HomeMy WebLinkAboutSeptic Pump 4/22/20 YARMOUTH- DENNIS SEPTAGE TREATMENT FACILITY
System Identification
Town Pumped Telephone#
No. . Street
Village Owner's Name: Dok- (//�
dl'C/la 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? Yes No Back Flow? Yes — No -
Gallons Pumped: Comment:
Pumped By
Licensed Pumper: 1 ` ��-�'C,_
Truck License No.: Date: Z L
:::me
: l/
:
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Septage Received at Yarmouth - Dennis
Approved by: Date:
Received: Gallons Ticket#