HomeMy WebLinkAbout0442 MAIN STREET (HYANNIS) - Health �fya (rl�,in ��-reed; I�m�s
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TOWN OF BARNSTABLE - UNDERGROUND DUEL AND CHEMICAL STORAGE REGISTRATION Pe
OWNER AND INSTALLER INFORMATION
, ADDRESS: + / 17q S-r'` ll E ¢ MAP NO. I Q T PARCEL N ,
OWNER NAME: 4(Jf` OF f 1�C�«iJV 1 � VILLAGE: lV /`-�
INSTALLATION DATE: BY:
ADDRESS: � / CERT. NO.
4_r (""' � A � ` �TANK I NFORMAT INFORMATION 6 0 '7 7_5-0 j��
LOCATION OF TANK: '
CAPACITY 000 TYPE E L.� AGE FUEL/CHEM I CAL ! i. 6 L' 0m,
TESTING CERTIFICATION C I PASS C I FAIL DATE
LEAK DETECTION C I CHECK IF N/A TYPE/BRAND
ZONE OF CONTRIBUTION C T YES C ] NO DATE,TO BE REMOVED
FIRE DEPT. PERMIT ISSUED C I YES C I NO DATE
CONSERVATION C I CHECK IF N/A -DATE
BOARD OF HEALTH TAG NO., POO-ft IC_; ...7 C ]C ] "DATE
PLEASE PROVIDE A -SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD
`t' .tk •ae'.r .y., .'Y• .. ,...fi•- +. ;+s..r,-: r.� .. „r ... -
o�- s s9 5903
CG -Y
fN Q fir' — 1o:- S'S ?F R. I 9 3 2 S N E Sa^�+E<L
� GRIGGS ASSOCIATES INC.
" ' � Street 'ry`t�r .. LEE
} , 400 Hingham, i , .
h'w -ROCKLAND, MASSSACHUSETTS 02370-0369 1
1
' (617) $71-6040 f/ — —
'GATE J. —J� JOB NO- � s
1 € ATTENTI '
To �,�?'
4
C ,
3<rN SP .�'c-tX��s tea ,Ete
Ads,.
x .,W� ARE SEN(71NG'�YOU Attachedt'f� Under separate,,cover,via _the following
items:
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:�❑ Shop 4draw¢ngs, " ❑ Prints ❑ Pans ❑ Samples ❑ Specif¢cations,
Copyf Metter cGS ❑ Change order CI
u; DATE 7 NO y DESCRIPTION
1
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THESe ARE eTRANSMITTED'as checked'below
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i � ' r ❑ yFOr rOVal § } ❑,Appro j'as submitted `• ❑'.Resubmit—
aptCOp18s fOr'`apprdVal [ '
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ruse '❑`Approved;as noted ❑ Submit copies for distritiution
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t {��Asxrequested ,. � °",❑ Returned for Corrections ❑ Return_.®.vcorrected.prints
�'Y�y� '".v.� �;r�'��k�.7�ry"�_.'f 'c�"�'.. ,`�"'C��.,' ,R,� '° - • �; ,,. W,P �•. f. � � , ,� \.
❑. For review and comment
OpFOiBIDS DUE 19 Q PRINTS :RETURNED AFTER LOAN TO, UStL�
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i,s -SIGNED;t
*•�,af .` }. ,}, _ y!f not as srtcfasur.*$are n 40, hM 1Y n6V'f!'ui t Once�l u :t, r k •/;.,_,.. + a Ae. • ;: -ri'"'s. Sc � c� r-, �..k r' �s, -: f ..w
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1-40V— 1 -S 8,`8 PR i 09 32. EHE S° SECUR I —r � P 03
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# a ATTACF,, MENT "B"
Please Print. o
,
TEST METHaEi_ el
f Tank Testing Company RL00114q -&Ilatl Date,�Q_j,
lcompany name, address].•
TanlC.Owner- /7 /P. I r� 1 e Tank Location G
t� l tl 1 _:�. 4j l
OF
Tack ldentiftcat4on flu be
VN
� N R'
. 4 (all Dept,dt ,Ub ca fetyform.sF.P. 2 0 p 3 posted a storage facility)
Rom` �a� .NaTE'if`I ; 2 O was not qn file poi✓this facility, notify local ire department/district)
4" ,3 rah ?;" 4 c `" • ` '
���� ���� �Reasort`for Test"�
0 rij,.y.. ,`!/ a r 14:✓!' t Y tF
d�ametr � J Tankage Tank construction 9 a
-� (inches)'. t (years)
"T7 , k7 o pa it�;� C + 'C Was tank c horated ,?`lES t N -''
If"'caiibr ted attach tlie' calibration strip 'chart indicating product level; amount added or
removed and number ofincrements: /
When was the last bulk delivery made ? ci
(time, date, type of product)
's ' Type of pro duct �nftank at time of test
. 9
r
.level of waterf '� at time of test f °t t'X8
y
ArnoUnt ofr product added at time of test rv ,
. _ s� AW
` (gallons) g
�'� ""�,�c.e ��,���; '�r• � ' , r M° 1, t i. .. / ._ - 4 'i},
A 'Graundwater height rolative td;tank bottom at time of test.
(inches).
®oes testcompe teEforgroundWater pressure on tank ?. YES v'' NO
•.'Vapor.pockets found ? N0 Where they eliminated;? YES M NO
Where any motlf1catio,nst made to tih tank% fin prior to, during,
Ow
y e, ptp g p g,
or atter.•the test?`YES .IU If.YES Explain what modifications:
r p
s +dii d
FOR THE PURPOSES OF THIS SECTION A NON-TIGHT SYSTEM SHALL BE DETERMINED
BY A DEFINABLE LEAK RATE OF 0.05 GALLONS PER.HOUR OR MORE. j
Was the test not completed or considered inconclusive ? .YES _ y NO l
33
4<
Fd O - 1 5 y— $ 3 ?,F R I 0 9 3 3 ENE . S- S E C U R. I T"Y F 04
_ r ,
If,YES explain. }# ,. ,:
1
According to the test results is the tank leaking .? YES !/ NO _
'g Jgr If the tank and or piping is considered leaking was the head of the local
•R
fire department notified ? YES NO
DATEyNOTIFIED,: TIME NOTIFIED
;"i CERI`I�Y TMAT THE;TEST WAS DC N UCTED ACCORDING TO THE PROTOCOL OF THE
r• �k, STEST �°M TFiQ"D USED -TESTIi�G WAS DONE IN ACCORDANCE WITH ALL
-_,
'OMMONWEALTH OF' ASSACHUSETTS RULES AND REGULA'nONS.
Ael
to 1`o signat 'O rint testors name) (certification number) (date)
calibration,;chart as w 11Tas'ali ertinent data to co es of the test charts clear) indicating'�Attachs �. .' .
Are ,the producizlevel terriparafiur and time of reading at intervals of no less'than every 5 minutes,,
leted test fa ahe,cgrnp rmias well as all other data shall be submitted to the head of the local fire
u x } degpartmer t/dastnctA�mmedaately upon completion,vf testing.
-, •.,gY vyr'�'�.?�^��a �,.a*^,z+EF�,.u•r yr. . . • � - -
} rgs W • ' a s c
� kd r.
J _
J
f
y i
N 0 V - 1 S - $ 8 ' F FZ I 0 9 3 4 E M E S S E C U R I T Y P 0 5
.` I'tTROTITE TA1vI SY TEnI TIG ITNE S TEST r
�1
Funk of New England 442 Main Straat Hyannis, MA 10/24/88
Name of Owner or Dealer Address No. and Street City State Date of Test
TANK TO TEST CAPACITY
10 sidis of Bank Nominal Capacity 3000 0t3
Gallons Actual Capacity 30
T__ .....__ Gallon
Identify byaPosition
opil; x; `
is-
there doubt as to the True Capacity 4 From Chart
Ic
r G INVENTORY
-, ILL-,7P FOR TEST Stick Reading Gallons
. before F�li•up� to 1/8 - �7 Gallons` 3008
gyp; s
Water - 27 '
�� x S4" a Top Off +10
TANK LtIAMETER ^ _ •; _ _ .. f
� � "s �,t' Product in full tank pup to fill pipe)
t
f ri fl FOR TSTf ASSEMBLY EXT�NSlON HOSE SETTING t
tax STANK MEASURr=MENTs ..
Tank top to grade .30
�,z aBottom o#;tankttafg�ade .� t�4 � , ..............
Extend hose on suction tube G"
or more below tank top .
Add 24"for
• Total tubeyassembly Approx. ....: WW 11$ " - " If Fill pipe Extends above grade, use top of,fill,
TEMPERATURE/VOLUME FACTOR(a)TO TEST THIS TANK
is.
today wanner? Colder?�] 60's F Product in Tank F Fill-up Product on Truck F
. Thermal Sensor readin" after circulation _
sky f ¢ 9 - Cigits Nearest deg.F ••
` x r.-
' Dig lt par t=din rartge of changepigits
� F
R, _ Gallons
o a quan i y'�n u an ' ; oe, jai nM o expansion or - o uh c ange to tills an
" � involved product per deg.F
This i f t
o ume c an a per e its er e . n test an e . _ a uma c an e s lost
M- 9 :p �9 ram, . ,r,. p. 9 g 9 Per igi factor
Y_). r Compute to 4 decimal places'.
" ;TEST RESULTS: .'Tests were made on the above tank system accordance with test procedures prescribed.
for"'PETROTITE"as detailed on attached test charts with results as follows.
Tank Identification ?Tlght xrc; Leakage rate indicated Date Tested
< .
#2 oil NO Gross Leak 10/24/88.,CERTIFICATION This is to certify that the tank system was tested on the date shown. Those indicated as "TIGHT"
1762 meet the criteria established by the National Fire Protection Association pamphlet 329.
Serial no. of thermal Cindy Jackson/110411826 Briggs Associates, Inc. j
sensor. .. :.
Technician I Certification No, TESTING COMPANY GNATURE
Y y, r t. . - 4 � '� ':;.,w`-+-�� a+. F•�#��"'t'' llt� j h.! 's"'1=�+���_'- Y"-' y„�,-''�t.'....�y'Aesr..,,�-=
M O V -,.1 5 - 8 8 F FZ I 0 .3 3 4 E N.E S. S E C U R" I T Y ~P .'0 r,
F} ATTACHMENT „B„
r ,3 ,ems Please Print:
r TEST METHOD
dank T$stin
COpany aRIG�S ASSOCIATES, INC,�N4, R�CKLgND,' MA. .
• ''t os.a.,.rn.va�r•wfpeno,w1+®a I� �'w 1 ,®
(company name, address]
' Tank Location
Ltd•` '4' k' y E R� "v#Z 't-RLy,_/fp -
K4 � �' F�,' '�'��-`•v��,��a�C d�`•n:* 'd�� ��}�`�*r'S`.r• �`k4 •4 ! .. -
an1C Identification-Number ' -
Y
(an t�ept ..0 Public"Safety form F.P. 290 Dart 3 posted at storage facility)
* Nbl'E yIf F:F':29t):was not 6 •file for this facility, notify la�al fire depart ment/district}
xs spy
4
m Reaton orst
A
Tank a oTank Construction ?
� FiII,�j ,,Diameter �` `` y
� t� y �, , ��, , � � �l;�nches) �`_ (years) ' ;•
Wf" ;n'�` �„ rt' ,.j ni�;y •I"'`w'' " 'u'•z�•:3^'4 ' •c, , , -
k _ C Was tank Glibrated ' YES N(?
Wank capacity ,'
.; allons)
. < If;caiibrtedattach the., calibration strip 'chart indicating ,product level, amount addedr or .
removed, n`d'nu tuber of increments.
When was the last bulk delivery made ?
ST (time, date; type of product)
f prvduct��r tank at time of to r
4 4a_z z
^ �W
Level of grater(�f any t at tir h f tes
Sr � 4mount offproduct added at time-of„test
(gallons)•
�{ y
" Grour ,dWater'heightirelativoio tank bottom at time,o#test -
;, _ > (inches)
r A
•
'Does`test compensate for groundwater pressure on tank ? YES NO "
Vapor pockets found ?YES.. NO Where they eliminated,?YES NO
Where'.any modifications to the tank/piping prior to, during, t
If YES Explain what modifications, w ,
•�{. or a#te�the test ? YES . N0 _ .
YtLZ
4
. • ;. '
FOR THE PURPOSES OF THIS SECTION A NON-TIGHT SYSTEM SHALL BE DETEHMINED,.
BY A DEFINABLE LEAK DATE OF 0,05 GALLONS PER HOUR OR MORE, j
Was the test not completed or considered'inconclusive ? YES NO ,,,.�
.,. N 0 V 1 8 — 8. F R I 0 9 3 5 E N E S SECURITY P .: 0 7
ff.
If YES explain.
`' ACLfc7rding to 4h® test resultsiS the tank leaking •YES _-- NO
-if-the tank and or piping is considered leaking was the head of the local
ire department'notified .` YES' NO
SATE°iUCT1FiED } . TIME NOTIFIED
t
' �,� pax,' � :�'" P��'�k•aT'.4:f�$�n f d,:.• �. ,�:,
"1 YHA7 TI-fE, 'EST VITAS CONDUCTED ACCORDING TO THE PROTOCOL OF THE
LATEST tETHc�CP}�U?E[ TES
-TINS 'WAS DC3NE i�1 ACCORDANCE R®A►NCE �I11TN . ALL
CCMMONVVEAL'Tk, CF A,SSACHU-SETTS RULES AND REGULATIONS.
iz-.,.�49d,.�
gs�gnatur ) tpri testors name} (certification�number} (date)
�� �6 �.. 'r� • � * '
s Attach calt,brat:on'chart'as°well as.61i�Oertlnent data to copies of the test charts clearly lndicatin r
�thekpr V,level,#emperature and time of reading at intervals of no less than every l5 minutes.'. '
The completed #eat form as well as all other data shall be submitted to the head of the.local fire
^y'
epartmentldistrict;immpdaately upon completion of testing.
Ad
5 4-'N�An. s{
t Y' �b,�rr�
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PETRO TI'TE TANIK SYSTEM TIGHTNESS TEST
Bank'of Now England
442 Main Street Hyannis MA 11/03/88
'Name'of Ownor.or Dealer Address No. and Street City State Date of Test:
> *_)v."TANK TO TEST t CAPACITY
Between Bank&JQwelry Store f: uaminal'Capacity 3000 f' Gallons Actual Capacity 3008 _' Gallons
Identify by.Position � W.
20t11,� �� r` k kbY -
Chart
��.=� is ahem doubt as to the True Capacity ?
t* El
From
,Brand or Gra a 5, "
QL
ONVENTORY
FILL UP%FOsgTEST� � Stick Reading Gallons
>' y" tick Water�gottom'
,,�iibefore FiII up `'. �tC1 1!8'' 60 Gallons. 3009
Water .50
� 'a �' ."� �< r 64 `'r Top Off +8
� TANt4 DIAM "1 k 'V Product in full ETER
.� u k(up t 1 pipe)II tan o fill 2966
v' .. fM1R'"'li pF�'3 ffi -_ y •. � 3 ALE + t,.
' �i TANNI
K MEASUREMEN F fOR TSTT ASSEM$LY EXTENSION HOSE SETTING ' z:
�t $e �i
� x Sg Tank top to grade " ...................
rr � f3ottor�iof tank to:grader.
A,tl � " , `.. ,�-, �, . . , - Extend hose 4n suction tube 8 ,
r40
� 0 for 4 .L
or more below tank tank top ... ... "
'66-24",for,3 L
Total tu!?e''sssembly Approx,�. >. r. a 'If Fill pipe Extends 0pve grade,use top of fill.
