HomeMy WebLinkAboutSeptic Pump 4/22/20 YARMOUTH— DENNIS SEPTAGE TREATMENT FACILITY
1 System Identification
r Jc
r� H
Town Pumped /� Telephone#
W No. Street U ( (r() )2
Village
Owner's Name: eb 77: ` (o I'_A
I
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:
II- 22-Z02G
Truck License No.: Date:
Driver Name: 1)
Signature: C
Septage Received at Yarmouth - Dennis
Approved by: Date:
Received: Gallons Ticket#