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Application for Septage Hauler Permit

  1. No permits will be issued until payment has been received in full and processed by the City of Gardner Health Department. The fee for this permit is $150.

  2. In accordance with MGL c.111, Section 31B, and 310 CMR 15.502 (Title 5), the undersigned makes application to the Board of Health or approving authority for permission to remove and transport septage and the content of privies and cesspools as set forth below:

  3. Your other licenses

  4. I certify that the information I have provided above is true and accurate. I recognize that it is a violation of this permit to dispose of septage anywhere other than the identified disposal locations or others approved by the Board in writing as an amendment to this permit.

  5. Under the Laws of the Commonwealth of Massachusetts, Chapter 223, Section 35, Acts of 1983, you are required to provide the following: Pursuant to M.G.L. Ch62C, Sec. 49A, I certify under the penalties of perjury, that I, to the best knowledge and belief, have filed all state tax returns and paid all state taxes required by law

  6. No permits will be issued until payment has been received in full and processed by the City of Gardner Health Department. All checks must be made out to "City of Gardner" and sent to Gardner Board of Health, Gardner City Hall Rm 29, 95 Pleasant St. Gardner, MA 01440. The Fee for this permit is $150.

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