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filum• Action Department
Board of Appeals — Board of Health — Planniing Board — Conservation Commission — Building Department
Commonwealth of Massachusetts
Massachusetts
System Pumping Record
System Owner System Location
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Date of Pumping: Quantity Pumped: (OQ�,;gallons
Cesspool: No u Yes U Septic Tank: No U Yes
System Pumped by: vellwelf 461&O "4 License#
Contents transferrred to : Greater Lawrence Sanitary District
Date: _ Inspector: