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HomeMy WebLinkAboutSeptic Pump 4/23/20 YARMOUTH - DENNIS SEPTAGE TREATMENT FACILITY System Identification Town Pumped Telephone# No. Street , , _ i J Village Owner's Name: ;)+ b` / f 11 cotylo 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: !f�0C Comment: Pumped By Licensed Pumper: 111 /(1- 23. zozo Truck License No.: Date:J. ::::e : ' ' ` Septage Received at Yarmouth - Dennis Approved by: Date: Received: Gallons Ticket#