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Septic Pump 5/15/20
YARMOUTH- DENNIS SEPTAGE TREATMENT FACILITY ivOu., System Identification Town Pumped Telephone# No. Vf L� U�(Street 't°(Vi/f( Village Owner's Name: kk7 ,)� y C/l f� Mail Address: (if different) Use: Residence Business 7 ,Name Reason Pumped: Maintenance ---- Overflow Blockage Pump's Observations Facility Septic Tank iy Cesspool Converted Cesspool Pumped: Holding Tank Leach Facility Grease Trap Cover within 1 foot? Yes No Back Flow? Yes— No '""--- Gallons Pumped: IL) CI Comment: Pumped Licensed Pumper: J i5rOCJ( Truck License No.: Date: ( � Driver Name: �C/"" Signature: (,'` :� Septage Received at Yarmouth - Dennis Approved by: Date: Received: Gallons Ticket#