20 pumping report System Pumping ReportGreg
Wastewater Removal
239 A Greenfield Road
South Deerfield,MA 01373
Phone 413-665-3989 Fax 413-665-7358
****** Thisreport willbesent to the BOARD OF HEALTH within 15 DAYS1 *******
Permit# �I ELU'3,V1ll1 MA License# Date of Pumping — 1 0\ 1 I 0
oCo
Address 20 HAWTHORNE TERRACE
Property Owner BOB BACON Address 2
Home Phone 413-727-8181 Address 3
Bus Phone City FLORENCE
Cell Phone State MA Zip Code01062
Total Volume: 1 KO Q
Tank Size: 1500 GAL
Concrete
Good
Tank Location FRONT YARD
Septic Holding Tank pl Leach Tank L Cesspool Grease Trap
Date of Previous Pumping, If Known: \''1 1P 1
Waste Received at Licensed Facility: C
Licensed Facility Phone Number: LUa. 7 'jc�o
Town: q"if \ )l(I
Miss Comments:
Drive : -
Created 7/10/2018 at 2.00'.14 PM - Page 1 of 1