32 Pump Report 9-6-12 System Pumping ReportGrWastewater Removal
239 A Greenfield Road
South Deerfield,MA 01373
Phone 413-665-3989 Fax 413665-7358
****** This report will beysent to the BOARD OF HEALTH within 15 DAYS ******
Permit# V>' I}Y' 2-4:-D( "DMA License# Date of Pumping 'I /rT / 12-
013 c 3
Address 32 DUNPHY DRIVE
Property Owner KATHY RICHARDSON Address 2
Home Phone 413-584-2741 Address 3
Bus Phone City FLORENCE
Cell Phone State MA Zip Code 01062
Total Volume: I SO
Tank Size: 1500 GAL
Concrete
Good
Tank Location MAP ON FILE
Septic /Holding Tank Leach Tank Cesspool Grease Trap r
Date of Previous Pumping, If Known: C4I I'I +/ JR /�
Waste Received at Licensed Facility: ') i y n(I u-A
Licensed Facility Phone Number: r� - C (
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Town: i 1 (Y\--L/ ,p`"
Misc Comments:
Driver: Ddb r 7
Created 11/7/2017 at 9:58:25 AM Page 1 of 1