The URL can be used to link to this page

Home My WebLink About0073 HARBOR BLUFFS ROAD - HAZMAT n,� THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) mF°�L DATA TOWN::'OF BARNSTABLE — •UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION OWNER AND INSTALLER INFORMATION _ ii.�ADDRESS:'. .`1 -_0 C '+~E lc� T)I V'Fr �d MAP NO. PARCEL NO. OWNER NAME: a'��• .•.S : .I t i"�cy`a VILLAGE. INSTALLATION DATE: I q ` 3 )BY: ADDRESS: ,, y j CERT e+ NO 10 €'"'TANK INFORMATION LOCATION OF -;TANK:,� CAPACITY TYRE �,`� c.I, ' AGE FUEL/CHEMICAL - TESf ING CERTIFICATIONq C FAILa DDATE. P LEAK DETECTION z`C ISHECK IF `N/A TYPE/BRAND ^ ZONE OF CONTRIBUTION:- C ]`YES Cx] NO DATE TO 8E •REMOVED. '' `` FIRE DEPT. PERM I.T!4, ISSUED ' C _.YES,` C ]. NO DATE'` CUNSERVA i ION C �Q/CH.ECK.,'I,F. N/A DATE BOARD OF HEALTH -TAG NO. C l/ C ' ]E. ]C - ]C ] .DATE 6/ L PLEASE PROVIDE A SKETCH- SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD t - •y �•-.�. 7�"`Sr. .,r-''�+ t •e_?r�M'` ," '�Z"'r-s'. <r a;+,u r '"�.'., r1Y'�" �{' • r i�� !+ • • � • • • • • • � °+d.. 'v' � 1' t� g;,'" 'f i a :k`i� <:;•� r*_:e;.Jo- y` t.� �.1�:T''..�.�A'• of � r � �k 'tY�+kt+y't, �' \ FIRE DEPT. FIRE DEPT. STATE USE ONLY CERT FI CAI ION >j" LO.Number Submit to: ,L �ll l� LOCAL FIRE DEPARTMENTDate Received • 1,;� Sd �" ter 3'` •Sit ^yC y„N% ,r .. '�� ry R`.'t_;Ti= • • �. Notification is required by Federal law"for all underground tanks that have been 4, pipeline facilities (including gathering lines) regulated under the Natural (;as used to store regulated substances since January 1,1974,that are in the ground as of Pipeline Safety"Act of 1968.or the Hazardous Liquid Pipeline Safety Act of 1979,u1 May 8,1986,or(hat are brought into use after May8,1986.The information requested uhichisanin u"astatepipelinelacilit�regulatedunderStatelaus: is required by Section 9002bf the Resource Conservation and Recovery Act,(RCRA), 5.surface impoundments,pits•ponds,or lagoons: as amended. 6.storm water or wan'Te water collection systern%: -1 he primary purpose of this notification program is to locate and cyaluate under- 7•flow-through process tanks: ground tanks that store or have stored petroleum or hazardous substances. It is 8.liquidtrapsorassoetatedgatheringlinesdirectl)Wlatedtooilorgasproductionand expected that the information you provide will be based on reasonably available gathering operations: records,or.in the absence of such records.your knowledge.belief,or recollection. 9. storage tanks situated in an underground area (such as a basement, cellar. Who Must Notify? Section 9002 of RCRA,as amended, requires that, unless mineworking.drift,shaft,or tunnel)if the storage tank is situated upon or above the exempted,owners of underground tanks that store regulated substances must nntif)" surface of the floor. ' designated State or local,&ncics of the existence of their tanks.Owner means— what Substances Are Covered? 1 he notification requirementsappl%y to under- (a) in the case of an underground storage tank in use on November 8. 1984.or ground storage tanks that contain regulated substances.phis includes any substance brought into use after that date,any person who owns an underground storage tank defined as hazardous in section 101 (14) of the Comprehensive Eno if mmemal used for the storage,use,or dispensing of regulated substances.and Response.Compensation and Liability Act of 1980(CERCLA)•with the exception of (b) in the case of any"underground storage tank in use before November 8. 1984• those substances regulated as hazardous waste under Subtitle C of RCRA. It also but no longer in use on that date,am person vvho owned such tank immediately before includes petroleum.e.g.,crude oil or anc fraction thereof which is liquid at standard the discontinuation of its use. conditions of temperature and pressure(60 degrees Fahrenheit and 14.7 pounds per What Tanks Are Included? Underground storage tank is defined as any one or square inch absolute). combination of tanks that(1)is used to contain an accumulation of"regulated sub- where To Notify? Completed notification forms should be sent w the address stances."and(2)whose volume(including connected underground piping)is IV.j or given at the top of this page. more beneath the ground.Some examples are underground tanks storing:1.gasoline. used oil,or diesel fuel.and 2.industrial sohents.pesticides,herbicides or fumigants. When To Notify? 1.Owners ofundcrground storage tanks in use or that hate hccn What Tanks Are Excluded? Tanks removed from the ground are not subject to taken out of operation after January I. 1974•but still in the ground.must noiilt bt notification.Other tanks excluded from notification are: May 8.1986.2.Owners who bring underground storage tanks into use after May 8. 