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HomeMy WebLinkAboutSeptic Pump 6/5/20 YARMOUTH- DENNIS SEPTAGE TREATMENT FA,CfGT ystem Identification (...."L„..„-- Town,:, ":.,,> _\//57,1,,,///, ,,,t) Pumped / Telephone# No. � 7 Street c/�f/ p� Village_ Owner's Name: ( ��-e _e-f - `(afr, ), / 643f Si Mail Address: (if different) _ .— ,n ,7 Use: Residence Business Name Reason Pumped: Maintenance (/Overflow Blockage Pumper's Observations Facility Septic Tank pesspool Converted Cesspool Pumped: Holding Tank t Leach Facility Grease Trap L.7 7'3 / 2' Cover within 1 foot? Yes No Back Flow? Yes _ No m Comment: �6" %%ram}/ Gallons Pumped: i Pumped By (- 04_--,e (0-( z_._. i , ,�, Licensed Pumper: 7- /.. Truck License No.: S Date: O Driver Name: f�L./ —,)C�G—.e—'C Signature: Septage Received at Yarmouth - Dennis Approved by: Date: C/SS/ }° 0, 1 V '� . Received: ' Gallons Ticket# y + �� 7 7 i +. .h _ a= ',ate-r�.� �,, , .� -f+rygiy �� sp wa v3s5v,�31 ;?1.!tea" _ Y - ,te.tT' �� Fi xd - :. - ', - r . ,�� .,..ae ' _2. • r - ` "" }j .:M.+ Gaf: _ SAP -;;*•' ''''-:, I..-z:p,,77:=.-Kik,....7'''' S -iiitia et-� w a taw -* ..,,...-.-47 ...�.. _ r..'t C`.F€£-. t ,,:g.F_ -