HomeMy WebLinkAboutSeptic Pumping Slip - 855 WINTER STREET 5/24/2016 j.,.
Commonwealth of Massachusetts
ity
System humping Record
Facility Information:
System Location:
'4
Address
N 01`141 (S0,J A
City/Town State Zip Code
System Owner:
w�1
kw
Name:
Adress (if different from location of pump)
City/Town State Zip Code
r? _ 6, Y
Telephone Number
Pumping Record
Date of Pumping Quantity Pumped------/
gallons
Type of System Septic Tank Grease Trap Other (what)
System Pumped by:
Company: ROOTER-MAN 46 Portland Street Lawrence, MA 01843
Location where contents were disposed: ( =-/m_„ w S )o
ry w
Signature of Hauler Date