TEMPERATURE/VOLUME FACTOR(€)TO TrST THIS TANK I_ Y,
�, is today V;trmsrr?e' ]' ' vldet?^ ] 40's F Product in Tank F Fill-up Product on Truck F'.
t. 54 55
r� k Tl7ermaf5�n�or raadmg after circulation . 10694 ®igits Nearest deg, F
_" '
9its per ..,"in,range of®xpected change " Digits v
�2222 1.3348334 a
s� .,,:�an�.,4;���'� x�,'°. � � � _�, /� ,�.; : � '' ,� ' ' Gallons
ti a icien o expansion orX,• o ume c ange�n't is tan
A.
nVOiVed product pot deg.F
v
� iw3348334�� 311 y pd292
,y. 0 This.lstest 4*
�^ 9 o;ume c ange per eg ' agit8 p r,®g. in es ange o ume change per +g+t factor(a)•
Compute to 4 decimal places.
NEST-RESULTS _ ` Tests�ws'r®made on the above tank systarn in accordance with test procedures prescribed
°far"PETROTITE":as detailed on attached test charts with results as follows.
Tenk Identification Tight}. leakage rate Indicated Date Tested
#2 Oil - Yes .00151 11/03/$$ ;
�tF
CERTIPiCATION This is to certify that the tank system was tested on the date shown. Those indicated as "TIGHT",?" "
1018 meet the criteria established by the National Firs,fttection Assoolatiora<Pamp let 329.
'Serial no,of thermal Cindy Jackson/110411626 BRIGGS ASSOCIATES, INC. y f
sensor.
Technician/Certification No. TESTING COMPANY NATURE
_0!,rw�rY e2 .y a rs
a �1.-s �3
�.0O TEST RRO(rEDt tES <. F YD STATE O mE P1 U#�E6°i��i�'�� �TE�"�PERAT43RE (�01°'1P�#�SAT� ` . SET-VOLU E L
PRESSJREtON (�} RECORD "t ' USE F T -4 a ). .EACH REA3IN43� ' •� ti
kq
f. _ �y:' ° L d a �rodixt 1rw P( UCt r :ti` L' J Utt� ! C ypy g
Date
UJtment• w a.
Record details of sett .,, nc� duate
. ' i ��� �� _ ; Or ad cYx(a�;_ i.
up and runnier test' n9- a ` r Sam' Hft volur6e minus _gyp.
r,
r
=. o, lieir�nin Lea�tstors �Aftr #�rodi�ct` {. .
F tine r�`� � r"� <� `� #�^ .,,; `. �"� y�'r -� 3:r r ,�,# a� � � � _ ;p� Ex i t ��+� Q���~ Q]�
•71
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y4� e11Cf ,,..
�G4��i�raCti�t t1E���.�....
t�ntrac T'
• � _n xf.r.. ~ ^1,.- ,{�,s}}�,xg. icy .rV*
(f
}. j ' t �:./f✓ d {/ .1!''
}t ! a •v 4.Y}'£ , .:( 4'a�+ 'Y i 4.J' f '#
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NOTES;
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Dat& ,
Lmtion: Depth to WatBr Table �.
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1
HYANNIS FIRE DEPARTMENT
95 HIGH SCHOOL ROAD EXTENSION
HYANNIS, MASS. 02601
RICHARD R. FARRENKOPF BUSINESS: 775-1300
CHIEF Swope Oetectazd Save .eived EMERGENCY: 775-2323
DATE 1- I g-8'
TO Ma, &ALL. mcmanawa-'(
�rancll. Wl�ina�ec
,n off- 1YQ.a rcn —C-30LA h
Li4'Z Tncl\%. 5k. )A Ya" nynyh ffi o?(gp
In accordance with 527CMR 9 .21 (1) [below] the following
tank (s) ;
�17 3,b®® Q al ton s���l kanlc �c.ntcl� �ye.d. �nc �Z haa�i,. oV
Located at 41AZ IMa\n S�re� �yanv�l�
Have been approved to be abandoned in place. The tank (s) have
been properly cleaned by ;
C
and have been filled with an approved inert material of ,
Cav�c 're. o c
Each step in the process has been inspected and was
ndrto
be in—c-o-mpl-iance with the code
L�.—1 Dea.,e, L. VtOanonoh cell �e�e,�r►u�. C7 �eec
For;
Richard R. Farrenko,pf , Chief
Hyannis Fire Department
CC.
