HomeMy WebLinkAboutSeptic Pump 4/22/20 YARMOUTH- DENNIS SEPTAGE TREATMENT FACILITY
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System Identification
Town Pumped Telephone #
6-4((Pi/ T
No. Street
Village
/
Owner's Name: r J!�C ���j �� �
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: 'Lk] Comment:
Pumped By
Licensed Pumper: r.)` ���` f� vL/
Truck License No.: Date:
Driver Name:
Signature:
Septage Received at Yarmouth - Dennis
Approved by: Date:
Received: Gallons Ticket#