HomeMy WebLinkAbout0053 WIANNO CIRCLE - Health (2) b/
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UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS ®/® _��Cti �/6
ASSESSORS MAP NO. -� A 3 q PARCEL N0. ,. G
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CONTACT PERSON t ff,5"rcl,,ly7v--, PHONE NUMBER �t 7>� oq t?
LOCATION OF TANKS:. CAPACITY: TYPE- OF- FUEL.' AGE: TYPE: Goo LEAK
OR CHEMICAL: DETECTION
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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.