HomeMy WebLinkAbout0900 SHOOTFLYING HILL RD - HAZMAT � = �� a-c.�s�
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TOWN OF BARNSTABLE — UNDERGROUND FUEL AND CHE//MICAL STORAGE REGISTRATION
MAP NO. !CZ PARCEL NO.� t
ADDRESS OF TANK: '' ` ' # `�'l� ll
"" el VILLAGE:
Num b4wrr mtr��t
MAILING ADDRESS ( IF DIIFFERENT FROM ABOVE) : J
OWNER NAME: � Al D/9 PHONE: ( ^'
INSTALLATION DATE: / f 7 BY: f A7
I INSTALLER ADDRESS: 17?r'rn "A � t� CERT.NO.
STANK LOCATION: �'U e'41D `�u1,6","'v /yC, A ALP
(DLYCRI=K TANK
NK LOCATION WITH mmemKCT TO BUILDINm)
CAPACITY 5-j'j 0/3L TYPE. OF TANK 3 eEL AGE �%f YRS. FUEL/CHEMICAL U)L-...
TESTING CERTIFICATION C ] PASS C ] FAIL DATE
LEAK DETECTION [ ] CHECK IF�N/A TYPE/BRAND s
ZONE OF CONTRIBUTION ' ["] YES [ ] NO DATE TO BE REMOVED 4006
FIRE DEPT. PERMIT ISSUED C ] YES C ] NO DATE
CONSERVATION [ ] CHECK IF N/A DATE
BOARD OF HEALTH TAG NO. [ _ ] DATE —9GZ/
* PLEASE PROVIDE A SKETCH SHOWING THE TANK� LOCATION ON THE BACK OF THIS CARD
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