HomeMy WebLinkAboutMiscellaneous - 12 MASSACHUSETTS AVENUE 4/30/2018 (8) 3482
• : Town of North Andover
HEALTH DEPARTMENT
,sSACMUSEt
CHECK#: DATE:
LOCATION:
H/O NAME:
CONTRACTOR NAME: L%!
Type of Permit or License: (Check box)
❑ Animal $
❑ Body Art Establishment $
❑ Body Art Practitioner $
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❑ Dumpster $
❑ Food Service-Type: $
❑ Funeral Directors $
❑ Massage Establishment $
❑ Massage Practice $
❑ Offal(Septic)Hauler $
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❑ Recreational Camp $
❑ Sun tanning $ `
❑ Swimming Pool $
❑ Tobacco $
❑ Trash/Solid Waste Hauler $
❑ Well Construction $
SEPTIC S,,stems:
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❑ Septic-Soil Testing $
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❑ Septic-Design Approval $
❑ Septic Disposal Works Construction(DWC) $
❑ Septic Disposal Works Installers(DWI) $
❑ Title 5 Inspector $
❑ Title 5 Report $
Other:(Indicate) OW $
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Health Agent Initials
White-Applicant Yellow-Health Pink-Treasurer
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Town Of North Andover INV X
CE
Department of Weights and Measures
1600 Osgood St. Blg 20 Suite 2-64
North Andover 01845 INVOICE
Phone (978)688-9540 DATE: 10/20/08
(Cell) (508)783-6403
TO: FOR:
Sam's Mobil Mart Testing and Sealing of Weights and Measures Devices
12 Mass Ave.
North Andover 01845
Fees and adjusting charges authorized by Section 56, M.G.L. Chapter 98 as amended.
Device Legal Sealing Fees Adjusted Sealed AMOUNT
Test And Seal Gas pumps $15.00 per meter 16 240.00
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RECEIVED
NOV 0 3 200
T®w .0 r� +>ARTM T�VER
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TOTAL $240.00
This is to certify that I have this day tested, adjusted, sealed or condemned tt,e above de d device in compliance with the
M.G.L., Chapter 98 as most recently amended. ?1��i
Inspector—S a er of Weights and Measures
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10 State Street,Woburn,MA 01801 te1781.246.8897 fax 781.246.8950 www.ecsconsult.com
July 13,2012 ECS Project No.95-215837
Ms.Susan Y.Sawyer - - - ___
Health Director '*
North Andover Health Department
1600 Osgood Street � � 10 Q'�
Building 20, Suite 2-36
North Andover,MA 01845 TOWN OF NORTH ANDOVER
HEALTH DSpA1RTMENT
RE: Public Notification Requirement
Immediate Response Action(IRA)Completion Report/
Class A-2 Response Action Outcome Statement
Mobil Station#1432
12.Massachusetts Avenue"'"--t,
North Andover,Massachusetts
RTN 3-30456
Dear Ms. Sawyer:
This letter is being sent to you to fulfill the public involvement provisions of the Massachusetts
Contingency Plan (MCP) for the above-referenced Site. The public involvement provisions [3 10 CMR
40.1403(3)(f)] require that the Chief Municipal Officer and the Board of Health in the community in
which a disposal site is located be notified that an IRA Completion Report/Class A-2 Response Action
Outcome Statement has been prepared for the above-named property and was submitted electronically to
the Massachusetts Department of Environmental,Protection. It is available for review using the
following link: http://public.dep.state.ma.us/SearchableSites/Search.asp
If you should have any questions concerning this submittal,please do not hesitate to contact our office.
Sincerely,
ENVIRONMENTAL COMPLIANCE SERVICES,INC.
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Shawn Rising,LSP o
Senior Project Manager
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