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0362 YARMOUTH ROAD - Health
362 YARMOUTH RD. , HYANN.IS A= I I w r 1 `Y I °p IKE*or,. Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 ` BARMAN�. ` 200 Main Street• Hyannis, MA 02601 �OrFDMn+"�0� TOXIC AND HAZARDOUS MATERIALS INSPECTIO EPORT Business Name: �iMlt-r x� CO �-,rc�c o rS � Sk`� Date: 4 9 Location/Mailing Address: 3 -2 a..r e 4 vt✓�r S Contact Name/Phone: Spa}k- L.cw.ba Inventory Total Amount: vX1 MSDS: Qi5 License#:t Tier II JV n Labeling: Spill Plan: A , Oil/WaterSeparator: �J J A Floor Drains: a Emergency Numbers: ok Storage Areas/Tanks: S,Mu�\ gl2c, ��,( 5}or�o Clowk r a&) 0,00}41MLAS Emergency/Containment Equipment: Waste Generator ID: lA Waste Product: Date&Amount of Last Ship ment/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 V 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 V 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/RECOMMENDATIONS: de , o p t Z 2 LDVti�►+l�� o� � '�, Inspector- 1 r LaV-e- 1� Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS TOWN OF BARNSTABLE Date: 313 11`� ��g �;o,,`, TOXIC AND HAZARDOUS MATERIALS FORM NAME OF BUSINESS: ;5 P Cow <ACAwr6 BUSINESS LOCATION: 3(02 a Ala nvt t S INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: 5'OQo -T7'5-119-0 C%);,QO N 4, 12DCC4 CONTACT PERSON: 5co+k Maj.16V F owj—,/ �v�4-+,C K5 - kb EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: C1fAv,v, 25To! tio,ti- C..!S INFORMATION / RECOMMENDA IONS: c2\f\5,k \v� •p v-,De,, Fire District: w�9 11 \,\o0 41A.a-s1Aoa yn t 5 Waste Transportation: A 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 re uires 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 Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes w��`�' Other chlorinated hydrocarbons, Lacquer thinners a V, v (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 Date: 3 / 3 TOWN OF BARNSTABLE -�y ��-o,� TOXIC AND HAZARDOUS MATERIALS RE:.G:IS-T1 4T N FORM NAME OF BUSINESS: w� BUSINESS LOCATION: 3102. /`& Mof �IGnvt s } INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: sy`�� _�'1�—I 1�-p ���.P,n�l. ti 12J C, CONTACT PERSON: Sao 1k 6�loj1h� , nww1_1/ EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE?Y/b TYPE OF BUSINESS: CIfc\v\vy> [1�_e5�v<w� INFORMATION / RECOMMENDATIONS: \v. ln Fire District: MtAO ,•)`�n.C�e_51A,Aa LV I��1�ny�t5 Waste Transportation: I 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 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 Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar Q PCB's bu�. Paints, varnishes, stains, dyes — wl } �" Other chlorinated hydrocarbons, Lacquer thinners a'o\16"T (including carbon tetrachloride) ❑ NEW ❑ USED CQ i Any other products with "poison" labels (including,chloroform,formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) a 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 Stiff's Initials 4 JON-DON 800-556-6366 * ACCOUNT #EME599 I Updated Prices end of 2011 Frei ht purchase $350 of Free Frei ht items and they Daythe frei ht on them Frt. What Number -by Price past order on hand order Free Herbal Fresh MX-HF-04 4 x 1 al/cse $70.33 Free Lemon Fresh MX-LF-04 4 x 1 al/cse $70.33 Free Mountain Fresh MX-MTF-04 x 1 al/cse $70.33 Free Melon Mist MX-MMF-04 x 1 al/cse $70.33 Free Linen Fresh MX-LNF-04 x 1 al/cse $70.33 Free Bag Nets/Hose Nets CA-HN-EA each $7.89 1 Free Blue Blocks CA-BB-CS 1008/case $25.57 3 Not Clincher Mop Holder ME-CLM-EA each $6.96 Free Dehu Antimicrob Filter DP120 DP-E038 3 er case $57.38 840 BUY.SPONGECO Not Extension Pole 9 foot ET-EP93-EA each $32.28 Not KleenGuard Coveralls XP w/h MI-KXHB2XL-CS25 to case ##### vek suit with Hood/Booties MI-TCHBL-EA each LARGE $5.72 Not Mop, Eliminator, Blend ME-EMLW-EA each $7.26 2 Not Nitrile Exam Gloves XL -case MI-NITXL-CS 10 boxes 10 $79.64 1 Not Nitrile Exam Gloves Xlar e MI-NITXL-EA box/100 $7.80 Respirator 3M P 100 3M-R8293-CS box 20 $146.38 1 Not Spray Bottles 24 oz PA-SB24-EA each $0.49 24 Not Sprayer Heads PA-HDTCR-EA each $1.93 24 Free Squeegee Tool MP-VTST-EA each $13.75 2 Free Tabs, Clear 3X3 CA-TP3C-EA box/1000 $10.19 Not Threaded 60" handle 15/16" BB-TH60-EA each $2.48 2 Not Threaded Handle 60" BB-TH60-CS 6/case $12.95 a 9- BUY ERC Not Wand 54" Aluminum MP-VTAW-EA each $32.32 1 Free All Fiber Rinse PC-AFR-04 4 x al/cse $60.83 Not Brite 'N Glass Cleaner ??? UN7BGC-04 4 Gal. $22.91 1 Free C.O.C. Commercial Grade US-COCC-CS 4 x 10 lb cs- $112.19 1 Not Clorox Bleach JC-CB-CS 6 x al/cs $24.96 4-5 Free Dry Slurry Detergent PC-DS6-CS 4 x 6.5 Ib/cs $133.87 I2v9a I Not Finishing Touch Furn. Polish UN-FTFP-CS 12 x 16 oz/cs $50.78 1 Not Gojo Antibacterial Soap ??? RA-GJAS-01 gal $9.95 Free Liquid Wall Cleaner CS-LWCB-04 4 al/case $78.02 2 ??? Matrix All Purpose Deoderizer MX-LEMON-01 per gal $16.90 2 Free Microban Hospital Spray US-MBHS-04 4 gal/case ##### 4-6 Free New Decade Traffic Lane Clnr MX-NDTLC-01 _per gal $15.77 2 Not Odorcide 210 Concentrate CC-OC210-ea 16 oz ea $11.26 4 Shock Wave RP-FLSW-04 4 gal case ##### ?? Smoke Odor Sealer (spec ord CS-FS-04 al/case $128.25 1 Free S of Out MX-SO-01 1 al $18.48 Not Stone Quest Cleaner ??? SC-SQC-04 al/case $103.74 Free Thermal55-Citrus US-T55L-04 al/case $191.08 Free Tri-Foam Shampoo MX-TF-01 1 gal $14.11 Free Unsmoke Space Spray (cherry US-SSC-01 1 gal $71.50 Free Unsmoke Thermo 2000 US-T2000BG al/case $264.21 Free Un-soot Encapsulate US-US-04 4 gal/case $138.24 Free Upholstery Dry Clean Solution KR-UDCS-04 4 gal/case ##### 1 Free Wood Cream Restor. 8# CS-WCR8-EA 8 Ib/cs ,,- 1 $40.19 1 Free Yellow RX for Browning PC-YRX-04 al/case 1 $75.65 IAL� 30"(o 4 JAl/,Av- q Ial)OR OR- ��J YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates(cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.), You must first obtain the necessary signatures on this form at 200 Main St.; Hyannis, Take the completed form to the Town Clerk's Office,.1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is I required by law. DATE: Fill in please: tips„ APPLICANT'S YOUR NAMEA: el, S _ ?eC BUSII/N/ESS 7 YOUR HOME ADDRESS: M l C� � &SM y� TELEPHONE # Home Telephone Number NAME OF CORPORATION: NAME OF NEW BUSINESS. + "X� TYPE OF BUSINESS IS THIS A HOME'OCCUPATION� YES r R2.1': �7 - �. Assessin ADDRESS OF BUSINESS ''_ i i n'ti MAP/PARCEL NUMBS ( g) When starting anew 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 G070 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 SI ER'S OF E This individu I s n#nfor a per_ it requirem nts tha pertain to this type of business. Au horized Signature* COMMENTS: 2. BOARD OF HEALTH This individual haslbeen rye � he permit requirements that pertain to this type of business. N1USY'e;0MnLY ' ",LL l� I �I gf z V I t,'ARD01JS MATE.RIA.t: CUL ATV)INP, Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: r� • Date: TOWN OF BARNSTABLE P� 0 i TOXIC AND HAZARDOUS MATERIALS NAME OF BUSINESS: �S ENcZ BUSINESS LOCATION: SG2 VQTr9QQ4h ZA a NS MVINVENTORY MAILING ADDRESS: Sar,�P_ TOTAL AMOUNT: TELEPHONE NUMBER: - 6 - 7 CONTACT PERSON: C. EMERGENCY CONTACT TELEPHONE NUMBER: am C-2 1 MSDS ON SITE? YTYPE OF BUSINESS: -V � — ei INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: L)q4AP Oil 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 Anti eeze (for gas a or coolant systems) Miscellaneous Corrosive 4 NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) 3 ( Hydraulic fluid (including brake fluid) Refrigerants 3T� Mot 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 ?G�SO�1 UG12 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 P icant's Signature Staff's Init Is f Town of Barnstable P# 13-26� ' Departinent of Regulatory Services tu►wwrA m Public Health Division Date A� 200 Main Street,Hyannis MA 02601 Date Scheduled_ 2 E 6 oZ Time 6 . �� �_ Fee Pd. /00 Soil n'nSuitabiiity assessment for Sewage .disposal Performed By:_ 1 C.Y4DO 0 Witnessed By:_ O cg D aQN zt , LOCATION &�'�GENERAL INFORMATION ya Location Address 3 6a n_(1 Owner's Name ^', �X Address 9 Assessor's Map/Parcel: 3(I A a 16 Engineer's Name NEW CONSTRUCTION REPAIR Telephone# rJ�O 36a $i 3a Land Use: Slopes(%)- Surface Stoues N r'1 Distances from: Open Water Body _ft possible Wet Area Drinking Water Well `I ft Drainage Way ft Property Line 6 ft Other ft SIDI TCH:(Street name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands in proximity to holes) Parent material(geologic) 04� Depth to Sedrock—.— Depth to Oroundwater. Standing Water in Hole:. nay-L ' Weeping from Pit FICC_ IV A Estimated Seasonal High Groundwater I DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: I4, Depth td soil mottles: ht. Dcpth to weeping from side of obs.hole: In, Groundwater Adjustment f[. Index Well# Reading Date: Index Well level__._ Adj,&cior ,r Adj.Groufldwater Level , PERCOLATION TEST mate 8 T►wa 1(5 :oD Observation Hole# Time at 9" .7� Depth of Pere Time at G" Start Pre-soak Time @ Time(9,14') End Pre-soak to:o 5 Rate Min.fluch (� Site Suitability Assessment: 'Site Passed V 5i[p Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back----' ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1)week prior to beginning, Q:\S EPTICIPERCFORM.DOC DEEP-OBSERVATION HOLE LOG Hole#_�____ Depth from Soil Horizon Soil Texture .Sdil Color Soil• Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. • �� ,� i to �y,96'Gravel) L.-S C , S , 914 NIA 90=1a0' C , s s ? DEEP OBSERVATION HOLE LOG Hole#—C4 _ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.Consistency.%Grave •C) a14 _.3'9 10\2 5 1510-Rol DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Co i to c G c DEEP OBSERVATION HOLE LOG Hole# Depth from Soil,Horizon Soil Texture Soil Color soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.Boulders, Cositn Flood Insurance Rate Map: Above 500 year flood boundary No— Yes Within 500 year boundary No Yes Within 100 year flood boundary No.____ Yes ._ Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise and experience described in 10 CMR 15.017. Signature Datb Q:1S.RPTlaPERCF0RM.D0C 1- P Town of Barnstable °F'THE ro Regulatory Services ti Thomas F. Geiler,Director '" KAWSS r i639• ArEDr�e�°i 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 W� NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT a 1�� Jw ��• �� (/�(/<< C 'V v J TELEPHONE NUMBER ��(�) • W 1 v J SOLE OWNER: YES,�NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: LL �Soo�� 4,AmAt'v", ocw-e s LLL �Sk'oe IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION U�( FULL NAME AND HOME ADDRESS OF: . PRESIDENT TREASURER A2 CLERK t ✓ b �' SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADD S HOME TELEPHONE# J , Haz.doc/wp/q �]� YOU WISH TO OPEN A BUSINESS? • 1 �f For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. f' Take the completed form t6 the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: I I Fill in lease: <b.. p ,: APPLICANT'S' YOUR NAME/S: �^ C W� S�or BUSANEQS YOUR HOME ADDRESS: TELEPHONE # Home Telephone Number H., o NAME OF CORPORATION: c Swbf w ti.� v{ e- oOW 5 C�-L NAME OF NEW BUSINESS TYPE OF BUSINESS c., r' IS THIS A HOME OCCUPATION? YE NO ADDRESS OF BUSINESS 3 a k�u�ow IZ 4 NHS R MAP/PARCEL NUMBER (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 TO 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 COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: 2. BOARD OF HEALTH This individual has en informed, f th per i requirements that pertain to this type of business. �- Aut zed Signature** COMMENTS: A 1ur'y /5 Re"Z11-u/2-e� To ', 74/A/ A iV.��r,-,6o05 tc4-rW-rEIA-r c PX6v4&)e--7-) 7-0 _"g- i, 41)j KIQ,e ti 7Y � /ii/za/Z. 4AJ i�usPt--C- OAJ 1s /Z f3Ew�rlr v sae. wELxS. 3. CONSUMER AFFAIRS LICENSING AUTHORITY A This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: c c Hazardous Materials Inventory Sheet Checklist 4 40—Physical.Street Date Address-Check database to ensure it exists Working Phone Number V Actual Amounts -( ie. gas being used to fuel machines,thinner to clean brushes all count as hazardous materials-no blanks) ✓ Storage Information -location of storage, how long is storage for? If none, note that. Disposal Information -where and who? If none, note that. WILL Cr,ET Applicant Signature -understand what is listed and noted -7 Staff Initial -any questions, know who to ask Vehicle Washing/Rinsing? -give a vehicle washing policy and explain it . Attach.the Business,Certificate with your.sign off and comments **-The inventory form should explain what the business:consists of and:the procedures they are doing.: Notes need to be left to explain what you-discussed with them. I � ,J it Dater/ / TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS NAME OF BUSINESS: �e`At� CC,( C (� �"� �" `5 r—V BUSINESS LOCATION: 30- INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: y CONTACT PERSON: EMERGENCY CONTACT TE EPHONE NUMBER: �y-Z--- 0 1 MSDS ON SITE? TYPE OF BUSINESS: „ 1�C ew— INFORMATION/RECOMMENDATIONS: Fire District: 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 -S Automatic transmission fluid Disinfectants S� Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants aoU Motor Oils Pesticides ❑ NEW ❑ USED •, (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED U Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink C 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,deg lossers - _ 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 S� Windshield wash WHITE COPY=HEALTH DEPARTMENT/CANARY COPY-BUSINESS Ap lic s Signature tneyare-uvmy. IN, - Hazardous Materials Inventory Sheet Checklist ✓ Date Physical Street Address-Check database to ensure it exists Working Phone Number Actual Amounts -( ie. gas being used to fuel machines,thinner to clean brushes all count as hazardous materials-no blanks) Storage Information -location of storage, how long is storage for? If none, note that. ,4/ 4 Disposal Information -where and who? If none, note that. Applicant Signature -understand what is listed and noted Staff Initial -any questions, know who to ask Vehicle Washing/Rinsing? -give a vehicle washing policy and explain it Yes J Attach the Business Certificate with your sign off and comments "*The inventory form should explain what the business consists of and the procedures they are doing. Notes need to be left to explain what you discussed with them. YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $40.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in the Town (WHICH YOU MUST DO according to M.G.L. - it does not give you permission to operate). You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st F1., 367 Main St., Hyannis, MA 02601(Town Hall) and get the Business Certificate that is required by law. Fill in please: DATE jo3t APPLICANT'S YOUR NAME/CORPORATE NAM <CG(, BUSINESS TYPE:{ Ca BUSINESS YOUR HOME ADDRESS: e, A-\NkA c.{ - TELEPHONE # Home Telephone Number NAME OF NEW BUSINES Have you been given approval from the building division? YES NO ADDRESS OF BUSINESS' C, pUlt�l1 MAP/PARCEL NUMBER 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 TO 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 COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 2. BOARD OF HEALTH This individual has b n infor ed q th erm' r quirements that pertain to this type of business. utho i ed Signature'* COMMENTS: l�SE1� G.� 5�4 t.�r5 D A)L-V l.0 FLU / 1�A -�OCQS H,4-92CIAe-C 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has b7olormed of the icen ing requirements that pertain to this type of business. COMMENTS: Aut a Signat Date: TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE NAME OF BUSINESS BUSINESS LOCATION: 3 GL INVENTORY MAILING ADDRESS: kq5 1X2�(1 (V�Q^Q(�A, O,`('lt��(;n�Pt ©�(D�l� TOTAL AMOUNT- TELEPHONE NUMBER: `nH-a�a- wiq, CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: `l-1�I'o2�a-I�`1� MSDS ON SITE? TYPE OF BUSINESS: INFORMATION/RECOMMENDATIONS: Fire District: 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 ` FNEW ❑ 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 T$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 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 __>C (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 plicant's Signa ure Staff's Initials 014 H. zar ous Materials Inventory Sheet Checklist Date Physical Street Address=Check database toensure'.it.exists �— orking Phone Number Actual Amounts.-( ie. gas being used to`fuel machines;-thinner to clean brushe&all.count as hazardous.:materials-no.blanks) Storage Information location of,storage, how long is.storage for? If none; note that. Disposal Information o where and who?.If nne;note hat VApplicant:Signature-understand what is listed and noted 1- taff Initial-.any,questions; know who to.ask e.7 ehicle.Wash ingl.Rinsing?. --give a vehicle-washing policy and explain:it. .. Attach the Business Certificate,,with your sign off-and comments **The inventory form should explain what the business consists of and the procedures they are doing. Notes need to be left to explain what you discussed with them. 001 1 YOU WISH TO OPEN A BUSINESS? r For Your Information: Business certificates(cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed fond to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that,is required by law. { DATE: V, 7 Fill in please: g,3t1 APPLICANT'S YOUR NAME/S: y� Y' CrG r2c �'� . �. BU INES YOUR OM ADDRESS: . 7 87 7.65.2 -44 Y1- 01 TELEPHONE # Home Telephone Number NAME OF CORPORATION. 0 i=1 A)Cf, 0 w i » NAME OF NEW BUSINESS TYPE OF BUMNESS IS THIS A HOME OCCUPATION? YES NO I ADDRESS OF BUSINESS _� 6 �(�y >�o�1-►, x o MAP/PARCEL NUMBER y2"I11 H DI (0 (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 TO 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 COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature** ' COMMENTS: 2. BOARD OF HEALTH This individual has bee or d of the its that pertain.to this type of business. ` ` MUST,*;OMPLY WITH ALL (J _T a V-V1�i1e perm requirements HAZARDOUS MATERIALS REGI!I_AT! Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: -•. �� TOWN OF BARNSTABLE Date: q /Z�/ TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: BUSINESS LOCATION: G , t1 ral o INVENTORY MAILING ADDRESS: TOTALAMOUNT: TELEPHONE NUMBER: ,— CONTACT PERSON: C C A � EMERGENCY CONTACT TELEPHONE NUMBER: %(g 7 MSDS ON SITE? TYPE OF BUSINESS: M e.C P7Ot AJ I-( INFORMATION/RECOMMENDATIONS: Fire District: 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 Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) 5 - V Hydraulic fluid (including brake fluid) Refrigerants �f Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) � Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED • l Miscellaneous petroleum products: grease, Photochemicals (Developer) ty V lubricants, gear oil ❑ NEW ❑ USED Z_ Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine /O 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 Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS plicant's Sig r ,� Staff's Initials I. 1................... - _ Af y o o v 1 ry DOWN j � x, l .- I i - - can _ . cerR#{covc :�_ ' :t PROP. Fi-$o PbB SX J !!r / .fofl ; .✓�/ff '�>1�,/` // f j //ra 1 4 QU, . PtIC ��S ' r\ +� —�� j',, \� .�,,�'_ /ft/�/'f ��J•• !�//f �j f / l f f/ i/.? �l ! 't !/i a(,!! �fr"!r� !!✓,,jfrrr ,.:f f ,,-, fi.ri � `I 59ZJ� O f/',��/!/•f� ;!/ //l f•`. ' /!%/r.�'/fj, ffi. f// r ;� `L PROP. B'sB B-ZO tJl;tCSAJUA •�. ,r'%%Y! / ; / / f ,o f or SMY 8 r j/flr//,,!/f• //�fJlrl. lf Ir /'r. :rr ; PlAr. ♦ f f/,fyl /f .f r;!r�; /:,�f/'! f/!/'• �fr/i ! /I .. --•-� t-PROP. .TLlC9^• ;;�';fl;,,�����f f�/�/✓• � !r,'/f i f �. i J OP PAMMY7 �//fFF 6 t. w �... - i:. �.. • 4 •.1 •Fi. •M .we. � ' k ' •wt .. _ + } �•� „� ,. � y Lr • 1 .+1, .. � - .* x �� � ' y . + { �� � A R, �;`. � '�� � Y + . /7 Ke Town of Barnstable Hazardous Materials On-Site Inventory and Inspection FACILITY INFORMATION: Business Name: , - Business Location: .4'-ciYD�J�2! 0) Mailing Address: AS '4-M0yL Telephone.Number: 77 Y VP-7—-76 5 Contact Person: 01 H iE i ( d IUCACO Emergency Contact Telephone Number: Type of Business: A u 7-y 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 - 1 - Misc. Combustibles Misc. Corrosives Misc.Reactive I Misc.Toxics Inventory Total Amount: Hazardous Materials License Posted?Yes No Contingency Plan Posted? Yes No Fire District: Fire Extinguisher Service Date: Metal Covered Rag Bin: No Absorbent Material Available? Yes No Type of Absorbent: Cpeed3yD Pads Pigs.Other: MSDS on site? Yes e9o Hard Copy Computer Access Hazardous Waste Handling . Hazardous Waste Generator Identification Number: r Type(s) of hazardous waste product(s): Date of last hazardous waste shipment,type of waste and quantity: Hazardous Waste Transporter(s): Designated Hazardous Waste Facility: Hazardous Waste Storage Area Description: Is hazardous waste storage area labeled: Yes No 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 No If hazardous waste is stored out of doors is it covered from the elements? Yes No Is it in 110% containment? Yes No If hazardous waste is stored indoors is it on an impervious floor? Yes No - 2 - f FLOOR DRAINS (Chapter 381) Town Sewer Account Number: Indoor floor drains: Yes r 6 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 site? Yes& If yes,is it protected from the elements? Yes No If yes,how? Is it on a foundation larger in size than the tank? Yes No COMMENTS/RECOMMENDATIONS/CORRECTIVE ACTIONS Date: Public Health Inspector: Facility Representative: i I ii - 3 - I �A Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 362 YARMOUTH RD. Property Address ESTATE OF ROBERT TIVEY Owner Owner's Name information is required for MA. 02601 8/15/12 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out ,f forms on the Q computer,use 1. ' Inspector: U only the tab key to move your MICHAEL O'LOUGHLIN cursor-do not Name of Inspector use the return key. - ti Company Name r� 714 MAIN STREET Company Address YARMOUTH PORT MA 02675 'eR01 Cityrrown State Zip Code 508-362-4942 577 Telephone Number License Number B. Certification I certify that l have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ® Passes ' ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority + 8/15/12 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. (,I � v t5ins-11/10 Title 5 Official Inspection rm:Subsurface Sewage Disposal System-Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r M 362 YARMOUTH RD. Property Address ESTATE OF ROBERT TIVEY Owner Owner's Name information is required for BARNSTABLE MA. 02601 8/15/12 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N FIND (Explain below): t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 362 YARMOUTH RD. Property Address ESTATE OF ROBERT TIVEY Owner Owner's Name information is required for BARNSTABLE MA. 02601 8/15/12 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the'environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, ' safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 15ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w 362 YARMOUTH RD. Property Address ESTATE OF ROBERT TIVEY Owner Owner's Name information is required for BARNSTABLE MA. 02601 8/15/12 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No I Backup of sewage into facility or system component due to overloaded or Ell' ` ® clogged SAS or cesspool 0 ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than day flow l5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments , 362 YARMOUTH RD. Property Address ESTATE OF ROBERT TIVEY Owner Owner's Name information is required for BARNSTABLE MA. 02601 8/15/12 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) - Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.. ❑ . ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system'is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. j ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in'addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ - E the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 362 YARMOUTH RD. Property Address ESTATE OF ROBERT TIVEY Owner Owner's Name information is required for BARNSTABLE MA. 02601 8/15/12 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period?' ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and'the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: Z ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): l5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form . o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M , 362 YARMOUTH RD. Property Address ESTATE OF ROBERT TIVEY Owner Owner's Name information is required for BARNSTABLE MA. 02601 8/15/12 every page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: Does residence have a garbage grinder? ❑ Yes ❑ No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ❑ No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑. Yes ❑ No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ❑ No Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: EQUIPMENT &ATUO REPAIR Design flow(based on 310 CM 15.203): ' 569.5 gpd.per.plan by DOWN CAPEENGINEERING provided 678.6 gpd. Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ® No Industrial waste holding tank present? ❑ Yes ® No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ® No Water meter readings, if available: 2011/ 16,200 cu/ft 2010/ 35,000 cu/ft t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 362 YARMOUTH RD. Property Address ESTATE OF ROBERT TIVEY Owner Owner's Name information is required for BARNSTABLE MA. 02601 8/15/12 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ❑ No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 � Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �w 362 YARMOUTH RD. Property Address ESTATE OF ROBERT TIVEY Owner Owner's Name information is required for BARNSTABLE MA. 02601 8/15/12 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: SEPTIC TANK, D. BOX ,& ONE LEACHING PIT 1993 PER TOWN ,2"D LEACHING PIT UNKNOWN Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3'+- feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 2.33 feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) 1,500 H-20 If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1,500 GALS. H-20 Sludge depth: 4" t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 362 YARMOUTH RD. Property Address ESTATE OF ROBERT TIVEY Owner Owner's Name information is required for BARNSTABLE MA. 02601 8/15/12 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 32" Scum thickness 0 Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? TAPE MEASURE Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): ARREARS TO BE IN GOOD WORKING ORDER , NO NEED TO BE PUMPED AT THIS TIME. Grease Trap (locate on site plan): Depth below grade: - feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M ,••'" 362 YARMOUTH RD. Property Address ESTATE OF ROBERT TIVEY Owner Owner's Name information is required for BARNSTABLE MA. 02601 8/15/12 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal, ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 362 YARMOUTH RD. Property Address ESTATE OF ROBERT TIVEY Owner Owner's Name information is required for BARNSTABLE MA. 02601 8/16/12 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): APPEARS TO BE IN GOOD WORKING ,INSTALLED FLOW ADJUSTERS TO EQUALIZE FLOW. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: I t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 � Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 362 YARMOUTH RD. Property Address ESTATE OF ROBERT TIVEY Owner Owner's Name requinform r on is BARNSTABLE MA. 02601 8/15/12 requiredd for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 2-6'x6' ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): BOTH PITS APPEARS TO BE IN GOOD WORKING ORDER NO SIGNS OF HYDRAULIC FAILURE. PIT#1 WAS EMPTY WITH STAIN LINE 3'+- FROM BOTTOM AND PIT#2 HAD 2'OF EFFUENT WITH STAIN LINE 4' FROM BOTTOM OF PIT. Cesspools (cesspool-must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 362 YARMOUTH RD. Property Address ESTATE OF ROBERT TIVEY Owner Owner's Name information is required for BARNSTABLE MA. 02601 8/15/12 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, , etc.): t5ins•11/10 Title 5 Official Inspection Form;Subsurface Sewage Disposal System•Page 14 of 17 � Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 362 YARMOUTH RD. Property Address ESTATE OF ROBERT TIVEY Owner Owner's Name information is required for BARNSTABLE MA. 02601 8/15/12 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system;including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately f u ct, rcovc' SID p ! n . T.......... a y,f 1, Y ' s v CT f� / //' rf l /./ !�✓!/ '. a rzl / r tz� ✓rr✓. ✓ C .+'r/,!/�/'" ,/y`/,��/`�f'rf./"/✓'/,„fr'1 +q�'�/� i / r / 'f f �/ + £ 'v '1 1J r/ "'<`^.s�.,r�f.,r °,r �//°;�✓', f/ / rfr j�/�/° /'%�'/'r//..'fl., "u 3 . c 3 t/ '�/�✓// Berra I)f'r'l //'��f✓. °�, r./�l./��`✓!' �� r�,.�fl fir✓ � �/'r1�; COA Ts / i i ✓ !✓ /r am// P.R,0. 0S' D - i°!"a�,.,rr�r/f':�i/�/.F ram''j! ,r"s './!/f .//✓x 'r .r r'A .. Ifs: .. �✓'�. /..r(j /.r"/j/, / '!�f/ ! ^/ /!✓.- /! l5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments N 362 YARMOUTH RD. Property Address ESTATE OF ROBERT TIVEY Owner Owner's Name information is required for BARNSTABLE MA. 02601 8/15/12 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 41+ feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record 1f checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health - explain: ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: AUGERED HOLE IN PIT#1 DOWN 4'.NO WATER. Before filing this Inspection Report,please see Report Completeness Checklist on next page. (Sins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 362 YARMOUTH RD. Property Address ESTATE OF ROBERT TIVEY Owner Owner's Name information is required for BARNSTABLE MA. 02601 8/15/12 every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 .nu c,# 7g�' uyAf7 Jam' t '` `,, % l 'its1 f i L t� L ! J:f - - PROF. B--20 1500 _-c _SIP1fC Te7vHi CA 07 ice'_._" �•-_..-� u! V -/ •ri _�//;"/i'JJ%'/. ',�j1/'..lip ,r''J!I�.'",ri.%.f, t -vju1v., ff-20 "AC$, { AABCA PIT rim .71 : .. j`/'`/•/r:f<J�!'ii`,'i :J,, ,:�.;,r,r,,,.,.,,:�, OF :1 7' PAR / .. ' • A '. :�` ,�f/ r�if�/!!/, /•- _ Tsf r `r j i� + -i f''- '•i>. •J F� •. .'f/.fl f r F/���✓'"f lies TRAM ?w __� •PROP: OF PA tit ►J Ap.GA IS AuTo R4 TOWN OF BARNSTABLE tLLATION �6�;;' �.�1�/1J�/1(�( SEWAGE # oZ01 ' eQ AGE� Y ASSESSOR'S MAP & LOT 3 b INSTALLER'S NAME&PHONE NO. dMC, ` y SEPTIC TANK CAPACITY f 1500 ob a.- �nrwna�rr.v,� LEACHING FACILITY: (type) allhl , (size)a` a5 Y y NO. OF BEDROOMS BUILDER OR OWNER _lat,ent, W PERMIT DATE: �g 1 I �- COMPLIANCE DATE: 9 1941 Q '#_ Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility" Feet Private Water Supply Well and Leaching Facility (If;any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by__TA, 0 S4A • i s OTO a rf • �0 W Ltd t I � �j'� No.V`� � � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF'BARNSTABLE, MASSACHUSETTS Yes Rpplitatlon for 30ispoBal 6pstrm Cone-trUtt[on Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) [Complete System ❑Individual Components Location Address or Lot No. Owner's Name,-dress,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. 5 O$ 6 oZ Designer's Name, dd e ,and Tel.No. S M 3 6 a �C7` c�InnG ygr�a , p' pA�,nc� 4q �St Type of Building: Dwelling No.of Bedrooms Lot Size y 6 9 7 sq.ft. Garbage Grinder( ) Other Type of Building Cftml�n" No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min. uire re ) G00 gpd Design flow provided 02 p3 gpd Plan Date 21 � a Number of sheets Revision Date Title pp I Size of Septic Tank 0® �}- Type of S.A.S. Jl:lKA-.y�iV�,� ' ' 3 It 3�1? Z5 Description of Soil �QQ� �Q�/V� Nature of Repairs or Alterations(Answer when applicable) Qea, Date last inspected: 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 Certificate of Compliance has been issued by this Board of Health. 1 Signe Date t Application Approved by Date ,�-- Application Disapproved by Date for the following reasons Permit No. d'S Date Issued No-C `' (' 95 / Fee A10 Entered in computer: THE COMMONWEALH OF MASSACHUSETTS p Yes i PUBLIC HEALTH DIVISION -T60 FOF BARNSTABLE, MASSACHUSETTS Zipplic tion for Disposal *pstem Construction Permit _-—Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) [Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 3�f d 14 Installer's Name,Address,and Tel.No. pg '3�, Designer's Name, ddres1,and Tel.No. S p$ 3 6 01 ygya 9 9 qa Type of Building: Dwelling No.of Bedrooms Lot Size y, 697 sq.ft. Garbage Grinder( ) III''i Other Type of Building �t No.of Persons Showers Cafeteria YP g t/mnrw�or�, ( ) ( ) Other Fixtures Design Flow(min.re Tired) '300 gpd Design flow provided p 3 gpd Plan Date �� I a Number of sheets 1 Revision Date Title Size of Septic Tank 5 b® 4- Type of S.A.S. `c wac� mlj�W ' 3 _A 3 X �,5 Description of Soil n Nature of Repairs or Alterations(Answer when applicable) I Date last inspected: Agreement: i a 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 Certificate of Compliance has been issued by this Board of Health. 's Signe Date Application Approved by Date Application A Disapproved Date I'f PP PP roved by for the following reasons Permit No. t Date Issued A 11 Y. -------------------------------------- ' THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS '! Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed(V) Repaired( ) Upgraded Abandoned( )by 0 at36 a.� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No'�Cjl dated Installer V (�Ml• Designer MSZ #bedrooms Approved dVsign flow a 0 gpd The issuance of this permit shall not b construed as a guarantee that the system will ction esi ed. /L� t j Date ! 7 I�- Inspector --------------------------------------------------- ------------------------------------------------------------------------------------ No. UI fJ r -5 Fee 14`C THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS disposal �6pstrm Construction Permit Permission is hereby grantedto Construct(L ) Repair( ) (Upgrade(V) Abandon( ) '� System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Constructio must be com leted within three years of the date of this permit. Date { Approved By, Town of Barnstable Regulatory Services Thomas F. Geiler, Director * BAMSrnsLE, 9�pM�. �e� Public Health Division Thomas McKean,Director 200.Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: Sewage Permit# Assessor's Map\Parcel 34 O 1401 Designer: .57Z--P/'6e-� Installer• MJ Address: 993 4ai-&r-E7 6A Address: 7 IIm 9 ' On 2 X � was issued a permit to install a (date) (ins er) septic system at -A ��6v7)4 "Ab based on a design drawn by (address) �4- t4 g. PE dated 0 7 /Z (designer) /I certify that the septic system referenced above was installed substantially g accordin to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic:system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. IN AA A i ly (Installer's Signature) ; Zv (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT :BE ISSUED UNTIL BOTH. THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Revised.doc 'S In a k -e !O u s esS Loll * 5 mr,n c- YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. - it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, I" FL., 367 Main Street, Hyannis, MA 02601 (Tow H 11). a DATE: '' 7 V.S \1 �� C��SS va-1 ��6 ��<c�{-�d �t�c.r�2c9 c7,�4 s� frs� tf 'F " Fill in please: a1 o-.�r��YS'Firl�it ns� � � • ��"C C �.a"Kf APPLICANTS YOUR NAME: - t L P.1✓Y)C' �C cc i_BUSINESS YOUR HOME ADDRESS: Cl GI,W� U t{�Q6�25 TELEPHONE # Home Telephone Number: S-0t a ;NAM:£ OF NEW BUS1N'ESS � TYPE OF EtUSINESS �,�. .,:: :... .. IS THIS A HOME aCC1JPATlOI�d? YES NCB : : ! , ,. m .. u�,ld'Ing i $►on : 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 TO 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 CO ONER'S OFFICE This indivi ual in 01 any per it requirements that pertain to this type of business. th rized Si lure** , COMMENTS: 02 — C)c I ' 2. BOARD OF HEALTH This individual ha be ' ormed of p equirements that pertain to'this type of business. Authorized Si twLe. MUST COMPLY WITH ALL COMMENTS: O(/l ( Q l(� K ARDOLIS MATERIALS REGULATIONS 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual h been nor ed of the licensing requirements that pertain to this type of business. uthorized S' nnat * / COMMENTS: rV Zr Cam/ F Date: 0-1 / -6/- io TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: BUSINESS LOCATION: Q\'kV kCS INVENTORY MAILINGADDRESS: lc-A b W,\ J � a"` �` ��Gv�k�v��va`'�`'� TOTAL AMOUNT: TELEPHONE NUMBER: 'AS' ��!_' a f® O o CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: �i "�� r`� `��S MSDS ON SITE? TYPE OF BUSINESS: USc-= S\> aAu�t INFORMATION/RECOMMENDATIONS: Fire District: 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 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 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 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 tJ° (including bleach) Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS YOU WISH TO OPEN Aa BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1 FL, 357 Main Street, Hyannis, MA 02601 (Town Hall) DATE. - Fill in please: p APPLICANT'S YOUR NAME/S: BUSINESS YOUR HOME ADDRESS: N R� TELEPHONE # Home Telephone Number - O NAME OF CORPORATION: NAME OF NEW BUSINES .sS on S TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES D -� II,,II U ADDRESS OF BUSINES Oc MAP/PARCEL NUMBER�tT— y 1� [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 TO 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 SI ER'S OFFICE This individual ha eri infar. an �rmit requirements that pertain to this type of business. uth riz d Sig na ** Q� S o I J � MMENTS S 2. BOARD OF HEALTH This individual has been i ed of the mit r q irements that pertain to this type of business 1�111TH MUSTCOMPL e/ 77/rs thorize ignature* HAZARDOUS MATERIALS REGULATIONS Siti�55. COMMENTS: 4r yCiz . �'�,0,V V2=.�776� STR-� ?7!A 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) Atti&7= This individual has been informed of the licensing requirements that pertain to this type of business. /tl�(ff�c2 iS uN_sup_E IZ.1T �AuthorizedSignature** A--SaF-- ` ilea COMMENTS: S / y� n,� Hazardous Materials Inventory Sheet Checklist 'ate �PhoneNumber :hy sieck database to ensure it exists rking Actual Amounts -( ie. gas being used to fuel machines,thinner to clean brushes all count as hazardous materials) / Storage Information - location of storage, how long is storage for? C/ If none, note that. isposal Information -where and who? If none, note that. Applicant Signature -understand what is listed and noted — Applicant Initial -any questions, know who to ask Vehicle Washing/Rinsing? -provide a vehicle washing policy and explain it - note that it was given Attach the Business Certificate with your sign off and comments "The inventory form should explain what the business consists of and the procedures they are doing. Notes need to be left to explain what you discussed with them. Hazardous Materials Inventory Sheet Checklist TOWN OF BARNSTABLE Date: 6 131 TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: 77L e— pvro tress 1 oyt4_l s BUSINESS LOCATION: j4$cr,, INVENTORY MAILING ADDRESS: C& UtA �30 bs' Is A L TOTAL AMOUNT- TELEPHONE NUMBER:`� s-e5 S' 7G o - /S g- lo CONTACT PERSON: ✓ hl ,� �( v�LA � ®•-�� EMERGENCY CONTACT TELEPHONE NUMB 566- 7&G - / &-d e' MSDS ON SITE? TYPE OF BUSINESS: FGf?7J fie. INFORMATION/RECOMMENDATIONS: Fire District: �v 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 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 Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, d_yes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) - Any other products with "poison" labels ❑ NEW ❑ USED (including chloroform, formaldehyde,-` _Paint&varnish remo_v_ers, 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 Crocker, Sharon From: Crocker, Sharon Sent: Monday, May 03, 2010 4:15 PM To: McKean, Thomas Subject: 326 Yarmouth Road, Hyannis The water is read quarterly and their largest quarter should be the Aug/Sep time frame. The readings for the summer quarter readings ending in Aug/Sep are 55-67 cubic feet per quarter. This is 412- 502 gallons/quarter With 7.5 gallons in a cubic feet, the useage is at 5-6 gallons per day. 1 gA L-,�� �� •OIL WASTE OIL OIL FILTERS ANTIFREEZE a WASTE ANITFREEZE 3e, GASOLINE WASTE GAS DIESEL FUEL +L D ATF HYDRAULIC/ c *�I�� MISC. MISC. MISC. BRAKE FLUID Q4MMRUS=LE FLAMMABLE CORROSIVE PETROLEUM (GEAR OIL/GREASE/ LUBRICANTS) 4L I i FREON ACETYLENE CAR WASH CAR W SH PAINTS/ WAX DETERGENTS OWNERS .i 5 SEALANT CLEANING BATTERIES/ POISION/TOXIC CAULK/GROUT SOLVENTS BATTERY ACID' FERTALIZERS WASTE SOLVENT BL ACH- DISH WASH AND MSDS # - DETERGENTS MANIFESTS V MV9� 7SlPS� / /F6�TS SP/LLK/ t / 5� (4kL - ,4-Z,s0 - - aX/ �� 1 Fo rA Mee .+ y 071, C. f= /yn - Z/1v ! i I i � 1 f r � � r 1 �i F � i i I � � 1 � r 1 r 1 1 T f � 1 i ! F 1 + I 1 � ., ! } / ! I i I A i i I � j. r � � i I 1 I j f j 1� _ i 1 1 s � ! � a � � � ; e � i � '�1 it 1 � ,f� I t � � I 1 � � 1 t 1 I 1 i I 1� } r:� � � ` I � 1 1 r 1 1 � � r� fy`, 11 1 1 � , . ' I 1 aY � ,t � { 1 y 1 ' j r 1 ' ; � � 1 i ! I � � � � � � � , { { � { 1 � i { �* 1 1 I � 1 � 1 ,i. I i � 1 �ll { � M 1 ! � 1 �1 I � � II 1 r � � � I ' � ! lI t I � i � � � � � �.�- � I � i I ,- � , I � 1• >` # 1 t r { + � � � � i �? - { � � � ��' � I it �' 1 I r � f 1 1 I � , � � � . � i � I ' + } I I ! 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July 8, 2009 To whom it may concern: I The following materials were moved to our W.Wareham facility on 7/2/09. 5 empty drums 1 drum unused 1OW30 motor oil 2 %2 drums hydrogen peroxide for greenhouse use 2 drums engine coolant %2 drum battery acid for use by parts & service department 7 %2 drums drainout oil to be pumped by Cynn Oil when our drainout tank is emptied Sincerel , Richard Canning President 31 2_v6 a 22 Cranberry Hwy West Wareham, MA 02576 © / Phone: 508-295-155&' : 50�187 ��7�1S1P � lo Date: -'; TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON—SITE INVENTORY NAME OF BUSINESS: 6, , , 'opsr BUSINESS LOCATION: 311 Z VAP-ROUIP INVENTORY MAILING ADDRESS: AS A oyf TOTAL AMOUNT: TELEPHONE NUMBER: 5_0 dq o CONTACT PERSON: EMERGENCY CONTACT TELEPHONENUMBER:,gH :3y�`- "�'/> } MSDS ON SITE? TYPE OF BUSINESS: V6-9-/W40HPa-7Lr INFORMATION/RECOMMENDATIONS: off h2,es-c Azusi AZR14e r-10414 Fire District: /�lA �l-�UGts Af1t7E7z/A2. L/G6;k1& o SUBH/T 41V•Li!i1 Y'C,&--;ULy Z A-,A1*1S PLA 4/ .4,Vb 41PA.4-7� 7N61p At.4 /mac -Z b.477l- S#frn.-+ A (-'a I✓Emeb RA 6 BiAcl /S AVf/L f 6IC A S 8A4eE -Ae Sig&-a L9 /Z)- Waste Tfanspe at-ion:Mt/� 77S/E_SOLast shipment of hazardous waste: Name of Hauler: Destination: Waste Product: GK/ASM H03"7781-E-1-'4ky-6Licensed? 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 KETkIL5ALES Antifreeze (for gasoline or coolant systems) Misc. Corrosive le LE�.1JW,-5 NEW /X0 USED �G50'L'4MT I+S Cesspool cleaners LT1No 55 G�L•7,)tL(,t,HS Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants LIP Motor Oils Pesticides -4�A NEW 00 USED (insecticides, herbicides, rodenticides) ea 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 �0 C,rtLS �AIEW rEr Lye or caustic soda Rustproofers /! C-oKt5s 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, f�rET"kll_ ,L-YtS � Misc. Flammables Sr LA,N A,�S of eL hydrochloric acid, other acids) ��, ONr GALt6� Floor &furniture strippers)ehp s or- FAjpT Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers UAILACaL� JalOtAl,rl,/ tiiA72�PALo (including bleach) 2-,r-� 6S Spot removers &cleaning fluids _y���t7►l P�2yX��t 35�'0 6 %VV(At AIJ (dry cleaners) Other cleaning solvents /ASP A b7ES Bug and tar removers PA46�9) ; i Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS G �I I .t I R. F. Morse Hazardous Materials Inventory/Inspection Notes June 4, 2009 R.F. Morse 362 Yarmouth Road Hyannis, Ma. Cynthia Martin, PHD Thomas McKean, PHD Rick Quast, General Manager The following is a description of the five major storage areas in the R.F. Morse facility as they relate to Hazardous Materials storage containers and the corrective actions to be taken regarding the material storage or handling. 1. The new product drum storage area consists of(six) fifty-five gallon drums of engine oil and hydraulic fluid. These drums are stored on elevated shelving. Speedy Dry was observed on the floor under the filling area of these drums. This Speedy Dry should be cleaned up on a periodic basis. 2. The retail store area contains shelving for individual consumer sized containers of miscellaneous flammables and lubricants. These containers range from fifteen- ounce spray cans to five-gallon plastic buckets. 3. The garage area contains (two) two-hundred fifty gallon, and (one) one-hundred gallon above ground storage tanks. These tanks are used for"used fuel oil" storage, this fuel is burned in an on site waste oil heater. Corrective Actions: The three tanks are required to be labeled with the words 6� "REGULATED RECYCLABLE MATERIAL", "USDED FUEL OIL", "TOXIC" capital letters at least one inch high. In addition the two large tanks are to be labeled with the date on which accumulation began, also in one inch high capital letters. 4. A bermed room which houses (two) two-hundred and seventy-five (approximate, capacity unknown) gallon, steel, diesel storage tanks. And several plastic gas cans. The diesel fuel is used in the large equipment(tractors, etc) and for the pressure washer. Gasoline is used in the smaller equipment such as lawnmowers. 5. The "Wash Room" is also used as a storage area for various hazardous materials. Following is a list of drums and their location noted during the inspection. Along the left wall as you enter the room, stored on wooden pallets: (1) Full 55 gallon metal drum labeled Turf Guard Motor Oil (1)Half full 55 gallon metal drum labeled Turf Guard Motor Oil - 2 - (2) 55 gallon plastic drums of 35% Hydrogen Peroxide (1) 55 gallon, open drum of unlabeled/unknown material- (1) 55 gallon plastic drum of Engine Coolant. (1) Half full plastic drum of Battery Fluid Acid Corrective Actions: The two metal drums of Turf Guard Motor Oil were rusting and appeared to be stored for a long period of time. The integrity of these drums is questionable, as is the age of the material. These two drums of Turf Guard Motor Oil should be returned to the supplier if the use of the material is obsolete, or disposed of as hazardous waste per Commonwealth of Massachusetts Hazardous Waste Regulations. Should these drums contain useful product that will be consumed the drums are to be stored in a dry environment and in a containment area designed to contain 110% of the volume of the material. Corrective Action: The opened drum of unidentified/unlabeled material shall be identified by a laboratory, labeled and treated as hazardous waste per Commonwealth of Massachusetts Hazardous Waste Regulations. Corrective Action: The partial drum of Battery Fluid Acid shall be disposed of as hazardous waste per Commonwealth of Massachusetts Hazardous Waste Regulations. Stored on wooden pallets against the rear wall of the Wash Room: (1) Half full, open, 55 gallon plastic drum of 35 % Hydrogen Peroxide (3) Full 55 gallon steel drums of unlabeled/unidentified material (1) 30 gallon (approximate) steel drum of unlabeled/unidentified material (1) Five gallon,plastic bucket of miscellaneous petroleum product.$� cu -ds1 Corrective Actions: The material in the three, full, unlabeled/unidentified 55 gallon and one 30 gallon steel drums shall be identified by a laboratory, labeled and disposed of as hazardous waste per Commonwealth of Massachusetts Hazardous Waste Regulations. During the inspection the 30 gallon drum of unknown material was noted as being loosely covered and had the odor of a strong solvent. This drum shall be tightly closed immediately upon receipt of this letter. Stored in the rear corner of the Wash Room adjacent to the floor drain system was an open 55 gallon, blue,plastic drum of unidentified/unlabeled material. quK pp-p „, Corrective Action: The drum of material appeared to be petroleum based however ,q there was no obvious odor. This drum is to be tightly closed immediately upon receipt of (;9� this letter. The material in this drum shall also be identified by a laboratory, labeled and - 3 - disposed of as hazardous waste per Commonwealth of Massachusetts Hazardous Waste Regulations. Stored against the right hand wall at the entrance to the Wash Room are two, full fifty-five gallon, metal drums. One is spray painted with the words Old Coolant the other is unlabeled but has a pan on top which appears to contain residual green antifreeze. Corrective Action: These drums are to be closed when not being used. The material in these two drums is to be identified by a laboratory, labeled and then disposed of as appropriate per the Commonwealth of Massachusetts Hazardous Waste Regulations. In addition, there were five drums located behind the building. Three drums, labeled Guard Transmission/Hydraulic Oil, Pennwood 15W40 Oil and Cool Guard were empty. A drum labeled 35% Hydrogen Peroxide drum appeared to be full of water, as did a thirty gallon unlabeled drum. Corrective Action: These empty drums are to be disposed of as appropriate, (i.e. recycle/solid waste). All corrective actions related to the disposal of hazardous waste shall be implemented and documented per the Commonwealth of Massachusetts Hazardous Waste Regulations. At the time of the inspection Safety Kleen was noted as your waste hauler of record. They may be able to assist you in the identification, labeling and disposal of the above noted material. The corrective actions noted above shall be completed within twenty-one days of receipt of this document. Please be aware that proper documentation of all hazardous waste identification, handling, and removal will be verified by the Public Health Division. The Public Health Division will contact you regarding a follow-up inspection scheduled for July 7, 2009. Also of note, there is an approved one-thousand, seven-hundred and fifty gallon Industrial Waste Water(IWW)holding tank in the "Wash Room". The application indicates that this tank was to be pumped out three to four times annually at approximately five-hundred gallons per pump out. The waste water was to be transported to either the Barnstable WPCD or Yarmouth WWTF by Bortolotti Construction. Reportedly the tank has not been pumped out in several years, pump out records at the facility were non-existent. (Copies of the IWW Application, Approval Letter and are attached for your convenience.) Corrective Actions: The holding tank waste water is to be pumped out and the waste water transported to an approved waste water disposal facility. (Please be aware that the disposal facility may require that waste water analysis be performed to verify -4 - compliance with their pretreatment regulations.) Documentation of the pump out, transport and final disposal of the waste water is to be made available upon request. TOWN OF BARNSTABLE Date: TOXIC AND HAZARDOUS MATERIALS ON-SITE-INVENTORY NAME OF BUSINESS: 77C- A7P 36PV BUSINESS LOCATION: ZX 4AfZf0 It 21 44.,A I INVENTORY MAILING ADDRESS: A o TOTAL AMOUNT: TELEPHONE NUMBER: -17Y -7 - 3994 44t- CONTACT PERSON: -3 EMERGENCY CONTACT TEL PHONE NUMBER: ������� "� MSDS ON SITE? TYPE OF BUSINESS: 4-ary 5e6x fi�FPAf W-S -N&Z-0s 7' 0--- INFORMATION/RECOMMENDATIONS: C���E�✓E 4-r776�U�S� �7)&- Fire District: � �S OIL b OU M b akbh 9-6 T$ St- L NA ZAOW O A-AW15 WA-tM "WAS7-E" io le " 1-b.X y y� SP&W7- A-iV77,cRE-4- Di2cc�'( /S 7-6",5 P6vrr 4N77,,r-7KeE-,�..®I+1LA-Aj"L 4u7a 15oby /S rD 06fi /,v 4 #s+2Aoev6VS /D.4-6 A4 A-7W ikGS oas'r,+ ,/z7,v4kXky PGAAJ Waste T+aa,spo4atfen: ast shipment of hazardous wa �te: - —,ZOO Name of Hauler: -34 erg" Destination: Waste Product:as& o/z- -+1NT Licensed . 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 deterrhined 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 NEW /0 USED�4,N�S Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils W4-,STE Del. Pesticides NEW USED LD� nG���� (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 (A'N�'I� P�o�o� (inc. carbon tetrachloride) �( (o NEW USED CLZAA/Ck Any other products with "poison" labels _ Paint &varnish removers, deglossers (including chloroform, formaldehyde, fro Misc. Flammables /y 3� � �� CA-PAS-/7y hydrochloric acid, other acids) GG.4 HA�3c�5 ekB1NE-I' Floor &furniture strippers Other products not listed which you feel V F Metal polishes 219C i77AJ4 may be toxic or hazardous (please list): Laundry soil & stain removers(including bleach) � - N,,� GUjj. Spot removers &cleaning fluids(dry cleaners) /S#t7zSS w&WE u P 7-0 Dkr 50 Other cleaning solvents bA44 w,q-S AIVA11,491C G,oX 4 MCTAL, t4,0V,57e.M /AJ Bug and tar removers W,'S A-VA/LA-F�t.� Peg- 0/1/ ,R�9S, /VO >i24/1vS Windshield wash 1wgc og 5&--kVC-7)- WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS r ,,..,,.....,,,,,....,.. ..,�. ....--r.rJ�,..,�r --r�.,ri�xr.�r(i .�.,cane�.a �v...-:„•-.m�e .-- r.r m'".-i.:. FfHE l 0 o''tio TOWN OF BARNSTABLE Date: .. ............................................. S ❑ New Application > �AB>� ; LICENSE APPLICATION [KRenewal 9� MASS. `�i 200 Main Street '❑ Transfer 1°rF1 59.ra Hyannis,MA 02601 508-862-4674 ❑ Other NO BUSINESS MAY. OPERATE WITHOUT A VALID LICENSE ON THE PRENIISES a-- Name of applicant/corporation: QIJ0 0,1 Home phone#: Address of appIicant/corporation:_._`..w......__...._... v _..._ _ Business phone#: — ...................................-.-........... • ---....-..._._......._..__..__...- ---..._._.... - ....._._.\:.._../_m.r._r-N.a _ . ....._._...-Y'°1_F ...._..t _ 1_ .:_.._.... -..._ _ - .........:.._....-_.._-.:._...--._.... ---...--._......... S r Q D/B/A __ .._ ____ ._ ...... ......___....._ : .........-_.................__.._......_..._.__._._...._..._.... Business phone#: �a '-�_ - Business location: .._....-b .._..._..__... � (5,r- _�A ,_hj........_ .._:....7...._a TJ�/..1.._�_.._......_�__!....1.__..__ Business mailing address: .................................................... .. .............. Local business address: Q ._..........................._....._...._..._.__...._..._........._._....-_...._....__........._...:_...__..._..................._............._..........----.-...._................................_..._...................._..._................................_.._....._...........__._..._.....--._...._...._........... .....- ---........._....._ Local mailing address: _._.._._---------_...._..._..__.._..___..__...__.__......_ .._ ._ _ _......._....._....._.._...._..............._...._.__.__. .. _........_._....._......._..---._...._...._.._._.... -....._....._.............._........_........ LICENSETYPE: ................��.Q.............�....;.. .`? ............:...-:.r-'-^-.............................. .......... Annual Seasonal 0 HOURS OF OPERATION: n':_:......_q_`(0....._...._S_:i-5._..... AD#: V Name of manager: i Ema ] Local mailing address:` .........._ ,,.. ,._ '. !........-.Q:._ .._ .+ ......... ......................... ../&/...a^"1:.d...........:...... 1© Manager's Permanent mailing address: U Y'� _.__.._._..._._.........:....____._.:.._..._....._.........._......._.................._........__.._..._....._.......................................... ........................_............................................._.........................._................_......._..........._.....- . - Manager's home phone#: 5M�_)�_�:.__u._�.__`�(vo Business phone#: Q "!°l.1_..':..._Sc �+��. �--- - ......-. Name of property owner: R:Q e ! ► _v. .. . _ . .r.._.. .. __... ...._ _. ASSESSOR'S MAP/PARCEL#: MAP .�-1 '-# PARCEL (} List any flammable substance or hazardous waste used in bus ess(specify): Applicants must contact the Building Commissioner's office, (508) 862-4038, the Board of Health office, (508) 862-4644, and the appropriate Fire District office to schedule inspections. Signature of applicant ftll .... ............................................................................................. ....... ................................................................................................................................ For tJTo se ory REAL ESTATE TAXES PAID IN FULL PAYMENT AGREEMENT IN EFFECT ON IS THIS USE PERMITTED WITHIN THIS ZONING DISTRICT? YES NO INSPECTORS APPROVAL ......_ ............... C .................._..............................................................._...............................................................I........_.. .._... ......... ...... ,. _......................................._.._..._! .........._....................._... Building/Zoning................... h.........._........................-......._......................_..........._.. .................._.................................._......... Date _.............. ...............-................... ........ Wire .............................._................................................ Date .................................................._............_............. Plumbing .................._...........__...................................................._.........Date ...................................._......... .._.....:........... Gas ............................................................................. Date ........................................................._................ Fire District ..............................._......_......................................_... Date Comments:_._.. White-Licensing Authority Canary-Health Division Gold-Building Commissioner Pink-Fire Department ' 1 Town of Barnstable-Health Department Page 1 HAZARDOUS MATERIALS INVENTORY SITE VISITS DMA: Scott's Cycle Fax: — Corp Name: Mailing Address "• Location: 362 A Yarmouth Rd., Street: 362 A Yarmouth Rd. mappar: City: Hyannis Contact: :Scott Hardy State: Ma Telephone: 1508-771-5252 Zip: 02601 Emergency: Person Interviewed: 5 Business Contact Letter Date: 6/24/2004 Category: Inventory Site Visit Date: 6/28/2004 Type: Follow Up/Inspection Date: public water ❑ indoor floor drains ❑ outdoor surface drains ❑ license required ❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc ❑ currently licen ❑ town sewage ❑ indoor catch basin/drywell ❑ outdoor catch basin/drywell expir - --- on-site sewage ❑ indoor on-site syste ❑ outdoor onsite system date: _.._............ ______ 4/21199-Obtain MSDS sheets. Recycle oil filters. col)1 e: 5 S, isfaatory f le <--6 - eozw aa Wes. 1, Page 2 y r'` K 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 qty's 111 gals or more gtyI I unit;of measure waste oil 1 551drum.... __.._ m...-- -_.. ___.... ....... __._. .__.. hydraulic fluids"(including break fluid) y✓_`1 cases _.. gasoline �"`- VWWV �rvW J 1'gallons batteries/battery acid 1 gallons ........................._........._._.___.........__.___.,........._... __._ .....__...._.___..........--_....._..........................._.._._.._.. .............._...._._.__ motor oil 55dr Waste Transporter QAI��Cr R . Fire District: LastHW Shipment Date V Waste Hauler Licensed: O Town of Barnstable-Health Department Page 1 HAZARDOUS MATERIALS INVENTORY SITE VISITS L?8A: Scott's Cycle Fax: — Corp Name: Mailing Address ° Location: :362 A Yarmouth Road,Hyannis Street: 362 A Yarmouth Rd. mappar: City: Hyannis Contact: Scott Hardy,Owner/Manager State: Ma Telephone: `508-771-5252 Zip: 02601 Emergency: Person Interviewed: Scott Hardy ......... ............. Business Contact Letter Date: 6/24/2004 Category: :Vehicle Maintenance Inventory Site Visit Date: 6/28/2004 Type: Follow Up/Inspection Date: ... ❑� public water ❑ indoor floor drains ❑ outdoor surface drains ❑ license required ❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc ❑ currently licensed ❑ town sewage ❑ indoor catch basin/drywell ❑ outdoor catch basin/drywell expir - - -- ----- W on-site sewage ❑ indoor on-site syste ❑ outdoor onsite system date: ..__. ......... ...... 4121/99-Obtain MSDS sheets. Recycle oil filters. 6/29104 Onsite compliance: hazmat inventory. Oil filters taken to Yarmouth landfill for recycling. Satisfactory MSDS onsite. Batteries to Interstate weekly. Solvent taken by Advanced Liquid Recyc. John Deere(next door)takes used oil for heat-this is exempt from his total. Has all documentation for taking f Q heat oil next door. Excellent documentation and knowledge of record /�%�// t� U U CA r keeping. Bob's Tire takes motorcycle tires. Absorbent onsite. ORDERS: Move tire pile under awning out back. If left in open then UU cover. Label waste oil drum"Toxic"and"Hazardous Waste". Page 2 Town of Barnstable-Health Department HAZARDOUS MATERIALS INVENTORY Chemicals: ❑ Zero Toxic Waste Materials gty's>25 Ibs dry or 50 gals liquid but less than 111 gals ❑ gty's 111 gals or more a, .... descnpt" q Ys unit of sure mea waste oil 10 gallons Batteries 11 gallons other cleaning solvents _ 2.5gallons _......__.__...____.__.. ___._.____ _._.__.._........___._._.____........._ --- _ _- _ -....._.......__.__......_. _ Misc.Acid ; 0.5 gaIons motor oil t4 gallons misc.petroleum products:grease,lubricants 3 gallons Waste solvent 10 gallons antifreeze(for gasoline or coolant systems) ( 1 igallons ............. Waste Transporter: Interstate Battery Fire District: Hyannis ........... .. ...... Last HW Shipment Date 11/1/2003 Waste Hauler Licensed: Yes Date: Co /2q / 0 y, TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: S °S C LACA e_ BUSINESS LOCATION: .360 9 A �A ► ��INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: 5708— —7-7/--5-Z Ste. aagms CONTACT PERSON: - ' EMERGENCY CONTACT TELEPHONE NUMB MSDS ON SITE? TYPE OF BUSINESS: ! - oe INFORMATION/RECOMMENDATIONS: Fire District: — 14 /�rts/S '1 Az.4A-)m j s t.4)As q." a,�ud _ab a o oozz!Au/hiZ_4LA70--rL -- Waste-Transportation:Ae4- Last shipment of hazardous.waste: A&V 1, 2003 I Name of Hauler: Destination: Waste Product: Licensed? Ye 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 `*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 jftJSED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED 3 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)/Batt�s 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) —! � /0 maw Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS TOWN OV BARNSTABLE CO LlANCE: CLASS: 1. Marine,Gas Stations, Repair satisfactory 2. Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY �� S C�-i 0 (see"Orders") 5.Retail Stores `1 6.Fuel Suppliers ADDRESS �1A2 `EAR cSl rtl.�,4bass: L R�N 7. Miscellaneous QUANTITIES AND STOe9'A6E (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: waste motor oil (C) r.� ` I► 5_ new motor oil (C) �S. transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: PT, � Q � X DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply Town Sewer ublic O On-site OPrivate 3. Indoor Floor Drains YES-No O Holding tank:MDCT 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 Name of Hauler Destination Waste Product 1_� 1�7 I 2• Q` ig-7/02 Person(s) Int6rviewedf Inspector ate S TOWN OF BARNSTABLE OMPI,IANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers ,�Ly � O (see"Orders") 5.Retail Stores COMPANY •.++te�a {�;fG 6.Fuel Suppliers ADDRESS .7�� �1�����Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MAT IALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jetii'ae� 1.3 Heavy Oils: waste motor oil(C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O Town Sewer ublic �On-site OPrivate t 3. Indoor Floor Drains YES N011_' or O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES N0j,/ O E O Holding tank:MDC 5 Vs O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 2. Person (s) Intervielfed Inspector Date i HONDA SUZUKI Scott'S Cycle, 362A Yarmouth Road,Hyannis,MA 02601 Motorcycles•Watercraft•A.T.V. Parts•Accessories Used Bikes Bought&Sold•Inspections SCOTT HARDY 508-771-5252 Factory Trained Technician KAWASAKI YAMAHA i TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY sSB , � � (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS764AV4C18SS' 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATRAIALS 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) 6 transmission/hydraulio� Synthetic Organics: degreasers Miscellaneous: DISPOSALSECLAMATION REMARKS: 1. Sanitary Sewage 2. ater Supply O Town Sewer gPublic . � 2 Pn-site OPrivate lv `rt 3. Indoor Floor Drains YES NO'k O Holding tank:MDC O Catch basin/Dry well Jt O On-site system 4. Outdoor Surface drains:YES NO ORDERS: <— O Holding tank:MDC , L O Catch basin/Dry well O On-site system 5.Waste Transporter Narne of Hauler Destination Waste Product 7," 2. 1 'N . Person (s) Interview nspector Date �. Date: TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: t Cr© \ Gj G- e BUSINESS LOCATION: air rti o k MAILINGADDRESS: �S1 rv. Q Mail To: TELEPHONE NUMBER: �S_ 9 Board of Health CONTACT PERSON: Town of Barnstable S �-o ( 4�/'- 4 P.O. Box 53 EMERGENCY CONTACT TELEPHONE NUMBER: �� �' �� g Hyannis, 3 02601 TYPEOFBUSINESS: a+br U� :e , ���..� 1��ir� �[� 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 otherthan 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 G4Se- INEW eeze(forgasolineorcoolantsystems) Drain cleaners USED © Cesspool cleaners Automatic transmission fluid b Disinfectants b Engine and radiator flushes Road Salt (Halite) C-asf Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides q,1 s NEW '9' USED (insecticides, herbicides, rodenticides) GaIh,J Gasoline, Jet Fuel _ Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED 'D,(fA5V_5 Other petroleum products: grease, 0 Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Q Printing ink _2 Degreasers for driveways & garages C2 Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers O Lye or caustic soda Car wash detergents. _ 2 Jewelry cleaners 0 Car waxes and polishes _� Leather dyes 0 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 0 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: ' ' TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: CO- C C' BUSINESS LOCATION: . YOU r-\ o Lk � MAILINGADDRESS: S 0" Mail To: TELEPHONE NUMBER: Board of Health • ter^ Town of Barnstable CONTACTPERSON S G a t I �` P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: �-�� V& g Hyannis, MA 02601 TYPEOFBUSINESS: Tn 1 or A,`r -Pa.rt qS 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 ayes or no answer. Use the enclosed " envelope for your convenience. v 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 9 g .. q Y i you store. NOTE: LIST IN TOTAL LIQUID VOLUME"ORPOUNDS. E Quantity r Q uA ntity l La Q Antifreeze(for gasoline or coolant systems) Drain cleaners NW USED 0 ...Cesspool cleaners G Automatic transmission fluid 0 Disinfectants U Engine and radiator flushes Road Salt (Halite) coSO Hydraulic fluid (including brake fluid) Refrigerants ef Motor oils l Pesticides 'k' F'P" a,).° )NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel _) Photochemicals (Fixers) { 0 Diesel fuel,kerosene, #2"heating oil � NEW USED Other petroleum products: grease, C Photochemicals (Developer) lubricants, gear oil NEW USED ;. C) Degreasers for engines and metal f Printing,ink t!% Degreasers for driveways & garages (-1 Wood preservatives (creosote) Battery acid (electrolyte) C, Swimming pool chlorine Rustproofers C? Lye or caustic soda 0 Car wash detergents C Jewelry cleaners Q Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's C� Lacquer thinners Other chlorinated hydrocarbons, (inc.°carbon tetrachloride) Paint & varnish removers, deglosse`rs Any other products with "poison" labels 0 Paint brush cleaners 0 ' Floor & furniture strippers (including chloroform, form-aldehyde, � � • `' h"ydrochloric acid, other acids) CMetal polishes V 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 r C� Bug and tar removers ` WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: "7 / / / Oy TOWN OF BARNSTABLE ,TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: - BUSINESS LOCATION: 2- INVENTORY MAILING ADDRESS: W TOTAL AMOUNT: TELEPHONE NUMBER:. S08- -7-7 l �-39v76 vn-5 CONTACT PERSON: S EMERGENCY CONTACT TELEPHONE NUMBER: S'�8 39 MSD§ON SITE? TYPE OF BUSINESS: 60E�A 1 5S I�� INFORMATION/RECOMMENDATIONS: 9- Fire District: � e1 Waste Tr sporta on: Lasts ipment of hazardous.waste: Name of Hauler- Destination: Waste Product: Licensed? Yes No S or (.ess) 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 EW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides Z P ED (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 Avr4Car 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 Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS '► Date: " / J i b,4 °TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: a"bQ441 BUSINESS LOCATION: 3(OD- �sIn-trynoi,.^ Pri 4gcgx p t'S Wl P, MAILINGAD Mail To:DRESS: ,�C:�Y1P Board of Health TELEPHONE NUMBER: 6oA `7"7t 3 i ace Town of Barnstable CONTACTPERSON: z P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: 60 3C1 /00ci Hyannis, MA 02601 TYPEOFBUSINESS: Does your firm stor_a ny of the toxic or hazardous materials Iiste_d below, either for sale or for you own use? YES J` 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 �19aints, 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 Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS y Date: b OXIC AND HAZARDOUS MATERIALS REGISTRATION FORM - NAMEOFBUSINESS: a4/ex )4'7L. BUSINESS LOCATION: ('oa �1� Uyvtou} 1pC� t-4�lcsnr� S VVl MAILING ADDRESS: ,, G Vyle Mail To: Board of Health TELEPHONE NUMBER: �I( Town of Barnstable CONTACT PERSON: t771 P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: 1001; Hyannis, MA 02601 TYPEOFBUSINESS:Q_1A_ bll"��4 x7)40 `Does your firm stor_e�ny of the toxic or hazardous materials listed below,either for sale or for you own use? YES 'X NO This form must be returned to-the Board of Health regardless of ayes 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 otherthan 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 gasolineor 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 I USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) -Diesel fuel,.kerosene, #2 heating oil NEW USED c 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) f Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners ,f Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers 5�aints, varnishes, stains,dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW , j 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 s may be toxic or hazardous (please list): (including bleach) Spot removers& cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS "Where your caf`:ora[uckgets in shape"_. � oEU00 AUTO COLLISION CENTER (508) 771-3936 362 Yarmouth Rd.,Hyannis,MA 02601 JAMS&RANDY GOLD 24 HOUR TOWING i 1 TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH (Y satisfactory 2.Printers 3.Auto Body Shops 4 O unsatisfactory- 4.5.Retail Manufacturers COMPANY6;� � ,e� (see"Orders")u�a Stores C 6.Fuel Suppliers ADDRESS Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) I-MAJOR TERIALSUnderground IN OUT IN OUT IN OUT #&gallons Age Tes (' Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: A 461Y 47 DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply gw ',�_5' O Town Sewer OPublic ,KOn-site OPrivate 3. Indoor Floor Drains YES—A/ NO- 0 Holding tank:MDC E O Catch basin/Dry well t ;tf. O On-site system 4. Outdoor Surface drains:YES NO ORDERS��,4WX— e-� O Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste'Pro�duct Licensed? tag rY 4/ -✓t� taa YES NO 1. 2. nterviewed Inspector Date Person( f, T HICK QUASI . Manager R.F.MORSE&SON,INC. 362 Yarmouth Road P.O. Box 2126 Hyannis,MA 02601 508-775-1850 Fax:508-778-6499 Mowers,Skidsteers and other grounds care equipment for golf courses, contractors,homeowners and others 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 e /la-xi (see"Orders") 5.Retail Stores 1 6.Fuel Suppliers ADDRESS 2 �> 7 Wg"z4�!"'�, ass: 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MAARIALS Case lots s IN OUT IN OUT IN OUT 1#&gallons 7277 Test Fuels: (A o �;� , Heavy Oils: !� waste motor oil (C) new motor oil(C) transmission/hydraulic k/1?J1 if� Synthetic Organics: 47 degreasers .� Misc laneous: -,.,!V� l © 1 5 ltv DISPOSALIRECLAMATION IM REMARKS: 1. Sanitary Sewage 2.W ter Supply O Town Sewer Public ° �On-site OPrivate 3. Indoor Floor Drains YES NO f Holding tank:MDC c5' 629 i O Catch basin/Dry well f�' O On-site system n � 4. Outdoor Surface drains:YES 'V NO ORDERS: 'G� O Holding tank:MDC :. V Catch basin/Dry well O On-site system 5.Waste Transporter Narne of Hauler Destination old 2. Person (s) Interviewed Inspector Date s e E worse Sons WILLIAM R.ROCKWELL,JR. may, ' 'g SALES REPRESENTATIVE �.= JOHN DEERE GOLF&TURF KPH (508),2951553 JOHN DEERE SKID STEERS CELL(508)789-5293 RES (508)771 9456 CRANBERRY HIGHWAY .FAX(508)295-8187 WEST WAREHAM, MA 02571 e He Fe KOM SOBS WILLIAM R.ROCKVYELL,JR. SALES REPRESENTATIVE JOHN DEERE GOLF&TURF f PH i 5 )295-1553 JOHN DEERE SKID STEERS W CELL(508)789-5293 RES(5p8).771-9456 CRANBERRY HIGHWAY FAX(508)295 8187 WEST WAREHAM, MA 02571 y X TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Re ai BOARD OF HEALTH 4 satisfactory 2.Printers 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores .�/ 6.Fuel Suppliers ADDRESS Class: �" `' G 7•Miscellaneous XX QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MTERIALS Case lots Drums IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel(A) Diesel, K*, e , #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers vye, ,4, Miscellaneous: Z / DISPOSAURECLAMATION REMARKS' 1. Sanitary Sewage 2.Water Supply 4e O Town Sewer Public 'O On-site OPrivate 3. Indoor Floor Drains YES N0-y— O Holding tank:MDC O Catch basin/Dry well O On-site system f� 01 4. Outdoor Surface drains:YES �0 ORDERS: O Holding tank:MDC , O Catch basin/Dry well_8t D O On-site system 5. Waste Transporter DestinationName of Hauler YES INO 2. da Person (s) Interviewed In pector Date F TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas StatioiYs,Repair BOARD OF HEALTH satisfactory 2.Printers 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY C�VJI�� j 1�e—y (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS 3 6 Z Y6,rvk® vq-i,,. Z rT Class: 7.Miscellaneous 14Y QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground 1 SP IN OUT IN OUT IN OUT #&gallons Age Test 114 jZ3a �c Fuels: Gasoline,Jet Fuel(A) Diesel, Kerosene, #2(B --7 5— p� Heavy Oils: 7 Z— bC waste motor oil (C) 300 'e-K3 C'i e0- •?,Sj Y new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers 4� G C1nL i Miscellaneous: C-1 pl ,5zd1Cr," "J/ i`CG. ('Gw� W-CX O a2.I- DISPOSAL/RECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply GloT ej rc'G( ,-c U Ank— O Town Sewer Public )50n-site OPrivate h y --ext b (A4 vu,s r sA f2f 3. Indoor Floor Drains YES Y- NO- 0 Holding tank:MDC up O Catch basin/Dry well e(ok&5y) as _rCfiC( Grxj,&_,? peevie e'cn.oef O On-site system 011744, 4. Outdoor Surface drains:YES N0_&_ ORDERS: v O Holding tank:MDC Li� nlu 1 e AS:.e O Catch basin/Dry wellTI old pallj TO O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 2. C C a r % • Person (s) ntervi r edInspector' Date 5'GS S-5 / - F 13 - s� r - �� CCrt4- v c i e rs i B` 3 - S5 3 eS CGtnJ� G Su / I C-5 Z — S l e S Fa z - - r.5 Ili `. t , - _ �. + � ; i .- �� s4 • �� � 1 TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 2.Printers BOARD OF HEALTH ' satisfactory isfa ry 3.Auto Body Shops O4.Manufacturers COMPANY. 6116;cf- 'Tv (see"Orders") s.RetFue suppliers ADDRESS RtoN+-O _ Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS .• , �i IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Dre". `2l Diesel, Kerosene, #2 (B) Heavy Oils: S f 1 e waste motor oil (C) ®' " ' �7 4-, new motor oil (C) I x � tr- smissio ydrauli a x 'f Synthetic Organics: degreasers O-K-e Miseella eous: Lew OkY u4e, . S7tif(; 60 re bey baft DISPOSAL/RECLAMATION .-REMARKS: 1. Sanitary Sewage 2. Water Supply �iil f�c C/ woj ( S S 0-Town Sewer Wublic S d r n-site QPrivate IKO 3. Indoor Floor Drains YES NO O Holding tank:MDC Ua O Catch basin/Dry well S �` O On-site system zc a j 4. Outdoor Surface drains:YES x NO. ' O Holding tank:MDC Catch basin/Dry well O On-site system I v r 5. Waste Transporter Name of Hauler Destination Waste Product d. pA ,, YES NO 2. -Person s n e ew d Inspector Date j ^V e Commonweafth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection ' Southeast Regional Office Wllilam F.Weld Govemor Trudy Coxe David B:Struhs i December 12, 1995 j Mr. Robert Tivey Sr. RE: BARNSTABLE--Industrial Wastewater Gillis & Tivey, Inc. Branch BWP--Gillis & Tivey, Inc. . 362 Yarmouth Road @ 362 Yarmouth Road, Hvanni s, '�assac:0se�.ts 02601 Industrial Wastewater Holding Tank Approval Transmittal No. 105449 Dear Mr. Tivey: The Department of Environmental Protection has completed a .Technical Review of the above-referenced application for the installation of a non- hazardous industrial wastewater holding tank. The plans are titled: GILLIS & TIVEY 362 YARMOUTH ROAD HYANNIS, MA. 02601 EQUIPMENT WASH CLOSED LOOP WATER RECYCLING SYSTEM CONSERV GROUP INC. 110 STATE RD P.O. BOX 278 SAGAMORE BEACH, MA 02562 GEORGE S. PETERSON, P.E. P.O. BOX 6144 PLYMOUTH, MA 02362 DATE 20 JULY 1995 SCALE AS NOTED SHEET M-1.0 ONE OF TWO SHEETS and. �r SHEET M-2.0 TWO OF TWO SHEETS 20 Riverside Drive e' Lakeville,Massachusetts 02347 0 FAX(508)947-8557 0 Telephone (508) 946-2700 -2- The plans propose to dispose of 1,750 gallons of non-hazardous industrial wastewater (equipment washwater) from the . site by means_ of an industrial wastewater holding tank that is incorporated in a 'closed loop water recycling system. .This discharge will be generated from the wastewater .; recycle system should the system ever fail or need to be purged. The Department hereby approves the plan pursuant to the Massachusetts Clean Water Act (the "State Act") M.G.L. , Ch. 21, Section 27(13) , as amended, j and the promulgated regulations thereunder subject to the following provisions: 1. Failure of the owner or person having control of the tank to keep it from overflowing and properly maintained will constitute grounds for the revocation of approval for the use of the industrial waste holding tank. 2. Written certification that the industrial waste holding tank has been constructed in accordance with the approved plan shall be submitted.to this office with a copy to the Board of Health. Said certification shall .be submitted by a Professional Engineer who is registered in the Common- wealth of Massachusetts. Nothing in this .provision is intended to interfere with the right of the Board of Health to inspect the industrial wastewater holding tank at any time during construction in order to assess compliance -with the final plan, as approved by the . j Department. 3. All solids, sludges, filter backwash, or other pollutants, removed in the course of treatment or control of wastewaters shall be disposed in a manner consistent with applicable Federal and State laws and regulations .. including but not limited to, the State and Federal Acts, the Massachusetts Hazardous Waste Management Act, M.G.L. 4: A copy of the contract shall be sent to this office upon renewal with the industrial waste hauler. No Environmental Notification Form is required to be submitted for this project since it is exempt under the Environmental Protection Regulations of the Executive Office of Environmental Affairs and the project has, therefore, been determined to cause no significant damage to the environment. The Department would like to bring to your attention a policy between the Bureau of Resource Protection and the Bureau of Waste Site Cleanup for Massachusetts Closure Requirements for Shallow Injection Wells (see enclosed copy) . This policy is guidance provided by the above mentioned Bureaus for facilities that are closing out injection wells such as the one at 362- Yarmouth Road. i -3- Enclosed herewith are stamped approved copies of the plan, a copy of which must be kept on-site and used for construction purposes. If the Department can assist 'you further or if you need additional information, please contact Robert Greene at (508) 946-2826. Very truly yours, Christopher Tilden, P.E. Regional Engineer for Waste Prevention T/RWG/re Enclosure cc: Town of Barnstable Health Department 367 Main St. Barnstable, MA 02601 ATTN: Donna Miorandi, Health Agent , Consery Group, Inc. � 95 State Road, P.O. Box 278 Sagamore Beach, MA 02562 ATTN: Roy Catignani, President V TOWN OF B STABLE LOCATION .� MNQ RC� SEWAGE # 99 - 3S VILLAGE h VI `.S ASSESSOR'S MAP& LOT 3y40 14 INSTALLER'S NAME&PHONE NO. =e-A '. 1t/2ti tl Kr �7S I WO SEPTIC TANK CAPAC= I sapC.c LEACHING FACILITY: (type) 1 -(size) NO.OF BEDROOMS BUILDER OR OWNER Ro6e-,A C.. ! 1ye_y PERMITDATE: S 02 COMPLIANCE DATE: ^ I - i Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet `Furnished by _ LA �z Sr i �h WALL' OLD yAIZNotk4, TZ c Y y 3 S 9 Flcs......../0-6...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Aliptiration for Divi-pw3al Work.6 (foustrnrttnn 11ami# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atVe / 3C.2-..-11f Am v7 ...!�a.!�'.P.............................. -`---------------.....---•------...-•---....----- Loca \ddress or No. ` --------•----•--•-... Vic.. ,... D a ��� J /eV/C V!� �i.11 f✓�s'�� .. Ad ress {�,44 -- -------- ---- -- - .(,OV Installer Address 10 ape of Building �q r� �j' /f l of ,- ��4 Size Lot............................Sq. feet Dwelling—No. of edrooms......................................._.__Ex ansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building __________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures _______________________________ __ W Design Flow-------------------------------------------- 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........................................ a Test Pit No. I................minutes per inch Depth of Test Pit________-:___-.._.._ Depth to ground water-._______.___.___---.--- (14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ----•--••-•-----------------------------•------------------•--------••-••--•••............--------•-......................................................... 0 Description of Soil........................................................................................................................................................................ x U x ------------------------------------------------------------------------------------------------------------------------------- ---- -- -------------------------- U Nature of Repairs or Alterations—Answer when applicable._.._�_-_.__�k-______________{1�1�..._................................. ••-------------------------------•-••----- ---------------------------------------•--..........-------------- ---------------------------------------------...---------------------------...---••' Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental o — h undersi further agrees not to place the system in operation until a Certificate of Compliance / s be i e b e oa alth. Q Signed ............. .. ...... .................- _ rJ ..a............... .. ................. ...._...._.....Dare........- � A hcation Approved B _. ... ....................._ . . : '- PP PP y ----------- ----------------------------- ----- ------------------ --------- ---- .. / Application Disapproved for the following reasons: ........................................................................... ........... _ ' .............................. ......_....... .. .........' _ _....... ............. ................. ' -_..' - ........................... ' .._.......................... Permit No. ......... ... ../....c�-...?� ............. Issued ------------- .`^..--® V i Daze ---------- ......Dare_.... { THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Diopw3al Work.5 Tonotrnrt"ton Prrmit Application"is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System - at:—. �R rw1 ovTl� -(�a�v �-•------•--••-----•----------------------•--- _ Loca ion \ddress or Lot No. ......wa ..........�.�..u.•�-�--.e___r..-._f.., , VIZ.. Addre-ss C v2 `Z !%� Cr 6 / --•• Inst , tis ih i�e[J Address Type of Building a.-�( l2�S — 6l /�-f r}- 77V� Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) QI Other fixtures ............................... . . W Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons. W 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. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ G%4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •..................................•----.......--•--•--•••••--------------••--••••-.........------••......................................................... 0 Description of Soil......................................................................................................................................................................... x V .....•-•--•••---------------•.....------------••------•---•-----•---•------•--------••••----••-•----•----•--•------------•--••-----------•------•---••....-••-•--•---••••-•••-•-...-----------•-•-------- ----------------------------------------------------------------------------------------------------------------------------------------- -- -------------- U Nature of Repairs or Alterations—Answer when applicable- _4__s'_______���.........�f'�_�..................................... •---------••--------------------------- --------------------------------------------------------•--•----......----------------------------------------------------------------------------_----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental C Th undersig e&further agrees not to place the system in operation until a Certificate of Compliance has been ise b, ,he oa o su f health. r J _3 Signed ...................f..,:.. ..........._..............-....-.........-...... _......... .......--....---Date----------- Application Approved By ------------�� ---------- -----'C L1 5.................................................------------ ----- Dace Application Disapproved for the following reasons: ...... . ........................... . ........................................... . ... ................. . . .......... ................. ............................... ... . -- .................... . ................... ........-- ---------------------------------------- Permit No. t/.-.... .....� Issued /9-....3.0_..-....fir'.. 1..... ---------r--....., J --- --------------- ...................... _ Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE TPrtifirate of Contlatiance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) I4a_er-� C, -T'� i Z---------------------------------------------------------------------------------------------------------------------- by .................. - .. -------------------------- 1/. . - ►..... Installer s at ......$6 - yAi2A►P.h:�A------------QJ------ -------------kVCAL1__�.�,.►-5 _.... - - - - - has been installed in accordance with the provisions of TI i'I.E 5gof The State Environmental Code as described in the application for Disposal Works Construction Permit No. ....9.i/.......3..S.�S...._ dated .30--.-----`'�... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE......................6? ....j....-- --------------------- _. Inspector .... - - --- f L._d' C:'..'��/ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No..... :...�J• FEE j ....... Dispoua1 Morb Tongtrurtion Prrmit Permission is hereby granted `c7-.......�-•----C ` 5 1-r\.. .... to Construct ( ) or Repair O an Individual Sewage Disposal Systerl�- atNo................. ---•-- cs�.,t ...� � ► .1. --__ i� . ------------`-----------------------------f-------- -------••rf--- Street C� as shown on the application for Disposal Works Construction Permit No. y: S� Dated ... ::_._.....__' .. - �- " BoaKd.of Health FORM 36508 HOBBS✓!WARREN.INC..PUBLISHERS ►Massachusetts Department of Environmental Protection For DEPUseonty (�1 0544 9 I_...... - — — Permit No. Transmittal Transmittal Form for Application Re�;ewe Date- 0 — — t and Payment Permit ate ❑Denied Decision Date Facility/D(if known). ' Application Information B._Y a P._i_I W U '1 INSTRUCTIONS Permit,Approval or Other Category(seven character code from the from the first page of the directions on Now to Apply).Examples:8WPAO01,WWI,etc. 1.Please type or . Construct and install non-hazardous industrial wastewater holding tank. - _. -...........-_...... _.__.._._._..- print. Use a Category Name separate Transmittal Closed loop wastewater recycling system installation. Form for each Bdel Project Description application. 2.Use an original, Applicant or Legally Responsible Official 3-part Transmittal Form for each _Tivey - Robert Sr. _ application. Last Name First Name Middle Initial Photocopies will not 362 Yarmouth Road be accepted for any ----- - - --- 1...-- ---- --—=- - ----------- ------ --=—---- application or Address payment.(You may Hyannis, MA 02601 ( 508) 775 _1850 ext. - - usephotocopiesfor City/Town State Zip Code Telephone Number(including area code and extension) reserve location., Robert Tivey Sr. , President where applicable.) Contact 3.Make check payable to Facility, Site or Individual Requiring Approval Commonwealth of ' Massachusetts. Gil_lis_& Tivey, Inc Please mail check Name of Facility,Site or Individual and yellow copy of 362 Yarmouth Road Transmittal Form to: --._ _ .... ....- --............ - ----- --- Department of Address Environmental Hyannis, _MA __ 02601 (508 ) 775 1850 ext.-- _ .. . --------- _ - -------- - ---- Protection, City/fown Slate Zip Code Telephone Number(including area code and extension) P.O.Box 4062, Boston,MA,02211. Application Prepared By (if different from section B) 4.Both fee exempt ConSery Group Inc and non-exempt -- — _ First Name Middle initial applicants must Last Name mail yellow copy of 110 State Road, Suite #9, P.O. Box 278 - Transmittal Form to: Address Department of Sagamore Beach, MA 02562 ( 508) 888 -6555 ext.-- Environmental . 9 ---.)- --- _-.-_----_._._..— _ —_ Protection, City/Town State Zip Code Telephone Number(including area code and extension P.O.Box4062, Roy Catignani, President _.-.__--._.____--------.------------ -- Boston,MA,02211. Contact LSPNumber(for2lEon1y) Other Related Permits. If you are applying for other permits related to this application,please list them below. Transmittal No. •rr mi gescription _None -------------. —. � - --- - I Amount Due Special Provisions: ❑ Fee Exempt* (city,town,district,or municipal housing authority)(state agency if permit fee is$160 or less) ❑ Hardship Request(payment extension according to 310 CMR 4.04(3)(c) ❑ Alternative Schedule Project Request(according to 310 CMR 4.05 and 4.10) There are no fee exemptions for 21 E sites,regardless of the applicant's status. Check No.-- -_------.--_- Dollar Amount$ Date Make check payable to Commonwealth of Massachusetts.Please mail check and yellow copy of Transmittal Form to: Department of Environmental Protection,P.O.Box 4062,Boston,MA,02211 WHITE:must accompany application YELLOW:must accompany payment PINK:retain for your records Rev 7/94 Massachusetts Department of Environmental Protection 105449 Bureau o/Waste Prevention—industrial Wastewater NmemltW 0 BWP 1W 01 Permit to Construct and Install aon.hazardone industrial wastewater holding tankI A ' BWP IW 28 Permit to convert existing tonic to non-haardons Industrial wastewater holding teak Facility ID(rl Imown) ' facility Information 1. Which permit are you applying for? 6. List,in descending order of significance,the four(4)digit Standard Industrial Classification(SIC)Codes which best Mailing Instructions ❑BWP 1W 01 ❑BWP IW 28 describe the facility producing the discharge in terms of the Return this principal products or services provided,Also,specify each application along classification in words. with the while copy 2. Applicant: of a completed DEP Transmittal Form to Gillis & Tivey, Inc. SIC CODE' Description the lndushiel. Facility M 5082 — Construction and Wsslew�ler 362 Yarmouth Road _ Msnapemenf Addms t Mining Machinery and Equipment Program at the h. MA 02601 appropriate DEP Hyannis, - Regional office. city/rMnO270CDde Same-------- d Mailing Address(it dilleren►lrom above) 'Note:SIC Codes can be obtained by contacting the MA --- Division of Occupational Hygiene at 617-969-7177 Clly/row uTp code 3. Facility work schedule in 7:30 _ 4:00 7• Sources of Wastewater.List the amounts of Wastewater,In 8.5 _ gallons per day,above the name of the enure,. Also,oheolt Hours per day; Irorn b off whether this amount is estimated or measured. Always 5 Monday Friday list total flow. paysPerKeek rrom tc esNensMar Estimated, meoss"d 4. Facility receiving wastewater: s)sarnitary(sinka,bilets,etc) ❑ ❑ Barnstable W.P.C.D. b)cooling Tow 10*down ❑. ❑ Hamm 617 Bearse's Way -- c)BolkrBioKdown ❑ ❑ Address Hyannis, MA 02601 d)Contact Cooling Water p ❑ Town.State.ZIP (Back Up) Yarmouth, S.T.F. S.Yarmouth, MA e)HonContacl Cooling Waler ❑ ❑ 5. List any pollutants which you know or have reason to believe are/will be discharged. For every pollutant listed, _ ❑ ❑ indicate its approximate concentration in the discharge and Press wale► attach any analytical data in your possession which g)EqulprrentUlliy Washdown ❑ supports your statement. Additional wastewater analysis andorAermainrenanoe Zero Excess may be.required as part of this application. E ui ment Washin ❑ . b)Air Pollution ctd units: ❑ Dissolved road salt Wasie Site CleanuP. ❑ ❑ n Oil & gr ase G 100 P.P.M. ❑ n teachale(saMhry,industrial,ek.) ❑ Biodi�&radable Determent — - ❑ q Toil flan *Zero Excess Flow, * Closed Loop System; Pump out to _ ---- P.O.T.W 3-4 times annually at approximately 500 gallons per pump out Page i of 2 Rev.7193 Massachusetts Department of Environmental Protection 105,449 Bureau of Waste Prevention—Industrial Wastewater Transmitta►I BWP IW Ol Permit to construct and install non•huardous Industrial wastewater bolding tank l BWP 1W 28 Permit to convert existing tank to aoa-bazardora Industrial wastewater bolding teak Facility 10(d(mown) Facility information (cont) 011st raw material and products used.Include any and all 8. Type of holding tank: products or ehe.Weals used in Processing,elantn0,ft. ZEP - 940 —. E ❑mobile tank trucks5f� �f�� � + El above ground _. ER in-ground if in-ground tank,provide name and signature of appropriate local board of health official (M S D S Sheets Attached) Barnstable.Health D partment Pd Um Snun` 1.Provide name and address of transporter(licensed septagel waste hauler): 9. Does./will wastewater receive pretreatment? Bortolotti .Construction, Inc. M Yes ❑ No l�rne IfYes,is treatment 765 Wakeb Road Address ® continuous ❑ batch ❑ both _ Sa oS�A m Eirj'/PownR►D°°� 02648 Engineer Information Name and address of Mas sachusetts Registered Processional Engineer designing the proposed industrial wastewater holding tank: George S•-Peterson -- Shure �- Print Name P_0`Box_ Address No. P l_YTMouth___ - t city 02362 , 4 v MA___ _— ----- DD We #2268 3 (508) 88876555 Terephone Certification Gillis & Tivey, Inc. R1nf a '1 certify under penalty of law that this document and all attachments were prepared under my direction or supervision Ao edsr9nature in accordance with a system designed to assure that qualified p e.sident personnel properly gather and evaluate the information ntte inquiry of person or persons who 19v submitted. Based on my q ry p ���j, manage the system,or those persons directly responsible for �e gathering the information,the information submittedcurate, an is to the Corporation____.. —__ best of my knowledge and belief,true,accurate,and best I am aware that there are significant penalties for TYMorApdicant(eorvoranon.comps"K9o�rnmenl agency,dtyAowMlrstrld, omer) complete. Massachusetts submitting false information,including the possibility of fine pdncipa(address StaffedrncorporaBonane and imprisonment for knowing violations.' 362 Yarmouth_ Road.__ H anriis, MA 02601 Page 2 of 2 Rev.7/93 Massachusetts Department of Environmental Protection Bureau of Waste Prevention • Industrial Wastewater Management Program BWP IW 01 Permit to Construct And Instao Non-Ilaaardaus Industrial Wastewater Holding Tank BWP IW 28 Permit to Convert an Existing Tank to a Non-Hazardous Industrial Wastewater Holding Tank Application Com pleteness le teness Check list . �i The DEP Transmittal Form is completed. yd Application Parts A through C have been completed. Application includes four (4) complete sets of engineering reports, plans and specifications which are stamped and signed by a Massachusetts Registered Professional Engineer. Application includes a letter of acceptance from a disposal facility and also includes the name.and address of a backup facility. Application includes a copy of a contract with a hauler. To submit the application package: Checklist items have been completed. one copyof the a lication along. Send four copies of the plans and Transmittal Form to: with the white page from the TOM of Environmental Protection * Regional Office Industrial Wastewater *See back cover of this kit for the addresses of DEP Regional Offices. Send fee of $1,050 for BWP IW 01 or $200 for BWP IW 2alth he r Se _ able to Comm f o form of check or money order made Paag a from the DEP Transmittal Massachusetts, along with the yellow p Form to: Department of Environmental Protection P.O. Box 4062 Boston, MA 022.11 BWP IW:01, 28.Ck1 Rev. 07193 (Reformatted 3/94). < : +� _ 6280• Sep. 05 1995 12:56FM P2 Town of Barnstable Department of Public Works 367 Main Stem, Hyannis, MA 02601 Office 508-790-6300 Thomas J. Mullen Fax 508-790.6400 Superintendent September 5, 1995 Mr. Peter Sorrentino ConSery Group, Inc,, ` 95 State Road P.O. Box 278 Sagamore Beach, MA 025622 - ir Re: Acceptance of Non-hazardous Industrial Wastewater from Gillis & Tivey ,Hyannis, MA.. Dear Mr. Sorrentino: The Town of Barnstable, Water Pollution Control Division, has received your specifications for the RGp Environmental Systems, Inc.. The Ultrasorb system seems a viable technology for the steeds of Gillis& Tivey, our concern is the maintenance required to sustain its efficiency. The waste will be accepted at our Treatment]Facility, but we must require a maintenance contract and some analysis be performed to verify compliance with our pretreatment regulations. If you have any questions, please feel free to call me at(508)-790-6336. Very truly yours, ` John Quinn Pretreatment Coordinator INC. R N C NS T UCTIO BORTOLOTT1 CO DRAINAGE LAND DEVELOPMENT SEPTIC SYSTEMS August 23, 1995 Gillis& Tivey, Inc. 362 Yarmouth Road Hyannis, MA 02601 508-775-1850 ATTN.