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KEEPING YOU ORGANIZED
No.10334
2-153L
MADE IN USA
GET ORGANIZED AT SMEAD.COM
TOWN OF BARNSTABLE .L �
UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS %C3
ASSESSORS MAP NO. PARCEL NO. 0(-),3
ADDRESS, G
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NAME' _
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CONTACT PERSON PHON UMBER
LOCATION OF TANKS: CAPACITY: TYPE OF FUEL. AGE: TYPE: LEAK
OR CHEMIC L:� DETECTION
SYSTEM,
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DATE OF PURCHASE OF. EACH: 1. 2. 3. 4. 5. _
DATE O`F FIRE DEPARTMENT .PERMIT:
TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS'
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PLEASE PROVIDE A SKETCH SHOWING TIIE LOCATION OF TANKS ON THE BACK OF THIS CARD.
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