50 WASHINGTON ST SO UJQS N /NG 7V n/ St.
Fonn 4-=System Pumping Rewrd' ,
r commonwealth of Mossachusetss +� � - w s
Massachusetts 4 -
f .5` ,system Pumoino Record • ,
System Owftr - - -- a System location ' «.
ihcmau Mackay 6 Gonu Inc.: Llan homea Mackay S Sona Inc, lean "n 4�
P.O. Box 366. i0 Washington Streat i /� ��y/-•///fB�
ielom. MA; 01970 i814N. MA. 01970,
3707443049 r - + 1087767.003 Dan. F r' x•
.aboiincklo Church.
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Type: Emegewy _ Routine
Cesspool: P, _ Yes Septic tank:
u
Yes y
Date of Pumpirg: " . Quantity Pumped: wy,
System RmVed 9y: i" Wind RAv EnWioart7ento% LLC "t a Pernik#: •.
Contents hnnsferred'to:i w ' �e��,�y� at Row
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Cantenri Disposed at: tee,.. , `i .. Is,
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Date: ,+ A , Pumper Signature: V LJ 1• ,• a
Condition of SysteWOt er Comments - - t. ie
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Dep Approved from - 12/07/95 r
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