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HomeMy WebLinkAbout0002 CHEQUAQUET WAY - HAZMAT D�a LA r" TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION t� �-jl^I, �} OWNER AND INSTALLER INFORMATlI�O}N j ADDRESS: c c FA Ed ) A(A u E� MAP NO. 1 t_I PARCEL NO. OWNER NAME: 13 PZ �a 1�CL rd'P V I LLAGE: rJ"i •��� ~r J INSTALLATION DATE: BY: i� +NARavL,SA.M ')EL--E'AArl ;.R✓��-�S J _w ADDRESS: �-N�4JA Jc WA CERT. NO. � �, TANK INFORMATION LOCATION OF ANr: r to _T" 1\ � (.0%4 r ✓ C-4 4 LO �a p � �✓S G E L CAPACITY 10 Ate. TYPE AGE _,FUFL/CHEMICAL,"o,,,-L ► F' � - TESTING CERfN TION C I PASS C I F' IL DATE �< MO-b LEAK DETECT �] CHECK IF N/A TYS /BRANDZONE OF CDNION C 7 YES C NO DATE TO BE REMOVEDFIRE DEPT. ISSUED C I YES C' NO DATE CUNSERVAIIOC I CHECK IF N/A DATE ti BOARD OF HEALTH TAG NO. C ., ]C 1111.1 ]C ] DATE 1 O _ Ll 1 l PLEASE PROVIDE A SKETCH SHOWING THE ,TANK LOCATION ON THE BACK OF THIS CARD ©A ?AA ►- L�.i-1 s JS4t�d WAY, Q r Q V 1