HomeMy WebLinkAboutSeptic Pump 4/22/20 YARMOUTH- DENNIS SEPTAGE TREATMENT FACILITY
\/ �G��n System Identification
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Town Pumped pia
, Telephone#
No. 1') Street W a-(
Village
Owner's Name: Db S // // / 1
Mail Address:
(if different)
Use: Residence % Business Name
n
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: r ''o Comment:
Pumped By
Licensed Pumper: ,i�
5<cri�- S2 '1, (-
4' 1/... 2,2 - ?0/0
Truck License No.: -G- D e:
r, r '
Driver Name: l�
Signature:
Septage Received at Yarmouth - Dennis
Approved by: Date: —
Received: Gallons Ticket#