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HomeMy WebLinkAbout0011 CIT AVENUE UNIT UNIT 5 - Health 11 Cit Avenue ., >• . -, -Sewer Acct #4104 Hyannis A = 312 = -14 —OOA w t it 4 (:JXAtXou-,U 0,71d o ;7 (_,c:4 TOWN OF BARNSTABLE LOCATION SEWAGE# VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. O SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) R NO.OF BEDROOMS OWNER EW k PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility), Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet ` FURNISHED BY TOWN OF BARNSTABLE LOCATION SEWAGE# VILLAGE ASSESSOR'S MAP&PARCEI�Ja—/ oOC INSTALLER'S NAME&PHONE NO. #� SEPTIC TANK CAPACITY LEACHING FACILITY.(type) (size) NO.OF BEDROOMS OWNER 2zo-e.d PERMIT DATE: COMPLIANCE DATE: (rl1 �1 GPI Q// Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on . site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY �TO/WN� OF BARNSTABLE LOCATION �� L.e� 1Y�`� SEWAGE# VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S 1,4AME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY.(type) (size) NO.OF BED OMS .411 OWNER -s!ow. �,.o�-j�0--� PERMIT DATE: COMPLIANCE DATE: r 'o? ` Separation Distance Between the: fl Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on . site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY I' TOWN OF BARNSTABLE LOCATION SEWAGE# VILLAGE. - ASSESSOR'S MAP&PARCEL.3/a^4J�- 00 7 INSTALLER'S N E&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY.(type) (size) NO.OF BEDROOMS .OWNER �?ati7yrdV.e ) PERMIT DATE: COMPLIANCE DATE:f�p7A4W_U �—AD Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY Yid r y �� TOWN OF ARNSTABLE V\ Date: 3 TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: eves a i t - v10 o < bJS vas `� �K- Qs {'S©via, olp Ll� oval loca..t,o►ti.s,rt,�e.l�t�33 BUSINESS LOCATION: CI ('A�e Uvt��' INVENTORY MAILING ADDRESS: TOTAL AMOUNT- TELEPHONE NUMBER: cell S-0 660 aal wlw c CONTACT PERSON: Cff ` '®'," EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: o o vt. �5 i v�e55 INFORMATION/RECOMM NDA IONS: 11 GIT ve. f 6 5 Fire District: ace. Xof r bKgj to r4 fob \" 0Vd P1ans kc, 're M,>VP— 1A Alzo Ir gr Ve, L- So .0 Sa /1 I Waste Transportation: A)IA Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS — 11 J1 o 1 o 1 r-ttpor- -C-4- I PvQ►� eS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED' Cesspool cleaners Automatic transmission fluid Disinfectants j Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED . Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers&cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initial Date.: ll ! to TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY -20(5 NAME OF BUSINESS: NL--1/L S AGL 7d .BUSINESS LOCATION: ]/ t4_/> Ave. I-INAAANa keg5 A-6 INVENTORY MAILING ADDRESS: A-(30 VL 4�/Ue\ks 15 Iw TOTAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON: &A RI'Es X L, 6A. a fA51 '� EMERGENCY CONTACT TELEPHONE NUMBER: 2 °, �yS 00 N MSDS ON SITE? TYPE OF BUSINESS: tt ro 86--'Aln- INFORMATION/RECOMMEND5IONS. /�/� RaOI/S, �� �� Fire District: s/SSE /S PAiD ,+Ac, f0s�.CC2—/A EX177,J604s pgxS R_-- 1,P-r-7-A T-r / A JX)I-S 4 H,5 7 L &.+/7R/NO2 /5 ra'f RA,S.S®spy/IbR/ /3 4VA/L/#6tE Waste Tr-mlisper4eliti n: /DMA ��.L1�1�9 � Last shipment of hazardous wa te: Name of Hauler:13 Destination: snnv Waste Product:PeW&AE /V.4prhA stir—Licensed . Yes N 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. UV).,I Gvu I�bfe �w M��n Observed Maximum Observed/Maximum / IS .now «ovto' Antifreeze (for gasoline or coolant systems) Misc. Corrosive NEW .SS USED Cesspool cleaners w/ Au tomatic.transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants D Motor Oils Pesticides /55' NEW 3a.S USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED ,J� Misc. petroleum products: grease, Photochemicals (Developer) lubricants, gear oil A,273 YVAS&-P-- NEW USED Degreasers for engines and met .Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Caulk/Grout 3ccge:>6'U'517. Swimming pool chlorine 6AVE7UES Al2E PiOU �U' Battery acid (electrolyte) atteriesbg�,pp2a, Lye or caustic soda eye GRL tis Rustproofers A1*0k/tom 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 inrm DR 'l/1CG�J s�>/LI-S- 9Wa gi-.002 6RA-10 0636?2,VCD iN 71C 6,4)eA 3A Waste Tr-ai a ten: b> HA���.L� J9�� Last shipment of hazardous waste: Name of Hauler•-3,4Fi � Destination: 6P& ksllj L Waste Product:f u�c /tf�pntA AAlrl Licensed? Yes N NOTE: Under the provisions of Ch. 111, Section 31, of tbie General Laws of MA, hazardous materials use, storage and disposal of 111 gallons or more:a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed/Maximum Observed/Maximum Antifreeze (for gasoline or coolant systems) Misc. Corrosive 53' NEW f"�6' USED Cesspool cleaners Automatic transmission fluid -- Disinfectants Engine and radiator flushes. Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants 0 Motor Oils Pesticides /.!� NEW :30:S 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 AKTS WkS#6_R- NEW USED /5 ,uA-IA17- IA105 Degreasers for engines and metq,34r-E7yK Printing ink Degreasers for driveways &garages Wood preservatives (creosote)- Caulk/Grout oA-).5 7F, Swimming pool chlorine ��a Battery acid (electrolyte) atteries6"pp� -�.i3' Lye or caustic soda Rustproofers 'v �'e- � ' �'S Misc. Combustible Car wash detergents Leather dyes Car waxes and polishes . Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, Misc.. Flammables' hydrochloric acid, other acids) Floor&furniture strippers Other products not listed which you feel Metal polishes may be toxic or.hazardous (please..listJ:: Laundry soil & stain removers (including bleach) _P,0 f{PLETE ATf`b .POS t i7d� l���UTl�:�y t3 Spot removers &cleaning fluids JPL� 7kh d l hi-b vote. ATTRtE I 1--t.8 6r THE (dry cleaners) r Other cleaning solvents Bug and tar removers S4r-e- bkT4 Windshield wash wHrrE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS GtS Date: TOWN OF BAR N STA LE Gke( TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: ajdD 00,0dhll BUSINESS LOCATION: INVENTORY MAILING ADDRESS: �� " TOTAL AMOUNT- TELEPHONE NUMBER: 08-771 - -7700 � CONTACT PERSON: fV19ARC �16Vf S EMERGENCY CONTACT LEPHONE NUMBER: 29 M4— 15KP0 y MSDS ON SITE? TYPE OF BUSINESS: k INFORMATION/RECO,MMENDATI NS: -UtP- Fire Di riot: D - A Mor AsYe TransportatU 1 Last shipment of hazardous waste: r Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed/Maximum Observed/Maximum _ Antifreeze (for gasoline or coolant systems) _ Misc. Corrosive NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils ��,//�� Pesticides J�JNEW dv USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED Misc. petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Misc. Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt & roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor&furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers wi�e &I t31)jQAj1 01S, (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Y OIL WAS E OIL OIL FILTERS ANTIFREEZE WASTE IOD ,X � 5 ANITFREEZE 10 .I l ►s-��.f. s �, �. II GASOLINE WASTE GAS DIESEL FUEL W/W FLUID ATF 3 0 3 HYDRAULIC/ MISC. MISC. MISC. MISC. BRAKE FLUID COMMBUSTIBLE FLAMMABLE CORROSIVE PETROLEUM (GEAR OIL/GREASE/ LUBRICANTS) ►I FREON ACETYLENE CAR WASH CAR WASH PAINTS/ WAX DETERGENTS THINNERS SEALANT CLEANING BATTERIES/ POISION/TOXIC CAULK/GROUT SOLVENTS BATTERY ACID FERTALIZERS NV STE SOLVENT S II , MA STS V1 &A an p�rr� oil Into-f -215 all .7t�t - g Town of Barnstable O�'THE r, Regulatory Services Thomas F. Geiler,Director Public Health Division * sextvsT L LE, Thomas McKean,Director y Mass. �►i639• 200 Main Street, Hyannis,MA 02601 �� prFD MA'S A Phone: 508-862-4644 Email: healthntown.barnstable.ma.us Fax: 508-790-6304 Office Hours: M-F 8:00—4:30 September 12, 2006 Mr. Charles Neves Neves Auto Repair 11 Cit Ave. Hyannis,MA 02601 Dear Mr.Neves: Thank you for your time and cooperation during the hazardous materials inventory and site visit at Neves Auto Repair on August 14, 2006. This letter contains information from that visit that will help you become compliant with Chapter 108 of the Town of Barnstable Ordinance: Hazardous Materials. Enclosed are copies of the Chapter 108: Hazardous Materials ordinance and a copy of the Toxic and Hazardous Materials On-Site Inventory form from the visit to your business. Please note the observations from your place of business during the hazardous materials inspection listed below: OBSERVATIONS: • Registered for the 2006-2007 Hazardous Materials Permit. • Housekeeping is satisfactory • Empty all waste oil catch pans immediately after service work is completed. • Keep all hazardous and flammable materials stored in capped containers. • Material Safety Data Sheets need to be updated. On Site Inventory Total The Toxic and Hazardous Materials On-Site Inventory from August 14,2006 shows that you have approximately 359 gallons of toxic and hazardous materials being used, stored,generated and disposed of at Neves Auto Repair, 11 Cit Ave,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. Si cerely, mm Alisha L.Parker Hazardous Materials Specialist All orders to correct violations of Chapter 108 of the Town of Barnstable Ordinance: Hazardous Materials shall be c pleted upon receipt of this letter. Thomas A.McKean,RS, CHO Director of Public Health Enc. On-Site Inventory(copy) Chapter 108 (copy) Town of Barnstable yvt ro� � Regulatory Servicesl��lP x P Thomas F. Geiler,Director Public Health Division 7 11fA33_ �} —9 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.3 la -61V OUX)DATE 0Ij- Y Y/d6 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT \ y TELEPHONE NUMBER S0? 7 7 N .SOLE OWNER:4YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL A PARTNERS: 0- i7? b".r IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS (:k r,1C s (Pa� . YOrPOAk . � HOME TELEPHONE-# .Sae 3 9y®SGOd Haz.dn/vipfq MAIL-IN REQUESTS r Please mail the completed application form to the address below. Also include copies of your employees food sanitation training certificates. In addition, please include the required fee amount (see fees at bottom of this page). 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 copies of your employees food,sanitation training certificates. In addition, you must mail the required fee amount (see fees at bottom of this page). 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. t For further assistance on any item above, call 508 862-4644 Back to Main Public Health Division Page .i i { i Number Fee 181 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Neves Auto 11 Cit Avenue, MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. --------------------------------------------------------------------------------------------------------- ----------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 30, 2007 unless sooner suspended or revoked. --------------------=------------------ WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. May 24, 2006 PAUL J. CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health NEVES' AUTO REPAIR 3250 TOWN OF BARNSTABLE 5/14/2006 HAZARDOUS MATERIALS PERMIT 100.00 r CAPE COD COOPER HAZARDOUS MATERIALS PERMIT ,10000 ,,. - .. Town of Barnstable w �oFt ro�ti Regulatory Services , o ✓ � Thomas F. Geiler,DirectotQVIN t?F BARNS TABLE r ` MAM ' Public Health Divida 9�A 1 ��� Q 18 AM I t: 34 ree�te Thomas McKean,Director 200 Main Street, Hyannis,MA.0260I Office: 508-862-4644 D I VI$�Q —'"Fd�:. 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. 0.Y,-22)() DATE L�O, APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT �C,VW TELEPHONE NUMBER �U '_77'610 . SOLE OWNER: t/YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK L SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS Gr4 ,� �' yOWbGtB-1 HOME TELEPHONE# SUS' 2Fy- S'(olJG Haz.doc/wp/q ' Town of Barnstable &:- ` I tMME r Regulatory Services Thomas F. Geiler,Director RECEIVED 9MAS&"Bff Public Health Division JUN 2 12004 63 q ♦0 iOrFO Ma+" Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 TOWN OF BARNSTABLE HEALTH DEPT. Office: 508-862-4644 Fax. 508-?90-6304— Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. 31,a°-0 _ ),DATE ©� APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111.GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT ADDRESS OF`ESTABLISHMENT �� �`� .�e.�v� . } TELEPHONE NUMBER Sb e -77L 9 7 Q O 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. NO STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER �' , CLERK SIGNATURE F APPLICANT RESTRICTIONS: HOME ADDRESS—'? HOME TELEPHONE# S_i F 39V-5-a& Haz.doc/wp/q L ,ter Neves' Auto Service 11 Cit Avenue Hyannis, MA 02601 508-771-7700 CONTINGENCY PLAN TO HANDLE HAZARDOUS WASTE SPILLS In The event of a hazardous waste spill at this location employees shall do the following; 1. Whenever safely possible immediately stop the cause of the spill and contain the spill to the effective area. 2. Containment and cleanup shall be achieved using approved materials provided by management. Materials used for cleanup shall be disposed of in proper containers and removed by a MA approved waste hauler. 3. The Hyannis Fire Department shall be notified by dialing 911 if the hazardous spill is of a flammable or explosive nature. Employees shall evacuate the building and await the arrival of the fire department. Upon arrival the fire department shall be advised of the hazardous material involved and the nature of the spill. 4. Management shall notify the Town of Barnstable Health Department of any spills that require any of the above actions. 5. Management shall be responsible for contacting a Massachusetts approved hazardous waste hauler for proper cleanup and disposal of any hazardous materials. Per Order of Charles Neves June 17, 2004 Date: S 28 6y TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: /V"—tS BUSINESS LOCATION: I C,,Lk /4'yeru.-t T -5 INVENTORY .MAILING ADDRESS: `' TOTAL AMOUNT: TELEPHONE NUMBER: 6_0 9 - -7-7/- •7 7Dd CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: FWE D(57�ICT TYPEOFBUSINESS: At.� OTHER INFORMATION: P`ea� Q S o>"C- -es Waste Transportation: 0)5, �s � � u Name of Hauler: /V4E_5 Destination: Waste Product! %W ,_1 fe7-e- Licensed. Ye No 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. . NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed (gallons): Antifreeze(for gasoline or coolant systems) Drain cleaners .NEW y`L USED Cesspool cleaners Automatic tra emission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) ZoNzk Hydraulic fluid (including brake fluid) Refrigerants ✓ Motor oils Pesticides /N�NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diese[fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint &'varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor&furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil &stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids Misc.: (dry cleaners) Other cleaning solvents Bug and tar removers Town of Barnstable Regulatory Services RECEIVED s Thomas F. Geiler,Director, �,SZAB � •� J U N 0 3 2003 g Public Health Division i6g9 Thomas McKean,Director �TO W HEALTH DNPTABLE 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee:'$100.06 ASSESSORS MAP AND PARCEL NO.31&1---d l Y-6WNATE 6, Qa ZO 3 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT V+E a NAME OF ESTABLISHMENT N E11y ` V�\Jya (54 ADDRESS-OF ESTABLISHMENT TELEPHONE NUMBER -�—O 7-2/ - 7 7 0`0 SOLE OWNER:�C YES -_ NO_. 1G" T I �'�Nffl HOW S 11Ti A T T IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER * ' CLERK -- SIGNATURE OF APPLICANT" RESTRICTIONS: HOME ADDRESS �Q` aev+ HOME TELEPHONE# So k 39%s—(,aL Haz.doc/wp/q NEVES AUTO REPAIR HYANNIS; MA 02601 y r� a ,:��-ram--•--- / j TOWN OF BARNSTABLE REGULATORY SERVICES PUBLIC HEALTH DIV. 200 MAIN STREET HYANNIS, MA 02601 /jj(3j} ) jj))did } jjyy _._.. ..: ^l i•?..•._.._ IIIfff-11f�f 111 it ffff 11difl ll�!dj!