HomeMy WebLinkAboutSeptic Pump 4/22/20 YARMOUTH- DENNIS SEPTAGE TREATMENT FACILITY
System Identification
Town Pumped Telephone#
" ( I j (
No. Street i 1
Village Owner's Name: 'DP 5 .)V/ (OW% 5
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?JJ Yes No Back Flow? Yes — No
Gallons Pumped: /00OJ Comment:
Pumped By
Licensed Pumper: ka , jcOUl ' C
Truck License No.: 4- Date:
Driver Name: j .,
Signature:
Septage Received at Yarmouth - Dennis
Approved by: Date:
Received: Gallons Ticket#