Town of Barnstable Board of Health
527CMR 9 . 21 (l) If the owner decides to abandon a tank which is either located under a
building and_ cannot be removed from the ground without first removing the
building or which is so located that it cannot be removed from the ground
without endangering the structural integrity of another tank, the owner shall
promptly notify the head of the local fire department of this condition. After
verification that such condition so exists, the owner shall have all product
removed from the tank, by hand pump if necessary, under the direction of the
head of the fire department, acid shall have the tank filled with a concrete
slurry mix or any other inert material approved by the Marshal for this purpose.
1
f Q Q �1) 011�1, � •(Il • �0 � 1jJr���)�r1e�Y, 4 * y r f '•f f
.'-'.-.. 5:�.•..1>�.-.•-�._a»w.�i:_ —-aa:�'.i.+iy.�..��.1�1KK...� __ _ uu: t 1. t._t LFIRE
�� DEPT. STATE USE ONLY (ERIIDIC�lX
. O.NumberSubmit to: 404egZZi+�•s•,
LOCAL FIRE DEPARTMENT
�� 4 � Date Received
Jw.....w..._.:i�r.._♦..�....._31.+-..e_•.---.. - ..."._.y - 4 __•� -'1wM ��wah .�iL�.�...�.L.��.a.Y+,.a..�....�1..._..:..._ -�.
MID
Notification is required by federal law for all underground tanks flint have been 4. pipeline lacilities (including gathering line,) regulated undo the N:uutal (ia,
used Ur store regulated substances since January I,1974,that are In the ground as of Iripclinc Safety% Act of 1968.o d r the Ilav:oou,I.iquid Pipeline Satctt Act o u
f 19' .ur
Mal 8,1986,orthatarebrotightinlouseafter Nifty,8,1986.Theinfonnationrequested whichisanintta,tate pipeline facilitvregulatedundei State
latts:
is required by Section 9002 of the Resource Conservation and Recovery Act,(RCRA), 5•surlace Impoundments,pits.ponds.or lagoons:
as amended. 6.storm water or teasic water collection systems:
'I he primary'purpose of this notification program is to locate and evaluate under- 7.Ilow-through process tanks:
ground Tanks that store or have stored petroleum or ha!ardous substances. It is 8.liquidlrapsoiassociatedg;tlhcringlinesdirectlyrclatedtooilur gas ptoducuonand
expected that the information you provide will be based on reasonably available gatheringoperauons:
records.or.in the absence of such records.your knowledge.belief,or recollection. 9. storage tanks situated in an underground area (such as a ba,cotcnt, cellar.
mincworking.dt11t.shaft.or tunnel)it the storage lank is%iltfatcd upon or ahovc the
Who Must Notify? Section 9002 of RCRA, as amended• requires that, unless surface of the fluor.
c\cmptcd,owners of underground tanks that store regulated substances must nolify
designated State or local agencies of the existence of their tanks.Owncr means— What Substances Are Covered? I he noelication rcquirc'ments appl'I to under-
(a) in the case of an underground storage tank in use(fitNo%cmber H. 1984.or ground storage tanks that contain regulated substances.1 his include,am suh,umce
bruucht into use alter that date.an\person who owns an underground storage tank defined a, haiardotu in section 101 (14) of the ('on,ptchcn,hc I nt irtnnnCIIIA
used for the storage.use.or dispensing of regulated substances.and Response.Compensation:md l.iabilit\Act of 1980(CI:RC'I.A).with thecwt,ption of
(b) in the ease of any underground storage lank in use before Novemtrer 8. 1984. those substances regulated as h:vard„us waste undo Subtitle C of RCRA. It ako
but no longer in use on that date.any person who owned such tank immediately belire includes petroleum,e.g.,crude oil or ant fraction thcrcol which is liquid at standard
the discontinuation of its use. conditions of temperature and pressure(W degrees Fahrenheit and 14.7 pound,pet
What Tanks Are Included? Underground storage tank is defined as any one or square inch absolute).
