TO:97e 740 9705 P.002'002 r" FORM 4 - SYSTEM PU14PING RECORD Commonwealth of Massachusetts Salem ,Massachusetts S►Stem Pumping Record , - 9 n Dwncr: System Lor: ?Lion: Collins rear yard 33 Appleby Road Salem Ma 01970 Date of Pumping; June 27,2001 Quantity Pumped: 7.000 gallons Ceespool: No /X/Yes / / Septic Tank: No / / Yes /X/ Sy:twn Pumped by: Service Pumoina R Train Co.,, Inc. Licen e $ 55=01 Contents transferred to: SESD Date: _Octobez ,L,2007 Pumper: B.L. This is PROPRIETARY and CONFIDENTIAL information that may be used only by the Board of Health for regulatory purposes. NOU-06-2001 14:50 FROM: TO:978 740 9705 P.001'002 Service Pumping & Drain Co. Inc. Sewer Cleaning Contractors 5 Hallberg Park North Reading Mass 01864 Phone (978) 276-0217 Fax (978) 276-0548 (800) 794-9265 servicepumping@aol.com F A X T R A N S M I T T A L M E M O To Jeff / Salem Board of Health From Mitch Date October 6, 2001 Re Collins Disposal Report. Fax # 978-745-0343 # of pages: 2 (including this cover sheet) X Deliver Immediately Personal. & Confidential _Reply Requested _Other Comments: If you have 'received this fax in error or if you did not 'receive all pages, please contact the office at the above number. Thank you. CITY OF SALEM, MASSACHUSETTS a BOARD OF HEALTH120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT November 6, 2001 Service Pumping & Drain Co. 5 Hallberg Park North Reading, MA. 01864 To whom it may concern: Please consider this as a reminder that in accordance with the State Environmental Code Title V: Minimum requirements for the Subsurface Disposal of Sanitary Sewage, whenever a septic tank or cesspool is pumped, its condition shall be noted on a system pumping form approved by the DEP, and the results shall be submitted to the local Board of Health. Our mailing address is: Salem Board of Health 120 Washington Street 41h Floor Salem, MA. 01970-3523 If you have any questions regarding this letter please call me at 978-741-1800. Thank vou. Sincerely, Jeffrey Vaughan Sr. Sanitarian Cc: DEP—NE Region