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0095 AIRPORT ROAD - Health
95 Air 'ort`Road Sewer Acct #3914 Hyannis (MultipleyTenets) A 294-064 a j ° i o ° i 1 0 ° r r Town of Barnstable Hazardous Materials On-Site Inventory and Inspection FACILITY INFORMATION: A Business Name: 42M 6-Nr NCt- t)llerl Ay rz ��Lf�,cJ�A770,tl) Business Location: "17S /��o�T IfO,+b A/, +AJAJ/s Mailing Address: S A 60 V—'- Telephone Number: Contact Person: -sT57'` /UE;4Y&-S ARESM&WT Emergency Contact Telephone Number: ��D 55t' 773 Type of Business: f wy tT7f/t-i.Jl� 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 C� -,--4 CiE L �R� i Jr �i/N�O�clS 5�C�AYGLo� T,t'c x 6- 6m-"AJ.s Ci��o c� slat� Gam.S� N J_`y 4-t- 4 /4'1qD 5 4AUZeAfS a f= 5afft.�5 1xJA-�c doAlPouAuD 3 C'*"_d�S Af15CCu-,4A40US ilgRiaas sib �ZA-�IKR�3 S �skU-6Al 'S PKAy GAiVS Is, PO Auo AJ S PfA7 w4 6 A ho ar S 66 h-T," t/ Dzt3s�A�� 4 t , c , Misc. Combustibles Misc. Corrosives Misc.Reactive Misc.Toxics Inventory Total Amount: Hazardous Materials License Posted?Yes No N�A Contingency Plan Posted? Yes Fire District: I-IvAW N/S Fire Extinguisher Service Date: OGr Metal Covered Rag Bin: Yes Absorbent Material Available? Yes Ro Type of Absorbent: Speedy Dry Pads Pigs Other: MSDS on site�9 No azd Co Computer Access Hazardous Waste Handling Hazardous Waste Generator Identification Number: Type(s) of hazardous waste product(s): i Date of last hazardous waste shipment,type of waste and quantity: Hazardous Waste Transporter(s): Designated Hazardous Waste Facility: Hazardous Waste Storage Area Description: Is hazardous waste storage area labeled: Yes 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) Yes No { If hazardous waste is stored out of doors is it covered from the elements? Yes No Is it in 110% containment? Yes No If hazardous waste is stored indoors is it on an impervious floor? Yes No - 2 - FLOOR DRAINS (Chapter 381) Town Sewer Account Number: Indoor floor drains:& No If yes,circle one,does it discharge to a: holding tank dry well on site septic. .a O<L-/I,tf s�P,*i,4-7DP 7-0 S 6-We=T 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 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 (9 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 GuH/Gib o k/s ?o A-A1 014-1 w1A17-7' sE AIC, d e 1RAOi2 rd69 .�isCH �i c1c- A4057- PRohae.T.S A-Az Pugh-sc� i.A/ GvtiC&- eJ7 �D r-CM_ IA moo) PGASnG Ce AJ 7A-1,vEna A-N b 1—ht-AJ -/ e/BuTED ra V-%012IK 5TAT1 o M S.. AA) /> 0 nV'7"L 5 AIO PS. AS -171f 7V roc- &�AAJ-77 9 67� "A-M7;Z-/Az. uj.-s less TY-Alj 6A-1-"1J 5 Nor- ,Q-Lz- H s h S A-(,a-�-7C1Azs Li�RAGT�d2�ST1LS,�WL'VEI� �E �Dl.�wi�1� PR.o�u.c-7S Lc./E�E /�t7�J�' 14�iNCP 7-b A3E h'-A- ,2: -ieZ)caJ : /3A)C. p#// ..-/ Ld Arc�iyBvsnB / _W4_ t3ki7r) rhtll /1ivoo1XJ , G Ae0vsnt3LE , , Date: Moy /t to Public Health Inspector: —� Facility Representative: - TLFE �,�ci r�9 �S �o T .S u 7- All' - 3 - �G . MATERIAL SAFETY DATA SHEET Mark V Products Revision Date 12/31/05 400 El Sobrante Road Date Printed: 12/31/05 Corona, CA 92879 Product Number: Window Sheen (951) 280-9799 � For Chemical Emergency, Call Chemtrec (951) 280-9393 FAX ta 1-800-424-9300 EALTH HAZARD 2 - Moderate FLAMMABILITY HAZARD 3 - Serious REACTIVITY HAZARD 0 - Minimal PERSONAL PROTECTION n + p SECTION 1 - IDENTIFICATION Product Name: WINDOW SHEEN Product Type: Concentrated Glass&Chrome Cleaner Description: A Clear blue glass cleaner SECTION II - HAZARDOUS INGREDIENTS HAZARDOUS INGREDIENT CAS NUMBER PEL 2-Buioxyethanol ' 111-76-2 TLV: 25 ppm PEL: 25 ppm Isopropanol 67-63-0 TLV: 400 ppm I 1. This chemical is subject to the reporting requirements of section 313 of SARA Title III SECTION III - PHYSICAL DATA Appearance: A thin blue liquid_ Specific Gravity: 0.964 Boiling Point: 184 F % Volatile by volume: 100 Vapor Pressure: 36.2 mmHg SECTION IV - FIRE AND EXPLOSION DATA Flash Point (method): "�-1GZ-Fn(PM_CC1 Extinguishing Media: CO2, dry chemical, foam, water fog, water spray. NFPA Classification: (lle . NFPA Symbol Codes: Flammability 2, Health 2, Reactivity 0 Fire Fighting Procedures: Wear approved SCBA with full facepiece operated in positive pressure demand mode. SECTION V - REACTIVITY DATA Stability: Material is Stable Hazardous Polymerization: Hazardous Polymerization is not expected to occur Incompatibility: Avoid contact with strong oxidizers. Hazardous Decomposition: Combustion may produce Carbon Monoxide, I ,a SECTION VI - HEALTH DATA Routes of Entry: Inhalation, skin absorbbon, ingestion Listed Carcinogen: Not listed by IARC, NTP or OSHA �— Medical Conditions Aggrevated: Pre-existing condtions of the skin & respiratory system. Inhalation: Inhalation of vapors can cause nasal and respiratory irritation, central nervous system effects, including dizziness, weakness, nausea, headache and asphyxiation. Ingestion: May cause gastrointestinal irritation, nausea, vomiting and/or diarrhea. Eyes: May cause irritation, redness, tearing, blurred vision. Skin: May affect pre-existing conditions of dry skin and dermatitis. SECTION VII - FIRST AID Inhalation: Remove to fresh air. If breathing is difficult, administer oxygen. If breathing has stopped, give artificial respiration. Get medical attention Ingestion: If conscious give two glasses of water and induce vomting. If spontaneous vomiting occurs, keep airway clear. Get medical attention immediately. Eyes: Flush with large amounts of water for 15 minutes. Hold eyelids apart to ensure flushing. Get medical attention. Skin contact: Wash with soap and water. Remove contaminated clothing and wash before re-use. Skin absorption may contribute to the overall absorption of this material. Appropriate measures should be taken to prevent absorption so that the TLV/PEL are not invalidated. SECTION VIII - EMPLOYEE PROTECTION Respiratory Protection: If exposure is anticipated to exceed recommended TLV, wear a NIOSH approved respirator with an organic solvent cartridge. Protective Clothing: Nitrile gloves and chemical splash goggles. Addt.ional Measures: Do not place product in unmarked container. Keep away from children. Slippery when spilled. Wash hands before eating or smoking. Keep containers closed when not in use. Do not store near flames , sparks or hot surfaces. Store in cool location. SECTION IX - SPILL AND DISPOSAL DATA Spill: Dike to prevent spillage into stream or storm drain system. Turn off all sources of heat or ignition. Recover all material possible. Absorb remaining material with vermiculite or other absorbent material. Waste Disposal: Follow Federal, State and local guidelines. Handling & Storage: Store in a cool, well ventilated area. Avoid over heating. SECTION X - OTHER REGULATORY INFORMATION Shipping Name: Combustible Liquids, n.o.s. UN Listing: UN 1993 Packing Group: II Constituent: Isopropanol SECTION XI - PRECAUTIONARY STATEMENTS WARNING: This information contained in this MSDS is based on the data available to us from sources we believe to be reliable. No warranty or guaranty expressed or implied is made regarding the accuracy of this data or the results obtained from the reliance on this data. The manufacturer assumes no responsibility for injury from the use of this product. Be safe: Read this safety information and forward it to all persons who may be exposed to this product. f.eel �° \ Material Safety Data Sheet T ^:-, ` 1-5 this form is�'sd in compliance with