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HomeMy WebLinkAbout1341 HYANNIS-BARNSTABLE ROAD - HAZMAT ii�aoo\6-3�NfFc6bbLQ k z � a���� - aq i i i . . . �..-..n�-...r-o. -w-.-....r�..- .-...'^--+.+.i.4rta...y.,,,.W,1.�......,�.t+�-.,...r-w-.....-.......r.,..-..:�.-......._...-..-,-...-...--..--... . .. ..a TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHE�MjI�CJAL STORAGE REGISTRATIION {=} Q(1►�IS_ Rn, b PARCEL NO. ✓ ADDRESS OF TANK: -/ 1'YJNA116 AZ) VILLAGE: 64015 MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : OWNER NAME: �J�"�'�'I S " /l�fr '7�" G'1� /,� � PHONE: .34 2-- 28: 3 INSTALLATION DATE: ✓� 17� BY: I KISTALLER ADDRESS: CERT.NO. *TANK LOCATION: �'P AMlr hL A 11-01,witl f t3 .tJ iC �J!Willy �i'�I/f-lt/c7 (DttYOR I ft TANK 1LOCAT I O NWITH FRW'0i-CCT TO Bt9/2 LLD I Nm) CAPACITY © a TYPE OF TANK < AGE '� YRS._.--FUEL/GHEM-ICAL. TESTING CERTIFICATION [ ] PASS [. ], FAIL DATE �77— � � { LEAK DETECTION [ ] CHECK IF N/A� TYPE/BRAND''�� =' '" l-/!g ZONE OF CONTRIBUTION 411 V] YES C ] NO DATE TO BE REMOVED -' FIRE DEPT. PERMIT ISSUED C ] YES C ] NO DATE .CONSERVATION [ ] CHECK IF N/A DATE BOARD OF HEALTH TAG NO. [ /f=/'�,. ] DATE _418 Iq3 PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD _� ����_. �= r-. ��- p�-�- � l �