11 PATTON ROAD C,$'eOTtr)
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IMPORTANT MESSAGE
FOR
i
DATE '" TIME/-1� S .M.
M � �
OF
PHONE
AREA CODE NUMBER EXTENSION
O FAX
G MOBILE
AREA CODE NUMBER TIME TO CALL
TELEPHONED PLEASE CALL
CAME TO SEE YOU WILL CALL AGAIN
WANTS TO SEE YOU RUSH
RETURNED YOUR CALL WILL FAX TO YOU
MESSAGE
SIGNED
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� Y��R .
NOTES - --__---..- I
i
IMPORTANT MESSAGE
FOR
DATE " �� �— TIME
OF
PHONE
AREA CODE NUMBER EXTENSION
O FAX
O MOBILE
AREA CODE NUMBER TIME TO CALL
TELEPHONED LEASE CALL
CAME TO SEE YOU WILL CALL AGAIN
WANTS TO SEE YOU RUSH
RETURNED YOUR CALL WILL FAX TO YOU
MESSAGE
sL"
SIGNED
® FORM 4009
LL 09
YY MARE IN
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90CMED
FORM 4 - SYSTEM PUMPING RECORD
SEP 2 - 1999
CITY OF SALEM
HEALTH DEPT.
ConTwnwealth of Massachusetts
Salem, Massachusetts
System Pumping Record
System Owner: System Location:
Joseph Augusta front yard
11 Patton Road
Salem
Date of Pumping: August 10, 1999 Quantity Pumped: 1000 gallons
Cesspool: No JX//Yes r/ Septic Tank: No /—/ Yes /X/
System Pumped by: Service Pumping & Drain Co., Inc. License #
Contents transferred to: Salem Treatment Plant
Date: August 10, 1999 Pumper: M.F.
This is PROPRIETARY and CONFIDENTIAL information that may be used
only by the Board of Health for regulatory purposes.