OSHA Hazard Communication Regulation 29 CFR 1910120 oziv _ N. SECTION 1: GENERAL INFORMATION GLEAM PRODUCTS Product Name: BAM G Carl Street MSDS#:Gleam Products/BAM pg.1 of 2 21 Date Prepared: January 3,2011 Johnston, RI 02919 1-800-33-GLEAM SECTION II: HAZARDOUS INGREDIENTS/IDENTITY INFORMATION Trade/Material Name: BAM Description: A green liquid with a lime aroma used as a concentrated degreaser and cleaner for automobiles,boats and RV's. CAS: Concentrated Cleaner/Degreaser Chemical Name: Mixture Phone: 800-33-GLEAM Manufacturer. GLEAM PRODUCTS Chemical Emergency: Chem Trec 1-800-4249300 21 Carl Street Johnston, R102919 CAS Number_ �osure Limits: Percent Ingredient Nome: � TLV/PEL ZS ppm Ethylene Glycol' 111-76-2 Mixture n/a Surfactant Blend 6834-92-0 TLV/PEL 2mg/m3 Sodium Metasilipte Anhydrous TLVJPEL 5mg/m3 8hrs Sodium Tripolyphosphate 7758-29-4 -,otassium Hydroxide 1310-58-3 TLV 2mg/m3 %r SECTION III: PHYSICAL/CHEMICAL CHARACTERISTICS Specific Gravity(H20=1): 1.085 Boiling Point: >212°F@760 mmhg Melting Point: vapor Pressure(mm 149): Evaporation Rate(Butyl Acetate=1): Vapor Density(Air=1): Solubility in Water. pH: 13.5 Appearance and Odor. * A thick blue colored aroma free liquid. Flash Point: >200"F SECTION IV: FIRE AND EXPLOSION HAZARD DATA Flammable/Combustible Classification- 111A Liquid Classification Extinguishing Media: Water Fog,Alcohol foam,CO2,Dry Chemical Special Fire Fighting Procedures: Fire may produce irritating fumes. Wear approved S.C.B.A.with full facepiece,operate in positive pressure demand mode.Use water spray to push down vapors.Cool exposed containers with water. Fire Hazard Symbol Codes: Flammability: 2 Health: Reactivity: 0 Protection: N+P SECTION V: REACTIVITY DATA �Ib�Tdy: Material is stable_ Conditions to avoid: n/a h Try and avoid contact with strong oxidizing agents and addic materials and mineral acids: �lnan� Hawdow p0VnW&0on: Not expected to occur. ' I Material Safety Data Sheet e.a _ .IC This form is used in compliance with OSHA Hazard Communication Regulation 29 ffR 19101200 R I V c O_ S Fi t c GLEAM PRODUCTS product Name. BAM G Carl Street MSDS#. Gleam Products/BAM pg.2 of 2 21 Johnston,RI 02919 Dote Prepared: January 3,2011 SECTION VI: HEALTH HAZARD DATA Routes of Entry: Skin,eyes,ingestion and/or inhalation. Health Hazards: Awe: Eyes—may cause severe irritation bums if not immediately treated. Skin—repeated prolong exposure may cause dermatitis and/or drying. Inhalation—may be irritating to nasal tracts or mucous membranes. ingestion—may cause severe bums to nose,mouth,throat and gastrointestinal trac. Chronic: Prolong and repeated exposure may cause skin irritations. carcinagenicUy. This product is not considered a known carcinogen by OSHA,IARC or NTP. Emergency and First Aid Procedures. Eye Contact: Immediately flush eyes with water for a minimum of 15 minutes—hold eyelids apart to ensure flushing of entire eye surface. Seek medical attention. Skin Contact: Immediately wash affected area with water.Remove clothing and wash before re-use. Get medical attention if irritation persists. en.If Inhalation: Place individual in open fresh air area. If difficulty breathing,administer oxyg breathing stopped,administer CPR and call for emergency personnel. Ingestion: Do not induce vomiting.If person is conscious,have him/her drink large amounts of water,if spontaneous vomiting occurs,keep airway open. Seek immediate medical attention. SECTION VII: PRECAUTIONS FOR SAFE HANDLING AND USE Steps to be taken in case material is released or spilled: Stop any source of ignition immediately.Observe precautions listed in sections III and Vlll.Contain and stop spill at once_Dike area of spill to prevent further spreading of substance. Wear protective clothing and have adequate ventilation. Recover as much as substance as possible and absorb remaining substance with vermiculite or other compatible absorbent Prevent spill from draining into sewers. streams or water shed areas. If spill contaminates a water source,notify proper authorities immediately. rdous waste containers in accordance to local,state and federal Waste disposal method: Place substance in approved haza regulations. Precautions for handling and storing: Always wash hands after exposure to material. Wash hands before eating,drinking or smoking. Do not store anything edible in work areas. Always keep containers tightly secured when not in use.Store in a cool dry place away from combustible and other incompatible materials. Other precautions. All hazardous precautions in MSDS must be adhered to_Containers of this substance may be hazardous when emptied;because some residual of the substance may still be in the container(i.e.liquid,vapor)Never heat or weld an empty container. UN#1760 DOT CLASS., Cleaning Compound,Liquid,Corrosive SECTION Vlll: CONTROL MEASURES Respiratory Protection: n/a Unless expected exposure is expected to exceed stated TLV limits.Then use a respirator pack. Ventilation: Provide mechanical(general and/or local exhaust)ventilation to maintain exposure below TLV. —)tective Gloves: Always wear chemical resistant gloves when working is advised that with lens not be worn when working with Protection: Wear OSHA approved safety goggles. material,as they may contribute to the severity of an eye injury. �. ,er protective<yujpmeri: H chemical resistant apron may be worn if splashing is a concern. Workf Hygienic Practices: A safety eyewash station and shower station is recommended in the immediate work area incase of exposure to skin or eyes. Material Safety Data Sheet ^ � T This form is used in compliance with OSHA Hazard Communication Regulation 29 cFK 1910.1200 ��_--- f Product Name: COAT IT GLEAM PRODUCTS mSDS#: Gleam Products/Coat It pg.2 of 2 21 Carl Street pie prepared: April 1,2010 Johnston, 11102919 SECTION VI: HEALTH HAZARD DATA Routes of Entry: Skin absorption,ingestion,inhalation. Health Hazards: Acute: EYES—may cause severe irritation,redness and tearing. Skin—may cause dry skin,dermatitis and defatting. inhalation—repeated inhalation of vapors may cause nasal,respiratory nausea,vomiting,he duce may affect central nervous system including dizziness,weakness,fatigue, aches and unconsciousness,at high levels of exposure death may occur_ ingestion—may cause gastrointestinal irritation,nausea,vomiting and diarrhea. Chronic: Prolong and repeated exposure may cause skin irritations,dizziness,weakness,vomiting. RC Carcinogenicity: This product is not considered a known carcinogen by OSHA or skin condition_ aggravated by exposure: Any pre-existing respiratory Medical conditions generally agg t 1,5 minutes—hold eyelids apart to Emergency and First Aid Procedures: � Eye Contact: Immediately flush eyes with water for a minimum o ensure flushing of entire eye surface- Seek medical attention. Skin Contact: Immediately wash affected area with soap and water- emove clothing and wash before re-use.Get medical attention if irritation persists. en.Ir Inhalation: Place individual in open fresh air area_ If difficulty breathing,rs mini nnel�er oxygen. breathing stopped,administer CPR and call for emergency perso and an aspiration ' ingestion: Do not induce vomiting.This product is slightly toxic by ingestion hazard.Aspiration of material the lungs physican or poisondue to control centeg can cause r,d ermine pneumonitis,which can be whether