HomeMy WebLinkAbout21E document 1993 - - (3)1Z1 F.P. 292
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Department of Public Safety
Division of Fire Prevention and Regulatiol
FDID#-Q 7 Z/ 0 Permit Date 19
Ald-Aw L-)"vpr
City, Town or District
Fee Paid: $,26 0. 0
C.82 5.40 M.G.L.
DIG SAFE NUMBER
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start date
In accordance with the provisions of Chapter 148, Sec. 38A, M.G.L.,
527 CMR 9. 00 application is hereby made by: J, 6), a)qL<Cn jr -T-11 c
Street Address & City or Town:
Signature of applicant:
Applicants name printed:
For permission to remove and transport one underground storage tank from.
Owner: 111ZnIc Street Address:
Firm transporting waste://,/-9 eklylpA?�State Lic.# RY Id6
Hazardous waste manifest # E.P.A.#
Approved tank yard: 1j'-re #
Tank yard Address: '71a V4."
Type of inert gas: UL tank #i
Tank capacity: Substance last stored: q,14-f
)ate of issue: 19 Date of expiration:(-' I / -Z 19 ES
gnature/Title of officer granting permit: =t""