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119 Title 5 Pumping Record 2015 System Pumping Report Greg's Wastewater Removal 239 A Greenfield Road South Deerfield,MA 01373 Phone 413-665-3989 Fax 413-665-7358 ****** This report will be sent to the BOARD OF HEALTH within 15 DAYS ****** Permit# t3HP-7015--02J3 MA License# Date of Pumping C / I3/ I5 Property Owner NOONIE HAMMARLUND Home Phone Bus Phone Cell Phone 413-584-5887 Tank Size: 1000 GAL Concrete Good Tank Location MAP ON FILE (WEST SIDE) Address Address 2 Address 3 RENTAL City FLORENCE State MA Zip Code 01062 Total Volume: / 00Q C-rmi Septic N. Holding Tank Leach Tank Cesspool Grease Trap Date of Previous Pumping,If Known: Waste Received at Licensed Facility: Licensed Facility Phone Number: Town: 9- 13 -/3 0"1 Qrcic`ct -1-73 - ggo\i Miss Comments: Driver: f ,Lf Created 6/1/2015 at 2:06:07 PM Page 1 of 1