HomeMy WebLinkAboutSeptic Pump 7/12/22 Yarmouth Septage Treatment Facility
System dentification
Town Pumped yo.Qt1w. le ne#
No. ( Street `p S [11
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Village
Owner's Name
DP*6.5 ,4 l( ( jo s
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: ! 00 Comment:
Hauler Information
Company: ; ' '
Truck No.: ate: '
Driver Name:
Driver's Signature:
Septage Received at Yarmouth
Weighmaster Initials: -? -2 /_/
Date: ����
Gallons Received: I (WO Ticket#: