HomeMy WebLinkAbout- Septic Pumping Slip - 259 CAMPBELL ROAD 5/4/2019 Y
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System
MpIng Record
Form 4
DEP
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Telephone Number
if
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1 lo DateOf'PUMpIng
Date 2. Quantity P ..
3
C n � �
C S 1s Septlo
Tlght Tank
Gtease Trap
0 Other(desorlbe):
Effluent Tee Filter present? E] Yes D No
If y0s,was It cl Yes
No
Observed condition Of component
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North Red:vig,MA W 84
7. Location where contents were dig
SIgnature of Hauler
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Date
81lonature of Receiving Fs
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SYstem Pumping Record page