HomeMy WebLinkAboutMiscellaneous - 27 Dale StreetFORM 4 - SYSTEM PUMTENG RECORT)
Commonwealth of Massachusetts
IU'-4fUDU,.,CA, , Massachusetts
. Svstem Pumping Record
Svstern Location
�)Yslern Owner I
2-7 VJ
/U.- �+U
T,,Ipe: Emergency 0 Routine
Cesspool.. N o Yes El SLptic Tarik: N o Yes
Date of Pumping: Quantli-v Pumped: gallons
Svs-Lem Pumped by Co mpa ny-): 0,:� z <— .-Per-mit
Contents transferred to:
ConjeriLs disposed at:
-L -0 k� Pumper Sianature
Daie
Condition of systeriVother cor=ents:
& () v A
iDEF APPROVED FOR -',I - 12/07195
(-Uwv A I IV( (;, �N