565 System Pump Report 2020System Pumping Report
Greg'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 ***�*,**
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Permit # %nA9 MA License # Date of Pumping 11 (LO
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Address 565 COLES MEADOW ROAD
Property Owner BRUCE & JOYCE ROTH Address 2
Home Phone 413-585-9023 Address 3
Bus Phone City NORTHAMPTON
Cell Phone 413-210-8962 State MA ZipCode01060
Total Volume: V
Tank Size: 500 GAL
Concrete
Good
Tank Location MAP ON FILE
Septic E Holding Tank E Leach Tank [] Cesspool 11 Grease Trap
Date of Previous Pumping, If Known:
Waste Received at Licensed Facility: U h ) Y
Licensed Facility Phone Number: OG
Town:
Misc Comments:
Driver: d q f
Created 7/17/2020 at 3:22:47 PM Page 1 of 1