HomeMy WebLinkAboutSeptic Pump 6/20/22 I '
Yarmouth Septage Treatment Facility
System Ident' 'cation
Town Pumped T le hone#
No. Street ?
Village Owner's Name L` , r'� 1(U(4//
Use: Residence Business Restaurant? Yes No
Reason Pumped: Maintenance Overflow Blockage
Pumper's Observations - Facility Pumped
Septic Tank Cesspool Converted Cesspool
Holding Tank Leach Facility Grease Trap
Porta-Potty Lift Station Other Wastewater Plant
Cover within 1 foot? Yes No Back Flow? Yes No -"
Gallons Pumped: t C ° Comment:
CHauler Information
Company: j�' ' r�f` �
Truck No.: I / �j`7 0- 72
!zt,Driver Name: /� "
Driver's Signature:
Septage Received at Yarmouth
Weighmaster Initials: 01,7S Date: /6`21)/2 Z
Gallons Received: I bOd Ticket it: 2 y 2/3