HomeMy WebLinkAbout0190 BRIDGE STREET - Health (2) 3 69e?
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KEEPING YOU ORGANIZED
No. 12134 '
2-153LGN
SUSTAINABLE
FORESTRY MIN.RECYCLED
INITIATIVE CONTENT10%
Certified Fiber sourcing POST-CONSUMER®
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MADE W USA
GET ORGANIZED AT SMEAD.COM
Make application to local Fire Department
®— Fire Department retains original application and issues duplicate as Permit.
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�PLICATION and PERMIT Fee: 10.00
for storage nk remdv- all d transportation to approved.tank disposal yard in accordance with the provisions
of M.G.L. Chapter 148_Section 38A, 527 CMR 9.00„application is hereby nia6e, by:
•
- Peter Reynolds
.
Tank Owner Name(please print) X
agn re i apllying orpe
Address , 190 Bridge Street, Osterville '�
Street City State Zip
"Companyame Advanced Environmental . Co.or Individual Advanced Environmental
Print Print
Address P.O. Box 472, S. Dennis. MA Address
Print Print
Signature (if applying fcr_ermit) Signature (if applying or_ermit)
IF Certiries they F IFCI Certified = LS= # Other
-- - Tank_ Location 190 Bridge Street, Osterville, MA 02655
Steet Addressc
Tank Capacity(gallcrsl 500 Substance Last Store^ #2 Fuel OI1
Tank Dimensions(dian-ei---r x length) x
Remarks:
7FFirmsporting waste Advanced Environmental State Lic. #MAV5083856100
Hazardous waste mac r E.P.A. #
Approved tank disposal vard J.G. Grant Tank yard# 03501
Type of inert gas Tank yard address Readville, MA
City or Town Centerville FDID# 01920 Permit#
Date of issue October '9, 1997 Date of expiration October 23, 997
Dig safe approval nurrber_ 973730164 Dig Safe Tall Tel. Number-800-322-4844
Signature/Title of Ofac--__ranting permit Pt?3
After removal(s)send F=L=?-290R signed by Local Fire Dept.to UST Regulatory Compliar=—Unit, One Ashburton Place,
Room 1310, Boston, MA M7 08-1618.
FP-292(revised 9/96)