HomeMy WebLinkAboutSeptic Pump 7/11/22 Yarmouth Septage Treatment Facility
System Identification
Town Pumped - :F ' `-
NStreet Q!5 4, I
�TjelepJ� #
o �l`yy
Village
Owner's Name ' (( 5'
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
Gallons Pumped: Comment:
Hauler Information
Company: f f
Truck No.: 7-f( 2 Z
Driver Name: ///7
,
Driver's Signature:
J
Septage Received at Yarmouth
Weighmaster Initials: /ir Date: 7/11/ 7.-
Gallons Received: /ierQ Ticket#: 2-'JZ 7'3 T