- Bob Tivey. Sr- RE: Equipment Wash Non-Hazardous Wastewater Holding Tank on Bortolotti Costruction, Inc, agrees to pump the waste-water from the mycle m, product water holding tank on a periodic basis as requested to do so. The was to-water will be transported to either the Barnstable W.P.C.D., and at the Yarmouth W.W.T.F. n be reached at 508-428-8926 or 508-771-9399 or FAX us at 508-428-9399. We ca Sincerel , ' Robert J. B tolotti Presient Bortolotti Construction, Inc. 8926 765 WAKEBY ROAD • MARSTONS MILLS,MASSACHUSETTS 02648 • (508)428 MATERIAL SAFETY DATA SHEET o AND SAFE HANDLING AND DISPOSAL INFORMATION WAGE i U7~ 3 ZEP MANUFACTURING COMPANY DATE ; 1 1/a9/8�1 ZE d� , U4 A,�.9.�4 FIRSTIN MAINrENANCP PROOUCTS SUPERSEDES: 06/15/88 R0'DUy (lMBEpI SECTION I -- E M E R GCE .N C Y C 0 N T A C T S ZEP MANUFACTURING COMPANY NON—OFFICE HOURS, WEEKENDS, AND HOLIDAYS-, AREA CODE 404 P. O. 13OX 2015 435-2773, 996-0899, 252-1587► 351-2952, 445-9226 ATLANTA, GEORGIA 30301 LOCAL POISON CONTROL CENTER , , , , ; , , , , , , , , , ; ; TVLEPHONE (404 )352-�1680 TRANSPORTATION FMERGENCY . BETWEEN 9: OOA. M. --5; 00P. M. CHEMTREC: TOLL FREE 1--800-424-9n00 ALL CALLS RECORDED (EASTERN TIME ZONE) DISTRICT I)F. COLUMBIA (202).483-7616 ALL CALLS RECORDED -_ -----,-------------____-------------------------- SECTION II - H A Z A R D 0 U a I I N G R E D I E N T 6 TLV EFFECTS % IN DESIGNATIONS (PPM) (SEE REVERSE) PROD, SODIUM MET'ASILICATE 4.# silicic acid (H2-Si-03) di N/D COR 5--10 sodium salt) water glass; CAS# 6(334--92-01 RTECS# VV9275000; OSHA Dust Limit-2mg/m3 ( for powders only ). ifs NONYLPFiENOXYPOLY(ETHYLENEOXY)ETHANOL N/D. EIR < 5 paly (axy—1, 4—ethan�diyl ), alpha—(non,ylphenyl )—oma�a-- - ' hydroxyc CAS# 9016--45-91 RTECSO MD0900000j OSHA PELF N/D # SODIUM DODECYLPENZENIr SULFONATE # linear alkyl N/D IRR < 5 aryl sodium Sulfonatel CAS# 25155-30-0r RTECS# DB6025000; OSHA PEL N/p SPECIAL NOTE: ADVERSE HEALTH EFFECT'S. WOULD NOT BE EXPECTED UNDER RECOMMENDED CONDITIONS OF USE 80 LONG AS PRESCRIBED SAF[FTY PRECAUTIONS ARE PRACTICED. SECTION III H. E A L T H H A Z A R D D A T. A ACUTE EFP'ECT8 OF OVEREXPOSURE: CONCENTRATE MAY Cat` CORROSIVE TO EYES AND MUCUS MF:MDRANES AND SOi_UTION5 ARE SEVERE EYE IRRITANTS. EYE CONTACT MAY RESULT IN CORNEAL DAMAGE OR BLINDNESS, SKIN CONTACT MAY PRODUCE IRRITATION DEPENDING ON LENGIH .OF CONTACT TIME. INHALATION MAY PRODUCE UPPER RESPIRATORY IRRITATION CHARACTERIZED BY SORE THPOAT OR DIFFICULTY IN DREAYNING. INGREDIENTS IN THIS PRODUCT MAY .AGGRAVATE EXISTING SKIN, EYE, OR RESPIRATORY DISORDERS. a,�panp �Std d1 jlmo,vtl Jgvr,N 1>>d I0J1uA3 ON lag UO1jd1.»sa0 J tipy- 1 E•-.95 TI IE ? _ 2 G i I I i = 0.r,d T i .:oy I n._ 50e77^_FS499 P_ Cl4 MATERIAL SAFETY DATA SHEET 'It m AND SAFE HANDLING AND DISPOSAL INFORMATION PAGC 2 or 3 zEP MANUFACTURING COMPANY DATE 1 1/29/E3q ZEph FC)RMULA:•940F�P"<LLr Wr j , t FIRST IN MAINTENANCE PRGOUCTS SUPERSEDES: 06/15/89 Rd60CT4-'NVMbER' OSf SECTION III H E A L T H H A Z A R D D A T A (CONTINUED) CHRONIC EFFECTS OF OVEREXP09URC: REPEATED OR PROLONGED SKIN. CONTACT MAY PRODUCE CHRONIC INFLAMMATION OR DERMATIT- IS, CHARACTERIZED DY REDNESS, SCALING. OR ITCHING. REPEATED EYE: EXPOSURE MAY .PRODUCE CHRONIC INFLAMMATION OF THE EYE OR CORNEAL DAMAGE: NONE OF THE INGREDIENTS ARE LISTED AS CARCINOGENS BY IARC, NTP, OR OSHA. EST 'D PEL/TLV: NOT ESTABLISHED PRIMARY ROUTE'S OF ENTRY: N/A HMIS CODES` HEALTH 3; FLAM.. n;:REACT. 0; PERS, PROTECT. D ) CHRONIC HAZ. NO. FIRST AID PROCEDURES: SKIN IMMEDIATELY FLUSH CONTAMINATED SKIN WITH PLENTY OF WATER FOR AT LEAN 15 MINUTES. GET MEDICAL ATTENTION IF" IRRITATION DEVELOPF EYES IMMEDIATELY FLUSH EYCS WITH PLENTY OF WATER POR AT LEAST 15 MINUTES, OC- CASIONALLY LIFTING UPPER AND LOWER LIDS. GET MEDICAL ATTENTION AT ONCE. INHALE: MOVE EXPOSED PERSON TO FRESH AIR. IF IRRITATION PERSISTS, GET MEDICAL ATTENTION F'nOMPTLY. INGEST: IF THIS PRODUCT IS SWALLOWCD, DO NOT INDUCE VOMITING. IF VICTIM IS CONSCIOUS GIVE PLENTY OF WATER TO DRINK. GET MEDICAL ATTENTION AT ONCE. SECTION rIVl-. S-P E C I A L P R 0 T E C T I 0 N I N F 0 R M A T 110 N PROTECTIVE CLOTHING WEAR .NEOPRENE, NITRILE, OR NATURAL RUBBER GLOVES OR . GLOVES WITH PROVEN RESISTANCE TO THE INGREDIENTS LISTED. EYE PROTECTION . WEAR SPLASH-PROOF SAFETY GOGGLES ESPECIALLY IF CON'CACT LENSES ARE WORN. RESPIRATORY PROTECTION: KEEP FACE. AWAY FROM SPRAY MIST AND DO NOT BREATHE VAPORS. VENTILATION VENTILATION SHOULD RF EQUIVALENT TO OUTDOORS. USE EX' HAUST FANS AND OPEN WINDOWS IN ENCLOSED SPACES. T ^- � - -A� T A^ . - �.-._---_ ____ _____._ _�- _�-_�__.�_------- SECTION- ECTION V P H Y a I C L A TA ROILING POINT (F) 730F SPECIFIC GRAVITY 1. 10 ..VAPOR •PRESSURE(MMHG) : N/D PERCENT VOLATILE BY VOi_UME (X) 83_5 VAPOR DENSITY(AIR=1 ) : N/D EVAPORATION RATE(WATER SOLUBILITY IN WATER : COMPLETE PH(CONCENTRATE) 13: 0-13. 3 PH(USE DILUTION OF 1 : 100 ) : It. 2-11. 5 APPEARANCE AND ODOR : CLEAR. THIN, LIGHT AM1IER LIQUID WITH DETERGENT-LIKE ODOR. SECTION V I F I R E A N D E X .P L 0 S 1 0 N D A T A FLASH POINT(F) (METHOD USED) ; NONE ( ). FLAMMABLE LIMITS LEL N/A UEL N/A EXTINGUISHING MEDIA : NON-COMBUSTISLE. SPECIAL FIRE FIGHTING: WEAR SELF--CONTAINED POSITIVE PRES, BREATHING APPARATUS. UNUSUAL FIRE HAZARDS MAY DECOMPOSE TO FORM TOXIC/CORR091VE GASES . d T i 87 MATERIAL SAFETY DATASET AND SAFE HANDLING AND DISPOSAL INFORN4ATION . PACE O OF O Si DATE 06/09/F19. -EF*q4. v4p ZEP MANUr ACTURING COMPANY FIRST IN MAINTENANCE PFtODUCy$ SUPERSEDES: 04/21/E�9 �, D�1C , SECTION VII - R E A C T I V I T Y D A T A STABILITYSTABLE INCOMPATIBIL.ITY(AVOID) STRONG OXIDIZERS POLYIIIER17ATION WILL. NOT OCCUR. HAZARDOUS DECOMPOSITION: CARBON DIOXIDE, CARBON MONOXIDE, AND OTHER UNIDENTIFIED _-- �___- ------ -- ^ORGANIC-COMPOUNDS. ------- ------------------------------- - SECTION VII I - S P I�I-. L A N D D I S P 0 S A L PR Q C F D U R tE S STEPS TO BE TAKEN IN CASE MATERIAL IS RELEASED OR SPILL-ED; OBSERVE SAFETY PRECAUTIONS IN SECTIONS 4 & 9 DURING SPILL CLFAN-UP LARGE SPILLS ARE UNLIKELY DUE TO PACKAGING, SPILL MAY BE ABSORDED. ON AN INERT ABSORB- I SUITABLE CONTAINER FOR. DISPOSAL.. WASH AREA - 0 ) , PLACED N A (e XEP q 7C Ri3 ENT g THOROUGHLY WITH A DETERGENT SOLUTION AND, RINSE WELL WITH WATER. WASTE DISPOSAL METHOD: PRODUCT IS CONSUMED IN USE., DO NOT CRUSH,, PUNCTURE OR INCINERATE SPENTCONTAIN- ERS. LARGE NUMBERS OF AEROSOL CONTAINERS MAY REQUIRE' HANDLING AS A HAZARDOUS WASTE, BUT IN MOST. STATES TOTAL HAZARDOUS WASTE AUANTITIES LESS THAN 220 LBS PER MONTH MAY ALLOW DISPOSAL IN A CHEMICAL OR INDUSTRIAL. WASTE LANDFILL. CONSULT LOCAL, STATE AND FEDERAL AGENCIES FOR THE PROPER DISPOSAL METHOD IN YOUR AREA. ----RCRA HAz. WASTE-NOS. D001-------------------------------------------_ . --- _--------' -- SECTION IX - SIP E C I A L P R E C A V T I Q N S PRECAUTIONS TO BE TAKEN WHEN HANDLING AND STQRING: DO NOT STORE AT 'TEMPERATURES ABOVE 120F. OR IN DIRECT SUNLIGHT. Do NOT PUNCTURE OR INCINERATE CONTAINER. DO NOT BREATHE SPRAY MISTS OR VAPORS. KEEP PRpDUC.'T OUT OF EYES, AVOID PROLONGED CONTACT WITH SKIN, KEEP OUT OF 'THE REACH OF CHILDREN. SECTION X T R A N S P 0 R T A T I O N D A T A DOT PROPER SHIPPING NAME CONSUMER COMMODITY DOT HAZARD CLASS: N/A DOT I. D. NUMBER : N/A DOT LABEL/PLACARD: ORM-D' EPA TSCA CHEMICAL INVENTORY -. ALL INGREDIENT'S ARE LISTED EPA CWA 40CFR PART" 117 SUDSTANCF..(RQ IN A SINGLE CONTAINER) : N/A r �P�©� CHFrp�O T©IMLV;©F BARNt ABC.l: OFFICE of _ sasasrvsv y nnea; 367 MA1N`STREET" QgPYP NYANl�IS :M{ASS:02601 August- 10 ;'1993 Robes-It: 'Tivey 362• Yarmouth Road: Hyannis..,: MA G 2.6'01. Dear Mr. T vey You. are •granted;;a variance to ristall a :replacement onste sewage: disposal .system at 362 Yarmouth: Road,: Hyannis`, listed "a a, "parcel 16 "on Asses`sor'.s map 344 with the following conditions ( ) No _Mdre. than 200; gallons. of wastewater shall Be,., discharged: per day from the building. The.' amount of wastewater; discharged shall; ;be :determined by vrAter. meter readings,.:.: (2) Each month, ,the applicant, shall provide. the Board of - Health with water metes read�n s z g, (i n bath cubic feet and` gal o s) for,„the .calendar. month- preceding the. month In vhIch` said ,-report .is due;., Said readings shall be provided to tfie : Board.. of -Health before the 15th day of he succeeding, month_: (3) The ;applicant shall agree that the Health I3epartment Director, or his du"e designate, ;may° appear ,at this st%bject, space,,: without prior notice; "to observe `the water .mstea� for the purpose: of, determining that the water, riieter, read�ng;s match-up with. future, sU muted. tleddi:ngs :(4) The applicant; shall determine the: water 'usage (,in gallons) "on. a daily basis also»; I the applicant determines� that the water usage has reached or 'exceeded 6,.00.0 gallons; or 6,2,bQ gallons diiring a- 31 "day month) prior to 'the end 'of { . the calendar month' the applicant shall `notify the Town of: Barnstable Director of .Pub] is Health. and ''take all necessary` steps :to curtaa l the number of "customers znc;luding but not: Ai: pd to, canceiling 'repair appointments or l n�Ling the numbe'r of�dail entrants.. (5) Sn the event: that "the Board of Health deter'Mines` that the, water u'se in the preceding month has exceede''d 6,000 gal.l:ons,' or (;6,;2Q0 gallons durlpg. a 31-day pera vd) the applicant, upon notice, shall immediately take the following steps: (a) limit the number of daily entrants into the subject space, (b) cancel appointments at the facility, (c) provide the Health Department Director with daily readings of the water meter; and (d) limit the hours the facility is to remain open. (6) In the event that the Board of Health determines that the water use in the preceding month has exceeded 6,000 gallons, (or 6,200 gallons during a 31-day month period) and after the applicant had followed through with those steps as outlined in paragraph 16, above, the Board of Health may require the applicant to attend a hearing to consider further steps to limit the wastewater discharge. (7) In the event that the Board of Health determines that the monthly water usage has exceeded 6,000 gallons (or 6,200 gallons during a 31-day month) during two consecutive months or in any three calendar months within any six-month period, the Board of Health may require the applicants to attend a hearing to consider further steps to limit wastewater discharge including, but not limited to, closing the repair facility and limiting the number of hours that the facility is opened on a daily basis. (8) The septic system shall be pumped on an annual basis and the applicant shall submit written certification of said pumping to the Board of Health. (9) A licensed hazardous waste transporter shall collect, transport, and properly dispose of waste from the reclamation system. (10) Failure to comply with the conditions contained in this permission letter shall result in the" revocation of the occupancy permit for that portion of the premises. occupied by the applicant. 1 (;1;1 y This variance shall he recorded ar the; ..deed, at the Marnsstable Coup ty Reglstry of Deeds Sincerely ;yours;, oseph Ce Snow, Mope oard o, H`eal,th Town of Barnstable JCS/bcs cc Matthew Dupuy, 'A'a.7. w P�OFTHE Tory TOWN OF BARNSTABLE OFFICE OF BesAM M r BOARD OF HEALTH � MR � �p 1639. `gym 367 MAIN STREET HYANNIS, MASS.02601 August 10, 1993 Robert Tivey. 362 Yarmouth Road Hyannis, MA 02601 Dear Mr. Tivey: You are granted a variance to install a replacement onsite sewage disposal system at 362 Yarmouth Road, Hyannis, listed as parcel 16 on Assessor's map 344 with the following conditions: ( 1) No more than 200 gallons of wastewater shall be discharged per day from the building. The amount of wastewater discharged shall be determined by water meter readings. (2) Each month, the applicant shall provide the Board of Health with water meter readings (in both cubic feet and gallons) for the calendar month preceding the month in which said report is due. Said readings shall be provided to the Board of Health before the 15th day of the succeeding month. (3) . The applicant shall agree that the Health Department Director, or his due designate, may appear at this subject space, without prior notice, to observe the water meter for the purpose of determining that the water meter readings match-up with future submitted readings. (4 ) The applicant shall determine the water usage (in gallons) on a daily basis also. If the applicant determines that the water usage has reached or exceeded 6,000 gallons (or 6,200 gallons during a 31-day month) prior to the end of the calendar month, the applicant shall notify the Town of Barnstable Director of Public Health and take all necessary steps to curtail the number of customers including but not limited to, cancelling repair appointments or limiting the number of daily entrants. (5) In the event that the Board of Health determines that the water use in the preceding month has exceeded 6,000 gallons, or (6,200 gallons during a 31-day period) the i applicant, upon notice, shall immediately take the following steps: (a) limit the number of daily entrants into the subject space, (b) cancel appointments at the facility, (c) provide the Health Department Director with daily readings of the water meter; and (d) limit the hours the facility is to remain open. (6) In the event that the Board of Health determines that the water use in the preceding month has exceeded 6,000 gallons, (or 6,200 gallons during a 31-day month period) and after the applicant had followed through with those steps as outlined in paragraph 16' above, the Board of Health may require the applicant to attend a hearing to consider further steps to limit the wastewater discharge. (7 ) In the event that the Board of Health determines that the monthly water usage has exceeded 6,000 gallons (or 6,200 gallons during a 31-day month) during two consecutive months or in any three calendar months within any six-month period, the Board of Health may require the applicants to attend a hearing to consider further steps to limit wastewater discharge including, but not limited to, closing the repair facility and limiting the number of hours that the facility is opened on a daily basis. (8) The septic system shall be pumped on an annual basis .and the applicant shall submit written certification of said pumping to the Board of Health. (9) A licensed hazardous waste transporter shall collect, transport, and properly dispose of waste from - . the reclamation system. ( 10) Failure to comply with the conditions contained in this permission letter shall result in the revocation of the occupancy ,permit for that portion of the premises. occupied by the applicant. i ( 11) This variance shall be recorded on the deed at the Barnstable County Registry of Deeds. Sincerely yours, Poar ph C. Snow, M.D. d of Health Town of Barnstable JCS/bcs cc: Matthew Dupuy, Esq. -Tc. . ; Hydrogen Peroxide Material Safety Data Sheet Date Prepared 10/11/93. Kim., 5 ..n� '.yy: ,v� 4M. 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Product Hydrogen Peroxide 35% 24 Hour Emergency Ilssistanee Chemical/ 14,0,/Peroxids SI-(713)479-2826 Synonyms Chemtree-1-800-424-9300 Health 2 Chemical inorganic Peroxide Hazard Rating Family Least SOght tt "Gote Nigh awaffle tri 0 CAS.Number 7722-84-1 UN Number 2014 . 0 1 2 3 4 Reactivity 2 '6a f•:i i�i j::<i;:>'?:si�'?"S'a: .ox:ii:n•x• Y.r Gel•: .:::tiZ:}7Gis:: ...,!":1:::; ti"e•o�i:•. .....:...,.,%.>,.>,,.,t..x.>•r.,en>.: •;x• .n•.,•.:n.n:...rn..r�:,.n..::.:n� :rG:: .::..:i• .•..r I �^'%•:' �:is n::...n ...<..>.x.>:v: • .. .;•:vn.I..n::I.n..n.....n w.•'LY•>!:,!::i.Y.X...,, ...x.:<.w'..x.:..x•w•S:!,a:v! <Y:•;^'^.".,':i:.. v h.