HomeMy WebLinkAboutSeptic Pump 7/11/22 Yarmouth Septage Treatment Facility
YCAtilcxh—System Identification
Town Pumped Tele ne#
/ p
No. r Street ( 9 r f
Village
D-&cP& 5 CCSO
Owner's Name
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: / C) Comment:
Hauler Info • ation ,
Company:
Truck No.: % Z
Driver Name:
Driver's Signature:
Septage Received at Yarmouth
Weighmaster Initials: M J f. Date: —)/1h/2_
Gallons Received: / 6'0 0 Ticket#: Z y 2.