HomeMy WebLinkAbouttank removal undatedMake.application to local Fire Department.Fire Oepartment retains original application and issues duplicate as permit.
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APPLICATION and pERMtT
for siorage tank removal and transportatj
of M.G.L. Chapter i48, Section 3BA,527
on to approved tank disposal yard in accordanc
CtulR 9.00, application is hereby made by:
Fee !
e with the provisions
C,t/
ase printlriTank Orv
ACCress
lying m,t)
Other Othera lFCl Cediiied ! LSp #ri
Co. or lndividual
SiEnature (,f apptying lor permit)
Address
Company Name
Slgnature
Aidiess
Tank Loc
Tank Cag
Tank Oim
Remarks:
/ameter x length)
ci:/-s
/a
atic n
acity (gallons)Substanc-- Last Slored
I
E.P.A, +
Tank
Tank yard addre
-/,L
-/
/1
-
/-l-..\a /z z-zSiale Lic. #
/7'r1
Type ol inerl gas
Firm transponing lvast
Hazardous wasie manitest#
Approved tank disposal yard
Dig Sal oll Free Tel. Number - 800-322.4844
permit -d_,
Permit.' <l f - Ov (
Date ol expiralion
FDID#
Signature / Title ol Olficer grantin
oval number:
Cily or Tov/n
Date ol issue
Dig safe appr
Alter removal(s) send Form FP-29OFi signed by Local Fire Dept. to UST Regulatory Compliance Unit, One Ashburton place,
Room 1310, Boston, MA 02108-1618.
FP-2S2 (reviseC 9/-.6)