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0064 PLANT ROAD - Health
64 PLANT RD. ,HYANNI MAP- PA = I 1 o; i i o I 45-7 LOCATION SEWAGE PERMIT NO. VI L.LAG E �GHHi 3 INSTALLER'S NAME i ADDRESS Jody �lEW t U I.L D E R OR 'OWN ER ` GATE PERMIT ISSUE°'D' a DATE COMPLIANCE ISSUED 2b f / L �` S VIZ) > THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH � J ...................OF..........Z� _,*sx0.�lle.....--------------..._..--.----- Appliration for- Disposal Works Tonstrurtivit ramit Application is hereby made for a Permit to Construct (VI"or Repair ( ) an Individual Sewage Disposal System at: ................ .............................. �: ��` ���� ���---..67Z AD ---- ---- ----- ---- �_._.L ion-Address or Lot allo. caner C� .Ad-ess Installer Address Type of Building Size Lot...1JO�__7l.0...Sq. feet Dwelling—No. of Bedrooms................... ...___ _____ .._.._Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Buildingo�� - � W� b` � sons............................ Showers — Cafeteria a d Other fixtures ---/-- `-------4- --------------------------------------------------------------------------------•----.....---------- W Design Flow............................................gallons per person per day. Total daily flow................................._..........gallons. WSeptic Tank—Liquid capacity------------gallons Length................ Width-_____--__-__-- Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No_________________ ___ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ~' Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water..._.................... f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 94 --•----------•------•----•---••--•----•---•-•------•---•••---•••••-•........................•--•--...........--••-----......._...----•--------•------------- 0 Description of Soil_:...................................................................................................................... .............................................. x --------------------------------------------------------------------------------------------------•-----------------------------------------------------------------------------------------------.•--- U Nature of Repairs or Alterations—Answer when applicable.............................................................................................. ---------------------=--------------------------------------------------------------•-------------------------------------------------------•-----------------------------------•-------------•-------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the s stem i operation until a Certificate of p ' n �a issued by the b d o 'ealth. �� � Signed- l. Dat ApplicationApproved By.............. --�. -... ••• -------•'--------...................................... -------- ...... Date Application Disapproved for the following reasons----------------•••••••••••-•-••-------••----•-••-...------•-•••••-••---•--••-•-•--•--•••---•---•-•••.......---- ....•---•...--•••-•--'-•..............•-:..•••--•--•-------•-•---••---•-•---'-----•-•---•••••••---•----•.-•••••••-••-••--•-•-•-•----------------•---•••-••-----•--•-----------•----•••••--••---...------ Date Permit No...... H 1 g ................. Issued...........� 1 : . ate ----------------- --- --- - .. � rto................_. . `7 Fss....,..,,.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF.......................................................................................... Appliratinn for Disposal Works Tons#.ration flrrmi# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................_........_...T..... .............................. ...---•-•-•-••-----•-.........--------•-•-. ...--•---...............----•-........... Location-Address or Lot No. ................ ....................... ... ..... -...... ... - •-•............................. W , Owner Address Installer Address Type of Building Size Lot............................Sq. feet aDwelling—No. of Bedrooms.............................................Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtures -------------------------------------------•--........ . .. Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid*capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area...................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......................... fs� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ----------------------------------------------------------------------•••-•----•..........................---•-•--------------------------------•------...... 0 Description of Soil...................................•---••-----•----......---•---•---..............--------------.....-•----------........---......-----•---••-..............._.......... W U •--••------------------•--•-----...............-•---•----•-•----•..............--... . .......----....................................•-----......................................---................. W ----------------------------------------------------------------------------------------•---•----•------------------------------...............------------------------------------......._.•-•--_..... V Nature of Repairs or Alterations—Answer when applicable............................................................................................... ---.................................................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of p ' n Effl�tdi�issued by the board of health. Signed...................................................................................... ................................ Dat Application Approved By_... 'J C ,�. ... ,.. i.._. r4�/:: :................................... Z yl� ,. fi� .............. Date Application Disapproved for the following reasons:..........................................................................................................--- .......---•---------•-•.......................................................•-----•--................_....--•---.......................---•--........----------------...........------......•••-•----- Date PermitNo......................................................._ Issued_.................................................... Date THE COMMONWEALTH OF MASSACHUSETTS { e � BOARD OF HEALTHr9 ..........................................OF..................................................................................... 10111rr#if iratr of Toutplittnrr THIS IS TO CERTIFY, Th the ndividual�Sewa sposal System constructed ( ) or Repaired ( ) by............. -----.:T..•................. ..........►L.........-ez •-eezz ... - • - ...--••• ............................... I staller CjY�at............. .._......`.�...---....... ... ......._ _ ..------.....------.........----------------•-......-----.... has been installed in accordance with the provisions 5 TLE 5 of The State Sanitary Code a described in the application for Disposal Works Construction Permit No.....I_'. ........ dated........':?... ..01 2S.............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS UED AS A GUARANTEE THAT THE SYSTEM WILL FUN O SATIS ACTORY. DATE.............................._.....2..6.. -15................ Inspector............. ....... ..... .... .................... THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH t� ..................... � No.. FEE.....�..�Q G. ....... isnsi.� orks (Ion �n r # Permissionis hereby granted.......... ..........:..........k .•••..---.-- -• -----....-----... ........................................................... to Construct (�() or Repair � ) an Individual Sewage D' osal System atNo........L..o'.E...... ....... �.:.--L'�[:-a... l` r--• 4'.4►n-+•�--------------......------...---••------•--------------------...----•--••--•........ �. Street as shown on the application for Disposal Works Construction Per 't No `^'._lr�'i._. Dated......._ /..�1 �`� .�_�.. .............. ` -5 Bard of Health DATE.. ............................................� AWWAAFfn truce-►- �:sr..uT FORM 1255 A. M. SULKIN• INC.. BOSTON O1 lTZ Arlon�vlT • C- ,ri C��'v �� !1._.I c_ S�Tr1fA ��: �i�•`'-� T� M WRIT7Alro t� TS t E [y¢/?(� rF I�S�iST�rr! .�75 fV� r N I1GCtRl1•tines 1 4 ,akt' Y 362.4541 926 main street yarmouth mass. 02675 down cape en,g ill eeiing civil engineers& land surveyors structural design Arne H.Ojala P.E.,R.L.S. land court Richard R.Fairbank P.E. surveys site planning July 31, 1985 sewage system designs Barnstable Board of Health Barnstable Town Hall inspections South Street Hyannis, MA 02601 permits Gentlemen: On July 30, 1985, Down Cape Engineering inspected the installation of the sewage system for Lot 6 Plant Road in Hyannis, and we certify that it com- plies with _.the intent of our site plan # 84-262, dated October 19, 1984 ( revised October 30, 1984). Thank You for your attention. Sincerely, gneH. ,�A , . o . WES/kmk cc: Mr. Bennett 35 Main Street Yarmouthport, MA 02675 V o, > I/I �a�aW.5 cr� ha�j aw(duo- M axl m vnA s-r = Rccz,avroL _r �"*e4-tc2t L/CE/VE� 11EQv/RED fl•5.4.R F/eaae_ � Date: S s oy a,t -11ri, - N-e.aAA-h De<- A-- -I-Q uvm o,- c e S. TOXIC AND HAZAREfOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: BUSINESS LOCATION: .MAILINGADDRESS: INVENTORY •TOTAL AMOUNT: TELEPHONE NUMBER: 5-09 - -77$ - 05-6V CONTACTPERSON: Js- So cj,�aA EMERGENCY CONTACT TELEPHONE NUMBER: FWe 1)(5.7�ICT TYPEOFBUSINESS: A AA-ft OTHER INFORMATION: ��Qa�-e, ,Q � avc vvc1-� osl ago( S s 's s n 'o_ M S®S co 54e_ wry a-�, b a� d a�f`� cwo r•ol -Fir e Waste Transportation: rr P.�s�cti e — G'a •e� �a Z'a d. Name of Hauler: 5a-�e�4-h t- 1ee4a- Destination: blasttee Product: Licensed?. es No past- LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. . NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed (gallons): Antifreeze(for gasoline or coolant systems) Drain cleaners 29 . VEW 1215- USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite)JSc-e /jJe.l.4 Hydraulic fluid (including brake fluid) Refrigerants Motor oils s Pesticides Z2_gsPA NEW � USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED 9.� 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) Z Battery acid•(electrolyte)&emit -u-e-a 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 Floor &furniture strippers (including chloroform,formaldehyde, Metal polishes hydrochloric acid, other acids) Laundry soil &stain removers Other products not listed which you feel (including bleach) may be toxic or.hazardous (please list): Spot removers & cleaning fluids Misc.: W,,2dAA!,,C ea �w�ah Zo as t (dry cleaners) Se. _ a.( Other cleaning solvents Bug and tar removers Town of Barnstable Hazardous Materials On-Site Inventory and Inspection FACILITY INFORMATION: Business Name: / ¢" Tare(�116 lZkk,$� iUC Business Location: 6� />Li 4.)7T 11 b,X4A_ !S Mailing Address: .4s t6cyc Telephone Number: _77H `� -,ff'O Contact Person: Emergency Contact Telephone Number: X u.- RP etc -'FfL- %ok- 0,9 V Type of Business: AGt Tv ��'�i.� .f�v® 1W1Ar7AcfA-At41- HAZARDOUS MATERIALS (CHAPTER 108) Virgin Product Total Quantity Container Size(s) Storage Location Major Materials Gallons or Pounds Quarts,gallons, Shed,retail store, drums,tank,etc... cabinet,closet,etc sq94ZG4NJ �!Vb>1 v'/DurQ2 -P4477S AgdW ONE-a*t'Lox4 &-m W11w>511&7c.4 ��ti� 4�c r.�� G{�rf•�r 36 srA/ems VIP6,/AI u4r.T_e6AITA1.0J Ots N'RrS A- OIL- /e3 61ti-LcNs f 3oo4!Mt ,Ji¢S'i /QL "DACE$ 4u-4A.)s 4azosoL C AJS ?A'ar5 4-u,7P At knC- 6mtold eo v mA rs 7p.A0S,flSS'/6 AJ Awl " _4 'v s '��� `' ' ��® 6 Wks rE- o5v 4 At-c-o R1 S-'-v ae,+q f - 1 - Misc. Combustibles Misc. Corrosives Misc.Reactive Misc.Toxics !9/T/E a44" -PfR-775 C/I-4-"itds d,0,V7*-1AJ,5 Inventory Total Amount: --X_O&fj_ &A' /.$ Hazardous Materials License Posted?Yes o Contingency Plan Posted? Yes (TO Fire District: / vA-AIAI,S Fire Extinguisher Service Date: OGT Metal Covered Rag Bin: es No Absorbent Material Available? es No Type of Absorbent- peedy D Pads Pigs Other: MSDS on site? Yes `V Hard Copy Computer Access Hazardous a dous Waste Handling Hazardous Waste Generator Identification Number: Type(s) of hazardous waste product(s): U567> D/L- r- Date of last hazardous waste shipment,type of waste and quantity: LSEn7Z1-Heert l fikS7Z- P N_7117F No�cJ �iiOAS �y,i.� Z f Hazardous Waste Transporter(s): (© dJ <L Designated Hazardous Waste Facility: 5 Tn"fHaAJ 1,14 Hazardous Waste Storage Area Description: Ag_C4 u[1+tr-o 12) A_f,6_ A Nm LIl 3�b to � y� �, �® s ra gA4 E 'T7tO S � l•ocA r" i s O ASI�" A �A�-ACE 3 �7t� consc,R rtt�� �u�. S-MA I S A. µf77V TiZA I LEr2- W M4 W06b LQC* 4s 6AR-OF ME _eA&P� Is hazardous waste storage area Labe ed: Yes /0 Are tanks/drums/containers labeled with the words "Hazardous Waste",the type of waste and the associated hazard(i.e.ignitable,corrosive,reactive or toxic) Yes If hazardous waste is stored out of ors is it covered from the elements? es No Is it in 110% containment? Yes No If hazardous waste is stored indoors is it on an impervious floor? es No - 2 a FLOOR DRAINS (Chapter 381) Town Sewer Account Number: Indoor floor drains: Yes l` o If yes,circle one,does it discharge to a: holding tank dry well on site septic. Outdoor surface drains: Yes No If yes,circle one,does it discharge to a: holding tank dry well on site septic. FUEL AND CHEMICAL STORAGE TANKS (Chapter 326) Underground Storage Tank(s) on site? Yes No Age: Is removal required? Yes No If yes,when? Is testing required? Yes No If yes,when? Out of doors above ground storage tank on siterDe No If yes,is it protected from the elements. Ye No If yes,how? 57a��b /�s CAE of T1 !L�� Is it on a foundation larger in size than the tank? Yes TA-AJa:S ,0®Al107- l .4 ry C0AJr&>,4J11lQur 7Wo OF 77C ?kt/KS wDeC 6W0T% oN� W*S COMMENTS/RECOMMENDATIONS/CORRECTIVE ACTIONS Q*'4meIA-f— 5�—CM SO S IYA 4kAQ0us kR rEXiA2S ThR T &APLC)�� i 044 W'Ai-Y A-46-7 Ta 0'e- A yA:j"aCtr '&u S i rF: 'ON S 1fr, A 13 50P-Fajr-6cok5 S l-w u-LD BE- KEPT ON s or ID cwihjx, Apt ?6TrW-"/*L' S1>1LLS. 'PA; �41 -- "WASTE o 1 L�57a 4AGE 7W&3 KS A-4 - TV r3 E u4-+5 is LED~R IE4u L.kTEO K -t.yc-L4 x NA--TeV4*0 Vs(Z YL-r—a.(FL'' A-Pb"TO A is -n4 c w"Tt-- ajL- c,&bpy s A AZEAtSd TD 5E' LAt6�-D AS S4jet4, A µAt lMebUyS HAsTERV AL- L 1 SSE tS Ta BE dl-PP wEt ro i� k Esb -FoSTET> 613 51Tr VJt+a3 KfCEAIED, SPILL Co Nil nseAMC4 PLA}t A � �€ 'k VA I L46tZ 0�j s j TE. Date: Public Health Inspector• Facility Representative: -T44 E lLz56- 0f= -rWC W00bW FL®®rL -I-V k1 LUL- C—op Vj !E Gl1_ SIZ2ACeE l LtN AC C-E�ThPAE I P HEC71 A- & T*C -STWAAC /R,iF-6uAPCAY,&-7u73 Cr eO4Om-z- /a8' 11-1-C 44 g0vC 4 P-OVAb 7?t-,J/cs "e.47 you -,H-C 7RA/tom /V&-rb 7P i v� 1/0% C0A J7-7�1 JA40Jr• V'Ts-. 907V2eW 0 94S,, ¢5 OWAXa or- 7W-6 iN A167E7 cl i- ISPA-C,6' P� fhN s Po It r W-+� - 4- F✓Lahc o TliL--rZ- 5`MS vpr c0 V 7�T T7fE L- O-7� 7 �C lrl eAl �o F a i�C)o f o a e- WA-S� e-Xj R-A-7V1Z 5 7*Ttt.5�uo9 SET yrc. .vAD�74�t3L�IV&-1Zi -ICA7740AJ ®0 �/ ram, / /�i'y!� N AO E S /R.t ,�,,R4 -ov, *r Fok AN 1 AJJ P&-r-n,0N a� 7ME PE�i 4 iT i� ts�c PSAh4G m.+1i[s"12 hNDY-IPAC� J-A��I-TNL /ov6TA1 CLA77BA1- YOU WISH TO OPEN A BUSINESS? For Your Inforn"aation: Gusiness certificates (cost$40.00 for 4 years). A business certificate ONLY"REGISTERS YOUR NAME in town (which you must do by M.G.L.. ir,doe:it neat give you perrnission to operate.) YOU must first obtain t.hc necessary siKnature's can this forn"r at 200 Main St.., Hyannis. Take the.c:oni)loed form to thr: Gown Clerk's Office, 1st Fl.., 367 Nl�rin St., Hyannis, MA 02601 Town Hall) and get the Business Certificate that is required by DATE: -� .�; 2 Fill in please: APPLICANT'S YOUR NAME/S: ,� �i J��c h s BUSINESS YOUR HOME ADDRESS: ce'A yL�Le A yo'lC_ t 4 ljt�� 27 W v v' (oCrA y TELEPHONE # Home Telephone Number `�1rl�t_�(�� i NAME OF CORPORATION: Z v +t z h S 11 Z.- NAME OF NEW BUSINESS TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES„ ADDRESS OF BUSINESS � 6U MAP/PARCEL NUMBER 2�L� V� `� [Assessing] . When starting a new business there are several things you must do in order to.be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO T0.200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits.and,licenses required to legally operate your:business in this town. 1. BUILDING COM SION R'S OFFICE ✓ <�� � c This individua hay b n info f ny p rmi requirements that pertain to this type`of business:. Auth sized S' tur COMMENTS: 14 2. BOARD OF HEALTH This individual has n inf rmed o th er it,requirements that pertain to this type of business. r Autho zed Signature COMMENTS: FA C"/L-z T�ZT �� /Jt7►�G/ti 4 � 'J//2� eE7t1% f'U /f/f��M r�uJ" ' s+`�7?//F .J 3. CONSUMER AFFAIR NSING A THORITY) frThis individual hS e om f th licensing"requirements that pertain to this type of business. 46thorize ignature* COMMENTS: Date:("I /Z /-2 Iz TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE NAME OF BUSINESS. i r i BUSINESS LOCATION: Co Lf daoGA INVENTORY MAILING ADDRESS: TOTAL AMOUNT- TELEPHONE NUMBER: 5-6t-- ? 'OE(oLI J CONTACT PERSON: ovv� Xy��pP EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: \-* 6C94ir- \&_S INFORMATION/RECOMMENDATIONS: Fire District: kA 01 Waste Transportation: _lhkds�,kc Last shipment of hazardous waste: Name of Hauler: 5� 4-� Xta�,, _ �• Destination: Waste Product: AAA Licensed Y No WAA-4- nil ,y bu"' - i s 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 '('e_�, Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive IAEW USED Cesspool cleaners a y\ Automatic transmission fluid Disinfectants Engine and radiator flushes `\ Road salts (Halite) c\ Hydraulic fluid (including brake fluid) `\ Refrigerants Motor Oils Pesticides 170 .\ 3Sv ,4NEW BUSED (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 ` - r Laundry soil &stain removers IJ - (including bleach) r cM Spot removers&cleaning fluids (dry cleaners) ��y L-L �s 1 `\ Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials Date: /Z'5 / TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS OWSITE NAME OF BUSINESS: BUSINESS LOCATION: Co L( I���n� ,� I '`�r4V1Y, l Cdfoyl INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: Lt CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: IvAd Akr- Last shipment of hazardous waste: Name of Hauler: 5� �, l�lAv� = �,AV&fi u. Destination: s. , Waste Product: Licensed . Ye No � Ilk Wt-A 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 Ye Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive . "EW ZI USED Cesspool cleaners a �\ Automatic transmission fluid Disinfectants Engine and radiator flushes �� Road salts (Halite) �\ Hydraulic fluid (including brake fluid) \ Refrigerants (c Motor Oils _/ Pesticides , NEW 'I 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 L,%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, (including carbon tetrachloride Lacquer thinners ( g ) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables 't Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes l W (A� � td Ren Laundry soil &stain removers (including bleach) �t�� Spot removers & cleaning fluids h (dry cleaners) AC_ eA 4/"L- L( 5 l s\ Other cleaning solvents v 1 Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1. Marine, Gas Stations,Repairi 2. Printers satisfactory BOARD OF HEALTH 3.Auto Body Shops �^ n O unsatisfactory- 4.Manufacturers COMPANY wV-_y IVAQ 3 (see"Orders") 5. Retail Stores � _ � 6.Fuel Suppliers ADDRESS � Cl�lc�A n: � Class: 7.Miscellaneous nCS� QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: I waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers 'p,e 0 r Miscella eous: S- �^ kCE 4e._ DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply ,Town Sewer Public �. O On-site OPrivate Slr 3. Indoor Floor Drains YES NOx O Holding tank:MDCS � £� O Catch basin/Dry well 5 U� _ & li Guf1�, O On-site system 4. Outdoor Surface drains:YES N0!)j_ ORDER : O Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destin;�tion Waste Product ,d YES NO 2. t&Ll✓ 6 �- Person(s) Interviewed Inspector Date f a Town of Barnstable °FtHE rq� Regulatory Services c 4 "�• °� Thomas F. Geiler,Director 1 9� S&�$ Public Health Division ,0 '°'En►r+A+° Thomas McKean,Director q G� 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 r FULL NAME OF APPLICANT ff,,e V C, ,C/W NAME OF ESTABLISHMENT �(/�� � ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER 7 r t SOLE OWNER: YES L//NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 043.')-q I on- STATE OF INCORPORATION l� . FULL NAME HOME RESS OF: PRESIDENT ( 4'1 U/ P kU / on A �,.✓ TREAS j"1 1 °L(.0 �-i VI-ACMt, ® J CLE i4ar e)L,0-(u 16 ecyIP—clT SlijINATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# Haz.doc/wp/q P. 1 COMMUNICATION RESULT REPORT ( AUG.30.2004 11:11AM ) s� TTI BARNSTABLE BOARD OF HEALTH FILE MODE OPTION ADDRESS (GROUP) RESULT PAGE ---------------------------------------------------------------------------------------------------- 852 MEMORY TX 95087905977 OK P. 3/3 5 5e/Y7� (1, 40 .10 ----------------------------------------- ------- REASON FOR ERROR E-1) HANG UP OR LI FA E-2) BUSY E-3) NO ANSWER E-4) NO FACSIMILE NNECTION Z),J—N Town of Barnstable . FAsa�►ers, = nets; s Number of pages iwlu&g cover sleet: Jv"" To: From: Town of Barnstable mtalth niviaion 200 Main streat Fltra�s,MA 02601 Phone: M—M— 01�j Phone: 1 L508)362.46U Fax EIM: '�D 9 �.� FAx phone: 1,(508)790-6304 CC: Town of Barnstable , Oq TAX �axsr"acs, ' Date: KAM Ik Number of pages including cover sheet: To: From: Town of Barnstable ' Health Division 200 Main Street A"I-1 CHI D/t/ Hyannis,MA 02601 Phone: 5-61; Phone: 1 508 8624644 Fax phone: 5-0 g — -7 0 S�'-7 Fax phone: 1 (508)790-6304 CC: REMARKS: ❑ Urgent .For your review ❑ Reply ASAP ❑ Please comment 6-07117 Spill Contingency Plan ^- I. Evacuate the immediate area, if necessary. 2. Shut off valves, pumps, and electrical equipment as appropriate. I Remove or restrict any potential ignition source from the area if the material is flammable. 4_ Cover or dike all existing sumps, and storm drains if not already covered. 5. Contain the spill by use of absorbent socks/booms,then apply appropriate absorbent material or additional absorbent socks/booms. Contact spill response firms in Appendix E.if necessary, to assist in these activities. 6. Remove all absorbed material or contained liquid and package in DOT approved container. Used absorbent materials should be packaged separately from Iiquids. 7. Label all containers with the type of waste and the start date of accumulation. 8. Notify the appropriate agencies and ILI corporate contacts as prescribed in Section IV. 9. Once the spill has been controlled and materials collected and secured,inspect the area for cleanliness and decontaminate all equipment used in the clean up. 10. Replace all used materials and ensure all response equipment is in good working condition. 11. Manage and dispose of collected absorbents and liquid in accordance with Federal and State environmental regulations. 12. For any spill greater than the reportable quantity(see Section IV) or 25 gallons, whichever is less,this plan shall be implemented-and proper records of action - shall be kept on-site as prescribed in Section IX. 13. Spill clean up equipment is located in the lower level of the building. -14. The following is a list of the spill equipment on site. a. Sill response kit capable of containing a spill of at least 25 gallons_ This kit includes absorbent spill pads, socks, and/or booms_ b. An adequate amount of nitrile gloves, nitrile or rubber boots and other personal protective equipment C. First aid kit d. Eye wash e_ Fire extinguishers EXHIBIT G Emergency Services Local Fire Department Telephone Number: (508) 775-2323 Local Police Department Telephone Number. (508) 775-1212 Local Ambulance Service Telephone Number: (508) 775-2323 National Response Center Telephone Number: 1-800-424-8802 List any other emergency service numbers below: NAME TELEPHONE NUMBER Local DEP Office / (508) 946-2850 ADvA&rc ed L%Bv1-EL 12ec7'cl;As 203 - d39 •6?7/ Clean Harbors = (617) 849-1800 &% 617- 4 35- 170006 Jiffy Lube Corporate Office ( - 6I7- S 78- 4 I A ! Garner Environmental I-800-442-7637 Pennzoil.24-hour Incident Reporting: 1-800-848-7525 JLI Environmental Coordinator: (713) 546-85I2 JLI Public Relations: Mickey Gentry, (713) 546-8538 Emergency Services Local Fire Department Telephone Number: (508) 775-2323 Local Police Department Telephone Number: (508) 775-1212 Local Ambulance Service Telephone Number: (508) 775-2323 National Response Center Telephone Number: 1-800-424-8802 List any other emergency service numbers below: NAME TELEPHONE NUMBER Local DEP Office (508) 946-2850 ,aDua&•c ed G:@v.'d 12e cycC:Ns 203 - d39 -G?7/ Clean Harbors = (617) 849-1800 &% 6/7. 135. loco(. Jiffy Lube Corporate Office (6- - 6/7- S 78- 4« ! Garner Environmental 1-800-442-7637 Pennzoil 24-hour Incident Reporting: 1-800-848-7525 JLI Environmental Coordinator: (713) 546-85I2 JLI Public Relations: Mickey Gentry, (713) 546-8538 c=�. ��- EXHIBIT A ' Spill Contingency Plan ! j I. Evacuate the immediate area, if necessary. 2. Shut off valves, pumps, and electrical equipment as appropriate. I Remove or restrict any potential ignition source from the area if the material is flammable. 4. Cover or dike all existing sumps, and storm drains if not already covered. 5. Contain the spill by use of absorbent socksibooms, then apply appropriate absorbent material or additional absorbent socks/booms. Contact spill response firms in Appendix E,if necessary,to assist in these activities. 6. Remove all absorbed material or contained liquid and package in DOT approved container. Used absorbent materials should be packaged separately from liquids. 7. Label all containers with the type of waste and the start date of accumulation. 8. Notify the appropriate agencies and JLI corporate contacts as prescribed in Section IV. 9. Once the spill has been controlled and materials collected and secured., inspect the area for cleanliness and decontaminate all equipment used in the clean.up. 10. Replace all used materials and ensure all response equipment is in good working condition. 11. Manage and dispose of collected absorbents and liquid in accordance with Federal and State environmental regulations. 12. For any spill greater than the reportable quantity(see Section IV) or 25 gallons, -whichever is less, this plan shall be implemented and proper records of action shall be kept on-site as prescribed in Section TX. 13. Spill clean up equipment is located in the lower level of the building. 14. The following is a list of the spill equipment on site. a. Sill response kit capable of containing a spill of at least 25 gallons_ This kit includes absorbent spill pads, socks, and/or booms- b. An adequate amount of nitrile gloves, nitrile or rubber boots and other personal protective equipment C. First aid kit ' d. Eye wash e_ Fire extinguishers tj2!!:� , 40 NO C-0 -91 et C raoet -, f �+ PHONE F C,AI::L: IOR— DATE_CA l TIME P.M. Im P,HflNEO„ ;' OF RETU1aNE� PHONE YDUR CRLL AREA CODE - NUMB R EXTENSION � � ,l PLEASE CALL. MESSAGE " DC UAL CAtL ' AGAIN , "GAME TO„ SEE YOkJ VtiANTS TO` ;SEA YbU SIGNED �niver'SaI 48003 z 0 m a. ox r.r i �r•5 ? I/ l na r4 0W.5 Shp�wral cllca- /j7 �a c/nl i = I-{czar roLoz�s Date: 5` 5 0 ea A*Hl D Q. )Ar TaurN o 4Ei c e 5. TOXIC AND HAZARdOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: A4 O.A. ' BUSINESS LOCATION: .MAILINGADDRESS: VENTOR TO a(e T. TELEPHONE NUMBER: Tog -77B - 05-41/ �w, �_ CONTACTPERSON: ' EMERGENCY CONTACT TELEPHONE NUMBER: iFlRE Orr ; TYPEOFBUSINESS: AAft OTHER INFORMATION: �,Qa� ,Q w�yt-� crr.! wr�� •S s .s To s 's s a - M 5 D, oo ,5ik Com-mcil P i r o 5 e r ,a t a�rib aa� b a� Waste Transportation: - _*e..p Name of Hauler: Destination: Waste Product: a� L,�o2�- Licensed?,-(Ye No LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. . NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed (gallons): Antifreeze(for gasoline or coolant systems) Drain cleaners Z EW lnpA-USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite)lSce 1j7ct* -�-- Hydraulic fluid (including brake fluid) Refrigerants Motor oils s Pesticides z� NEW �USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diese j fuel, kerosene, #2 heating oil NEW USED 9�'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 ac d (electrolyte)�b �•per. Swimming pool chlorine Rust roofers p Lye or caustic soda Car wash detergents Jewelry cleaners Car wakes and polishes Leather dyes Asphalt& roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, _ NEW USED (inc, carbon tetrachloride)- Paint &varnish removers,`deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform,formaldehyde, Floor&furniture strippers Metal polishes hydrochloric acid;other acids) Laundry soil &stain removers Other products not listed which you feel (including bleach) may be toxic or.hazardous (please list): Spot removers & cleaning fluids Misc.• (M;l&2&z;a c,1 W-am. Zo 4 (dry cleaners) Sc. Other cleaning solvents Bug and tar removers M1 a I � dQ CA t .r" r Town of Barnstable a:oFtHE%rp� Regulatory Services ��O Thomas F.Geiler,Director p�j Public Health Division (� * saRzvsnsi ;s* Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 11A> Phone: 508-862-4644 Email: health(a-),town.barnstable.ma.us Fax: 508-790-6304 f-�e ��//P� Office Hours: M-F 8:00—5:00 Bennett's Auto Repair Attention: Manager - _ //� �' ��-�v June 2, 2004 64 Plant Road � 77 � Hyannis,MA 02601 RE: Hazardous Materials License Required Good Morning: �y,�t-s Thank you for your time and cooperation during the Toxic and Hazardous Materials On ite Inventory at Bennett's Auto Repair. The inventory total from May 5,2004 shows that you ha e approximately 584.50 gallons of toxic and hazardous materials being �o�e > used/stored/generated/disposed of at your place of business(Please refer to the Toxic and / 7 D�/- � ► Hazardous Materials On Site Inventory sheet). The Town of Barnstable Board of Health has determined that using, storing, generating and/or disposing of over 111 gallons of hazardous materials per month requires businesses in the Town of Barnstable to obtain an annual Hazardous Materials-License. This license should be purchased by your business as soon as possible from: Town of Barnstable Town Offices Public Division of Health 200 Main Street,Hyannis Passing your Hazardous Materials Inspection and obtaining your license will keep your business compliant with the Control of Toxic and Hazardous Materials ordinance(Article 39). Following the recommendations given after your annual inventory can prevent contamination of Barnstable's existing and future drinking water supply,prevent environmental contamination which can bankrupt site owners,lead to future regulatory, and possibly,legal problems,lower or destroy land values, drive out residents and industry,depress local economies and endanger public health. You will receive your Hazardous Materials License certificate after you have passed your inspection and paid the license fee. Your continued cooperation is greatly appreciated. If you have any questions or need further information,please do not hesitate to contact the Public Health Division. Thank you, 7. Thomas A. McKean,RS, CHO Director of Public Health v Date: S_ ' '1-ow� TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: ' BUSINESS LOCATION: M ems[6 f 0(a MAILING ADDRESS: VENTORY •TO T: TELEPHONE NUMBER: ,' Q8 — -7-$ - OS(o�/ CONTACTPERSON: EMERGENCY CONTACT TELEPHONE NUMBER: 1=tit�E Ut 5.7�1r✓T" TYPEOFBUSINESS: LA-ft R�nau. OTHER INFORMATION: �JQa ,Q Q,vc w�y1-Q 044 ea wa •S S S To C at s 's s a K M SAS o� Srf� s �S. Cent/ -acne-^ in Se,� a to,q dou tLf eot A. Waste Transportation: sr, �, _ Qa�KQ.c�.?� tna z-a-td. Name of Hauler: S e w t-S 1 e.e ., Destination: Waste Product: Licensed? es No wcty� 0,:t h mot- 1 b J LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. . NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed (gallons): " Antifreeze(for gasoline or coolant systems) Drain cleaners Z �VEW 1np�L USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) /Sce /j7e Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides 2_2aoA NEW USED (insecticides, herbicides, rodenticides) Gasoline, Je 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) Z_ Battery acid (electrolyte) b � �. Swimming pool chlorine ( ' Rustproofers x 20 ha Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes lb ) Leather dyes Asphalt& roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc.. carbon tetrachloride) - Paint &varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners Floor.&furniture strippers (including chloroform;formaldehyde, Metal polishes hydrochloric acid, other acids) Laundry soil &stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids Misc.: P'(N1hdajea 20 (dry cleaners) 3e - _ Other cleaning solvents AcgellAj Bug and tar removers Town of Barnstable-Health Department Page 1 HAZARDOUS MATERIALS INVENTORY SITE VISITS DBA: Bennett Auto Repair Fax: — Corp Name: Mailing Address Location: 64 Plant Road Street: 64 Plant Road _ ......... ._.. _ mappar: City: Hyannis Contact: :Neal State: Ma Telephone: 508-778-0564 Zip: 02601 Emergency: 362-9991 Person Interviewed: Business Contact Letter Date: _ ......... ...... .........__... Category: VehicleMaintenance Inventory Site Visit Date: Type: Follow Up/Inspection Date: public water ❑ indoor floor drains ❑ outdoor surface drains k/1 license required ❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc ❑ currently licensed ❑d town sewage Qkndoor catch basing ,e&`outdoor catch basin/drywell expir ...------- - --- ❑ on-site sewage ❑ indoor on-site syste ❑ outdoor onsite system date: ._.___..............._ .._ Remarks:4/22/97 MSDS sheets,spills-spedi dry&rags,Laundry- compliance: Acme,No diesel storage on site. Orders: Cover on Satisfactory rags. REMARKS: 6/18/98-MSDS in file is incomplete.4 electr.Lifts. Numerous stains on floor w/speedy dry.Mea Aqueas parts washer. Oil filters drained then chucked in solid waste.Unifirst rag service. Metal buckets w/lid present. Interstate trades batteries. Town Fair, e S Fairhaven MA takes 2 tires to 1. ORDERS: Update Material Safety Data Sheets for all prodicts. Request from retailers/distributors/manufacturers. Remove dispose of empty 55 gallons drums and esids scrap metal. Comply in 30 days.Tires too. 5/1/02 REMARKS: Speedi Dry used for small spills. Two waste oil tanks kept in shed out back,pumped to bays&burned. Rags kept in fire retardent container. Aqueous rased parts cleaner. ORDERS: Make sure all drums&tanks are labeled. Batteries recycled with Interstate. Burning all waste oil to heat bays. 4/20/04 Follow up on sketchy compliance issues listed above. Need to inventory to ensure they obtain a HazMat license. Never acquired one from last inspection. ff. s % sl Page 2 Town of Barnstable-Health Department HAZARDOUS MATERIALS INVENTORY Chemicals: ❑ Zero Toxic Waste Materials ❑ gty's>25 lbs dry or 50 gals liquid but less than 111 gals ❑d gty's 111 gals or more S J description; qty: unit of measure antifreeze(for gasoline or coolant systems) 5 cases ..._......_._.._._______..._._.___.__.__..___................ ._...... ._ ......._._.. 9._ . .._ _.... motor oil 300 allons _ _.. ... . gear oil 35gallons motor oil 55'gallons ....................._._._._....._...........__.........__ _.._._.._..._----...._..__.....--.._....__.... __._....._........_...--._..._.._.__._................._...._....._................_...._......_..._........... ...__. waste oil 880gallons ---� waste antifreeze 275gallons ____..___....._..__.._ ._ batteries/battery acid 10.units . Windshield Wash 6 cases ..............................__ - __..._.. __ ................_.._....... other cleaning solvents 2units antifreeze(for gasoline or coolant systems) 1cases .__. _ _.. _________. __................_.___ _._.. .........................._.___._.----....._.........._...... Batteries 0 5 �e ez .. ........ ......... Waste Transporter: 'Saf `(S ety Kleen Fire District: ..... Last HW Shipment Date l�@ Waste Hauler Licensed: No -� Hazardous Materials On-Site Inventory/Inspection For ALL Shops and Businesses: DBA: ostv$o Location: to 69 Date: Physical Features to Inspect: 1. Hazardous waste generation sites (production/manufacturing areas): G(/Yt�'� p Lh dF-Rn'GG�S 2. Waste,storage areas: a 3. Satellite accumulation points throughout: 4. HazMat stored outdoors — CHECK OUTSIDE: xi z w a_.C*,L 5. Shipping and receiving areas: 6. Run down of shop activities: 7. Housekeeping practices: 5� ✓"` S CSC` ��7/!�' i `�1C/Lvt.. o ' fit 5 —A-2e ice_ j i(� S I'�Q S % G�-tyQ52-off!i/lv�� 41_Q •�'�1,¢�� HazMat On-Site Inventory/Inspection: Records to Review for SQGs and CESQGs DBA: c !%&� Location: (p �� 4�u. Site visit date: S—S—by • Hazardous Waste Manifests: \r(a rrwu'(e 3 D�,-v cvaiyry� -f�S • Employee training documentation (if required): Al /l9- • Hazardous substance spill control and contingency plan: • MSDS on site? 1/1 • HazMat Inventory records (if applicable): 6a=a�lj o� vim, • HazMat Waste Shipping documentation: • Spill records (if applicable): �//A y t Sigma Tires Comfortable W ailing Roon► Texaco Motor Oil State j4specti6s Bosch Electrical, Interstate Batteries_ Amsoil Synthetic Lubricants Shocks, Compate,Invoicing' ;.Quick Oil Changes Diesel Service well§tucked parts room FueCInjeotion' j Tune-ups', Electrical Diagnosis, j Transmissions Exhaust Systems t Clutches Brakes Same Day Appointments(in most cases) } BENNETT AUTO REPAIR r 64 Plant Road o (behind K-Mart Plaza) V Hyannis,MA 02601 _ \e 1-800-649-0564 (508) 778-0564 TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH O 3.Auto Body Shops fiV unsatisfactory- 4.Manufacturers COMPANY 5e(Av_e n (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS G 'SI�yIS$S: 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALSUnderground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel(A) t-Z7S D� Diesel, Kerosene, #2 (B) Heavy Oils: Z-27S' x waste motor oil (C) new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers �Myscel eousN's� 1� ��-ee..ee �.¢.w S•-G s 15,tS pe "Cb�eq � ,4-e S r ZCS DISPOSAUREMATION REMARKS CI A : / 1. Sanitary Sewage 2.Water Supply S D f J, I' of C 0 P"l ?Jc� zt�ee `� c (-Town Sewer ublic ¢.t�S S i c ice,S �`d cam- �v .f e O On-site OPrivate C,1 c,-,O GLA dA � � GG 3 �w�o lam- . ®� 3. Indoor Floor Drains YES N0� 7 �� t S O Holding tank:MDC_ O Catch basin/Dry well f O On-site system, 4. Outdoor Surface drains:YES N04 ORDERS: 4-keS Z O Holding tank:MDC (/ &16 !u& j JP ' N4 S h 41/ l�l�rr�vc O Catch basin/Dry well V4 fd�VW O On-site system 5.Waste Transporter Name of Hauler Destination WasteProduct Licensed? jj _ YES NO c.4,4 ce Ise C 'Person(s) Interviewed Inspector Date f TOWN OF BARNSTABLE C MPLIANCE: CLASS: 1. Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY ,��-�� (see"Orders") 5.Retail Stores G� 6.Fuel Suppliers ADDRESS ' Class: 7.Miscellaneous UANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATER S Case lots Dr nderground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Heavy Oils: v waste motor oil (C) � 4�, }� new motor oil (C) , G' transmission/hydraulic Synthetic Organics: degreasers 19 Miscellaneous: DISPOSALIRECI AMATION REMARKS: 1. Sanitary Sewage 2.Water Supply Town Sewer Public O On-site OPrivate 3. Indoor Floor Drains YES NO_z:::� O Holding tank:MDC_ - O Catch basin/Dry well O On-site system 4.-Outdoor Surface drains:YES NO" ORDERS: O Holding tank:MDC G, Catch basin/Dry well N A��- O On-site system 5.Waste Transporter B� Name of Hauler Destination Waste Product 2. Person(s) Interview.ed inspector Date w 7 , State Authorized Emissionp Repair Facility . Comfortable Waiting Room Bosch Electrical ' State Inspections Computer Invoicing Interstate Batteries Diesel Service Shocks Fuel Injection Quick Oil Changes Electrical Diagnosis Well stocked parts room Stainless Exhaust Systems Tune-ups Yokohama Tires Transmissions Gislaved Tires Clutches Aurora Tires Brakes All data on disk C BMETT AUTO REPAIR O SOPIN '�EPIttR` 64 Plant Road(Behind K-Mart Plaza)a 1.800.649-0564 Hyannis,MA 02601 _ i (508)778.0564 TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory 2.Printers �' 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY �.�� (see"Orders") 5.Retail Stores ® 6.Fuel Suppliers ADDRESS ��� i � Class: g 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS •' - IN OUT IN OUT IN OUT #&gallons 1 Age 1 Test Fuels: Heavy Oils: waste motor oil (C) new motor oil(C) transmission/hydraulic Synthetic Organics: V degreasers Mt ce laneous- IA � l r t DISPOSALIRECLAMATION i REMARKS: 1. Sanitary Sewage 2.Water Supply own Sewer ublic Ij s 0 On-site OPrivate 3. Indoor Floor Drains YES NO V 'j 0 Holding tank:MDC_ '� O Catch basin/Dry well ~ ` 0 On-site system f L ' 4. Outdoor Surface drains:YESJ NO ORDERS:... olding tank:MDC atch basin/Dry well _ 1� 0 On-site system a 5.Waste Transporter P. Name of Hauler'. ro YES NO 2. Person(s) Ifiterviewed r Inspector Date _ V TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory 2.Printers 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY Re,0r (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS to _ Class: / 7.Miscellaneous 444_ie ' UANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS C se lots 1Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) r Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) TV transmission/hydraulic Synthetic Organics: degreasers lla Misceneous: /a �; /o vvGK / r,L� 6 p ua-4 Q , s DISPOSALlREC;LAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply U Z?qown Sewer Public O On-site OPrivate 3. Indoor Floor Drains YES-NO X •, O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO OADERS: O Holding tank:MDC 1n Watch basin/Dry well O On-site system 5. Waste Transporter 1 Product S � YES NO 1• 14 tc_..L. D Person(s)I) I ewed Inspector Date i IRepair O 2. • , • • • , • • �.� satisfactory 3. . Body Shops • unsatisfactory- 4.Manufacturers (see • rders") 5.Retail Stores 6.Fuel Suppliers 7.Miscellaneous Case lots Drums Above Tanks Underground Tanks 0 . . . . , . ANN • • • • L • MEME . 111 • • . MOSEEMENOMIN .l s 1 gulf FA.91 Ioff , AT Mom • •, li 2• Name of Hauler Destination Waste Product Licensed? VAIN ' 11 L ♦ r. TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: REN"ZIA=91R�/'�AX Mail To: 64 PIANT ROAD Board of Health BUSINESS LOCATION: MA •02MI Town of Barnstable MAILING ADDRESS: 508-778-0564 P.O. Box 534 TELEPHONE NUMBER: Hyannis, MA 02601 CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, 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 character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Qu,an/tit�/Case Quantity/Case /© /O Antifreeze for gasoline or coolants stems Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants 7&V Motor oils/wasteMP Road Salt (Halite) Gasoliae�, Jet fuel Refrigerants lop Di �t'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 TOXIC AND HAZARDOUS MATERIALS REGIS FfATION FORM ' NAME OF BUSINESS: _Avacj_+ �uv& 0 CA r Mail To: BUSINESS LOCATION:79nab' ►3a t- N[ Cj+j hGGIg �� Board of Health �— Town of Barnstable MAILING ADDRESS: Sams: P.O. Box 534 TELEPHONE NUMBER: SOS —1 of 0 Hyannis, MA 02601 CONTACT PERSON: �� S'E7"an�„�✓ EMERGENCY CONTACT TELEPHONE NUMBER: 5 aT IciO- 0(63 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own 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- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case a5 &66Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants 3o3o Gallo^ 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) BoGql s Wt RzS Gicss C�Oa+t�n Other cleaning solvents 1 Ca&) Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business 4 SECTION - SEWAGE —SEPTIC TANK — "D"BOX — LEACH _P\ ^ TOP OF FON 3 •,x'•OF�h+TO�h' 5'•' (MSL)# WASHED STONEIIIr IN OUT OUT fFV'- tizrt �•y ZO l _ �J�.QTS Di� SEPTIC TANK �..�-.•-•-- ` ►`o e,41 (7 ELEV. �. E(EV ELEV. EtEVt � �Ur , t3•tl:' �' � y� ELEV. ELEV. ly S bE °✓+ ice; T o WA51-1E;D STONE � •� � W p{�y�,S.4••l o Cam'(_ ;:. . � l TEST'HOLE-LOG ' • _ 4 v,*1 o� v-_ , 1 ' 'TEST BY WITNESS £ TEST DATE DESIGNaG71"�_�� 1 5c�a� t�f 4t�CC? ..tares. T,H, 2 l� . F2S �`"•�' `� �Y ELEV.St'l , NO t?I$PU$tcR ' Res (7 3a°� j.•�"� !1 a ' PERC RA 1 pISPO.SER FLOW RATE ZZS (G;AL,/DAB'). J $EPTIGTANK _.Z5 x E` .°�n a :for cw?sZ REO'D SEPTIC TANK SIZE r _ R� 4� y ��� rpaY"�Syr t�e,c-cxv S1 ,St•'1' �-• i C A'l- IL - C �.R. LEACH FACILITY ' \ IaIZ.S /D. SIDE WALL \Q, 1 x5 .. �' r, Ati+ BOTTOM i0�'C'�"I41'" '1$• I•cs.y _ G/D. �; . rf ,.aHt,k , 2 r 0 , cfshrrte.F1 . "`r"z3wt y�x41c.� 'LEACHING USE; Q� � " 411 *x �r` evu`' „/fix . IV®oA .WATER ENCOI.INTERED. •� �Q" LpGvj� •, } ea."--+- • Of NOTES: (UNLESS OTHERWISE NOTED) ��- / , •, ,., �`a w. .. AF �r 1- DATUM(MSL)��.TAKEN FROM..�.Ll �•�-�--�-��•-•-••-QU�'�"DRANGLE MAP �-w�� ,� ,��a"I'� `t3•' OJALA - 2-.MUNICIPAL WAFER .._�.. - .____..._...._..AVAILABLE v otuiI« 3..PoPE PITCH,YA"PER FOOT r �;Q ,qq .� kt DISTANCE AS CERTIFIED •�, 4. D651GN.LC)ADING FOR ALL PR7=•CAST UNIT$:AASHO \A- ,+ No, 30792 5.M)N_GRbUNO COVER'OV$R ALL SEWAGE FACILITIES: (I) FT. c () x SITE PLAN 6.PdPE IpiNTS SHf1Ll BE MADE WATER TIGHT 7.CONSTRUCTIbN'DETAILSTO 9E-ACCORDANCE WITH COMM. MASS. LOCUS: STATE ENVIRONMEN7Af_CODE YITLE 5 8.•V�F�•�Tr"{ ''�.dtaSrwsEis SETQA�'� )�EQ�ti"'c.E.t�'tEw•�T5 ,�+ �'�`GIS1Ea �� �� � �.� � H`•+rArs o Go1�,S"CRVCTtcatJ' US SU ,! _ _ �, k V. A-�^+?,t7 S.p�p� �Flt C �'/d!ti"�" .' REG.PROFESSIONAf FIVGINE£R C7� uS r-REF: ASbXs�trc} Mrfca Ica � ��>a� Ilow17 cape engiheeiing TT- PREPAREOFOR: 5\0 CIVIL ENGINEERS _---- ---=— LAND SURVEYORS Rg�; LANDsuRVEwoR— , t�� ( � �� 8 BOARD' OF HEALTH 929 t-Azin SL SCALE „��"DATE • y 7 wcg T. _ � j>;"X1S i _••,_ _,-..: _ � '. APPROVED OR'7`t Cbt37OtRS. .o--o- DATE , (pR♦POSED) .r ♦ s A_ .