HomeMy WebLinkAboutSeptic Pumping Slip - 102 WINTERGREEN DRIVE 6/19/2013 FIECEIVED
Commonwealth of Massachusetts
City/Town of TOWN OF aW�1ANE)O b u
System Pumping Record
Facility Information.
System Location:
Address
[�'i 0 N- I ),� r""') 1 6 �w
City/Town State Zip Code
System Owner:
Name: ..
Adress (if different from location of pump)
City/Town State Zip Code
Telephone Number
Pumping Record
Date of Pumping_1 I q i Quantity Pumped 1.1 gallons
Type of SystemSeptic Tank Grease Trap Other (what)
System Pumped by:
cy
Company: ROOTER-MAN 46 Portland Street Lawrence, MA 01843
Location where contents were disposed: ( .
Signature of Hauler Date ..