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1174 Pump Report 7-2020System 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 G1 J` 6 � I� MA License # Date of Pumping 1 6- /J o c?co� P Address 1174 FLORENCE ROAD Property Owner JOHN FORTIER Address 2 Home Phone (413) 584-2062 Address 3 Bus Phone City FLORENCE Cell Phone State MA Zip Code 01062 Total Volume: 1, IW Tank Size: 1500 GAL Concrete Good Tank Location / Septic 1/1 Holding Tank 7 Leach Tank [—] Cesspool D Grease Trap [:] Date of Previous Pumping, If Known: Waste Received at Licensed Facility: Licensed Facility Phone Number: 5 W I Uci Town: Misc Comments: Driver: Created 8/11/2020 at 10:03:27 AM Page 1 of 1