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123 Title 5 Pumping Record 2010 System Pumping Report Greg's Wastewater Removal 239 A Greenfield Road South Deerfield, MA 01373 Phone 413-665-3989 Fax 413-665-7358 This s report will be sent to the BOARD OF HEALTH within 15 DAYS ****** Permit#dvP�0-o20U9-07Y MA License# Date of Pumping 08103, /0 Property Owner NOONIE HAMMARLUND Home Phone Bus Phone Cell Phone Tank Size: 413-584-5887 1500 GAL Concrete Good Address 123 MEADOW STREET Address 2 MAIN HOUSE Address 3 City FLORENCE State MA Zip Code 01062 Total Volume: AS 00 ?O. Tank Location MAP ON FILE (NORTH SIDE) Septic )(Holding Tank Leach Tank ! Cesspool Grease Trap Date of Previous Pumping, If Known: Waste Received at Licensed Facility* Licensed Facility Phone Number: Town: ariizict wafJn° 4/d d -x700 Misc Comments: Driver: Created 8/3/2010 at 437:58 PM 2 Page 1 of 1