HomeMy WebLinkAbout0195 WIANNO AVENUE - Health OJ3�n�61� Y3 = Imo - I�IZ
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TOWN Or BARNSTABLE GYM
UNDERGROUND FUEL AND CHEMICAL. STORAGE SYSTEMS '
ASSESSORS MAP NO. PARCEL NO.
ADDRESS; p A wf Jq Nt h[Q V E_ VILLAGE �SKV f LL Pi B ��(odC'S
CONTACT PERSON PHONE NUMBER
LOCATION OF TANKS CAPACITY: .TYPE OF FUEL. AGE: TYPE: LEAK
—� OR CHEMICAL , DETECTION
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< 2 SYSTEM'
GR® 0 nl�p-
DATE OF PURCHASE,OF. EACH: 1. 2. 3. 4. 5.
DATE OF FIRE DEPARTMENT PERMIT:
TESTING CERTIFICATION 'SUBMITTED: PASSED DID NOT PASS
'PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD.
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