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HomeMy WebLinkAbout0092 BARNSTABLE ROAD - Health Ol 92 Barnstable Road Sewer Acct # 039� Hyannis A = 327 -057 I Q f Town of Barnstable OFTME t Regulatory Services '1- Thomas F. Geiler,Director /, Public Health Division �U" RA BM Thomas McKean,Director MASS. 94j i639. 200 Main Street, Hyannis,MA 02601 ArFD��p Phone: 508-862-4644 Email: health(a)town.bamstable.ma.us Fax: 508-790-6304 Office Hours: M-F 8:00—4:30 ' May 30,2006 Mr. Aaron Goodale and Mr.Dawson Farber Nauset Marine 92 Barnstable Road l Hyannis,MA 02601 Dear Mr Goodale and Mr. Farber: Thank you for the letter of notice regarding the Hazardous Materials quantities located at Nauset Marine,.92 Barnstable Road;Hyannis,MA at this time. A site visit to Nauset Marine on January: 24,2006 shows inventory levels;at.zero (0),which are far below the threshold of 111 gallons to obtain a Hazardous Materials Permit. The Board of Health has determined that the using, storing, generating and disposing of over 111 gallons of hazardous materials per month requires businesses in the Town of Barnstable to obtain an annual Hazardous Materials License. You are not required at this time to obtain a permit due to your current inventory levels. If levels do increase due to maintenance of boats or sales of materials at any time,please contact the Health Department to have an inventory site inspection. If you have any questions or need further information, guidance or assistance,please do not hesitate to contact the Public Health Division. Sincerely, Alisha L. Parker Hazardous Materials Specialist i CORPORATE OFFICE Route 6A, P.O. Box 357 Orleans, Massachusetts 02653 (508) 255-0777 fax(508)255-0373 •Sales Fax: (508) 255-3906 May 16, 2006 Town of Barnstable Public Health Division- We have received the application for hazardous materials. We do not store^ - any quantity close to 100 gallons of hazardous materials here at 92 1. Barnstable Road,.Hyannis._ So we have returned the application to you. Thank you, tf Aaron Goodale Y Sales manager Nauset Marine, Inc. ; OFF CAPE • 366 Wareham Road, Route 6, Marion, MA 02738 (508) 748-0911 fax (508) 748-1557 UPPER CAPE • 692 MacArthur Blvd., Route 28, Pocasset, MA 02559 • (508) 563-1110 fax (508) 563-1172 MID CAPE •92 Barnstable Road, Hyannis, MA 02601 (508) 771-2522 fax (508) 771-4994 MARINA•Off Barley Neck Road, East Orleans, MA 02643 • (508) 255-3045 www.nausetmarine.com YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 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.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: 0511001 Fill in please: APPLICANT'S YOUR NAME/S: BUSINESS YOUR HOME ADDRESS: TELEPHONE # Home Telephone Number c:VMVRVA,. NAME OF CORPORATION: NAME OF NEW BUSINESS TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES NO ADDRESS OF BUSINESS a I MAP/PARCEL NUMBER 3 27 (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 T TO 200 Main St. - corner of Yarmouth This form is intended to assist you in obtaining the information you may need. You MUST GO Barnstable. y 9 Y Y � Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. r: 1. BUILDING COtiT�l MISSIO ER'S OFF E This indivi has a ir�for d f(Wy er it requirements that pertain to this type of business. A I Aut on ed-Signature* COMMENTS l 2. BOARD OF HEALTH This individual has bee for Jed of the permit requirements that pertain to this type of business. rv�]r� Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: J DAWSON FARBER CEO, NAIJSET MARINE, INC. ROUTE SA• RO BOX 357 ORLEANS, MA 02653 508.255-0777• FAX 5Q6-255-3qo E-MAIL: dawson@nausetmarine.com r M Date: /0& TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: - / BUSINESS LOCATION: INVENTORY MAILING ADDRESS: ' TOTAL AMOUNT. TELEPHONE NUMBER: ,�2L271- ' , CONTACT PERSON: 2°L, [ EMERGENCY CONTACT TELEPHONE NUMBER: t u 7,q6 '0771 MSDS ON SITE? TYPE OF BUSINESS: f INFORMATION/RECOMMENDATIONS; FireDistrict: Waste Transportation:_ Last shipment of hazardous.waste: Name of Hauler: Destination: — Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials 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) _ Misc. 