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HomeMy WebLinkAboutSeptic Pump 4/27/20 YARMOUTH - DENNIS SEPTAGE TREATMENT FACILITY System Identification Town Pumped Telephone # No. Street I Village I - Owner's Name: u-0'f��✓`- /(t-// (��n 0`' 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: !r)('r'1 Comment: Pumped By Licensed Pumper: 5CCUf `fit fJ ` Truck License No.: Date: 7 17 Ze}2G / Driver Name: Signature: Septage Received at Yarmouth - Dennis Approved by: Date: Received: Gallons Ticket#