>:�+t:I i r� it iii! j }i} iiili iil iy i ! iliiii F iy11 i !i. i �� s s , Town of Barnstable RECEI �� I r Regulatory Services Thomas F. Geiler, Director DEC 1 6 2002 Y BLE AN& Public Health Division TOWN OF BARNSTA b 9 a`$� HEALTH DEPT. r�1 met Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 November 20, 2002 NOTICE TO ALL BUSINESS OPERATORS WITH HAZARDOUS MATERIALS IN BARNSTABLE Last year, the Barnstable Town Council adopted a new requirement for each business operator to obtain an annual permit and to remit a fee of$100.00 if one-hundred and eleven (111) gallons or more of hazardous materials are stored and/or utilized at a particular site. Please complete the attached application form and submit it along with the required fee of $100 to this Office on or before December 20, 2002. Checks should be made payable to the: Town of Barnstable. Upon receipt of the fee and a completed application form, and after an inspection is conducted revealing no violations or minor violations, a permit will be issued. Please feel free to call or visit our office if you should have any questions or concerns. is%/3/oa i v000\�L \eke 0 c\C\\OnI i- Q:WP/HAZFEEI.doc \`nCP cep Town of Barnstable °Ft roy, Regulatory Services ti Thomas F. Geiler,Director BARNSTABM i M MASS 9� tb 9. �Ec Mai°i 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 `-//5 0d APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT C r'(a"k \en NAME OF ESTABLISHMENT 'N ����' Vsojva 9\--go'vs- ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER -S—y k 22/ - 77 02 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. G STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS_ °I HOME TELEPHONE# Haz.doc/wp/q { t F / C Q x TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair BOARD OF HEALTH 0 satisfactory 3.Auto Body Shops _ unsatisfactory- 4.Manufacturers COMPANY ' (see"Orders") 5. Retail Stores 6. Fuel Suppliers ADDRESS Class: 7. Miscellaneous QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MAT RML9 Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: S waste motor oil (C) new motor oil (C) X transmission/hydraulic Synthetic Organics: degreasers S C:) Miscellaneous: DISPOSAI./RECLAMATION REMARKS: 1. S nitary Sewage 2.WiLter Supply !. ;Town Sewer Public �S O On-site OPrivate 3. Indoor Floor Drains YES NO� O Holding tank:MDC O Catch basin/Dry well O On-site system ���� 4. Outdoor Surface drains:YES NO ORDERS: iN 2 O Holding tank:MDC " CA\ T k O Catch basin/Dry well O On-site system 5.Waste Transporter Narne of Hauler Destination Waste Product Licensed?l YE INO � lti� n 2. 1 iry- Peis6n, InteMewed Inspector Date TOWN OF BAR,NSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 2. Printers BOARD OF REALTH satisfactory 3.Auto Body Shops /� Q unsatisfactory- 4.Manufacturers COMPANY � �'N (see"Orders") 5. Retail Stores SS 6. Fuel Suppliers Ok ADDRESS )i C t� Class' 7. Miscellaneous QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2(B) Heavy Oils: waste motor oil (C) new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: r r DISPOSALIRECLAMATION REMARKS: 1. S pi Sewage A.Water Supply Town Sewer Public O On-site OPrivate 3. Indoor Floor Drains YES NO-XI O Holding tank:MDC O Catch basin/Dry well L), b U O On-sit6 system r pm �� r.5�L 4. Outdoor Surface drains:YES NO Lj�, � O Holding tank:MDC SI:S T"�VC`i ALL O Catch basin/Dry well O On-site system 5.Waste Transporter Narne of Hauler Destination Waste Product 1. YES NO 2. 7 P Person(s) Interviewed Inspector D to J 1 �Y G' Rask ' Miller r• f V TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body shops ,,��,�► unsatisfactory- 4.Manufacturers COMPANY /I✓-��'�..S �� 0 (see"Orders") 5.Retail Stores �l 6.Fuel Suppliers ADDRESS Glass: 7•Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS IN OUT IN OUT IN OUT #&gallons Age Test Fuels: o ine, et uel iese , erosene, 2 Heavy Oils: 2�� waste motor oil (C) IJ new motor oil(C) � transmission/hydraulicr ," , Synthetic Organics: degreasers Miscellaneous -- W LAZ k9a kft ,V ��� �c� 4 DISPOSAURECLAMATION REMARKS: 1. S nitary Sewage 2. ater Supply %2 n Town Sewer qPublic O On-site OPrivate 3. Indoor Floor Drains YES N0 O Holding tank:MDC O Catch basin/Dry well O On-site systemah 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter YES NO JT 010 --- P so (s) n erviewed Inspector Date TOWN OF BARNSTABLE COMPLIANCE: GLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops -O unsatisfactory- 4.Manufacturers COMPANY AV-;* S40 4- (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS C183S: 7.Miscellaneous yAU-6 I-V QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS _ IN OUT I IN OUTI IN JOFIA &gallonsjAge ITestj 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: LM� 4 L= I �s 5 DISPOSALIRECLAMATION REMARKS: 1. S nitary Sewage 2.Water Supply 421141 � Town Sewer *Public O On-site OPrivate 3. Indoor Floor Drains YES NO z O Holding tank:MDC_ O Catch basin/Dry well j's�G� �.4 -7 O On-site system n c�YYL.- 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 De i , A .as o YES NO 1. I 2. i Person(s) Interviewed -Inspector Date Ott TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory 2.Printers 3 3.Auto Body Shops p i_ unsatisfactory- 4.Manufacturers COMPANY Cc�s O (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS C183S' 7 7.Miscellaneous R-k44.6-1 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: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneo DISPOSAIJRECLAMATION REMARKS: ((�� 1. Sanitary Sewage 2.Water Supply X'y 0-1!rp( S Town Sewer 'ublic O On-site OPrivate 3. Indoor Floor Drains YES_,�CNO O Holding tank:MDC 7 ` O Catch basin/Dry well ' O On-site system 4. Outdoor Surface drains:YES NO O DERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5. Waste Transporter DestinationName of Hauler YES NO 1. 2. ?1 Person (s) Interviewed Inspec or Date TOXIC AND HAZARDOUS /ATERIALS REGISTRATION FOR41 C7 NAME OF BUSINESS: f%1EVES AUTO 1;9-:PA1*R Mail To: k ' - R01 A�, Board of Health BUSINESS LOCATION: C�'`�I`'E°R /`+IR° O`�� `{ C6T �������' ar, Sl M ASS 21 Town of Barnstable MAILING ADDRESS: P.O. Box 534 TELEPHONE NUMBER: "' ' l'C� 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: 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-J!! Antifreeze (for gasoline or coolant systems) Drain cleaners JAutomatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners ydraulic fluid (including brake fluid) Disinfectants j for oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) ' Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish-removers, deglossers Other chlorinated hydrocarbons, I 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 • •LIANCE: CLASS: 1.Marine,Gas Stations, Rep. 2.Printers satisfactory 3.Auto Body Shops k r • unsatisfactory-"Orders6.Fuel Suppliers 7.Miscellaneous Case lots Drums Above Tanks Underground Tanks • NAi1 0 0 Ing new motor 1 _. ► �r. N a tin Pq, MENEM _ 1 �a 4 A A ARTA :1 .•1 s11 .1 I MAW. �'1 IN IIIIIIIII!,1111111 •1 Name of Hauler Destination Waste Product Licensed? wer TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops Q unsatisfactory- 4.Manufacturers COMPANY I A !�eveS @�` (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Class: 7.Miscellaneous 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: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: l - 'waste motor oil (C)- new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers i cellaneous: 1% - DISPOSALfRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply W XTown Sewer Public 6 O On-site OPrivate 3. Indoor Floor Drains YES N0� O Holding tank:MDC rile O Catch basin/Dry well O On-site system \ 4. Outdoor Surface drains:YES NOk ORDER O Holding tank: MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 2. (,vie: (' Person(s) Interviewed Inspector' USG Date No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS ZIppYicatton for Mizpoml *pgtem Construction Permit jv� Application for a Permit to Construct( )Repair( )Upgrade( Vrbandon( ) El Complete System El Individual Components Location Address or Lot No. / ' C;14 A U e. Owner's Name,Address and Tel.No, O NAP.1es 1`. d- 6019 )q A Neves Assessor's Map/Parcel 31 OOA 4o aQ G Q F21 l: P,�S 4-I)q N Q'o1 aV Installer's Name,Address,and Tel.No. Designer's Name,Ad ess and Tel.No. -7"7 77 a 0 GAI. Sr,44e- PtloIT6 " , AC 17t/ Phepcnt Rd P 19NIV1s YhA 0a4Y2. 77S_U49 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. g P Y Y Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construc ion and maintenan of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 e nvironmental Co and not to place the system in operation until a Certifi- cate of Compliance has been is s o of Healt . Signed r Date f f Q Application Approved by IffIf j Date Application Disapproved for the following reason Permit No. Date Issued 1 I 1 r' v � i r 'No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Application for. 10ioomt *pmtm Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( �bandon( ) El Complete System ❑Individual Components tt Location Address or Lot No. r C,+ R v e Owner's Name,Address and Tel.No. 3 Assessor's Map/Parcel ^ O/y � l- 0 1 't PA-1 H 131 Pc 4G vo �, e�� 'l Installer's Name,Address,and Tel.No. Designer's Name,Add(ess.and Tel.No. 7 7)- 77700I I Yh,4 0;74 Y 7-67 1 C' Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other -. Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures _ ]Resign Flow gallons per day. Calculated daily flow gallons. Plan Date' Number of sheets Revision Date Title`— 'SizCof Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: f r Agreement: The undersigned agrees to ensure the constuuc on and maintenan of the afore described on-site-se-wage disposal system yin accordance with the provisions of Title 5 e nvironmental Cod and not to place the system in operafion until a Certifi- cate of Compliance has been iss e s o of Healt _t - Signed _�_ Date �I f k. Application Approved byoft Date ._Application Disapproved for the following reason Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS • Certificate of Compliance THIS QoCERTIFY,that the On-site Sewage Disposal System Constructed( ) Repaired( )Upgraded( ) Abandoned(�/' "y at t✓ ros' as b e "constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated/- Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as d signed. Date //—�'�- 2 "7 Inspector, —— — — =—————————— —————————————— — No. '"' Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS lwigpogal *p!6tem Construction Permit Permission is hereby granted to Construct( )Repair( )U g ade( )-A ando System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction ust a completed within three years of the date of th'/ ermit. G P Date: Approved by "1'41" r' NEVES' AUTO REPAIR TOWN OF BARNSTABLE 6/7/2004 2409 Store Hazardous Materials 100.00 A CAPE COD COOPERATI 100.00 4/4 7M / D t � ate: S 2 916 y TOXIC AND HAZARDOUS MATER - NTORY NAMEOFBUSINESS: IU .A P'5 .A%4c t� BUSINESS LOCATION: I �� �'�/�✓f-tc�;_,l�-C�. S INVENTORY .MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: 120 8 — 7 71— -700 CONTACTPERSON: C a,c Je g.. A/&Ai era-- EMERGENCY CONTACT TELEPHONE NUMBER: FI(�E 0t57-RI�,T TYPE OF BUSINESS: �0�. OTHER INFORMATION: cam. ec: 'ca�M ter,,. M 5 L,S or1 �Ife 5gA& s t�Vt?,vr4� ,� s�'��t�C ygLAe�DO'u.5 (�Y Stu @s Waste Transportation: Name of Hauler: Destination: Waste Product: waa� wnAiM fe _*— Licensed, -Ye No 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. . NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed (gallons): Antifreeze(for gasoline or coolant systems) Drain cleaners .X&ot.NEW USED Cesspool cleaners Automatic tradmission 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 ear oil • g NEW USED Degreasers for engines and metal Printing ink Nk Degreasers for driveways &garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car wakes 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 Floor.&furniture strippers (including chloroform;formaldehyde, Metal polishes hydrochloric acid, other acids) Laundry soil &stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids Misc.: (/vale p (dry cleaners) ..� - .. Other cleaning solvents Bug and tar remover`, Town of Barnstable-Health Department Page 1 t.A r HAZARDOUS MATERIALS INVENTORY SITE VISITS DBA: Neves Auto Repair Fax: — ......... Corp Name: Mailing Address Location: '11 Cit Avenue,Hyannis Street: 11 Cit Avenue mappar: City: Hyannis Contact: Charles Neves State: Ma lephone: `508-771-7700 Zip: 02601 Eme ency: 508-394-5606 Person Interviewed: C' ........... ?t!!.. Busin ss Contact Letter Date: G Catego VehicleMaintenance Inventory Site Visit Date. Typ Auto Repair Follow Up/Inspection Date: ❑� public water ❑ indoor floor drains ❑ outdoor surface drains ❑ license require Elprivat water El indoor holding tank mdc El outdoor holding tank mdc ❑ currently lice sed r// ❑ towns wage ❑ indoor catch basin/drywell El outdoor catch basin/drywell expir .. --- - - ❑� on-sit sewage ❑ indoor on-site syste El outdoor onsite system date: .........__........ _ v e.� Remarks Waste antifreeze is recyclable at Tirrell Radiator. Safety- compliance: �L Kleen p s washer on-site. 2 Electric/Hydraulic lifts. Batteries-No Satisfactory ork do e. Recycles oil filters. Orders: Need label on oil filter Sfrum. 5128104 Onsite inventory. CaA Y-Le 9,f 7 fo 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 ,,.'descnptlon, .qty `° ' unit of measure antifreeze(for gasoline or coolant systems) 1cases _....__.._.._....__._._...__.._...---_.__.___._._-.____......_._..___.._._____......__._._._.-_-----._.__........_..._....._..._....__._.._......._....... automatic transmission fluid 11cases hydraulic fluids(including break fluid) motor oil 175gallons _.......__......._.._..._. _._....._..__......____....__.___.e.._._.�...........__..........._..........................._..._._...._.. ._...__._._..._.._;....__......__...._........_........._......__. ....._......... degreasers for engines and metal 1gallons diesel fuel,kerosene,#2 heating oil 55;gall6ns misc.petroleum products:grease,lubricants 5 gallons __..._..__.._ ..__......_--___....____..._._._....____..___----...__.,. ..__._.........__..____..__.___._....___._........._._....._......._......_.._.._._............_..__..._._...... waste antifreeze 35gallons Waste Transporter: WA// Fire Distract . 5 / zzf24�--1 /r Last HW Shipment Date: ? Z/� /b y iGVaste Hauler Licensed: �� � b Hazardous Materials On-Site Inventory/inspection For ALL Shops and Businesses: DBA: JV e,,s� C_ Location: y _ Date: —o`7 Physical Features to Inspect: 1. Hazardous waste generation sites (production/manufacturing areas): `mow 2. Waste storage areas: 3. Satellite accumulation points throu hout: 4. HazMat stored outdoors — CHECK OUTSIDE: /I L_ 5. Shipping and receiving areas: 6. Run down of shop activities: 7. Housekeeping practices.* HazMat On-Site Inventory/Inspection: Records to Review for SQGs and CESQGs DBA: /Vev� /4"*. Location: Site visit date: • Hazardous Waste Manifests: • Employee training documentation (if required): • Hazardous substance spill control n2d efstingency plan: • MSDS on site? • HazMat Inventory records (if applicable): • HazMat Waste Shipping documentation: • Spill records (if applicable): 9�(�. �, o � �� N� v' .� � o c�.1'W . � -. .._ � � � �` I ' J I 1 I _ - _-- �t Town of Barnstable Department of Health, Safety, and Environmental Services ` '"R"'" Public Health Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health February 12, 1998 Bruce L. & Linda S. Stewart 11 Cit Rd. Hyannis,MA 02601 RE: UIC Notification Letter Dear Mr. and Mrs. Stewart, �y On November 7, 1997 the Barnstable Public Health Division inspected the exterior portions of the property located at 11 Cit Rd., Hyannis, MA. The property was inspected due to the abandonment of the on-site septic system and subsequent connection to municipal sewer. At that time, an Metropolitan District Commission (MDC) trap was observed at the south west corner of the property. The MDC trap was in use at the time of inspection. On December 12, 1997 an inspection of the interior portion of the on-site structure revealed that the floor drains in units of Neves' Auto has been sealed. Floor drains in the Auto Home Glass unit had evidence of use. Units owned by Stewart and Blackburn were not accessible at the time of inspection. Due to the presence of the MDC trap, the discharge point is considered an Underground injection control system or UIC. Please review the following options for your property. All options below include the proper"closure"of the UIC, according to 310 CMR 27.00. As mandated under the Federal Safe Drinking Water Act, the state Underground Injection Control (UIC) regulations prohibit potentially polluting discharge to injection wells. Vehicle maintenance operations commonly use unauthorized injection wells, such as floor drains leading to a septic system, dry well,or oil/water separator which leads to any subsurface leaching structure. Under the State Plumbing Code (248 CMR 2.09 (1) (c) (3), owners/operators of facilities with floor drains tied to injection wells (or discharging to any surface point)have three options: 1. Seal the floor drain. Contact your local plumbing inspector for the appropriate filing form. If choosing this option, all previous discharges to the drain must be eliminated at their source. For example, cars should no longer be washed and floors should no longer be hosed down. 2. Connect the floor drain to a holding tank. The tank will need DEP approval. The DEP approves two types of holding tanks for this waste: new installations and conversions of existing structures (e.g. oil/water separators). These tanks are for non-hazardous, industrial wastewater. If solvents, antifreeze, oil and other fluids are washed down the drain,the waste is likely to be hazardous. municipal sewers stem if available. An oil/water separator Connect the floor drain to a system,3. Co p is required to be installed under this option. This requires a permit from DEP and the Town of Barnstable Department of Public Works along with the sewer connection application. The amount of discharge shall not exceed ten parts per million(10 ppm). In all cases,the owner must file a UIC NOTIFICATION FORM with DEP. You are directed to comply with the state's UNDERGROUND INJECTION CONTROL regulations (310 CMR 27.00) by informing this department in writing of your intentions within ten (10)days of receipt of this notice and completing the work within thirty(30) days. PER ORDER OF T E BOARD OF HEALTH Thomas A. McKean Director of Public Health Enc. Industrial Floor Drains cc: Ed Jenkins, Town of Barnstable Plumbing Inspector David Anderson,Town of Barnstable Engineering Department. �tKE Town of Barnstable + ■nxtvSTABIZ, • Department of Health, Safety, and Environmental Services 9. � Public Health Division �En s 367 Main Street,Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health February 12, 1998 Raymond Blackburn&Eleanor, Trustees 993 Main St. Centerville, MA 02632 RE: UIC Notification Letter Dear Mr. Raymond Blackburn, On November 7, 1997 the Barnstable Public Health Division inspected the exterior portions of the property located at.,I I Cit Rd.;Hyannis, MA. The property was inspected due to,the abandonment, of the on-site septic system and subsequent connection totmunicipalwsewer ;;At=that time, an Metropolitan:District Commissionr(MD.C)atrap.,was.. observed;at. the.south-west corner-..,of the property. The MDC trap was muse at the time of inspection. On December 12;. 1997 an inspection of the interior portion of the on-site.structure revealed.that the floor drains in units of Neves' Auto has been sealed. Floor drains in the Auto Home Glass unit had evidence of use. Units owned by Stewart and Blackburn were not accessible at the time of inspection. Due to the presence of the MDC trap, the discharge point is considered an Underground injection control system or UIC. Please review the following options for your property. All options below include the proper"closure"of the UIC, according to 310 CMR 27.00. As mandated under the Federal Safe Drinking Water Act, the state Underground Injection Control (UIC) regulations prohibit potentially polluting discharge to injection wells. Vehicle maintenance operations commonly use unauthorized injection wells, such as floor drains leading to a septic system, dry well, or oil/water separator which leads to any subsurface leaching structure. Under the;State:Plumbing Code (248 CMR 2.09 (1) (c) (3), owners/operators of.facilities-with floor drains tied to injection wells (or discharging to any surface point)have three options: �Lt Seal the floor drain:..Contact your locah.plumbing.,inspector for the,appropriate filing form. If choosing',this option;call previous discharges to the drain must be eliminated.,at their source. .For example, cars should,no longer be washed and floors should no;longer.; be hosed down. .ry 2. Connect the floor drain to a holding tank. The tank will need DEP approval. The DEP approves two types of holding tanks for this waste: new installations and conversions of existing structures (e.g. oil/water separators). These tanks are for non-hazardous, industrial wastewater. If solvents, antifreeze, oil and other fluids are washed down the drain,the waste is likely to be hazardous. 3. Connect the floor drain to a municipal sewer system, if available. An oil/water separator is required to be installed under this option. This requires a permit from DEP and the Town of Barnstable Department of Public Works along with the sewer connection application. The amount of discharge shall not exceed ten parts per million(10 ppm). In all cases,the owner must file a UIC NOTIFICATION FORM with DEP. You are directed to comply with the state's UNDERGROUND INJECTION CONTROL regulations (310 CMR 27.00) by informing this department in writing of your intentions within ten(10)days of receipt of this notice and completing the work within thirty(30) days. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health Enc. Industrial Floor Drains cc: Ed Jenkins, Town of Barnstable Plumbing Inspector David Anderson,Town of Barnstable Engineering Department. mot ,, Town of Barnstable Department of Health, Safety, and Environmental Services ELUWgrMLE, Public Health Division t639. jOrEo & 367 Main Street,Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health February 12, 1998 Charles F. & Donna T. Neves 9 Erik's Path South Yarmouth,MA 02664 RE: UIC Notification Letter Dear Mr. and Mrs. Neves, On November 7, 1997 the Barnstable Public Health Division inspected the exterior portions of the property located at 11 Cit Rd.,Hyannis, MA. The property was inspected due to the abandonment of the on-site septic'system and subsequent connection to municipal sewer. At that time, an Metropolitan District Commission (MDC) trap was observed at the south west corner of the property. The MDC trap was in use at the time of inspection. On December 12, 1997 an inspection of the interior portion of the on-site structure revealed that the floor drains in units of Neves' Auto has been sealed. Floor drains in the Auto Home Glass unit had evidence of use. Units owned by Stewart and Blackburn were not accessible at the time of inspection. Due to the presence of the MDC trap, the discharge point is considered an Underground injection control system or UIC. Please review the following options for your property. All options below include the proper"closure"of the UIC,according to 310 CMR 27.00. As mandated under the Federal Safe Drinking Water Act, the state Underground Injection Control (UIC) regulations prohibit potentially polluting discharge to injection wells. Vehicle maintenance operations commonly use unauthorized injection wells, such as floor drains leading to a septic system, dry well, or oil/water separator which leads to any subsurface leaching structure. Under the State Plumbing Code (248 CMR 2.09 (1) (c) (3), owners/operators of facilities with floor drains tied to injection wells(or discharging to any surface point)have three options: 1. Seal the floor drain. Contact your local plumbing inspector for the appropriate filing form. If choosing this option, all previous discharges to the drain must be eliminated at their source. For example, cars should no longer be washed and floors should no longer be hosed down. 2. Connect the floor drain to a holding tank. The tank will need DEP approval. The DEP approves two types of holding tanks for this waste: new installations and conversions of existing structures (e.g. oil/water separators). These tanks are for non-hazardous, industrial wastewater. If solvents, antifreeze, oil and other fluids are washed down the drain,the waste is likely to be hazardous. 3. Connect the floor drain to a municipal sewer system, if available. An oil/water separator is required to be installed under this option. This requires a permit from DEP and the Town of Barnstable Department of Public Works along with the sewer connection application. The amount of discharge shall not exceed ten parts per million(10 ppm). In all cases,the owner must file a UIC NOTIFICATION FORM with DEP. You are directed to comply with the state's UNDERGROUND INJECTION CONTROL regulations (310 CMR 27.00) by informing this department in writing of your intentions within ten (10) days of receipt of this notice and completing the work within thirty(30) days. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health Enc. Industrial Floor Drains cc: Ed Jenkins,Town of Barnstable Plumbing Inspector David Anderson,Town of Barnstable Engineering Department. �t Town of Barnstable Department of Health, Safety, and Environmental Services '"M' Public Health Division �Eo 367 Main Street,Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health February 12, 1998 Raymond Blackburn &Trustees Corner Airport Rd. &Cit Rd. Hyannis, MA 02601 cc: Charles &Donna Neves RE: UIC Notification Letter Dear Mr. Raymond Blackburn, On November 7, 1997 the Barnstable Public Health Division inspected the exterior portions of the property located at 11 Cit Rd., Hyannis, MA. The property was inspected due to the abandonment of the on-site septic system and subsequent connection to municipal sewer. At that time, an Metropolitan District Commission (MDC) trap was observed at the south west corner of the property. The MDC trap was in use at the time of inspection. On December 12, 1997 an inspection of the interior portion of the on-site structure revealed that the floor drains in units of Neves' Auto has been sealed. Floor drains in the Auto Home Glass unit had evidence of use. Units owned by Stewart and Blackburn were not accessible at the time of inspection. Due to the presence of the MDC trap, the discharge point is considered an Underground injection control system or UIC. Please review the following options for your property. All options below include the proper"closure"of the UIC, according to 310 CMR 27.00. As mandated under the Federal Safe Drinking Water Act, the state Underground Injection Control (UIC) regulations prohibit potentially polluting discharge to injection wells. Vehicle maintenance operations commonly use unauthorized injection wells, such as floor drains leading to a septic system, dry well, or oil/water separator which leads to any subsurface leaching structure. Under the State Plumbing Code (248 CMR 2.09 (1) (c) (3), owners/operators of facilities with floor drains tied to injection wells (or discharging to any surface point)have three options: l. Seal the floor drain. Contact your local plumbing inspector for the appropriate filing form. If choosing this option, all previous discharges to the drain must be eliminated at their source. For example, cars should no longer be washed and floors should no longer be hosed down. 2. Connect the floor drain to a holding tank. The tank will need DEP approval. The DEP approves two types of holding tanks for this waste: new installations and conversions of existing structures (e.g. oil/water separators). These tanks are for non-hazardous, industrial wastewater. If solvents, antifreeze, oil and other fluids are washed down the drain,the waste is likely to be hazardous. 3. Connect the floor drain to a municipal sewer system, if available. An oil/water separator is required to be installed under this option. This requires a permit from DEP and the Town of Barnstable Department of Public Works along with the sewer connection application. The amount of discharge shall not exceed ten parts per million(10 ppm). In all cases,the owner must file a UIC NOTIFICATION FORM with DEP. You are directed to comply with the state's UNDERGROUND INJECTION CONTROL regulations (310 CMR 27.00) by informing this department in writing of your intentions within ten(10)days of receipt of this notice and completing the work within thirty(30) days. PER ORDER OF THE BOARD OF HEALTH �omasMcKean Director of Public Health Enc. Industrial Floor Drains cc: Ed Jenkins,Town of Barnstable Plumbing Inspector David Anderson,Town of Barnstable Engineering Department. I Town of Barnstable Department of Health, Safety, and Environmental Services MAN."'M � Public Health Division 7 A98. eorr+M" 367 Main Street, Hyannis MA 02601 t 11mmu A.Mcl(ft" Office: 309-790-6263 Director of Publio HeaM FAX: 509-773-3344 e 7) / r I s f.e„_Q Of Der . � . RE' As mandated under the Federal Safe Drinking Water Act, the state Underground Injection Control (UIC) regulations prohibit potentially polluting discharge to injection wells. Vehicle maintenance operations commonly use unauthorized injection wells, such as floor drains leading to a septic sytem, dry well, or oil/water separator which leads to any subsurface leaching structure. Under the State Plumbing Code(248 CUR 2.09 (1) (c) (3), facilities with floor drains tied to injection wells (or discharging to any surface point) have three options: 1. Seal the floor drain. Contact your local plumbing inspector for the appropriate filing form. .ng this option, all previous discharges to the drain must be �. a theri urce. For example, cars should no longer be washed and floors should n onger be hosed down. 2. Connect the floor drain to a holding tank. The tank will need DEP approval. The DEP approves two types of holding tanks for this waste: new installations and conversions of existing structures (e.g. oil/water separate These tanks are for non-hazardous, industrial wastewater. If solvent antifreese` it and other fluids are washed down the drain, the waste is likely to be hazar ous. 3. Connect the floor drain to a municipal sewer system, if available. An oil/water separator is required to be installed under this option. This requires a permit from DEP and the Town of Barnstable Department of Public Works along with the sewer connection application. The amount of discharge shall not exceed ten parts per million (10 ppm). In all cases, the owner must file a UIC NOTIFICATION FORM with DEP. You are directed to comply with the state's UNDERGROUND INJECTION CONTROL regulations (310 CMR 27.00) by informing this department in writing of your intentions within ten (10) days of receipt of this notice and completing the work within thirty (30) days. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health { Jet' t t 1 t s t PAR ] ` Real Estate System - General Property Inquiry] Help [ ] Parcel Id: 312 014-OOA- Account No: 329102 Parent : 231056 Location: 11 CIT RD HYANNIS Neighborhood: 0530 Fire Dist : HY Devel Lot : Lot Size : . 00 Acres Current Own: STEWART, BRUCE C & LINDA S State Class : 319 11 CIT RD No. Bldgs : 1 Area: 1487 Year Added: 85 HYANNIS MA 2601 Deed Date : 060185 Reference : 4592/117 January 1st : STEWART, BRUCE C & LINDA S Deed MMDD: 0685 Deed Ref : 4592/117 Comments : Values : Land: Buildings : 62300 Extra Features : Road System: 11 Index: 316 (CIT AVENUE ) Frntg: Index: ( ) Frntg: Control Info: Last Auto Upd: 050695 Status : C Last TACS Update : 121488 Land Reviewed By: Date : 0000 Bldgs Reviewed By: Date : 0000 Tax Title : Account : Taken: Account Status : Hold Status : Cancel [ ] Press XMT for more data Next screen [PAR ] Action [ ] Owners Name [ ] Road Index [ ] Road Name [ ] Parcel Number [312] [014] [OOB] [ ] [ ] PAR ]' Real Estate .System - General Property Inquiry] Help [ ] Parcel Id: 312 014-OOC- Account No: 32912 Parent : 231056 Location: 11 CIT RD HYANNIS Neighborhood: 0530 Fire Dist : HY Devel Lot : Lot Size : . 00 Acres Current Own: NEVES, CHARLES F & DONNA T State Class : 319 9 ERIK' S PATH No. Bldgs : 1 Area: 1363 Year Added: 85 S YARMOUTH MA 2664 Deed Date : 120186 Reference : 5447/317 January 1st : NEVES, CHARLES F & DONNA T Deed MMDD: 1286 Deed Ref : 5447/317 Comments : Values : Land: Buildings : 49000 Extra Features : Road System: 11 Index: 316 (CIT AVENUE ) Frntg: Index: ( ) Frntg: Control Info: Last Auto Upd: 050695 Status : C Last TACS Update : 110891 Land Reviewed By: Date : 0000 Bldgs Reviewed By: Date : 0000 Tax Title : Account : Taken: Account Status : Hold Status : Cancel [ ] Press XMT for more- data Next screen [PAR ] Action [ ] Owners Name [ ] Road Index [ ] Road Name [ ] Parcel Number [312] [014] [OOD] [ ] [ ] PAR ] Real Estate System - General Property Inquiry] Help [ ] Parcel Id: 312 014-OOF- Account No: 329157 Parent : 231056 Location: 11 CIT ROAD HYANNIS Neighborhood: 0530 Fire Dist : HY Devel Lot : Lot Size : . 00 Acres Current Own: BLACKBURN, RAYMOND & E TRS State Class : 319 NEVES, CHARLES & DONNA No. Bldgs : 1 Area: 1363 COR AIRPORT & CIT RD Year Added: 85 HYANNIS MA 2601 Deed Date : . 090195 Reference : 9831/327 January 1st : BLACKBURN, RAYMOND & E TRS Deed MMDD: 0995 'Deed Ref : 9831/327 Comments : Values : Land: Buildings : 49000 Extra Features : Road System: 11 Index: 316 (CIT AVENUE ) Frntg: Index: ( ) Frntg: Control Info: Last Auto Upd: 052596 Status : C Last TACS Update : 022296 Land Reviewed By: Date : 0000 Bldgs Reviewed By: Date : 0000 Tax Title : Account : 4052 Taken: 021192 Account Status : Hold Status : PO Cancel [ ] Press XMT for more data Next screen [PAR ] Action [ ] Owners Name [ ] Road Index [ ] Road Name [ ] Parcel Number [312] [014] [OOG] [ ] [ ] PAR ] ' Real Estate •System - General Property Inquiry] Help [ ] Parcel Id: 312 014-OOG- Account No: 329166 Parent : 231056 Location: 11 CIT ROAD HYANNIS Neighborhood: 0530 Fire Dist : HY Devel Lot : Lot Size : . 00 Acres Current Own: BLACKBURN, RAYMOND TR & State Class : 319 BLACKBURN, ELEANOR TR No. Bldgs : 1 Area: 1319 993 MAIN ST Year Added: 85 CENTERVILLE MA 2632 Deed Date : 090195 Reference : 9831/327 January 1st : BLACKBURN, RAYMOND TR & Deed MMDD: 0995 Deed Ref : 9831/327 Comments : Values : Land: Buildings : 47400 Extra Features : Road System: 11 Index: 316 (CIT AVENUE ) Frntg: Index: ( ) Frntg: Control Info: Last Auto Upd: 052596 Status : C Last TACS Update : 022296 Land Reviewed By: Date : 0000 Bldgs Reviewed By: Date : 0000 Tax Title : Account : Taken: Account Status : Hold Status : Cancel [ ] Press XMT for more data Next screen [PAR ] Action [ ] Owners Name [ ] Road Index [ ] Road Name [ ] Parcel Number [312] [016] [ ] [ ] [ ] �Q��FTHEt��`o TOWN OF BARNSTABLE �O OFFICE OF BAs :E,MABL BOARD OF HEALTH MA6& ' yip 1M YA 0 367 MAIN STREET � `!M�� HYANNIS, MASS. 02601 . August 14, 1987 Charles Neves Neves Auto Repair Cit Avenue Hyannis , MA 02601 Dear Mr. Neves : You are reminded that State regulations require periodic , pumping and or cleaning of all MDC traps (Metropolitan District' Commiss,ion, 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 $200 . 00 daily under the Town of Barnstable Toxic' and Hazardous Waste By-law. Very Truly Yours, ,John M. Kelly , Director Barnstable Health Department TOWN OF BARNSTARLE Date: ll / ld /,.Ucq TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: C"S At y BUSINESS LOCATION: & d/7- A VE, Z1,y ><Awa INVENTORY MAILING ADDRESS: As A-6o yc TOTAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON: &I-ARICs t/6vEs EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: U Ty INFORMATION/RECOMMENDATIONS. /776S /fAZ aouJ A1AZT22�Ls Fire District: �i sE is nA *IJ Pos .U iZ �n)v 1j�s -xs u,P-/-a-,A A� �-NN1-3 /k H&74Y_ &.,V7A/.vCJ2 /.S 4V,41Z_,q FAX dACs,S®sPe-a/Q,e/ /3 4VA/u_5tC R- 1,06-0A)s�iL Z S 0,(/a �2o©r2 69 i0 d SAS V ED i�y �/£�.�i��vE$�/. Waste Trams n: /D �1A����f�1�9 � Last shipment of hazardous.wa te. Name of Hauler 3AFi K � Destination: � �► Waste Product-P _M 1V,4,0rNA- AF .icensed Yes N NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed/Maximum Observed/Maximum Antifreeze (for gasoline or coolant systems) Misc. Corrosive Jr NEW f6" USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides /63' NEW 305"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 AP_73 YVA-S#&-P— NEW USED Degreasers for engines and met �r K Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Caulk/Grout 3cO&6s o,u5irE. Swimming pool chlorine 3Anru_-5A96 yicxe�u Battery acid (electrolyte)O 3atteries6,4ppE.;5 oFF F Lye or caustic soda Rustproofers N °p— ® ,uS Misc. Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt & roofing tar PCB's - _ Paints-, varnishes,--stains;-dyes Other chlorinated hydrocarbons, - Lacquer thinners (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor &furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers &fa�� (including bleach) ' _0,0M , �IPoS'(' i71� �r_� 9-f11�3Cy Si's-r Spot removers & cleaning fluids ?Lk O fkb V!hil'b y�[fl �i7zP�"f"I1�t dF 1 (dry cleaners) S Other cleaning solvents OP ��Nh �'�A/,(J �a/ .!wr Y&7EP4AL Bug and tar removers bA-T4 Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Hazardous Materials Inventory Sheet Checklist Date Physical Street Address-Check database to ensure it..exists Working Phone Number Actual Amounts -( ie. gas being used.to fuel machines, thinner to Mclean brushes all count as hazardous materials) Storage_Information location of storage, how long is storage for? If none, note that. Disposal Information -where and who? If none, note that. Applicant Signature -.understand what is listed and noted Staff Initial.-any questions, know who.to ask Vehicle Washing/Rinsing? provide a vehicle washing policy and explain it - note that it was given Attach the Business Certificate with your sign off and comments "The inventory form should explain what the business consists of and the procedures they are doing. Notes need to be left to explain what you discussed with them. YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for years). A business certificate ONLY REGISTERS YOUR NAME i you must do.by M.G.L.- it does not give n town n w g y permission to operate. Business Certificates (which r. ficates a Main Street Hyannis, re available at the Town Clerk's y , MA 0260'f (Town Hall), Office, 1" FL., 367 mar,zv�m ual mou' DATE: e�� ^��1© Fill.in please: APPLICANT'S YOUR NAM BUSINESS.. YOUR HOME ADDRESS: v Jy a c d .� �ru H 3z'r TELEPHONE # Home Telephone ,Number �v. NAME"OF CORPORATION: NAME OF.NEW BUSINESS 9 TYPE OF BUSINESS r7 IS THiS A HOME OCCUPATIONS YES NO ADDRESS OF BUSINESS MAP/PARCEL NUMBERI "gG�'�C�4 [Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstdble. This form is intended-to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 2. BOARD OF HEALTH This individual ha be nfor j ad of the permit requirements that pertain to this type of business. MUST COMPLY WITH ALL m aw 1H'AZARDOUS MATERIALS REGULATIC­�3 Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS LICENSING U( AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: TOWN OF BARNSTABLE Date:// / I / TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: 1/ v oRpv� BUSINESS LOCATION: ! �� ' G��t INVENTORY MAILING ADDRESS: _ -S ��Zr-2_ TOTAL AMOUNT: TELEPHONE NUMBER: c'i ,` CONTACT PERSON: r& j Lg:.5 EMERGENCY CONTACT TELEPHONE NUMBER: MSDS O SITE? TYPE OF BUSINESS: 07D —� I4 el ORMATION/RECOM ENDATIONS: ire Distr''ct: Y 71 5 Waste Transports ' n:/ Last shipme of hazardous waste: Name of Hauler: Destination•. Waste Product: 'censed Y s o NOTE: Under the provisions of Ch. 111, ection 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antize (for ga1iror coolant systems) 9 Miscellaneous Corrosive ❑ EW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants M? P ils S66- Pesticides ❑ccpag ❑ USED (insecticides, herbicides, rodenticides) NEWGasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and met Printing ink Degreasers for driveways&garag Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes - Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash , WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS A licant's Signature Staff's Initials OU 'C - 00 a. S �'kl� r B �pq� IOv [('Ll,: �✓"�(.vy� :f <� f ���J���r �U d c6A, y1 G %reteo or to v ac/ v ,J ��455 Co. A"EV,1;7j 4v7u cy= !� r le, 1 e ,� w. 4 y + �.} d • • - a u k �.. r" s THE COMI: ONWEAL.TH OF MASSACHUSETTS BOARD OF HEALTH Town ...:OF ...................................................Hyannis Appliratiun -fur El ipuiittl Works Towitrnrtiun rrutit Application is hereby made.for a Permit to Construct (x ) or Repair ( ) an Individual Sewage Disposal System at: Cit Avenue & Air ................................................