HomeMy WebLinkAboutSeptic Pumping Slip - 315 SOUTH BRADFORD STREET 1/1/2002 Form 4 Syste"I Konpinq R-orvi
Commonwealth of Massachusefts
: Massachusetts
gyge W f apin
system Owner System LoLation
Type: Emerg my Routine
Cesspool: 1Jaa Yes Septic tors: K6 [DY.S
Date of Pumping: Quantity Pumped;
System Pumped By: Wind Riw&vjr✓jjwnW, LIC per
Contents transferred W
Contents bisposed at:
bate: Pumper Signature:
Condition of System/00wr Covownts
D Appv ved Fivm - 12107195
corm 4 _.. System Pumping Record
Commonwealth of Mossachusetss
Massachusetts
Este Pum iq R
`i
E
System Qtr System Location �w
Type: Emergency Routine
Cesspool: tear Yes .. °'"" Septic tank: W Yes
Date of Pumping: /rs` C`�c°,,.
Quantity Pumped: Gallons
System Pumped 6y: Wind fiver EnOvnmentel, UC Permit
Contents transferred toe
Contents Disposed at:
{
Date: Pumper Signature:
Condition of System/Other Comments
bep Approved Form - 12/07/95
CvwmmvweWth of Maros aachus ss
�tva�v� mv�R°tv
Syslvsmm a 'mmrmvaa r tvamm q°mr a°sammm
i
M
tvvrw W;ww o h Wo w w W wW WwpuW ry m m Yes� Septic Pam w 140
�� El
' aorta' of r'tummmpiNj � � ama d Pumpej � P mflonam
System Flumped ayn Wind A'n'm r^4'"h Va°r°arrrradaaa'wta t, tI C PerWt ti
C'on antmm Vamwmsforro'x�f toa
rout nt Disposed amt.
uu imi u�uuwwuu a :uwwuwwuuuu nn uu uw�wwuu wwww�wwuwu�w�owuuww �n a k-m------u�muumoumuuuwwwwmmwuwiwuw�w�wuuiwmmmmwiimmiw�m�wmmmmiimm w���wwwuiwmwimawwwuuuumimu�umauuiwmuuumiiimuuwuum
�wuw
Condition of
Systamm/Mer Comments
mmpm Approved Form - 12/07/95
Form 4 .. ystrra Pumptaug Roan
CoNsWnwealtiv of Massachusetss
Massachusetts
System Owner System L=Gtioa
r r
f,
i r, f. f i5
nexmw y�naw„� r�
Ru
tia a �
"
anti lop IWY ^ Emergency Cesspaod: No Septic tack Yes
ti of Pumping:
u
Idorrs
4
System Pumped icy: Wind RIW envIronmental Ue
Permit
Contents tr*artsfen ed to:
Contents Disposed at: `� � � e �
a
Data: Pumper Signature:
GorAitiort of System/other Go"Iments
Dena Appivved re'tvm - 12107195
Form 4 -- System Pumping Record
Commonwealth of Mossochusetss
; Massachusetts
&stem PumWnq Recowd
System Owner System Location
Id
Type: Emergency Routine
Cesspool; No � Yes Septic tank; P6a Yes
Date of pumping; " .. Quantity Pumped; Gallons
System pumped By; i4/ind River Environmental, UC Permit
Contents transferred to;
Contents bisposed at;
mate; Pumper Signature:
Condition of System/Other Comments
p Appvved Ftwm - 1 21071
Form 4 System Pumping "ate
C'saanamvr raaalth of Massochusetss
Massachusetts
System avAer . System Location
a
I
wmwrvmewuowo���wowoo
Ty' : u wg rrcy Routines
+
cessg l: ".- 'hex septic tank: Per Yep
Croats of Punrpingi: "s U r ��w � quantity Pumped '0411ons .
�
System Pumped By* Wind a2 w-Environrn ntaa/, IW Permit
Contents transferred to:
Contents Disposed at:
bate,: Pumper Signature:
Condition of System/Other o nts
Peer Appvv verb From - 1 210719
Form 4 -_ System Pumlairrg Record
Commonwealth of Massaclwsetss
; Massachusetts
§XLteq Pumging Record
System Owner System Location
j
Type Emergency Routine �"
Cesspool: w r C„,.°” yes Septic tank; Pdo yes
Date of Pumping: t .��„..t A - ) " Quantity Pumped; `7 ouv Falcons
System Pumped By; Wind River E°nv>rsoninental, U6- Permit ar&.
Contents transferred too
Contents Disposed at;
Vi
Date; Pumper Slgnatur
Condition of System/Other Comments
beep Approved Frow - 12107195
Forwrr 4 ;system Pumping Record
Courrnonw alth of Massachusetss
Massachusetts
st Pumrrina R�oar^d
system r Systamtheation
' s septic Tank: (�kr Yes
ypa: Rout
C-ss I: Y
�.
Crag of Pumping: w (quantity Pumpod: ailons
,system Pumped By: Wind River Enviranrr ntal, G1 C Permit
Contents transfer to:
......
Contents Disposed at: %
Crag: Pumper Signatures: ::521
Coalition of systemlher Comments
D p Approved From - 12107195