HomeMy WebLinkAboutSeptic Pumping Slip - 60 PATTON LANE 9/3/2015 Commonwealth of Massachusetts
City/Town of
System Pumping Record
Facility Information:
System Location:
Address
City/Town State Zip Code
System Owner:
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Name:
Adress(if different from location of pump)
City/Town State Zip Code
"7j,
Telephone Number
Pumping Record
Date Of Pumping
Quantity Pumped
4� 15 lions
Type of System A Septic Tank Grease Trap_Other w hat)
System Pumped by:
.
Company: ROOTER-MAN 46 Portland Street Lawrence,MA 01843
Location where contents were disposed:
Signature of Hauler Date
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