HomeMy WebLinkAbout0630 SOUTH MAIN STREET - HAZMAT 630 StA
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_4�J � TOWN OF BARNSTABLE X
�✓ UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEM . ; /
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i ASSESSORS MAP NO. PARCEL NO. t LJC--}, }
ADDRESS: 63 D So Mfj I�l �I �N%�i@�///_C�'VILLAGE
14AME;._.. ..._
CONTACT PERSONS dVl L PHONE NUMBER 7S 7S-73
LOCATION OF TANKS: ' CAPACITY: TYPE- OF- FUEL. AGE: TYPE: LEAK
x OR CHEMICAL: DETECTION
SYSTEM!
DATE OF PURCHASE OF EACH: l.., 2. 3. 4. 5.
DATE OF FIRE DEPARTMENT PERMIT:
TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS
PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD.
JUL 08 '91 1E: 1.9 CENT.OST.FIRE DEPT. �- - P.2/2—
FORM F.P. 292
(rev. 9/90) J ��
Y Department of Public Safety
Division of Fire Prevention and Regulation
APPLICATION FOA PERMIT, AND PEFUT, FOR REMOVAL AND TRANSPORTATION TO APPROVED TANK YARD
01920 Permit #, Date JULY 8, 19 91
CENTERVIL'LE(TOWN OF BA STABLE)
City,Town or olstrWt
DIG SAFE NUMBER
.•�.Fee Paid: 91280219
S t.�.00,----
start date
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In accordance with the provisions of Chapt r 148, Sec. 38A, M.G.L. ,
527 CMR 9.00 application is hereby made by: SHORELINE TANK
NE:_ST.: OS't�R�ILLE MA.. � •._ ,
Street :Address & C3ty or own:
signature of applican s
7 X�12 1
Applicants name printed: �-
For permission to remove and transport one underground storage tank from.
owner.,
MRS. R.C. PRATT Street Address: 630 MAIN ST. , CENTERVILE, MA
Firm transporting waste: HITCHCOCK WASTE OIL State Lic. # MA--10
Hazardous waste manifost # E•P.A. #
Approved tank yards A.IWDONED #�
Tank yard Address:
Type of inert gaa: UL tank #:
Tank capacity: 275 .GALLON Substance last stored: #2 FUEL
Date\of issue: JULY s 19 91 Date of expiration: JULY 2z, _lg 91
�,`Sig4riatur6/Title of officer granting permit:
t
KEEP ORIGINAL AS APPLICATION AND ISSUE DUPLICATE AS PERMIT