HomeMy WebLinkAboutSeptic Pump 7/11/22 Yarmouth Septage Treatment Facility
•
System Identification
If ti
Town Pumped (Mc elepho #
No. r Stree Q 5 1, 1
Village
,c)efrµ 1( (cinjor
Owner's Name
Use: Residence Business Restaurant? Yes No
Reason Pumped: Maintenance Overflow Blockage
Pump'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 L No Back Flow? Yes No
j&
Gallons Pumped: ��— Comment:
Hauler Information
Company: "felt: id/6
Truck No..•
��(� 2 Z
9.64/
Driver Name:
Driver's Signature:
Septage Received at Yarmouth,
Weighmaster Initials: Date:
Gallons Received: Ticket#: 77 "j