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HomeMy WebLinkAboutSeptic Pump 4/27/20 YARMOUTH- DENNIS SEPTAGE TREATMENT FACILITY • /�( !:. , System Identification Town Pumped Telephone# No. Street �` riciA Village /�(� Owner's Name: ..,J- 5I 'l( (Gn Mail Address: (if different) Use: Residence Business Name (2 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 /0e2r) Gallons Pumped: Comment: Pumped By Licensed Pumper: 7 Truck License No.: Date: /� G { ~ �G C Driver Name: Signature: X Septage Received at Yarmouth - Dennis Approved by: Date: Received: Gallons Ticket#