HomeMy WebLinkAboutSeptic Pump 4/28/20 YARMOUTH- DENNIS SEPTAGE TREATMENT FACILITY
tem Identification
I
Town Pumped // Telephone#
No. Street 7(� ',P
Village
Owner's Name: .1/. !/ 1,-),,,-to
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: Comment: -
Pumped By
Licensed Pumper: C. :5T0(11 C
Truck License No.: Date: � 7070
Driver Name:
Signature:
Septage Received at Yarmouth - Dennis
Approved by: Date:
Received: Gallons Ticket#