HomeMy WebLinkAbout0019 COVE ISLAND ROAD - HAZMAT l�'7 -osr�
TOWN OF BARNSTABLE -� UNDERGROUNDFUEL AND CHEMICALISTORAGE REGISTRATION
OWNER AND INSTALLER INFORMATION Q�
ADDRESS: PT t�r� l_C I n h�l/ u MAP NO. PARCEL NO. ;
OWNER NAME: �6 C.f P"'�� l t 0 I ] � � VILLAGE: 61�� �� I ) t I
INSTALLATION DATE: BY: 1 l
ADDRESS: AR Y C ,y CERT. NET.
A s v u a r 'r n cu C�TANK INFORMATION y
LOCATION OF TANK: - ' S UL ) S P✓ �..� r«y o� y'C) (�
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CAPAC L;TY r Lu
`TYPE 1 AGE v Y FUtEL HE,M i
TESTING CERTIFICATION C I PASS C I FAIL DATE
LEAK DETECTION C I CHECK IF N/A TYPE/BRAND'
ZONE OF CONTRIBUTION C I YES C� 1, NO DATE �TO+.BE)REMOVED
P U r" c C"
5 PERMIT ISSUED C C"J�NO DATE
FIRE DEPT. PE ] YES # . T�
CONSERVATION C ] CHECK IF N/A DATE
f^ BOARD OF HEALTH TAG NO y (�jt_ I C I[ ]C ] DATE �I I
PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD
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