induced vomiting or evacuation is in order. SECTION ViI: PRECAUTIONS FOR SAFE HANDLING AND USE (pilot lights).Dike to system. Recover all material possible.Absorb remaining materials do not absorb b Steps to be taken in case material is released orspilled. Eliminate all sources of ignition such as heaters or flames p g prevent spillage into stream or stoite or rm drain other absorbent material. A fire or vapor hazard Ill venti ventilation- these dean up materials only absorb liquid federal regulations. vapor.Wear proper clothing and provide adequate Waste disposal method: Place substance in approved hazardous waste containers in accordance to local,state an precautions for handling and storing: Store in cool well ventilated area.00m ch freezing An eyewash stationand safety shower should Other precautions: Do not place product work area. unmarked container.Keep away be maintained in the UNd 3993 DOT Class. Combustible Liquid NOS packing Group: IlConstittuenti Petroleum Distillate SECTION VIII: CONTROL MEASURES Respiratory Protection: Wear an OSHA approved respirator for organic solvents.. Ventilation: Provide mechanical(general and/or local exhaust)ventilation to maintain exposure below TL . may contribute Protective Gloves: Always wear ch o resistant gloves ves when working with product. Eye Protection: Wear OSHA appr o les. It is advised that contact lens not be wom when working with material,as they to the severity of an eye injury_ nt apron may be worn fi splashing is a concem_ Other protective equipment: A chemical res�sta 'Nock/Hygienic Practices: A safety eyewash station and shower station is recommended in the immediate work area incase o '� xposure to skin or eyes. s Material Safety Data Sheet _Z, IT _` 'r;- 9 CFR 1910.12n0 This form is used in compliance with OSHA Hazard Cammunication Regulation 2_ SECTION 1: GENERAL INFORMATION Product Name: COAT IT GLEAM PRODUCTS aducts/Coat It pg.1 of 2 11 r?rl Street Date Prepared:April 1,2010 Johnston, RI 02919 SECTION II: HAZARDOUS INGREDIENTS/IDENTITY INFORMATION Trade/Material Name: COAT IT Description: A clear liquid with a vanilla aroma that is used as rubber coating. CAS: Mixture Chemical Name: Petroleum Hydrocarbon Blend Phone: 800-33-GLEAM Manufacturer: GLEAM PRODUCTS Chem Trec 1-800-424-9300 21 Carl Street Chemical Emergency: Johnston,RI 02919 F,cposure Limits: Percent: Ingredient Nome: CAS Number m 100ppm 64742-89-8 PEL/TLV 200PP / Aliphatic Petroleum Distillate* -3148-62-9 PEL/TLV no estimate Polydimethysiloxane P m Inter Epoxy Resin and low odor base solvent.Mixture is VOC compliant and contains less then 500g "This product contains shellsol heptane ^.\- ,EcnON III: PHYSICAL/CHEMICAL CHARACTERISTICS Boiling Point 149-F Specific Gravity(Hz0=1): 0.7431 Melting Point: n/a Vapor Pressure(mm Hg):85.4mmHg Evaporation Rate(Butyl Acetate=1):>I.00 Vapor Density(Air=1): n/a %Volatile by volume:100%volatile by volume. Solubility in Water. Negligible Appearance and Odor: A clear liquid with a vanilla aroma. SECTION IV: FIRE AND EXPLOSION HAZARD DATA 3SF ITGQ—; Flammable Limits. LEL:1% UEL:7% Flash Point: Flammable/Combustible Liquid Classifrcatiorr'.IBA f waters spray.Extinguishing Media: CO2,dry chemical,foam,water, og, P y Special Fire Fighting Procedures: Use and wear approved S-C-B-A and gives off.with which face may travel along'the ground andressure mode. Material is highly oth- may be ignited by pilot lights,sparks,heaters,smoking electric motors,static discharge or er ignition source distant from handling point. Health: 2 Fire Hazard Symbol Codes: Flammability: 3 Reactivity: 0 Protection: N+P+U • Material is stable_ Conditions to avoid: Heat;flame,sparks Stability: SECTION V: REACTIVITY DATA incompatibility.* Combustion contact with strong oxidizing acids and agents. �..1azardous Decomposition: Combustion may produce Carbon Monoxide,CO:and various hydrocarbons. Hazardous polymerization should not occur. HazardousPolymerization: i MATERIA SAFETY DATA SHEET Mark V Products Revision Date 12/31/05 .. 400 El Sobrante Road I Date Printed: 12/31/05 �- Corona, CA 92879 Product Number: Wheel Brite (951) 280-9799 For Chemical Emergency, Call Chemtrec (951) 280-9393 FAX 1-800-424-9300 HEALTH HAZARD 3 - Serious FLAMMABILITY HAZARD 0 - Minimal REACTIVITY HAZARD 1 - Slight PERSONAL PROTECTION D + u SECTION 1 - IDENTIFICATION Product Name: WHEEL BRITE Product Type: Acid-based chrome and aluminum cleaner Description: A thin, clear liquid with an acid odor. SECTION II - HAZARDOUS INGREDIENTS HAZARDOUS INGREDIENT CAS NUMBER PEL Sulfuric Acid 7664-93-9 1 mg/m' Hydrofluoric Acid- 7664-3973 3 ppm Phosphoric Acid 7664-38-2 1 ppm Surfactant Blend Mixture None Est. SECTION III - PHYSICAL DATA Appearance: A thin clear liquid Specific Gravity: 1.09 Boiling Point: 212'F %Volatile by volume: NIA Water Solubility(%) 100 [-,OK t' 7 SECTION IV - FIRE AND EXPLOSION DATA Flash Point(method):. > 200' F (TCC) Extinguishing Media: CO2, foam, water fog, water spray. NFPA Classification: 1116. NFPA Symbol Codes: Flammability 0, Health 2, Reactivity 1 Fire Fighting Procedures: Wear approved SCBA with full facepiece operated in positive pressure demand mode. SECTION V - REACTIVITY DATA Stability: Material is Stable Hazardous Polymerization: Hazardous Polymerization is not expected to occur iIncompatibility: - Avoid contact with strong alkaline solutions, oxidizers, powdered metals I' �. organic materials. ) Hazardous Decomposition: Combustion may emit toxic, corrisive fumes.of Hydrogen Fluoride, Sulfur Dioxide & Fluorine Gas. SECTION VI - HEALTH DATA Routes of Entry: Inhalation, skin absorbtion, ingestion Listed Carcinogen: Not listed by IARC, NTP or OSHA Medical Conditions Aggrevated: Pre-existing condtions of the skin & respiratory system. Inhalation: Excessive inhalation of vapors and mist can cause severe tissue damage, even death. Ingestion: Can cause gastrointestinal bums,vomiting, diarrhea and death. Aspiration of material into lungs may cause chemical pneumonitis. Eyes: May cause severe irritation, redness, tearing, blurred vision and blindness. Skin: May cause severe irritation, redness, dryness and tissue damage. SECTION VII - FIRST AID Inhalation: Remove to fresh air. If breathing is difficult, administer oxygen. If breathing has stopped, give artificial respiration. Get immediate medical attention. Vctom should be examined by a physician and held under observation for 24 hours. Ingestion: Do NOT induce vomiting. If conscious, give large quantities of water. Follow with Milk of Magnesia. Keep person warm and quiet. Get emergency medical treatment. Eyes: Immediately flush with large amounts of water for at least 25 minutes, holding eyelids apart and away from eyeballs. Get immediate medical attention. If a physician is not immediately avail able, apply one or two drops of 0.5% Pontacaine Hydrochloride solution followed by a second irrigation for 15 minutes. Irrigation with dilute (1%) Calcium Glucconate in normal saline for 1 - 2 hours may prevent or lessen comeal damage. Skin contact: Immediately rinse with water using a hose or safety shower. Remove contaminated clothing. Treat affected area with a solution of iced 0.13% Zephiran Chloride. NOTES TO PHYSICIAN: Treat inhalation as chemical pneumonia. Monitor for hypocalcemia. 2.5% Calcium Gluconate in normal saline by nebulizer or by IPPB with 100% oxygen may decrease pulmonary damage. Bronchodilators may also be administered. For burns of large skin areas, (> 25 square inches), for ingestion and for significant inhalation exposure, severe systemic effects may occur. Monitor and correct for hypocalcemia, cardiac arrhythmias, hypomagnesemia and hyperkalemia. In some cases renal dialysis may be indicated. For certain bums, especially of the digits, use of intra-arterial calcium Gluconate may be indicated. SECTION Vlll - EMPLOYEE PROTECTION Respiratory Protection: Wear NIOSH approved acid gas cartridge respirator. Protective Clothing: Nitrile gloves, chemical resistant apron (rubber or plastic) and chemical splash goggles. Addtionai Measures: Do not place product in unmarked container. Keep away from children. Slippery when spilled. SECTION IX - SPILL AND DISPOSAL DATA Spill: Dike to prevent spillage into stream or storm drain system. Recover all material possible. Absorb remaining material with vermiculite or other absorbent material. Waste Disposal: Follow Federal, State and local guidelines. Handling & Storage: Store in a cool, well ventilated area. Avoid freezing or over heating. Wash hands with soap and water before smoking or eating. SECTION X - OTHER REGULATORY INFORMATION hipping Name: Corrosive Liquids, Poisonous, n.o.s. (Hydroflouric acid and Sulfuric Acid ) 8 UN Listing: 2922 Packing Group: III Constituent: Hydrofluoric Acid, Sulfuric Acid SECTION X1 - PRECAUTIONARY STATEMENTS WARNING: This information contained in this MSDS is based on the data available to us from sources we believe to be reliable. No warranty or guaranty expressed or implied is made regarding the accuracy of this data or the results obtained from the reliance on this data. The manufacturer assumes no responsibility for injury from the use of this product. Be safe: Read this safety information and forward it to all persons who may be exposed to this product. Hazardous Materials Inventory Sheet Checklist (' ,aDate Physical Street Address-Check database to ensure it exists Working Phone Number Actual Amounts -( ie. gas being used to fuel machines,thinner to clean brushes all count as hazardous materials) Storage Information -location of storage, how long is storage for? If none, note that. Disposal Information -where and who? If none, note that. Applicant Signature -understand what is listed and noted Staff Initial -any questions, know who to ask Vehicle Washing/Rinsing? -provide a vehicle washing policy and e ain it- note that it was given Attach the Business Certificate with your sign off.and.comments `T e inventory form should explain what the business consists of and:the.procedures they are doinq. Notes need:to.be left to explain what you discussed with them. s� �I YOU WISH TO OPEN A► BUSINESS? For Your Information: Business certificates (cost$440.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you.must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: l �J��-�� Fill in please: ti ? �; • _ �,;� v ; APPLICANT'S YOUR NAME/S: �f ✓eGl 2l�VI�S- ' ' ' Jix' BUSINESS YOUR HOME ADDRESS: TELEPHONE # Home Telep orre Nd- er fl.94tiI,_ •i f 7 n5%Ti ��M9'.�2:9��' �''ji NAME OF CORPORATION: iEV % NAME OF NEW BUSINESS TYPE OF BUSINESS c i IS THIS A HOME OCCUPATION? YES NO/'• ADDRESS OF BUSINESS i/L or�- MAP/PARCEL NUMBER �� _ (Assessing) When-starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1: BUILDING CO ' ISjbinfer_Fed� 'S OE �I This individ al h an errrit requirements that pertain to this type of business. th riz d Signature*COMMENTS: u,�A iL S Cts rw%roK Se-w�-►z 2. BOARD OF HEALTH;�* 3 14 sly V 15,T v L-74AIc� This individual ha n inf r ied,of the ermit r quirements that pertain to this type of business. FLO6g. Tk-5-pGN j jsC41-e-Ct ra 0.1L a Wf� T��2 St' L_VZA zJ�P i�I��NTu S�wt nature** CT�ya74 0wof BLftU, Lf-hsinsc. ra Authorize Si g MUST�:OMPLYWITH ALL �v�-�+cS 4�>z-1�6 IV"r PL "�7oaa:� COMMENTS: S-MA I EIRIALS RIEGIJtA I R71S z 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** . COMMENTS: TOWN OF BARNSTABLE Date:/� / /3/ / � ti TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: A71j2, BUSINESS LOCATION: I i/L" or INVENTORY MAILING ADDRESS: , �O ,0 o a �S,P TOTAL AMOUNT- TELEPHONE NUMBER: -7 3 CONTACT PERSON: eyie�f EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: A---/1 &A� INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: east shipment of hazardous waste: Name of Hauler: ,L? Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use', storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED .(insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives(creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers&cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Appli nt's Signature Staff's Initials OTT • ri i ;. �i a Vy._., • 1 �, tr d w. '+y Qr r ` • � �a�tl ,V ed'tr t' f� � t�'"�p�, ; * ���+ 3� �.- a �• r wy r t 4 IJ 71 M , Q #wn v, IL Jrv� V4 1 If lvrk .{S 4•., LL�' ,i�a:. A�- t �' �I rY. �t.,�` .�f (+jF(!a: . �,� i � €�+ ��'�,�F•' � �y.,:1.`J 0' } ft. ��� t • � :, rr ��� arm cf ,U` �� r `G -s i r � s• dry r � f-. '..+�',�u , 'i� i•j���y '� a.L �� c� y�� F +�._ a• � � , r•, .i� �j t f i _A^is �. ��r f ,}g,. i• lyre+' ;t r !y t.. '"1 w�, t' y +t•� d\Y ,f.' f µ � rr,�,f � A � r '�' ,.: ea�,`T;�tl u t/, 1. ra ►�„x i�`T7�w#� Yty.. 5 + a.r. if '1 4 ffj 1. •} ',. • ¢ 4,P -�' -;i#T� `C',,' . 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'��� e:'" .i qt - \ r ry *_c + n. m ..� w � _ � _, c .. v. _ �I a. _ a � .. _ �. �, .. _ � � .. 3 �, ". ,. c �- No.--X-jc ---C)� Fee---- -------- BOARD OF HEALTH TOWN OF BARNSTABLE Application-*rVell Cootructionperrnit Application is hereby ade for a permit to Construct (L- Alter ( ), or Repair ( )an individual Well at: Location — Address Assessors Map and Parcel / f wner p Address — sa --- Installer.— Driller Add ss Type of Building Dwelling ---- — ----- Other - Type of Building-- ----- No. of Persons.— Type of Well �� Capacity -__ao '� Purpose of Well l/1/lied-�� Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until Certi ' ate nce has been issued by the Board of Health. 12 Signed — ate Application Approved By date +l Application Disapproved for the following reasons: ---- - ------ -- date Permit No. y�� \ — Issued ( '- '� ------ ---- date BOARD OF HEALTH TOWN OF BARNSTABLE C ertif icate'®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed , Altered ( ), or Repaired ( ) by Installer —— ———at 1S A,2.F341-T fL`1� �n r, ----- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well fr�otection Regulation as described in the application for Well Construction Permit Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. w..; I DATE i �r �� Inspector —_— — a �s No.— � c)------------ Fee------------------- BOARD OF HEALTH TOWN OF BARNSTABLE 0(pplicat ion for lVell Conoructionpermit Application isbereby gnade fpr a permit to Construct , Alter (' ), or Repair �)an individual Well at: Location — Address Assessors Map and Parcel' Owner _ Address --------------- ------- ------------ Installer — Driller Address Type of Building Dwelling ---——=—--- , Other - Type of Building— -- No. of Persons -- -- Type of Well CASPd Capacity Purpose of Well 7d��G— �'"`'. Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a e ti ' ate 1 nce has been issued by the Board of Health. Signed ate 1 s Application Approved By date Application Disapproved for the following reasons: -- - .