HomeMy WebLinkAboutSoares Sanitation Pumping -12/31/2021* I �r ( (') A - :)-ag, 9-'-
Town of Mansfield
Town oj'Mansfield - Board of Health 6 Park Row
Mansfield, MA 02048
IL NSeptagelFOG Haulers Application
AU, 2021 1�!
DATE:
LICENSE NUMBER: ir
=i�S �NAME: 'C�O'Y-ers axnx4a2inoln
MAIL ADDRESS: TOWN: at!G toya-SNNIY STATE M Pk ZIP CODE: 19 13
NAME OF OWNER:
V—Obu1 Sow-e-s
BUSINESS TELEPHONE: 60?) Ea4 S':510 CELL: FAX: 150% %34 9456
EMAIL: jg-sslco-(gboo-re-spurnp,rg.
FED ID/SS NO: C�+ - 01.9 1I09L ALT EMAIL:, - Q;\es, 6) z50a-reQ?Ur1'11F I 1�, Con,
FEE PER TRUCK: $100 NUMBER OF TRUQK(S):
Truck, Ri3gistration number: -063
Circle one:
eptage
FOG
Truck Registration number:
Circle
Sep age
FOG
Truck Registration number:
Circle one;
Septage
FOG
Truck Registration number:
Circle one:
SePtage
FOG,
Truck Registration number.�
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Circle,one:
............... ................
Septaige
....... . ......
FOG
; ....... .......
SEPTAGEPUMPERS:
310 CMR,15.505.Equipment: No person shall use equipment to remove or transport the contents of prives, cesspool, or
septic tanks or other offensive substances unless suers equipment has first been inspected and approved by�the Board of
Health, '
TRUCKS INSPECTIONS: DATE., THURSDAY, NOVEMBER 12,.2020 TIME: 7.'0QAM-1 1:60AM
PLACE: GILETTE,STADIUM - PARKING LOT P10
PLEASE BE THERE; OR CALL THE FOLLOWING NUMBER (504) 261- 7366, IF YOU CAN NOT MAKE THIS DATE
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FOG PUMPERS..
Town of Mansfield BOH Fats, Oils and Grease. (FOG) Regulations
Article 3 ' Section 9: As of January 1, 2019, all SepticIFOO Hauler trucks that service systems, in the Town of Mansfield
will be. required to have a Septic/FOG Hauler Permit. Septic/FOG Haulers must provide a list of all FOG customers as
part of the permitapplication,
PLEASE NOTE: Onsit& logs must be kept at all locations recording the % Combined Solids and Grease, when pumping
occurs for BOH records.
— I a6knowledge that all pumpers will record the % Combined Solids and Grease on the onsits logs.
All documents must be completed signed and returned to the Health Department with the appropriate payment.
Checks can be made payable to Town of MaWeld. Mail to., Board of Health, Town of Mansilleld, Six Park Row,
Mansfield, MA 02046, ...7 d 27
SIGNATURE: DATE: