HomeMy WebLinkAboutSeptic Pump 6/23/20 - 2 YARMOUTH- DENNIS SEPTAGE TREATMENT FACILITY
System Identification .1 1
Town Pumped Telephone#
No. Street 7 �L ..
Village --
Owner's Name: -R /
Mail Address:
(if different)
Use: Residence Business Name
Reason Pumped: Maintenance Overflow Blockage
Pumper's Observations
Facility Septic Tank f 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:
Truck License No.: Date:
Driver Name:
Signature:
Septage Received at Yarmouth - Dennis
Approved by: Date:
Received: Gallons Ticket#