`..,.�__._- I�j /� �•- — date _ Permit No. via ` Issued — -- ---- date _ BOARD OF HEALTH TOWN OF BARNSTABLE C ertif irate & CompUnre THIS IS TO CERTIFY, That the Individual Well Constructed Altered ( ), or Repaired ( ) by— Installer —�— —— — — — - a t—_ �S � ,(2. pc��.-S f'L`1 F-�� ,n. r,r�t _—__------- • has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. ----= -- —Dated------- - THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. �l w' DATE-- Inspector BOARD OF HEALTH TOWN OF BARNSTABLE Vell Congtruct ion Permit L' No. —��- �——Ul Fee— Permission is hereby granted to Construct (>4, Alter ( ), or Repair ( ) an Individual Well'at: No. -- Street as shown on the application for a Well Construction Permit No. �'�' U Dated -- - --------------------- - -- ----------------------------- - --T DATE Board of Health 1 � �I �C.�'�— -_ . TOWN OF BARNSTABLE Q MPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers C0MPANY/� �R�ait/�-� ,� (see"Orders") 5.Retail Stores IV6.Fuel Suppliers ADDRESS , �d�lve-I'-0� Class: �•Miscellaneous 0"V~QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATIIALSUnderground IN OUT IN 0 UTI IN JOUTI#&gallons Age ITest aso r , e �-s osene, (� ntor oiler new motor on transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: - DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.fPnvate ter Supply ,Town Sewer ublic gyp- O On-site 4"n 3. Indoor Floor Drains YES V NO O Holding tank: MDC 2� O Catch basin/Dry well O On-site system w�xkwpw 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 NO 2. e on ) In ervi wed Inspector Date Date: TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: Fogg n d/�U hJ ? BUSINESS LOCATION:. \0 P1 F Q e-T h'O 1?�15- M09- MAILING ADDRESS: O - 8,0 X 15-65- Mail To: TELEPHONE NUMBER: - - � 7 o � Board of Health Town of Barnstable CONTACTPERSON: IgLI S164 AIGO C4L,�'R4 s/7A'(:R64 P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: �1M� Hyannis, MA 02601 TYPEOFBUSINESS: MA4 ai GAL 1,4u Does your firm store a of the toxic or hazardous mat eria s 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 OI Cfl56 Motor oils Pesticides V'NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED GAS Otherpetroleum products: grease, Photochemicals (Developer) lubricants gear oil NEW USED �! C-7,4L• 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 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 15G?d_Aaundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids 125 ; � (dry cleaners) Other cleaning solvents �5 Bug and tar removers 6VL6ek . 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 unsatisfactory- 4.Manufacturers COMPANY,4 �- �G,j Ct4 O (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Class: 7.Miscellaneous kt_ QUANTITIES AND STORAGE (IN=indoors;OUT=out oors) MAJOR MATERIALSCase lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline Jet Fuel(A) ,*-z- /"33v X Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneou : Dt4, .+ i4v �L CR,-Y V- S (,VIA u G 11�i , 1465 S to DISPOSAL/R.ECLAMATION REMARKS: f 1. Sanitary Sewage 2. Water Supply !41 S o S ) <f e/ OL4 Winn evc,j ((e-c Town Sewer Public N ' I e-"— v ,�C/ O On-site OPrivate 3. Indoor Floor Drains YES_,X NO O Holding tank:MDC �v�'`� aGit,f r 4 330 1 s T' L O Catch basin/Dry well S.Q,,,ttti- IV. o, Sys o wi i r<< S Hj. 2 7 51 14©f- O On-site system C.-OL111-e-ekd 4. Outdoor Surface drains:YES—NO 41 ORDERS: O Holding tank:MDC i S'e'e_ec c1 -�' �/�✓ O Catch basin/Dry well Sam S e O On-site system 5.Waste Transporter I, DestinationName of Hauler YE NO 1. S 2. N Person (s) Interviewed Inspecto to TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH o 3.Auto Body Shops 1 O unsatisfactory- 4.Manufacturers COMPANY ffll-�1�O�' L�l�i-�l� (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS 15 Class' 7.Miscellaneous 141 �U QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS C. se 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 r Miscellaneous- /S� ` x J �. Ned-mil•���v�- � �/ DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O Town Sewer OPublic 0 On-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 NO ORDERS: 0 Holding tank:MDC 0 Catch basin/Dry well O On-site system 5.Waste Transporter DestinationName of Hauler YES NO 1. 2. Person (s) Interviewed Inspector Date TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair O satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY�l'/�-- ofI— (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS 1n.S� �ry�� �� �� Class: 7.Miscellaneous P� 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) a7s Heavy Oils: waste motor oil (C) new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers u Miscellaneous: Ix �� r DISPOSAL/RECLAMATION 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 1, 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank: MDC w• M O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product �,,•� YES NO 2. Person (s) Interviewed Inspector b i Date HAZARDOUS MATERIALS REGISTRATION FORM - - --_._._..._......__._-_............—.--._. --... - DBA: All Seasons Laundry fax: ' ............................_..__.._........................-.-._.................----.....................:_....._.............__.........., ---..............................---....................... -- corp name: ;Anselmo Caldeira j Mail Addr -............................................................................................................__.................................................._....... . . . . ., ............_.._.......................................................................-............................_.__..- -. location: 05 Airport Road street 95 Airport Road .._..........................._...- .............................,...............---...................__._..._...................................__..... ..................._.._-._......._........................................_._..............._..----......._............................. mappar: city :Hyannis ..._......_....---..........----_ ................._._...................._._.__........-_............. _: _.:_...__...._.._..._...................--- contact: :Anselmo Caldeira state: 'Me -----........._..----—......... -: telephone: 771-8700 zip: 02601' ..................._._._ emergency: ....--................-......---....-..................... erson interviewed: :Anselmo Caldeira Business: ....................- ---.... inspection date 1. 3/8/95 category: Dry Cleaner/Laundry _:_.._........................... inspection date 2 j type: inspection date 3 Q public wate Q indoor floor drain Q outdoor surface drain Q license required �[ private wate indoor holding tank and Q outdoor holding tank and 0 currently licensed Q town sewag Q indoor catch basin/drywel outdoor catch basin/drywel expir , Q on-site sewag Q indoor on-site syste Q outdoor onsite syste date: notes: Remarks: No Industrial Waste Permit. Dave Anderson gave application to COm .... P_._._ owner in process. Send information or Eye Wash ;Unsatisfactory Station. Orders: Shall obtain MSDS Sheets and have on site. Chemicals' Q gty's > 25 Ibs dry or 50 gals liquid description: . unit of measure laundry soil &stain removers (including beach) 10 Gallons ......._.._.............-..--..--_..----..............................._..__.........._.__.-......