HomeMy WebLinkAboutSeptic Pump 4/23/20 YARMOUTH- DENNIS SEPTAGE TREATMENT FACILITY
System Identification
Town Pumped Telephone#
A7
No. `-1 Street � t rl a J (
Village
Owner's Name: )-r !rr fI (cArr,0 5-
Mail Address:
(if different)
Use: Residence ___ Business Name
f„
Reason Pumped: Maintenance Overflow Blockage
Pumper's Observations
f
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: 11 � � f`�'"
rTruck License No.: te: C Z Zo 20
/ I
Driver Name:
Signature:
Septage Received at Yarmouth - Dennis
Approved by: Date:
Received: Gallons Ticket#