HomeMy WebLinkAbout0363 BARNSTABLE ROAD - Health o 363 Barnstable'Road,
Hyannis r _
A 310 .120
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Town of Barnstable
oFt►+e ram, � •
o Regulatory Services
• snxxscaar.e,
Thomas F. Geiler,Director
MANDs 9�A 1 � ,•� Public Health Division
lFD MA'S A
Thomas McKean,Director
200 Main St,
Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
February 19, 2003
Jonathan and Nancy Parkka TR j f�l
C/O Parkka, Daniel
74 Old Toll Rd. b�K q6
West Barnstable, MA 02668 '�
RE: Map & Parcel 310-120
Dear Sir and Madam:
You are directed to connect your building located at 363 Barnstable Rd.,
Hyannis, Massachusetts, to public sewer on or before July 15, 2003.
The Department of Public Works, Engineering Division, has notified us that
your property abutts town sewer lines. The lines were extended because of the
density, and the size of the lots in the area, and the potential for serious health
problems.
Failure to comply with this order will result in a court complaint against you for
failure to comply with a Board of Health Order.
If you should have any questions, please telephone me at 862-4644.
PER ORDER OF THE BOARD OF HEALTH
Thomas A. McKean, R.S. CHO
Health Agent for:
.TOWN OF BARNSTABLE BOARD OF HEALTH
Wayne Miller, M.D., Chairperson
Susan G. Rask, RS.
Sumner Kaufman, M.S.P.H.
Return receipt requested
Cc: Barbara Childs, Water Pollution Control
y Q:Sewerorder.doc
Town of Barnstable
P��p tHE 1p��
Regulatory Services
• saxivsrns�.
Thomas F. Geiler,Director
MASS.
039. Public Health Division
�0
Thomas McKean,Director
200 Main St,
Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
February 19, 2003
Jonathan and Nancy Parkka TR
C/O Parkka, Daniel
74 Old Toll Rd.
West Barnstable, .MA 02668
RE: Map & Parcel 310-120
Dear Sir and Madam:
You are directed to connect your building located at 363 Barnstable Rd.,
Hyannis, Massachusetts, to public sewer on or before July 15, 2003.
The Department of Public Works, Engineering Division, has notified us that
your property abutts town sewer lines. The lines were extended because of the
density, and the size of the lots in the area, and the potential for serious health
problems.
Failure to comply with this order will result in a court complaint against you for
failure to comply with a Board of Health Order.
If you should have any questions, please telephone me at 862-4644.
PER ORDER OF THE BOARD OF HEALTH
Thomas A. McKean, R.S. CHO
Health Agent for:
TOWN OF BARNSTABLE BOARD OF HEALTH
Wayne Miller, M.D., Chairperson
Susan G. Rask, RS.
Sumner Kaufman, M.S.P.H.
Return receipt requested.
Cc: Barbara Childs, Water Pollution Control
Q:Sewerorder.doc b
U.S. Postal Service
CERTIFIED MAIL RECEIPT
(Domestic Mail Only; No Insurance Coverage Provided)
1
PS Form 3803,January 2001 See Reverse for Instructions
Certified Mail Provides:
■A mailing receipt ,
■A unique identifier for your mailpiece
■A signature upon delivery
■A record of delivery kept by the Postal Service for two years
Important Reminders:
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■Certified Mail is not available for any class of international mail.
■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables,please consider Insured or Registered Mail.
■For an additional fee,a Return Receipt may be requested to provide proof of
delivery.To obtain Return Receipt service,please complete and attach a Return
Receipt(PS Form 3811)to the article and add applicable postage to cover the
fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for
a duplicate return receipt,a USPS postmark on your Certified Mail receipt is
required.
e For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent.Advise the clerk or mark the mailpiece with the
endorsement"Restricted Delivery .
■If a postmark on the Certified Mail receipt is desired,please present the arti-
cle at the post office for postmarking. If a-postmark on the Certified Mail
receipt is not needed,detach and affibel with postage and mail.
IMPORTANT:Save this receipt and present it when making an inquiry.
PS Farm 3800,January 2001 (Reverse) 102595-M-01-2425
UNITED STATES POSTALJSERVIC
• ?�� n Gs _ Pe mSLNo-G-�Q
R� � . . •- -r-- ,--�=ems,
• Sender: Please pri M your qa . ,,address and ZLP-+4ja this Qx.
Public Health DWI"
Town of Barnstable
200 Main St.
Hyannis,Massachusetts 02601
#il?11?il}?i?!??Hi!?illliielli???'e�itll???!�???i'1?!?!
i
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
i
■ mplete items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. X , ❑,Agent
■ Print your name and address on the reverse Addressee
so that we can return the card to you.
■ Attach this card to the back of the mailpiece, S eRec ' d by(Pn a ) Dat Deli e
or on the front if space permits.
D. Is deliv m address different fro item ? ❑ es i
1. Article Addressed to: If YES,enter delivery address below: ❑ No I
3. Service Type
QF-16e Tied Mail ❑ Ex ress Mail
❑ Registered eturn Receipt for Merchandise
❑ Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. "�bqoqjt40. O1704, 138,r
k: is? Ei
PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540I
it i it iiitiiiitiiii 11 f+i1 1 11 H.
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No......... ..7... FC$.... 5: .......
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..._................Town..........OF..... .arns t.a.b..l.e
.....................................................
Appliratinn for DispnsFal Works Tonstrnr#inn rrntit
Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal
System at:
Road
...Barnstable..__................ ............................................... --•--- ......-•-----------••-.....................
Location-Address or Lot No.
...Rotary--.Au oa..BodY-.Shop................................... Hyannis
Owner Address
W P Macomber Son Inc . Centerville
...Jos-eP� .:...............•--•-.I sta.... ......--•-••---.......••••-----...................................................................
Installer Addresa
Type of Building Size Lot----------------------------Sq, feet
Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building ......... No. of persons............................ Showers — Cafeteria
Pa 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.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date........................................
a
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
(z, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
•-•--•-------------------------------------•--•------------------....---------------..............._.........................................................
0 Description of Soil...........Sand..-&---gr'avel........................................................................................................................
U ---••----.....•-- �....--•-•---•-.
/Y -•--------- FY�t.!'..P�1.. .. k .yE . - 1........ •--.•...............................
U Nature R airs or Alterations—Answer when applicable... `� ----------•---•-••---•--•--•----•-•---•---------------
y �----------------------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iITL. S of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has b i ued by the ardpf lth.
R
Si ned....• ..... ............ la.� ".�.
Date
Application Approved By........ .......,l;�'S_. ----Z f_.---
Date
Application Disapproved for the following reasons:..............................................................................................................
---------------------•-------•---................-•----------•-•-•-...........-----..........------....---------------------------------------------•-•----------------------------------------.........
Date
Permit No......................................................... Issued..... .`. --?��
-•------••........ -
Date
No........ Fs$...%5.,<_QO......
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...................Town...........OF....Parns tab le.........................
ApplirFation for Disposal Works Tonotrurtion Verntit
Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal
System at:
..Barns tab le-,Road ..................................••--•-•---....-.........---•------------•---••-----.............
Location-Address or Lot No.
..Rotary_,Auto--Body ShoP... Hyannis....................
Owner Address
a .-aoaep P� Macomber &.-Son.•_Inc-..-_.••-••---.-• Centerville
Installer Address
Type of Building Size Lot............................Sq. feet
V Dwelling—No. of Bedrooms.............................. .. .....Expansion Attic ( ) Garbage Grinder ( )
Other—Type T e of Building No. of persons............................ Showers —
a YP g -••------------------------- P ( ) Cafeteria ( )
QI 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.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
-`'Percolation Test Results Performed by.......................................................................... Date........................................
•;� Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water....................,-..
44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
p4 .............••--••-••••-•--•••••...:••-•••••••..........---••••_.._......._,.....____......_••-•........._._........._----_......-•-•-••..._•••--••••--....--
Description of SOU..._______Sand & gTaVe..
.---••••--•• •--••..................................... •••---••-•••••-••--•--•••••••-•••••••......._.........---••••-•-•._............•-
x - ••---... ........
- ----- .• . ............................................
x T ? �' �� l• • Wit....
U Nature of Repairs or Alterations—Answer when applicable -------------------•---------•..................•--
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLL
S of the Statet.Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Complian e',tlas bee i sued by the board'ofealth.I
4 __S d...... . ...__............... ..---...
!' Date
Application Approved By...... --= '- ----� . Gt/Jrj ..•.. -,�-'-. f�
.... �• Date�I
Application Disapproved for the following.reasons---------------------------------•-•--------------------------...----------------••............-•---••...••--•--
..................................
-•.....•••-•••••--••-•-••...•--••••-•---•--•••....-•--•--•.....•--•-..__................•-•--••---•---•••-•-••••--•--•-•--••-••----••-•--••••-•-•••••--•••••••-------
�•- Date
Permit No.......... -----._.. Issued A'-"p Z�'::.:.. •-
Date
''
,THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town Barns table I ; 0
f
(Intifiratr of Toutplittnre
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( X)
by....Joseph__P....Macomber & Son Inc .
............ .........••--• ....._..
at... a�rr�stable_,•_.Road, annis; _::_: Installer Rotary Auto
Y --•--•••••••......••••••-•••---••-••••-•-•----•-••-•-•......•••-•......y-•-•-•......•••---.
has been installed in accordance with the provisions of T Z-,`F j of The State Sanitary Code as described in the
application for Disposal Works Construction Permit Nd.7.1/..... dated....-/ -`.5�-=-1. ....................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................................................................................ Inspector........................................................ .........................
THE CO1
M-11,MONWEALTH OF MASSACHUSETTS
'BOARD OF HEALTH
07f 7. Town Barnstable
7�
.............O F..................................................................................... �.0�
No.........................
FEE .... ..................
Disposal Workii Wontrttrtion eruttt
Permission is hereby granted..J08eph P.....Macomber & Son nC.
. ...................-• .. .... ------•-- -------
to Construct ( ) or Re air (( X) an Individual Sewage Disposal System
at No..Barnstable toad, Hsyannis RotaryAuto
------------------------------------------------•-•-•--•-•--••••••.
Street
as shown on the application for Disposal Works Construction Per it No210.
�Dated,� �.% _____________
.....................................
and of Ith
........................---------------------------•--•----•--•----______--
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS '+'
No.& Fxa..Si.0b.....
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.......................1( .WY)...OF........ . . smb.).e.................................
Appliratiun for 11ispau al urks Tvustrurtuan ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( L-ran Individual Sewage Disposal
System at
...Zum. al. ------------------------- -----------------••----.............-----.....---------------------------.........................
. Locatio - ddre or Lot No.
��0 ------•---•------------- _:4 -•---.............-----------------................
Ow er Address
a .P►. Y �? ,ar .. ?n. :......... ...........................•••..................... ---------------------........--------......
Installer Address
�. Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic ( ) ' Garbage Grinder ( )
Other—T e of Building No. 'of persons...............r............ Showers — Cafeteria
Q' Other fixtures ..................................
WDesign 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.
Seepage Pit No..................... Diameter..._................ Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed bY.......................................................................... Date.........................................
aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.........................
f� Test Pit, No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
O Description of Soil..........
-
W --------------------------------------------------------------------------------------------------------------------•••:.. • ------------........................................
x
U Nature of Repairs or Alterations—Answer when applicable_--_�..-�.(,�_(�®.. .41� �].1.`� .................................
----------------------------•---•--................------------------------•--•-----•--••-•-------•-----.....----------------------.....---.........--------1-----........------------••.................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iIT`E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has ben * sued by the bgar ealth.
f Jn
Signed.: _�..�. . .........:..� r`� ��7!r � -----------• �a .....l.l ....
�.. :�� Date
Application Approved BY----•----�,-�,: !..,-- t A. 1-.�a.�..............
t Date
Application Disapproved for the following reasons:------------•-••--•-••-•----------- -----------------••---------------------------------------••••••••.........
.............................•---....---.....------•-----•-••---••---.....-•---------------•--•---......-•••••-•----•-------•---••-••-•••-•-•-•••••------�..--•••-•---•--- .....
- Date
<. Y' A, C
PermitNo......................................................... Issued.... --..•....... ---------------•-------•---•--.
e ,
i t
f '
NO.....=-- .. FBB.S1
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
L(. ...OF........' a� it ...�1 ..._......................................
4plirFation for -11isposFal Works Tonstrurtion Permit
Application is .hereby made for a Permit to Construct ( ) or Repair (lol''an Individual Sewage Disposal
System at:
ocatio - ddre or Lot No.
LY ?4 ............................. ....l� . �?. .-------- -.............----------....._........_•-•---..._.....
• Ow er Address
w ._ C. ----- ................................................................
Installer Address
Type of Building Size Lot.............................Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder
'04 4 Other—T e 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.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by........................................•••••---••-•-•....•-••--•...•---- Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.........................
fr4 Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water........................ .
a ;r .............. ..---•----------------------------------------------.........................................................
ODescription of Soil........... ,_....C�.L_ ..--•----------------•-------•---•----•------------•-•--•----------...-------------.._.__.....--------•----••-
W ..............-----------•-•---••....
•------------------------------------------•----•------------------------•--•_..._._..•---••--•-••--•--•-•--••-------•--•----•••---•-••••-••--••-•••••-••--•-•--•_----•----•-••----••----••.......::.:_.
U Nature of Repairs or Alterations—Answer when applicable...
................................
•---•---....--•............................•-------------------•-••--•--•-•----------•--............----•--•----------------------....-•---------------•------------•------------•--•....--------•----••
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordince with
the provisions of T IT LE 5 of the State Sanitary Code— The undersigned further agrees•not to place the system ffi,
operation until a Certificate of Compliance.has b n ssued by the hgar of ealth.
Signed--- _ � a"-d?� � �D �d
= --- ............. •- ••--
ate
ApplicationApproved By............................................-....................................................... --------------••-•-••-••-•---•-••••-••--
Date
Application Disapproved for the following reasons:-•---•---------------•---•-----------------------------------•------------------------------------•-•••-------
--•---•----------•-•--------------------------••-•----•---•...-----•---•--•-----•••--•---------•----........•--•-------------•-•------•---------•-•-••---••--•--••••--•••-•-•••--... ...................
Date
PermitNo...................................................-.... Issued.-•------------------------•--•--•--•--•---------_.....
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
s
10- .`OF.......! l..d '..............................................
(1lertifirate of (SoanpliFanrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (6�
by...� :. :.. <.CC S I;,:'!f" �° l7A- } 1� ,
.Ywsa................. _____________
- 1 Installer
aj
has been installed in accordance'with the provisions of T r�4qe State Sanitary Co eas�descrie in the
application for Disposal Works Construction Permit No.__-,,�_ ............... dated.:..... _________________
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE........................................... .............................. Inspector.....:°.........................................:..................................
THE COMMONWEALTH OF MASSACHUSETTS'
BOARD OF HEALTH
....l:,t.�1-OV)......0F..... ��/.�
No._._ .. FEgE: :._.__6�_........
- �is�rosttl ork� �onstra�tion eraatit
Permission is hereby granted..71-P. MCLC fir- o
to Cons uct ( ) or epair,�(�t aq Individual Sewage Disposal System
f ...__.._.__._S eet 7
as shown,on the application for Disposal Works Construction t ______ lated____l..................................
DATE_ _ '~ 'l �. Bo rd of Health yN,
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS �'�'� _�• •• ' t
LOCATION SEWAGE PERMIT NO. '
VIIL GE
�ok �
INSTA LLER'S NAME i ADD' VIESS .
B UILD R OR WNE
DA. T.E PERMfiT�iS5UED.
DATE COMPLIANCE ISSUED
0-10
i
w
O
I
LO CAT I SEWAGE ERMIT NO.
Jecl
VILLAGE
IMSTAh �lti'S MAME i ADDRESS
a U It -R OR ARN ER
d l
DATE PIE R T ISSY E D 12_ S--:7c�
DATE COMPLIA.MCE -ISSUED p .,7-7
6�
,
l
- Date: S /� /��'
TOWN OF BARNSTABLE
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY
NAME OF BUSINESS: V &D L,&1SA0A) S
BUSINESS LOCATION: S - -4NNIS INVENTORY
MAILING ADDRESS: As efaaivE TOTAL AMOUNT:
TELEPHONE NUMBER: 52f — 77-5--
CONTACT PERSON: C
EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE?
TYPE OF BUSINESS:_ Aaa 13o,6 y /,Yv>A/,y A11A/1A,64r an/ Gb
INFORMATION/RECOMMENDATION,•��°'v%�� N oS Fire District:
fiAC .0A1 517iT.4 4- .S'£ I;01V 7_AJ vE)ZS A ASrE 49 Ta 6£ 6�
® gc GL-g ,1 oaS ,a-f T1<Xl-t2 b TD 6E LA trLE7)Q9hR_U [ of-U&idEa�,rrF/tZ Wit-37ir
4 E A1R+N/GL-S7Zb 0105E s i�, •4 N STD��G[�(�j y 1 & TO 13E fflOrl- .(AW)
Waste /P Ab 0,7117VE* Last shipment of hazardous waste:
Name of Hauler: S. a27X A4EZ�wc 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 A L-L- �
Antifreeze (for gasoline or coolant systems Misc. Corrosive
�A Lt- /tA�st�Dous
,NEW USED K- G-o 7 Cesspool cleaners � ""SrE
Automatic transmission fluid �'�` Disinfectants
Engine and radiator flushes Road Salts (Halite)
Hydraulic fluid (including brake fluid) Refrigerants 0 a.(S DS "0'"Ta g£
/5 Motor Oils -/ -of Pesticides vqI-461Z /N N,4'6 �pY
NEW /6' USED `)b"PPA> oF` �d w.4-S� MAge 1-r
(insecticides, he Ides, rodenticides)/a<,e Ti7
Gasoline, Jet fuel, Aviation gas PLAY F0� �a5T1 � Photochemicals (Fixers) /Na'd
Diesel Fuel, kerosene, #2 heating of RA-T. T'� NEW USED s, /NFd
i n� Li sT, OT"H4�
Misc. petroleum products: grease, L}A Z K/!� D"P�-o Photochemicals (Developer). —'
_ Go u►.s Goa-�T7�GT. � K L-T1�LS k ieE
lubricants, gear oil nay � 6 NEW USED s�-t.�s IPP�t'� rD
hetsaus -LTM- 10 -416dI, w4�-i+te(.
Degreasers for engines and metal ) yt[iU.�� Printing ink ,��cs�snL pu W�
Degreasers for driveways &garages �) V 6V L F j Wood preservatives (creoso a yu�- - "
�U- (;rJ�-1 Kt3�57Ua�F, �
Cau1J�LGcaut goa>y FILLE'1'�T �ZoS Swimming pool chlorine �T1Kt5 pmi4&D
Battery acid (electrolyte)/Batteries fJr-R r..V9Lµe-0 Lye or caustic soda u P e-y
Rustproofers Misc. Combustible yl/f LL P&VFUK►-_
Car wash detergents Leather dyes r-pLwvi--u P I L)SPtC4764
Car waxes and polishes r pst�AfTk�b�`t Fertilizers fN lthP1� (o �t
,�
Asphalt & roofing tar p'E"V7� �L�t�Cek�, PCB's t�t�
HsheoJt�s,
C Paints, varnishes, stains, dy leet uc�s�ui�1 Other chlorinated hydrocarbons,
Lacquer thinners ONE Gss�2f0/>D�tSNf= (inc. carbon tetrachloride)
Q vtRTGaa°rxi•�s
NEW USED Any other products with "poison" labels
Paint &varnish removers, deglossers (including chloroform, formaldehyde,
SPeA.f a tds kN b
Misc. Flammables f otSSoa-Tc ►4.a-�'tLS 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 C�� `y✓£ �Au�� G'yAlTAjAJ�72S OF ANT/-F/�� E
(including bleach) WA-S/-Z� 6/L q/k
Spot removers &cleaning fluids C2� /=ivy
(dry cleaners) tauN cu�#J 10c
Other cleaning solvents s�vt�r&c rat N
Bug and tar removers 'ALCM C LA-ALJ"JC..
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
Please print or type.(Form designed for use on elite(12-pitch)_typewriter.) Form Approved.OMB No.2050-0039
UNIFORM H ' RDOU 1.Generator ID Number 2.Page 1 of 3.Emergency,Response Phone 4.Manifest Tracking Number
WASTE MANIFEST NP-3N47,75'1351 �» 002130748 S KS
5.Generators Name and Mailing'Address AAddresslif'diffeWnt than mailing address)
0 GMIRY'COLLISMIN- C ENTC:R"I ;.
345 BARNSTt BUE ROAD
HYANNIS 14A 0260.1
Generators Phone:
6.Transporter 1 Company Name U.S.EPA ID Number
SAFETY-•KLEF.N SYSTEMS, TNC; TXRU' 0050930
7.Transporter 2 Company Name - U.S.EPA ID Number
8.Designated Facility Name and Site Address /ttr�� y` } q R G �t INC.
nPt+ t��Ai7 U.S.EPA ID Number
�JP'lFE t•7,•-.`KL.Lr EN SYSTEMS, INC. 01!06 5
167 MILL STREET
C RIcINSTrON R i 02905
Facility's Phone: 401.�781-0 08 C1I'1;►�t34?���9r� ff�'.
ga. 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit
HM and Packing Group(if any)) 13.Waste Codes
No. Type Quantity WtNol.
o X 1-10 VIOSTE 'MINT RELATED MATEfi.T.A;._ , DIYi / I:s a F005.F003. 0001 .
3 C.IN1.263 €`GI I (D001.)
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3.
4
14.Special Handling Instructions.and Additional;) formation r
SK f r RCK#1.1 0 f l."h 02, Xf4,�e�wY���:t•I`:'7 ::t•, '
1)E.RB#1 128
GE S OR' ER I A N: I hereby a IF
are(fiat the confen s o cs consignmen are Ily and"aawre ely escn ed a'6ove y the proper shipping name,and are classified,packaged,
marked and labeled/placarded,and are in all respects in proper condition for transport according to applicable intemational and national governmental regulations.If export shipment and I am the Primary
Exporter,I certify,that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent.
I certify that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(if I am a small quantity generator)is true.
General s Printed/Typed Name S ature Month Day Year
16.Intemational Shipments
f- ❑Import to U.S. ❑Export from U.S. Port of entry/exit:
z Transporter signature(for exports only): Date leaving U.S.:
w 17.Transporter.Acknowledgment of Receipt of Materials
OTrarispgrter 1 PnnteillTyped Name)r !, ,, ^--r Signature,,--! Month Day Year
N: � _.rl f r�S1� `r�.� � 'r�� _ ..�r ..i.d �'�-1 ,%O•.:,^ ^., !' �i
Q TranSporterh pdnted/ryped Name �" `;- �y Signature ` r' r;. �` Month '`Day Year
Ix s
18.Discrepancy
18a;Discrepancy IndicetionrSpaoe. ❑ quantity ❑Type. ❑Residue El Partial Rejection El Full Rejection
Manifest Reference Number.
18b.Alternate Facility(or'Generator) U.S.EPA ID Number
J
V .
'Facititys Phone:
w 18c:Signature of Alternate Facility(or Generator) Month Day Year
Q
z
N19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous:waste treatment,disposal,and recycling systems)
LU. 1. 2. 3. 4.
20.Designated Facility Owner or Operator..Certification of receipt of hazardous materials covered by the man'dest except as noted in Item 18a
Printed/ryped Name Signature Month Day Year
EPA Form 8700-22(Rev.3-05) Previous editions are obsolete. GENERATOR'S INITIAL COPY
Il Ii"00i1653 2) 3) ' )
5400 Legacy,Drive,Cluster II B3 800-669-5740
Plano;Texas 75Q24 :. www.safety-kleen com.i
PLACEMENT+FORM' FOR SERVICE CALL BRANCH MANAGER
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3 ! `1 P3Qr�F.5 Ai4fa' ®S I�'1atDc
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DE IGNATED FACILITY NAME AND ADDRESS 1 r
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AND TOTAL CHARGE
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.
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EMERGENCY CALL By
CUSTOMER REFERENCE '' " Custpmer's uthonzed. epresentative �`� 0Q�'� ''
INF(1RMAT.ITIN:..;.. -,,,, L L •L -rUIC AY_`OCCAACAIT I,II ICC/ h.I TUC OC\/CoCC CIrYC
i
CONTINGENCY PLAN
Emergency Coordinator;.Name: �oG ,
Address: ` / .
Daytime Phone: 50g 973 q01 3
Evening Phone: O S ?73 Y073
Fire Department: &alflh's'
F re l
DEP 24 Hour Spill Hot.Line: 888-3.04-1133
Waste-Hauler: Name:
Phone: V 00 Co 37 S470
Building diagram indicating hazardous niaterial/waste storage area, location
of absorbent scavenger materials, fire extinguishers, fire alarms (if present),
and evacuation route (if applicable).
q i®n S few
S+omje A
o�
ElAi
Actions to be taken to control a spill or release and preventing it from
reaching a catch basin, sewer system or the ground. h
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eon +y .�_0t, 1-C
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�w
Town of Barnstable
oFtHe Regulatory Services
Thomas F. Geiler,Director
Public Health Division
BARNSTABLE, Thomas McKean,Director
7b i ASS. ' 200 Main Street, Hyannis,MA 02601
ArF p g A
Phone: 508-862-4644
Email: health(a town.barnstable.ma.us
Fax: 508-790-6304
Office Hours: M-F 8:00—4:30
June 12, 2007
Mr. Jonathan Porkka Jr.
Rotary Collision Center
345 Barnstable Rd. I
Hyannis,MA 02601
Dear Mr. Porkka:
Thank you for your time and cooperation during the hazardous materials inventory and site visit
at Rotary Collision Center on June 4, 2007. This letter contains information from that visit that
will help you become compliant with and remain compliant with Chapter 108 of the Town of
Barnstable Ordinance: Hazardous Materials.
Enclosed is a copy of the Toxic and Hazardous Materials On-Site Inventory form from the site
visit. Please note the problems identified at your place of business during the hazardous materials
inspection and their corresponding orders or recommendations listed below:
PROBLEM:
• There were open or uncapped containers being improperly stored throughout the
servicing areas.This violates the Town of Barnstable General Ordinance,Chapter 108:
Section 108-5C. Storage Controls.
ORDER:
• Keep all hazardous and flammable materials stored in capped containers at all times.
PROBLEM:
• The hazardous waste drums on your property are not labeled and don't indicate what the
material is.
ORDER:
• Please label all hazardous waste containers indicating the type of waste contained(i.e.
"Waste Oil" or"Waste Solvent").
• You are responsible for any waste that is removed from your facility. If you take the
waste oil to another facility to support their building,heating with a waste oil burner,
please retain all waste oil disposal receipts from the facility receiving the deliveries. The
receipt shall include the date, quantity of product being disposed of,name of product
I '
being disposed of,the name of facility accepting the disposal, the reason for disposal,and
a signature from a representative receiving the waste product.
PROBLEM:
• Smoking is taking place inside the facility.
ORDER:
• Per the Board of Health, smoking is prohibited within 10 feet of an existing building.
This was mentioned in the letter last year as well. If this continues, the Hyannis Fire
Department will be notified.
RECOMMENDATIONS:
• Tires shall be frequently removed from the outdoor storage area to prevent mosquito
gathering.
On Site Inventory Total
The Toxic and Hazardous Materials On-Site Inventory from June 4, 2007 shows that you have
approximately 308 gallons of toxic and hazardous materials being used, stored, generated and
disposed of at Rotary Collision Center, 345 Barnstable Rd.,Hyannis,MA(Please see enclosed
Toxic and Hazardous Materials On Site Inventory sheet).
If you have any questions about these problems, the orders and recommendations, or you need
further information, guidance or assistance,please do not hesitate to contact the Public Health
Division.
Sincerely,
Al s a L.Parker
Hazardous Materials Specialist
All orders to correct violations of Chapter 108 of the Town of Barnstable Ordinance: Hazardous
Materials shall be comple d upon receipt of this letter.
o as A. McKean,RS, CHO
Director of Public Health
Enc. On-Site Inventory(copy)
.. _. - Date &
/ l07
TOWN OF BARNSTABLE
TOXIC, AND HAZARDOUS MATERIALS ON-SITE INVENTORY
NAME OF BUSINESS: r7,1
BUSINESS LOCATION: INVENTORY
MAILING ADDRESS: '� '/ TOTAL AMOUNT-
TELEPHONE NUMBER: 60i'_?26_ 4353 111010-n 5
CONTACT PERSON: prrkk� tjY'
EMERGENCY CONTACT TELEPHONE NUMBER: 6D 4/.4" qo& MSDS ON SITE?
TYPE OF BUSINESS: �/G�l.1GLZ f�2Gun ��ce. G[.c�,'ty b0 dil
INFORMATION/RECOMMENDATIONS: ire istrict:
L / ` ~It - L�
Gl.
Yd1lYY !: "--�
Waste Transportation: • Last shipment of hazardous.waste: a-b
Name of Hauler' Destination: _
Waste Product: Licensed? es No
NOTE: Under the provisions of dh. 111, Section 31, of the Gener , aws 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.
j 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 A 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)
i
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 fie �G(,l
(including bleach)
Spot removers &cleaning fluids
i
(dry cleaners)
Other cleaning solvents
i Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
OIL ASTE OIL OIL FILTERS ANTIFREEZE WASTE
n D r�� ,1 ANITFREEZE
✓
( ,x
GASOLINE WASTE GAS DIESEL FUEL W/W FLUID ATF
HYDRAULIC/ 1VIISC. MISC. MISC. MISC.
BRAKE FLUED COMMBUSTIBLE FL ABLE CORROSIVE PETROLEUM
(GEAR OIL/GREASE/v
LUBRICANTS)
5
FREON ACETYLENE CAR WASH CAR WASH PAINTS/
WAX DETERGENTS THINNERS
r. 1 o
2C5 15 c
3Z
SEALANT CLEANING BATTERIES/ POISION/TOXIC CAULK/GROUT
SOLVENTS BATTERY
ACID
FERTALIZERS WASTE SOLVENT BLEACH DISH WASH AND MSDS
/ DETERGENTS
,� MANIFESTS
L1J�rJ�
Lcuxlg 6-,A pMttctT fty w,,-OC, L'?,(01(
Ko Em o kin
Town of BarnstableV/
d
Regulatory Services
• os Thomas F. Geiler,Director
UMNSTABIZ " Public Health Division
TFD MA'S Thomas McKean,Director
200 Main Street, Hyannis,MA 02601
Office: 508-862-4644 Fax: 08-790-6304
Application Fee: $100.00
ASSESSORS MAP AND PARCEL NO. DATE 7/0r'/0Y
APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN
111 GALLONS OF HAZARDOUS MATERIALS
FULL NAME OF APPLICANT, rlJc�,
NAME OF ESTABLISHMENT 9,0&afV 611'SjG„ 611446, ,%/G,►�%5
ADDRESS OF ESTABLISHMENT
• TELEPHONE NUMBER SV5>— 7-73-1353
SOLE OWNER: YES NO
IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL
PARTNERS:
IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO.OV3.201'p®41
STATE OF INCORPORATION
FULL NAME AND "HOME ADDRESS OF:
PRESIDENT �/ICt lire �C�RJCICG .2Y-6 end 5-1- Q-5,hy)&
TREASURER
CLERK
SI;2, -
F A I NT
RESTRICTIONS: HOME ADDRESS o?�d . OS�9!/</ t
• HOME TELEPHONE# 0
Haz.doclwp/q
i
MAIL-IN REQUESTS
Please mail the completed application form to the address below. Also include a copy of your
contingency plan (to handle hazardous waste spills, etc). ,In addition, please include the required fee
of$100. Make check payable to: Town of Barnstable. Allow five to seven (7) working days for in-
house processing. Our mailing address is:
Town of Barnstable
Public Health Division
200 Main Street
Hyannis,MA 02601
FOR FAXED REQUESTS
Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax us a
copy of your contingency plan (to handle hazardous waste spills, etc). In addition, please mail the
required fee amount of$100.00. Please make the check payable to: Town of Barnstable. The check
must be mailed to the address listed above. Allow up to four days for in-house processing.
r
•
For further assistance,on any item above, call (508) 862-4644
Date: 1;; / ZL/ OV
TOWN OF BARNSTABLE
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY
NAME OF BUSINESS: 6 q- •5 i'crYt Pivl ^s
BUSINESS LOCATION: �NVENTORY
MAILING ADDRESS: TOTAL AMOUNT:
TELEPHONE NUMBER: •SO 9 — `7.75 — 1353 l 'CVVM75
CONTACT PERSON: o'Y! A- .
EMERGENCY CONTACT TEL HONE NUMBER: MSDS ON SITE?
TYPE OF BUSINESS: %
INFORMATION/RECOMMENDATION : Co4sC =5' Fire District:CT
L` Cy-
�iick�Sf., R�' �
Waste Transportation: Last shipment of hazardous.wage: ��-� -�3
.Name of Hauler: Destination:
Product: . = Licensed? es No
ANOTE: nder the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use,
e and disposal of 111 gallons or more a month requires a license from the Public Health Division,
LIST OF TOXIC AND HAZARDOUS MATERIALS ��� ,p nceX 3 d s
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
YcwMEW 5'SUSFED Cesspool cleaners
Automatic transmission fluid Disinfectants
Engine and radiator flushes Road Salts (Halite)
Hydraulic fluid (including brake fluid) 3 Refrigerants
Motor Oils Pesticides
j Q,a-14EW Jr� ED (insecticides, herbicides, rodenticides)
Gasoline, Jet fuel'Aviation gas Photochemicals (Fixers)
Diesel Fuel, kerosene, #2 heating oil NEW USED
Z 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
aril Car wash detergents Leather dyes
Car waxes and polishes Fertilizers
Asphalt & roofing tar PCB's
/ Paints, varnishes, stains, dyes Other chlorinated hydrocarbons,
V Lacquer thinners (inc. carbon tetrachloride)
957 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 w Q , y„ �� �°n t 16 8�
(including bleach) •�
Spot removers &cleaning fluids
(dry cleaners)
Z- Other cleaning solvents
Bug and tar removers
(o Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
ad
TOWN OF BARNSTABLE U�165K6
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY
NAME OF BUSINESS:
BUSINESS LOCATION: INVENTORY
MAILING ADDRESS: i� fi U TOTAL AMOUNT:
TELEPHONE NUMBER:
CONTACT PERSON:
EMERGENCY CONTACT TELEPHONE NUMBER: rpQ&- �I�_ gow MSDS ON SITE?
TYPE OF BUSINESS:
INFORMATION/RECOMMENDATIONS: Fire is riot:
5365;' "
7, j
toe WC/0
D 0-LF -
Was a Transportation: Last shipment of hazardous.waste:, .2�6/
Name of Hauler: Destination-
Waste Product: Licensed? Yes , No
NOTE: Under the provisions of Ch. 111, Section 31, of the Genera 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 (90 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,
D Misc. Flammables hydrochloric acid, other acids)
Floor&furniture strippers I 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
(dry cleaners)
Other cleaning solvents
Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
Town of Barnstable-Health Department Page 1
HAZARDOUS MATERIALS INVENTORY SITE VISITS
DBA: Rotary Collision Center Fax:
Corp Name: Mailing Address
Location: '345 Barnstable Road,Hyannis Street: 345 Barnstable Road
mappar: City: Hyannis
Contact: :Jonathan M.Porkka State: Ma
Telephone: 508-775-1353 Zip: 02601
Emergency: 508-428-9061 Person Interviewed: Jonathan Porkka Jr.
Business Contact Letter Date: 6/16/2005
Category: VehicleMaintenance Inventory Site Visit Date: 8/24/2005
Type: :Auto Body Follow Up/Inspection Date:
91 public water ❑ indoor floor drains outdoor surface drains �/❑ license required
❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc currently licensed
W town sewage ❑ indoor catch basin/drywell ❑ outdoor catch basin/drywell expir - -- - -
❑ on-site sewage ❑ indoor on-site syste ❑ outdoor onsite system date: __,._,__._6/30/2006
Remarks: Closed system spray booth. No freon work. Shall transfer compliance:
two outside above ground tanks to inside. Remarks:6/10/97 Spray Satisfactory
Booth,MSDS sheets. Note: See 97 inspection report for current list of
chem.On site. 6/22/04 Onsite inventory. Shop is messy.
Open pans of AF. Car washing taking place in at least 3 bays. No OIL
WATER SEPERATOR. Town sewage only. Waste oil and AF barrels are
a mess and full. Additional ventilation is needed in paint mixing booth.
ORDERS: Label waste barrels,relocate to be more accessible and
clean up. Have them emptied more often. When they are full,where is
the waste being dumped?? CEASE&DESIST ALL CAR WASHING
IMMEDIATELY. Oil water seperator info mailed to him with hazmat
permit application. CC'd copy to Mary,"Safety Rep"for the Hyannis
Rotary Collision. Basic training should be taking place. OSHA has
been there recently,supposedly to respond to a"disgruntled"
employee's complaint. 7/22/04
Followed up with pop-in inspection. Stopped washing cars with soap.
They pressure wash with water only. Properly disposed of oil and AF
waste. Only keeping the AF waste barrel. Briefed staff on inspection
orders. Mailing them a HW sticker and example contingency plan.
8/24/2005 alp-MSDS on site,Manifest for waste anitfreeze ORDERS:
most flammable aerosols kept in metal storage cabinet,chain all
cylinders(3),empty all oil catchement pans immediately(on floor),
empty waste antifreeze catchment pan sitting in middle of floor,all
waste must be labeled"waste of or antifreeze"or"used oil or
antifreeze",clean speedy dry up off the floor and dispose of after a
release,No smoking in shop areas,dispose of all unused product in 55
gallon drum(tar)and 15 gallon drum misc.petroleum,only one exhaust
fan output in paint room,need to post a contingency plan,275 gallon
heating fuel storage in back of building needs to be on a concrete pad,
needs rustproofing also.
Page 2
Town of Barnstable-Health Department
HAZARDOUS MATERIALS INVENTORY
Chemicals: ❑ Zero Toxic Waste Materials
❑ gty's>25 lbs dry or 50 gals liquid but less than 111 gals
0 gty's 111 gals or more
`description:. .. unito "easure
antifreeze(for gasoline or coolant systems) 3 gallons/_
new lacquer thinner 83 gallons
paint,varnishes,stains,dyes 167 gallons
Waste Paint__ _ _ __ 55 gallons V _
misc.petroleum products:grease,lubricants _ 61 gallons✓�-�
Misc.Flammable 104 gallons
aste oil 10 gallons
waste antifreeze 60 gallons
Batteries 15 gallons ✓----
motor oil _ 2 gallons
gasoline 10 gallons r/
Toxic 1 gallonsy/
Misc.Combustible 3 gallons
_ _.._.... _...._. .
.............._.....
Waste Transporter: :Advanced Liquid Recycling j Fire District: :Hyannis
_._. ...._ ......._.. _ .._.._.._.. ..._._
Last HW Shipment Date 2/11/2005 Waste Hauler licensed: No
I
I '
Town of Barnstable-Health Department Page 1
HAZARDOUS MATERIALS INVENTORY SITE VISITS
DBA: Rotary Collision Center Fax: —
Corp Name: Mailing Address
Location: 345 Barnstable Road,Hyannis Street: 345 Barnstable Road
mappar: City: Hyannis
Contact: Jonathan M.Porkka State: Ma
Telephone: 508-775-1353 Zip: 02601.
Emergency: 508-428-9061 Person Interviewed: Jonathan Porkka
_ /ltp/off
Business Contact Letter Date: 4 614?i4@94--
Category: VehicleMaintenance Inventory Site Visit Date. c6127/20"
Type: Auto Body Follow Up/Inspection Date:
public water ❑ indoor floor drains d❑ outdoor surface drains W license required
❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc ❑d currently licensed
RJ town sewage indoor catch basin/d 6/30/2006
g ❑ rywell El catch basin/drywell expir
❑ on-site sewage ❑ indoor on-site syste ❑ outdoor onsite system date: ............_.._.... ._.._...
Remarks: Closed system spray booth. No freon work. Shall transfer compliance:
two outside above ground tanks to inside. Remarks:6/10/97 Spray Satisfactory
Booth,MSDS sheets. Note: See 97 inspection report for current list of
chem.On site. 6/22/04 Onsite inventory. Shop is messy.
Open pans of AF. Car washing taking place In at least 3 bays. No OIL
WATER SEPERATOR. Town sewage only. Waste oil and AF barrels are
a mess and full. Additional ventilation is needed in paint mixing booth.
ORDERS: Label waste barrels,relocate to be more accessible and
clean up. Have them emptied more often. When they are full,where is
the waste being dumped?? CEASE&DESIST ALL CAR WASHING
RAI%E1XATELY.:O9.waW,6epe aW-info augWd.lo Ukaiwitb i►ozfwat..,:,..,.:. :,..,.; �11 p �� i:�
permit application. CC'd copy to Mary,"Safety Rep"-for the Hyannis
Rotary Collision. Basic training should be taking place. OSHA has
been there recently,supposedly to respond to a"disgruntled"
employee's complaint. 7/22/04
Followed up with pop-in inspection. Stopped washing cars with soap. O Y�
They pressure wash with water only. Properly disposed of oil and AF
waste. Only keeping the AF waste barrel. Briefed staff on inspection 1 '
orders. Mailing them a HW sticker and example contingency plan.
CPr�Vj C&9 &n d.kk-s (3 ) ���� P a c•t�.�-.
�seke r' yr '' 75
u s ccl'' `Z
U 1
J 0" a v0-I;-hr�ee,� C c•�Mt k f r+,-, on hDo-,( -y not rvsip ra°-k d
N�7pow of oh' bA trf rnIsc.
V PM4j 0-�i" V,n Y\V� cam.e -�,t, � L
0-TPw0.a awt ODD 4'
Page 2
Town of Barnstable-Health Department
HAZARDOUS MATERIALS INVENTORY
Chemicals: ❑ Zero Toxic Waste Materials
❑ gty's>25 Ibs dry or 50 gals liquid but less than 111 gals
qty s 111 gals or more
description. qty,- unit d measure
antifreeze(for gasoline or coolant systems) _ 8 gallons
new lacquer thinner 95 gallons
paint,varnishes,stains,dyes 196 gallons
Waste Paint _ 110 gallons _
misc.petroleum products:grease,lubricants 23.5 gallons _
other cleaning solvents 2 gallons
Misc.Flammable 8 gallons
car wash detergents 17 gallons
refrigerants 3 gallons
waste oil _ 55 gallons
waste antifreeze 55 gallons
Batteries 22 gallons
Windshield Wash 6 gallons
motor oil 10 gallons
Waste Transporter: Autobody Solvent Recovery Corp. Fire District: !Hyannis
Last HW Shipment Date: Waste Hauler Licensed: No
-.._..._..___.�_.__._...__._......_...... i...___._...._......._.........._.__.._..._.._.__
C4 6
tj
,-j bef bei��� a� t,4f
?,o(,trj
I
�6�71lotca
SY�
� I �
OIL WASTE OIL OIL FILTERS ANTIFREEZE WASTE
D ANITFREEZE
-
so
GASOLINE WASTE GAS WASTE W/W FLUID A F
S SOLVENT .
s
HYDRAULIC MISC. MISC. MISC. MISC.
FLUID COMMBUSTIBLE FLAMMABLE CORROSIVE PETROLEUM
3 �s 4 15 a t,r
75
a0� C.C55
1
FREON ACETYLENE CAR WA H CAR WASH PAINTS/T,HINNER
WAX DETERGENTS
ID l,CIO g
5
�S Z 9
� 3
SEALANT CLEANING BATTERIES OISION/TOXIC CAULK/GROUT
SOLVENTS
FERTALIZERS DIESEL FUEL (kW aWpw-X
995
c�PL+,►-e cv.
5c D,�
I
Town of Barnstable
°Fz r Regulatory Services 05
Thomas F. Geiler,Director
&" MASS. ' Public Health Division J
AtEOMJ►�A Thomas McKean,Director
200 Main Street, Hyannis,MA 02601
Office: 508-862-4644 Fax:', 508-790-6304
Application Fee: $100.00
ASSESSORS MAP AND PARCEL NO. DATE
APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN
111 GALLONS OF HAZARDOUS MATERIALS
FULL NAME OF APPLICANT J D n of ho n Qo R k k
NAME OF ESTABLISHMENT I'1 o+c4 f U
ADDRESS OF ESTABLISHMENT c3`f5 Barr n S-lq b/F 4d N,yG nn;S Ma OL-0/
TELEPHONE NUMBER - 509— 77 S= IJ S" 3
SOLE OWNER: ✓YES NO
IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL
PARTNERS:
IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. D 4*5 a0 I Roy
STATE OF INCORPORATION WA
FULL NAME AND HOME ADDRESS OF:
PRESIDENT It)nl .4 1'0 Wx 2kn Pa nd 0 NSJeCuill,4 a
TREASURER
CLERK
SIGNATURE C
RESTRICTIONS: HOME ADDRESS &4 S�-• C�S-I'efVj lip,
i
HOME TELEPHONE#_50R-q?_y-yio(e i
Haz.doc/wp/q
' ollision'Centers
Jonathan POrkka
President
(508) 775-1353
24-Hour Towing:-1-888-696-0272 • Nights,Weekends&Holidays:(50]906'1www.RotaryCoflision.com Rotary@capecod.net • Fax(508)77
Over 45 Year,of Service Excellence•See All Locations on Reverse Side
'Date: / 2-L/ 0`7l
TOWN OF BARNSTABLE
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENT �Y
NAME OF BUSINESS:
BUSINESS LOCATION: ,3 y5� - �� ��� NVEN
MAILING`ADDRESS: TOTAL gMOUNT.
TELEPHONE NUMBER: •SO $ — -7-7 ' 1.36�3 "Wan,
CONTACT PERSON:
EMERGENCY CONTACT TELPPHONE NUMBER: MSDS ON SITE?
TYPE OF BUSINESS: a*�%
INFORMATION/RECOMMENDATION C-CAS6: Fire District:
L L ?iGu'rit�.. s
�7u.rld�ia
Waste Transportation. Last shipment of hazardous_wage: —os
Name of Hauler-, Aw , .4! 69Sd4 e. Destination-
Waste
Product: &z;(- -= Licensed? es No
NOTEeand
nder the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use,
disposal of 111 gallons or more a month re u' es a license from.the Public Health Division.
UST OF TOXIC AND HAZARDOUS MATERIALS av,P rye 3 0 0l s/
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
NEWUSD Cesspool cleaners
Automatic transmission fluid Disinfectants
Engine and radiator flushes Road Salts (Halite)
Hydraulic fluid (including brake fluid) 3 Refrigerants
Motor Oils Pesticides
LQ,a-,NEW JrED (insecticides, herbicides, rodenticides)
Gasoline, Jet fuel`Aviation gas Photochemicals Fixers
Diesel Fuel, kerosene, #2 heating oil NEW USED
2 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
2-2 Battery acid (electrolyte)/Batteries. Lye or caustic soda
Rustproofers Misc. Combustible
1-7 JaA Car wash detergents Leather dyes
Car waxes and polishes Fertilizers
Asphalt & roofing tar PCB's
9 Paints, varnishes, stains, dyes Other chlorinated hydrocarbons,
►✓ Lacquer thinners (inc. carbon tetrachloride)
qS 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) • , .sue, � �k- �a
Spot removers &cleaning fluids
(dry cleaners)
2- Other cleaning solvents
Bug and tar removers ,
�o Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
No � nrylV
6 J� Town of Barnstable-Health Department Page 1
HAZARDOUS MATERIALS INVENTORY SITE VISITS
DBA: Rotary Auto Body Fax:
Corp Name: Mailing Address
Location: 345 Barnstable Road,Hyannis Street: 345 Barnstable Road
mappar: City: Hyannis
Contact: Jonathan M.Porkka State: Ma /
Telephone: 508-775-1353 Zip: 02601 q l
Emergency: 508-428-9061 Person Interviewed: Jonathan Porkka I�iJ�
Business Contact Letter Date: 6/17/2004
Category: VehicleMaintenance Inventory Site Visit Date: 6/22/2004
Type: 'Auto Body Follow Up/Inspection Date:
❑� public water ❑ indoor floor drains 0 outdoor surface drains ❑d license required
❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc d❑ currently licensed
❑d town sewage ❑ indoor catch basin/drywell ❑ outdoor catch basin/drywell expir -
❑ on-site sewage ❑ indoor on-site syste ❑ outdoor onsite system date: 6/11/2004
Remarks: Closed system spray booth. No freon work. Shall transfer compliance:
two outside above ground tanks to inside. Remarks:6/10/97 Spray Sati
Booth,MSDS sheets. Note: See 97 inspection report for current list of dw
—
chem.on site. ^j5�4S•"
51 5'
----------------
In
�� ' z-b '
i
Page 2
Town of Barnstable-Health Department
HAZARDOUS MATERIALS INVENTORY
Chemicals: ❑ Zero Toxic Waste Materials
❑ gty's>25 Ibs dry or 50 gals liquid but less than 111 gals
gty's 111 gals or more
description: qty: unit of measure
antifreeze(for gasoline or coolant systems) 5gallons
automatic transmission fluid 1gallons
hydraulic fluids(including break fluid) I'gallons
motor oil _ 1'cases
car wash detergents 1gallons
acquer thinners 400gallons
waste oil 551gallons
diesel fuel,kerosene,#2 heating oil 5501gallons _
paint,varnishes,stains,dyes 4001gallons
Waste Transporter: iAutobody Solvent Recovery Corp. Fire District: 'Hyannis
Last HW Shipment Date Waste Hauler Licensed: No
? Hazardous Materials On-Site Inventory/inspection
For ALL Shops and Businesses in the Town of Barnstable :
DBA:
Location: 5.