_.........._.._................... waste transporter -------.-...._.............._.-._.............---...........---............ waste transporter TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH .0 3.Auto Body Shops Ve G unsatisfactory- 4.Manufacturers COMPANY ? �� (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Glass: 7.Miscellaneous IS QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MA MIALS 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: >s �ee1� OxyC�m 8"C�,71"P�n X DISPOSM,MECLAMATION REMARKS: '`►V 16kkm"V16 1. Sanitary Sewage 2. ater Supply 1/ � L-W O Town Sewer RpublicAN&Rls9d1e_:^ �On-site O rivate 3. Indoor Floor Drains YES-No X_ :161M ad 9-*- O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: 00-1 O Holding tank:MDC -L-,, 0 A-61 J'N In"ZVIS O Catch basin/Dry well ^1 O On-site system 5. Waste Transporter Name of Hauler Destination Waste Product YES NO 1. 2. ReYsalf(s) Interviewed Inspe or D to A/C_ g v C�1b Ail DNS mAME OF PROSPECTIVE gl1SINF35kiz , TYPE OF BU51NE55: R _ M - 02601 AWFXSS OF MMIHESS: �1 -----(From your taa Will or the assessor s o ice PARS mUKBE t: Offices: OV9R - please fill in the above and then proceed to the following TO ALZ. Hsw 13USMMS ar NMW new business there are quite a few things you If you -are starting a, need to do. in order to be in com»l�ance with all rules and regulations 'of - 5 you have been checked off on this sheet you the Town of Barnstable. Once may apply for a business certificate at the Town Clerk's office (1st floor - Town Hall) . 1. Go to the "ensing 'Authority office (3rd Floor School Adm. Building) This individual awillen informtod of, anb licensing nessing(Licensing requirements thatP Authority signature: ao 2. Go to the uildiag Inspector's ffice (4th Ploor Town Hall) This individual ism compliance: d has permission to star a business at (business address (Bu ' ding Inspector's signature) ping to do with ��food, lodging (bed(dry breakfast) , your business has anyt hazardo -9 waste cleaning A.arm produce, automotive repauf our business has etc. ) , or animals you must go to the Board of Health- If Y take this form to the Town Clerk's nothing to do with any of the above. . .office now and you can get a business certificate. If it attains to any Y of the above proceed to the third floor of the Town Hall to the Hoard of Health office. 3 . This Individual is in compliance and has per issio ,to start business at a (Board of Health - Inspector's signature) If your business is a bed and breakfast or has anything to do with food, liquor or junk, your last stop before the Town Clerk's office is the Town Manager' s office (second floor Town Hall) . 4 ' This individual is in compliance and has permission to get a --' business certificate.- Manager's, office) is Complete you Clerk's can be issued a businessOffice' This Once this form omP form will be filed with your certificate in the Town I Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection ' Southeast Regional Office William F.Weld Governor 8 Trudy Coxe ��s Secretary,EOEA Thomas B. Powers O� Acting Commissioner C (DPY September 7 , 1994 Mr. Anselmo Caldeira RE: BARNSTABLE--Sewer System P.O. Box 1683 Connection, BRPWP55 Hyannis, Massachusetts 02601 Commercial Laundry 95 Airport Road Permit No. 86417 Dear Mr. Caldeira: This letter is in response to your application for a sewer connection permit to discharge into the sewer system located at 95 Airport Road, in the Town of Barnstable, Massachusetts. After due public notice, I hereby issue the attached final. permit. . No comments objecting to the issuance or terms of the permit were received by the Department during .the public comment period. Therefore, in accordance with 314 CMR 2 . 08 , the permit becomes effective upon issuance. This Permit is an action of the Department. If you are aggrieved by this action, you may request an. adjudicatory hearing. A Notice of Claim for an Adjudicatory Hearing must be made in writing and postmarked within thirty (30) days of the date this permit was issued. Pursuant to 310 CMR 1. 01 (6) , the Notice of Claim shall state clearly and concisely the facts which are grounds for the proceeding and the relief sought. The Notice of Claim, along with a valid check payable to the Commonwealth of Massachusetts in the amount of one hundred dollars ($100. 00) , must be mailed to: Commonwealth of Massachusetts Department of Environmental Protection P.O. Box 4062 Boston, MA 02211 20 Riverside Drive 9 Lakeville, Massachusetts 02347 • FAX(508) 947-6557 • Telephone (508) 946-2700 -2- The Notice will be dismissed if the filing fee is not paid, unless. the appellant is exempt or granted a waiver as described in 310 CMR 4 . 00. Very truly yours, :.f .-7 : 'Robert P. Fagan; Regional Engineer for Resource Protection F/RR/ljr cc: Mr. Robert Burgmann, Town Engineer 367 Main St. Hyannis, MA 0260'1 Mr. . Thomas Mullen, Superintendent Barnstable Public Works Department 367 Main St. Hyannis, MA 02601 I 1 m �s��� �� �F� �;cTs c""` � t • No...4r:...:x_ FEB....:1.SI o•.....- THE COMMONWEALTH OF MASSACHUSETTS BOAR® QF ,,HEALTH , _.h.U�....OF.....-..---* 'C,.t2`-'4 `''.................................... ApplirFa#inn for DiaposFal Works Tnnitrurtinn Permit Application is hereby made for a Permit to Construct ( ) or Repair (yI an Individual Sewage Disposal System at: Xl w4mim sex-... �-..,.4 m.� guL ---------------- .....-- ..- ......._ Location-Add s or Lot No. .�V.�.3.T_..1.L24!?�44tl�QP...._�k.`CJoiv C�1S11r2.. /�It2.f>o 120. �!..4�t ..�i.................... Owner Address a ... _ v�C:.._.�.__.l.! 5.r_,... ................. ....................... Installer Address UType of Building Size Lot.............................Sq. feet �. Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures -------------------------------•------------------•---.-----------•-•-------•------••--•----..._._.._..------------------...--------••---•--------••-- W Design Flow................................l Q.__--gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid'capacity_ ._gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.. Seepage Pit No.......Z.......... Diameter---- Depth below inlet.........J�_...... Total leaching area..................sq. ft. Z Other Distribution box (i ) Dosing tank (A&) '-, Percolation Test Results Performed by.......................................................................... Date........................................ �4 Test Pit No. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water........................ fs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ---------•-•------------•------ -------------------•--••--------••••-------.........•--•.._............................................................... 0 Description of Soil..................................................................................................................................................................... x U .-••------..;•----••-•-•--•-------------------•.._....-----••----------------......------......---•.._...-----•-•-••--------------------------••...........•----------•-------••-••-•----•------------ W .. x - - U Nature of Repairs or Alterations—Answer when applicable.-ADO.....P?..