46 Pump Report 2019 System Pumping Report
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#n. MA License# Date of Pumping `'I / I / '" 1
Dmlu
Address 46 CLARK STREET
Property Owner JIM 8 CHRISTINE FOUDY Address 2
Home Phone 413-584-9257 Address 3
Bus Phone 413-585-5250 City FLORENCE
Cell Phone State MA Zip Code 01062
Total Volume: ( 5 0 3
Tank Size: 1500 GAL
Concrete
Good
Tank Location ***OWNER MARKS TANK TO BE PUMPED W/ORANGE CONE
Septic PI Holding Tank Leach Tank Cesspool Grease Trap
Date of Previous Pumping, If Known:
Waste Received at Licensed Facility: NV.)t YI-1Y ,m pken
Licensed Facility Phone Number:
Town:
Misc Comments:
Driver: -YJC"
Created 4/15/2019 at 1058 58 AM Page 1 of 1