HomeMy WebLinkAbout0479 WIANNO AVENUE - Health (2) ds-rvi 11-P I(019- UGS-
TOWN OF BARNSTABLE — UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION
y, MAP NO. a"' PARCEL N0. ,----
ADDRESS OF TANK: VILLAGE
Numbmr
MAILING ADDRESS ( IF DIFFERENT,,FROM ABOVE) :
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OWNER NAME: PHONE:.. .�;'� ;,�.�',;c..Z.�; ..�;,
INSTALLATION DATE: BY:
INSTALLER ADDRESS: CERT.NO.
*TANK LOCATION:
(OKOORZWK TANK LOCATION WITH MKSPWCT TO WUILOINO)
CAPACITY TYPE OF TANK AGE %l YRS. FUEL/CHEMICAL 4" 2 e)l
TESTING CERTIFICATION [ ] PASS , [ ] FAIL DATE
LEAK DETECTION [ ] CHECK IF N/A TYPE/BRAND
ZONE OF CONTRIBUTION [ ] YES [ ] NO DATE TO BE REMOVED �. � �
FIRE DEPT. PERMIT ISSUED [ ] YES C ] NO DATE
CONSERVATION [ ] CHECK IF N/A DATE f
BOARD OF HEALTH TAG NO. [ F44(10 ] DATE
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* PLEASE . PROVIDE A SKETCH SHOWING THE -TANK LOCATION ON THE BACK OF THIS CARD
TOWN OF BARNSTABLE �
UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS'''ASSESSORS MAP NO. z PARCEL NO. z®b 7y4;G / Ile
ABA: el,1 VILLAGE
070
CONTACT PERSON PHONE NUMBER
LOCATION OF TANKS;_ CAPACITY: ..TYPE- OF- FUEL AGE: TYPE: LEAK
OR CHEMIC : DETECTION
a /^ -SYSTEM-!—:
Ze �c�
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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TOWN OF BARNSTABLE
�F THE:mp
OFFICE OF
INAHa]TABL BOARD OF HEALTH
fro NA88- 367 MAIN STREET
2639.
'EOIf HYANNIS, MASS. 02601
1981
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Dear WlCkNj
Enclosed is brass valve tag # L��ID. 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 .
---- Have your tank tested starting now . You must test
during the 10th, 13th, 15th , 17th and 19th year and
annually 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 instal:"17ed . Croce the' monitoring wei —has- eeri
installed you can then call 362-2511 , Ext. 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. Currently, the
test is done free of charge under the auspices of an EPA
grant.
AwMe 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 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 775-
1120, Extension 183 .
Thank you,
Donna Miorandi
Health Inspector