HomeMy WebLinkAboutSeptic Pump 6/14/22 Yarmouth Septage Treatment Facility
System Identification
Town Pumped X G(N1�t I Telephone#
No. ( Street � "7
Village
Owner's Name
DeL 4/:1t ram/0 s
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
Cover within 1 foot? Yes CL No Back Flow? Yes No i
' r • r�
Gallons Pumped: Comment:
Hauler'Information
Company:
•
Truck No.: Date:
Driver Name:
Driver's Signature:
Septage Received at Yarmouth
Weighmaster Initials: Date:
Gallons Received: Ticket#: