HomeMy WebLinkAboutSeptic Pump 4/27/20 YARMOUTH- DENNIS SEPTAGE TREATMENT FACILITY
6' mou-n System Identification
Town Pumped Telephone#
-11 No. "IS Street 4!,
Village
c r
Owner's Name: ) 4l 11 ` a G5
Mail Address:
(if different)
Use: Residence Business, —) Name
Reason Pumped: Maintenance' Overflow Blockage
Pumper's Observations
Facility Septic Tank C Cesspool Converted Cesspool _—
Pumped: Holding Tank Leach Facility Grease Trap
(.2
Cover within 1 foot? Yes No _ Back Flow? Yes — N�
Gallons Pumped: C' Comment:
Pumped By
Licensed Pumper: = «I -S /I
Truck License No.: Day
Driver Name: "4/
/t
Signature: •
Septage Received at Yarmouth - Dennis
Approved by: Date:
Received: Gallons Ticket#