HomeMy WebLinkAbout0033 NOB HILL ROAD - Health (2) 33 Nobh� ll Rc�d, I4yan�tis
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LOCATION OF TANKS: CAPACITY: ..TYPE. OF- FUEL AGE: TYPE: LEAK
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DATE OF PURCHASE OF EACH: 1. / �(o �_ 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. d
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+INSTRUCTIONS TO SENDER 1.DETACH YELLOW COPY. 2.SEND WHITE AND GOLDENROD PARTS TO PERSON ADDRESSED.
INSTRUCTIONS TO RECIPIENT 1.WRITE REPLY AT BOTTOM. 2.DETACH STUB.RETAIN WHITE COPY AND RETURN GOLDENROD COPY TO SENDER.
BRADY BUSINESS FORMS-LOWELL.MASS.-TEL.458-2585 211706-1 ` FORM RM 110R
�o:• _ ___ .._.... .......... WRIGHT — JENNINGS OIL CO.
P. O. BOX 428
..... ............ ..................-......_......i.-�<7� ORLEANS E. FALMOUTH WEST YARMOUTH
255-6167 MASS. 02536 775-1797
548-0131
SUBJECT��� DATE
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SIGNED z4y�!l
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SIGNE,p DATE OF REPLY
BRADY BU91NE88 FORME-LOWELL MABB.•TEL.•BB•2668
RM 116R
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