428 Pump Report 9-8-15 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 D�AYS' ***,*�**
Wt..) t1 1
Permit# -ion MA License Date of Pumping 1 al- /1St)
OGp1J
Address 428 WESTHAMPTON ROAD
Property Owner STEVEN BERLIN Address 2 RTE 66
Home Phone (413)320-8455 Address 3
Bus Phone City FLORENCE
Cell Phone State MA ZipCode 01062
Total Volume: 160LT)
.
Tank Size: 1500 GAL
Concrete-LOW PROFILE
Good
Tank Location MAP ON FILE
Septic J Holding Tank j Leach Tank Cesspool Grease Trap
Date of Previous Pumping, If Known: �'� o S -
Waste Received at Licensed Facility: m n� ``�-L -
Licensed Facility Phone Number: y3- ��J
Town: mon1 GSC{Ui— -_
Misc Comments:
Driver:
Created 4/30/2018 at 3 08:06 PM _ Page 1 of 1