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 Misc. 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 Misc. 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 (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor& furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers (including bleach) Spot removers & cleaning fluids i DIAJU I I A (dry cleaners) Other cleaning solvents 0�-p Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS �._ Date: TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: Nq 0 5 E 7- ;'V,'9 ►e I N E � c. BUSINESS LOCATION: 961 19A 2N ,57-,4$L E A'b.',0P4A),V15, NA 60661 MAILING ADDRESS: 8 6 X 35-7 QA LE N S lN1q- o a 6 s3 Mail To: TELEPHONE NUMBER: Sob- 7 -a5:2 Z CRP1410N r s Board of Health Town of Barnstable CONTACTPERSON: b A10 So/y EAI $EE� '57 P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: Sob- a SS—6-2 Hyannis, MA 02601 TYPEOFBUSINESS: {' ,4 )ewE7 SALES /4W 6 RE/of}//e Does your firm store any of the toxic or hazardous materials listed below, either for sale or for you own use? YES >0 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: 9,1 6ARN67-4 t9� E" P2b. yMA)AJ1519 M/- 6a6 ,0 TELEPHONE: SO 8— 7 7 /—0 sa D_ 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 /U6N—7'ox I C Antifreeze(for gasoline or coolant systems) NONE Drain cleaners 7 NEW NbN'rUSED N6NE Cesspool cleaners Automatic transmission fluid Disinfectants iUoN,9- Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Mw. yo 6A-L. Motor oils /N T4tA)mE� SLDC . llowF Pesticides 'A dNEW USED (insecticides, herbicides, rodenticides) Gasoline, fief' OA) Photochemicals (Fixers) Diesel fuel, kexesVT, #21*aftn oTl NEW USED /o C61— Other petroleum products: grease, N E ON Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal ONF Printing ink /t1 oNE Degreasers for driveways & garages ON Wood preservatives (creosote) Battery acid (electrolyte) IJONE Swimming pool chlorine NONE Rustproofers oNE Lye or caustic soda 1 G AL onl Car wash detergents oN5' Jewelry cleaners I C � Car waxes and polishes ON E Leather dyes NONE Asphalt & roofing tar /VoNE Fertilizers - SEE 14TTAC#fbPaints, varnishes, stains, dyes k0N5_ PCB's /U o N15' Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) /)0u Paint &varnish removers, deglossers ONE „ /� Any other products with poison labels AUON6' Paint brush cleaners (including chloroform, formaldehyde, /1)0NC Floor& furniture strippers hydrochloric acid, other acids) I PINT- Metal polishes �VoN� Laundry soil & stain removers Other products not listed which you feel /J (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids (dry cleaners) SFE A-Triiac OOther cleaning solvents A)dNE Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS CUU �l Lim - GkBB(cy*%I a,-PA - ��' � W.�-I-cseece- 7-Y. cf1 m t-L ; o u�!€ _ Gar'i e C) �a - Gcfe�. �ul,n - ue�vsE Luat ,— ---- _ CA4 X7-/,0 L�7Yl/e�L !i _ �1�i�'sJ �����:� . ,��Ifl�l�t•�" �c1� i Ole G��lCff-N% C�4l/G,�S'/c-iJ�,�- -�i-�t(��/c�-G� K�c�s r�vex-�f���N /✓��. ,1 C�l G W/c ,c5/Ly47 - G/ � ,i G44014'cW% cX S P— %-4, s,��•vc- „� ' ©wigs/Ly&lz- - i: �� IK ;i C��1/C�5 ic.