HomeMy WebLinkAboutSeptic Pump 7/19/22 Yarmouth Septage Treatment Facility
System Identification
Town Pumped yc•qicicx.,441 Telephone#
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No. ' __ ! Street 9ocJCcJ/\ 54
-
Village
Owner's Name / ( P
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Use: Residence Business Restaurant? Yes No
Reason Pumped: Maintenance " Overflow Blockage
Pumper's Observations - Facility Pumped
Septic Tank Cesspool Converted Cesspool
Holding Tank Leach Facility Grease Trap
Porta-Potty Lift Station Other Wastewater Plant
r Cover within 1 foot? Yes No Back Flow? Yes No '�
Gallons Pumped: / 6 Oo Comment:
Hauler Information
Company: :t, ,,
!iI /ej-Truck No.: te: ? Z
Driver Name:
Driver's Signature: -
Septage Received at Yarmouth I
Weighmaster Initials: �' � � Date: t 9 -c)( `�j
Gallons Received: Ticket#: 3 t