HomeMy WebLinkAbout0120 IRVING AVENUE - HAZMAT /2,D I01 AVAu¢ ,
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TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION
OWNER AND INSTALLER INFORMATION
ADDRESS: ) 2,0 MAP NO. IS PARCEL N0. 01,7
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OWNER .NAME: �.�`�.t� C` E-aril A-u17� VILLAGE:
INSTALLATION DATE: �" BY: "r. C A( 644.1r
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- CERT. NO.
4 M 0 ! ! lJ G� . TANK INFORMATION
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LOCATION OF TANK.- t"r .<'. / .►
TYPE .{ . A: �,IK,--,'` AGE Ned-
CAPACITY FUEL7CHEM I CAL -
TESTING CERTIFICATION C ] PASS C I FAIL DATE
LEAK DETECTION C,]''CHECK IF N/A TYPE/BRAND•,t
ZONE OF CONTRIBUTION C I YES A-3 NO DATE TO BE REMOVED ^ _
FIRE DEPT. "PERMIT :ISSUED - C,,..]-Y-ESy ri C,: ] ;NOS DATE.
CUNSERVAiION Cam]'` HC ECK IF N/A DATE
BOARD OF. HEALTH TAG NO. JC JC ]C ] DATE ! �� MAIL
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PLEASE PROVIDEIA SKETCHtSHOWI'•NG THE TANK LOCATION ON THE BACK OF THIS CARD '
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