HomeMy WebLinkAbouttank removal 1998Make application to local Fire Oepartmenl.Fire Department retains original application and issues ,,rplicate as permit.
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APPLICATION and pERMtT Fee. $20 .00
for storage tank removal and transportation to appro
of M.G.L. Chapter '148, Section 3AA, 527 Ctrln g.OO,
ved tank disposal yard in accordance with the provisions
application is hereby made by:
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Address Baker9 Rd, W Yarmouth ltA 0267 3
Tank Owner Name (please print)John Nellanback
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Spencer Co.
adin 0r864
permit)
Other
si9nature
Company Name
Address
. lFCl Certified tr LSp #Other
Co. or lndividual
Signature (lf applying for permit)
Address
Tank Oimensions (diameter x length) 27.5" x 44" x 60"
Flemarks:
/i2 heating o11Tank Capacity (gallons)
I'tA 0267 3W YarmouthBaker Rd
275 gaL
' civ
Substance Last Stored
Tank Location 96
I
Spencer Co.
Mv5086640222 E.P.A. #
009
Tank yard address
srare Lic. # MV5086640222
dry lce
Firm transporting waste
Type of inert gas 207 Marston St, Lawrence, MA
Tonbarello Tank yard #
Hazardous waste manifest#
Approved tank disposal yard
( - AOO-322- 4844DisSafe Toll Free Tel
Lt YMichael Caruso
Date of expiration
City or Town Yarmouth
Signature / Title of Officer granting permit
Dig safe approval number
Date ol issue
FDrD# 1351
Dec 12, 1998Dec I1, 1998
TankOwner
Contamination Assessment
Approvals
After removal(s) send Form FP-290R signed by Local Fire Dept. to UST Regulatory Compliance Unit, One Ashburton Place,
Room '1310, Boston, MA 02108-1618.
FP-292 (revised 9/96)
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Permit#
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