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HomeMy WebLinkAboutUntitled Ol�I Z 0 P—hc�.s t L -Town-of Barnstable Regulatory Services FZWE lOy� Thomas F.Geiler,Director °* Building Division * BaxNsraBLE, Tom Perry,Building Commissioner, v Mass• �+' 039. a .200 Main Street, Hyannis,MA 02601 ArFD MA'S Office: 508-862-4038 Fax: 508-790-6230 Notice of Zoning Ordinances Violations) and Order to Cease, Desist and Abate: Sean Breau, aka The Pool Man; Donna Sabo, Estate of James Sabo - - And all persons having notice of this order. As owner/occupant of the premises/structure located at 40 Industry Road, Marstons Mills, Unit.15 ; Map 058 Parcel 028.OOM,you are hereby notified that you are in violation of the Town of Barnstable Zoning Ordinances and are ORDERED this date,January129 2009 to: 1. CEASE AND DESIST IMMEDIATELY,all functions connected with this violation on or at the above mentioned premises. SUMMARY OF VIOLATION: Violation of Town of Barnstable Zoning Ordinances: Chapter 240 Section 35 Groundwater Protection Overlay District 240-35 G (2) (e) Prohibited Uses:Generation or storage of hazardous materials exceeding 50 gallons liquid volume or 25 lbs dry weight. 2. COMMENCE immediately,.action to abate this violation. SUMMARY OF ACTION TO ABAT • Storage of toxic or hazardous ardous substances (pool chemicals.and any& all other toxic substances) exceeding 50g.allons liquid volume or 25 lbs dry weight. And,if aggrieved by this notice and order,to show cause as to why you should not be required to do so,by filing an appeal with the Town Clerk of Barnstable,a Notice of Appeal(specifying the ground thereof) within thirty(30)days of the receipt of this order(in accordance with Chapter 40A.Section 15 of the Massachusetts General Laws). . If,at the expiration of the time allowed,action to abate this violation has not commenced,further action as the law requires will be taken. :.. ' = c a order, .Robin C.Anderson Zoning Enforcement Officer l� f_ - Cc:FPO Martin MacNeely,COM Fire Q/FORMS/viozonel ,. L/Il L Page 1 of 1 Anderson, Robin From: MacNeely, Martin [mmacneely@commfiredistrict.com] Sent: Friday, January 09, 2009 4:13 PM To: Anderson, Robin Subject: The Pool Man_ Robin, Here is that contact info The unit is located at: 40 Industry Road, Unit#15 Marstons Mill, MA 02648 Owner is: Donna SaboZo a 7 P.O. Box 533 Centerville, MA 0263�De)02 Let me know if you need anything else Martin �E 7 f 19 � t , LW i 3 I s� ' v I � Town of Barnstable Hazardous Materials On-Site Inventory and Inspection FACILITY INFORMATION: Business Name: ZoAl /tuTo &�A/d Business Location: TAT& -0 e OA-D. MIRS MU S Mailing Address: d. O)c JQ. 05 � Telephone Number: Contact Person: YAI�+77- W 14/i &A-A/A-62 ME5/� h�,��j D WAI Emergency Contact Telephone Number: d7If-U6 - J/57S Type of Business: A-U TD &-)°A Ad HAZARDOUS MATERIALS (CHAPTER 108) Virgin Product Total Quantity Container Size(s) Storage Location Major Materials Gallons or Pounds Quarts,gallons, Shed,retail store, drums,tank,etc... cabinet,closet,etc 3'S -rev WEVR-S, C*.4r,4 -C 16A1 hN® �rAU-oAJS A_Nn Auk2f gorr-ES N' WASlr OIL l;�"���-e-t��t1S �Srr uocJ J,�va�s (,A9,kJiE /3` / 33_4A-u6A)J6)e-&k G4X,46 841Ar tNg 'WA-5>-r �5�i�c��cJ Dot/-( /kAl - �2�� �.S U�a�s � y w/A/0s4671> sir atlok�bra q4W B kNh —M+V'Sy/5:5/'01J 3, GA2Zo�buiA(S 441--ACyE AAP oNe ZgUkr,r &M a ,Z Alb o S COr.�oN.S 449A 6 AAJb S �y 2N��o S oa �Z/}yc(f-f1�8 S (ti �/ZLD�DS c*x/s 60AIfA-r,vdP-5 Nb�'Lp�r i�k'r9Czfti ,f6*t4_, r)AJ �P,9 P./CA 4)75 qA r� z /3t 4 f0K16-g_Adr />0d1v� s/�u�ct u z ti� 6 SppRA<E ' - 1 - i Misc. Combustibles Misc. Corrosives Misc.Reactive Misc.Toxics Inventory Total Amount: J� C,A--(—Qk1S A—N6 x0 F00a)hS Hazardous Materials License Posted?Yes Contingency Plan Posted? Yes (V Fire District: Fire Extinguisher Service Date: .Zoo Metal Covered Rag Bin: No Absorbent Material Available No Type of Absorbent:CpeeEyDt Pad Pigs Other: MSDS on site? es No Hard Cop Computer Access Hazardous Waste Handling Hazardous Waste Generator Identification Number: 9 fs,-4f elzf Type(s) of hazardous waste product(s): SEfj o��. eeS�� A AJ 77 FiOE�&- U//I-S/r ee Y&,sn8t& Date of last hazardous waste shipment,type of waste and quantity: 75G4-L A-Nr7-,vr/ Z,4' -7s-4*L e(<e7J OIL. Hazardous Waste Transporter(s): LEEx1 Designated Hazardous Waste Facility: S A-rery k iEEU, Aj S i b t) Hazardous Waste Storage Area Description Of 3-j G A't-zo,c1 6 ket/-cs A pec 5 ra g"--o 6AI �LASTIG (?�j�llTkf�(1/�( 1T �4�C1� •��/ 1kLb�t/(� OA)C- VJiK-L 6F 7WE -17V-6 f A R-4-ES E )q-o ox.. &Kje ?Lc G 4� /-j/C L PA4- Tj. kjA-SN-l2 /S 4-oGA-TED /'AP TtfE 64AA4�6 &�; /TiS 1YA1 vrX-1aJ`-b AJ- Is h3Zrdous wake storage area labeled: Ye No Are tanks/drums/containers labeled with the words "Hazardous Waste",the type of waste and the associated hazard (i.e.ignitable,corrosive,reactive or toxic)(!�5l No If hazardous waste is stored out r s is it covered from the elements? Yes (9Is it in 110% containment? Yes -� If hazardous waste is stored indoors is it on an impervious floor? es No - 2 - FLOOR DRAINS (Chapter 381) Town Sewer Account Number: �IA git511u 8Zs AS CAI 0 AIS!7E- S t''P77C-S YS 7" Indoor floor drains: Yes 09 If yes,circle one,does it discharge to a: holding tank dry well on site septic. Outdoor surface drains: Yes No If yes,circle one,does it discharge to a: holding tank dry well on site septic. FUEL AND CHEMICAL STORAGE TANKS (Chapter 326) Underground Storage Tank(s) on site? Yes 6 lV6 jt/JK-S 77-IIS -ja 4W65S Age: Is removal required? Yes No If yes,when? Is testing required? Yes No If yes,when? Out of doors above ground storage tank on site? Yes No If yes,is it protected from the elements? Yes No If yes,how? Is it on a foundation larger in size than the tank? Yes No COMMENTS/RECOMMENDATIONS/CORRECTIVE ACTIONS �'. �- c iq A. . ; .