combination of tanks that(1)is used to contain an accumulation of"regulated sub- Where To Notify' Completed notification lorms should be sent Io the address
stances."and(2)whose v olume(including connected underground piping)is IOr i or given at the top of this page.
more beneath the ground.Somc examples are underground tanks storing:1.gasoline.
used oil:or diesel fuel,and 2.industrial sol\cnis.pesticides.herbicides or fumigants. When To Notify? (.Owners of underground storage n lire in use . Thal h:nc hrcn
What Tanks Are Excluded? Tanks removed from the ground are not subject to taken our of operation. \ aflcr Januan I. 1974.but still in the ground.runt notil by
notification.Other tanks excluded from notification are: Mav 8. 1986.2.Ow Hers who bring undrrgrmmd storage Tanks into use alter Pray t.
1.farm or residential tanks of 1.100 gallons or Icss capacity used for storing motor fuel 1986,must motile within?0 days of bringing the tank,into use.
for noncommercial purposes: Penalties: Any owner who knowingly fails to notify or submits false information
,2.tanks used forstoring heating oil for consumpike usconthe premises%%here stored: shall be subject to a civil penalty not to exceed S10,000 for each tank for which
3.septic tanks: notification is not given or for which false information is submitted.
Please type or print in ink all items except signature"in Section V.This form must by completed for Indicate number of (�
each location containing underground storage tanks.If more than 5 tanks are ow tied at t ins location, I continuation sheets U
photocopy the re\erse side.and staple continuation sheets to this form. attached
.ten
Owner Name(Corporation,Individual,Public Agency,or Other Entity) (If same as Section 1,mark box here ®)
Bank of New- England Fa i sty,Name or Company Site Identifier,as applicable
Street Address•
442 Main Street Ar
County AY I YT
V y Stre t ddress or State Road,as applicable
Barnstable
City State ZIP Code County
Hyannis MA 02601
Area Code Phone Number City(nearest) State ZIP Code
617 775-0925
Type of Owner (Mark all that apply®)
® Current State or Local Gov't ® Private or Indicate Mark box here if tank(s)
Corporate number of 1 are located on land within
❑ Former ❑ Federal Gov't ❑ Ownership tanks at this C� an Indian reservation or ❑
(GSA facility I.D.no. uncertain location on other Indian trust lands
)
` Name(If same as Section I,mark box here ❑) Job Title Area Code Phone Number
Stephen R. Parkhurst Senior V.P. 617 775-0925
--7777777
❑ Mark box here only if this is an amended or subsequent notification for this location.
certify under penalty of law that I have personally examined and am familiar with the information submitted in this and all attached
documents,and that based on my inquiry of those individuals immediately responsible for obtaining the information, I believe that the
submitted information is true,accurate,and complete.
Name and official title of owner or owner's authorized representative; Sienre ,,`� Date Sig ed
Stephen R. ParkhurstSenior V;P^ L % �
,,..,. _-_,_�.. .___- - —� G`� ---- - _
Form F.P. 290 Part 2
a A •
Section 1)Bank Of Neu F,nq1 nnrl_ Locatioon' (from Section II) y�y�yre +!!Page No. 1_of 2—Pages
- - - __._...•.__W
,ank Identification No.(e.g.,ABC-123),or Tank No. Tank No. Tank No. Tank No. Tank No.
ArbilrarilyAssigned Sequential Number(e.g.,1,2,3...)
