296 Pump Report 2019 System Pumping Report's Wastewater Removal
239 A Greenfield Road
South Deerfield,MA 01373
Phone 413665-3989 Fax 413665-7358
****** This report will be sent to the BOARD OF HEALTH within 15 DAYS ******
Permit# ' MA LicenseDate of Pumping 9, ;3 / 1 61
bt-AA
Address 296 SYLVESTER ROAD
Property Owner ADAM LESKO Address 2
Home Phone (413)695-5875 Address 3
Bus Phone City FLORENCE
Cell Phone State MA Zip Code 01060
Total Volume: 1wlU
Tank Size: 1500 GAL W/FILTER
CONCRETE 2 COMP
Good
Tank Location
Septic Holding Tank Leach Tank Cesspool j Grease Trap
Date of Previous Pumping, If Known: li` ‘(--41
Waste Received at Licensed Facility: COY f jP\C uy 4u
Licensed Facility Phone Number: ) ) 1/C1
Town:
Misc Comments:
Driver: .\\s
Created 4/25/2019 at 3:43:59 PM
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