HomeMy WebLinkAboutSeptic Pumping Slip - 315 SOUTH BRADFORD STREET 1/1/2001 Pot"4 ... y�sterwe Pumpiwwj Record
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Quantity Purrwpa : a , . �� Gallons
Date of
"y � wa Psaa y` Yuy�ar ",w imr Ftiviroomental, IW Permit y$:
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Forma 4 .. System Pumpinwj Record
: Massachusetts
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System Owner System[Axation
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C x paean: NO Poi. Y �W lytic fiaank4 P Ely-
Date
of 7TMunpirmcy:�www � ��ww�� a �� QuaantiPy Purnp d: � -11,ons
Sy tmmu Pumped y: Wind Ri F.aru<iromwa eal,, ule Permit
Contents trana�f'e °Pam:
C ontawnis Disposed at:
ps
Pumper airdrea same:
Condition of Syslewt/Oth r Comm ents
Pep Appvved Fmm _ M10719
Form 4 Systent PurnrAiiq Rareord
Commonwealth of MassocIvAsefts
Mossadvisetts
24
System Owner SyStisul LAVOtiOn
TY13e: t rgency Roo ine
;;Z� 1� t-sti" T--4 Septic tank: W [DY., [!a
Coss l: W Yes
Crate of PuITIP4IUj: Q�L,.2,- Quantity Pumped: 6-y,j> Gallons
System Pumped By: Wind Wwr Cnvlronawatal, UC pannit#:
Contents transferred to:
Contents bisposed at:
Crate: Pumper Signature:
Condition of system/Otfw Comments
Dep Approved Ff wm - I Z107195
�n m Cowwwww0waw aalth of Massaamseus
Massachusetts
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Sytwwww �r �� System Location
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Type„w W awawr”. ney ww Routine
Septic trtrwdt,
Date Of Puw 'nq
_ �� ro .314 aw i9y Pump d h By:"Ons
ystw n Pumprwa^:, Wind `iw ^t-J--nvirofl#r rtdtatf Cl &'erwaaiP
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ra'arm°Wawwats Nsposed at.
MAW Aimper Signature
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d,`aauwaptfaaawa u w yste a/ 9w r Comments
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romp 4 ..... System Pumping Record
Coma oymeolth of Mossachus tss
: Mossoehus tts;
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System OWYM, System Location
Type: �Wn�rg YY�y i�otYtiVY� ���
Cesspool: Igo °` Yss ptio toYrd�: hio less
bate of pumping: fYaontity pumped; ollirns
System Pumped By: Wlraor River EavilvnMental, W Permit X
Contents transferred to:
Contents Disposed cat:
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—45sat�5 'h,,�a—a
bate: Pumper Signature:
Condition of System/Other Comments
p Appmved From om - 121071
orin 4 .. System Pumplw, Eta oml
C'Omwnwealth of a assacl,sasetss
Massachusetts
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y:de ira CJ System Location
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Of
"Type: Emergency RoutiaaW
Cesspool: Kw Yes Septic tank: Pia Yaes
bate of Pumping:_ ' � � Quantity pump d: Gallons
System Pumped By: Wind River Eavirvowntal, W par"it
Contents transfened to.
Contents Disposd at:
Date: Pumpor ignatur^�:
Condition of System/Other Comaan:ntsm � ^^m�W
Form 4 __ System Pumping Record
Cowwnwealth of Massachusetss
: Massachusetts
System PunvoiN Record
System Owner System Location
Type: Emergency Routine ""„'
Cesspool: No Yes Septic tank: w Yes
Crate of Pumping: i ' Quantity Pumped: dons
System Pumped Fay: Wind Rim-Environmental, UC Permit
Contents transferred to:
Contents Disposed at:
Coate: Pumper Signature:
Condition of System/Other Comments
bep Apppoved From - 1210719