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HomeMy WebLinkAbout0020 CHARLES STREET - Health 20 Charles Street - Sewer Accu# 1352 Hyannis 'A ='327'—244—003 o Date: /7 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FOR /� C NAMEOFBUSINESS: BUSINESS LOCATION: ;Ieo MAILINGADDRESS: emu - Mail To: TELEPHONE NUMBER: `771 3 Board of Health Town of Barnstable CONTACT PERSON: P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: �0 7 �'l a6 Hyannis, MA 02601 TYPEOFBUSINESS: + by Does your firm store aryy of the toxic or hazardous materials listed below, either for sale or for you own use? YES p 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: 5 TELEPHONE: 7 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 Anti reeze(forgasolineorcoolantsystems) Drain cleaners NEW USED Cesspool cleaners ✓ Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) y Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides L/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 L/ 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 PROVIDENCE LACQUER CAPE, INC. (dry cleaners) 135 BARNSTABLE ROAD HYANNIS, MA 02601 Other cleaning solvents 771-2391 FAX 0(508) 771-8316 Bug and tar removers 1-800-924-2391 _ _ j WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS j i '�.• l ..` s�) �` .� 1 ------- �"' 1 j � i 1 i � i `� TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF H�FALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY 9 - j��n�©� ""v.- Y , (see"Orders") 5.Retail Stores , ' 6.Fuel Suppliers ADDRESS A ----Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS .... IN OUT IN OUT IN OUT #&gallons Age Test x s IP4� ' , t Fu (A) Diesel, Kerosene, #2 (B) `� Heavy Oils: ne or of h" � I - t issfon/hydr is Q9/ S n t' 0 <: Ul-W scellaneous: " Z_/ DISPOSALMECI AMATION REMARKS: 1. Sanitary Sewage 2.Water Supply Town Sewer Public O On-site OPrivate 3. Indoor Floor Drains YES NO O Holding tank:MDC d 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 ii;;4i" ' ti'On � �det YES NO 2. Person(s) Interviewed Inspector Date Ci�r�Sb�er R, Lee TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF..HEAL �L. Satisfactory 2.Printers 3.Auto Body Shops . fW� et.' 4",tj. O unsatisfactory- 4.Manufacturers COMPANY d9-�• � (see Orders ) 5.Retail Stores , k b a6=— pp 6.Fuel Suppliers ADDRESS I35— Class: 7.Miscellaneous f-`" 49-,� R QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: 1 ►'t cN 2e,5 ' DC ZV_Sy 9 DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water SupplyS ,Town Sewer bPublic �-� 15�y, a v„�W�� VVVA1 0 On-site OPrivate ` 3. Indoor Floor Drains YES N0 0 Holding tank:MDC_ 0 Catch basin/Dry well t t go, 0 On-site system/ ® 4. Outdoor Surface drains:YES �N0 ORDERS. 0 Holding tank:MDC O Catch basin/Dry well 0 On-site system 5.Waste Transporter YES NO 1. 2. Person(s) Interviewed Inspe for D to l