811 pumping report System Pumping ReportGreg'aWastewater Removal
239 A Greenfield Road
South Deerfield,MA 01373
Phone 413-665-3989 Fax 413-665-7358
****** Thiss report will be sent to the BOARD OF HEALTH within 15 DAYS ****"*
Permit# MA License# Date of Pumping 7,,i3
Dot to
Address 811 NORTH KING STREET
Property Owner MASS D P W Address 2
Home Phone 413-325-4582 Address 3
Bus Phone City NORTHAMPTON
Cell Phone State MA Zip Code 01060
Total Volume: 7 -C
Tank Size: 200 GAL GRINDER PUMP
PLASTIC
Good
Tank Location SOUTH SIDE OF BUILDING THEY HAVE
Septic FrHolding Tank Leach Tank Cesspool Grease Trap
Date of Previous Pumping, If Known: YLe 12. ) oS
Waste Received at Licensed Facility: 1 \I1\'\1\G((\(11-
Licensed Facility Phone Number: \n S
1
Town: r\,;(--)\\\.(V --
Misc Comments:
Driver: 'QV
Created 8/14/2018 at 10:04'.53 AM Page 1 of 1