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Home My WebLink About0055 LITTLE RIVER ROAD - Health piwr RM4 r t i i i i S M E A KEEPING YOU ORGANIZE© No.1®S34 ' 2453L WD€IN USA GET ORGANIZED AT SMEAAD.C©M TOWN OF BARNSTABLE — UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. PARCEL NO. ADDRESS OF TANK: TTL 11-C^ VILLAGE: COT14 MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) " OWNER NAME:-, l 5T" Q kg-71l gr 414 • PHONE: INSTALLATION DATE: BY: 4e'1114A,.0WA-1 INSTALLER ADDRESS: s' ? 'CERT.NO. *TANK LOCATION: �iGNaf~�1+ S�r>Cr GF ,•ti 'U15 ! � ,6iJS get /S �lf (0=00M 2 m¢ TANK LbdW+.z ONA"`W;I'TH PRQOPQOT TO mu I LD 2 NO) CAPACITY 02-K TYPE OF ff ANXK -� LZ-6L )a YRS. FUEL/CHEMICAL f` 1 TESTING CERTIFICATIONS [ ] PASS [ ] FAIL DATE LEAK DETECTION C ] CHECK IF N/A TYPE/BRAND ` rs. � ZONE OF CONTRIBUTION I YES [ ] NO DATE TO BE REMOVED S.9 ?tti(,i FIRE DEPT. PERMIT ISSUED [A,"] YES CI NO DATE CONSERVATION [ ] CHECK IF N/A DATE BOARD OF HEALTH TAG NO. [ DATE ✓" '' n PLEASE_ PROVIDE . A ,.SKETCH SHOWING THE TANK- LOCATION ON. THE BACK OF THIS CARD t w - _ - ��s�s� r---- . � �,,� ;,�,tc. d d, �- a I �.� �n�!-�`� 1V�'r' � ��T� I