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HomeMy WebLinkAboutSeptic Pump 12/2/19 YARMOUTH- DENNIS SEPTAGE TREATMENT FACILITY `.e System Identification 7 -, =) VT 11,9_,_ /i& L._ -/ Town Pumped Telephone # No. i Street -'Zj7 "( Village Owner's Name: ": �t ; e.{._ 6-z-_vy / - s Mail Address: (if different) Use: Residence Business Name / Reason Pumped: Maintenance Overflow Blockage 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: �p77 Comment: Pumped By Licensed Pumper: -?,1/ Truck License No.: Date: / / 9 Driver Name: 'i r Signature: Septage Received at Yarmouth - Dennis Approved by: ift�,J •S Date: /211 u 5 77 �, Received: Gallons Ticket#