�/ G�iPz�i�/C A�72Dq4:5 `• <r ii it i� . 11 { ii it �i I' it �i l {i ii it j` 14 �1 I I ` i i? i i! i. �1 .I it II l kl6QAS OIL WASTE OIL OIL FILTERS ANTIFREEZE WASTE ANITFREEZE 0-h be GASOLINE WASTE GAS DIESEL FUEL W/W FLUID ATF HYDRAULIC/ MISC. MISC. MISC. MISC. BRAKE FLUID COMMBUSTIBLE FLAMMABLE CORROSIVE PETROLEUM (GEAR OIL/GREASE/ LUBRICANTS) FREON ACETYLENE CAR WASH CAR WASH PAINTS/ WAX DETERGENTS THINNERS SEALANT CLEANING BATTERIES/ POISION/TOXIC CAULK/GROUT SOLVENTS BATTERY ACID FERTALIZERS WASTE SOLVENT i' MSDS�� >Ai ANIFESTS T `IE-T• A ti F 5 PVD YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates(cost $30.00 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, 1st FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) W DATE: )°Z /,q D s Fill in please: ' Maw APPLICANT'S YOUR NAME: bAtj6b/U I- Ir►QR_gg- BUSINESS YOUR HOME ADDRESS: 3 "1 se3 EA)AJE'rlY I AAJE� 53 TELEPHONE # Home Telephone Number 50 $-a.511sr- 6,8019 NAME OF NEW BUSINESS 05 E A) TYPE OF BUSINESS S 4 IS THIS A HOME OCCUPATION? YES NO Have you been given appr val from the bu'Idin diu.isio ? YES ?O NO ADDRESS OF BUSINESS �RRA)57 A LE kh. 9AA)A)j,5Ak6A661 MAP/PARCEL NUMBER T When starting a new business there.are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St.-(corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMM NER'S OFFICE This individgal hqs errinf r ed of any permit requirements that pertain to this type of business. in Au on d Signatur COMMENTS: 2. BOARD OF HEALTH This individual has bee infor ed of a per it q,irements that pertain to this type of business. Authorized Signa&40 COMMENTS: -,► D -- — db n�j Q.�P L2.1 ( p Aoe_.cr' tD ag -f' !ten .�•�i',�u.J 3. CONSUMER AFFAIRS LICENSING AUTHORIT This individual h n infor d'of the lic ngu' ments that pertain to this type of business. Authorized Signature" (mil COMMENTS: CAPE COD - F&%,W Pon ul..)' Ne dell fun/// Century by Vomoho, Fountain, Sport-Croft Boots Watercraft&Je//tb�ots by Kawasaki, Seo Doo-& Yamaha 508-771-5900 fox: 508-771-1170 94-94 Bornstoble Rood Hyannis,MR 02601 TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas StatiQs, epair BOARD OF HEALTH satisfactory 2.Printers 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMP P �� O (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS t�v»b �(2 ® Class: 7.Miscellaneous YQ`'K� QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS 1Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: ti®L..0 Gasoline,Jet Fuel (A) I-VIA-k Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) �s�vue f® �-$— transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: Y DISPOSAIJRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply iS O Town Sewer Public 0�i ,�5 i qtdLeJ LjtE, 4 v 14, r VS'a877is OCR Pon-site OPrivate �' AMP 9 1Oro A Z-7 3. Indoor Floor Drains YES N0� �T-- 4, f �,� O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES_,�<,NO ORDERS: Q Holding tank:MDC O Catch basin/Dry well 0-On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES I NO 2. ' ),ZwL.,,A 33 � Person (s we "Inspector Date REGISTRATION FORM I TOXIC AND HAZARDOUS MATERIALS RE G S NAME OF BUSINESS: csL. ym-raP-PRISES,sac 16& CAPS GOD P0%JEr5PQgrS Mail To: BUSINESS LOCATION:( 9ZJ�1W( 6ARNSTRSL?, ZXX4D NyPMu%S,ma. o26Ot Board of Health � V ' Town of Barnstable MAILING ADDRESS: _ (SAMO P.O. Box 534 TELEPHONE NUMBER: 508- 71t-5900 Hyannis, MA 02601 CONTACT PERSON: ap" LRi2Gfly EMERGENCY CONTACT TELEPHONE NUMBER: 5o6-W-S911 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in qu tities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES V 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: ^1� 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 ✓ 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) ✓ 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) 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 TOWN OF BARNS TABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH �run 3.Auto Body Shops satisfactory- 4.Manufacturers CON �si labia (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS 7.Miscellaneous ANTITIV AND T RAGE IN=indoors;OUT=outdoors) ��,��U 5 S O ( , MAJOR MATER S Drums IN OUT IN OUT IN OUT #&gallons Age Test Fuels: G oli ,Jet Fuel (A) L Diesel, Kerosene, # Heavy Oils: waste motor oil(C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers 00411% az ,,Mis ar- A:V fjPiW DISPOSALRECI AMATION REMARKS: 1. Sanitary Sewage 2. Water Supply Town Sewer Public O On-site O rivate _ cat- 3. Indoor Floor Drains YES N0_1/_ O Holding tank:MDC 2 O Catch basin/Dry well r O On-site system I / � 4. Outdoor Surface drains:YES NO 1� ORD S: Q Holding tank:MDC O Catch basin/Dry well ,m. O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product Licensed?� 1 •t �L ei01V �'l�l�Glj YES NO 2. e<A 4?d4yd Person (s) Interviewed _ Inspector Date C'A 22,E Y L gRo&J A� CAPE COD s 1r�e dell f uhl,/l JACK DUFFY Soles Representotive 508-771-5900 fox:508-771-1170 92 Barnstable Rood Hyannis,MR 02601 I 6:11?c TOWN OF BARNSTABLE C: MPLlANCE: CLASS: 1.Marine,Gas Stations,Repair 2.Printers BOARD OF HEALTH satisfactory 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY — (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS _ Class: 7.Miscellaneous TI'IES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATEIS�� IN OUT IN OUT IN OUT #&gallons Age Test Fuels: , � jr Heavy Oils: � 1/ waste motor oil (C) �- Ave new motor oil(C) � . transmission/hydraulic Synthetic Organics: degreasers ..� - Y lG e, , . �r Miscellaneous: xcz JI DISPOS ECLAMATION REMARKS: 1.Panitary Sewage 2.Water Supply r � Town Sewer Public O On-site OPrivate �^ L 3. Indoor Floor Drains YES NO O Holding tank:MDC L O Catch basin/Dry well ` O On-site system 4. Outdoor Surface drains:YES NO ORDER_ S: O Holding tank:MDC _ O Catch basin/Dry well O On-site system t 5.Waste Transporter Name of Hauler, bes"tinati ' d YES 2. f;F— Pers nterviewed -inspector Date Fc PE COD JACK DUFFY Soles Representative 508-771-5900 92 Barnstable Rood fox: 508=771-1170 Hyannis,MR 02601 www.ccpowersports.com TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD 2F�HF TH O satisfactory 2. Printers 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY �C` �L� S (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS e_+0\35�� � Class: 7.Miscellaneous rIiS QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERMLS 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: JCS waste motor oil (C) CA 16% new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers i ho po, - sue Miscellaneous: DISPOSALIRECI AMATION REMARKS: \1. anitary Sewage 2. ater Supply Town Sewer Public 1.�� CAk IS1" 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 N0\ RDERS: 0 O Holding tank:MDC R O Catch basin/Dry well O On-site system 14 5.Waste Transporter 11 Name of Hauler Destination Waste Product j� �a- Person(s_ 'ewed Inspector Date THE ADVERTISN6 SOLUTION ed"Jwepxaductiuna° J,&&fling d ex"A&j9tdi" DANIEL R. MAGUIRE 94 BARNSTABLE ROAD 35 ROUTE 134 HYANNIS,MA 02601 SO.DENNIS,MA 02670 TEL:(508)'862-2600 TEL:(508)394-1900 FAX:(508)862-2686 FAX:(508)760-3692 IC6 Date: 2 / 9 TOXIC AND HAZARDO ' S MATERIALS RE ISTRATION FORM NAMEOFBUSINESS: Tnc , r . /yBUSINESS LOCATION: Pall MAILING ADDRESS: �,�,-,�_ Mail To: TELEPHONE NUMBER: �'[�� — ,a��n ' Board of Health Town of Barnstable CONTACT PERSON: �� f (`(aa��i rk. P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: Hyannis, MA 02601 TYPEOFBUSINESS: Q -��x ), Does your firm store any of t ,e toxi or hazardous m�r a(s sted 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 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 (dry cleaners) Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS tt pkocl?41� ATTN: DONNA MIORANDI, BARNSTABLE HEALTH INSPECTOR Julianne Giragosian Vice President, Director of Operations (516) 850-7187 Gracie Fitness, 92 Barnstable Rd., Hyannis, MA 02601 Outline Gracie Fitness Hyannis "Kids Summer Enrichment Program" Gracie Fitness is the premier destination where boutique fitness meets relevant forms of dynamic martial arts. Expert Instructors curate the art of human movement, creating purposeful fitness that transcends into positive social enrichment and elevated, optimal wellbeing. The "Kids Summer Enrichment Program" is a new, unique opportunity for today's Youth to acquire an educational foundation on the History of Martial Arts in a contemporary setting. There are several key components that differentiate us from any other Summer Program in that we are offering a playful, artistic twist on organized, extracurricular activities with different Themes for each the eight weeks. Kids have the opportunity to be exposed in a safe and effective classroom setting to a blended overature of Gracie Fitness Martial Arts Programming. This experience is significant and serves as a pre-requistite to selecting the Kids Fitness Memberships offered, while furthermore retaining these new Students & Parents as long-time Gracie Members. Dates: July 6th through August 28th 2015. Ages: 6- 12 years old. Options: Full-day is offered 5-days per week; 1/2 day is offered Mondays & Wednesdays. Supplemental Fitness Classes: Mondays and Wednesdays only from 8-9am /or 3-4pm. Pre-registration and additional fees required for these Add-on Classes. The following is an Outline that provides the format of the Kids Summer Enrichment Eight Week Program that showcases purposeful fitness. Themes encompass art, culture, history and encapsulate the Gracie Core Values... Being:True, Passionate, Positive, Respectful, Confident, and Humble. Program Director: Michelle Connolly. 7am-8am Drop-off "Social" hour is a time for the Program Director to connect with the Students and Introduce today's Lesson Plan as it relates to the Week's Theme. 8am-9am Creative Movement (Pt. 1), mental focus, body awareness, flexibility, artistic use of props with movement (parachute, ribbons, hula hoops, & small balls etc.). 9am-10am Arts & Crafts tied into Theme; ie. Kids create cultural Flags 10am-11 am Snack /Themed Movie (Pt. 1); ie. Disney's Mulan 11 am-12am Theatre Games to increase confidence / 1/2 Day Pickup 12am-1am Creative Movement (Pt. 2), mental focus, body awareness, flexibility, artistic use of props with movement (parachute, ribbons, hula hoops, & small balls etc.). 1pm-2pm Lunch /Themed Movie (Pt. 2); ie. Disney's Mulan 2pm-3pm History/ Guest Speakers are our Gracie Fitness Instructors: Juliano (Jiu Jitsu), Bernee (Capoeira), Rodrigo (Jiu Jitsu), Mike & Janette (Muay Thai), Mark (Kids Strength. Training/Fitness), Brendan (Wrestling), Julianne (Capoeira Musical Instruments). Each daily History Lesson articulates the lineage of each respective Martial Art, and will include live Demos with Adult Instructors & Adult Students. Show &Tell will kick-off the beginning & conclude the end of each week (Program Director displays Academy prop, met with Kids interpretation of the weekly Theme/Lesson Plan).