173 Pump Report 11-2-17 System Pumping Report
Greg's Wastewater Removal
239 A Greenfield Road
South Deerfield,MA 01373
Phone 413-665-3989 Fax 413665-7358
****** This report
will be sent to the BOARD OF HEALTH within 15 DAYS "n***
Permit#12) 010\ 19 MA License# Date of Pumping I \ /l'9\ / j-1
0303
Property Owner MARY BATES Address 173 MAPLE RIDGE ROAD
Address 2
Home Phone 413-586-6386 Address 3
Bus Phone City FLORENCE
Cell Phone State MA Zip Code 01062
Total Volume: /a(-0L7 - _
Tank Size: 1500 GAL
Concrete
Good
Tank Location MAP ON FILE, 10"DEEP
Septic Holding Tank ' _ I Leach Tank ICesspool ; Grease Trap
R
Date of Previous Pumping,If Known: )£1 ) 109
Waste Received at Licensed Facility: fn or\-k C( L/A
Licensed Facility Phone Number:
Town: n() C)1( CV! A
Misc Comments:
Driver: "bp?
Created 11/7/2017 at 9'59:57 AM Page 1 of 1