HomeMy WebLinkAbout0332 IYANNOUGH ROAD/RTE 28 - Health 332 Iyannough Rd%Rte
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TOWN OF BARNSTABLE �
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY
NAME OF BUSINESS:— �IA/v Z 6-
BUSINESS LOCATION: -Z A14 NVIS INVENTORY
MAILING ADDRESS: 04S E TOTAL AMOUNT:
TELEPHONE NUMBER: 114 _ -7/
CONTACT PERSON: .Jf1RES 4-i'/AiS
EMERGENCY CONTACT TELEPHONE NUMBER:•J+,,4V4 x,/AfS 01-31ll-JLI V O MSDS ON SITE?
Av.4ic.agte v1
TYPE OF BUSINESS: Au?y 1-21+a7_S L Iqi I CS Coaou 7b A-"-
INFORMATION/RECOMMENDA IONS: ,(/6t�s:OA/e �G°Ore-b4Q"u ®1350e Fire D strlct�:
ExnA)C,yisNt7t P D*-7z0.5 DR t3so PEd1T A-V,+E-JLAALE 6J.s/R,
�i ll 7a �/ `/ �4 �
Vd9-J0/d MF ZA'e& s 14AIZ-XIAt- is Pos r!A�&AJ77, 4
PZ,�'xJ is Pa 57FD.
Waste T--at}---%* igR"A��ARo0o0/G30-3 Last shipment of hazardous waste: /d _
Name of Hauler- 54f L-cE Destination: SkGe-rY KLZ--5i0 UAdS9->d , R
Waste Product: 6ls"o d14. Licensed? es 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
33 NEW USED Cesspool cleaners
Automatic transmission fluid Disinfectants
Engine and radiator flushes Road Salts (He#t ) a77 PCvAf6s
Hydraulic fluid (including brake fluid) Refrigerants
Motor Oils Pesticides
°�j NEW /7O USED (insecticides, herbicides, rodenticides)
Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers)
Diesel Fuel, kerosene, #2 heating oil NEW USED
/17 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 399'5A Swimming pool chlorine
�'�. 0A/.S/7r Ar A S
Battery acid (electrolyte)/Batteri c7.*u.oais kcw Lye or caustic soda
P, 13A H05T caht'eus;tgc�S
Rustproofers Misc. Combustible L-15T�'7) .-s a/L/
Car wash detergents Leather dyes h"Ah"7Vc t�`{
S/7120�
Car waxes and polishes Fertilizers
Asphalt & roofing tar p,�� , cF PCB's
/�fAIT/S -
Paints, varnishes, stains, dye �i�V; Other chlorinated hydrocarbons,
Lacquer thinners sP�fr ` (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 -rDXIC (�� ►.�'rS Sla�4l latJS
(including bleach) 13tG ���,tp��—���C �►�-t2S I ���i � '��
Spot removers &cleaning fluids tM l S L STD F-W I b A-D A i n VrS /77?-&- k-THM- TS 1
(dry cleaners) D6
Other cleaning solvents
Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
3 3 � ?`'Zl - �3 - �,� tom✓ 3���ti�.GLvw�
1 _ _
OIL 'WASTE Of) OIL FILTERS AN T-FREEZE. WASTE
ANITFREEZE
N
GASOLTNE WASTE GAS DIESEL FUEL WAY FLUID ATF
l
HYDRAULIC/ misc. MISc. MISC. MISC.
BRAKE FLUID COMMBUSTIBLE FLAMMABLE RIB IVE PETROLEUM
AR-49W GREASE/
UB ICAT�
t � Z
FREON ACETYLENE CAR WAS
I3[ CAR WASTI p Tg/
WAX DETERGENTS THINNERS
SEALANT CLEANING BATTERIES/ POISION/TOXIC CAULK/GROUT
SOLVENTS BATTERY
OV/ ACID
FERTALIZERS WASTE SOLVENT BLEACH DISH WASH AND MSDS
DETERGENTS
�Z7 ;
MANIFESTS
93
SP/wl�ii- Srx &177k)C csxl
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Please print or type,(Form designed for use on elite(121*ch)typewriter.)
