HomeMy WebLinkAboutSeptic Pump 4/27/20 YARMOUTH— DENNIS SEPTAGE TREATMENT FACILITY
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(A1,\ System Identification
Town Pumped Telephone#
No. Street O'65 {'u"`-`
Village
Owner's Name: ( S. 1/ (c)!'t?C>
Mail Address:
(if different)
Use: Residence Business Name
Reason Pumped: Maintenance Overflow Blockage
Pumper's Observations
Facility Septic Tank Cesspool Converted Cesspool
Pumped: Holding Tank Leach Facility Grease Trap
Cover within 1 foot? Yes No Back Flow? Yes — No
Gallons Pumped: Comment:
Pumped By
Licensed Pumper:
`!'('X�(`tP
Truck License No.: Dat . ! "-2 /f 7o7
Driver Name: i
Signature:
Septage Received at Yarmouth - Dennis
Approved by: Date:
Received: Gallons Ticket#