- _._1 Ud GVT -Z-_(o__t�_'__. `37,0 U"eveIke pt c ��' Comes a Ts a'"r GsT, Agreement: The undersigned agrees to install the afored ribed Individu Sewage Disposal System in accordance with the provisions of TITL% 5 of the State Sanitary de—The unde i ed Nyther agrees not to place the system in operation until a Certificate of Compliance has bee issued the ar of hea Si ... ........................................................... --------- -••----------..__.......--_..._ Date Application Approved By......................... -------- ....-------•-- Date Application Disapproved for the following reasons----------------------------------------•------------------------------------------------------------------••••- --------------------••----_...__.._._...-------_._...-------...-•--------•....---•-....._._._...-----••-•.•-------....-------------•-•--------------••---------------------------•---------••-----.._.._ Date PermitNo......................................................... Issued_....................................................... Date F4 � THE COMMONWEALTH OF MASSACHUSETTS BOARD F- HEALTH .................. 1,....... V....OF........ BLS Appliration for Disposal Works Tonstrnr#inn j1prutit Application is hereby made for a Permit to Construct ( ) or Repair (%) an Individual Sewage Disposal System at: } , -- ''t1 •}?f..k .�..... ................. ------------•------•------••-•---...-•-------.._....-•--------------------••-•--------.........._. Location-Add ss or Lot No. -- `IA0%er__�JI DgM.(;XAa1?....(ss!!yJnra CI• fp.-.Q• �-t!c.��.+.�,y��r ._.......... Owner Address W -1 .__.....Ex..._4 ... ............ ....... Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures W Design Flow.................................,_--gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid'capacity ..gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area......,.............sq. ft. 3 Seepage Pit No-------'............ Diameter... Depth below inlet.....__._IG...... Total leaching area..................sq. ft. Z Other Distribution box (E ) Dosing tank (V) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water......................... fro Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -••••••••--••••••••••-------•••••-•----•--•--•-••------•••-•••......--•-.....--•--•..............:........................................................... 0 Description of Soil....................................................................---------•-------------------------------------•-------------------•----------------......-----•••- x U w M. --••-•••••••------------••-•-----••--•••---••-•••••--•••------------•••-•••--•-----•••••----•-••--•-•---------•-•-----------•.....•-•-••----••-••---••-•-•-•---•--•-•-----••........................•-•- U Nature of Repairs or Alterations—Answer when applicable-AN-----ri�... !S_n!�C:_...1.1W _�-GT'..:.x.-_6. b.'... Agreement: The undersigned agrees to install the aforedff��ribed Individu Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary rde—The unde i ed f rther agrees not to place the system in operation until a Certificate of Compliance has be issued fy the boar of hea h. # Sr ......................... ......... ........ .........---Date.............. Application Approved BY-•••-•-••--•---•••.......-•=•-••...................... j' - Date Application Disapproved for the following reasons==-------------••---------------•----•-------•----------..--.--------•------------•--•-••••......••------------- •-------...-•-•------------------•-••----.....-----------------•-------------•---------•---------••------.••-•-••---•--••--•---••----••-••---------••••-••---•--•••••••••...---•-••--•-••-•---.....------ Date PermitNo......................................................... Issued....................................... Date l�t 1 THE COMMONWEALTH-OF MASSACHUSETTS BOARD OF HEALTH V. ..........................................OF........................................................................... (9rrtifiratr of Tamptiana THIS IS T CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by .... exls.,,_.......-•-•--•---•.......................••-------•-------............_......-••-------..............-•---..........--------•--•-......------_...._ Insta/' , er has been installed in accordance with the "ro provisions of TIT 5 of The State Sanitary Code as described in the P Y application for Disposal Works Construction Permit No....... ............... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS ED AS A GUARANTEE THAT THE SYSTEM WI 7TION SATISFACTORY. DATE.... ------------------------•-----••--•-•••------_•---• Inspector... - -•--•••--•-•-•-----•--•--•-----•-•.........-•••---••-..._•---•---•------•- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH f ........................................... ....................... ko.......................... FEE.r:.................. 1' �i��ro��tl forks �on�#rnnr�ion rrnti� � 5 ' Permission j hereby grante . 1�--•----------------•---- •-•--.---P•-----•-•-- ---------•--------------------...------......------.....----.............---- to Construes airy Ir�divid Sewage Disposal System at No. �, ( Street as shown on the appli tion. Disposal W -s Construction Permit No..f.._,A............ Dated''/! _.. ............... A� f DATE. Board of Health FORM 1255 A. M. SULKIN, INC., BOSTON TOWN OF BARNSTABLE LOCATION i°.yD c4 owed A; 2 AT SEWAGE # VILI:'AGE YyA nni es ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO.l�t�b>•✓5 c .✓ 7 �`Z SEPTIC TANK CAPACITY &A ( S %t n✓g' LEACHING FACILITY:(type) 15' 4�AA---Ys (size) JC 6 NO. OF BEDROOMS/VA PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER r DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �' POOR J✓ l�i�1s� C I ` TAAP ;S �/e- 1 | BORING REPORT �w L. ��N0N N�N0NN���� �� ����N�N���� INC. BORING REPORT / C. _ _ ---_-_' _ ---__-- - _ -_ BORING_ - _ - _ '. _ - _ aRAINrmE, Mumm TO .......................�Vi������-�Y�T�*�-�F-��P�'gD�------------��-ENTERPRISE'R�\D-----HYANN!S^-MA�S8CMU0�IT�---- sncLoc*«mw �RP�gS��'�y�I��I��'�'���-------------------A!��y�[R���--------.MY&@N�5°'M&85ACMUS�IT5----. scAa �"=-.1\--'rr mseoswcsoxrum---IU'�['EuR�i�H[�'�1.O�u[8S----------------__-'-'_--------- | BORING mo'--'L-' BORING wo..................... moxINa NO.......... _ oomws mo------. O.n/ o'O 0.01 o`o -- TOPSOIL / ,0 ` u-5 /-c�a -- O-/e | '6 -- 2/0 ' _- ` a.5/ '_-4.u/ NOTE I , � 5/» -- 5`» FINE TO MEDIUM -- |T-|8-/] / 6/6 8-7-9 |-- 6/6 ' / -- , _ _ -- |o`o |o`o -- |z-| |-|] GRAVEL-TRACE OF 7-9-9 -- | | `6 | | /6 -- |J`6 -- -_ 6-8-8 -- SILT /510 15`01 15/0 -- -- 16.51 16/6 9-13-16 ` BOTTOM OF eoe|we BOTTOM U� BORING i5.o` -- |h.5` R[AU|ncD DEPTH -- ncQu|REo ocpr* -- |-- -- r wuTc | : r/mc TO mcp/u* s^wo, rn^cc woTc e; r/wc a^wo, rpAcc OF r/ws or SILT, r=»cc or r/wc an^vcL. GRAVEL, SOME u/Lr^ rnAcc or nnoro. -- -- -- NOTE: NO w^rse cwcnuwTcpco uwLsys /wo/cArso -- _ _ -- -- aop/wo wp~...�,.,...°.. _- -- -- -- --| -- _-. -- 0.0/ 0`O -- |-- |-/-2 '6 -- |-- 1 ,51 | — FINE SAND SOME e-c-e — ]/» -- 4,J` -- FINE TO MEDIUM 5/» 6-7-9 -- 6/6SAND, LITTLE -- FINE TO |0`o ' 19-23-2/GRAVEL,TRACE OF | | /6 _ SILT |4/O ^ 16-18-2e --- ' 15`5/ |5`6 --| � �� � | BOTTOM OF BORING ` / --- � |5^5, -- ` REQUIRED DEPTH *INDICATES wmo LOST IN THIS LAYER OF SOIL---------------.FOOTAGE op BORING THIS SHEET..................4.7'g................................................ wArm xEAo/ws wm/cATEx uuxFAcs OF wArm AT comraT/ow of oonIwo UNLESS NOTED or*smw/ec nouno IN LOG coLumm /wo/cAr eo 4o womoco OF BLOWS no omv�------'SPLIT SPOON----'/mcmavwn*'!--...LB. WEIGHT FAuIwa.3.9'INCHES UNLESS or*ERwms xrEcmoz /o ad No.--• -•--/......... F>�s.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH (11.��" /t�d-S T/?6 t e .. .................OF.............................................................I...................... ..... Appliration -for Uiipuiittl Workii C owitrurtion Puniit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: Leeatio -Address, or Lot No. W wg r r r Address Address �� �r� nstaller d Type of Building� � Size Lot_St"Z`h.:�✓YP g .........................Sq. feet U Dwelling—No. of Bedrooms......................... ....Expansion Attic ( " ) Garbage Grinder ( ) aOther—Type of Building iw&Rf,;S/_4�[!10 No. of persons.......aS72Q............ Showers ( ) — Cafeteria ( ) d Other fixtures V47� eib9 ---------------------------------------------------------------- W Design Flow......................I.%.............gallons per person per day. Total daily flow-----------C2c*-�._________-____.........gallons. WSeptic Tank—Liquid capacity-l$',0.0gallons Lengtl# Width. __. ._...._. 1' . Diameter_•---------•_-.. lle�th....5-4__ -... x Disposal Trench—No........ Width-------_" ------ Total Length------------- Total leaching area..... .......sq. ft. Seepage Pit No........S......... Diameter..... Depth below inlet------46---(...... Total leaching area....-s�.Kne--_sq. fl. Z Other Distribution box (l,,j ' Dosing tank ( ) • aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of "Pest Pit.................... Depth to ground water........................ �14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 ------------------------- ---------------- ---------------------------------•----------------•-•----....................................................... P T`, Pam. .-------/�.-----.L-3e eln- Z... ------------- p✓...1 C �!C i� Descri tion of Soil.............; U -----------------------------------------------------------------------------A—bV70 --------------------------•------------------------------....--••------------------- _ U Nature of Repai s or,,�;�Iterations—Answer when ....... ..................................... ----•-.3-17, '0 �d' � ------.....Lifrw i C ��� cs c%icc�irGw ..... .........•--•--------------------------•-•-- Agreement: , The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article \I of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. �/V Signed../� '?.... ............ ... Date Application Approve B ---- 's1'ST t�`! O'k �C!t,sOAa //Owe-o''/L 4u 0 wd Z1,ke Date Application Disapproved for the owing reasons* .... - e-- ermit No...........'........................................... Issued..... -r . f .ate-----•. Date --------_-------------------------------------------------------------------. No. - Fs$............................_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF...................................St�94c.-.. ............... , ...-.................... pphration -for Bbpoottl Works T tio mit onu#ruxn Vrr Application is hereby made for a Permit to Cdastruct (✓r or Repair ( ) an Individual 'Sewage Disposal System at: t Iva W Ct� Locati Address or Lot No. 1 ,- i Address ,Address $'44 0�.40J Q Type of Building W Size Lot____________________________Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( )' Garbage Grinder ( ) per, Other—Type of Building ltvrt/!! SAAAC& No. of Pei-soiis..__...I_Q------------khowers ( ) — Cafeteria ( ) Other fixtures X AAW..... .--...'-j....................................................... W Design Flow....................../16...............gallons per persoq�per day. Total J�ily flow I..........6CN.......................gallons. P4 Septic T:trtk—Liquid capacity.100gallons Len �- Widtlt �_._ Diameter................ Deptlt.._ Disposal Trench—No. .......MO..._. Width.......... '_______ Total LengthZ....... Total leaching area_...r!r! -------sq. ft. Seepage Pit No.._..__$........ Diameter.....&AjV--- Depth below inlet:,..`..... Total leaching area....0( ----Sq. ft. z Other Distribution box (pof Dosing tank ( ) Percolation Test Results Performed b -`•....................... Date........................................ a Y.....................• Test Pit No. 1................minutes per inch Depth of Test Pit............ ...... Depth to ground water........................ LT,. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4` ..------•----------•-------•---------••-----....•••.............................•-•-......•.................................................................. O Description of Soil-------------#.../�•�I! 4?�' --•-•-It>- ......PA_4W. a_ -------L �Itles� 4 ...IS/ iC7?�f.----------- x s U a;r, --- �-------------------------------------------------------------------------------------------------------------- --- � � U Nature of Re ai s,or Alterations—Answer when applicable._._�._#alb-___'. .. ...................................... j -----------tip s� ��<.�..........ctii� Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. c7 !, �It! Signed. ,A !-� - fFLfJIy .S 1 ,ST��/ �---�-{-i F.ik'l��GF' DaEe Application Approved B - . .... F-•---•• 1 Y ---- ---------------------------------- -- - - -------- ------------------- ------ f r— Date Application Disapproved it the o owing I�" c4 /F G/GEatlE reays/otnsr:cf-- ..jr ...: � ..................................................... - / � • Date PermitNo......................................................... Issued------------ .......................................... Date THE COMMONWEALTH OF.MASSACHUSETTS ' ,BOARD OF HEyAI�TH 41101 tr . .................. ....OF................ ................................. �rrtifirn#r of Tomphatirr f THIS S CF„RTIF That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) b -•----- s:......................................... Y----•--•--•- ----------- ------ a1ler + at---•------••--•••................•--•-•------. ......................... ........................................................ has been installed in accordance wi the provisions of A icle XI of The State anitar Code s de ribed in the P Y application for Disposal Works Construction Permit No.......... .................. dated_-_._ . 1 ...7!............... THE ISSUANCE OF THIS:CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE :,SYSTEM WILL FUNCTION SATISFACTORY. ' DE Inspector-"_----•--•----------------------••-..__.........---------•--•••----•------------ r THE COMMONWEALTH OF MASSACHUSETTS 4 BOARD VF HEALTH 00 No. 'r�' 1 FEE .............. its I Irko Tatuitrurtiviv, Vrrmi# i Permission is ereby4 anted..... • ------------- ---------------------------------------------------••---_--_.. to Construct o R it an Indi]�'dual S Dis oral iS street L� as shown on the application for Disposal Works Cons3luctio mit N _ DaYeB.........7���/71t.. B rd of Health DATE -------------------------------------•--------------------...-------------• v FORM 1265 HOBBS & WARREN. INC.. PUBLISHERS 6 ri CI j - m �I' � I �IrnI �) m I� /' s .�� j ..� � , . ... i `,:r � � .: � .. . . .,. S � ,._ , _ .. S 0. Y., I, 0 _ o. Y . "- �''`•�, .sue �.•'+�,r� J� �/' G•'�C._%1. 4 `-J f.«. ��.,� Y,-_.,.1 .k..«.1 jy t"' 1 A.r•�.._. .,.�J .�J��L.../.-,.,,?!•w 6.. �.....J I", _ '.!!a .i,_'..._.ems `i "E27 4 71- Il �'_ - ''� �<�:.� ��.a ,�eC,. _-.a„Y 4""� '^,•1��.;. 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