HomeMy WebLinkAboutSeptic Pump 4/27/20 YARMOUTH - DENNIS SEPTAGE TREATMENT FACILITY
J/ System Identification
Town Pumped Telephone#
No. Street T; GI `T .
1 Village
Owner's Name: >nL i 7( ( '
Mail Address:
(if different)
Use: Residence k. 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: z raw( P r�
Truck License No.: Date' 1/_ ?" 207G
Driver Name:
t
Signature: G`
f Septage Received at Yarmouth - Dennis
Approved by: Date:
Received: Gallons Ticket#