HomeMy WebLinkAboutSeptic - Septic Pumping Slip - 145 BRADFORD STREET 12/19/2025 Commonwealth of Massachusetts
City/Town of _
} System Purn�aing Record
ti. Forrrt
DEP his provided this form for use by local Boards of Health. Other forms may be: used, but the
information must be substantially the sarne as that provided here, Before using this form, check with your
Vocal Board of Health to determine the form they use, The System Pumping Record must be submitted to
the local Board of Health or other approving authority within 14 days from the, purnping date in
accordance with 310 C'MR 15, 351.
A. Facility _ _. ._- BUILDING:�NG. ror c, side rearC'21t�t
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F.3. Pumping Record
1 Date of Pumping J- _ - _-__. 2 Quantity F7urnped: _--
nl`� Gallons
3, Component: Cesspooi(s) Septic Tank ( Tight Tank Grease Trap
i__[ Other (describe)
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4. Effluent Tee Filter present? [J- Yes If yes, was it cleaned? ❑ Yes ❑ iVo
5. Observed condition of corn on nt (�
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