0078 VALLEY STREET - Burner Installation Form 2' Power Burners
Date 12-08-82
��Name
Location 78 Valley St No. of Tanks 1
Name of Burner Beckett Mass. Approval No. 969
Gals. Stored RR9 500 Kind of Heat F.H°.W.
Under round
Location of Ton k 8 $$ Kind of Oil #2
Installed by Paul D Ashley C. of C. x 200 1
Inspected by R .Dansreau Date Approved 12-07-82
RECEIPT OF DISPOSAL OF UNDERGROUND STEEL STORAGE TANK
NAME AND ADDRESS'TURNER TRUCKING & SALVAGE CO.
OF — ,
APPROVED TANK YARD --L OD MA 0190-5
APPROVED TANK YARD NO. __IUQ
Tank Yard Ledger 502 CMR 3.03 (4) Number:
I certify under penalty of law I have personally examined the underground steel storage tank
delivered to this "approved tank yard" by fim, corporation or partnership
and accepted same in c0nfonnence with Massachusetts Fire Prevention
Regulation 502 CMR 3.00 Provisions for Approving Underground Steel Stor 7
a Tank ti�ntling yards.
A i lofficiwal
a to TITLE DATE SIQ�D
This signed receipt of disposal must be returned to the local head of the fire department
FDIDM _____ pursuant tc 502 CMR 3:00. (EACH Ma MUST HAVE A RD=lPr OF DISPOSAL)
DIMENSIONS Tank-Removed
�From
Width Length o '��-�-- -��-----------------
o (no. street
Tank 1 --� X y�
--------------------------------------------
Tank 2 -- -- X ----- (city or town)
Tank 3 ----- X ----- Fire Department
Permit # ----� �- --------
Tank 4 ----- X ----- (if applicable)
Tank 5 ----- X -----
(feet) (feet)