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TOWN OF-4BARW—TIABLE — UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION
OWNER AND INSTALLER INFORMATION
-- ADDRESS: ' �C..f� ll'imij- # MAP NO. AT PARCEL NO. f09
OWNER✓ NAME:• w fA f t � 1.•t VILLAGE: it
INSTALLATION DATE`e% /� =-B
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AIDDRE S: CERT�..�- lp� - -- -- =- -°-s TANK INFORMATION
LOCATION OF TANK:
J `CAPACITY S.-AT6 .TYPE !/ AGE FUEL/CHEMICAL
tTr^ESTING CERTIFICATION C ] PASS C ] FAIL DATE %
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LEAK DETECTION A CHECK IF N/A TYPE/BRAND
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"ZONE OF CONTRIBrtFFU-TION E]-YES-�-�C NO DATE TO BE REMOVED
t/F I RE f''DEPT ' .REfEtf M,LT....I. SHIED CsJ] YES C '"l-NO DAT f
f CONSERVATION [ CHECK IF N/A 'DAT
BOARD OF HEALTH, TAG NO, ]C IT ]C ] DATE
PLEASE PROVIDE A -SKETCH SHOWING THE TANK LOCATIOPON HE BACK OF THIS CARD
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CENTERVILLE OSTERVILLE MARSTONS MILLS FIRE DISTRICT
i UNDERGROUND TANK REGISTRY PROGRAM
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j Owner of Property: s',j e Date of Installation: /T
Address: _ 3 10Y c_e til
Description:_ f—e e Installer: u
Size: �~�O — Certification:
! Location of Tank:
f. INSPECTION INFORMATION DATE COMPLETED BY
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I Site Inspection
Air Test on Tank—Above Ground
Air Test on Tank—Within Hole
4° j Test on Piping
t Cathodic Protection Test
i. Continuous Monitoring System Type
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Backfill Operations
Vent and Fill Pipes
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Other:
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May 28 , 1992
Mr. Tom McKeon
Health Dept .
Town of Barnstable
P . 0. Box 534
Hyannis , MA 02601
Dear Mr. McKeon:
I am enclosing my orange certificate of registration for my
underground oil tank located at 34 Joyce Anne Road in Centerville .
Gas was brought up the street the beginning of this year and as of
April 1 , 1992 , I have converted my heating system from oil to gas .
There is no oil remaining in the tank, however, I am not in a
financial position at this time to have the tank removed. I
understand I have 2 years to act on this as my house is 10 years
old and the tank was installed at time of construction.
If you have any questions , you can reach me at the above address or
call me at 775-6092 .
ours truly,
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J ith A. Cacci i