HomeMy WebLinkAboutSeptic Pump 6/14/22 Yarmouth Septage Treatment Facility
System Identification
Town Pumped Y��'l 44
Telephone#'
No. Street 1)..-0 4 5 (`�'
Village l 1 /
Owner's Name I �o h? S f f t•/� ( C1/i o/o
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_ 'No Back Flow? Yes No
/r?�cC�
Gallons Pumped: Comment:
Hauler Information
Company: U`
Truck No.: Date: _- f `
Driver Name:
stir,
Driver's Signature:
Septage Received at Yarmouth
Weighmaster Initials: Date: •
Gallons Received: Ticket#: /f0,