172 Pumping Report 2017 System Pumping Report
Greg's Wastewater Removal
239 A Greenfield Road
South Deerfield,MA 01373
Phone 413-665-3989 Fax 413-665-7358
****** This repport will be sent to the BOARD OF HEALTH within 15 DAYS ******
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Permit# CA,- (5.3.A MA License# Date of Pumping / /
1
Address 172 NORTH FARMS ROAD
Property Owner STEPHEN PETEGORSKY Address 2
Home Phone 413-584-0999 Address 3
Bus Phone City FLORENCE
Cell Phone State MA Zip Code 01062
Total Volume: !Soo
Tank Size: 1500 GAL 2 COMP
Concrete W/FILTER
Good
Tank Location
Septic ✓ Holding Tank i_ Leach Tank I Cesspool L_ Grease Trap
Date of Previous Pumping, If Known: LI ) H
Waste Received at Licensed Facility: H.(91 L.Q.
Licensed Facility Phone Number:
Town: 1 l«4-6� -
Misc Comments:
Driver: ( r
Created 5/112017 at 3:02:07 PM Page 1 of 1