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jgWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION-,
OWNER AND INSTALLER INFORMATION
ADDRESS: / �E�,r REP?.
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OWNER 'NAME: �`l i9if r14 Aj R SW 21 �/ VILLAGE:
INSTALLATION DATE: �'7a�/ BY: .lS 1 /0 lAJA,
ADDRESS: CERT. NO.A
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LOCATION OF TANK: t. AJlk;RG�?(N)b igppkoy, } irgotf hotjs� (S6"E"9k-lF1'eN
CAPACITYa75 TYPE M97AL - AGES .FUEL/CHEMICAL "c FiyO�iL.
TESTING CERTIFICATION , C I PASS C I FAIL DATE Nor Y 7- 7s,5 rt----i l
LEAK DETECTION CV14000CHECK IF N/A TYPE/BRAND
ZONE OF CONTRIBUTION. C ] YES N NO DATE TO` BE REMOVED
FIRE DEPT. PERMIT ISSUED C ] YES Clf] NO DATE
CUNSERVAIION EVI CHECK IF N/A DATE
BOARD OF 3'WEALTH TAG NO. C1!]C ]C .31 ]C 3 DATE: f.
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PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD
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OFFICE OF �
i BABaSTABL i
y NAM BOARD OF HEALTH
1639. 367 MAIN STREET
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HYANNIS, MASS. 02601
February 17, 1989
Ms. Martha Andersen
115 Old Stage Road
Centerville, Ma 02632
Dear Ms. Anderson:
As you requested during our telephone conversation today, is this letter of
clarification concerning your underground fuel storage tank. You registered
the tank on May 3, 1988, therefore it must be removed from the ground prior
to May 4, 1990.
If you have any questions please feel free to call me at 775-1120, ext. 183.
Since ely yours, \
Thomas A. McKean �-
Director of Public Health
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