HomeMy WebLinkAboutSeptic Pump 4/27/20 YARMOUTH- DENNIS SEPTAGE TREATMENT FACILITY
System Identification
Town Pumped Telephone#
No. Street , V F�^fP�r��
Village
Owner's Name: r C,� �� // CCcca
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
) y , ,1 �
Licensed Pumper: �'4' � C
F l/� 7
Truck License No.: Date: 6/1l ?Ct
f Driver Name:
Signature: //4 !!f'
Septage Received at Yarmouth - Dennis
Approved by: Date:
Received: Gallons Ticket#