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C. � � � 1I�
TOWN OF BARNSTABLE — UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION
MAP NO. �` 5 PARCEL NO. 025
" ADDRESS OF TANK: Ca /"1�4 r►y � Vr rnv2 �� -J
VILLAGE:
1 Num bar 0tr�wjw! do
,i MAILING ADDRESS ( IF DIFFERENT—/FROM ABOVE) : !✓ /`% ' =� ����--
OWNER NAME: � � � � � �- ' � PHONE:
INSTALLATION DATE: /(Iq BY:
I NSTALLER ADDRESS: (( rr CEtRT.NO. f
*TANK LOCATION: + l ;`, � r.,uz c�v�r ► C yvi _ ~(aJ.Y�r,-1 , ,
(DQOCRSD TANK LOCATION WITH RQOPKCT TO HUILDINW)
CAPACITY TYPE OF TANK � �-'d AGE �YRS. FUEL/CHEMICAL
TESTING CERTIFICATION [ ] PASS [ ] FAIL DATE
LEAK DETECTION C ] CHECK IF N/A TYPE/BRAND
ZONE OF CONTRIBUTION [ ] YES EVI NO DATE TO BE REMOVED r t�'
FIRE DEPT. PERMIT ISSUED Ct,/f YES C ] NO DATE
CONSERVATION [ ] CHECK IF N/A DATE / >
BOARD OF HEALTH TAG NO. C ] DATE
*:.PLEASE- PROVIDE A SKETCH SHOWING .THE TANK LOCATION ON THE BACK OF THIS CARD
t
�Py�FTeEtO�d TOWN OF BARNSTABLE
.. ��
OFFICE OF
sesasTnsL% _rase. BOARD OF HEALTH
�
1639. `�' 367 MAIN STREET
D IN k•
`r HYANNIS, MASS. 02601
�j /t/-��
e 2
7 1989
Dear*p—,
Enclosed is brass valve tag #_ _ Please attach to
the fill pipe of your underground tank .
You must do the following as indicated:
---- Remove your tank. I have enclosed information for you
regarding tank removal .
Have your tank tested starting _ yl.i_"" . You must test
during the loth, 13th, 15th, 17th and 19th� .�--d
annually thereafter. Removal in the year l I
have enclosed 1 nforma-t g g '
,,,,,��,� i-rgardin tank tes l.lii Y .
order to have your tank tested you must first contact an
- engineering company (see attached) to have a monitoring
well installed. Once the monitoring well has been
installed you can then call 362-2511, Ext.334 and ask
for Charlotte Stiefel or George Heufelder at the
Barnstable County Health Department, to have your tank
tested via the Boll Vapor Analysis Test. Currently, the
test is done free of charge under the auspices of:an EPA
grant.
____ ;,►u�, +.►,A unk own aga of your tank we must w-or;11111 , i f;
is twenty (20) years of age. You must have It" t'.0 i,ed
every year and remove it by the year 1993 . To have it
tested please follow the procedure as indicated above
from -the ** (asterisk) on.
If you have any questions plea3e feel free to call me at 775-
1120, Extension 183 .
Thank you,
&X_ w4t -
Donna Miorandi
Health Inspector
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