HomeMy WebLinkAboutSeptic Pumping Slip - 29 GRANVILLE LANE 11/16/2015 Commonwealth of Massachusetts l
City/Town of �
System Pumpm ��ecofd
Facility Information:
System Location:
Address
L4 0 1
City/Town State Zip Code
System Owner:
Name:
Adress(if different from location of pump)
City/Town State Zip Code
Telephone Number
Pumping Record
Date of Pumping Quantity Pumped , ; '--
gallons
Type of System ,,* Septic Tank Grease Trap Other (what)
System Pumped by:_ � 1 .. L \ 6"`
Company: ROOTER-MAN M 4
46 Portland Street Lawrence,MA O1843
Location where contents were dis sed;
Signature of Hauler Date
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