58 Title 5 Pumping Record 2013 System Pumping Report
Greg's Wastewater Removal
239 A Greenfield Road
South Deerfield,MA 01373
Phone 413-665-3989 Fax 413-665-7358
****** This report will be sent to the BOARD OF HEALTH within 15 DAYS ******
Permit
# MA License# Date of Pumping9 /31/
Property Owner BRUCE MARTIN
Home Phone
Bus Phone
Cell Phone
Tank Size:
413-584-2118
1200 GAL
Concrete
Good
Tank Location CUSTOMER HAS
Address 58 AUTUMN DRIVE
Address 2
Address 3
City FLORENCE
State MA Zip Code 01062
Total Volume: San
Septic -Holding Tank Leach Tank –z Cesspool Grease Trap
S
Date of Previous Pumping, If Known: S- 1 -C
Waste Received at Licensed Facility: �t 29--I c_'[6.)(151-4i)(1
Licensed Facility Phone Number: U'3-"""5
Town:
Misc Comments:
Driver: `Y!�
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Created 6/1/2016 at 9'05'.38 AM Page 1 of 1