486 Pump Report 2018 - via -si
Commonwealth nnot' Nr ?
City/Town of ' n g;Record
/, scna 4m P ,y,n for use In Boards
Mea" Bend using$18 tonal P PI^9 R moat to
DEP of Health.Otter lotme may be used,but'Swim our
informag� , as au +mireeChaform they use. Ste days ii ma ee-e:re - .
tical eat ,approving autlwAH
the local
"Ann 1
accordance vitth 310 Mark 15.35 . .
A. Facility Infon^ttlon
1. System Location: —�
R WY ----- ------- nam I
1.
ie yo spa u.
W,Ws amiss"
020 ,
ie yorya �h�iv��
not»nom' 2 stem Owner ss' h.n
'it
g umPin9 Record-51-3-3-1(---) 1 .1------
2. Duval Punnet caws
. . 1. Date.of Pump
.
Tait 0
- .
Grease
Trap
lied
3, :ofsYr' pcessPoc i rtcTek
❑ merdam s Yea N
Yo �
.Tee Fitter m7 ❑ � " d + n
r oiii 9, l`-gal 5. GandlSon_ G-1 e-lss — A r �'
1
,: L ,on vrttere contenva
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om _.P,ae,�+
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