9 Pump Report 10-27-17 System Pumping Report
Greg's Wastewater Removal
239 A Greenfield Road
South Deerfield, MA 01373
Phone 413-665-3989 Fax 413-665-7358
****** This reportwillbe sent to the BOARD OF HEALTH within 15 DAYS ******
Permit#1131")V- ��l`Cc MA License# Date of Pumping)L /213-/ 13-
01
3-
01 Lc3
Property Owner ED JAZAB Address 9 SHEPERDS HOLLOW
Address 2
Home Phone (413)584-1439 Address 3
Bus Phone City LEEDS
Cell Phone (413)222-4910 State MA Zip Code 01053
Total Volume: /Sr)
Tank Size: 1500 GAL
Concrete
Good
Tank Location MAP ON BACK
Septic Holding Tank (_ Leach Tank L 1 Cesspool ! Grease Trap 1
Date of Previous Pumping,If Known: H ) c ) I '97
Waste Received at Licensed Facility: V ° I )11 a(-0--(
Licensed Facility Phone Number:f� 7� 2 V-0 S
Town: I l-)LD kCLC.(L-t
Misc Comments:
-crDriver: - --
Created 10/30/2017 at 2:38:54 PM Page 1 of 1