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Home My WebLink About0077 CARRIE LEE'S WAY - HAZMAT q j eio-r'rI e-LL�,e es W a 1 62 � 08-- oo 'i Cam- rvd1 -7,V V l A T- TOWN OF BARNSTABLE — UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION /l OWNER AND INSTALLER INFORMATION ADDRESS: �� ( / :r'�c'/C' Pf' 'S 4)4.y MAP NO. 140) PARCEL NO. ?~009 OWNER NAME: 1./tl liy /(./• / �-f VILLAGE: INSTALLATION DATE: VG'�� l d 14 BY: ADDRESS: CERT. NO. TANK INFORMATION LOCATION OF TANK: �f�i�' CAPACITY A ©0 TYPE -e L AGE 0 FUEL/CHEMICAL i C TESTING CERTIFICATION C I PASS C ] FAIL DATE LEAK DETECTION C I CHECK IF N/A TYPE/BRAND ZONE OF CONTRIBUTION C 7 YES J NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED C I YES C)] NO DATE CONSERVATION Cy] CHECK IF N/A DATE _ BOARD OF HEALTH TAG NO. C ]C ]C ]C ] DATE / l0 � - f PLEASE PROVIDE A SKETCH SHOW ING THE•TANK LOCATION ON THE BACK OF .THIS CARD