FACILITY NAME OR SITE IDENTIFIER MAILING ADDRESS STREET ADDRESS / FACILITY If / OF TANKS AT FACILITY / / /
IndustryTerm
gas production / heating oil / /
Organization
OF FACILITY PUBLIC GAS STATION PRIVATE GAS STATION MARINE GAS STATION PETROLEUM DISTRIBUTOR AIRLINE AND/OR AIRCRAFT OWNER AUTO DEALERSHIP RAILROAD LOCAL GOVERNMENT STATE GOVERNMENT FEDERAL/NON-MILITARY FEDERAL-MILITARY COMMERCIAL INDUSTRIAL HOSPITAL / Department of Licensing and Regulatory Affairs / CERCLA NAME AND/OR CHEMICAL ABSTRACT SERVICE / Bureau of Fire Services / / /
Department of Licensing and Regulatory Affairs, Bureau of Fire Services, Storage Tank Division P.O. Box 30033, Lansing, MI[removed]Phone[removed], Fax[removed]INSTRUCTIONS FOR FORM BFS-3821, REGISTRATION OF UNDERG