HomeMy WebLinkAbout0647 POPONESSETT ROAD - Health (2) lye Pdpd-nejje44- /ZQa6l 11
OWN
ABLE
,A1 o T A/ ��her. UNDERGROUND FUEL TAND OCHEMICAL TSTORAGE 'SYSTEMS
/ .�..
ASSESSORS MAP NO. 'PARCEL NO. 21 .
ADDRESS T 7 �a�:1d011f55 .Q7� VILLAGE C�/JT�/T
NAME' _ . y�,QLGl t✓G._._:. fC�,,50 l0 4dl S
CONTACT PERSON PHONE NUMBER ( '5131 ( J
LOCATION OF TANKS: CAPACITY: TYPE OF FUEL. AGE: TYPE: LEAK
OR CHEMICAL: . DETECTION
-j'2�9,�Ji .�e� Sr�c UP= i U�I,sD i?!J✓r/. 10�® (R� ,�1 � Oft( - / bgW4�/'5 jys, ` SYSTEM'
' �Ge/LQ'6Siyit//t✓tL7.�%Itl'y� dal r.0
Sri t�
DATE OF PURCHASE OF. EACH: 1 2. 3. 4. 5.
DATE.OF FIRE DEPARTMENT PERMIT: Solnwlr>Z oA (2+,Ly f9m. .
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TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS
-. PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS. CARD.
I:
TOWN OF BARNSTABLE
UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS
NAME
ADDRESS ( V 7 /�'�.%f'&,z) �-S C ✓ AP, VILLAGE C,97-12/ 'T
LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE:
OR CHEMICAL
000 /-/e.
(Give same information for any additional tanks on reverse side of card)
DATE OF PURCHASE OF EACH: 1. 2. 3. 4.
DATE OF FIRE DEPARTMENT PERMIT:
TESTING CERTIFICATION SUBMITTED:
PASSED DID NOT PASS
APPROVED
Barnstaole Conservation. Commission
Signed ate
TOWN OF BARNSTABLE
UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS
NAME `
ADDRESS ! 2 (� VILLAGE
LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE:
OR CHEMICAL
(Give same information for any additional tanks on reverse side of card)
DATE OF PURCHASE OF EACH: 1. 2. 3. 4.
DATE OF FIRE DEPARTMENT PERMIT:
TESTING CERTIFICATION SUBMITTED:
PASSED DID NOT PASS
Paradtabia-CancarmUon Comloolen
Signed at
TOWN OF BARNSTABLE
UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS
NAME Lr"
ADDRESS VILLAGE &&&Z&4z
LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE:
OR CHEMICAL
4000 -� -
(Give same information for any additional tanks on reverse side of card)
DATE OF PURCHASE OF EACH: 1.' 2. 3. 4.
DATE OF FIRE DEPARTMENT PERMIT: jomtrw
TESTING CERTIFICATION SUBMITTED:
PASSED DID NOT PASS