HomeMy WebLinkAbouttank removal 2002Fire Dep
Mako applicaflon torent retajns orlglnal appl
local Firo Oep"-.Tent.
Icatlon and ls J duplicate as permit.
@"7-a"-rt"7&i*e7*.b*- % "r-l r7&a" ?r*,*ra._
APPLICATIO N and PERMTTlor storage tank re
ol M.G. L. Chaprer
Fee: .?o.o6rnoval and transportation to approved tank disPosal yard in accordance with the provisions148, Section 3BA, 527 CMR 9.00, application
tamhatiGonon Assessment
neoouat Gon&actor
Tanf trfonnation
TankOtruner is hereby made by:
lank Owner Name (please pr,nt)
Aooress
Company Name Na t iona l Environmental
X
crt
ervrces,I !tU:st.Ne!rton
Co. or lndividuat
Addrsss
Aodress
S,9na lu
shln ton
lap ng ,or permil)
O iFcr csnitied Oth6r
Signaluro (il applying ,or permjt)
O lFCl Cenitied O LSp r Orher
a^k Localron
-arx Capacrry 193119n5;car
S ubstance Last Slored aIanx 0irnensrons (diameter r tength)
a e mar,(s:
7'q x b 0"
Diqssat ln omalr1on
F,rrn transponlng wasre Nation aI EnvlronmentalServicelInc.raearoorrs v/asle manllestt N/
sraroLic., t4A #442
g.P.a. p MAR0 0 001127 0
^99toteA tank drsposal yard
I/pe ot rnen gas
Tank yard I
laa rtorr{
Ja le 01 ,SSue
C,g sa le agproval number
Aher remova.l(s) send Form Fpaoom t3tO. Boston. MA 02tO
S,gnature / Tile ot O,licer granting permit
.290F1 signed by Local Fire Oepl. to UST
FDro# O ,J J,
Oals ot expiration O'1 4
Dig Sato Tolt Fred Tel Numb6r . 80O-322.,r8+1
sb ,?0tI
,, 29? .e,,iea 9ts6
8. 1618 Bogulatory Comptiance Unrt One Ashbunon Ptace
Tank yard address
Permi!, go- Ol,t