HomeMy WebLinkAboutSeptic Pumping Slip - 725 BOXFORD STREET 5/16/2016 FORM 4 . SYSTEM PUNTLNG RECORD",
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Commonwealth of` Massachusett IRECEIVED
, Massachusetts
S Stel7l (c)'IZ Z�l ecord
I OWN OF WAR
Syste n caner ystem ovation �n�rrar� rtrd r
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T\,pe Emergency Cl Routine
❑ tic Tank: No Yes �M%
Cessp( ��I: No � Yes St p
Date (, :` Pumping. R) -� � Quantity Pumped: _ gallons
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Permit
Svster.; Pumped by (Company).
Conte ,Ls transferred to;
Cont. .tt.s disposed at.
Date ` pumper Sienature
Conrition of systemlot.her comments;
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DE.P'LPPROYED FOR`1 - 1:107 19S
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TOWN OF
SYSTEM PUMPING RECORD
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DATE:
SYSTEM OWNER & ADDRESS SYSTEM LOCATION
(example: loft front of Douse)
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mm
f
P,
DATE OF PUMPING: QUANTITY PUMPE IS : � � GALLONS
.mm
CESSPOOL: NO_ "�' YES SEPTIC TANK: NO S
NATURE OF SERVICE: ROUTINE, EMERGENCY
OBSERVATIONS:
GOOD CONDITION FULL TO COVE,R
HEAVY GREASE BAFFLES IN PLACE
ROOTS _ LEACHFIELD RUNBACK
EXCESSIVE SOLIDS FLOODED
SOLIDS CARRYOVER OT HE R(E LAID _ --
SYSTEM PUMPE ID BY: Bateson Enterprises, Inc.
COMMENTS:
CONTENTS TlAaNSFERRIPM TO: .Le a w Lowell Waste