HomeMy WebLinkAboutSeptic Pump 4/23/20 YARMOUTH - DENNIS SEPTAGE TREATMENT FACILITY
System Identification
Town Pumped Telephone#
No. Street
Village / f
Owner's Name: .0'Q v 5 1l /( (0i145
Mail Address:
(if different)
Use: Residence Business Name
Reason Pumped: Maintenance„.-`(1 Overflow Blockage
Pumper's Observations
Facility --C";
Septic TankCesspool Converted Cesspool
Pumped: Holding Tank Leach Facility Grease Trap
Cover within 1 foot? Yes No Back Flow? Yes — N&
Gallons Pumped: Comment:
Pumped Bey^
Licensed Pumper: + (air 570/0 l C
Truck License No.: Date: 73-7G. G
Driver Name:
Signature: i'�/�11 l '
Septage Received at Yarmouth - Dennis
Approved by: Date:
Received: Gallons Ticket#