HomeMy WebLinkAboutSeptic Pump 4/23/20 YARMOUTH- DENNIS SEPTAGE TREATMENT FACILITY
`� „ System Identification
Town Pumped Telephone#
No. J Street t (i L
Village 1 �
Owner's Name: ` l,,5-- 7/// (O/"r
Mail Address:
(if different)
Use: Residence --'`\._ Business Name
Reason Pumped: Maintenance Overflow Blockage
Pumper's Observations
Facility Septic Tank L. Cesspool Converted Cesspool
Pumped: Holding Tank Leach Facility Grease Trap
(s)
Cover within 1 foot? Yes ' No Back Flow? Yes — No-
Gallons Pumped: - Comment:
Pumped By
Licensed Pumper: �--% M3rev S P r C
Truck License No.: Da /- 2 3' 7070
:::
me:
g
Septage Received at Yarmouth - Dennis
Approved by: Date:
Received: Gallons Ticket#