MALONE FENCE i
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06,22./2015 23:52 9782814869 WINDRIVER PAGE 84/09
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Commonwealth of Massachusetts Form 4--System Pumping Record 1%
Massachusetts
System Pumping Record
System Owner System Location 3 "
Malone li,ence Malone Fence
471 Highland Avenue 471 Highland Aver=ue
Salem, i4'L, 0:1.970 Salem, KA, 019-10
(9712)-255-^8399 it h
Type: Emergent Routine
Cesspool: Na Yes Septic Tank: No O YeS701
Date of Pumping: L'�...l7,,, _ Quantity Fumped:_t W CmAons
System pumped 8y: Wind River Environmental,LLC permit#:
Contents Transferred to:
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Contents Disposed at:
5� FoYA Avt - bA
)ate: Pumper Signature:
:ondition of System/Other Comments
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Dep Approved Form-12/07/95 '
F' ..._
FORM 4-SYSTEM PUMPING RECORD
CURRIER °
SEPTIC'& DRAIN SERVICE
107 FOREST STREET;MIDDLETON;MA 1949
y '»' "(978)774.2772
APR .4 9MO
CITY OF SALEM
HEALTH DEPT.
COMMONWEALTH OF MASSACHUSETTS
MASSACHUSETTS
SYSTEMPUMPING RECORD
SYSTEM OWNER: Ci SYSTEM LOCATION: .D?e�I fn�/`
.�� , �l, (�ne� •eve 1
?A
DATE OF PUMPING: `a,y:UC) QUANTITY PUMPED: GALLONS
CESSPOOL:.NO F-� .YES, -0 SEPTIC TANK: NO Q YES -
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SYSTEM PUMPED BY: CURRIER SEPTIC& DRAIN SERVICE
CONTENTS TRANSFERRED TO::,. SFS D
y( A
DATE: 3 a V-1 00 INSPECTOR: 4ey)_., -
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