II.Stalus of Tank Currently in Use [ Q Q Q Q
(Mark all that apply®) Temporarily Out of Use Q] Q Q Q Q
Permanently Out of Use Q Q Q Q Q]
Brought into Use after 5/8/86 Q Q] Q Q Q
2.Estimated Age(Years)
3.Estimated Total Capacity(Gallons) 000
4.Material of Construction Steel ® QQ 0 Q Q
(Mark one®) Concrete Q QQ Q Q Q
Fiberglass Reinforced Plastic Q Q Q Q Q]
Unknown Q Q Q Q Q
i
Other,Please Specify
5.Internal Protection
(Mark all that apply®) Cathodic Protection Q Q Q Q Q
Interior Lining(e.g.,epoxy resins)
None
Unknown
Other,Please Specify
fi.External Protection Cathodic Protection Q Q Q] Q Q
(Mark all that apply®) Painted e.g.,asphaltic)
Fiberglass Reinforced Plastic Coated Q Q Q Q Q
None
Other,Please Specify
7.Piping Bare Steel Q Q [Q 0 Q
(Mark all that apply®) Galvanized Steel ® Q Q Q Q
Fiberglass Reinforced Plastic Q Q Q Q Q
Cathodically Protected Q Q Q Q Q
Unknown Q Q Q Q Q
Other,Please Specify /1'
8.Substance Currently or Last Stored a. Empty ] Q Q Q Q
In Greatest Quantity by Volume
b. Petroleum
(Mark all that apply M)
Diesel Q] Q Q Q] Q
Kerosene Q Q Q Q Q]
Gasoline(including alcohol blends) Q Q] Q Q Q
Used Oil Q Q Q Q Q
Other,Please Specify
c. Hazardous Substance Q Q Q Q Q
Please Indicate Name of Principal CERCLA Substance
OR
Chemical Abstract Service(CAS)No.
Mark box®if tank stores a mixture of substances Q Q Q Q Q
d. Unknown
9.Additional Information(for tanks permanently
taken out of service)
a. Estimated date last used(mo/yr) /
b. Estimated quantity of substance remaining(gal.)
c. Mark box®if tank was filled with inert material
(e.g.,sand,concrete) Q Q Q Q Q
Paae 2• ■
uAr ( tUW1U1rj0UW1 of : t�z� url�za�ri
Ki N 1
E,�I I'/'► 1Tj 4E-1A1T OF PUDLIC SAFE -"-DIVISI014 OF FIRE f F'CVL14-11011
APPLICATION FOR. PERMIT TO MAINTAIN AN EXISTING/NEW UNDERGROUND
STORAGE ''FACILITY
=- k_ To: Head of Fire Department
_...;i_
Hyannis April 18 , 19 86
City or Town Date
Application is hereby made for a permit to maintain an existing/new
Form F.P. 290 underground storage facility as required by 527CMR9.00: Permits.
Part 4 g. g
Location of property: 442 Main Street'
Street address
Owner of property: Bank of- New England-Barnstable County
Full name of person, firm or corporation / �4 l
Signature of owner or authorized representativvw
Fee:$ 5 . 00 (M.G.L.A. Chapt. 148 Sec. 10A) (
,ye i'�-g Oif 7;,4
(Fire Department's Copy to be Filed with F.P.290 part 2)
f:)E 1�1.1 -N. -.IIT OF PUDLIC SAFETY" 'DIVIS;10i4 OF T'IrIE: P1:EVE 14- 01d
41
2 19�6
Date
Form F.F. 290 TO MAINTAIN AN EXISTING/NEW UNDERGROUND STORAGE FACILITY
Part 4
In accordance with the provisions of 527CMR9.24 this permit to maintain an
existing/new underground storage facility cis granted to:
Location of property: V1 2 ft Y4
� �street address
Owner of property: q,c► e� /(/C��l moy �aivc�1",roy� b� l k
Full name of erson, pirm or corporation
Restrictions:—, iiv al
0
Fee Paid:$ (M.G.L.A. Chapt. 148 Sec. 10A)
This permit will expire -----�— 4ds Date Sianatu of HeadAFirept. or ap{� intee
(Oi:rner' s Copy to be posted at the storage facility with F.P.290 Part 3)