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25 Septic Pumping Records 2016 Commonwealth of Massachusetts Massachusetts System Pumping Record ACM A nnnn Form 4--System Pumping Record■% System Owner New England Deaconess Assoc. BO Deaconess Road Concord, MA, 01742 (978)-931-3095 x System Location OS - Rock Ridge Retirement Community 25 Coles Meadow Road Northampton, MA, 01060 (617)-959-119B .x New England Deaconess Assoc. Types: Emergency{ Cesspool: No Date of Pumping: Routine Yes Septic Tank: No Yesr Quantity Pumped:_Gallons System Pumped By: Wind River Environmental,LLC Contents Transferred to: Permit#: Contents Disposed at: USb I-ao °Ib Date: I � ON� � � Condition of System/Other Comments Pumper Signature: i3/419 Level tedon ,vRr Dep Approved Form-12/07/95 - I 0252014342 L Commonwealth of Massachusetts Massachusetts System Pumping Record 08/14/2002 Form 4--System Pumping Record System Owner New England Deaconess Assoc. 80 Deaconess Road Concord, MA, 01742 (978)-031-3085 x System Location 90 - Rock Ridge Retirement Community 25 Coles Meadow Road Northampton, MA, 01060 (617) -9+9-1190 x New England Deaconess Assoc. Type: Emergency{ C Cesspool: Date of Pumping: f —, — ico Routine Yes System Pumped By: Wind River Environmental,LLC Contents Transferred to: Ti Septic Tank: No Sr Yes Quantity Pumped:'+ O6 Gallons Permit*: Contents Disposed at: u•bv) Date: r 23—/(0 Pumper Signature Condition of System/Other Convnents / /1(60 U Pali C /01.9572.C. Pliormimedn• Dep Approved Form-12/07/95 • Commonwealth of Massachusetts Massachusetts System Pumping Record nRNGnnn0 Form 4--System Pumping Record i% System Owner New England Deaconess Assoc. 80 Deaconess Road Concord, MA, 01742 (97B)-831-3005 x System Location OS - Rock Ridge Retirement Community 25 Coles Meadow Road Northampton, MA, 01060 (617)-959-1168 x New England Deaconess Assoc. Type: Emergency ✓ Cesspool: No Date of Pumping: / Routine Yes Septic Tank: Quantity Pumped No c'IicW YesrL Gallons System Pumped By: Wind River Environmental,LLC Permit#: Contents Transferred to: Ntti Contents Disposed at: 1g5.1cp Dare: (-ZS—/c. Condition of System/Other Comments Pumper Signature: numedmrecyceinwt, Dep Approved Form-12/07/95 Z � 0252014350 Commonwealth of Massachusetts Massachusetts System Pumping Record 08/1412002 Form 4--System Pumping Record System Owner' New England Deaconess Assoc. 80 DeadDbess Road Concord, MA, 01742 (978)-831-3095 x Type: Em Routine Cesspool: No Yes es Date of Pumping: %- 4- 'f/1 System Location OS - Rock Ridge Retirement Community 25 Co1es Meadow Road Northampton, MA, 01060 (617)-959-1108 x New England Deaconess Assoc. Septic Tank: No Yes Quantity Pumped: .' Gallons System Pumped By: Wind River Environmental,LLC Permit#: Contents Transferred to: Contents Disposed at: �i eith d 112 Date: Condition of System/Other Comments Pumper Signature: Arm BK - 01-261- ph E;$,nl-t7t Printed on recycled paper Dep Approved Form-12/07/95