� �. Date: ���— �J Public Health Inspector: Facility Representative: ! Imo_ %m Y,9 OU �/ n irra(or/� dy !'ce�- /Z m W�rlwq -no�J i Fee-.6y�fzo�/c9 �6'�T Y ��R �a�NiiU� Health Complaints 29-Mar-04 Time: 9:00:00 AM Date: 3/23/2004 Complaint Number: 17331 Referred To: DONALD DESMARAIS Taken By: DONNA MIORANDI Complaint Type: TOBACCO Article X Detail: Business Name: Number: 40 Street: Industry Road Village: MARSTONS MILLS Assessors Map_Parcel: Complaint Description: worker named Jim Curtis is smoking and this bothers her. She does not believe it is allowed. Actions Taken/Results: SPOKE WITH JIM CURTIS. HE OWNS THE BUILDING HE OCCUPIES. IT IS NOT OPEN TO THE GENERAL PUBLIC. THE COMPLAINTANT COULD USE A MAIL SLOT DIRECTLY ADJACENT TO THE ENTRANCE. CURTIS TOLD ME THE COMPLAINTANT (THEY GUESSED CORRECTLY WHO IT WAS) COMES IN 1X OR 2X PER YEAR, JUST TO DROP OFF PAPERS. SHE INSISTS ON HANDING PAPERS TO CURTIS RATHER THAN USE MAIL SLOT. NO FURTHUR ACTION. Investigation Date: 3/23/2004 Investigation Time: 3:30:00 PM 1 i LAW OFFICES OF PAUL REVERE, III 226 River View Lane Centerville, Massachusetts 02632 (508) 778-7126 March 29, 2004 Mr. Donald Desmarais Health Department Town of Barnstable 200 Main Street Hyannis, Massachusetts 02601 RE: Huntingest Management Industry Road a C Marstons Mills, Massachusetts 0 Dear Mr. Desmarais: X � can co � Recently, you met with Jim Curtis of the Huntingest Management Group gardi& a o_v complaint that Huntingest's building on Industry Road in Marstons Mills (the 'Props y") is in violation of the Town of Barnstable's "Prohibition on Smoking Regula ion." This letter follows up on that meeting and explains that the regulation is inapplicable to the Property for the reason that it is neither a "Public Place' nor a "Workplace" under the Regulation. In particular, the Regulation regulates both "Public Places" and "Workplaces." '`Public Places" are defined as an "indoor area that is open to and used by the general public." Huntingest is a company that manages residential condominium complexes. At its office, it sends out bills and contracts for maintenance at condominium complexes. The office is not open to the general public. In fact, the only persons who even visit the office are an. occasional contractor or unit owner. Therefore, the property is neither "open to or used by the general public." "Workplaces" are defined as a place in which "two (2) or more employees perform services for their employer." Huntingest is the alter ego of Jim Curtis, a smoker. Mr. Curtis is self-employed and does not perform services for an employer, but only for his own benefit. Therefore, he is simply not an employee. In addition, Tina Squailia, who. also is a smoker, works at the office as an independent contractor on a part-time basis (i.e., 20 or less per week). While she may qualify as an employee, she only works one-half time and, therefore, for purposes of determining the number of employees, is only a 1/2 employee. See 40 C.F.R. Part 370. Thus, Huntingest has less than two employee and is not subject to the Regulation. • 1 If you have any questions, please feel free to contact me. Very truly yours, Paul Revere, III cc: Jim Curtis 2 Date: TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: -J-i m 's S'e U cc5- BUSINESS LOCATION: LA v .L NpUS mq yA LA 7) , /yH-V9N5T J.� MAILING ADDRESS: e-,L_S INVENTORY TELEPHONE NUMBER: SO S e q 2-8 TOTAL AMOUNT: CONTACTPERSON: X7'lAA/.4 6e#< 001,r—q ado EMERGENCY CONTACT TELEPHONE NUMBER:TYPEOFBUSINESS: Ft�{E pt 5-j-�I�— ,/-1-G�'a .S�-(��/lC� Cv11115117 OTHER INFORMATION: Ire. -.c.t.®.¢, i avC 0&,pa_ M 5 05 .5ik_ � k. 7��. �'lcz e use .Sad Sf.e�s a•s.rP. _r Will Waste Transportation: LAP Mali f-h ar� 1 n 30 41"s o Name of Hauler: 2rt�-��fce_ Destination: o'b�'n ee4 Waste Product: Licensed?,-E;T No LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. . NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed (gallons): Antifreeze(for gasoline or coolant systems) Drain cleaners /$a�AEW USED Cesspool cleaners 3 o_oaA Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides ANEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED . 9 Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED _ ): al Degreasers for engines and metal Printing ink Degreasers for driveways& garages Wood preservatives (creosote) 1- Battery acid(electrolyte), ba*e1Wes Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt& roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride)- Paint&varnish removers, deglossers An other products with ° Paint brush cleaners Y p 'poison" labels Floor&furniture strippers (including chloroform, formaldehyde, Metal polishes hydrochloric acid,.other acids) Laundry soil &stain removers Other products not listed which you feel (including bleach) may be toxic or. hazardous (please list): Spot removers & cleaning fluids Misc.: — � (dry cleaners) Other cleaning solvents Bug and tar removers Town of Barnstable-Health Department Page 1 HAZARDOUS MATERIALS INVENTORY SITE VISITS DBA: Jim's Service Fax: — Corp Name: Mailing Address .... .. _.--... Location: :40 Industry Road,Marstons Mills Street: 40 Industry Road . . ..... __._.. ........... mappar: 1058-028-OOM-000 City: Marstons Mills Contact: J.Sabo State: Ma Telephone: 508-428-6538 Zip: 02648' Emergency: ;508-771-3876 Person Interviewed: Business Contact Letter Date: 5/28/2004 ............................ Category: Miscellaneous Inventory Site Visit Date: Type: eb('� (*I�a`� Follow Up/Inspection Date: ❑� public water ❑ indoor floor drains ❑ outdoor surface drains ❑ license required ❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc ❑ currently licensed ❑ town sewage ❑ indoor catch basin/drywell ❑ outdoor catch basin/drywell expir -- - --- 91 on-site sewage ❑ indoor on-site syste ❑ outdoor onsite system date: ___. ........... __ Repairs Auto and Lawn Mowers complianc REMARKS: 2/17/1998 MAU 000004858. NAPA TRADES BATTERIES. Satisf ry NO RAGS OR UNIFORM-PAPER TOWELS ONLY. 2 ELECTR.LIFTS. j ANTIFREEZE RECYCLED-NO WASTE. SPEEDY DRY ON-SITE. PARTS CLEANER ON-SITE-maintained quarterly by Safety Kleen. Spill kit on site. REMARKS:2000-Recycle oil filters. 6/1/ waste is being disposed of properly or recyclecf A to spies? L censed to sell cars? C z44-NOW 1�_s 3 . J� R r • Page 2 Town of Barnstable-Health Department HAZARDOUS MATERIALS INVENTORY Chemicals: ❑ Zero Toxic Waste Materials ❑ gtys>25 Ibs dry or 50 gals liquid but less than 111 gals ❑ gty's 111 gals or more ;:'description:, qty:, vnitofimeas'ure -�,` antifreeze(for gasoline or coolant systems) i 13 cases _ _........__............................—____.___ automatic transmission fluid 5gallons hydraulic fluids(including break fluid) ! 2.gallons motor oil —25gallons .........-..................... __._.__._._____ ___..____._...._.._......................... .................__.....__.