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0332 IYANNOUGH ROAD/RTE 28 - Health
332 Iyannough Rd%Rte _ Hyannis A = 328 - 072 I i A Date: ///Ax¢/�o 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 n o •, L' C� 1 `h 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 0-7 lf-TI 32 g br7, °p IKE roKti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMASS. $! 200 Main Street• Hyannis, MA 02601 �prFOMP+a`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT 3 Business Name: Date: NurlA Location/Mailing Address: 14dwo.4% 2 ko fte Contact Name/Phone: c 0 - 3 Inventory Total Amount: MSDS: UP n License#: `80 Tier II : AJO Labeling: J Spill Plan 0044 Oil/WaterSeparator: Floor Drains: �� Emergency Numbers: `9 Storage Areas/Tanks: Emergency/Containment Equipment: aste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: I� Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS 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 requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives (creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: W4 J04 di b , INFORMATION/RECOMMENDATIONS: j. u , r- y 1 Inspector:' Facility Representative: ' WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS w Pi�s�r Town of Barnstable Office:508-862-4644 Public Health Division '� Q Fax:508-790-6304 BARMA�RLE.$' i 200 Main Street• Hyannis, MA 02601 32—U �-0/j 2 aYb tbS9• `0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT V PrFO MP'�e Business Name: .-Aubaont # 516o Date: 3 »01 Location/Mailing Address: To XSWAIM0- - r e V&j Contact Name/Phone: �� 7� Inventory Total Amount: `�� MSDS: License#: 13 AD Tier II : Labeling: Spill Plan:(AdOil/WaterSeparator: Floor Drains: Emergency Numbers: Storage Areas/Tanks: A I Emergency/Containment Equipment: Waste Generator ID: Maf 00OW361Ili Waste Product: Coyrost of Date&Amount of Last Shipment/Frequency: 6 1 011 Licensed Waste Hauler&Destination: aen Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS 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 requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers V/Hydraulic fluid (including brake fluid) Windshield wash 1/ Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil y/ Disinfectants Miscellaneous petroleum products: Road salts / grease, lubricants, gear oil Refrigerants %L Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible �L Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INF RMATION/RECOMMENDATIONS: no reconAgaddRi Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number Fee 1179 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that ENTERPRISE RENT-A-CAR --.... ........................ -- ••------ ---•----- ---....--------....---- ------ ........ 1 332 IYANNOUGH ROAD (RT 28), HYANNIS, MA .----••--------------------------------------------------------•--..........--------••-------------------....--------••-•--------...--------------------•--------------- Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. ------------- --------------------------------------------------------------------------------••----------...----------••--------....-----------------...••-•------- Restrictions: .---------•---------------•-•-------•-------------.....---------------........--------....--------------------••----------...-------------•--....------ ...... This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN, R.S.,CHO Director of Public Health • 7 l� Town of Barnstable Inspectional Services BARNS LE pF F N:TA%E•(EtRFlV U_CONR-11—Is Public Health Division ""�1639-202'4 � e 1639-2014 BARN LY� 1 Thomas McKean, Director KANKto c 39. 200 Main Street, Hyannis,MA 02601 S Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS, IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 � � (G� - CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ OC�a i *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 3 D-g 2. IS THIS A PERMIT RENEWAL? I/ YES NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. ^ 4. FULL NAME OF APPLICANT:_ 5. NAME OF ESTABLISHMENT :U' p 1 _I � o� Sron, LL C � w 6. ADDRESS OF ESTABLISHMENT: 3 3 2 (1CLYIn%)vq V1 '-d 9-V Z N\4 Ck'nr>3 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 4b5 VJ•e s-� yJ-S t pZ3"1 Cl 8. TELEPHONE NUMBER OF ESTABLISHMENT: S C S 7 `7 9. EMAIL ADDRESS: o V,6 1 (5? eh 1 , C z VV) 10. SOLEOWNER: YES V NO IF NO,NAME OF PARTNER: &rn ! v i LLC 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME 6n1CirM n SC ptn+ - (4- - C W C M OaM 0 &MA u C PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: • SIGNATURE OF APPLICANT C jo.0 DATE Q\Application Forms\Haz Mat Appli Draft Jan20l9.docx `°F�Me royti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMA-1Z . • 200 Main Street• Hyannis, MA 02601 16,59. - ptEDMP TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: s Date: 0 / Location/Mailing Address: Contact Name/Phone: Inventory Total Amount: SDS: �J—0 License#: Tier II Alh Labeling: eS Spill Plan: Oil/Water Separator: t Floor Drains: Emergency Numbers: Storage Areas/Tanks: 613 fl aAlf-, V Ol Emergency/Containment Equipment: Waste Generator ID: Waste Product: �( h Date&Amount of Last Shipment/Frequency: Af Licensed Waste Hauler&Destination: C0-V0,VCA 1.ick5je fKAngae11nC/1� Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS 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 requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils V Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout q5 4 J- *Iv insecticides, herbicides, rodenticides Battery acid (electrolyte) atteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: no Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number Fee 1179 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that ENTERPRISE RENT-A-CAR 332IYANNOUGHROAD (RT28), HYANNIS, NIA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. ------------------------------------------------------------------------------------------------------------------------------------ ---------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2020 unless sooner suspended or revoked. -------------------- ------------------- PAUL J.CANNIFF, D.M.D,CHAIRMAN DONALD A.GUADAGNOLI, M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health Town of Barnstable I KKE Inspectional Services BARNSTABLE O Public Health Division • BARNSTABLE, Thomas McKean, Director MASS. 1639. co a 200 Main Street, Hyannis, MA 02601 0 Office: 508-862-4644 Fax: 508-790-6304'-' X 0 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS, ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY I st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: El CATEGORY 2 PERMIT 111 —499 Gallons: _$125.00--% AVS1 c1h CATEGORY 3 PERMIT 500 or more Gallons: _Sr5ttft� El *A late charge of$10.00.will be assessed if payment is not received by July 1st. 600DI 44 a0o,�_ 1. ASSESSOR'S MAP AND PARCEL NO. 3 a B- 2. IS THIS A PERMIT RENEWAL? \/ YES NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. • 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS (IF DIFFER-ENT FROM ABOVE: "A 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: S ' pn 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME, HOME AD SS, AND TELEPHONE # OF: CORPORATION NAME k, PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE COMPANY ADDRESS EMAIL: *SIGNATURE OF APPLICANT DATE Q:\Application Forms\llaz Mat App Revised 09-0)-18.do)cx Number Fee 1179 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that ENTERPRISE RENT-A-CAR 332 IYANNOUGH ROAD (RT 28), HYANNIS, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. ------------------------------------------------------ ------------------------------------------ -------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2019 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2018 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health r ' Iowa of Unstable �s leg- atory emces Richard V. Scali, Director �t�' G� I u0(q Public Health Division BARNSTABLE `A r BARNSTABLE, Thomas McKean, earvsrnelerrtennue•mrun•rvranrs r� MA6$, A 7 Director 1639-2014 -- -- — -- — 1639 �0 —— -- — — — — — — -- �ED MAr A 200 Main Street,-Hpanrus;MA 02G01---- ---- ---,"-.-"-- �7_5- ------ -_-�; . Office: 508-862-4644 Fax: 508-790-6304 , APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS t.�a 1N ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st-JUNE 3 Oth). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 g (/S CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL N .� �_S�� I ��� 2. IS THIS A PERMIT RENEWAL? YES_NO. IF YES,SHIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF • GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4., FULL NAME OF APPLICANT:,�ny,f. o � � L^` f-C " 17- r pyn w , ' �S\-C l 5. NAME OF ESTABLISHMENT: - C, 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: via - _� M"11S 9. EMAIL ADDRESS: o& � 10. SOLEOWNER: J YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PLC PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: i COMPANY ADDRESS EMAIL: • SIGNATURE OF APPLICANT DATE b Q:Wpplication FormsOAZMAT APP 2017 REVIS4. bcxa�i k A� Number Fee 1179 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that ENTERPRISE RENT-A-CAR 332 IYANNO UGH ROAD (RT28), HYANNIS, MA Is Hereby Granted a License W For: Storing or Handling 111 - 499 gallons of Hazardous Materials. --------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2018 unless sooner suspended or revoked. --------------------------------------- PAUL J.CANNIFF, D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health I ' Roof Bagnstable egu atory ervlces tKME Richard V. Scah,Director r� Public Health Division BARNSTABLE + eaaxs;wuansic.caxvtrnaivbs_ Thomas McKean,Director ;� ;4F`"`"s + BARNSTABLE, + S��(y 9� tQ f MASS.. �0� cA�sl 0 prfD MAr s 200 Main Street,Hyannis,MA 02601 , b� Office: 508-862-4644 Fax: 508-790-6304 r- APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE '`m} HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ l9. CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ $IO La - *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 328/072 2. IS THIS A PERMIT RENEWAL? X YES_NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS • ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: Enterprise Rent-A-Car Company of Boston,LLC 5. NAME OF ESTABLISHMENT: Enterprise Rent-A-Car 6. ADDRESS OF ESTABLISHMENT: 332 Iyannough Road 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 405 West Street,West Bridgewater MA 02379 c/o Doug Valeri 8. TELEPHONE NUMBER OF ESTABLISHMENT: 508-778-2205 9. EMAIL ADDRESS: douglas.p.valeri@ehi.com 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME Enterprise Rent-A-Car Company of Boston,LLC PRESIDENT Brian Duffy TREASURER William Lazzarino CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT �' DATE 8/21/2017 C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.0utlook\BMQD49H2\HAZMAT APP 2017 REVISED.docx Number Fee 1359 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Floors + Walls Inc. .•••••••••••••••..............•••••••••••••••••••......••-••••••••••••••...•••••••••......•••••.................................. 332 Iyannough Road, Hyannis, MA ....-•••••••••••-••••••••••••••••••••••-••••••••••...•••••••••••••••.......••-••••....••••••••••••.......••••••••••.............•-•••••••......••••..................... Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. ••••••••••••••...................................................................................................................................................... Restrictions: ........•••-•••••••--•••••••••••••••....-•••••••••......••••••••••••........••••••••••.....••••••••••••.....•••••••••••........••••••............................... This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2022 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 04/06/2021 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN, R.S.,CHO Director of Public Health r c— ar Town of Barnstable Inspectional Services BARNSTABI,E of t r Public Health Division fi0.+5?WiS N.LLS•OSIERVILL=•MI[sl 0?IL4i4&E 1639-2C14 r Thomas McKean, Director MAM 1659. n59,,E s`� 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 ChV-0 2 V64 CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 3� _ 0-4-2L 2. IS THIS A PERMIT RENEWAL? YES ENO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONINGBUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGF/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? ✓YES - NO. 4. FULL NAME OF APPLICANT: (.1` c4d ZG h rr n • 5. NAME OF ESTABLISHMENT: F iC qrs 4- W G I Is ZN L 6. ADDRESS OF ESTABLISHMENT: 33a �-f Gnn cly0h - Hjcinn, rn�- Ga&o 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: J0? - 5 9. EMAIL ADDRESS: 6(-d1SU(-p4Ce P F toorS c.AiG115' COK,- 10. SOLEOWNER: ZYES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME Rwc S +'W G l I S 1, - C PRESIDENTwid G _ G0- TREASURER ci Zt� Cn CLERK �ln.►c� 7 �N 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: *SIGNATURE OF APPLICANT -- DATE �?�11 2_ �j Q:\Application Forms\Haz Mat App Revised 09-10-18.docx Number Fee 1120 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that IDEAL FLOOR COVERING .-------------------------------------------------------------------------------------------------------------------------------- 332 IYANNOUGH ROAD I RT 28, HYANNIS, MA .----------------------------------------------------------------------------------------------------------------------------------------------------------------------- Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. ------------- ------------------------------------------------------------------------------------------------------------------------------------------------------ Restrictions: .------------------------------------------------------------------------------------------------------------------------------------------------------------------. This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health y Town of Barnstable Inspectional Services BARNSTABLE Public Health Division flFRNSTABtE•E'6ONR•MYARNIS 'UiS.CNS N'll5• 5'EMLLc•CFSi 6A0.YST.4&.E 639-20139-1014; • fig a 1 BAM Thomas McKean, Director 0 339. s`� 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 50§=790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st—NNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 rlvsT- C.h'� CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. �fOS 1. ASSESSOR'S MAP AND PARCEL NO. / 2. IS THIS A PERMIT RENEWAL? 4/ YES NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONINGBUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. • 4. FULL NAME OF APPLICANT:. /77C-0S'S L C 5. NAME OF ESTABLISHMENT: ���"� �0,-z- Cr/�-e,,—z J G' 6. ADDRESS OF ESTABLISHMENT: Nyv-a `"y 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: -j�� -?,g r 9. EMAIL ADDRESS: �� RYA 6 ,J d49Ar lrb0fZ 10. SOLEOWNER:DYES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT /'�--__� AOD TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: • SIGNATURE OF APPLICANT DATE Q:\Application Forms\Haz Mat Appli Draft Jan2019. ocx Number Fee 1120 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that IDEAL FLOOR COVERING 332 IYANNO UGH ROAD (RT 28), HYANNIS, ALL Is Hereby Granted a License For: Storing or Handling 111 -499 gallons of Hazardous Materials. ------------------------------------------------------------------------------------------------------------------------------------ ---- ----------------------- --------------------------------- ----------------------------------------------- ---------------------------------------------------------------------- -------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2020 unless sooner suspended or revoked. ---------------------------- P-AUL J.CANNIFF, D.M.D,CHAIRMAN DONALD A.GUADAGNOLI, M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health m Town of Barnstable Inspectional Services BABSTABLE Public Health Division 1139_--2074 i M GU Thomas McKean, Director prEo5.�a`` 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 >m� APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE , HAZARDOUS MATERIALS '•�` IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st—JUNE 3 Oth). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 x V sj j CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ (�" *A late charge of$10.00 will be assessed if payment is not received by Jules 1. ASSESSOR'S MAP AND PARCEL NO. (30?8- 0:�' 2. IS THIS A PERMIT RENEWAL? v YES_NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: m61 sl4 LL C 5. NAME OF ESTABLISHMENT: ���� �- FL�2. (df1E/21A) G 6. ADDRESS OF ESTABLISHMENT: 33� � �I'�i11 p U(� Ft QU►A ( �(-pNn n-N 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE:8. TELEPHONE NUMBER OF ESTABLISHMENT: S—d 7' !n 90 9. EMAIL ADDRESS: PA J7YJ3 @, d eA tICLD o(Z, CCe►-• 10. SOLEOWNER: A-YES_NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT M pre K wo 0 6 S TREASURER CLERK I 12. IF PREPARED BY OUTSIDE PARTY: I NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT AN A ,, DATE Q:\Application Forms\Haz Mat App Revised 09-10-18.d x • �1 Number Fee 1120 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that IDEAL FLOOR COVERING 332 IYANNOUGH ROAD (RT 28), HYANNIS, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. --------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2019 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2018 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health r _ Voengatoryof Bqrristable Services TFIE Richard V. Scali,Director . OF Tp� Public Health Division BARNSTABLE MMSTMARKABLE. eawsTe •ar .mrurt•wu ms Thomas Mcgean, Director i�=0 4� " PrE1 659. e`� 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 V,$ . CATEGORY 3 PERMIT 500 or more Gallons: $150.00 *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? ✓/YES_NO. IF YES,SHIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGEIUSE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: ��Ia S S , &L c a 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: 3 3 - ZyoA ANn10;-) G F/ /0,19Z 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: j ,f : 2 it) 9. EMAIL ADDRESS: 77 yA-cd) 10. SOLEOWNER: )( YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME -- PRESIDENT _ 17)0ge- . 1000)� .f TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT TE ,Sad QAApplication Forms\HAZMAT APP 2017 REVISED.do" INE r° Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • snRMASSBLE.9` 200 Main Street• Hyannis, MA 02601 039. �"reO MA'�p`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Zw4er ,,se- Date: f �� t•7 Location/Mailing Address: Contact Name/Phone: Inventory Total Amount: MSDS: 61t, vim- ' -�°� License#: 1-7 � '�xQ• Tier 11 : )n Labeling: ©.K Spill Plan: M Ly erv- �14KV, Oil/Water Separator: �I�S Floor Drains: Aeov., Emergency Numbers: V Storage Areas/7anks: I � , .� j�,cl�-iatv5� doC�c2o•�ka2oo<s wo Cow}a,hwwn,�-7 Emergency/Containment Equipment: OW Waste Generator ID: Waste Product: C� Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: r1A Other Waste Disposal Methods: e01 �of LIST OF TOXIC AND HAZARDOUS MATERIALS 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 requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) 1\o Windshield wash 1.�5`5e Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil 1— Disinfectants 3 Miscellaneous petroleum products: Road salts Z56 f b grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) _ Car wash detergents k q Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil&stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: 00,.Z"A S ORDERS: oS k IM5p5 SW INFORMATION/RECOMMENDATIONS: �, t•� a Inspector: Facility Represent WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS TOWN OF BARNSTABLE BAR-W Ordinance or Regulation WARNING NOTICE .yam i p Name of Offender/Manager 0yL, t.,.�6 ;5 Address of Offender MV/MB Reg.# Village/State/Zip Business Name irq am//pm, on Ohg 201-7- Business Address t '� E n yf ..ra�AA�r./.1�s.�l "/"'x��� '�,,,n•.... ��a� ,,�.•- /�'Hv� J Signature o�/Enforcing Officer Village/State/Zip 0A, Vet i f� too i r Location of OffenseN r Enforcing Dept/Division Offense Cx i`ci•/oI-L s-4vt.k-) Facts I e,-e-<66 JA 14L ,P),?,cyt "2,5, .. 108 16 . ,,f 054 Vv( ��-/ fiAt, v- 5' w/is , This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. TOWN OF BARNSTABLE BAR-W Ordinance or Regulation WARNING NOTICE Name of Offender/Manager Address of Offender MV/MB Reg.# Village/State/Zip Business Name . 1%, .R.. ' am/pm, on " 20 Business Address 4 E x " Signature of,-Enforcing-Officer Village/State/Zip Location of Offense ,:;"' �` L p `'" 1t Enforcing Dept/Division Offense41 t Facts This will serve only as a warning. At this time nolegal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in ,. appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. Number Fee 1120 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health i This is to Certify that _ IDEAL FLOOR COVERING 332 IYANNO UGH ROAD (RT 28), HYANNIS, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2018 unless sooner suspended or revoked. -------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Tow1�, of Unstable Regulatoerices Richard V. Scali,Director �tKE °" 'o Public Health Division BARNS ABLE � XtN5:td5�151�VNLY�F3�i�Si P4YMT�4&F `• MA Thomas McKean,Director 639-Y0 1639. 200 Main Street, Hyannis,MA 02601 ' Office: 508-862-4644 / ^�v` Fax: 50&790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE to HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— i 10 Gallons: $ 50.00 ❑. CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 4V'6' CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO.. 2. IS THIS A PERMIT RENEWAL? V YES_NO. IF YES, SHIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF • GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: /�/ ��G✓S.