HomeMy WebLinkAbout0165 GREEN DUNES DRIVE - HAZMAT C,-re,m boned 06v-c
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TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEM'ICAL'�'STORAGE''REGISTRATION �«r.�
OWNER AND INSTALLER INFORMATION
ADDRESS: 165 Green DES Drive MAP NO. 245 PARCEL NO. 13-1_
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OWNER NAME: 17r. and Mrs. A:)bez't Jeffrey VILLAGE: West Hyarmisport
INSTALLATION DATE: 1977 BY: Unknown own � 7 7E -.
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ADDRESS: CERT. NO. flVfltWl
0 m- -7 T— TANK INFORMATION
LOCATION OF TANK: AT3 IOX. 30 feet "in f_Ton't ref_ (tarprip 1 Mr
CAPACITY ?il1�1�1 TYPE i.. , 'AGE , " ' FUEL�CHEM"ICAL" 'cZLxlt -Ui1
TESTING CERTIFICATION C ] PASS C ] FAIL DATE
LEAK DETECTION CX] CHECK IF N/A TYPE/BRAND, +�
ZONE OF CONTRIBUTION C ] YES C ] NO DATE TO BE REMOVED
FIRE DEPT. PERMIT ISSUED C ] YES C7 NO DATE
LUNSERVAi ION C�] CHECK IF N/A DATE
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BOARD OF HEALTH TAG NO. W� ]C ]C ]C ] DATE JIR
. PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS; CARD
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