HomeMy WebLinkAbout- Septic Pumping Slip - 54 OLD CART WAY 7/2/2019 k
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Form. 4 TOWN 0 1\1 011IR"I"11 ANDOVER
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DEP has _ram iform' r � lHealth. y,�ma' yb6*use ut the
information- of ll lhere. Before i . i x
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local Boardr other approving
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System1. h r house, Left Righ r � a; � � S� � � � �4
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telephone Number
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3. Type-of sy�terrf: El Cesspool(s) eptic Tank
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4. Effluent Tee
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Filter r I 'Yes, . Yes E] No
5. Condition of V!E;ystem:
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Name Vehicle lNumber IR"
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Ehterprises Ina
Company
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Lowell Waste Water
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Sign Mule Date