HomeMy WebLinkAbout0018 WOODLAND AVENUE - Health (2)_7 �
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d" 5 UNDERGROUND FUEL AND .CHEMICAL STORAGE SYSTEMS ov
ASSESSORS MAP NO. PARCEL NO. 3 9
ADDRESS; t W®ODLR N D Rif F VILLAGE a�rL=i�V/LLB
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7 296- 01392,�c
CONTACT.PERSON &Z>WI t2b IV CCDlZ C PHONE NUMBER - � € p- 33 ft a 0,'ri�1e V/L,G-
LOCATION OF TANKS: CAPACITY:. .TYPE OF- FUEL. AGE: TYPE: LEAK
-OR- CHEMICAL:
�..- _e .- _r.---_DETEi,TION,
6 Al, 9)N� g j�JY SYSTEM!
OUTS I D C. M k16--0T v5F
DATE OF PURCHASE OF EACH; 1. �✓[. J�7i+/Z. 3. 4. 5. _
DATE OF FIRE DEPARTMENT PERMIT:
TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS
PLEASE PROVIDE A SKETCH SHOWING THE LOCATIO
N OF TANKS ON THE BACK OF THIS CARD. /`9"-
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i made under autiloritJ' cnP_ree..
and Regulations
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CENTERVILLE • OSTERVILLE • MARSTONS MILLS FIRE DISTRICT 3
UNDERGROUND TANK REGISTRY PROGRAM 1977 7 /
Owner of Property: Obie Marney Date of Installati n:
Address: 18 Woodland Avenue Osterville
Description: Installer:
Size: 500 gal Certification:
Location of Tank: Underground
INSPECTION INFORMATION DATE COMPLETED BY
Site Inspection
Air Test on Tank—Above Ground
Air Test on Tank—Within Hole
Test on Piping
Cathodic Protection Test
Continuous Monitoring System Type
Backfill Operations
Vent and Fill Pipes
Other:
COPY
TESTING OF TANKS AND PIPING: EXISTING TANKS
1 Cth 13th 15th
17th 19tn 20th
21 st 22nd 23 rd
24th 25th 26th�
27th 28th 29th
(30) Removal
NEW TANKS:
15th 20th 22nd
24th 26th 28th
(30) Removal
Remarks: