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Home My WebLink About0599 MAIN STREET (HYANNIS) - Health S99 MAIN ST. SEWER A'= 308 118 t ° j N N m Q Q' Certifiq+Mail Fee E $ .6 r 3 S Extra Services&Fees(check box,add fee pf appTo a e) ' r [ leturn Receipt(herdcopy) $ ` Q ❑Return Receipt(electronic) $ Postmark Q ❑Certified Mail Restricted Delivery $ AU ? /��.•IerB o Q ❑Adult Signature Required $ G"M 2017 ••••t Adult Signature Restricted Delivery$ Q m Postage6 !�Q t � $ Total Postage and Fees �a P Ln $ p Q �t a ----- or P f N City- e, =-;0°1•- -�- Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.TD recelve.a.duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this y delivery. USPS®-postmarked Certified Mail receipt to the; ■A record of delivery(including the recipient's retail associate. 'l signature)that is retained by the Postal Service— Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent. fmPortantReminder�; Adult signature service,which requires the u You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mail®,First-Class Package Service®, available at retail). _ or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is notavailable for requires the signee to be at least 21 years of age, international mail. and provides delivery to the addressee specified"s ®Insurance coverage is notavaila6le for purchase by name,or to the addressee's authorized ageltt with Certified Maipservice.However,the purchase (not available at retail). Q of Certified Mail service does not change the o To ensure that your Certified Mail receipt is Insurance coverage automatically included with accepted as legal proof of mailing,it should bear a l certain Priority Mail items. USPS postmark.If you would like a postmark on fT1 ■For an additional fee,and with a proper this Certified Mail receipt,please present your --el endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for F, the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply T�-, You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.!3 electronic version.For a hardcopy return receipt, y complete PS Form 3811,Domestic Return Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT.Save this recelpt for your records. V Form 3800,April 2015(Reverse)PSN 7530-02.000-9047 -1C.— = Certified Mail: 7Q15 1730 0001 4990 3776 oFs�r� Town of Barnstable Regulatory Services BARNSm ti Richard Scali, Director prfo,Y,,�A Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-!4644 Fax: 508-790-6304 August 30, 2017 Mr. Shawn Jeffries D/B/A Twisted Tree 599 Main Street Hyannis, Ma 02601 { i NOTICE TO ABATE VIOLATIONS OF SECTION 353-5, TOWN-OF BARNSTABLE CODE. . The property.owned by you located at 599 Main Street, Hyannis was inspected on August 29, 2017 by Donna Z. Miorandi, RS, Health Inspector for the Town of Barnstable, because of a complaint. The following violation of Section 353-5 of the Town of Barnstable Code was observed: • Outdoor rubbish and garbage storage area is visible to the public view. 0 The dumpsters for Twisted Tree are on another property located at 450 South Street, Hyannis, known as Assessor's Map 308 and Parcel 122. • Much trash on the ground beside dumpster including beer bottles and many plastic drinking cups. You are ordered to comply with this Code by: Completely screening in the outdoor rubbish and garbage storage area(s) within ninety (90)idays of your receipt of this order letter. You may request a hearing before the.Board of Health if written petition requesting same is received within ten!(10) days after.the date the order is served. Please be advised that failure to comply with an order will result in a fine of$100.00. Each day's failure to comply with an order shall constitute a separate violation.. Q: order letters-dumpsters-599 Main St., Hyannis f Certified Mail: 7015 1730 0001 4990 3776 PER ORDER OF THE BOARD OF HEALTH G Thomas McKean, RS, CHO Health Agent Q: order letters-dumpsters-599 Main St., Hyannis 'Kidvsr•. t 4 4t w� i a x f i „y ; L cc AM i CON JW a ,' '• s.! p �� j. xkq'h�. ��y��.f 4� � •ti t t s v. 1 +"Y � 4 + e y �1 AL nk , a 5 a 1 �1 k Qa 111 �f f �. Est r • ' + <e r`t � �tc��Y�`�l �1}t�,?'�'1}1. 'Sfy � ti1 � -I V—O s. { �� as e�� #W�"eF. �: � u'y1^"t� t �•"kA '�r'Gt�'�.i, '•r; '• �v'i {' 91 .t _, � � ^irk 1• � ��',u� � � t r�*�� +±`/'k 5 r� �{,. „i•,, ems,,, .ti. F ' ✓Y..ti: .yyA ..- .. b- f c � b ] l 7 a F A � F A �A 4 t 1 a , a ! Le p'� A. t Al V. 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TMfw, ygtG• �. r� r No. �/ 6 ` Fe THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 7-v y Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ZIP01ication for Miopooar 6p.5tem Construction Permit Application for a Permit to Construct( )Repair(X )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components L Address or L NNo. Owner's Name,Address and Tel.No. ` � Main .. , . Hyannis David Baker Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Service P O Box 1089, Centerville Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or.Alterations(Answer when applicable) Install 1 ,000 gallon grease trap behind existing tank, and connect to town sewer. Date last inspected: 1 Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the,provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issu d by ' B d of He Signed L Date r3737 6 Z—01 Application Approved'by i Date 3—6'Z" L Application Disapproved for the following reasonsly Permit No. �� <— l2 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Baker Certificate of (Compriance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( X)Upgraded( ) Abandoned( )by I Wm. E. Robinson Septic Service at 5 9 9 Main S t, , Hyannis . has been constructed i accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. /� PI dated y jJ Installer_ Wm_ R_ Rohinsnn Sr- Designer The issuance of this permit shall not be construed as a guarantee that the s stem will fu ion as designed. , i- Dat Inspector j�,A ------- / ------------------------------- No. ?..fly t e F4 5 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Baker lwigosal *pstem Construction Permit Permission is hereby granted to Construct( )Repair(X )Upgrade( )Abandon( ) Systemlocatedat 599 Main St. , Hyannis and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions.. Provided:Construction must be completed within three years of the date of this permit. Date: �5 /� Approved b C G i� e Y G 4 i Health Complaints 20-Jun-05 Time: 9:15:00 AM Date: 6/20/2005 Complaint Number: 18196 Referred To: DAVID STANTON Taken By: JUDITH FLYNN Complaint Type: CHAPTER II HOUSING Article X Detail: UNSANITARY CONDITIONS Business Name: unknown Number: 599 Street: Unit C2 MAIN STREET Village: HYANNIS Assessors Map_Parcel: Complainant's Name:r �- —-__j Addres' _t Telephone Number:{ - Complaint Description: BUSINESS UNIT- NEVER OPENED- USED AS STORAGE- MOLD EVERYWAHERE- STRONG ORDER OF MOLD ( PREMATES CALLERS APARTMENT DIRECTLY ABOVE - CALLER SICK AS A RESULT- FIRE DEPT CAME OUT ON FRIDAY- FIRE INSPECTOR- WANTS HEALTH DEPT TO INSPECT. Actions Taken/Results: DS WENT TO SAID LOCATION AND MET WITH TENANT KEITH. THERE IS A STRONG ODOR OF MOLD\MILDEW PRESENT IN THE AIR. THE TOWELS OVER THE VENTS TO STOP THE MOLDY AIR FROM COMING INTO HIS UNIT ARE STAINED BLACK FROM WHAT APPEARS TO BE MILDEW. THERE ARE ISSUES WITH THE VENTILATION THAT NEED TO BE STRAIGHTENED OUT INCLUDING CLEANING UP THE ABUTTING PROPERTY WITH THE MILDEW SOURCE, ,AND MAYBE A CLEANING OF THE VENTILATION SYSTEM. UNIT C1 IS STUFFED FULL OF JUNK, AND YOU CANNOT EVEN GET INSIDE THE DOOR. THE TENANT IS NEVER THERE, EXCEPT LATE AT NIGHT, OR EARLY MORNING TO 1 Health Complaints 20-Jun-05 AVOID PEOPLE. SHE DRIVES AN OLD BLUE CAR THAT HAS A RUSTED TOP, AND SMELLS LIKE HER UNIT. DS SPOKE WITH OWNER, AND OPENED DOOR TO UNIT, BUT WE COULD NOT GET EVEN INSIDE THE DOOR. THEY ARE IN THE PROCESS OF EVICTING HER FROM THE UNIT. Investigation Date: 6/20/2005 Investigation Time: 10:45:00 AM 2 TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE Il:MINIMUM STANDARDS FOR HUMAN HABITATION Date 0 Owner Tenant �e-1 l V ke-r Sqq Add r sS Goo 0,+ Of I� r�[ Address n 54 4 c. 7 — S Compliance Remarks or Regulation# Yes No Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities ,k4k o Dtit 7. Lighting and Electrical Facilities 9 9 h .5�1 8. Ventilation r . v 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing PART II 37. Plocarding of Condemned Dwelling; � I Removal of Occupants; Demolition s (,lj(` r' 4r Zay/ be(gJ V,� Person(s) Interviewed Y Inspector \ �� 1 If Public Building such as Store or Hotel/Motel specify here Iv l I Al e �E o, ov- z rtn ..P <s } �4 1OAA r Iri --'— a t., y A AS N �•p � i ail rs �a�wf��—�� i• � .. 'r r k ; 1ly. = c • y 1 k �� T' i , r a., i Y e "`4 ' S) h • 'a 1 L 9 x q!e µ n ! q - r � a } IT lk Y• J4. tit Y a r } t.1s �Y ar \ MAL.' o- C° •' 3 Ail a f F a � Y. , r` 2' n _ a." t, , & r 4 _,d fie F, r f � 4 • M 0114� I i�. ! — �P•v u .v af� � &L � v i F � W ., dC r Massachusetts Department of Conservation and Recreation Massacfiuserts Office of Water Resources Well Completion Report 06-APR-10 09:31:33 WELL LOCATION 274537 GPS North: 410 38.948' GPS West: -700 17.42' Address: 599-," Main—Sty Property Owner/Client: c/o Green Seal Environmental_6 u Subdivision Name: (Hyannis) Mailing Address: 114 State Road Suite B1 City/Town: Barnstable City/Town, State:Sagamore Beach MA Assessors Map: Assessors Lot #: Permit Number: i Board of Health permit obtained: 14 Date Issued: Work Performed Proposed use Drilling Method Overburden Drilling Method Bedrock New Well Monitoring - 2 wells at this location. Direct Push CASING From (ft) To (ft) Type Thickness Diameter .00 -13.00 PVC Schedule 40 2.00 SCREEN From (ft) To (ft) Type Slot Size Diameter -13.00 -23.00 Continuous Wire PVC .010 2.00 WELL SEAL / FILTER PACK / ABANDONMENT MATERIAL From (ft) To (ft) Material Description Purpose -11.00 -12 Bentonite Chips/Pellets Seal WELL TEST DATA (ALL SECTIONS MANDATORY FOR PRODUCTION WELLS) Date Method Yield Time Pumped Pumping Level Time to Recover Recovery (GPM) (hrs & min) (Ft. BGS) (Hrs & Min) (Ft. BGS) Q t� STATIC WATER LEVEL (ALL WELLS) PERMANENT PUMP (IF AVAIL"A'BLE) � Date Depth Below Ground Pump Description:, Measured Surface (ft) 4Fk Type: Init ike Depth. 03/18/2010 16 710 Nominal Pump Capacity: Horsepower: WELL DRILLER'�S STATIIENT ADDITIONAL WELL INFORMATION Driller: Thomas E Desmond III Developed: No Fracture Enhancement:No Supervisor: Thomas Desmond III j�:3Rig'#0 98 Disinfected:No Well Seal Type:None Firm: Desmond Well Drilling Inc. Total Well Depth: 22.000 Depth to Bedrock: Registration #: .764 Date Complete:03/18/2010 Comments: OVERBURDEN From To Description Color Comment Water Loss/Add Drill Drill (ft) (ft) Zone of Fluid Stem Drop Rate .00 22.00 Sand & Gravel Brown Yes N/A BEDROCK From To Code Comment Water Drill Extra Drill Rust Loss/ # of (ft) (ft) Zone Stem Large Rate Stain Add of Frac Drop per ft 1/1 TO ALLNEW BUSINESS OWNERS: Fill in below: -p�5cgn� NAME OF NEW BUSINESS: TYPE OF',BUSINESS IS THIS A HOME OCCUPATION? i4A Land I— ��s � 0ESS OF BUSINESSYYl fl �l `S� ADORES MAP PARCEL NUMBER If you are starting a new business there arete a of Barnstable. Once yous you need to do lhaveer to be in compliance with all rules and retula been checked off on this sheet you may apply for a business certificate at the Town Clerk's office(Ist floor-Town Hall). 1. GO TO BUILDING INSeEGTO d has Fbeen FICE�exp sine he proVicedur�es needed to start This individual is m compliance a I ,�� - busines C s Building Inspector's Signature 2. GO TO BOARD OF HEALTH(3RD FLOOR TOWN HALL) This individual has been informed of any permit requirements that pertain to this type of business. Health Inspector's Signature 3. GO TO CONSUMER AFFAIRS(LICENSING AUTHORITY)-(3RD FL SCHOOL ADMINISTRATION BUILDING This individual hyenmad of any licensing requirements that will pertain to this type of business sin uthority Signaturebein checked o above-remember to return to the Town Clerk's office After g to actually obtain your business certificate. ' F Date: C� TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS:' 5 /!! 6-A) � �1 BUSINESS LOCATION: L//7 MAILINGADDRESS: =d QK -`151/ S> rM ait T, Mail To: �r 3�l �6 Board of Health .��°- �?TELEPHONE NUMBER: 1" 0�0 � Town of Barnstable CONTACTPERSON: 9Aj1Av Avnc.A G P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMB R: 4+1 ?.h $ Hyannis, MA 02601 TYPEOFBUSINESS: ?U1,e -A1,,e /A1_T4VOyt/� Does your firm store any of the toxic or hazardous materials listed below, either for sale or for you own use? YES N NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda i Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's .11a#I�5 Lacquer thinners Other chlorinated hydrocarbons, c ,R� NEW USED P (inc. carbon tetrachloride) Paint & varnish removers, deglossers Paint brush cleaners Any other products with "poison" labels Floor& furniture strippers (including chloroform, formaldehyde, Metal polishes hydrochloric acid, other acids) Laundry soil & stain removers Other products not listed which you feel (including bleach) may b toxic or hazardous (please list): cu,�V Spot removers & cleaning fluids ` (dry cleaners) a� Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: TOXIC AND' HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS:! 460 (A - BUSINESS LOCATION: .��rj J��.� .54k 4y cLm-1,`S MAILINGADDRESS: 4671 Mail To: TELEPHONENUMBER: 7i0 I 7? Board of Health oco Town of Barnstable CONTACTPERSON: 17'��vnt., /�/r%r�C/,+I�e P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: �5Qf 7— 031/ Hyannis, MA 02601 aa pp `- TYPEOFBUSINESS: _¢�r/L Does your firm store any of the toxic or hazardous materials listed below, either for sale or for you own use? YES NO >< This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE- LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor & furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents I Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: S TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM e NAMEOFBUSINESS: i 1 BUSINESS LOCATION: MAILING ADDRESS: 5/�Ivl Mail To: Board of Health TELEPHONE NUMBER: Town of Barnstable CONTACT PERSON: P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: S-O �2Li �l y Hyannis, MA 02601 TYPE OF BUSINESS: na e S v Does your firm store any of the toxic or h ardous materials listed below, either for sale or for you own use? YES NO�� This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. . Quantity Quantity , S Antifreeze(forgasoline orcoolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes °Asphalt & roofing tar Fertilizers (�/Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor& furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids (Z y 1; C, PCA 'l t1j* (dry cleaners) 1&34e Other cleaning solvents 00 6L Q Bug and tar removers , WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: BUSINESS LOCATION: HfA 4 ' � MAILING ADDRESS: �1M e-. Mail To: TELEPHONE NUMBER: Board of HealthTown of Barnstable CONTACT PERSON: Sion N el I I, P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: 5-0 a 44 IFIN Hyannis, MA 02601 TYPEOFBUSINESS: TM Does your firm store any of the toxic or ha ardous materials listed below, either for sale or for you own; r - use? i YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above,please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character-4 istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners ,. Automatic transmission fluid Disinfectants s Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides,,herbicios, rodenticides) Gasoline, Jet Fuel Photochemicalss (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for'engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Y Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda r Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers F Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners - (including chloroform, formaldehyde, Floor& furniture strippers hydrochloric acid, other acids) Metal polishes ° Laundry soil & stain removers Other products not listed which you feel;- (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids A a ) (dry cleaners) , I Other cleaning solvents Bug°and tar removers I g WHITE COPY•HEALTH DEPARTMENT/CANARY COPY BUSINESS ,°