HomeMy WebLinkAbout0130 CENTER LANE - HAZMAT /vd Ce4'1�9 l-cz-rie-
TOWN OF BARNSTABLE �� VA we
UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS
2) rA Q4533
1 ASSESSORS MAP NO. PARCEL N0.
ADDRESS,' u �����2 VILLAGE p
NAME,
CONTACT PERSON AA%W9-#L/ / A1AA' )V PHONE NUMBER_°
LOCATION OF TANKS: CAPACITY: TYPE- OF" FUEL• AGE: TYPE: LEAK
OR CHEMICAL: .tw_ � DETECTION
G _ �d Pin/11� Agv 11 o r q SYSTEM'.
DATE OF PURCHASE OF EACH: 1. l k l/ 2. 3. 4. 5.
DATE OF FIRE DEPARTMENT PERMIT:
TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS
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PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD.
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