115-129 Pump Report 2019 System Pumping Report
s 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# OPIA)' 40(6 - MA License# Date of Pumping (') / / , I
0000ce
Address 115-129 HINKLEY ST
Property Owner HINKLEY TRACE CONDO ASSOC. Address 2
Home Phone (413)397-3569 Address 3
Bus Phone City FLORENCE
Cell Phone State MA Zip Code 01060
Total Volume: of(�
Tank Size: INJECTOR PUMP
Tank Location BEHIND THE BACK GARAGE AT THE BACK OF THE PROPERTY
Septic Holding Tank n Leach Tank Cesspool Grease Trap
Date of Previous Pumping,If Known: ‘_.(n
Waste Received at Licensed Facility: ADrYACkc\
Licensed Facility Phone Number: 3
Town:
Misc Comments:
Driver: V
Created 4/17/2019 at 2:58:50 PM Page 1 of 1