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HomeMy WebLinkAbout0163 BARNSTABLE ROAD - Health 163 Bamstable.Road:!^ iSewer Acct # 3909 Hyannis A= 310— 150 Y I I 1 1 1 - 0' Date: `� 1 D'3 �3C1b� TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: CAjZ ,Odd QL.tt.& LAa4kLI jj,)&� Uh tJaXt6-1 Cau&,j�W BUSINESS LOCATION: B p MAILINGADDRESS: Mail To: TELEPHONE NUMBER: Board of Health �Jb� '�- � - Town of Barnstable CONTACT PERSON: Ir? S P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: )I 540- Hyannis, MA 02601 TYPEOFBUSINESS: 2=-tln rl r s V%tk 18t 1 � Does your firm store any of the toxic or hazardous materials listed below, either for sale or for you own use? YES NO 4 - 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, lease indicate if the materials are stored at a site otherthan your mailing address: ADDRESS: (�-2h MO(P Aff7'IaV 6UQ jeboynIE,Ma 1a 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 h2cCar 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 U2 Mtn b—,an— (dry cleaners) I� Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS r ir' COMMONWEALTH OF MASSACHUSETTS n DEPARTMENT"OF ENVIRONMENTAL QUALITY ENGINEERING DIVISION OF SOLID AND HAZARDOUS WASTE • One Winter Street Boston, Massachusetts 02108 ° Please print or type.(Form designed for use on elite(1 2-pitch)typewriter.) UNIFORM HAZARDOUS 1.Gener t tlSE A No. n'f t 2.Page 1 Information in the shaded areas WASTE MANIFEST ° of is not required by Federal law. 3.Givrator's N me aV Mail' g Address A.State Manifest Document Number ilc B. 163 Earrstable� Road Hyannis, �A+ (!25�-.1 BB C242662 n .State Gen.ID - 4.Generator's Phone( 6 1.7 7 7 1-4 I 0 3ru n 5.Transporter 1 Company Name 6. US EPA ID Number C.State Trans.ID t C yn C.i.1. Corporation ration D �' 3t% 7'7 ?� .. r t.:/ st 1 ru 7. Transporter 2 Company Name 8. US EPA ID Number D.Transporter's Phone 1 j' - 69t1r— E.State Trans,ID . I ;< 19. Designated Facility Name and Site Address — 10. US EPA ID Number a I .i C:t:i Y on.-.-!+o n f e 1. F.Transporter's Phone f 1 n 130 4 i f�1€ �; tits G.State Facility's ID Not Required,;, d' (N i --- WIaterbtiry. L•,•_067t%�__—_—_-- �' H.Facility's Phone l 20B 55-2 's V 12.Containers 13. 14. I. Q' p I 1. USDOTDescription(Including Proper Shipping Name,HazardClass,andl0Number) Total Unit Waste No. •• �O No. Type Quantity �—Wt/Vol to rf)l id NCjS OPM--e NA91_R , U M a� G b' (/! to E I —3 a Ei I Z ai R L D CC A O I T 1--1 o 0 — � I R d. I v, _ J. Additional Descriptions for Materials Listed Above(include physical stare and hazard code.) tK, Handling Codes for Wastes Listed Above 3 D ! I r FCPA HAZAR.r*'EiS M '' I—_b.__ _ _ I d. _ b, B d. 11 ly i15.Special Handling Instructions and Additional Information _ lD lo-Gc Nf..RATOR'S CERTIF(CATION:l hereby decia:e that the contents of this consigrunent are fully and arcurat6y above by Pieper shipping name and are classified,packed,marked,and labeled,and are in all respects in proper condition for transport by highway O I according to applicable international and national government regulations. D U If I am a large quantity generator,I certify that I have a program in place to reduce the volume and toxicuty of waste generated to the degree I have determined to be economically practicable 0 C and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human health and the environ- I ment:OR,i1 I am a small quantity generator,I have made a good faith effort to minimize my waste generation and select the best waste manageme-it method that is available to me and that I W � I can afford. Date Printed/Typed Name Signature Month Day Year O O T 17. Transporter 1 Acknowledgement of Receipt of Materials Date rn R CO A Printed/Typed Name Signature ; Month Day Year U N 0 18. Transporter 2 Acknowledgement of Receipt of Materials ;' / Date R T Printed/Typed Name Signature Month Day Year E R 19. Discrepancy Indication Space F A C I L 20.Facility Owner or Operator:Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. TDate Y Printed/TypedName Signature Month Day Year Form Approved OMB No.2050-0039,Expires 9-30-88 EPA Form 8700-22(Rev.9-86)Previous editions are obsolete: fADYSL.: DFCTTNATTAN TTATF'—MATt'rh DY.GCNCf?ATAD THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^�C DAATA WE OENTAL QUALITY ENGINEERING 011 h >jND HAZARDOUS WASTE ) FF Y"�sm� ! oN aAss o$o�z .Inter Street .achusetts 02108 ' $ , , DMf sj 6 2.Page 1 Information in the shaded areas PICKUP AT :r of is not required by Federal law. A.State Manifest Document Number TERRITORY ' MA C 2 4 2 6 6 2 D f B.State Gen.ID DRIVE Sam n „. nJ ��/ TRAILER KO US EPA ID Number C.State Trans.ID X7 TRUCK 14: ~1 7 f1J 6 15r GA DAT PS EPA ID Number D.Transporter's Phone( p— RECEIVED E. fate Trans.ID ni C.j )S EPA ID Number O I RECEIVED FRO F.Transporter's Phone( ) n O Co G.State Facilhy'e.1D Not Required � 3 H.Facility's Phone 1 't{5— Ns.l_ .1 2 _� 228 �Ga 12.Comaineis 13. ! 14. 1. 02 O ' jv�h rnterl I I l'ota! i Uni=. Waste No. •• p G ! /�/ I ppp No. Type Cuantity WtNol Co Q) Ale J =. t • i m Cu T c �� ✓ O 1, IR d. - ; I M to Z I I H s _J..._ .._.'__.1_ ._..______M I_v1._ J._ i z J I J.A code.) K. Handling Cn des b,r W'astes!_ie.ed Above M U litO � 39946 a ---- _ CO !---------- -- �---- - -I - -- I I c, 01 • I M 15. — ------._. M iI O �. � 76.GE tr.C.ual Clp descnbad obovc Iry I � pro - conrfnion la uaosnoo by highway O acc T i C) If I a2 y of waste generated to the degree I ha•.e deu•�ri 'ie economically xact rare C and oie which rninimizes the piw fent and rtunf il—a;to-t,man health and the enwron:.,. mere: ••••::n:::re my waste generation and select the best•.vaste managemera rt+ethoc that is available to rae and t!,;a I can ., a.... Printed/Typed Name Signature Month Day Year o Q) T 1 7. Transporter 1 Acknowledgement of Receipt of Materials _ —_ --� -- — —_ — Date y, UN Printed.'TypedName Signature Month Day Year C I - S -- - --------- --------- -- -L-1-:�_ 0 18. Transporter 2 Acknowledgement of Receipt of Materials Date i R — - ---------------------_--'--- - --------..-._ E Printed/Typed Name Signature Month Day Ye6f 1 JI1 .11 !J 19. Discrepancy Indication Space F A C L 20. Facility Owner or Operator:Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. _ Date T y Printed/Typed Name Signature Month Day Year Form Approved 0M8 No.2050-0039,Expires 9-30-88 - EPA Form 8700-22(Rev. 9-86)Previous editions are obsolete. COPY>8: GENERATOR-RETAINED BY GENERATOR l :T ��QyOFTHE TO� a TOWN OF BARNSTABLE _ OFFICE OF . seaAM N � BOARD OF HEALTH rasa 'pp 16;q. 0IV, � 367 MAIN STREET HYANNIS, MASS. 02601 August 14, 1987 Llyod Gonsalves Hyannis Saab 163 Barnstable Road Hyannis, MA 02601 Dear Mr. Gonsalves : You are reminded that State regulations require periodic pumping and -or cleaning of all MDC traps (Metropolitan District .Commission;• gas and oil separator tanks) . You are directed to contract with a licensed hazardous waste transporter\contractor to perform the required pumping and or cleaning of your MDC trap by September 11 , 1987 , or provide proof of such maintenance performed within the past three months . You are further directed to have your MDC trap inspected and . cleaned if necessary, by a licensed hazardous waste contractor every three months . Written proof from a licensed contractor will be required. Inspections will follow by the Health Department to verify compliance . You are reminded that failure to comply could result in a fine of $200 . 00 daily under the . Town of Barnstable Toxic and Hazardous Waste By-law. Very Truly Yours , Jhn M. Kelly Director Barnstable Health Department t., r f� Martin, Cynthia From: McKean, Thomas Sent: Monday, November 17, 2008 4:30 PM To: Martin, Cynthia Subject: 163 Barnstable Road Hyannis/Trailer with Paint Cans Craig Medeiros, owner of the property, called to ask us for help. There is a trailer on his property full of paints and paint cans at 163 Barnstable Road. Can you call him back at 775-0828? _ If /* �- 6� ,6ef Zee t p I - - �1� i� .'1[�- _,.�mil (•ds%� r.��� I V i THE APPLIANCE OUTLET 163 BARNSTABLE ROAD HYANNIS, MA 02601 TEL: (508) 790-2600 r THE NEW COMB FAMILY FAX: (508) 790-8884 i F � Q C 0 S a v o N � e. i TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations, air satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY 4-t , , (see"Orders") 5.Retail Stores _ ,,�� � 6.Fuel Suppliers ADDRESS Y2r .fl✓t�✓�fGrf�- Class: 7.Miscellaneous 'Lc QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATESTanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline Jet Fuel (A) Diesel, Kerosene, #2(B) Heavy Oils: I. waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: 6AA DISPOSALIRECI AMATION REMARKS: 1. S itary Sewage 2. Ater Supply zzz.9z own Sewer Public 7O On-site OPrivate 3. Indoor Floor Drains YES NO- 0 Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Niirne of Hauler Destination Was te Product �jJ YES N0 2. 112 Person(s) Interviewed n pector Date G TOWN OF BARNSTABLE MPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers ; BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY �1 /a2rJ?`Q/ (see"Orders") 5.Retail Stores 6.Fuel Suppliers ` ADDRESS Z f' !3 vt 09 C 6ss: 7 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALSl. , IN OUT IN OUT IN OUT #&gallons Age Test I" Fuels: Gasoline Jet Fuel (A) Diesel, Kerosene, #2 ( ) Heavy Oils: waste motor oil (C) new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: I , Lm 1 DISPOSAL RECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply e1:Fe0d Town Sewer Public O On-site QPrivate 3. Indoor Floor Drains YES N0 /V O Holding tank:MDC p Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC VCatch basin/Dry well _ ; On-site system 5.Waste Transporter Mime of Hauler Destination Waste Product YES NO 1. 2. 'Persons Interviewed_. Inspector Date C-1 ; o i G - - Date: TOXIC AND HAZARDOUS MATERIALS REGISTRA ION FORM NAMEOFBUSINESS: k \ U BUSINESS LOCATION: 1 5 MAILING ADDRESS: \� Lc`�1c -Q� Y�e,hbm }� Mail To: �'1�i Board of Health TELEPHONE NUMBER: I�-Jdg ©-ZI�6Z� Town of Barnstable CONTACTPERSON:L,)�� P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: 1,9 1.1 - rl q.-%+S-p Hyannis, MA 02601 TYPE OF BUSINESS: Does your firm store any of the toxic azardous materials listed below, either for sale or for you own use? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site otherthan your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity n if A t reeze(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 Paint brush cleaners Any other products with "poison" labels (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 t I. i I THE APPLIANCE- OUTLET 163 BARNSTABLE ROAD HYANNIS, MA 02601 Li Tel: (508) 790-2600 t THE NEWCOMB FAMILY Fax: (508) 790-8884 i i { 4 m am a v co s „S S S a p` YP a S TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops _- O unsatisfactory- 4.Manufacturers " r r " 5.Retail Stores COMPANY (see 0 de s ) 6.Fuel Suppliers ADDRESS 163 Class: 17 1 .Miscellaneous N-tf0-4ot-(jQUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALSUnderground 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 i Miscellaneous: DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply �' ha,� /OC)of 'P/' _Ql/ C ;,Town Sewer ./Public o u 0 On-site OPrivate 3. Indoor Floor Drains YES N0_,V 0 Holding tank: MDC 0 Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES_NO O D RS: 0 Holding tank:MDC VSatch basin/Dry well On-site system 5.Waste Transporter Name of Hauler Destination Waste Product49 YES NO 1. 2. � T �/GIV Person(s) Interviewed Inspector Date .ri 1 L0CATI SEWAGE PERMIT N0. 19 e�s� 3/0 VILLAGE INSTALL R'S NAME i ADDRESS _ _ s j YJ L n R U I L E R OR _o N ER DATE PERMIT I S S V E D DAT E COMPLIANCE !ISSUED QL Q .r Ckfi LdiION SEWAGE PERMIT NO. VILLAGE R fy INSTA LLER'S NAME i ADD ESS T SQ�v B UILD R OR WNE DATE PERMIT ISSUED . 7oll' DAT E COMPLIANCE ISSUED S� � -7f I, i I N 1 dOo 400, � 1 1 'op� 1100 -c r