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12 CEDAR AVENUE - SYSTEM PUMPING RECORDS L � FORM 4 - SYSTEM PUMPING RECORD IV99 a i Y GF SALEM HEALTH DEPT. Commonwealth of Massachusetts Salem, Massachusetts System Pumping Record System Owner: Kenneth Nichols System Location: 12 Cedar Ave. Salem front yard Date of Pumping: December 1, 1998 Quantity Pumped: 1000 gallons Cesspool: No F-/Yes /X/ Septic Tank: No /X/ Yes System Pumped by: Service Pumping & Drain Co. , Inc. License # Contents transferred to: Salem Treatment Plant Date: December 1, 1998 Pumper: P.K. This is PROPRIETARY and CONFIDENTIAL information that may be used only by the Board of Health for regulatory purposes . wot�tl q-MhNjJ , ri�lM,4 + SY�`l fit fttPINd ttkco" �'! ,yt t , PEABaOY, MA O1tIrt0 t , IT 6 i Ctltnn tifiWnith of Mmat:husetti 1 System PttM-Pl r Record Sjstem �5wner stem LOCHllOn � a CCA Hate of F w„ping: QuMtlry bumped! 4© ° gallons Cesspool: No ❑ Yes t I Septic Tahk: Ntl b yes ;: ystem Pumped by: �OA t�. M` ... oh "�.. License m .................._............._... .................. . Cont:nts transferred to: Dale Y . t i DEC 1997 A GITY G SAC Pon Fi;=Fi.;}l P EaE>=1:. •a i f