UNIFORM HAZARDOUS t Gerreretor ID Number 2 P 1 of 3.EForm Approved.OMB No.2050-W39
WASTE fiMANIFEST MAR00001630,iy Response Phone Yen /T�mclrinp Nrnnbw
5.Ger>arator a Mama and MaiWrg Address 1 �11 ;1:
R 17�►V I } CEX
AUTOZONE: # 316U SiteAddress(ifdiflerentme maiBngaddress)
33;' ROUTE 38
HY0041, MA 00). 2037
cmtors Plane: 508-7"1-?3"l
6.Transperier 1 Comps Name
SAi F T 1-hLErh SYSTEMS, INC. U.S.EPA IDNhlrrbr TXRO00Cl!;0g30
7.Trensperter 2 Company Name
U.S.EPA ID Number
6.Designated Facility Name and Site Address
SAFETY-I(LSTR SYSTEMS, INC, f}4Cl�{c� U.S.EPA IDNumbert
16'7 MILL STRtF°
(;RA�PB Tghi R t o?Yasa
R1
401'-181-•0801t 008480284;?
Fed.'s Phone:
ga. 9b.U.S.DOT Desg9Q5on(including Proper Shipping Name,Hazard Class,tD Number, 10.Containers
HM and g Group(if any)) 11.Total 12.Unit 13.Waste Codes
MAW.1 No. Type Quantity 1J�s=.O OIL (MADEP MA9U - (OFF SPEC'.. } 1 TY (, !'1A9'C� R0!;w:;T U9001' HAZARDOUS MATER.14L)
� 2
3.
4.
14.SpecialHarndlirhglnstrucgoresandAdditiomaflntormeC Sk TRCK0110913520 '0039884'164 000950285'e 0?41. .f 4
Sk IT .7_ t _ : 398540 EN f'
15. GENERATOW1110FFEROR'S CERTIFICATM: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packa*,
mwlhed and lebeled/ptacarded,and are in all respects In proper condlton for transport according to applic"international and national governmental regulations.If export shipment and i am the primary
Exporter,I oertity that the contents of this consignment conform to the Mmhs of the attached EPA AclwaA4gment of Consent.
I cartify that the woo minimization statement iderNNted in 40 CFR 262.27(a)(if I am a large We"generator)or(b)(f I am a small quantity generator)is true.
Generatoes'OHeroes PrkWffyped Name ' nature Monhn Day Year
16.In*nabonal Shipments n _
iJ Ir�rt to U.S. ❑Export from U.S. Port of entry/exit
Transporter signature(for exports orrly): Date leaving U.S.:
17.Transporter Acknowledgment of Receipt of Materials
Trensporter 1 PrinteCyped Name Signedxe Month Day Yeer
Trio Month
2 PrinEsd/Typad. natuib' nth Day Year
1 a.DrAepenky
18a.Discrepancy Mndicabcrh Space ❑ Qh"tity ❑Type ❑Residue Partial Rejection �NO RejekAoh
Manifest Reference Number:
18b.Ahemate Fadlity(or Generator) U.S.EPA ID Number
Fadlity's Phone:
1 k.%natwe.of Alternate Fad*(or Generator) Month. Day Year
f 9.HBLardCUS Waste Repot Ihanag tad Codas(i.e.,codes for hazardous waste troa rner+t.disposal,and racyding systems)
1 2.
3 a.
Operator.Certification of receipt of hazardous materials covered by the manifest except as noted in hem 16e Month y ear
20 Desgnated Facilityl)wner w C>pera tore
nn GStJERATOR'S INITIAL COPY
cow c at&221Rev.3-05) Previous editions are obsolete. 4
Town of Barnstable
oFtHe tqw Regulatory Services
Thomas F. Geiler,Director
Public Health Division
* BARNSTABLE, * Thomas McKean,Director
MASS. $ 200 Main Street f,
ArFD MA'1 A�
Phone: 508-862-4644
Email: health@town.bamstable.ma.us
Fax: 508-790-6304
Office Hours: M-F 8:00—4:30
May 1, 2007
Mr. Dan Freda
Auto Zone
332 Iyannough Road
Hyannis,MA 02601
Dear Mr. Freda:
Thank you for your time and cooperation during the hazardous matchals inventory and site visit
at Auto Zone on April 3,2007. 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 Toxic and Hazardous Materials On-Site Inventory form from the site
visit, Chapter 108: Hazardous Materials Code and an application for the hazardous materials
permit for 2007-2008. Please note the observations identified at your place of business during the
hazardous materials inspection listed below:
OBSERVATIONS:
• The annual Hazardous Materials Permit has not been obtained. Please obtain the Permit
for 2007-2008 by filling out the enclosed application and sending it to the address noted.
This permit will expire on June 30, 2008. Please ensure we receive a payment and
application for the 2007-2008 permit by July 1, 2007.
• Waste oil tank is properly labeled.
• Fire extinguishers are serviced.
On Site Inventory Total
The Toxic and Hazardous Materials On-Site Inventory from April 3, 2007 shows that you have
approximately 3557 gallons of toxic and hazardous materials being used, stored, generated and
disposed of at Auto Zone, 332 Iyannough Road,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.
t
Sincerely,
I
Alisha L. Parker
Hazardous Materials Specialist
All orders to correct violations of Chapter 108 of the Town of Barnstable Ordinance:Hazardous
Materials shall be comple upon receipt of this letter.
omas A. McKean, S.
CHO
Director of Public Health
Cc: Auto Zone Home Office
Enc. On-Site Inventoryco
(copy)
Application
Chapter 108: Hazardous Materials
•.-� .� �/� / �
TOWN OF BARNSTABLE
Date:
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY
011j7)
NAME OF BUSINESS: 7,c u - -
BUSINESS LOCATION: • / INVENTORY
MAILING ADDRESS: INA 02:501 TOTAL AMOUNT:
TELEPHONE NUMBER:
CONTACT PERSON: II
EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE?
TYPE OF BUSINESS:
INFORMATION/RECOMMENDATIONS:xa�i-i)I. -i-y1 6.1IM'd nlIS Fire District:
1 � . Y L ► _ �� ,r/ Mb
I ALA 9,ff iIA',' _ 0i, , aMh 01
Waste Transportation: Last shipment of hazardous,waste:
Name of Hauler.• 1✓ Destination,
Waste Product: License 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
xiNEW
, iNEW 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,
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)
Spot removers &cleaning fluids
(dry cleaners)
Other cleaning solvents
Bug and tar removers
EVEWindshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
r"E ov'1
OIL ATE OIL OIL FILTERS ANTIFREEZE WASTE
J l8 ZOO tQ t�i- t�b 18 ANITFREEZE
-fNt- 1►► � � � C�
��.
pµ,CE WASTE GAS DIESEL FUEL W/W FLUID'V4 ATF
11
x� ►
30
of
HYDRAULIC/ MISC. MISC. MISC. MISC.
BRAKE FLUID COMMBUSTIBLE FLAMMABLE CORROSIVE PETROLEUM
dl1C jj,u�� �jj1 11L[�oy1 / (GEAR OIL/GREASE
LUBRICANTS)
49
FREO ACETYLE CAR WAS$ CAR WASH PAINTS/
WAX DETERGENTS i�T�HINNERS
I I 0
SEALANT CLEANING BATTERIES �PL+)1ibSf0%*f4H4-0-X+e CAULK/GROUT
SOLVENTS BATTERY q L� )
ACIDtD''''''
FERTALIZERS WASTE OLVENT q� DISH WASH AND MSDS
I DETERGENTS C �-��`"vo
MANIFESTS i,eD
Id-f/�
4flt ii `
i
TOWN,OF BARNSTABLE COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair
nters
BOARD OFF HEALTH satisfactory g.A to Body Shops
unsatisfactory- 4.Manufacturers
C MPANYI�- (� O (see"Orders") 5.Retail Stores
�( 6. Fuel Suppliers
ADDRESS C —.S Z ass: 7. Miscellaneous
M4 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:
DISPOSALIRE;LAMATION REMARKS:
1. Sanitary Sewage 2.Water Supply 1
`V Town Sewer oPublic t1
O On-site OPrivate
3. Indoor Floor Drains YES N0�"l �--
O Holding tank:MDC
O Catch basin/Dry well Vf _ i
O On-site system
4. Outdoor Surface drains:YES N0� ORDER S O -Q- ��.
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
5.Waste Transporter
Name of Hauler Destination Waste Product Licensed?,
2.
Person(s) Interviewed vInspector a e
22
•P _ 3 Zg �7Z
TOWN OF BARNSTABLE COMPLIANCE: CL ne;Gas Stations,Repair
satisfactory 2.Printers
BOARD OF HEALTH 3.Auto Body Shops _
n 0 unsatisfactory- 4.Manufacturers
COMPANY �4�Q(�1� (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS a lass:
S 7.Miscellaneous
f QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors)
MAJOR MAT MATERIALS Case lots Drums Above 1anks 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) 7 x
new motor oil(C)
transmission/hydraulic �
Synthetic Organics:
degreasers
a4i* isce eous:
.w
q i.4s
�f v
`-90 r ~
DISPOSALJREC;LAMATION REMARKS:
1. Sanitary Sewage 2.Water Supply 071t
O Town Sewer ublic
AOn-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:YES2!�__NO
O Holding tank:MDC
Catch basin/Dry well
O On-site system
5.Waste Transporter
Name of Hauler Destination Waste Product
YES NO
1. Y6&v-
2.
Ak
erson(s) Interviewed Inspector Date
tA"
/(7
TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
satisfactory 2.Printers
BOARD OF HEALTH 3.Auto Body Shops
rr9' ass:
2ee
tisfactory- 4.Manufacturers
COMPANY k "Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS �- 7.Miscellaneous
;ViQUANTITIES AND STORAGE (IN=indoors;OUT=outdoors)
M MAJOR MATE LS Case lots Drums Above Tanks Underground
I JOUT IN OUTI IN OUT I#&gallons Age Test
Fuels:
Gasoline,Jet Fuel(A)
Diesel, Kerosene, #2 (B)
Heavy Oils: I
waste motor oil (C)
new motor oil(C)
transmission/hydraulic
Synthetic Organics:
degreasers
Miscellaneous:
0 `> 9 1�
I ILL I I I
DISPOSAURE TION REMARKS: �I� •
1. Sanitary Sewage 2.Water Supply (Allyf 4) ta4 "�
O Town Sewer ublic 6 " r tl. aaw
�On-site OPrivate
3. Indoor Floor Drains YES - N04
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
4. Outdoor Surface drains:YES--KN0 O ERS:
O Holding tank:MDC A4
Catch basin/Dry well ale On-site system `�
5.Waste Transporter
Name of Hauler Destination Waste Product
YES NO
1.
2.
Person(s) Interviewed Inspector ate
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
Mail To:
NAME OF BUSINESS: n��r �� 52 iRP -�}- CRV- Board of Health
MAILING ADDRESS: 3 Z' J-\tn►vn$k R u— nmj� AA 0101 Town of Barnstable
TELEPHONE NUMBER: r779 -'-I,-
ao P.O. Box 534
--�
CONTACT PERSON: �aS2pt� �Se.n9S4-ur't-nL Hyannis, MA 02601
Does your firm store any of the toxic or hazardous materials listed below, either for sale or for
your own use, in quantities tota ' g, at any time, more than 50 gallons liquid volume or 25 pounds dry
weight? 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
characteristics and must be registered
lease put a check beside each product that you store:
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
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)
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
E
TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,IYepair
satisfactory 2. Printers
BOARD OF HEALTH 3.Auto Body Shops
0 unsatisfactory- 4.Manufacturers
COMPANY V z, (see"Orders") 5.Retail Stores
� Fuel Suppliers
ADDRESS �,. L Class: < Fuel Suppliers
Miscellaneous
_ IES AND STORAGE (IN= indoors;OUT=outdoors)
MAJOR MAT IALS ,
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:
DISPOSAURECI AMATION REMARKS:
1. Sanitary Sewage 2. ater Supply
Mown Sewer Public l .
0 On-site OPrivate
3. Indoor Floor Drains YES NO
0 Holding tank:MDC
0 Catch basin/Dry well
0 On-site system ,
4. Outdoor Surface drains:YES___NO ORD RS:
0 Holding tank:MDC
O Catch basin/Dry well
0 On-site system
5.Waste Transporter
Mime of Hauler Destination Waste Product
1. YES NO
2.
Person (s) Interviewed ns ector / Date
TOWN OF BARNSTABLE C MPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
satisfactory 2.Printers i
BOARD OF HEALTH 3.Auto Body Shops
J unsatisfactory- 4.Manufacturers
COMPANY^ d (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS ! — lass• 7.Miscellaneous
jRjqANTITIES AND STORAGE (IN= indoors;OUT=outdoors)
MAJOR MATERIALS 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
Miscellaneous:
DISPOSAI./RECLAMATION REMARKS:
1. Sanitary Sewage 2.W ter Supply
Town Sewer Public
O On-site OPrivate
G -
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: rs-
O Holding tank:MDC
O Catch basin/Dry well
O On-site system C
5.Waste Transporter
N�ftne of Hauler Destination Waste Product
.. YES NO
A zvz/ 4&tli�e
2.
Person s) Interviewed Inspector' Date
;3`� AfIV-1 Ale,
J
�j
TOWNrOF BARNSTABLE jCOMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
BOARD,,. satisfactory 2.Printers
OF HEALTH 3.Auto Body Shops
unsatisfactory- 4.Manufacturer`s o
COMPANY (see"Orders") 5.Retail Stores
��}},, 6.Fuel Suppliers
ADDRESS 1� %�$ & "Class: 7.Miscellaneous
UANTITIES AND STORAGE (IN= indoors;OUT=outdoors)
MAJOR MATER►LS Case lots L)rums Above Tanks Underground Tanks
IN OUT IN OUT IN OUT #&gallons Age Test
Fuels:
—Gasolirre JetFuel=(A- •--
"Diesel;K&rosen,e;#-2-(&)--'
-. -Heavy Oils: /
waste motor oil(C) ✓J�
new motor oil(C) Fj
transmission/hydraulic
Synthetic Organics: 41
degreasers
rV
� .
Miscellaneous:
. 0
CIO:)
6 - 0
A rald
DISPOSAIJAECLAMATION REMARKS:
1. S Mary Sewage�� 2.�W,�ter Supply �
Town Sewer c0'Public
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:
O'Holding:tank:MDC
O Catch basin/Dry well 92
O On-site system
5.Waste Transporter
ProductName of Hauler Destination Waste
w YES NO
2. J
Person(s) Interviewed Inspector Date
TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,-Repair
satisfactory 2.Printers
BOARD OF HEALTH 3.Auto Body Shops
unsatisfactory- 4.Manufacturers w.
COMPANY A U �' O (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS 7.Miscellaneous
�` .t,, �Q ANTITIES AND STORAGE (IN=indoors;OUT=outdoors)
MAJOR MATERkS Case lots Drums Above Tanks Underground Tanks
b IN OUT IN OUTI IN OUT #&gallons Age Test
Fuels: i
Gasoline Jet Fuel (A)
j
Diesel, Kerosene, #2 (B)
Heavy Oils:
waste motor oil (C)
new motor oil (C)
transmission/hydraulic
Synthetic Organics: z
degreasers
s
Mi cells ous
or
j
DISPOSALIRECLAMATION REMARKS:
1. Sani4ry Sewage 2.Water/supply
O Town�,Sewer OPublic ✓'
Q On-site OP..r'ivate
3. Indoor Floor Drains YES NO
i O Holding tanks MDC��`
O Catch basin/D�:y well
O On-site system
f\ ,
4. Outdoor Surface drains:YES NO ORDERS.
Q Holding tank;,DC
O Catch basin/Dry well
O On-site'system
5.Waste Transporter
Nifnie of Hauler Destination Waste i
Product
YES N0
1.
.17
2. f
.�. 47--
Person(s) Interviewed Inspector Date
TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Rep r
2.Printers
satisfactory
BOARD OF HEALTH 3.Auto Body Shops
unsatisfactory- 4.Manufacturers
COMPANY �014 �QQ O (see"Orders") 5.Retail Stores
�/ 6.Fuel Suppliers
ADDRESS 3?Z tti.� C18sS' J 7.Miscellaneous
OWVAWO 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: Z7 0 YL
waste motor oil (C)
c&K 4.
new motor oil(C)
transmission/hydraulic
Synthetic Organics:
degreasers
Miscellaneous: C�
Al 1 iev W pov,0 t w�
►-w i o
DISPOSAIJRECI AMATION REMARKS:
1. anitary Sewage 2.Water Supply S -3 r�f S i/�j 1 f� t rf�icq
Town Sewer Public �a 6 ��� 73 Q ,
O On-site OPrivate
>s,;�abvd�
3. Indoor Floor Drains YES NO
O Holding tank: MDC at,u A&4 o-,&t r,et y°C(r' d C/r/ • ✓;e.c
O Catch basin/Dry well /4 S� o�-�'I 4e Q�C Gz�e,✓ �•�v eu ern
O On-site system A,u St;&t o
4. Outdoor Surface drains:YES-A'NO ORDERS:
O Holding tank:MDC
O Catch basin/Dry well
On-site system
5.Waste Transporter
Name of Hauler Destination Waste Product
1. Cil '� 3/� io Y et/��iv�y � No
2.
9Q
Person (s) Interviewed Inspect6r Date
AaA--v Q Ol,)e9.
\OI1��44I,1:
L ETIME
WARRANTY
I / Thousands of parts
® guaranteed for as long
as you own your car.
I NAM & 0I L,�CArV-, PHONE
TOWN OF BARNSTABLE fsatisfactory
MPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
2.Printers
BOARD OF HEALTH 3.Auto Body Shops
pp /� unsatisfactory- 4.Manufacturers r
COMPANY�stly 6�L� � ' (see"Orders") 5.Retail Stores Ir
6.Fuel Suppliers
ADDRESS Class: 7.Miscellaneous
QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors)
MAJOR MAT IALS
IN OUT IN OUT IN OUT #&gallons Age Test
Fuels:
Gasoline,Jet Fuel (A)
L��Itxf4v
Diesel, Kerosene, #2(B)
Heavy Oils:
waste motor oil (C)
new motor oil( )
transmission/hydraulic
Synthetic Organics:
degreasers
gcaneous:
�
G
DISPOSAVRECLAMATION REMARKS:
1. Sanitary Sewage 2.Water Supply
O Town Sewer ublic �
O On-site Private
3.Indoor Floor Drains YES NOZ
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
4. Outdoor Surface drains:YES NO ORDERS:
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
5.Waste Transporter
YES NO
r
Person(s) Interviewed Inspector Date