Lot 88 Title 5 Pumping Record 2010 System Pumping Greg's Wastewater Removal
239 A Greenfield Road
South Deerfield,MA 01373
Phone 413-6654989 Fax 413-665-7358
*** This report will be sent to the BOARD OF HEALTH within 15 DAYS ******
Permit# g.1P-7ar,-074 MA License# Date of Pumping O 1 is l )C)
Property Owner ROBERTA MATUSON
Home Phone
Bus Phone
Cell Phone
Tank Size:
413-582-1840
1500 GAL
Concrete
Good
Address 88 MAPLE RIDGE ROAD
Address 2
Address 3
City FLORENCE
State MA Zip Code 01062
Tank Location MAP ON FILE
Septic x Holding Tank Leach Tank
Date of Previous Pumping, If Known:
Waste Received at Licensed Facility:
Licensed Facility Phone Number:
FLY
Town:
Misc Comments:
Driver: Z(�
LI - 26 -67
Total Volume: 15CC) 6� I
Cesspool Grease Trap
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Created 8/12/2010
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