HomeMy WebLinkAboutSeptic Pump 4/27/20 YARMOUTH- DENNIS SEPTAGE TREATMENT FACILITY
System Identification
Town Pumped l Telephone#
Al
No. Street 41' 1'� ff'c ,� U" Pr
Village
Owner's Name: ri- /
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:
rrY1': rlf r
Truck License No.: Date:
Driver Name:
Signature:
Septage Received at Yarmouth - Dennis
Approved by: Date:
Received: Gallons Ticket#