__ gasoline 2cases household cleaners _ _ 2cases paint,varnishes,stains,dyes 9cans_— — motor oil 24CAses — -- gear oil 59 Drums Waste Transporter Fire District: ................ ...... Last HW Shipment Date: Waste Hauler Licensed: No �j v� ------------ nCOPT � � Date: fO �`� o�l i 4� , ° TOXIC AND HAZARDOUS MATERIALS O -SITE IVEI'dTORY NAMEOFBUSINESS: -TiAA-S SCE(-�yICC BUSINESS LOCATION: 40 S/VAyST 7) /yKe%/_T" 4 .� INVENTORY MAILINGADDRESS: �' TELEPHONE NUMBER: TOTAL AMOUNT: CONTACT PERSON: .Sft-C b 1%1AA1A 6_eK 80(,5-!a a 1. EMERGENCY CONTACT TELEPHONE NUMBER: Ft�E Qt TYPEOFBUSINESS: OTHER INFORMATION: �o�c.c.�e.r �•t �iaz:a�l,a-us waa c * ;•5 kam&,A 4o ck. nu--- I(i,e.80W0 ic, e°a-, A. �►e —.tr.�.� ori(. .-fo /�'�5DS on wife• k. a�eucr.� Sade�Fy `�� s�.ee,,�s c�.S,Q•P � w;/� � -� � Waste Transportation: au in Name of Hauler:_ 2'.-,mod-�sf �. Destination-,.,, Waste Product: afliir'eS Licensed?: es No ;nSP ,• LIST OF TOXIC AND HAZARDOUS BAATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. - NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed (gallons): Antifreeze(for gasoline or coolant systems) Drain cleaners / EW USED Cesspool cleaners 3 Automatic transmission fluid Disinfectants Engine and radiator flushes .: Road Salt(Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides Q0YNEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED t Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives (creosote) I Battery acid (electrolyte), 1®a�#P.L,es Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car wakes and polishes Leather dyes Asphalt& roofing tar Fertilizers Paints, varnishes, stains, dyes PCBs Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride)- Paint&varnish removers, deglossers Any other products with'poison' labels Paint brush cleaners - Floor&furniture strippers (including chloroform,formaldehyde,- Metal polishes hydrochloric acid,.other acids) Laundry soil &stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers &cleaning fluids Misc.: e— (dry cleaners) G-ea.L b i( _ Other cleaning solvents Bug and tar removers r l i Date: — TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: k ` b&l SI&A CO, BUSINESS LOCATION: UO (OhIN 2M, UN1T" n MNSR6S Atil,(,� s A OZ6u3 . MAILINGADDRESS: { u Z i (N. �ME�{`�r ( �nl�_ 026g Mail To: TELEPHONE NUMBER:( 54 ) GI/to - 5►32 Board of HealthTown of Barnstable CONTACT PERSON: [ ` Ny� P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER:(5bi) L'120 - Hyannis, MA 02601 TYPEOFBUSINESS: :�iC_N Does your firm store y of the toxic or hazardous materials listed below, either for sale or for you own use? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site otherthan your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool.cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers ✓ Paints, varnishes, stains, dyes io GA PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers :✓ Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor& furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids ?A1 J ,j r�AJ CVL (dry cleaners) Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS l - Date: �-- TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: �[ �1 BUSINESS LOCATION: U&1T n maImws ki,L,"A MAILING-ADDRESS: P,, � 4 29 Mail To: TELEPHONE NUMBER:+ 7g) LI%10 - Board of Health Town of Barnstable CONTACT PERSQW =O Ep I AN" P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER:(Sb.) L i 20 -O�S7- Hyannis, MA 02601 TYPEOFBUSINESS: -!�Lfv Does your firm store a y of the toxic or hazardous materials listed below, either for sale or for you own use? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above,please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool`cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt-&-roofing;tar _ _.., Fertilizers ✓ Paints, varnishes, stains, dyes (0 C-)AIL , PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers ; Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor& furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers �. Other products not listed which you feel (including bleach) may bettxic or hazardous (please list): Spot removers & cleaning fluids �AIQ (dry cleaners) Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS TOWN OF BARNSTABLE coMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair satisfactory 2. Printers BOARD OF HEALTH 3.Auto Body Shops ,�/ _ O unsatisfactory- 4.Manufacturers COMPANY'��JW.,r �� (see"Orders") 5. Retail Stores 6. Fuel Suppliers ADDRESS A� Class: 7.Miscellaneous UANTITIES AND STORAGE (IN= indoors; OUT-outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) iiesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) � new motor oil (C) s transmission/by a Synthetic Organics: degreasers or- Miscellaneous: V Ue� � iL M-7 5 �4�� _ DISPOSALIRECLAMATION REMARKS:: J� 1. Sanitary Sewage 2.�WeAer Supply HWe� �"'4 O Town Sewer ®'Public O-On-site O Private 9 3. Indoor Floor Drains YES NO -� O Holding tank:MDC_ O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter y hName of Hauler Destination Waste Product LicensedP YES NO 2. Person(s) Interviewed Inspector Date TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH ;�X satisfactory 2. Printers 3.Auto Body Shops Q unsatisfactory- 4.Manufacturers COMPAW I M � (see"Orders") 5. Retail Stores 6.Fuel Suppliers ADDRESS Class: 7.Miscellaneous ��\\S QUANTITIES AND STORAGE (IN= indoors; OUT-outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers C401-Dr k(jj��u �Q_cc.k_ Miscel aneous: DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O Town Sewer Public � 5 1,�(On-site OPrivate 3. Indoor Floor Drains YES NOx, O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO4 ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product ( rn ,d as �( �" � �S NO 2. - S _ 4`' ' /7/6 son(s) Interviewed Inspector Efatd TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2•Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY � � (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS ` '' lass: 7.Miscellaneous ko S AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATEKIAIS IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil(C) new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: 2i2" o 0��l DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply D 0 Town Sewer OPublic 0 On-site OPrivate 3. Indoor Floor Drains YES NO 0 Holding tank:MDC O Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC 0 Catch basin/Dry well 0 On-site system 5.Waste Transporter `-- YES NO 2. Person(s) Interviewed Inspector - �j Da ,e •J . ..... . {�''�:�� �r�,-_ �R,� �rf.