Date:
Physical Features to Inspect:
Hazardous waste generation sites.(production/manufacturing areas):
Waste storage areas:
Satellite accumulation points throughout:
HazMat stored outdoors — CHECK OUTSIDE:
�b
Shipping and receiving areas:
Run down of shop activities: /
Housekeeping practices:
i
HazMat On-Site Inventory/Inspection:
Records to Review for SQGs and CESQGs
DBA: ,a
Location:
Site visit date: lP — Z Z— o L4
• Hazardous Waste ,
Manifests: cr�
• Employee training documentation (if required):
P/Lc fix;✓-wc
• Hazardous substance spill control and contingency plan:
MSDS on site? (4 PO- `—ki d2046LAk-e-
• HazMat Inventory records (if applicable):
• HazMat Waste Shipping documentation:
• Spill records (if applicable):
Town of Barnstable
P�°FtME Tq,:� Regulatory Services
°s Thomas F. Geiler,Director
» BMWSrABLE, • • • • LFEB
� ��
MASS. Public Health DivisionA
i639. ♦0 ��_L:D
ArfDMA'�A Thomas McKean,Director
200 Main Street, Hyannis, MA 02601 6 2001
OF8 508-790-6304
Office: 508-862-4644 EALTH DEp7. LE
Application Fee: $100.00
ASSESSORS MAP AND PARCEL NO. I C O DATE ze-
APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN
111 GALLONS-OF HAZARDOUS MATERIALS
FULL NAME OF APPLICANT l fj I GrwO Ine-
NAME OF ESTABLISHMENT '& rV X&-&
ADDRESS OF ESTABLISHMENT ,GCl/�S In iP� n�iS /Lla
TELEPHONE NUMBER SZ>f 775- /3.53
SOLE OWNER: V/ YES NO
IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL
PARTNERS:
IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. ��Q/�®
STATE OF INCORPORATION
FULL NAME AND HOME RESS OF:
PRESIDENT �,��. ,�,d /� ,2k�for� �P,e�r1//el4
t TREASURER
CLERK a
SIW A OF APPLICANT
RESTRICTIONS: HOME ADDRESS 02� r�dsLI- 0&111k 114
HOME TELEPHONE # "y��YW
Haz.doc/wp/q
r
SENDER: COMPLETE THIS SECTION 6OMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. ❑Agent
■ Print your name and address on the reverse X ❑Addressee
so that we can return the card to you. B. Received Cy(Printed Name) C. Patejof Del've
i ■ Attach this card to the back of the mailpiece, Jvi
or on the front if space permits. �
D. Is delivery address different from item 1? ❑Yes
1. Article Addressed to: If YES,enter delivery address below: ❑ No
Rota- Av4o 130d�
i
6 a P �5 to h J.e
, 3. S ice Type I
/ ertified Mail ❑ Express Mail
O a 6 0 ❑ Registered ❑ Return Receipt for Merchandise
VV ❑ Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number 7 0 0 2 , 2 410..0 0 0 6 7254. 0716.
.
(transfer from service labe!• -
-PS-Form 3811,August 2001 Domestic Return Receipt 102595-01-M-2509
I
UNITED STATES POSTAL SERVICE First-Class Mail
Postage&Fees Paid
LISPS
Permit No.G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
I
OL,"., S
III.►���I�I�il��l1„„��II,i,gill►��fl►►�►�I�ill,��ll,�►�I►I►1
TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
BOARD OF HEALTH O satisfactory 2.Printers
3.Auto Body Shops
n II_ unsatisfactory- 4.Manufacturers
COMPANY CZ� fCIJ�'f l� y O (see"Orders") 5.Retail Stores
nn,, 6.Fuel Suppliers
ADDRESS S YU C18SS: 7.Miscellaneous
ckn ni*SS QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors)
MAJOR MATERIALS "iSe lots Di
IN OUT IN OUT IN OUT #&gallons Age Test
Fuels:
Gasoline Jet Fuel (A)
Diesel, Kerosene, #2(B)
Heavy Oils: S
waste motor oil (C)
SQ
new motor oil (C) x
cc
Synthetic Organics:
degreasers
� � G
Miscellaneous:
DISPOSALIR.ECLAMATION REMARKS: ,
1 S itary Sewage 2. ater Supply l��
own Sewer �ublic
. O On-site OPrivate
3. Indoor Floor Drains YES 'N0 > • A ,' saakod LV1,4c4
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
4. Outdoor Surface drains:YES NO-�/ ORDERS:
O Holding tank:MDC ti
O Catch basin/Dry well P\A . �e t
O On-site system -
5.Waste Transporter
Name of Hauler Destination Wastc-
�( �d
1. � .
C� rf/l YES NO
2• 1ANk c
Lp 0 IL L ok
Pero (s) Interviewed nspector Date
1.
rre�
TOWN OF BARNSTABLE OMPL/ANCE: CLASS: 1.Marine,Gas Stations,Repair
Satisfactory
2.Printers
BOARD OF HEALTH 3.Auto Body Shops
yQ Q unsatisfactory- 4.Manufacturers
COMPANY'Y���ti'O-/P✓ lt �XCIass:
(see"Orders") 6.Fuel SStores
pl ers
ADDRESS 7.Miscellaneous
QUANTITIES AND STORAGE (IN= indoors;OUT-outdoors)
MAJOR MATERIALS C� se lots l3h-unis Above Tanks Underground Tanks
IN OUT IN OUT IN OUT #&gallons Age Test
UIS Duels: 414
Gasoline Jet Fuel (A)
.44
liL� �esKerosene, #2 (B)
F1
Heavy Oils:
new motor oil(C)
transmission/hydraulic
Synthetic Organics:
degreasers
Miscellaneous:
44422
Lmmj
DISPOSALIRECLAMATION REMARKS:
1. Sanitary Sewage 2. ater Supply
Town Sewer VFublic —
O On-site OPrivate
3. Indoor Floor Drains YES NO
O Holding tank:MDC f�
O Catch basin/Dry well
O On-site system 42
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 V
• �
d�
2.
aJ
rson�� Interviewed nspector Date
TOWN OF BARNSTABLE OMPLIANCE: cLAss: 1.Marine,Gas Stations,Repair
satisfactory 2.Printers
BOARD OF HEALTH 3.Auto Body Shops
O unsatisfactory- 4.Manufacturers
COMPANY (see"Orders") 5.Retail Stores
iers
ADDRESS 91 7.Miscella6.Fuel neous
Class: ,
UANTITIES AND STORAGE (IN= indoors;OUT=outdoors)
MAJOR MATERT LS Case lots Drums Above Tanks Under&n-ound
IN OUT IN OUT IN OUT #&gallons Age Test
Fuels:
Gasoline Jet Fuel(A)
Pie rie, #2 (B)
Heavy Oils:
waste motor oil (C)
new motor oil (C)
Ole
transmission/hydraulic�
Synthetic Organics:
degreasers
Mis�ella orw
r
DISPOSALIRECLAMATION REMARKS:
1. Sanitary Sewage 2.NV ater Supply2
Town Sewer Public _
O On-site -OPrivate
,r
3. Indoor Floor Drains YES N0-11
O Holding tank: MDC
O Catch basin/Dry well s 2
O On-site system
40
4. Outdoor Surface drains:YES NO ORDERS:
Q Holding tank:MDC
O Catch basin/Dry well
O On-site system
5.Waste Transporter
Name of Hauler Destination Waste Product
YES NO
2.
Pe o Interviewed Inspector Date
I
7 ? s- 13s-3
TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
BOARD OF HEALTH iQ satisfactory 2.Printers
3.Auto Body Shops
O unsatisfactory- 4.Manufacturers
COMPANY 2d ��� (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS _3 NSJ �4r�► ass: 7•Miscellaneous
0-20 vI%J'QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors)
MAJOR MATERIALS Case lots Drums Above Tanks Underground
IN OUT IN OUT IN OUT #&gallons 7177 Test
Fuels:
Gasoline,Jet Fuel (A)
Diesel, Kerosen , �(B) a
Heavy Oils: _
waste motor oil (C)
new motor oil(C)
transmission/hydraulic
Synthetic Organics:
degreasers
i
Miscellaneous:
3110 W4:lr I
pcla� -Mw.kv,�- '),�- /1 C
DISPOSAL/RECLAMATION REMARKS: �/
1. Sanitary Sewage 2.Water Supply &0C� "/
Town Sewer Public
O On-site OPrivate
3. Indoor Floor Drains YES N0_,x__
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
4. Outdoor Surface drains:YES -NO ORDERS:
O Holding tank:MDC
Catch basin/Dry well
b On-site system
5.Waste Transporter
Name of Hauler Destination Waste Product
YES I NO
1042ete �`H
2.
Person (s) Int ewed Inspector do, Date
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAME OF BUSINESS: �.:r - — 4Mail To:
BUSINESS LOCATION: Board of Health
�bi� � Town of Barnstable
MAILING ADDRESS: ,11 �'.,tea e� �r �/�9/1��5 P.O. Box 534
TELEPHONE NUMBER: ASS°'/ S ��6od Hyannis, MA 02601
CONTACT PERSON: VOrl
EMERGENCY CONTACT TELEPHONE NUMBER:
Does your firm store any of the toxic or hazardous materials listed below, either for sale or for
your own use,
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: SR��
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
S Motor oils/waste oils Road Salt (Halite)
Gasoline, Jet fuel Refrigerants
5f-,9rS� %7,4Diesel fuel, kerosene, #2 heating pill 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
,30,0-y�/.Paints, varnishes, stains, dyes Fertilizers (if stored outdoors)
ape_ i / PCB's
Paint & lacquer thinners
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
i
Household cleansers, oven cleaners
i
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
COMPANYff� S
(see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS lass• 7.Miscellaneous
QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors)
MAJOR M 1 Underground Tanks
IN OUT IN OUT IN OUT #&gallons Age Test
Fuels:
Gasoline,Jet Fuel (A)
Diesel, Keros=#2 (B)
H
waste motor oil
new motor oil (C) .
transmi ssio'n/hydraulic
Synthetic Organics:
degreasers
Miscellaneous: ,fin
o
400
m D
�e
01
DISPOSAL/RE(;LAMATION REMARKS: e
1. S nitary Sewage 2KPb'ic
ter Supply 5L ` &0$
Town Sewer uO On-site rivate
0
3. Indoor Floor Drains YES N0� -
O Holding tank: MDCKapV o
O Catch basin/Dry well
O On-site system
4. Outdoor Surface drains:YES NO ORDERS:
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
5. Waste Transporter
Name of Hauler Destination Waste Product
1. V 90 3C,'
O s /), O� 8 Ot'0 YES NO
'T.�711 D I
2. S
rson. (s) lntdi5fewed Inspe r ate
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
�-7 A
NAME OF BUSINESS: Mail To:
BUSINESS LOCATION:aCl!; Board of Health
MAILING ADDRESS: �' t + 1 Town of Barnstable
P.O. Box 534
TELEPHONE NUMBER: , r 0 r) .1 Hyannis, MA 02601
CONTACT PERSON:
EMERGENCY CONTACT TELEPHONE NUMBER:
Does your firm store any of the toxic or hazardous materials listed below, either for sale or for
your own use
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:
i
a
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
J Grp/ Antifreeze (for gasoline or coolant systems) — Drain cleaners
Automatic transmission fluid Toilet cleaners
—0 Engine and radiator flushes Cesspool cleaners
tHydraulic fluid (including brake fluid) - Disinfectants
SOT. � 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)
yDO�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
1
TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
satisfactory 2•Printers
BOARD OF HEALTH � 3.Auto Body Shops
O unsatisfactory- 4.Manufacturers
COMPANY LC,6(,C—'(a, I(IVLv Y. (see"Orders") 5.Retail Stores
�a 6.Fuel Suppliers
ADDRESS s36 3 ��Yv6S�1�i�E�% Class: 7.Miscellaneous
4�WWIVL, QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors)
MAJOR MATERIALS Case lots Drums Above Tanks Underground
IN OUT IN OUT IN OUT #&gallons Age Test
Fuels: Y,,
Gasoline Jet Fuel (A)
Diesel, Kerosene, #2 (B)
Heavy Oils:
waste motor oil (C)
i
new motor oil (C)
transmission/hydraulic
Synthetic Organics:
degreasers
Miscellaneous:
w4 4-1 s� Lk,l"a
4"- .-zk-.
DISPOSAURECI AMATION REMARKS:
1. Sanitary Sewage 2.Water Supply V" k V44,1• 113 OLf,, ,/Ceo �0_4-1 7VOl
O Town Sewer OPublic
0 On-site OPrivate
" s /Z
3. Indoor Floor Drains YES-NO
0 Holding tank: MDC �.� Cu, �" L ov$I- 4/-,.cLtvil r �°
0 Catch basin/Dry well r � �'"I
O On-site system 4 ;, 2d )
4. Outdoor Surface drains:YES N0P!�_ O RS:
0 Holding tank:MDC e9942 44S
O Catch basin/Dry well
0 On-site system
5.Waste Transporter
Name of Hauler Destination Waste Product
� Yo YES INO
2.
Person (s) Inte ed Insp ctor Date
{ 3fQe'�1'e,0mousine c� ✓�/es
6-15 JassenyerBuxury Gimous nes.andGoaaAes
your Wedding C5pecralsl
_U5,2zarns(a6/e,Toaor•,}lyannfs ✓`�02601
508-775-1780 lax 508-775-3781
888-898-4796 24.�our i cSeruice .
I -
A
1,
TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair
satisfactory 2.Printers
BOARD OF HEALTH 3.Auto Body Shops
unsatisfactory- 4.Manufacturers
COMPANY 9t �t (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRE - 41/ lass: 7.Miscellaneous
QUANTITIES AND STORAGE (IN= indoors; OUT-outdoors)
MAJOR MATE Case lots Drums Above Tanks Underground Tanks
IN OUT IN OUT IN OUT #&gallons Age ITest
Fuels:
Gasoline Jet Fuel (A)
Diesel, Kerosene, #2 (B)
Heavy Oils:
waste motor oil (C)
Fr,
new motor oil (C) f
transmission/h draulic
Y
yn r
easers
Miscellaneous:
�h
iAIP -
�,�/l� 1'/1✓�z� ��t�
'a' G
DISPOSALIRECI AMATION REMARKS:
1. Sanitary Sewage 2.Water Supply 1�
Town Sewer Public
61"d On-site Private
3. Indoor Floor Drains YES NO
0 Holding tank:MDC
0 Catch basin/Dry well
0 On-site system Q,�7
4. Outdoor Surface drains:YES NO ORDERS:
0 Holding tank:MDC
O Catch basin/Dry well
0 On-site system
5.Waste Transporter
Narne of Hauler Destination Waste
Product
//��•
YES NO
2.
Person W Interviewed ns ec or Date