HomeMy WebLinkAboutSeptic Pumping Slip - 855 WINTER STREET 9/2/2015 Commonwealth of Massachusetts �,
City/Town of Aj( a
System Pumping Record
Ic: :
Facility Information:
System Location:
Address
4Ciown
State Zip Code
System Owner:
Name:"
Adress(if different from location of pump)
City/Town State
Zip Code
Telephone Number
I
Pumping Record
Date of Pumping 4(4��
Quantity Pumped_ , " , 1t. gallons
Type of System Septic Tank Grease Trap Oth
. er (what)
System Pumped by
Company: ROOTER-MAN 46 Portland Street Lawrence,MA 01843
Location where contents,, ere disposed:
Signature of Hauler
Date r