�,R�'ay"',' �._��':.`: — �r ________ ,_ .. . ' � -.,..TWe T'ri^y'e,. TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair nters BOARS,OF HEALTH satisfactory 3.A to Body Shops Qunsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores 6.Fuel Suppliers j. �� �'1� jags; 7.Miscellaneous ADDRESS US AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MAT ER SCase lots Drums Above Tanks Underground Tanks IN I OUT IN JOUTI IN OUT #&gallons Age Test Fuels: Gasoline Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil(C) new motor oil(C) i transmission/hydraulic All Synthetic,O•rganics: degreasers i l' _ Y 1. n 1 Miscellaneous: f f ! DISPOSAIJRECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply O Town Sewer OPublic O On-site OPrivate 3. Indoor Floor Drains YES NO O Holding,tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product 2. I ' Person (s) Interviewed Inspector Date f I ' I - S r{( Y ` t 1 C { c NSTRUCTION CO. = 'BUIL BUILDING R 5-MODELING D -CONTRACTORS LTracy[D). ox 1720•Cotuit, MA 02635 TEL(508)539-1022 FAX(508)539-1033 TOWN OF BARNSTABLE MPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY ��' (see"Orders") 5.Retail Stores � 6.Fuel Suppliers E ADDRESS -� �'It/�,Gl_.Class: 7.Miscellaneous QLANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIALS IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) Synthetic Organics: ' s yM�ascella neRus� _ .S U"LA A 4N2 DISPOSAI./RECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply own Sewer Public On-site OPrivate 3. Indoor Floor Drains YES NO O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES—Z11qO O RS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste:Product Licensed?! YES INO 1. 2. 6 V S erson(s) Inte we nspector Date i 7 ti + 1 y { r{ t . Y If you find this card in your door it means a representative from Yankee Survey has been here to m easure around the - outside of yoar house for the bank We need this information in order to complete a Mortgage Inspection Plan fo.4 your property. i SITE PLANNING-MORTGAGE SUR JE`"Z LAND COURT SURVEYS FOUNDATION CERTIFI LAT OTIO T STAKEOONS UTS RUCTION STAKEOUTS VANKEE LAND SuavEYoas CONSULTANTS PAUL A. MERI REGISTERED PROFESSIONAL LAND SURVEYOR LICENSE#32098 UNIT 1,40 INDUSTRY RD.MARSTONS MILLS,MA.02648 (508)428-0055 �i _ e TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY�� �/. ${����/ �e"Orders") 5.Retail Stores 6.Fuel dsklf Suppliers ADDRESS C ass• 7.Miscellaneous ° QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATECase lots Drums .,T ks Undeikroufid Tanks IN OUT IN OUT IN OUT #&gallons Age Test- Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: 1 � DISPOSAL RE(;I.AMATION REMARKS: 1. Sanitary Sewage 2. �ia er Supply O Town Sewer Rublic G7-" &On-site OPrivate 3. Indoor Floor Drains YES NO / O Holding tank:MDC v G O Catch basin/Dry well O On-site system �� - 4. Outdoor Surface drains:YES y NO O ERS: O Holding tank:MDC �r��/ Catch basin/Dry well G O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 2. �Z-z Person(s) Interviewed Inspector Date a TEL.(508)4286538 'l JIM'S SERVICE GENERAL AUTO REPAIRS •.SMALL ENGINES. 40 INOUSTRY ROAD JAMES SABO.Owner MARSTONS'MILLS.MA 02648 TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops t 0 unsatisfactory- 4.Manufacturers COMPANY � 1 .{ �a� (see"Orders") 6.Fuel Su pliers ADDRESS C1SSS: 7.Miscellaneous - QfJANTITIES AND STORAGE (IN= indoors; OUT-outdoors) MAJOR MATERIALS , IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Heavy-Oils: waste motor oil (C) � new motor oil (C) /17 G- transmission/,hydrauli . Synthetic Organics: degreasers Miscellaneous: t l t DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.W ter Supply 0�✓ Town Sewer � Pblic gr uOn-site OPrivate - 3. Indoor Floor Drains YES NO 0 Holding tank:MDC 0 Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES—ZNO ORDERS: 0 Holding tank:MDC O Catch basin/Dry well 0 On-site system 5.Waste Transporter Narne of Hauler Destination Waste Product �il, CJ�� YES NO 2. Person (s) Interviewed inspector Date I' ��� �� _ _ i �°'1Kfifir o TOWN OF BARNSTABLE HEALTH INSPECTOR'S OFFICE HOURS: Item No. In the space below describe all violations checked. Page of BOARD OF HEALTH 8:00-9:30 A.M. MASS 367 MAIN STREET MON. FRI. TEO MPy HYANNIS, MA 02601 790-6265 FOOD ESTABLISHMENT INSPECTION REPORT 0t" 4-- s G`'<_�P'N ral dzeeo /.0 S Establishment Name e} S' j Z or iZ2G+ �..0 Date �' ® , Time: S S Address U �Ge / In-3:iout Telephone L+ Z - �� G 0 Type of Establishment Purpose Owners Name Food Service Routine Retail Food Follow-up Residential Kitchen Complaint Person in Charge -U� Mobile Unit 9 Investigation Temporary Food Service Other Inspector's Name yv S, Caterer Based on an inspection today,the items checked below indicate the violated provisions of 105 CMR 590.000.Each item is followed by the applicable section of the Massachusetts regulation.Non-critical violations are marked under column"N"and critical violations are marked under column"C".Descriptions of each item appear on the back of this form. Each violation checked requires an explanation on the narrative page(s).This report serves as official notice of violated provisions and official notice to correct said violations. Food N C WT Sanitary Facilities N C WT 1. Food Supply .002 4 29. Water Source .015 4 2. Food Containers 002 1 30. Sewerage .016 4 Food Protection 31. Cross Connections .017 4 3. PHF Temperatures 004 4 32. Toilets/Handwashing .018&.019 4 4. Facilities, Hot&Cold Storage .004 ' 2 33. Insects/Rodents .021 4 5. PHF Re-service .006 4 34. Plumbing .017 1 6. Spoiled/Damaged Foods .003 1 35. Toilet Rooms .018 2 7. Food Protected .003 4 36. Handwashing Areas .019 2 8. Food Thermometers .004 2 37. Garbage/Refuse .020 2 9. Cross Contamination .005 2 38. Outside Disposal .021 1 10. PHF's thawed,cooked&cooled .005 2 39. Outer.Openings .021 2 11. Food Handling .005 2 40. Pesticide/Rodenticide Application .021 1 12. Dispensing Utensils .006 1 Physical facilities Personnel 41. Floors .022 2 13. Employee Infections 008 4 42. Walls,Ceiling 022 2 14. Employee Hygiene .009 4 43. Lighting .023 1 15. Employee Clothing .006 H 1 44. Ventilation .024 2 Equipment&Utensils 45. Dressing Rooms .025 1 16. Equipment/Utensil Clean&Sanitized .013 2 Other 17. Food Contact Surfaces .013 1 46. Toxics .026 4 18. Non-Food Contact Surfaces .013 :t' 1 47. Premises .027 1 19. Food Contact Surfaces Clean .013 `, 1 48. Living Areas .027 1 20. Non-Food Contact Surfaces Clean .013 1 49. Linen .027 1 o tH 21. Wiping Cloths .013 1 50. Pets .027 1 Discussion with Management "r't 3 22. Dish/Warewashing Facilities .013 1 51. Bulk Foods .031 1 e/ `0, o 23 Pre-Scraped, Soaked .013 1 52. Salad Bars .032 1 L,nJ e r t-'41 j 24. Wash/Rince Water .013 1 tk+��V�ti.C� -�- s`r ��CC/twtJ2, 25. Thermometers/Test Kits V" .013 1 No.of 13 Critical Items Violated 26. Equipment/Utensil Storage .014 1 These items require immediate attention. t'C7'-t",, " ✓ Q�- cf�1 27. Single Service Articles .014 1 11 Q- �r.