HomeMy WebLinkAboutSeptic Pumping Slip - 366 CANDLESTICK ROAD 6/19/2015 UEP has provided this form for use by local @Wdg Of Healk-.0ther famm may be U860, WI,
ififutiflaWn muSt tM SUMMMY thv"MG"UN Pfovid6d 4M. SOW- using NO fart,
iowl Board of Hesh to determine the form they u4e.The ftion Pumping Rewrd t
518 kcal Board of 146lb or other v0proVing outtoft within 14'day,8 from the Pu
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av%VWanCq with 310 CMR 15.361. Ong dati,
A. Facility Ififormation
JUL 2015
'roVVN OF NOR'ni ANDOM
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3KK HEALTH DEPARTMENT
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U". Pumping Record
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10,of Purnpifig Date 2. Quably purnpW:
Type of syste M* [j-CeSsPWI(s) /b' SeAcTank E) Ti8hMak
Other ode sctibe);
Eftent Tee Filter present? Yes No IfY03-waSitcleaned?
wa Condition of System:
8ySterra Pumped By:
Lowfian Whw#contents were d1uposed:
Of Date
Sift'Awto I ftW&M Faft
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