HomeMy WebLinkAbout0061 BODICK ROAD UNIT UNIT 61A - Health 61 Bodick Rd., Hyannis
A= Al-4 .2 R .
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TOWN OF BARNSTABLE
LOCATION �� �rck SEWAGE#
VILLAGE ASSESSOR'S MAP&PARCEL
INSTALLER'S NAME&PHONE NO. t�
SEPTIC TANK CAPACITY Ci
LEACHING FACILITY: (type) (size)
NO.OF BEDRUS
OWNER -�P _•O —?i�i
PERMIT DAT : COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist on
. site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BY
TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
satisfactory 2.Printers
BOARD OF HEALTH 3.Auto Body Shops
O unsatisfactory- 4.Manufacturers
COMPANYtiJ!/ W,X.,o �'` (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS e is Glass: 7.Miscellaneous
QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors)
MAJOR MATERIALS p
IN OUT IN OUT IN OUT #&gallons Age T
Fuels:
Gasoline Jet Fuel (A)
Diesel, Kerosene, #2 (B)
Heavy Oils:
waste motor oil (C)
new motor oil (C)
transmission/hydraulic
Synthetic Organics:
4
degreasers
Miscellaneous:
ov
DISPOSAIJRECLAMATION REMARKS:
1. Sanitary Sewage 2.Water Supply
O Town Sewer Public
J*10n-site OPrivate 00,
3. Indoor Floor Drains YES NO
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
4. Outdoor Surface drains:YES NO ORDERS:
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
5.Waste Transporter
Name of Hauler b6stinai,
YES NO
1.
2.
Pen&nterviewed Inspector Date