��^ l• G R 28. Single Service R -Use .012 1 SCOREy ���S Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered? Y N e #Seats Observed?_AaZL Frozen DesQrt Machines: �� Outside Dining Y ✓ N Self Service IV Wait Service Provided �1/ Variance Granted Y ✓ N Variance Letter Posted Y ^� N Inspected b Received by 13 CRITICAL FOOD HANDLING VIOLATIONS Full Item Descriptions 1. Food from an unapproved or unknown source or food which is or may be Food adulterated, contaminated or otherwise unfit for human consumption C1 Food Source, approved, wholesome %.is found in a food establiahment. 2 Containers. properly labelled Food Protection 2. Potentially hazardous food that is held longer than necessary for C3 Potentially hazardous foods at proper temperatures: 140OF or above, 450F or below, OOF; rapid cooling of cooked foods within a hours preparation or service at a temperature which is greater than 45° F u Facilities to maintain product temperature 0=70 C) (in the case of cold food) or less than 1400 F (600C) (in CS Unwrapped and potentially hazardous roods not re-aerved +� na cc of hnt f��A 1 6 Damaged, spoiled, returned foods segregated .... - A/ • 7 Food protected during storage, preparation, display, dispensing, service, transportation- 8 Thermometers provided, conspicuous, accurate 3. The food establishment's facilities are insufficient to maintain 9 No ern»-contamination 10 Potentlelly hazardous foods properly thawed, cooked, and cooled product temperature. 11 Food handling minimized 12 Dispensing utensils stored 4. Potentially hazardous food or unwrapped food that has been served to Personnel customers is re—served unless such re—service is allowed under C13 Employees with infections restrictedC14 Hands washed and clean; good hygienic practices section 105 CMR 590.006(G). 15 Clean clothes, hair restraints Equipment i Utensils 5. A person infected with a communicable disease that can be C16 Equipment, utensils sanitized (automatic and manudl methods) transmitted by food is working as a food handler in a food 17 Food contact surf sees: design, constructed, Installed, maintained, located establishment. is Non-food contact surfaces: design, constructed, installed. maintained, located 19 Food contact surfaces clean, free of all cleansers 20 Non-food contact surfaces clean, free or all cleansers 21 Wiping cloths; clean, use restricted 6. A person not practicing strict standards of cleanliness and personal 22 D13h/Worpwashing racilitles: designed, constructed, maintained. Installed, located, hygiene which may result in the potential transmission of illness operated through food is employed in a food establishment. 23 Pre-flushed, era soaked 24 Wash/pinse watt cleer clean, temperature 25 Accurate thermometers, chemical test kits provided; instructions posted 7. Equipment, utensils and food—contact surfaces are not cleaned and 26 Storage, handling of clean s orages dispensing 21 Single service articles, storage, dispensing sanitized effectively and may contaminate food during preparation, 2e No re-use of single service articles storage or service.. . Sanitary Facilities C29 Water source; approved, hot&cold under pressure 8. Sewage or liquid waste is not disposed of in an approved and C30 sewage .nd waste water diznosal C31 No cross-connections, back siphonase, backflow sanitary manner, or the sewage or liquid waste contaminates or may C32 Toilets & Handwashing: number, accessible, design. Installed contaminate any food areas used to store or prepare food, or any C33 No Insects or rodents; harborage prevented areas frequented by customers or employees. 35 Travelog; installed, maintained 35 Toilet rooms enclosed, sell-closing doors, fixtures good repair, Olean, signs 36 Hondwashing areas supplied with soap and towel dispensers, proper waste receptacles 9. Toilets and facilities for washing hands are not provided, properly 37 Garba eleenge and refuse: containers covered, adequate number, insect/rodent raalatant, frequency, installed or designed, accessible or convenient. 36 Outside area: dumpster covered. construction, clean 4 39 Outer openings protected 00 Pesticides and rodenticldes. proper application 10. The supply of water is not from an approved source or is not under pressure and the food establishment does not. use single service Physical Facilities �1 Floors constructed, maintained, clean articles and/or bottled water from an approved source. a2 Walls, ceiling, attached equipment; constructed, maintained, clean 43 Lighting provided as required, fixtures shielded 11. A defect exists in the system supplyingotable water that 44 Rooms and equipment vented as required y p may 45 Dressing. locker areas provided used, clean result in the contamination' of the water. - , Other 12. Insects,- rodents or other animals are /present on the premises . T Toxies properly stored, labelled, ':sed ( y. 5 590.027\ )(3))• e7 Premises liitter-free, unnecessarl articles. cleaning maintenance equipment properly stored. unless allowed b Section 10 CMR F Authorized personnel rg Living/sleeping quarters and laundry separate 13. Toxic items are improperlylabeled stored or used. 59 No pets properly stores r 50 No pets or other live animals except guide dogs ' - • ' 51 Bulk foods stored. labelled, dispensed 52' Soled bar operations prepared, refrigerated, displayed, protected Note: In additions to' the items' listed above, any other violation of the Massachusetts Food Establishment Regulations determined by local health 1 � . officials to have:the 'potential to seriously_affect .the public health shall y oftef written notice to the permit holder constitute a, critical violation. 1 Health Complaints 11-May-99 Time: 1:00:00 PM Date: 5/11/99 Complaint Number: 1851 Referred To: GLEN HARRINGTON Taken By: K.S. Complaint Type: ARTICLE X- FOOD Article X Detail: UNSANITARY CONDITIONS Business Name: Domino's Pizza Number: Street: Village: MARSTONS MILLS Assessors Map_Parcel: Complaint Description: On Thursday,May 6 she ordered pizza from Domino's, Marstons Mills. When pizza was delivered, she found a fly inside. Actions Taken/Results: Investigation Date: Investigation Time: 1 TOWN OF BARNSTABLE C MPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY*� a f/?L; �1 � (see"Orders") 5.Retail Stores 6.Fuel Suppliers 7.Miscellaneous ADDRESS MA Al , j Class: QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIAL Case lots Drums I . Above Tanks Undergrround Tanks S IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: �� waste motor oil (C) new motor oil(C) transmissio ie- Synthetic Organics: degreasers Miscellaneous: d DISPOSALIREC:LAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O Town Sewer ublic �� Non-site OPrivate - 3. Indoor Floor Drains YES NO O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC _� O Catch basin/Dry well ` O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO L 2. son(s) Interviewed nspector Date TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH O satisfactory 3.Printers Body Shops. Vunsatisfactory- 4.Manufacturers _COMPANY �bw� �.5 L Vv�-� (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS 4,0 ZVL-_&SkV, fftt Class: � 7.Miscellaneous /4 o,,J,�u J Mills QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots 1 ground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel(A) Diesel, Kerosene, #2 (B) Heavy Oils: 2S'0 DC waste motor oil (C) zqo K new motor oil (C) A10 7 C transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply V 6 0000 Al J 0 Town Sewer ublic �� t' g _ caw On-site OPrivate Sr WW��AV ,/ /rpZA oneG C "�'Ld 3. Indoor Floor Drains YES NO� O Holding tank:MDC `� Cfeuv�c�. O Catch basin/Dry W1 well �'1 --1 - V0&W 0 On-site system 4. Outdoor Surface drains:YES NO ORDERS: 0 Holding tank:MDC O Catch basin/Dry well ! -On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 1. G A (A v 1� 2. Person (s) Interviewed Inspect Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: Mail To: BUSINESS LOCATION: K iv u�� �� Board Health Town off Barnstable MAILING ADDRESS: P.O. Box 534 TELEPHONE NUMBER: Hyannis, MA 02601 CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: --TA-n4 AA2, Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO X This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: 11t1y✓S7A)-V Oy A1,+ZSFo y MIL- TELEPHONE: Sock' ti -ZL-k 6 k 39::� LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case IFS Antifreeze (for gasoline or coolant systems) 0 Drain cleaners t Automatic transmission fluid '0 Toilet cleaners Engine and radiator flushes _ Cesspool cleaners Z c— Hydraulic fluid (including brake fluid) 0 Disinfectants 30 C Motor oils/waste oils O Road Salt (Halite) ® Gasoline, Jet fuel 6 Refrigerants © Diesel fuel, kerosene, #2 heating oil 0 Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) ze- Degreasers for engines and metal Photochemicals.(fixers and developers) Degreasers for driveways & garages 0 Printing ink a Battery acid (electrolyte) 0 Wood preservatives (creosote) z.C- Rustproofers 0 Swimming pool chlorine O Car wash detergents O' Lye or caustic soda 6 Car waxes and polishes Jewelry cleaners _0 Asphalt & roofing tar Leather dyes d Paints, varnishes, stains, dyes d Fertilizers (if stored outdoors) G Paint & lacquer thinners ® PCB's 6 Paint & varnish removers, deglossers O Other chlorinated hydrocarbons, 0 _ Paint brush cleaners (inc. carbon tetrachloride) p Floor & furniture strippers C, Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, C� Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) 0 Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 2. nters BOARD OF HEALTH satisfactory 3.Auto Body Shops _ 0 unsatisfactory- 4.Manufacturers COMPANY ls` -�-� � (see"Orders") 5.Retail Stores - j 6.Fuel Suppliers ADDRESS 6c�rr�'zsP Class: 7.Miscellaneous /r/4F_,Q ANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: -Gasoline, Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) 44 �1;f,I--x new motor oil (C) transmissio';aydraulic Synthetic Organics: degreasers Mis us: •DISPOSAL/RECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply �, Olaf- 0 Town Sewer Publics u (yOn-site OPrivate _ 3. Indoor Floor Drains YES NO, O Holding tank: MDC 'z O Catch basin/Dry well _ a4��� O On-site system - 4. Outdoor Surface drains:YES NO O Holding tank: MDC 1/-•- C f<S �C z"' O Catch basin/Dry well A O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product , S NO 2. - - Person (s) Interviewed Inspector Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: Mail To: BUSINESS LOCATION: u Board of Health MAILING ADDRESS: _!T4 A4�� Town of Barnstable P.O. Box 534 TELEPHONE NUMBER: 01� Hyannis, MA 02601 CONTACT PERSON: f UL A , F 9�-1 t /!E (A) EMERGENCY CONTACT TELEPHONE NUMBER: 42'e— Bz's-5, Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities total ' , at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case �Y Antifreeze (for gasoline or coolant systems) 0 Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes _� Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel 0 _ Refrigerants Diesel fuel, kerosene, #2 heating oil N y Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal © `��1 Photochemicals (fixers and developers) Degreasers for driveways & garages 4r4as Printing ink Battery acid (electrolyte) 0 Wood preservatives (creosote) Rustproofers 0 Swimming pool chlorine Car wash detergents 0 Lye or caustic soda Car waxes and polishes 0 Jewelry cleaners Asphalt & roofing tar _0 Leather dyes Paints, varnishes, stains, dyes _ 0 Fertilizers (if stored outdoors) Paint & lacquer thinners _ - PCB's Paint & varnish removers, deglossers 0 Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 2.Printers BOARD OF HEALTH J'�7sa' isfactory 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY 41V �JfJ?' .•� / (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Class: 7.Miscellaneous UAN ITIES AND T STORAGE (IN=indoors;OUT=outdoors) MAJOR MA� � Case lots Drums Above Tanks Underground, IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) / Heavy Oils: waste motor oil (C) new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: DISPOSAL/RECLAMATION =42--7, S:1. Sanitary Sewage 2. Water Supply �%°.o G•i 0 Town Sewer Public On-site OPrivate �7 3. Indoor Floor Drains YES NOJ/ 0 Holding tank:MDC v O Catch basin/Dry well 0 On-site system Y-22 S.;q 4. Outdoor Surface drains:YES NO ORDERS: W <7 0 Holding tank:MDC O Catch basin/Dry well O On-site system 5. Waste Transporter Name of Hauler Destination Waste Product law 1. 2. Person (s) Interviewed 'Inspector Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: Mail To: BUSINESS LOCATION: Board of Health MAILING ADDRESS: ? ®a d a Town of Barnstable P.O. Box 534 TELEPHONE NUMBER: - - � Hyannis, MA 02601 CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NU BER: Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners U Engine and radiator flushes — Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants 1:k�,.Motor oils/waste oils — Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) '2A Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda "C.w. Car waxes and polishes "' Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers -- Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business x ' G TOWN OF BARNS TABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repairs satisfactory 2.Printers'' BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPA (see"Orders") 5. _ Retail Stores .1.Fuel'Suppliers-... ADDRESS Class: 7.Miscellaneous QUANTITIES AND STORAGE,, r ,,'r'.;.(IN=amdoors;OUT=outdoors) ' MANOR MATERIALS Case lots Drunis M)ove Tanks Underground Tmiks IN OUT OUT #&'gallons 'Age Test Fuels: . Gasoline Jet Fuel (A) �Diese ,'Kerosene, #2 (B) 'waste motor oil( '� new motor oil C-, ' transmissi ydraulic �cth�tac Organics: degreasers .v. ` r ,j, e-- 4 too .,'.t �1 s ;t' Miscellaneous: '_. : > DWI e n L a„ t /1 4 i .:. C54� It a• 6-1 ° r .s,' �y t - ' q..f'h,`<-•'�*".. t c .tii . DISPOSAIJRECLAMATION REMARKS: 1 �� �fi a ♦qL'`d �}�..s, �L.trir b� :; .x-�c ,t r,�S,t �' LTM�f' 1. Sanitary Sewage 2. ater Supply ! O � {''"'Y 95".y;:w"('•` } t "r`�" r.-. rxi R".��*ry � " 7� 4 � � Town Sewer Public On-site Q ri to 3. door Floor Drains YES NO 1y r AM Holding tank:MDC �r Catch basin/Dry well f �� Q On-site system r e 4. Outdoor Surface drains:YES)(NO O ERS• lHolding tank:MDC 5 Catch basin/Dry well O On-site systemA. 5.Waste Transporter p f „.' a aN.AMe of Hatiller Destination Waste Product �w o i YES NO ` `r r %154 e� w rrSa+o 2. ti c 3 z •may:, AA Y;i a Person(s) Interviewed Hf - . Insprector ty a y D to # „a _a �- t TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair O satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops �CO, unsatisfactory- 4.Manufacturers COMPANY W5.2 (see"Orders") 5.Retail Stores = 6.Fuel Suppliers ADDRESS �✓� 41 K- Y �. C1 � � Clam7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) D�'esel Kerosene, #2 (B) V Heavy-Oils. �� waste motor oil (CYIII �ew�motor (C) 1 tran�n/hydraulic V OY Synthetic Organics: degreasers Miscellaneous: f �, v Ir�0 ILI DISPOSAURECLAMATION REMARKS: 1 e 1. Sanitary Sewage 2. Water Supply O Town Sewer @Publics�Q.On-site 6Priyate ii )-(,' .l-7, ccr)ni� .'' iig� 3. Indoor Floor Drains YES NO �l- ° OHolding tank: MDC ' O Catch basin/Dry well r/ � / � O On-site system t r NA � �j (��f ��'l�aA UA N r-I /'-f�r r 4. Outdoor Surface drains:YES7NO ORDERS:5,0`� ��� � ���n� ffi ]4 _ "E) Holding tank: MDC 4 t1 OCatch basin/Dry well ` O On-site system w 5. Waste Transporter Name of Hauler Destination Waste Product License 1. I"}(WA1 V / S ', ; ly, NO Person (s) Interviewed Inspectors Date ► ASSESSORS MAP N0: PARCELN� TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH O satisfactory 2.Printers 3.Auto Body Shops i unsatisfactory- 4.Manufacturers COMPANY �' ;l/Jfsl¢ ,��r,-,�<f(rt/,t O (see"Orders") 5.Retail Stores ,d- 6.Fuel Suppliers �ir�%• i'' '. f Class' / 7.Miscellaneous ADDRESS'40 —2 /�YiQUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) ._MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: 5 DISPOSAI✓RECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply O Town Sewer oPublic �0'On-site OPrivate 3. Indoor Floor Drains YES NO d/r O Holding tank: MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES f/l/NO ORDERS: O Holding tank: MDC O�Catch basin/Dry well `O On-site system 5. Waste Transporter �l IName of Hauler Destination Waste Product License(d YES NO 2. Person (s) Interviewed Inspector J Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: Szle al G,�F Mail To: BUSINESS LOCATION: 'S�c� rYr'��Ji�- Y �4 i�MJr9n/Alr o n Health i own off Barnstable MAILING ADDRESS: P.O. Box 534 TELEPHONE NUMBER: S-3 jL Hyannis, MA 02601 CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: 771 3S;74 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in qua (ties totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: _ ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics of volume. Please estimate the quantity beside the product that istics and must be registered regardless q y you store: Quantity/Case/Case Quantity/Case Q Y Antifreeze (for gasoline or coolant systems) Drain cleaners _ Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Z Hydraulic fluid (including brake fluid) _ Disinfectants 2S— Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel 6 Refrigerants _(:) Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, _0 Other petroleum products: grease, lubricants rodenticides) _D Degreasers for engines and metal _ Photochemicals (fixers and developers) - Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine 6_ Car wash detergents Q Lye or caustic soda _ C) Car waxes and polishes — Jewelry cleaners _ Asphalt & roofing tar Leather dyes © Paints, varnishes, stains, dyes _� Fertilizers (if stored outdoors) Paint & lacquer thinners _ - PCB's _( Paint & varnish removers, deglossers Other chlorinated hydrocarbons, 0 Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers ( Any other products with "Poison" labels Q Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) 0 Other products not listed which you feel may Spot removers.& cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents `'Bug and tar removers y' .Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business ASSESSORSIWIPI_ `` PARCEL NO` 0�O/ TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH o satisfactory 2.Printers 3.Auto Body Shops o unsatisfactory- 4.Manufacturers COMPANY �.' ' (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS W' =� /> f i[ e -t~ / ' ,.- , ".,"Class: 7.Miscellaneous �' /'- QUANTITIES AND STORAGE (IN= indoors;OUT-outdoors) MAJOR MATERIALS I Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) 2 ' transmission/hydraulic Synthetic Organics: degreasers 14 ' Miscellaneous: z � s y DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply G�rY s O Town Sewer .OPublic Q On-site OPrivate 3. Indoor Floor Drains YES NO •`•1 ,.^ r O Holding tank:MDC O Catch basin/Dry well O On-site system r 4. Outdoor Surface drains:YES NO Y -ORDERS: O Holding tank:MDC �C .��Z r� �%'�f "`f.� ��7!�'✓�1//>>/r�.t �% O Catch basin/Dry well v O On-site system 5. Waste Transporter [,;/mil/� Name of Hauler Destination Waste Product YES NO Jam`/ PC7' Jr 2. Ji Person (s) Interviewed Inspector Date d as � TOWN OF BARNSTABLE !COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair G satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY r J ' 1 i �i �+ (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS 0 Class; /1 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors; OUT-outdoors) MAJOR MATERIALS- Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) � t Heavy-Oils:: � waste motor oil (C) J (� new motor oil (C) �) transmi ssion/hydraulic Synthetic Organics: degreasers)/r)� ) ()n vJJ� Miscellaneous:Pa,1,, I r DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O,Town Sewer �G.Public ��f ;M r' IQ On-site OPrivate 3. Indoor Floor Drains YES NO /�fr�� O Holding tank. MDC /-�� O Catch basin/Dry well O On-site system Im 0A 4. Outdoor Surface drains:YES NO -O-RDERS: O Holding tank:MDC 1 1 v` ti. �I�� l� Y , C O Catch basin/Dry well O On-site system 5.Waste Transporter Name o f Hauler Destination Waste Prod / YES/ NO uct Licensed?, 2. Y•' Person (s) Interviewed Inspector Date TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair nters BOARD OF HEALTH satisfactory 3.2.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY V/�h �'R�•to (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS lr di d�r.,�2 Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) A Diesel, Kerosene, #2 (B) Heavy Oils: a� waste motor oil (C) 1 . new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: -.� S DISPOSAL/REC;LAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply JltZ O Town Sewer Public �' , i AOn-site O Private 3. Indoor Floor Drains YES NO O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES YNO ORDERS: O Holding tank:MDC •� `Catch basin/Dry well ' O On-site system „ 5.Waste Transporter Name of Hauler Destination Waste Product YES N0 2 Person(s) Interviewed Inspect r Date f TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS:_ Vf 'I �`�`���-A G ` '_ Board of Health MAILING ADDRESS: ��s' ��� Town of Barnstable TELEPHONE NUMBER: 1:;r VIP-- P.O. Box 534 CONTACT PERSON: �'i 5�44� Hyannis, MA 02601 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stor Please put a check beside each product that you store: 6' L Antifreeze (for gasoline or coolant systems) Drain cleaners 3064-4.,Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners D C 4.Hydraulic fluid (including brake fluid) Disinfectants d /D c,tf-Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, ;�-: �13S' Other petroleum products: grease, lubricants rodenticides) M - Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink ` Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda �z CIS Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) J094- Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform,.formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) , Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners F White Copy-Health Department/ Canary Copy-Business A TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: 4M ./L ,50 Mail To: BUSINESS LOCATION: 4F CL46JIs2cl e® G,1 ,/1S a Board of Health � � �,���� Town of Barnstable 210 MAILING ADDRESS: SC 1000 On UL � P.O. Box 534 TELEPHONE NUMBER: yOR�l,// . Hyannis, MA 02601 CONTACT PERSON: �6+v� t'lU�•�t�CJ.� EMERGENCY CONTACT TELEPHONE NUMBER: Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants 494k Motor oils/waste oils Road Salt (Halite) �J Gasoline, Jet fuel Refrigerants Diesel fuel, k Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) � L Paint & lacquer thinners PCB's y Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory 2.Printers 3.Auto Body Shops �a O unsatisfactory- 4.Manufacturers COMPANY,V (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS - Class: 7.Miscellaneous /M< 4UANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Undergro d IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, 1-Ik2( Heavy Oils: yt" waste motor oil (C) new motor oil (C) 6AA" e TP, transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: 1 <11 77 , � •� f DISPOSAURECLAMATION REMARKS: C 1. Sanitary Sewage 2.Water Supply G 1 I �r t 121 O Town Sewer Public On-site OPrivate 3. Indoor Floor Drains YES NO O Holding tank:MDC %. O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES—ZNO ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 1. 2. Ik Persons) Interviewed r Inspector Date ASSESSORSMAPR PARCEL 3'0 TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY -',"*J' 11 91'1d )&YAf: (see"Orders") 5.Retail Stores ,,- _7 .-� 6.Fuel Suppliers ADD '�-��/ /� `�!���`�'� C18SS: ! 7.Miscellaneous �7� � -QUANTITIES AND STORAGE (IN= indoors; OUT-outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) �— Diesel, Kerosene, #2 (B) ~- Heavy Oils: waste motor oil (C) � . new motor oil (C) r v transmission/hydraulie , Synthetic Organics: degreasers Miscellaneous: A-z ' ;? 1;I DISPOSAL/RECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply ! L. a4� O Town Sewer OPublic ���� ,p On-site OPrivate 3. Indoor Floor Drains YES / NO 1 0 Holding tank: MDC 0 Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES NO Z ORDERS: n _ 0 Holding tank:MDC ,� 4 .�,/ ` G, � ♦ J --/j/�f'f'I 0 Catch basin/Dry well , 0 On-site system 5. Waste Transporter L�; �4�. � Name of Hauler Destination7� Waste Product _ YES NO 1. ���:f� t✓t^✓ ''C�� ,f.LiZ:?lti' i+._. s"r'~ _*".cam Fl�.r�%,/,� .!,,// � /J-, 2. Person (s) Interviewed Inspector Date