HomeMy WebLinkAbout0095 FALMOUTH ROAD/RTE 28 - Health (3) 95 Falmouth Rd. Cape Motors INC.
Hyannis
A = 311-073
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Date: b
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAMEOFBUSINESS: 61,�5 �����J 'L/C
BUSINESS LOCATION: c// ` �-✓���
MAILINGADDRESS: Mail To:
®� Board of Health
' TELEPHONE NUMBER: �� � � Town of Barnstable
CONTACT PERSON: P.O. Box 534
EMERGENCY CONTACT TELEPHONE NUMBER: � 731 Hyannis, MA 02601
TYPEOFBUSINESS:
Does your firm store any of the toxic or h rdous materials listed below, either for sale or for you own
use? YES NO
This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed
envelope for your convenience.
If you answered YES above, please indicate if the materials are stored at a site other than your mailing
address:
ADDRESS:
TELEPHONE:
LIST OF TOXIC AND HAZARDOUS MATERIALS
The Board of Health has determined that the following products exhibit toxic or hazardous character-
istics and must be registered regardless of volume. Please estimate the quantity beside the product that
you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS.
Quantity Quantity
Antifreeze(for gasoline or coolant systems) Drain cleaners
NEW USED Cesspool cleaners
Automatic transmission fluid Disinfectants
Engine and radiator flushes Road Salt (Halite)
Hydraulic fluid (including brake fluid) Refrigerants
Motor oils Pesticides
NEW USED (insecticides, herbicides, rodenticides)
Gasoline, Jet Fuel Photochemicals (Fixers)
Diesel fuel, kerosene, #2 heating oil NEW USED
Other petroleum products: grease, Photochemicals (Developer)
lubricants, gear oil NEW USED
Degreasers for engines and metal Printing ink
Degreasers for driveways & garages Wood preservatives (creosote)
Battery acid (electrolyte) Swimming pool chlorine
Rustproofers Lye or caustic soda
Car wash detergents Jewelry cleaners
Car waxes and polishes Leather dyes
Asphalt & roofing tar Fertilizers
Paints, varnishes, stains, dyes PCB's
Lacquer thinners Other chlorinated hydrocarbons,
NEW USED (inc. carbon tetrachloride)
Paint & varnish removers, deglossers Any other products with "poison" labels
Paint brush cleaners (including chloroform, formaldehyde,
Floor & furniture strippers r
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
(dry cleaners)
Other cleaning solvents
Bug and tar removers
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
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OFFICE TEL. 775-3700
PAGER: 1-617-546-1899
AFmaoe
otors Inc.
est 1936
DAVID BARDFIELD 95 FALMOUTH ROAD
PRINCIPAL HYANNIS, MA 02601
03PILL' WOE
TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
nters
BOARD OF HEALTH satisfactory 3.2.Auto Body Shops
Ounsatisfactory- 4.Manufacturers
COMPANY (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS Class: 7.Miscellaneous
��IIM- 16
QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors)
MAJOR MATEIALS 1Underground Tanks
IN OUTI IN OUT IN OUT #&gallons Age Test
Fuels:
Gasoline,Jet Fuel(A)
Diesel, Kerosene, #2 (B)
Heavy Oils:
waste motor oil (C)
IV
new motor oil (C)
transmission/hydraulic
Synthetic Organics:
degreasers
—q XYM 0t,
.Miscellaneous.' J
J
4<6 L, f4lk6 I 1 )z.
q)MAS(1_6t,(
DISPOSAIJRECLAMATION REMARKS:
1. Sanitary Sewage 2.Water Supply Cl.F/1 V1/( I �a-4 O7 (�41 k_s� t/V
A Z
O Town Sewer ublic 9 S ° r
0 On-site grivate C-4 ®
3. Indoor Floor Drains YES N0X 69
O Holding tank:MDC
O Catch basin/Dry well
O On-site system UZI 6 GA 6
4. Outdoor Surface drains:YES NO O DERS: a
0 Holding tank:MDC
O Catch basin/Dry well 4
O On-site system
5.Waste Transporter L�
Name of Hauler Destination te '
W=S ,
1.
2.
Perso s) In. er�iewed Inspecto at
TOWN OF B NSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
BOARD OF HEALTH satisfactory 2.Printers
3.Auto Body Shops
O unsatisfactory- 4.Manufacturers
COMPANY , Mtn (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS �� 44%o-� x Class: 7.Miscellaneous
QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors)
MAJOR MATERIALS Case lots Drums
IN OUT IN OUT IN OUT #&gallons Age Test
Fuels:
Gasoline,Jet Fuel (A)
Diesel, Kerosene, #2(B)
Heavy Oils:
waste motor oil (C)
a
new motor oil(C)
transmission/hydraulic
Synthetic Organics:
degreasers i
Miscellaneous:
DISPOSAURECLAMATION REMARKS:
1. Sanitary Sewage 2.Water Supply f4
Town Sewer ublicy
O On-site OPrivate
3. Indoor Floor Drains YES NO
Holding tank:MDC lee
O g
0 Catch basin/Dry well
O On-site system
4. Outdoor Surface drains:YES NO ORDERS:
0 Holding tank:MDC
O Catch basin/Dry well
O On-site system
5.Waste Transporter
Name of Hauler Destination Waste Product
_ YES NO
1.
2.
Z)azlllo
Person(s) I rviewed Inspector Date