HomeMy WebLinkAboutSeptic Pump 5/29/20 YARMOUTH - DENNIS SEPTAGE TREATMENT FACILITY
/ (M`-„ ! System Identification
Town Pumped Telephone#
S 0
No. Street (1-e t ( 1 ((
Village
Owner's Name:
Mail Address:
(if different)
Use: Residence Business Name
Reason Pumped: Maintenance Overflow Blockage
t
Pumper's Observations
Facility Septic Tank Cesspool Converted Cesspool
Pumped: Holding Tank Leach Facility Grease Trap
Cover within 1 foot? Yes No Back Flow? Yes — No
Gallons Pumped: ! U0
Comment:
,- Pumped By
Licensed Pumper:
Truck License No.: Date: Z 20,76
Driver Name:
Signature: rri
,
Septage Received at Yarmouth - Dennis
Approved by: Date:
Received: Gallons Ticket#