HomeMy WebLinkAbout0193 WHEELER ROAD - Health 199 Wheeler vc,6 _ :h
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09-26-199? 08:23AM CENT OST FIREDEPT - 508?902385 . P.02
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Fire Department retains original application and issues duplicate as Permit.
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'�`ra�t��nt��rn�CJ�e�uccea-- �c oa�o�c��►e _,,,✓�xeue,n�an{ '��APPLICATION and PERMIT Fee:!—f-60 UU
for storage tank removal and transportation to approved tank disposal yard in accordance with the provisions
of M.G.L. Chapter 148, Section 38A, 527 CMR 9.00, application is hereby made by:
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Tank Owner ame(please print) Harold Theran X
Address \O� 193 Wheeler Road, Marstons Mills sane r/1 ag for DermRl
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Company Name Advanced Environmental Advanced Environmental
Pal Co.o. Individual
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Address P.O. Box 472, S. Dennis, MA Address
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Signatur p yi or r i Signatu pp g r e
ClF I Certified rtfiec Other ` IFCI Certified = L??n Other '✓
Tank Location 193 Wheeler Road, Marstons Mills, MA
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Tank Capacity(gallons) 275 Substance Last Stored #2 Fuel !k'�1 =°
Tank Dimensions(diameter x leng r �
Remarks:
Firm transporting waste Advanced Environmental State Lic.# MV5083856100
Hazardous waste manifesz! E.P.A.#
Approved tank disposal yard J.G. Gran[ Tank yard# 03501
Type of inert gas v Tank yard address
City or Town Centerville FDID# 01920 Permit#
Date of issue September 24, 1997 Date of expiration nrtaber $ 1997
Dig safe approval number. 9 7.3 7 0 Saf oll Wel, umber-800-322-4844
Signature/"ride of Officer cranting permit
After removal(s)send Form=P-29OR signed b o tre Dept. to UST Re atory Compli a nit, One Ashburton Place,
Room 1310, Boston, 02?08-1618.
TOTAL P.02
TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION f f
OWNER AND INSTALLER INFORMATION
ADDRESS: .7 SrU S 15 MAP NO. A. PARCEL NO
OWNER NAME: < Oic' &NAI-Ell �� VILLAGE: dmi�%e /1;lls-
INSTALLATION DATE: �z BY: uee "ORMIC oRoigjEks
ADDRESS: 1,0 5/i. A �. Q za9.1r,, CERT. NO.
�1 TANK INFORMATION
LOCATION OF TANK: )EARbAIr 114 a2 9,4y OW,00 tv t
CAPACITY JQQQ e7 TYPE POW4AGE FUEL/,CHEM I CAL olL
TESTING CERTIFICATION E I PASS E I FA.IL � DATE
LEAK DETECTION E I CHECK IF N/A TYPE/BRAND
'ZONE OF CONTRIBUTION YES [, >NO` DATE TO BE REMOVED
FIRE DEPT. PERMIT ISSUED E 7 YES EVf NO DATE
CONSERVATION E CHECK IF N/A DATE tw `
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BOARD OF HEALTH TAG NO. I ]E 31 ] DATE .
PLEASE PROVIDE A SKETCH 'SHOWING THE TANK LOCATION ON THE BACK, OF .THIS CARD
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