185 pumping report System Pumping Report
s Wastewater Removal
239 A Greenfield Road
South Deerfield,MA 01373
Phone 413-665-3989 Fax 413665-7358
****"* This report will be sent to the BOARD OF HEALTH within 15 DAYS ****(**/
Permit#T)Pl o L011 MA License# Date of Pumping \ / �n it b/
000 A L)
Address 185 WEST FARMS ROAD
Property Owner SCOTT MCDANIEL Address 2
Home Phone (413)584-0938 Address 3
Bus Phone City FLORENCE
Cell Phone State MA Zip Code 01062
Total Volume: iSO
Tank Size: 1500 GAL
Tank Location MAP ON FILE
Septic /Holding Tank FT Leach Tank Cesspool Grease Trap Fl
Date of Previous Pumping, If Known: IV II B
M �1
Waste Received at Licensed Facility: 1 t r
Licensed Facility Phone Number: cD0-3
Town: i r�, UL�
Misc Comments:
Driven
Created 6/8/2018 at 12:12:31 PM Page 1 of 1