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T,GWN OF BARNSTABLE - UNDERGROUND FUEL AND. CHEMICAL STORAGE REGISTRATION
F. OWNER AND INSTALLER INFORMATION
ADDRESS: 1 � Eft a�tt... d ✓U44*4 MAP NO. 1 42 PARCEL NO. /X
..1.
OWNER NAME: C.eriT?�t�n^N ''f* �..�4�" �t/ ���' � V I LLAGE e A �
INSTALLATION DATE: BY:
'; y�J �, �14►1K INFORMATION
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LOCATIO OF TA K: l VC�f.��i�'
CAPACITY t TYPE t:.C. .� AGE f +FUEL/CHEM ICAfL
f 1
TESTING CERTIFICATION E ] PASS E ] FAIL DATE l
t
LEAK DETECTION E ] CHECK IF N/A TYPE/BRAND
ZONE OF CONTRIBUTION E -] YES'-1''7-A,-NO-- •-•DATE'-TO BE, REMOVED' �&D`�,i,
FIRE DEPT. PERMIT ISSUED ' ` C "] YES `= C ] -NO ' DATE
LUNSERVATION E ] CHECK IF N/A DATE
BOARD OF HEALTH` \TAG NO. [ ]E ]E ]E ]E ] DATE Ale 'r/
PLEASE PROVIDE,A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD
1
TOWN OF BARNSTABLE
OFFICE OF
DARN9TADL BOARD OF HEALTH .
MAss. 367 MAIN STREET 1639.
OM11`f k� HYANNIS, MASS. 02601
August, 1988,
Dear Underground Tank Owner:
You are now required by the ' Health Regulation Regarding
Fuel and Chemical Storage Systems" published in the December
17 , 1987 issue of the Barnstable Patriot, to register your
underground tank with the Board of Health.
Please complete the enclosed Registration card . Include
any evidence of the date of purchase and installation, a copy
of the permit from the Fire Chief, and a sketch map showing
the location of such tanks on the property.
Upon entire completion of the Registration card , you
will be issued a brass valve tag by the Board of Health.
This valve., tag. shall be .picked up by you or your
representative at the Health Department located in the
Barnstable Town Hall . The tag shall then be attached to the
filler pipe of the underground tank .
Please return completed Registration card to : Town of
Barnstable Health Department, P.O. Box 534 , Hyannis , MA
026.01 , as soon as possible. You were required to comply with
this regulation by May 31 , 1988 . After this date , if you do
not have an attached valve tag, your oil supplier is required
to report to the Health Department any untagged underground
fuel tanks .
If you plan to hand deliver the Registration Card or if
you have any questions , please see or telephone ( 775-1120
extension 182) Donna Miorandi or myself during office hours .
Office hours are Monday through Friday at 8 : 30-9 : 30 a.m. and
12: 45-2: 00 p.m. .
Vey ours ,
Thomas A. McKean
Director of Public Health
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L.%wov M Tank Services,=Inc: ..w.� ...
P.O. Box 765 Marston Mills, MA 02648
508-420-3365
.99 14a n stjnx r
Storage Tank Removal Receipts"
Date: ?-✓ '� `
TYPE: Oil v .,i.. • ... . ,
Gas
j Other 1 °itlt� {.its.t?•L
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Owner: Common West,-A' o1.J.
Address 599 Main Street 5
Hyannis, Ma, 02601
Tank Size: (2) 500 Gallon Underground 1
Date Removed: AQ- FDID #: 01922
LCR Tank # 323-89/324-89 Dig Safe rY 89031797 `.
LCR Project # T 2228 ! I
i Tank Transported To: LCR Tank Services, Inc. {
381 Old Falmouth Road, Unit #5
Marstons Mills, Ma. 02648 t
Inspector: Q
Comments:
Approved Scrap Yard I
James G. Grant Co., Inc
28 Wolcott Street
Readville, Ma. 02137
Yard #03501
For LCR jiTank Services
t' INVOICE NUMBER {1
15402 1
LCRTank Services, Inc. ;
P.O. BOX 765 INVOICE DATE
Marston Mills. MA 02648 V 2/7/89
508-420-3365
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,• R
S Common o 599 Main Street
0 135 West Main Street Hyannis, Ma. 02601
E Hyannis, Ma. 02601 T I
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PROJECT # CUSTOMER PO # START DATE COMPLETION DATE TERMS
T 2228 2/1/89 2/1/89 Net 30
QUANTITY DESCRIPTION PRICE AMOUNT
Removal of (1 ) 330 Gallon & (1 ) 500 Gallon
fuel oil tanks $ 1900.00
Removal of 225 Gallons of fuel oil fran
above referenced tank 258.75 a
i
SUB TOTAL
2158.75
TAX N/A .
MTAL $ 2158.75