9 Pump Report 2019 i
System Pumping Report
Greg's Wastewater Removal
239 A Greenfield Road
I 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# " A License# Date of Pumping / /�
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Address 9 CARDINAL WAY
Property Owner JENNA ILLINGSWORTH Address 2
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Home Phone (413) 586-4901 Address 3
Bus Phone City FLORENCE
Cell Phone (413)687-3058 State MA Zip Code 01062
Total Volume:
Tank Size: 1500 GAL
Concrete 2 COMP
Good
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Tank Location
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Septic Holding Tank ❑ Leach Tank ❑ Cesspool ❑ Grease Trap ❑
Date of Previous Pumping, If Known:
Waste Received at Licensed Facility:
Licensed Facility Phone Number: I S�a
Town:
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Misc Comments:
Driver:
Created 7/31/2019 at 11:01:25 AM Page 1 of 1
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