HomeMy WebLinkAboutSeptic Pump 7/11/22 Yarmouth Septage Treatment Facility
ntification
Town Pumped \/System
AMU c, o ele h #
No. / Street ��/�? f '(f c1 F
Village
Owner's Name1(-(1 (drol05'
Use: Residence Business Restaurant? Yes No
Reason Pumped: Maintenance (l 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: ( (9 ' Comment:
Hauler Information
Company: C)(
Truck No.: Da -,.
Driver Name: `
/
Driver's Signature:
Septage Received at Yarmouth
Weighmaster Initials: _
Date: 7/6/°
s Gallons Received: Ticket#: 2 7 7
I/