---------------------------•--..._...---•--•---- ...-•-----•-•----......_........................ ..........------•--------•-•--------••---------------••---. ................................. For: C,ondyn�;aC:`ldre'S 62 Derby Street, MA. ......................... - - - - -----------•-----•-•---............--------------..................---- Owner e Address W .... ,.Cif__-••----- Grove•Street_,--King,st_on....Mass.. ,a , Installer Address U Type of Building Size Lot.....22 763 .......................Sq. feet .-� Dwelling—No. of Bedrooms,............ ............. ..... -_.-Expansion Attic ( ) Garbage Grinder ( ) G. Other—Type of Building r09use No. of pesos... `8 n ------------------- Showers ( ) — Cafeteria ( ) p' Other fixtures ...................................................... . W Design Flow............ ....................:.......gallons per person. er day. Total daily flow.........12 ....0.._...... ...._ ........-- allon . WSeptic Tank=Liquid capacity--1:000gallons Length... �6"_... Width....4t10��. Diameter_......._-..._ Deptl ��4��.. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area........_......._-._sq. ft. Seepage Pit No......1............. Diameter....... Depth below inlet----------6:I._.... Total leaching are. ........ST ft. Z Other Distribution box ( ) Dosin 1• ( ) il�iarri R. Shaw, P.E• 6/8/82 Percolation Test Resu is Performed by........................................ Date.............-.-.-­--------------­-- Test Pit No. 1,le •_ --_..minutes per inch Depth of "Pest Pit..13------------- Depth to ground water..none_enC.. w Test Pit No. 20)_Z...._.minutes per inch Depth of Test Pit...12.-------- --- Depth to ground wa C --------- p c ;, O P:�I_._..2T-�fiIl;--IIr••med-ium/coarse sand--&--graveI----------•-• Descri tion of ._,ou... . '.. ---- --.WILLIAW.. v, x 8.P'.#2-l' fill, 9' medium sand &gravel, 2' fine sand R. w -------------------------------------------------•----------------------------------•--- . .................................................... s------ ... x .....-••---------.:-------------------- ---•. .....----•-----...------•----•--------••--•---••--•-•---------------------------------------------- -•--•• .... D .. V Nature of Repairs or Alterations—Answer when applicable.__...:..................................................... ---------------------- .---••----•-----------------•-------------------------------.....------------------------------....--•----•----.------ Agreement: y At. 1 The undersigned agrees to install the aforedescribed Individual Sewage Dispos'I Systen •I or a i the provisions of Article \I of the State Sanitary Code— The undersigned further agrees not to place the system in operation ntil ertificate of Compliance has been issued by the board of he th / Signed '� 4 � ------------- --------6 /---$---82-------- Application App 'ved :By.. t f ner ,Date �� � " Application Disapproved for the following reasons:......:... ...........................:.. bate ........................................................................ Date PermitNo....................................._................... Issued........................................................ Date .p..:........_,•. .„r •+-'. _..,,,,. r:. �a.Ml� .-.:.'--• `' >f.`^^.r.' r.• .s'r6'9�,.�-i'-t.r�w.a rM^"^"v-;.;.-1-..-+-w-.4 7. �'n+.:...� '�.,.r'.�s:.'t""-s.� T•...,rp.;.4.r. _ . _. �"�' - No.__So� It KK... +.� ....... &THE CKil NE rbWALTH OF MASSACHUSETTS S � I BOARD OF -HEALTH Town Hyanni6 /`Parnst6ple . . F , 1 App ration -fear B%:tipu,ial Workii Tvnftrnrttnit �� rrntit I ' F .�, . f Application is, hereby made for a Permit to Construct (X.) or Repair ( ) an Individual Sewage Disposal ,__ w System at :....__ # Avenue.A Atrpott R(jad Lots 5 & 6A ----•--•----------------------------•----•-------- ----------------------------- ` RglierVon+dym �at l�.eddress r 4,. 62 Derby Street°; '°� �xgt�arn, i+�A.,. ..----- ----------------•-- --------------------- we t T Owner e Address } a E ....... a __-_.• ...... !: ................ .----- Crdye S.tr ek.�__Ktnas_tc�n_e.. !I s.... F7 Installer f r Address Type of Building r ,` "Size Lot... ........_ D __-____Sq. feet U d Dwelling—No..of-Bedrooms. --_•-_- Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building _--?*OPUSe No. of pet suns.-____g____________________ Showers ( ) — Cafeteria ( ) Otherfixtures ----- ------ ---.................................................................. Design Flow. .............................9,111ons per person per day. Total daily flow.-.:....1.n�.-0:_.- __ .. 111on5 w - ooa8#61P 4'Lo,� �P4tt. . WSeptic Tank—Liquid capacity-_..._..__.gallons Length-_ _...__-_- Width.................. Diameter_.. . . . __._ Depth;. ..-... .- . x Disposal Trench-No. ..................'. NVidth-------------------- Total Length............... Total leaching area-.-.--.._ ._. -___`sq. ft Seepage Pit No_____ _------------- Diameter-_-_._Q .6.7.-__ Depth below inlet__.. _. e_._._. Total leaching area...2�2.- - sq. ft.. Z Other Distribution box ( ) Dosing to ( ) R= °V�+ filam , Shaw, p.£. 6/8/82 aPercolation Test Results Performed by --- . ........................................................ Date............................._..- .-- Test Pit \o. l�_11T'fi _minutes per inch Depth of Test Pit-. _-__•-.-____- Depth to ground .water T10n8-. CtC.. LL, e Test Pit No. Z y`l_Z--____minutes per inch Depth of Test Pit...�Z.`_._--_..___ Depth to ground water.:.� � �""• ,. 4. O Descr~tion of�Sci t Q' •. FI a �tllt3%C�t r $ S8t1 1 c grave ... ... .......................................2fail, ' medium sand-&.gavel, 2' tina sand.......................... - - -- AM_ yc� - ;WILLI ---- w ------------------- ---------•--- •. --------------- --------------------•---------••••--........ .----•---•----------•-----••---... -••---------------•-•---....--- ------ AYl[ SM ---- ' U 'Nature of Repairs or Alterations—Answer when applicable................................................................... ti ............. . .-•------•-------------------.-------------•-----•-------.-......--------•------••.------------...-- ..... ----------- P Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal.System o the provisiofis of Article \I of the State Sanitary Code— The undersigned�'further agrees not to s operation until a�Certificate of Compliance has.been ssued blithe Do' 266f he h Signed... " --- -------- ---------------- A f$ A lication A roved B f WStr 6a PP PP Y ...: r tL� -- --------- ---------i ,. 1ate Application Disapproved for the following`reasons;... '... ' .-•-.•------ --•---.---•-------------;----......--............ ....... r * N1ZDate- 1 Permit No. . •••• r Issued d ............. .: ...._. P• f • . �t , P -Date- THE COMMO'NWE'ALTH OF MASSACHUSETTS , �� t +• D OF. HEALTH r t BO/.1R. . -r .................... .OF.. Tertifiratr of (fam lltttrirp ;y° THIS 1 .�ZO CERTIFY TThhat�the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.....:.......�. � r, Install ._. ._.. ........ ..................•-•-••---•• - has been installed-in accordance with the provisions of Article XI of The State Sanitary Code as described in the application for Disposal,Works Construction Permit No:_e.« !�..2,.-9.`,,�►'............. dated........................................... THE ISSUANCE,,OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY � s- • � l t DATI✓_ -�� --------- � .. ..:..:.. Inspector_. THE COMMONWEALTH OP MASSACHUSETTS 1 BOARD OF HEALTH ffffOF........................................... .-.':.. FEE.... ...f.. , R-riva ial Works a' nstrurtipn rrruttf ` Permission is.hereby granted........ - .... ��.�`.��2ti- ------ ..- _..: !'- ........................ i. to Construct (yY or Repair ( ) ap Individual ewage Disposal System /� { atNo. 'wt.. ... $�' :._ .:. _:... ......- ........----• �...... ............ as shown on the application for Disposal Works.Construction .P rmit No..................... Dated_ ... f__ .- -- A } t of IIealth DTE.._..._.. .......::..r ..................................................