� �--C.c r 5. NAME OF ESTABLISHMENT: Ch C, 0U� 6. ADDRESS OF ESTABLISHMENT: 3 — A o d O y (Dfi I�-U 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: S. TELEPHONE NUMBER OF ESTABLISHMENT: 56T' 9%®"e;[S?9 9. EMAIL ADDRESS: 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT MAiQ K 1J 0 0 D S TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS M A. EMAIL: SIGNATURE OF APPLICANTW)---�TE LA I b 7 Q:\Application Forms\HAZMAT APP 2017 REVISED. cx °pINET°� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMASS .. g! 200 Main Street• Hyannis, MA 02601 p 1639. , 'FOMp+ TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: 4e1( ►�/�evuk- - I Date: Location/Mailin Addres : 2rtvloy 'l4ri1 Contact Name/Phone: 1 So R,--7-7 -a2.p q Inventory Total Amount: -`' 3a G, MSDS: A , License#: I t1 1 Tier II : AIA Labeling: 0�< Spill Plan: C/7 Oil/WaterSeparator: ev Floor Drains: YeA)--7 0W�5 Emergency Numbers: Yes Storage Areas/Tanks: 1- <-.Y&5 OvJ 1v1. A\ �A (paa-c. ,s e-A r ZLAe, ,a Ak x a0 0l,skc S Emercienc&ontainmentE ui ment: Waste Generator ID: A Waste Product: 6 . v Date&Amount of Last Shipment/Frequency: 0-5 4L„, JD6LS t o v4c4A Licensed Waste Hauler&Destination: Other Waste Disposal Methods: OW t) 1vb,e_. 7 aV O�zA k'ti 40 ` 0 LIST OF TOXIC AND HAZARDOUS MATERIALS eco0 '5� Zo7 _�'3- ' ss�- ty 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 requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) 110 Windshield wash �10 Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes 16,* Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform,formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: C�J m �a S{21MaK -Q pubes J 04 v t �O O 1 �o,r A Lf\, "VL O Z-.V'e-g Inspector:, 1 , t� \i-e- -2_ Facility Representative: —� WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS t, r °a IKE r° Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMASS. • 200 Main Street• Hyannis, MA 02601 i6'9 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT QED MP't a n Business Name: Ao Zo L-,-c Date: 4 Q Location/Mailing Address: 332T .> 2 . Contact Name/Phone: 6o8- '-► 1 - 73-73 - �C c�►uu9�� Inventory Total Amount: ���I MSDS: Ow I1 - Q <- License#. 1-7 3 C4�-,s Tier II : 4Jn,k�5 . Labeling: qoo SSpill Plan e�zm g• Oil/Water Separator: A Floor Drains: o Emergency Numbers: `' Tf, Storage Areas/Tanks: N:i?o wWu5k-e. &<c o s L w4,5+e., 0u150 AT"OLS 3.e .9,t+,eCs ,011 , Emer enc /Containment Equipment et< 5wr--2, "i1 , ova 6, Waste Generator ID: A%1RQQMIL-3o3 Waste Product: ar H�� �ol s ,ngigc rep J Date&Amount of Last Shipment/Frequency: ar2-3 ta to z- fA 05. Licensed Waste Hauler&Destination: y-'r- Other Waste Disposal Methods: '3 ,urn., cK A10. k4, , W,<-,% lL -c-ApL ,54ork LIST OF TOXIC AND HAZARDOUS MATERIALS ry144--9 e s44 at 4AV-4) 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 requires a license from the Public Health Division. Antifreeze Dry cleaning fluids —�� Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers J— Hydraulic fluid (including brake fluid) Windshield wash Motor oils 4 Was-Vc- ,/ Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants ✓ Miscellaneous petroleum products: -7- Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides �— Battery acid (electrolyte)/batteries t corf-s Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink �f Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners V Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes —� Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: X10 55RS-bl, "t S i Ze- , Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS III Number Fee 173 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Auto Zone 332 Route 28, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------ ---------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2017 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health s RECEIVE® Town of Barnstable JUN 15 2016 Regulatory Services Richard V. Scali,Director �STABM = BARNSTABLE r Public Health Division N s6;q. p�0 J, uuaA1iNn vseKus�N�v'rsnr aa":e e !"' CEO riot Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 � �(�� � Office: 508-862-4644j( Fax: 508-790-6304 ~ i 7t APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 Y A late charge of$10.00 will be assessed if payment is not received b Jul 1st. • g P � �Y ASSESSORS MAP AND RARCEL NO.. DATE FULL NAME OF APPLICANT:lEbDQ� wittlam-S NAME OF ESTABLISHMENT: aa&ae. 1o(J ADDRESS OF ESTABLISHMENT: MAILING ADDRESS (IF DIFFERENT)MAILINGYY�C Al /6 TELEPHONE NUMBER OF ESTABLISHMENT: EMAIL ADDRESS: eoit6zwe- eels SOLE OWNER: YES NO IF NO,NAME OF PARTNER: FULL CORPORATION NAMEHOME D SS AND T�EPHONE#�F- e PRESIDENT Q� TREASURER CLERK IF PREPARED BY OUTSIDE PARTY:IW ` • S T F CANT Name: C5 Company Address Telephone#: Email: QAApplication Forms\HAZZAPP Revl6.docx Page 1 of 2 `oF�"E royti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BABMS .AS. q 200 Main Street• Hyannis, MA 02601 OI16 3 9. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: A.r�o-go v .,-- Date: j -r ,� Location/Mailing Address: 332- !:—YA v�.h® 1e+X8 V tm ►�5 Contact Name/Phone: 1746..Q Spy- ?l- 3?3 ce -7751—Z68•739/ Invento Total Amount: D D MSDS: Cn<Jaf& .c- ,,��be 'k`' License#: ��3 Tier II : r\45 Labeling: �,\ \a ca,�`'�Jr Spill Plan: Oil/WaterSeparator: Floor Drains: V Emergency Numbers: Storage Areas/Tanks: V �-&-1 ww Ski v� 1 oLV A,. Emergency/Containment Equipment: l < A- O h1k4?i Sa 0.5 Waste Generator ID: rA Waste Product: yt, 0% Date&Amount of Last Shipment/Frequency: 8 14 I ! 00 c - rtio►�k�. Licensed Waste Hauler&Destination: Other Waste Disposal Methods: G W- LIST OF TOXIC AND HAZARDOUS MATERIALS 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 requires a license from the Public Health Division. VAntifreeze Dry cleaning fluids %/ Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers 7— Hydraulic fluid (including brake fluid) �— Windshield wash Motor oils — V Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil —� Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides �— Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink �— Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/EgcOMMENDATIONS: -0A 14S� � ` ITZavt -1(0 C0 C <' .n, a,A�. I 1 Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS Number Fee 173 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Auto Zone 332 Route 28, Hyannis, MA 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 06/30/2016 unless sooner suspended or revoked. -------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2015 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable RECEIVED Regulatory Services JUN 0,8 2015 • Richard V. Sc4 Director ELMINS ` 6 ` Public Health Division ;ATM ° Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 )ax 508-790-6304 Application Fee: $100.0.0 a, ASSESSORS MAP AND PARCEL NO. M 0 DATE I APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 1.11 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT Rjj o-Zohe_ S�tlrc llsu�t�, cr NAME OF ESTABLISHMENT f�0A672o%,c-' too ADDRESS OF ESTABLISHMENT 33-2 T-*- -? V TELEPHONE NUMBER SD V - '7? r - '73 7-7 SOLE OVVNER:_X�YES 5� NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO.U,L-/-q k 2 OK I.- STATE OF INCORPORATION Ti j FULL NAME AND HOME ADDRESS OF: PRESIDENT "St VAer\phi s l i s 3 L�Z TREASURER CLERK Gam-- SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS_ &010 1 3 S. �K vnd Tu HOME TELEPHONE# C:\cache\Temporary Intemet Files\0=31HAZAPP Rev2015.DOC FIKETor, Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • ennM A'�eLE� 200 Main Street• Hyannis, MA 02601 e1639. 0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Av�o Date: 6 13I1 y Location/Mailing Address: 332� R�n,nc., 12} 2d a►nv`�5 Contact Name/Phone: -7 7y-2(bS-g391 Inventory Total Amount: ten' ICI MSDS: Coy 05�ke- License#: ��3 Tier II : nl o Labeling: Gmo Spill Plan: OK Oil/WaterSeparator: Nit Floor Drains: 0 0 Emergency Numbers: YvS Storage Areas/Tanks: 100 aa\ AS 1- V-VL5-ti 0, I, Emergency/Containment Equipment: `ItA Waste Generator ID: 0000I V3O Waste Product: wfA.5+e-- 01 Date&Amount of Last Shi ment/Fre uenc : 5 17 1� 4,1 -._. I X w4 0. Licensed Waste Hauler&Destination: 'e t)t- Ie e-vk-tCc a.,,;Ao,- l,T V-�I bOS YZ Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS �)o 0. ©t r✓VA. 5 1V�,I1AV2v��vt S ihc2 �cYSt NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardoudmaterial use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes —�- Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils V Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil 9 Refrigerants J Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine �— Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers JFloor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: «W-WA ac,L Inspector: k • LoLof Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date:v/ //7/ /3 TOWN OF BARNSTABLEs .�o� TOXIC AND HAZARDOUS MATERIALS ��" "T "T' " FORM NAME OF BUSINESS: 74,40 �g.,e— BUSINESS LOCATION: $332 7%f,/,k v,v%ov h 2°r3 i �V In A 1 s INVENTORY MAILING ADDRESS: .Sayvc-� TOTAL AMOUNT- TELEPHONE NUMBER: -<v / 7573 44 CONTACT PERSON: r r eP EMERGENCY CONTACT TELEPHO E NUMBER: 77LI -268 - f3� I MSDS ON SITE? TYPE OF BUSINESS: ado o e e--I-e r A S F- INFORMATION / RECOMMENDATI NS: OSP?ed / eew uI!, wrCzyV °� �yn �'/�� � `fie=-lc.--^-/>�4" s -,�. � Fire District: -fee Zol�. 1 !'��0� '9 co-K 7e.. -r-'�.�.jea-� �Q.�J.N Il GGU\PC>0 '/\ i� l 9 Waste Transportation: Last shipment of hazardous waste: Y 3o p 3 Name of Hauler: 5Q ,��:, r`i-<1P�vtr Destination: �°r��s�}o Waste rod uct: 0, c be 4 s.I Licensed? a No I t�-nog g97— NOTE: Under the provision f h. 11 , Section 31,of the General Laws 6f MA azardous material use, storage and disposal of 111 gallons or more a month requires a license from t1r0 Public Health Division. 9 p 9 _� LIST OF TOXIC AND HAZARDOUS MATERIALS ►j L-a jw\je:hA�®Iyy Q� 4+ Store- The Board of Health and the Public Health Division have determined that the followffng products exhibit toxic or hazardous characteristics and must be registered regardless of volume.-ra*22I t ,+) e0rr-1A+a ct Obs rued / Maximum Observed /Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive eNEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes ✓ Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides 2/NEW C/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 Vf Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials f k Fax Send Report JUL-07-201115:03 THU Fax Number : 15087906304 Name BARNST HEALTH Name/Number 919014958399 Page 2 Start Time JUL-07-2011 15:03 THU Elapsed Time 00'24" Mode STD ECM Results [O-K] Town of Barnstable Regulatory Services ' Thomas F.Ccilcr,;Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 DATE: tVH NUMBER OF PAGES TO FOLLOW: TO: FROM: PHONE: PHONE: (508)862-4644 FAX PHONE:„G`_ �3 r� FAX PHONE: (508)790-6304 cc: LJ NOTES/COMMENTS: z- Q\Fmc rorm.doc Number Fee g 1120 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that IDEAL FLOOR COVERING 332 IYANNO UGH R OAD (RT 28), HYANNIS, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2017 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A. MCKEAN, R.S.,CHO Director of Public Health i N Town of Barnstable • �t *wr Regulatory Services ti Richard V. Scali,Director Public Health Division w BA MSTABLE 1639 10� .. aaeso"s° mos° ueCDwNs;'e axsve �fDNI1A�p Thomas McKean, Director 1639"2014 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES_ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS DULY 1st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ • A late charge of$10.00 will be assessed if payment is not received by July 1st. ASSESSORS MAP AND PARCEL NO. DATE FULL NAME OF APPLICANT: /�J�C�✓SS , NAME OF ESTABLISHMENT: �� L /- �U� C Oy e�2 N G ADDRESS OF ESTABLISHMENT: —;?3j-- -- MAV006hf 62b MAILING ADDRESS(IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: EMAIL ADDRESS: SOLE OWNER: X YES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT fI 29 C�JUU i�S TREASURER CLERK • IF PREPARED BY OUTSIDE PARTY: SIGNA OF APPLICANT Name: N1\ - — Company Address VV Telephone#: Email: QApplication FormsUTAZZAPP Rev16.docx Page 1 of 2 r 2. Town of Barnstable Office: 508-862-4644 . Fax: 508-790-6304 yRegulatory Services Department Public Health Division Thomas A.McKean,CHO 14 Ffl11 59. 200 Main Street, Hyannis, MA 02601 Payment Receipt ;Hazardous Materials Payment received: $125.00 (Check) on 6/14/2016 Permit number: 1120 `Check number: 7569 Check amount: $125.00 Name on check: Ideal Floor Covering of Hyannis .Business: IDEAL FLOOR COVERING .Address: 332 IYANNOUGH ROAD/RTE 28, Hyannis i i • I Number Fee 1120 THE COMMONWEALTH OF MASSACHUSETTS . 1oo.00 Town of Barnstable Board of Health This is to Certify that IDEAL FLOOR COVERING 332 IYANNO UGH ROAD (RT 28), HYANNIS, MA 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 06/30/2016 unless sooner suspended or revoked. --------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 07/01/2015 JUNICHI SAWAYANAGI THOMAS A. MCKEAN, R.S.,CHO Director of Public Health rd (16 e:. l Town of Barnstable dF ' ti Regulatory Services • Richard V. Scan,Director t r ` HARMASSNEM1.13M ' Public Health Division Ecru` 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 W APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT Z7n 6.9 d4�2062 4)(1 eiL rn) G • ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER SOLE OWNER:,DYES 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 /77 I FULL NAME AND HOME ADDRESS OF: PRESIDENT AAle 1V00J)j TREASURER CLERK _ • SIGNATURE OF APPLI ANT RESTRICTIONS: HOME ADDRESS i HOME TELEPHONE# Mcache\Temporary Intemet HeAOLMU AZAPP Rev2015.DOC f . W x Town of Barnstable Office: 508-862-4644 Regulatory Services Department Fax: 508-790-6304 • ; Public Health Division s* MASS, Thomas A. McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt Hazardous Materials Payment received: $100.00 (Check) on 6/24/2015 Permit number: 1120 jCheck number: 6909 Check amount: $100.00 Name on check: Ideal Floor Covering of Hyannis jBusiness: IDEAL FLOOR COVERING Address: 332 IYANNOUGH ROAD/RTE 28, Hyannis i • Fee Number �? 1179 THE COMMONWEALTH OF MASSACHUSETTS 100.00 Town of Barnstable Board of Health This is to Certify that ENTERPRISE RENT-A-CAR 332 IYANNOUGH ROAD (RT 28), HYANNIS, MA 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 06/30/2016 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 07/01/2015 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health 112it"" -00-02 21 :18 1022 15087904187 >> P 1/2 Town of Barnstable • Regulatory Services Richard V. Scala,Director Public Health Division �c1 ° 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 fi -072- DATE 611�5 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT Cn krd(I A- r&r _('O 1,29,,n W 0 h1541 t UL NAME:OF ESTABLISHMENT FLn{rj�j-rV-)k _ a t A - • ADDRESS OF ESTABLISRMENT 3 Z 1111A/it K CJ f�J6 n�1s ma '6 Z(001 TELEPHONE NUMBER -nK ZV �S SOLE OWNER: YES Y 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 FUT,L NAME AND DOME ADDRESS OF: PRESIDENT TREASURER CLERK • r URY OF APPLICANT RESTRICTIONS: DOME ADDRESS HOME TFLEPIIONE C:cachclTcmporary Internet Fi1cs10LKD3)I-IAZAPP RcQ015,00C 7l if)jLy *1HE► Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • MASS. S�LE,D` 200 Main Street• Hyannis, MA 02601 0 + TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: �w+{Y' �se- Q-e-4.o-- (,a.(, Date: G 1311`{ Location/Mailing Address: 4 332 RNV\o Ai�e ✓Iv)►S Contact Name/Phone: L,4✓<a- to v Inventory Total Amount: 'V R) MSDS: 7GS License#: Tier II : Labeling: D Spill Plan: Oil/Water Separator: len- Floor Drains: Emergency Numbers: Storage Areas/Tanks: a-SS r M1JINIQ��►„,(� WwSt- lal ltr� �ti,tQt.r�,iL1 Emergency/Containment Equipment: eQsk q.w IBA!5� 4\v 7 0�l/„���c✓ �cA<ta yr Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS 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 requires a license from the Public Health Division. I Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) %k D Windshield wash Motor oils Miscellaneous Corrosives 4— Gasoline,jet fuel, aviation gas Cesspool cleaners isele fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents < ` a coy4• Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners I Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil&stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, N )5 1 cil o I,���ti cl c_wa5� '1�, S hydrochloric acid, other acids) +o Ip.L Aiggn,,L a1% VIOLATIONS: ORDERS: RRkV,1L INFORMATION/R COMMENDA IONS: t<"VKI IS . 4 VA-(:e w+4, .k ,v15 0e, ,Qr-� ti I o I o 0% -94 hi w1 .J PL - t ,Aa C"-kac,r SA coy o«AQ- J Inspector: Q Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: 6/ 17 03 TOWN OF BARNSTABLE��,,s, TOXIC AND HAZARDOUS MATERIALS FORM NAME OF BUSINESS: �Yl�ec I BUSINESS LOCATION: SS:t INVENTORY MAILING ADDRESS: ►^w TOTAL AMOUNT- TELEPHONE NUMBER: .3-Ob- Y7,7- Ioo? &-7 4.11 CONTACT PERSON: V&Iz- -`� EMERGENCY CONTACT EPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: 6.'_ ye S INFORMATION / RECOMMENDATIONS: keddy c&K6i6, 5 A'TJ` Fire District: ® � �dt °I'v O e k9aa 8t 7G s� � �. / Q fL viv ,eeb-r Waste Transportation: Las shipment of hazardolts waste: Name of Hauler: Destination: Waste Product: 01 w>4,14(- � hp_-4 Licensed? Yes No NOTE:1Ur eta provisions off? 1�;�ectlo 31 he General &At�fL�t/7hazCaLrd-IoLu'�tgat'�-er al 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) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ 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(eorteek+,cL+ 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 Initia s TOWN OF BARNSTABLE BAR_W Ordinance or Regulation 6 WARNING NOTICE Name of Off ender/Manager Rt ' �.. V1 e, lrr-, 't V. r Address of Offender MV/MB Reg.# Village/State/Zip 2 0 Business Name 's „¢�'��, yvt�- �. - , < I 'a + am./pm, on f r Business Address 3' -Z Vr-7r, Signature'_of Enforcin Officer Village/State/Zip 01) D 4 t Location of Offense F—yt4,_<or, Enforcing Dept/Division ..► t } f Offense 1' A. VNr,.4, i v. CC-t ay r_'?_ Facts s., '-�V� d�IrJV�- [ xc1�`a ��GUj� �.. <i � 1( -6 yw1u4 This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. TOWN OF BARNSTABLE BpR_W Ordinance or Regulation WARNING NOTICE Name of Offender/Manager I r ~' t r Address of Offender MV/MB Reg.# Village/State/Zip 1 r/ Business Name ` ,�<F r` F ' am/pm, on 1 F ; 20 t Business Addressf':--- Signature _of Enforcing Officer Village/State/Zip 1.1 Location of Offense i Enforcing Dept/Division Offense IV" Facts -7 3 , This will serve only as a warning. .At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. Number Fee 1120 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that IDEAL FLOOR COVERING 332IYANNOUGHROAD, HYANNIS, MA 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 6/30/2015 unless sooner suspended or revoked. --------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health 1 I Town of Barnstable IME r � Regulatory Services Richard V. Scali, Director i MASS.BMWM # Public Health Division VV 039. Alep nna�° Thomas McKean, Director 200 Main.Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT /�/ L C NAME OF ESTABLISHMENT C®y •PR i-,y G ADDRESS OF ESTABLISHMENT 233 1- TELEPHONE NUMBER 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. STATE OF INCORPORATION /)7)3s.S FULL NAME AND HOME ADDRESS OF: PRESIDENT / 7,q/ 1` 000j')S TREASURER CLERK IGNAid OF APPLICA T RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# Q:1Application FormsUiAZAPP.DOC Number Fee 1179 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that ENTERPRISE RENT-A-CAR 332 IYANNO UGH ROAD, HYANNIS, MA 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 6/30/2015 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health Town of Barnstable °pTHE T Regulatory Services v � Richard V. Scali, Director &UMSTAMASS. ` Public Health Division Alec►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. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 1-11 GALLONS OF HAZARDOUS MATERIALS r _ FULL NAME OF APPLICANT r- NAME OF ESTABLISHMENT c kcw ADDRESS OF ESTABLISHMENT2 0 � aa6o� TELEPHONE NUMBER O� SOLE OWNER: YES NO j 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 IGNATURE APPLI ANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# J AHAZAPP.DOC i Number Fee 173 THE COMMONWEALTH OF MASSACHUSETTS 100.00 Town of Barnstable Board of Health This is to Certify that Auto Zone 332 Route 28, Hyannis, MA 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 6/30/2015 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 6/30/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of BarnstableCk �pFTHE ropti Regulatory Services y Richard V. Scali, Director BARNS9 MASS* Public Health Division A'F1 39. Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER 7? ( '73 7 3 SOLE OWNER: YES NO ;. Z € IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF-ALL =rA PARTNERS: �°��OC+C✓"'El o+� 12 3 S c vt-� �'.K e..t'- Ste: l [ '� Af el 'J7 D m IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION 4 is FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS 12 3 5. Fcc,,-,c--�a-, NQ w tom HOME TELEPHONE# 1-0 S -7A,7 Q:\Application FormsT AZAPP.DOC Number Fee 1120 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that IDEAL FLOOR COVERING 332 IYANNOUGff ROAD, HYANNIS,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 6/30/2014 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 2/18/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health Town of Barnstable Barnstable �&d Regulatory Services Department Public Health Division BARNWABLY- MAQQ 200 Main Street, Hyannis MA 02601 1 12� 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT L Dj6 NAME OF ESTABLISHMENT —T 06,q L A:LOOle CO(/P2f/'U G ADDRESS OF ESTABLISHMENT �'��- -ZY�N/1/DU G H 1619,6 I-IMAUNIJ TELEPHONE NUMBER ✓�U - 5 Q——��' SOLE OWNER: X YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO.3.1 -00-G,5-6 0 STATE OF INCORPORATION INS-rA Chi dse7iS FULL NAME AND HOME ADDRESS OF: PRESIDENT ^9X,9 X� GJOODs TREASURER A'Y ;2 Z-1 o/)j CLERK , SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# J:\inspection handouts\Haz Mat Applitation2008.DOC L Number Fee 173 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 r Town of Barnstable Board of Health This is to Certify that Auto Zone 332 Rte. 28, Hyannis,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 6/30/2014 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 6/30/2013 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health r 1, F 1 Own of .B;a stable Barnstable Regulatory Services Department Wd I : Pub ic Health' Division MAft on 200-Mainz Street,-Hyannis MA 02601 ! 2007. i Office: 508-862.4644 11 FAX: 508-790-6304 Thomas F.Geller,mrector Thomas A,McRean,CHO Application Fee: $100.00 ASSESSORS MAP AND:PARCEL NO. . DATE APpLi ATI®tV�O1t PERMIT O STORE ANVOR[TTIL E MORE THAN 111 GALLONS'Of HAZARDOUS MATERMLS FULL NAME OF APPLICANT 1�C� G n��� ,,� Q� e i NAME OF tS-TABLISHMENT ADDRESS OF ESTABLISHMENT j TELEPHONE NUMBER_ Sd K- 7 Z SOLE OWNER: ,YES _A_NO w �.. :......-_ . _. .._ IF APPLICANT IS A PARTNERSHIP,FULL NAME A.1vD ROME ADDRM OIL ALLY PARTNERS;: C> IF APPLICANT IS A CORPORATION: `FEDERAL IDENTIFICATION NO. 2 [ ' 74 I STATE OF INCORPORATION j�y FULL NAIVE AND HOME ADDRESS OF: PRESIDENT, TREASUREt CLERK 1 NATURT OR APPLICANT RESTRICTIONS: HOME kD DlRESS 1 e s ti T I � r HOME TELEPHONE q�i -�i .t -7 i I ]AimpeWon handoutMaz Mat Appliewion2008.DOC t Number Fee 173 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Auto Zone 332 Rte. 28, Hyannis,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 zzs and expires 6/30/2012 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2011 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable �FTHE Tp�, Regulatory Services do Thomas F. Geiler, Director • a BARNSTA ■ s " MASS. " Public Health Division 1639. ptED NIP' A Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT ICU a -�ka� NAME OF ESTABLISHMENT RAO ZO C1(*,s I (o n ADDRESS OF ESTABLISHMENT Poufe .2Z TELEPHONE NUMBER S-O f- 7 71 ^ 7372 SOLE OWNER: YES )C NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: NO IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. f2a y� STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS 12,3 S6 e�h �C(j r\f- tS`� • �Ctmphis jtj i HOME TELEPHONE# �(q S - 7,�t Haz.doc/wp/q Business Name AUTOZONE#5160 Address 332 Route 28, Hyannis, MA 02601 if you have a release or a threatened release of hazardous materials ahe Aquire emergency response;call 911;'If, you Have a release orthreatened release tlat is not anEmergencyas decnbed liegethen 911 can be,omitted ,go to,the a ro of �n l a .Notification re uirement betow�_ .,` , t. _ z - _ Person responsible for calling 911: STORE MANAGEMENT A hazardous materials Incident is a spill or release that can be absorbed,neutralized or otherwise controlled at the time of release;and can be controlled by the employees in the immediate work area or by maintenance personnel without exposure or health&safety hazards. A hazardous material Response requires a response effort by employees from outside the immediate release area,or by other designated responders(e.g.Fire Dept),to an occurrence that results,or is likely to result,in an uncontrolled release of a hazardous substance. t7 " §* ° ems � ex 3E Company-800-451-8346-Emergency Response Coordinator Alarm Central-800-313-9693 (Day) 24 hour Manned Store Monitor 800-313-9693 (Night) Barnstable Public Health Division: 508-862-4644 Barnstable Fire Dept: 508-362-3312 MA DEP 24hr Spill Hotline: 888-304-1133 Waste Hauler Safety-Kleen-800-545-3520 , - C) 1. Emergency Release Procedures a I PREVENTION o rr;; ALL PRODUCTS DELIVERED TO THE STORE WILL BE INSPECTED FOR LEAKS. THE STORE'S RETAIL CHEMICAL PRODUCTS AND USED OIL TANK WILL PERIODICALLY BE INSPECTED FOR LEAKS. DAILY USED OIL TANK INSPECTION WILL BE DOCUMENTED ON THE USED OIL TANK LOG. ALL USED OIL WILL BE INSPECTED BEFORE BEING POURED INTO THE TANK. ALL BATTERIES WILL BE INSPECTED FOR LEAKS BEFORE THEY ARE PLACED IN THE STORAGE AREA OR RETAIL RACK. MITIGATION ALL AUTOZONERS HAVE PARTICIPATED IN THE AUTOZONE EMERGENCY ACTION PLAN AND SAFETY TRAINING PROGRAM, WHICH INCLUDES TRAINING SPECIFIC TO HANDLING EMERGENCIES INCLUDING EVACUATION, FIRE ALARMS, FIRE EXTINGUISHERS, FIRST AID KITS, SPILL CLEAN UP AND SPILL RESPONSE EQUIPMENT. IN THE EVENT A SPILL OCCURS, AUTOZONE EMPLOYEES WILL PROTECT ENVIRONMENTAL SENSITIVE AREAS BY USING ABSORBENTS, RAGS OR PAPER TOWELS TO CONTAIN THE MOVEMENT OF THE RELEASE BY CREATING A BERM AROUND THE SPILL. EMPLOYEES WILL THEN PLACE ABSORBENT AROUND THE EDGES OF THE SPILL, WORKING INWARD UNTIL ENTIRE SPILL IS COVERED BY ABSORBENT. BATTERY ACID SPILLS WILL BE NEUTRALIZED USING SODA ASH. USING PROPER PPE, AUTOZONE EMPLOYEES WILL START AROUND THE EDGES OF THE SPILL AND WORK INWARD UNTIL THE ENTIRE SPILL IS COVERED WITH SODA ASH. AUTOZONE EMPLOYEES WILL CONTINUE THE PROCESS UNTIL ALL ACID IS NEUTRALIZED. Page 1 of 2 I ABATEMENT FIRE-MANAGEMENT WILL NOTIFY LOCAL FIRE DEPT THAT A FIRE HAS TAKEN PLACE AFTER THHEY HAVE EVACUATED THE STORE. IF SAFE, EMPLOYEES WILL ATTEMPT TO CONTROL FIRE USING FIRE EXTINGUISHERS LOCATED THROUGHOUT THE STORE. SMALL SPILLS-CHEMICALS WILL BE ABSORBED WITH CLAY ABSORBENT MATERIALS BY AUTOZONE EMPLOYEES USING THE PROPER PROTECTIVE AND SAFETY EQUIPMENT. 3E COMPANY WILL BE CONTACTED FOR CLEAN-UP AND DISPOSAL PROCEDURES. LARGE SPILLS- MANAGEMENT WILL NOTIFY LOCAL FIRE DEPT. TRAINED EMPLOYEES USING THE PROPER PROTECTIVE EQUIPMENT WILL ATTEMPT TO CONTAIN THE SPILL. 3E COMPANY WILL BE CALLED TO RESPOND AND ASSIST IN THE CLEAN-UP AND DISPOSAL OF SPILLED MATERIAL. ALL WASTE GENERATED FROM A RELEASE WILL BE PROPERLY DISPOSED OF BY THE EMERGENCY RESPONSE CONTRACTOR AND SENT TO A LICENSED DISPOSAL FACILITY. 1. Emergency Evacuation Procedures STORE MANAGEMENT WILL USE VERBAL COMMANDS TO COMMUNICATE TO ALL EMPLOYEES AND CUSTOMERS THAT THE STORE NEEDS TO BE EVACUATED AND WHERE TO GO IN THE EVENT OF AN EMERGENCY. ALL EXITS ARE MARKED ON THE EVACUATION MAP POSTED IN THE OFFICE. THE MAP WILL ALSO SHOW THE EMPLOYEE STAGING AREA IN THE EVENT THE STORE HAS TO BE EVACUATED. (SEE Emergencv Action Plan posted in the office) 2. Employee Training Program New AutoZone employees receive on their first day specific training related to all in house environmental operations including: Used Oil Recycling, Battery Handling, Spill Response and Clean-Up. In addition they are trained on the Emergency Action Plan and the California Environmental Policy. All employees are trained annually on: - Proper procedures for storing, handling and labeling hazardous waste -.Proper use of 3E Company services. - Proper procedures for maintaining records using 3E - Instructions in the Written Hazard Communications Program, including reviewing MSDS and safety procedures for materials. - Review of emergency action plans -Coordination of emergency action plans with local fire depts, paramedics, and clean up contractors. - Monthly inspection and maintenance of safety equipment(including fire extinguishers and eye wash stations) -Training on the proper use of fire extinguishers - Review of the Emergency Action Plan and store management's responsibilities in the event of an emergency Page 2 of 2 tiC E. htcw attic C, a 0 CAeS aGC- 1 o 0 0 �0 2 \ nC) o o O o 0 o o M Z s dA M Y / FE SCALE: DRAWING NAME: FPLN516O.dwg �Spt 41} TYPE: NON-PROTO LEIDNG HEIGHT: 12'-6° FIXTURE HEIGHT: 120° 'PIN TRANSFER DATE: 01/30/98 SEISMIC: NONE OPENING DATE 02 0 98 ' SHEET NUMBEfl: ' TOWN OF BARNSTABLE BAR-W 11,518 Ordinance or Regulation © WARNING NOTICE Name of Offender/Manager I ' i �t Address of Offender MV/MB Reg.# Village/State/Zip Business Name am/pm, on 20 Business Address R4k M4 20) r Signature .of,,,Enforcing Officer Village/State/Zip �/ 'tY1�l t , ✓ ►`7 �� � t Location of Offense tt Enforcing Dept/Division Offense �" 1vCrd. n '� `► r�S4,f6k, f UyS iMA4e_�< sA � Sr,- Facts CA This will serve only As /a warning. At this/time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. TOWN OF BARNSTABLE BAR_w 531 Ordinance or Regulation WARNING NOTICE Name of Of fender/Manager Y "a F Address of Offender MV/MB Reg.# Village/State/Zip f � Business Name %-4 f`O t,. am/pm, on "' 20 1-.= Business Address w a, . �/ . >r � � { j.`J "✓�l' �, . � s .,.. Signature .ofEnforcing Officer Village/State/Zip `/ �t` tj + r ''! V Location of Offense Enforcing Dept/Division Offense I'VI `' , :� • f ` e_ y a t ! Facts t f C o.- � This will serve only as `a warning. At this/ no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. °rIKKE Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 B, S48LE. ` 200 Main Street• Hyannis, MA 02601 ArFDMA�a`� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Date: Z 1 Location/Mailing Address: 3 32- TyaN,nova U-, b Contact Name/Phone: Inventory Total Amount: ^'W 4 4 0 )0 MSDS: * eti k y kwA °" 7, S License#: Tier II : Labelina: e-t A.W1 nj Spill Plan: y� 5 Oil/WaterSeparator: Floor Drains: Q0 Emergency Numbers: ¢S Storage Areas/Tanks: r.( .ti a lo•ti 5 eJkra, Emergency/ContainmentE ui m n : - Waste Generator ID: A Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS 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 requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants A ��egreasers for engines&garages Pesticides: N 1 Caulk/Grout 5 (� Ae insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" 102 ��lnzgjV�51� "`g� 6„ors (including chloroform, formaldehyde, t7x5��i � hydrochloric acid, other acids) VIOLATIONS: 2.b I ov ORDERS: INFORMATION/RECOMMENDATIONS: a.`� @0 2G Inspector: vJ 'e, Facility Representativ . WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS I SHE►ow� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 a^ MARSB`E.� 200 Main Street• Hyannis, MA 02601 i63 q' �0 '°fFOMA�a TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: rOo-((20Lw-fir Date: Location/Mailing Address: 3S Z :f ^^ ar)AI Contact Name/Phone: - S`'l 7 v J a Inventory Total Amount: Wll <«� [atI Tier II : Z Labelina: it-Aall )64 Spill Plan: OK Oil/WaterSeparator: N Floor Drains: No ImergencyNumbers: Storage Areas/Tanks: 44Jvla �Asac ,w �5 0�l vvl, 6, �� 5 Emergency/Containment quipment: Waste Generator ID: N(A Waste Product: AJIA Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: A� LIST OF TOXIC AND HAZARDOUS MATERIALS �" r lot c1tia 5 1w IA:q -w �l'� Stv�c-� 1&6+ �Ia� 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 requires a license from the Public Health Division. -a e-2©lLf Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Groutl&G%,h,�`� insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: LCo�M Inspector:' nspecto `- Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS °Q IKEA Town of Barnstable Office:508-862-4644 °* Public Health Division Fax:508-7s0-6304 R"MAIL%. 200 Main Street• Hyannis, MA 02601 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: I oo4e, VZ-(- Date: �Z Location/Mailing Address: 3Z J- cavr►'1dev Hy4orif6 Contact Name/Phone: M A 710 —2 S-7 G,1 k InventoryTotal Amount: '�-�(7 CN j a�00') MSDS: �S License#: Tier II : V Labelina: `i °O Spill Plan: 17 Oil/WaterSeparator: Floor Drains: A)b Emergency Numbers: Storage Areas/Tanks: Oc�i ti s v\ of Sty YL g - eJ24x. Emergency/Containment Equipment: Waste Generator ID: Waste Product: 10V Date&Amount of Last Shi ent/Fre uenc : �� Licensed Waste Hauler&Destination: Other Waste Disposal Methods: ,1 LIST OF TOXIC AND HAZARDOUS MATERIALS N o %/A-OL al t_\A6L� �- v�v'�w"��'�� 51yk tc5`f' NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, 04-5-�Ld0°'`- storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages ,,you( Pesticides: o4 va aulk/Groutf/td -Q-,,�,-eg So-59�� 41 insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries &,060lb Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil&stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: o avr er ©Q yt Inspector. te� Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS SECTIONSENDER: COMPLETE THIS SECTION COMPLETE THIS ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse_ 46�-- ❑Addressee so that we can return the card to you. B. Received by(Pri ame) C. Dat of livery ■ Attach tfiis card to the back of the mailpiece, Q b or on the front if space permits. D. Is delivery add different from item 1? Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No I'T,�• JCo�f �ladib�i Island's T /��U / '{ /1 eoz[ ' 3. Service Type ,aWCeri fied Mail® ❑Priority Mail Express- � i ��n��� �/� ba lJ/ ❑Registered Return Receipt for Merchandise ❑Insured Mail ❑Collect on Delivery 4. Restricted Delivery?(Extra Fee) ❑Yes ei [itii 7012 1010 0000 2847 820------------ 9' y ' PS Form 3811,July 2013 Domestic Return Receipt UNITED STATES,P6 AL 8900E First-Class Mail I 1y- ' ! Postage&Fees Paid Permit No.G-10 I '7• 5 I I • Sender: Please print your name, address, and ZIP+4®in this boxe' I 7L7 6f, abD �'Iai� St I Do?(, O / I �Q I I I .. ..... . . ... ... E Er . O nU rD 0 tF. I S c Postage $ fIJ `. Certified Fee $�, cp vi Postmark j O Retum.Receipt Fee a p (Endorsement Required) M Restricted Delivery Fee O (Endorsement Required) r=1 O Total Postage&Fees r-I Sent To rl Street,Apt N --PO Box No. a � h. ON State,ZIP+ (00/ Date: 1 0 / 4 TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: COV6.16 BUSINESS LOCATION: 3�'1.�'vuv�vo„�Cn, 'Rr,C , �Iy�wn�s INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: 0 --I- `7-1 -7�0 a CONTACT PERSON: ae�L SVOOLN EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: �\001 Coy,&(,!4 ('dr,,k INFORMATION / RECO++MMENDATIONS: ���� e�`k, ��s1,�..r5 \ Fi a District: v, c 4k 4r kl, 0 kak-I-w,.ak a Sef4,"k, Waste Transportation: 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 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 r 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 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) ID Caulk/Grout/ 1vf,s 14 W �.s(, Swimming pool chlorine Battery acid (electrolyte)/Batteries G<ou+ Lye or caustic soda Rustproofers /3-J00 I b= Miscellaneous Combustible Car wash detergents 1000 w\ Leather dyes Car waxes and polishes '11910 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 Initials