1.farm or residential tanks of 1.100 gallons or less capacity"used for storing motor fuel 1986.must notify within 30 days of bringing the teaks into use. for noncommercial purposes: Penalties: Any owner who knowingly fails to notify or submits false information 2.tanks used for storing heating oil for consumptive use on the premises where stored: shall be subject to a civil penalty not to exceed $10,000 for each lank for which 3.septic tanks: notification is not given or for which false information is submitted. Please type or print in ink all items except"signature"in Section V.This form must by completed for Indicate number of each location containing underground storage tanks.If more than S tanks are owned at this location. I continuation sheets photocopy the reverse side+and staple continuation sheets to this form. attached rpe"t t yy+r�2fo4'!x {..• n • 'w _' ",` pa, c 61 KS;s7S+' ,y,.•. • j7. '..w_�'�. '�' »9^",,,: r •`' �vs,�k� � ^✓�`• `1 • • 0 s�y �> 5�.,,,,ice � a, P.-; Owner N me(Corporation,Individual,Public Agency,or Other Entity) (If same as Section 1,mark box here❑) Facility Name or Company Site Identifier,as applicable Street Address Cou&4_40V'r � �� Street Address or State Road,as applicable City State ZIP Code County Area Code Phone Number City(nearest) " State ZIP Code Type of Owner (Mark all that apply®J Current ❑ State or Local Gov't nvate r Indicate Mark box here if tanks) rate number of are located on land within ❑ Former ❑ Federal Gov't ❑ Ownership tanks at this an Indian reservation or ❑ (GSA facility I.D.no. uncertain location on other Indian trust lands rme(If same as Section I,mark box here ) Job Title Area Code Phone Number �.,s Y",t�, ;c :a" t' '.tf: �.N.:x'� c )t'. to s • • fi.�.,.<.. ❑ Mark box here only if this is an amended or subsequent notification for this location. ION I certify under penalty of law that I have personally examined and am familiar with the information submitted in this and all attached documents,and that based on my inquiry of those individuals immediately responsible for obtaining the information,I believe that the submitted information is true,accurate,and complete. Name and fficial title of owner;Wowne 's authorized r resentative natu DateSigned � � 6 ' AMC ,x a R 1 r fn�l !r'-- -a <•'` �tit..�%rt'Ersr �+"f' t«�+F �. `� rr {etx.+ ++.. pF};.� :4-a* '�a7,f Form F.P. 290 Part 2 Pa� 9 r e Owner Name(from Section 1) Location from Section II { „•Vim"'""' ( ) Page Nu. _ of 'Pages ryr Tank Identification No.(e.g.,ABC-123),or Tank No. Ta nk No. Tank No. Tank No. Tank No. Arbitrarily Assigned Sequential Number(e.g.,1,2,3...) 1.Status of Tank Currently in Use �-- (Mark all that apply M) Temporarily Out of Use C� Permanently Out of Use r Brought into Use after 5/8/86 2.Estimated Age(Years) 3.Estimated Total Capacity(Gallons) e 4.Material of Construction Steel [� �� 0 (Mark one®) Concrete [� Fiberglass Reinforced Plastic Unknown Other,Please Specify 5.Internal Protection (Mark all that apply m) Cathodic Protection Interior Lining(e.g.,epoxy resins) None Unknown 9 , Other,Please Specify 3 6.External Protection Cathodic Protection (Mark all that apply m). Painted(e.g.,asphaltic) Fiberglass Reinforced Plastic Coated C� None Unknown Other,Please Specify '.Piping (Mark all that apply®) Bare Steel Galvanized Steel 0 O Fiberglass Reinforced Plastic C7 Cathodically Protected C� Unknown Other,Please Specify 8.Substance Currently or Last Stored a. Empty in Greatest Quantity by Volume EM (Alark all that apply m) b. Petroleum Diesel Kerosene C� Gasoline(including alcohol blends) • Used Oil •�� Other,Please Specify S�44 c. Hazardous Substance Please Indicate Name of Principal CERCLA Substance OR .Chemical,Abstract Service(CAS) No. Mark box.®if tank stores a mixture of substances d. Unknown 9.Additional Information(for tanks permanently taken out of service) a. Estimated date last used (mo/yr) b. Estimated quantity of substance remaining (gal.) c. Mark box®if tank was filled with inert material (e.g.,sand,concrete) Page 2 J t AMOCO$ ' r ( 7 5! ` It e 7 r t = v La tj� •ri r (• t� t t ^I ,tl r ,. r +17r 1 5 • + up Tit 001 Y'J owl .0 0A lop 4 t � i e 11 t .t• 1 not t . y� ttk y.. i � ` yo io , r .•. r , £'�.: - . .§t y e t: } r r fi } r + i Tons , fyt Y 11v 7 • ' r Z ry tt k '•+' t ' 001 , v )_( � r Jr^f y+ ;...o y t !, � l..• r.P'MI }�lo t t r 1 L !I •, s j �,t 1 /t lj r •It° a l r+.. J ; r . + ! Jr f 1�. {Y t I ! r � .'M1i ) ( y+. K 4 t. rL+' L tug,e•'• J+ � 1� 93 •e t tr'l i �1�5tr +j: rdr y r 6 r .lt °7}.7 r a� t l .fit ,;# tT ti.'.e ' t t Jr< ` 3y 1� ir rat r!`4 �'t� L.�t�D'tr yC Slt Ott. � �i rr 'r_y•`s t. I "f v ;rr i et a t V i ' , t•t S .. a .'r f r r�Jr l\F .,� ! )Y.t•'' -.9+i_ r; 1 �r++� r' •► Nta:'o4'F�r 4 t tf r t t,� i 7! t rti4f, Z ,rl if i.a �r.- . 1�,.^F 1 y. l v <��Gy /r• rMj+�7 t' B �Yr. i' + al «tr Sty .Y 'tkiwi € J J 1 .4',�1 d.. :Y J t :a t � Co ... 7•.v(., t1Y Ar ,• .:{l�f.�1 1 r•F:rt,.a?♦ 1Ji.+ -�+ 3 �f� ..'fl..y!�S,r,7d�itj:.»71. $ .i,t,��'� 7!x•.�.. .•v .