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HomeMy WebLinkAbout0050 LOUIS STREET - HAZMAT 50 tp U Z � TOWN OF BARNSTABLE — UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION OWNER AND INST--li-1ALLER INFORMATION f 6? ADDRESS:. /�/ � �J / - MAP NO. 4 : O PARCEL NO. Z OWNER NAME: ( )i U 14 1 X t �� ! VILLAGE I / INSTALLATION DATE: PtSQ f BY: NDDRESS: CERT. NO.. I TANK INFORMATION a � LOCATION OF TANK: CAPACITY TYPE 's'-) AGE/ c') FUEL/CHEMICAL TESTING CERTIFICATION C I PASS C I FAIL DATE LEAK DETECTION CJ CHECK IF N/A TYPE/BRAND ZONE .OF CONTRIBUTION C ] YES C\VI NO DATE TO BE REMOVED ! FIRE' DEPT. PERMIT ISSUED C I YES C ] 'NO DATE CONSERVATION C ] CHECK IF N/A DATE ti . .'BOARD OF HEALTH TAG NO. C ]'C dE I C ]C ].. DATE PLEASE PROV I DE A SKETCH; SHOW I NO THE,' TANK `LOCA:TLON ON THE BACK OF THIS CARD r.,.:e41.. bi`..al s ;nn:.Ka.�n FY...,v..rx rV a.,.. a,A,° ..rr_S°r r:.br. .. .x. H .r .,. rld •!y.r e_,s_§ •.r.i. .v^...r, r r.° t�r, w.i > e.. n `.ti. r'. Harbor Ridge Road P. O. Box 677 y forth Falmouth, Mass. 025561. ... .. _ ..Y� �y..,r• Y�. .a. v ir�:ry"'kF +"y.•^.v�.�r'4�i"�•'tr",.i^._.yk:.,�,M Y ye.� .. . ....• .. TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION / ,,, j OWNER AND INSTALLER INFORMATION L-l1�J ADDRESS: t. [ ./ l"-s t MAP NO. � PARCEL NO.y �q o c (71 OWNER NAME: W f t✓ �! ; 1 f 1°J1.►+ i / VILLAGE: V J INSTALLATION DATE: pt9l,�`i t i� BY: t � ADDRESS: CERT. NO. MA � �/ i (� jgT NK NF�OR T ON ® f�c� c; � ff i �J LOCATION OF TANK: _ CAPACITY TYPE AGE FUEL/CHEM I CAL f (/ L..- (02 L, TESTING CERTIFICATION C ] PASS C ] FAIL DATE LEAK DETECTION C)(] CHECK IF N/A TYPE/BRAND; ZONE OF CONTRIBUTION ; C 1 YES C) 7 NO DATErTO BE REMOVED s ;7 FIRE DEPT. PERMIT ISSUED C I YES I I NO DATE CUNSERtiAiION I CHECK IF N/A DATE BOARD OF HEALTH TAG NO. IV" 711 ]C ]C 7 DATE ! io t ^ PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD ', TOWN OF BARNSTABLE THE Tp OFFICE OF �!! 9TLBB BOARD OF HEALTH I, � DAH3 i MMa 367 MAIN STREET O 39 k� HYANNIS, MASS. 02601 4y 1988 Dear W rasa valve to # ( Please attach to Enclosed-l-a- b g5 _ the fill pipe of your underground tank. You must do the following as . indicated. ---- Remove your tank . I have enclosed information for you regarding tank removal. ---- Have your tank tested starting _ �!___ _ . You must test during .the loth, 13th, 15th, 17th and 19th y fr�and annually thereafter. Removal in the year �_ ��_ . I nave encioseri information reggardi.ng tank testing. in order to have your tank tested you must first contact an engineering company (see attached) to have a monitoring Once the monitoring well installed. 0 g well has been installed you can then call 362-2511 , Ext. 334 and ask for Charlotte Stiefel or George Heufelder at the Barnstable County Health Department, to have your tank tested via the Soil Vapor Analysis Test. Currently, the test is done free of charge under the auspices of an EPA grant. X _ Due to the unknown age of your tank we must presume it is twenty (20) years of age. You must have it tested _ r year and remove it by the year 1993 . To have it e p ease follow the procedure as indicated above from the ** (asterisk) on. If you have any questions please feel free to call me at 775- 1120, Extension 183 . T you, a onna Miorandi` Health Inspector TOWN OF BARNSTABLE — UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION OWNER AND INSTALLER INFORMATION ADDRESS: � bwl-cMAP NO. PARCEL NOa,VY9 AAOWNER NAME: VILLAGE: INSTALLATION DATE: /� BY: ADDRESS: �.�J_l�l�,l� 10'l" 0 I lU � ( �.� CERT. NO. TANK INFORMATION LOCATION -OF TANK: CAPACITY TYPE AGE FUEL/CHEMICAL 2 TESTING CERTIFICATION C I PASS E ] FAIL DATE ' 7 LEAK DETECTION E ] CHECK IF N/A TYPE/BRAND •� I ZONE OF CONTRIBUTION E ] YES E I NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED C 7 YES E ] NO DATE GUNSERVATION E ] CHECK IF N/A DATE 7 BOARD OF HEALTH TAG NO. [ ]E 7E ]E ]C ] DATE PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD TOWN OF BARNSTABLE — UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION OWNER AND INSTALLER INFORMATION p, ADDRESS: I�A C MAP NO. PARCEL NO 'r OWNER NAME: , 1 , VILLAGE: INSTALLATION DATE: BY: ADDRESS:�O 0" I f) I�(�d �C1� C�d CERT. NO. TANK INFORMATION LOCATION OF TANK: CAPACITY TYPE -� AGE FUEL/CHEMICAL TESTING CERTIFICATION C ] PASS C ] FAIL DATE LEAK DETECTION C ] CHECK IF N/A TYPE/BRAND ZONE OF CONTRIBUTION C I YES C ] NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED C ] YES C ] NO DATE ` LUNSERVATION C I CHECK IF N/A DATE " 7 BOARD OF HEALTH TAG NO. [ ]C IT ]C ]C ] DATE PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD