HomeMy WebLinkAboutSeptic Pump 7/12/22 4
Yarmouth Septage Treatment Facility
- System I entification
Town Pumped ttfl-fa i #
No. Street < ( 1 •b
Village Owner's Name A-96'5 Yi( a 11M
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
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Gallons Pumped: Comment:
Hauler Information
Company:
Truck No.:
1
Driver Name:
/ ,/f
I Driver's Signature: / ''
Septage Received at Yarmouth
Weighmaster Initials: Date: /// Z/ 3
1
Gallons Received: ,w:.� Ticket#: (i