856 Pump Report 2019 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#�' 1� MA License# Date of Pumping_ /,/-A 1.
00pq i
Address 856 BURTS PITT ROAD
Property Owner BENJAMIN BRAUDE Address 2
i
Home Phone 413-586-3048 ; Address 3
Bus Phone City FLORENCE
Cell Phone (413)695-2938 State MA Zip Code 01062
j
Total Volume:
Tank Size: 1500 GAL
Concrete
Good
Tank Location MAP ON FILE
Septic allo Iding Tank ❑ Leach Tank Cesspool Grease Trap
Date of Previous Pumping, If Known: - U 11-6 1
Waste Received at Licensed Facility: In fW"
Licensed Facility Phone Number:
Town:
Misc Comments:
Driver:
Created 8/29/2019 at 12:11:11 PM Page 1 of 1