820 Pump Report 11-8-16 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#�U�IT Lf,\(,0• MA License# Date of Pumping \ \ /� /)�
03D3
Address 820 NORTH KING STREET
Property Owner R.J.BARTLETT Address 2
Home Phone 413-586-9435 Address 3
Bus Phone City NORTHAMPTON
Cell Phone State MA Zip Code 01060
Total Volume: 61)(--)
Tank Size: 500 GAL
Concrete
Fair
Tank Location MAP ON BACK
Septic Holding Tank ( Leach Tank I Cesspool Grease Trap
Date of Previous Pumping, If Known: I\r0-)1°
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Waste Received at Licensed Facility: 1 1 i�i\ ' c�1�A
Licensed Facility Phone Number: �� `�
Town: \t\ 1A (Vi1i
Misc Comments:
Driver:
SK
Created 11/15/2017 at 9,41:45 AM Page 1 of 1