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HomeMy WebLinkAbout0027 NORTH BAY ROAD - Health (3) � � ��� r k M i �� �` a i I TOWN OF BARNSTABLE } UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS NAME 4�- /V L1 •L r ADDRESS 0,02 VILLAGE 01/S7/27a f-1�/266,2szS LOCATION10TIANKS: 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 1 A P P R O V E D Barnstable Conservation Commission .' Signed Date Board of Health Town of Barnstable P.O.Box 534 Hyannis,Massachusetts 02601 MUST BE COMPLETED,SIGNED AND RETURNED TO _ THE STEEL TANK INSTITUTE BEFORE YOUR COPY F -- OF THE LIMITED WARRANTY WILL BE MAILED. `STEEL TANK INSTITUTE y 666 DUNDEE ROAD NORTH3ROOK, IL 60062 Fn x e 'w' �f� 33 �� r a �i xi ' t � i r E, � NTY REGISTRATION ® __. THESE TANKS WERE MANUFACTIRED TO Stl-P3 _ THE FOLLOWING-st-P3 TANKS w-.._.. n_ WERE SOLD TO: SPECIFICATIONS BY: ,r r �M ass..achuse.ttsE ;-_g ia g, :CSoth Shore -Heati o I' nc 57 :Whites. Path ;~t Avon Industrial (:Park South _.Yarmouth, MA 02664 Avon, MA 02322 4 s ffia eS q }ys h r�i DATE�ELtVRBD y. afy n ,". 1/16/84 1 1 0,00 .ga.l,lon- UG,tank N0: J-1.44553 21963. STI.-P3 protecta.ve.system with . .... .,20 year...11m.i ted:.warranty I - - CERTIFY THAT THE ABOVE INFORMATION IF. INSTALLED AT DIFF- r 'CORREC ERENT LOCATION THAN Sam r In Hu11 I nt 94 ABOVE OR RESOLD GIVE North Bay Road, Oyster Harbors - MAA.,rACTJR.rcR . ..—_. ./ NEW INFORMATION. i Peter 14H..w_MUrphy y LOstervillPy MA 2/ 184 'I * TLkWN OF BARNSTABLE — UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. "y_. 0 " PARCEL NO o<� 2,�2.L ADDRESS OF TANK: 7 1116 - 9A a ',� C-) A 0 V I LLAGE: Q.S'1F,0_u r I l NumbOr V ®troot ' MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : 19 0. Y?(--X d r- Al A OWNER NAME: j .`) G1 't] r c a A r L X a L � PHONE: INSTALLATION' DATES I^!STALLER AIJDRESS s _ ."t A I- -�r� `(�t �I f� CERT o N00 e ~ *TANK LOCATIONa / �� c� f) /c7i:, . �- �] � I A (CaOCR E OQ �7f NK Loc4zd E ON W Z TH FiQOimcsCT 'TO ®U Z LD I N®) CAPAC I TY /000 lr4&I TYPE OF TANK : S7�! - AGE 9 YRS. FUEL/CHEM' I CAL TESTING CERT I F I,CAT I ON• . [ ]` PASS [ ] FAIL"- DATE LEAK DETECTION [ ] CHECK IF N/A TYPE/BRAND, ZONE OF CONTRIBUTION-, [ ] YES [ ] NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED C a ] YE C /S ] NO DATE /a-S�IrP CONSERVATION C ] CHECK IF N/A DATE / RBOARD OF HEALTH TAG NOa C � . ,;. DATE 9//9149 3 �c PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD ��df a° ;a„i` THE T�,f The Town of Barnstable Health Department 367 Main Street, Hyannis, MA 02601 ,63y. Office 508790-6265 Thomas A. McKean FAX 508-775-3344 Director of Public Health DATE a l 873 Dear m o Enclosed is brass valve tag # Please attach to the fill pipe of your underground tank. You must do the following as indicated: ---- Remove your tank. I have enclosed information for you regarding tank removal. m Have your tank tested starting n?4You must test during the loth, 13th, 15th, 17th and 19th year and an u y thereafter. Removal in the year '� I have enclosed information "regarding- tank testing. ** In order to have your tank tested you must first contact an engineering company (see attached) to have a monitoring well installed. Once the monitoring well has been installed you can then call 362-2511, extension 334 and ask for Charlotte Stiefel or George Heufelder at the Barnstable County Health Department, to have your tank tested via the Soil Vapor Analysis Test. ---- Due to the unknown age of your tank we must presume it is twenty (20) years of age. You must have it tested every year and remove it by the year DEC 1993. To have it tested please follow the procedure as indicated above from the ** (asterisk) on. If you have any questions, please feel free to call me at 790-6265. Thank you. Thomas A. McKean Director of Public Health " ` TGWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. nq" PARCEL ADDRESS OF TANK: ,;2 7 VQ , t?A �4 '\gn A b VILLAGE: Number Olr��t h` MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : Re"X ;;1',/ /' c'?s�e--u" JF_ AI A c)abS_S` OWNER NAME: _ ) /? 41 1- A L. PHONE: e,4 t, 1 INSTALLATION"DATE: OUT BY: _�e_3/r e� ��tF PA�r+� INSTALLER ADDRESS: �� ( A F '1r 0 u �f "✓t IV A , CERT.NO. = t *TANK LOCATION: A 9 0 A c��cv`� � ��c�� ��o�;�' �iu�—t-AtiCF f (DtYO/R I aR �-r NK L_oc4 J I ON W I TM RRoF-KcT TO OU I LD I NO) :5� CAPACITY /©Oo�t1!/ TYPE OF TANK , 7/ P- '� AGE A YRS. FUEL/CHEMj I CAL ;',. �-w X x o' C TESTING CERT I F I CAT I ON> ,,.C ]A PASS C ] FAIL, DATE LEAK DETECTION- C ] CHECK IF N/A TYPE/BRAND : ZONE OF CONTRIHUTION,,,. { ] YES [ ] NO DATE T'O BE REMOVED / FIRE DEPT. PERMIT ISSUED [ v]' YES C ] NO DATE CONSERVATION C ] CHECK IF N/A DATE OV HOARD OF. HEALTH TAG NO. [ / " ] 'DATE PLEASE PROVIDE A SKETCH SHOWING THE--TANK LOCATION ON THE HACK OF THIS CARD