HomeMy WebLinkAboutSeptic Pumping Slip - 151 SANDRA LANE 8/28/2015 Commonwealth of Massachusetts
City/Town of Ndm� j%*vx4
System Pumping Record
Facility Information:
System Location:
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Address
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City own W ~
State Zip Code
System Owner:
Name:
Adress(if different from location of pump)
City/Town State Zip Code
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Telephone Number
Pumping Record
Date of Pum in
p g (`+ Quantity Pumped
`� �' gallons
Type of System—,X Septic Tank Grease Trap Other what
System Pumped by: }, t -A ► 1 K t
Company: ROOTER-MAN 46 Portland Street Lawrence,MA 01843
Location where contents were disposed:
Signature of Hauler
Date