HomeMy WebLinkAbout0070 PADLOCK LANE - HAZMAT 76 PaAct la&/ u4xui\w
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UNDERGROUND FUELTAND CCHEM CI ALTSTORAGE SYSTEMS ' fl
ASSESSORS MAP N0. PARCEL NO.
ADDRESS- VILLAGE*
NAME ._.- .._ 0IQ!I
CONTACT PERSON . PHONE NUMBER
LOCATION OF TANKS: CAPACITY: TYPE OF FUEL. AGE: TYPE: LEAK
OR CHEMICAL: DETECTION
SYSTEM'
DATE OF PURCHASE OF EACH. 1. 2. 3. 4. 5.
DATE OF FIRE DEPARTMENT PERMIT: �Ca
--T
TESTING CERTIFICATION SUBMITTED: PASSED DID NOT-PASS
PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD.
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TOWN OF BARNSTABLE
UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS
NAME
ADDRESS 1� o A VILLAGE f
LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE:
D p OR CHEMICAL
y
t
(Give same information for any additional tanks on reverse side of card)
DATE OF PURCHASE OF EACH: 1. 2. 3. 4.
DATE OF FIRE DEPARTMENT PERMIT: 21 l-L S/7 g
TESTING CERTIFICATION SUBMITTED:
PASSED Q,- DID NOT PASS