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TOWN OF BARNSTABLE
UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS
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NAME;._.. _.. AP-��-� .._.�
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CONTACT PERSON 11L; PHONE NUMBER
LOCATION OF TANKS: CAPACITY: TYPE OF-FUEL. . AGE: TYPE: LEAK
OR CHEMICAL: DETECTION
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DATE OF PURCHASE OF. EACH: 1. C uw 2. 3. 4. 5.
DATE OF FIRE DEPARTMENT PERMIT:
TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS
PLEASE PROVIDE A KETCH SHOWING Ti LOCATION F K H S S 0 ING THE OC TION 0 TANKS ON THE BACK OF THIS CARD. e
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