• t1.X.1,•.,• •.< .i:.kJ> "�"it' .::<:'y',.':vxm�•..v,.n.x.:wA•:,h. .4i!{.r J �`.:�'y:+%,wn.(>' •,.!„L:;•k•..,h•• w:fk•Y.JY<C?Y,.Y.; J:ia..»$xa.,:J»��.h.. <•.%�:. r F`•' •A.ik::} yY•h ..•tsFn..a,a:GEC{a•""�%fit..7tii•'satiii: :;$::r ...:1••,rg;y',:!T•`:.,�,n h:r•::�'�f••: ...!;w ":;.<�:"'« x:•s!::e;�nn��pr(tgn ::'%.K'.•$!::�:h :a'r;•rva:ary n1T s•tJ �IlmSilr ; y,�����On, '%J»xipa '•>' >r >?'�rr�';:1w\`'6+o:iY, >::: •;,.s•Y o• 'xx%anx.a+`yY• ,g,`. :>,.?9�.q ,:,!':wirrwxe.e�3i>�"u�Rv`:tSi•.�vrJ•:.�x:.:��av'vu".chbtie:r>,:�vw>:aw�•r:�. tS, Composition % Toxicity Data Hydrogen Peroxide 36 30%Hoot 68 Oral TDu:f322 gm/kg (mouse) Water Trace Stabilizers ... ...... •• r tl�r ;;; t::bhr'*'� J: :t• .....� .....�.. .. 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Melting Point Vapor Pressure Boiling Point _� (mmHg) 23(�8WF Cn 225 @ 760 mm Hg Sir Volatile By Vapor Density Specific Oravlty 100 (Air 1 (HIO = it 1.131 @ 88"F Volume NA Solubility{n Evaporation Rate Water complete (f cityl Acetate _ 1) Less than 1 r1e liquid. �ef1t^enttdtion9 over 3596 may have sharp odor. solo ss I dor Gear, q Appearance And 0 :ii ,�x:'s' -•:t.xzn<i< ��. �:s>:ra:'<'?x�"•<s.x.: Aw � x•w:<;5:�:^s<'a":':'a;:iT'r::�e:�r:::;Yl:y::$1;S:yq:>.. ;,.,.<^r.::•x �:%.ia•^.,w:<• �'WP .=:x:;:Ya:>%:r:x:s:x;?� .e.....t a,..t.<.< ;.:x.r..:x.,:<.::.x.x�:�l•:.ry°�. :..»•.<.z:lily:•>,::s:,k:.s:,y:i`:>;. :w'�•Fi•:,eva<.':%•:•.>::<:i°,t::. «.%'a:•:Jn;:x•r xiY r;J:�>:n.. ;^:^:^s•'ti;�:''>X•r>s, .:e•Y:<%i}Y:h?t'x;i'. :a,:.: y,.. ,rY',. :f.iy:n:;.:.yi.^3,i/r t:Y.9:0%:%:Y.<:<:,•t:f:i:Y;%:% ^•<.,>'^!x•%.:7•!4XY i:M:n%�^� ,>ri.1•%.%:t"'•%: �i<i�•xn;vi>::%�%�r: :i:1•:: :i:e%i:ex x:%:xl• A;.... m .>.Jx;%.wxJN^»:�� ,.�1 •:t•>Ir't>:Ir.::•�X J:•.a,�. ....: '?S:?N � `!N... r xYr 'iL.e.,..Tt.r.r.: Y...2'fi•�i;!. i.+:@:x�r�t1• %�'f�:�t.e.k,>,. t�rex.wf �?i K.��t�,Yux;u wx x.:k:,:xF'?;%�aRxR. a {:,JrCG310iFa,�kv!•'bw�'':Y!'wxo,•.Qu'•�,w�xi,t?;f,mm i J'S».isl':�v:?;'?f:>,::xae;+s,x;x'S!:i<e:.Y..x.>.,. .. :..... ^ x................. � will Not Occur Stability. O Unstable 8Stable Hazardous Polymerization O May Occur trong Conditions And Mate►tals To Avoid Contaminaticn by many substar+ces including heavy metals end their sails,ith-increasing to agent, and oxidizers,alkalis and particulate solids will cause dscomPoeiUennana sts�°��It��ay Interox on handling and mater increases wials of co s uctaytbe very vigorous with rapid generation of large volumes of oxyg Products en,steam,peroxide vapor and heat. s Pro 9 oslUon �Y Hazardous P r , ... •s•1 s.X. r• .•.,••ts:••!t^'r:7•.!•ri; :?<'•:i•';.:oxv,:q:{s:F?!�<:r'k�isEis rt .,..rrll.>:.:;•rY,.> :r:.;':•r., ;;,.!:;,• r :a• .tx. hh.Y., ....�•f:J;;<<:tl�•'t"e'^<:?':4:+lxl•w�:.ii'xa.w.a:.J x.>x<.:c: - Ses'ticn: s:,..^. .;.....::<:.:r.'...:...,... .. Nonflammable Ftwrnabis Umhs(%Volume In Air) Lower Upper Flash Point end Method Uv4 NA Media Water Extinguishing Firs Flghtlng Procedures end Precautions Wear protective clothing and self-contained breathing appa ratus. Special Unusual Fire and Explosion Hazards Stronger Hydrogen peroxide is not flammable but can initiatepidsoxygenee spontaneous combustion o ion of paper, wood,cloth,and other organic materials. ignition may be rapid,but can be delayed for several hours. Flap' y9 decomposing hydrogen peroxide may inaea,+r the inten s fire. _ Oxygen enrichment of poorly ventliated organic atmosphph err es increases the potential of vapor phase explosions. To the best of our knowledge the in`•ormatton herein Is accurate w�th'However-neither Solvay Inleror not any of Its er11!ffi!e m�keti e env V.-hied y. C�i 1�VAY ex6res ed r IM151donof accepts any In oorim to)%Of the Droducthis t me OOmbinationion or its ew+hl ary 0 herlsubstan a or in any D:0 eW.This ie no a V O ^ altheir w,\'TEROX stems under ern/patent.The user alone must rmaliy determine edllablll4'of any enlorrcation Of+Ttatorial br any COntemDlatnd"�°•tin ma+mgr of SOLVAY I 1 r, Lea and whether any Deterns are INrin(red. .3333 Aictvnond Avenue,Houston,Texas T7098.3099 Malllr g Address:P.O.6ox 27328.Houston.Texas 77227-7328 1-000•INTESOX 713/525-6500 Fax:713/524.9032 ixr a, A,ction yl;: ...... . . .: �E rtiergenc)I d'Ftrst;`Al eiir ti:::.toe ......:..:..::..<..::•...:...;..: Skin/eyes; Flush with large amounts of wat,9r for at least 15 minutes. Quickly remove contaminated clothing and shoes. Flush clothing with large amounts of water. Cc'ntaot it physician In case of eye contact with peroxide. Ingestion' Drink large amounts of water to dilute. Sit upright. Contact physician. Note to Physician lieve or prevent increased pressure that may result from the rapid evolution M may be advisable to insert a gastric tube to re of oxygen upon decomposition. Inhalation: Remove victim to fresh air. Contact a physician. y •, ,,,.��,,,��as•.i::is:,.z :a�.�tr>iin,�rsa�•�• v•9:•xaC"• 0«•.,1i:;tb::<::i,:i::i.`.:'t; :.;:e,, :iwoiyti:'<,L�•).� ian5i"•:�y�i:•, Fl :t,�ZF.:;._..4:�,•i•tip`. ,�;�d'`,y<i;�^MYpYnN•` l'; v,:�..�.:•::-{".i^,1T,`2,'v,:,,'.;S:x:,;.:n:t.•:;:x>w.<.hy,�.,>:N":p.xoty.,.,.!:c..`p :•,M:,•:., :;`5,:,. :s:%,:):n:..<:, n9;: ..,;•t;lT.x >y4;.,ex•)Y:x•,:CiS<eY.;"s'`>.`f�Y.•,ti4• }:: ...:rc:,...:.:.r:.Y.`>..`>, ..`:<:.:..>. ..:�.:•.••....,.:.".:,.q:.i..)>T.<.`:.o:::,..>,..< .":::.a '> r.iYvx .y,•x•gGn:...<1 '%:X�i:...`..i.`>•p..`.,....`.n..`..•1�:1... ..:2': >..:..,><.:...'.:��:::,.>.:.:.:�•<.x«,<:;:T:..,.,:..:.X.::,..,..,.<,:v�T ry �>Prottialc��x K >::>�:;� �; .:a�:. r,:�:,k<.�::..` Respiratory protection Self-contained breathing apparatus should be available. PVC slicker suit. protective Clothing Adequate eye protection,rubber gloves and boots, y peroxide Is handled. source and safety shower/eyewash should be located close to whets hydrogen ve Measures Water tact 't•T •$! Pro dd U al <.,.x.. A «>a ::,.,....,.,>):•:.:v<,.is,..i:i. -. ..>..n:...::v:v, :..,y..:,..:.:..... ::. i.,;.n iVMn���:••: a.Y.: �:f:: 4' ::..•. <.��alf�t:lntotrii`1i'N Exposure b skin er eyes a+ay cause chemical bunts,Inhatatlen of vep�►e,►rr+ist ntay+revse lrrltatFrtil laltemioal bwna to mut�o t them tense and respiratory system. Ingestion may cause chemical burns as well as Injury by distention of the esophagus er stomach due to the sudt�°n evolution of gases. ...<::..Y.•:h\`.rres;:-:�::,3'rw':v::... ;.:w.:ii•r::;"•`�o�t:li$:?�ei%.)>:, ��'•<•,•s' �bll�� �. >` ����a�.•:.� �`x 'i `I :x.v< NS AGGtH-TLV-TWA-1 ppm eight average (TWN ,r•:::"..,;,":;•x X . « s x z OSHA-8 hour time w a"x s;x.•,...s,?:;,t>;��;)ti,',>'•,>ta'�';�:c..:,�e..t::�.5>Z�', ,,.• .>.;:a:<:»,:..::<,1�„•.�y'•A .11, flWLe. Oltt:r'•!:>:;.is' '.tO�F!Sdw.:'`�'•:.t�a,''••%•'' ... Y::<.)::,•x•.e;g•ak.,,;wr ,>., ,:., t undiluted prevent..' ::? .,:>o<:i:•,t:�ki•� �' :::.::.<;•; ..�... <-. ....... even. >SeGbl4r ::; z:: :.`>'s :" ::t:::",.:....,:ss:•........n•.`n:^:a..» .:.. ..:... ,. to original container. d with Federal.State.and local regulations on reporting spills. Spin or Leak Procedures Flush spill area with rrltarc� aunts of water. Do not return spilled material hydrogen peroxide from entering sewage sysl 1 with Federal,State and local regulations. Waste Dlsposal Dilute with large amounts of wste<then flush to sewer.. Comp y . ,::Cx)?,.X•i:,�Y,::t;>:��:$•);•.:...;pyX:?:•,:T;x,R?,'t:ii!•%:t:`; «.>,:•1,.,'i•:a��);�`•x,,:>f�%•):1t,�,.%,. None ronmentet Hazards Env! :a:X:isb:'t'C'•::L�!"t+l.•'.:�•:�:nTN:T:Q:o:<.., .<.%.,:,`'.)•y>,•Y,'nx.Y•,:!t:t:<.,;.;•k<::o r%•:K•i S'1T•Y�:e:ii:,':4'xiP:rt•:i.x•r::Fx;,.:,:ie�ii•�:<Y3:,•k•x•'• ...;:.�••;• >:�,,•e,:.>):.,:•;>:�,>�� ,;; ,,,, :,:,1;. x.!G.t�A�:n:•.r..<..orb:,�r>S.b:e:,.x;.:�R},...:;.1::f,;.:r;;���s!�e.i.x•'',:'�!(!',;xq:i:n:,:.;:e,%,�,i,x),��t:f;<;xx•)?•,?<•>.:<•:e.:e,!`..:..." ;,.»e..:6,:'r.:i�i};i• tigi :Y7 }i.: ?ti4•r<•,.:<; jtidi:iii,;•i:id>:tt?:.xj::..dxi�! >:,. i, It combustibles. 11) Avoid heating hydrogen peroxide and store away 304 or 318 stainless steel,Of 2) Do not contaminate hydrogen p@ roxide. rile materials. f (oxide. en peroxide must be vented and made at compatible materiels such as containers/vessels or by 9 additional Intotmatien regarding other compati 3) Storage lnterox for ad xx>;'�: Contact Solvay >x>: r k,<•:Kx »<".::? ••x«k'�:<.,: e,; : >°L^ aluminum, CA ;ii:.::`:x:+,!r:<:::�,:�;�i>:.,>„);<.:,:� Q..�Q�!: i,; •Y•: ���t�:<X,':>:a:Y.�:�v�:`�\:S.I::V!xrNX�% «<`�c#�:::�: high purity alu t •<",:.:.: g �:�:. :): ..<.:'•.`•.`.. wx•:�u; r,^x,:y:,•,. r•<•x,,.;:y.;. :•.x:,.:a•x•.:..;Ln:. ... ...;::::'l:".q,;:<.x•.C;e,'.,,'N!%.K.X!T::�.f<•t•i:'`ikl;k`'::tv.::::C n•Y n...v,• ::y:�'t{�:N,.:v,;•?:,>;..v.:•,:,.)><,.i'i?���^..<.Y.O>,:,.,:`.:%..x; <�>,i>,:�:iCw - . k:,,;>r,;�Tr;d(fi3pocUitJtfrt;:l�:pq. .:.:::::,:,.<.i:•.: >:fr��on.�(II�.�:�;r;.::<s:;.,..:>,•;::;::::�:c.::�:�:::<•r:.., .; `:............'.. NorrFtemmerile O Cvmbustlble a 00dtring Gas p Flammable Uquld Material Uquid O Not Hazardous By Department Ot p Poison, O Corrosive D_0,T.Fteguladona O Flammable Class A Materiel Transportation Solid O ether O Poison, O Irritating Speclly Below Q F1anlntaDle Class B Material paasl0catlon. Gas peroxide. O.O.T.Proper Shipping Name Hydrogen peroxide,aqueous BOOM-2096 to at)� :,!LX:Ai!>::.�::it:k::i '%;% ?:%>':!i ft•<::i<:�:K..Name %iix` •:r� id�;i<i?S:i:>x:xyr,:t,r,`a x;r>;'<i•:i):'n a' t.01�Yx,!X.%•%S,:%1ti:::lX`i L:i:k E%,i<r.'?.X:i;g>.p.•. y.ox>.,:n:•r::.<:.y.......i.�. lother Regulations i' Ilk' u .t r.... xe :>?A•� ::is:"v.i rtit^ •x F. ;<<�':[:.,4 x•'<YS:'�..n•'..!i:'.k:,a•.Er:';;e.,,., •"Y<•�;i•,`. >j:7f,F „�A-Food Grade hydrogen peroxide•must-meet food Chemical Codex apecincatiens. page two Ref . No. : 1015 Contact a physician if irritation develops INGESTION- If patient conscious, give several glasses of water for dilution effect and contact a physician. Do not induce. vomiting. Do not give an unconscious person anything by mouth. INHALATION- Remove from contaminated atmosphere. If breathing has stopped, give artificial respiration then oxygen if needed. Contact 'a physician. ************* SECTION VI - REACTIVITY DATA ************************** Stability: stable Conditions to avoid: Avoid mixing concentrate with .strong acids . Hazardous decomposition products : carbon monoxide and unidentified organic compounds may be formed during combustion. Hazardous polymerization products : Will .not occur. ************* SECTION VII - SPILL OR LEAK PROCEDURE ***************** Steps to be taken if material is released or spilled: Large spills : .Dike and contain. Place in nonleaking containers for disposal agency. Small spills : soak or mop up. Small spills may be flushed to sewer. Waste disposal method: Small quantities will evaporate readily. Large amounts should be given to licensed disposal agency. , ************* SECTION VIII - SPECIAL PROTECTION INFORMATION ********** Respiratory Protection: Should not be necessary when diluted before spraying. Ventilation -local exhaust : recommended -mechanical exhaust : not necessary Protective gloves : rubber Eye protection: chemical goggles if contact is likely. Other protective equipment : none ************* SECTION IX - SPECIAL PRECAUTIONS ****************dF***** Precautions to be taken in handling and storage: Store above 35 F. Keep container tightly closed when not in use . Other precautions : KEEP OUT OF REACH OF CHILDREN. NA means NOT APPLICABLE on this form. The information on this Material Safety Data. Sheet reflects the latest information and data that we have on hazards, properties, and handling of this product under the recommended conditions of use . Any use of this product or methods-of application which.-is not described on .the label or in the Product. Data Sheet is the responsibility of the user. This Material Safety Data Sheet was prepared to comply with the OSHA Hazard Communications Regulation and Massachusetts Right to Knovi Law. M A T E R I A L S A .F E T Y D A T A S H E E T Manufacturer: Date : 1-1-95 Synthetic Labs, Inc . Ref . No. : 1015 Victory Lane Emergency Phone 505-957-2919 Dracut, MA 01826 Preparer: David P. Miller ************* SECTION I - PRODUCT IDENTIFICATION ******************** Trade Name : FLEETWASH Chemical name / synonyms: Water .Ba.se Alkaline Detergent Formula: .Mixture D.O.T. : Non hazardous, no UN Number is required HMIS CODE: Health 1, Fire 0, Reactivity 0 HMIS ,KEY: 4=Extreme, 3=High, 2=Moderate, 1=Slight, 0=insignificant ************** SECTION II - HAZARDOUS INGREDIENTS ******************* substance % composition TLV No hazardous ingredients to be listed as regulated by the Massachusetts Right to Know Law or 29 CFR 1910 . 1000 ************** SECTION III PHYSICAL DATA ******* * ******** *** * * Boiling Pt M 212 Specific Gravity: 1 . 02 Vapor Pressure (mm. Hg) : NA Percent Volatile : NA Vapor Density (air=1) : NA Evaporation Rate (water=l) 1 , Solubility in water: complete pH: •, 12 . 1 (neat) 11 .1 (50 . 1) Appearance. and Odor: Blue color, no odor ************* SECTION IV - FIRE AND EXPLOSION HAZARD DATA *********** Flash Pt (F) None Flammable limits in air (vol) test method:_ NA Upper: NA Lower: NA Extinguishing Media: As necessary for surrounding fire . Special fire fighting procedures : NA Unusual fire and explosion hazard: NA ************* SECTION V HEALTH HAZARD DATA - ROUTES OF ENTRY ******** Threshold Limit Value : See Section II Primary Route (s) of Entry: Eye contact . Skin Contact . Inhalation of - mist if sprayed. Health Hazard (Acute and Chronic) : Although pH alone is not a precise indicator of irritation potential, this product should be handled as possibly irritating to eyes base on pH. Signs And Symptoms Of Overexposure : EYES- Tearing, stinging, redness . SKIN- Stinging, redness, some swelling possible . INHALATION- Coughing, soreness in, respiratory tract, chest .tightness," difficulty breathing. Conditions Generally Recognized As Being Aggravated By Exposure : Persons with pre-existing skin disorders may be more susceptible to irritating effects Persons with pre-existing lung disorders may be more susceptible to irritating effects . Emergency -And First Aid Procedures : EYES- Immediately flush with plenty of cool !water for at least 1.5 minutes while holding the eyelids open. Do not attempt neutralizing with chemical agents Contact a PY h sici6,n immediately. SKIN- Immediately remove contaminated clothing Y and flush area with large quantities an tities of water for at least 15 minutes . Do not attempt neutralizing with chemical agents . TOWN OF BARNSTABLE gTHET 40 M Ob� 9 OFFICE OF BOARD OF HEALTH y NAa> 1639. \gym 367 MAIN STREET �Fp qAY p. ,. — HYANNIS, MASS.02601 August 10, 1993 Robert Tivey 362 Yarmouth Road Hyannis, MA 02601 Dear Mr. Tivey; You are granted a variance to install a replacement onsite sewage disposal system at• 362 Yarmouth Road, Hyannis, ' listed as parcel 16 on Assessor's map%344 with the following conditions; ( 1) No more than 200 gallons of wastewater shall be discharged per day from the building. The amount of wastewater discharged shall be determined by water meter readings. (2) Each month, the applicant shall provide the Board of : Health with water meter readings (in both cubic feet and gallons) for the calendar month' preceding the month in which said report is due. Said readings shall be provided to the Board of Health before the 15th day of the succeeding month. ( 3) The applicant shall agree that the Health Department Director, or his due designate, may appear at this subject space, without prior notice, to observe the water meter for the purpose of determining that the water meter readings match-up with future submitted readings. (4) The applicant shall determine the water usage (in gallons) on a daily basis also. If the applicant determines that the water usage has reached or exceeded 6,000 gallons (or 6,200 gallons during a 31-day month) prior to the end of the calendar month, the applicant shall notify the Town of Barnstable Director of Public Health and take all necessary steps to curtail the number of customers including but not limited to, cancelling 'repair appointments or limiting the number of daily entrants. (5) In the event that the Board of Health determines that the water use in the preceding month has exceeded 6, 000 gallons, or (6,200 gallons during a 31-day period) the applicant, upon notice, shall immediately take the following steps. (a) limit the dumber of daily entrants into the subject space, (b) cancel appointments at the facility, (c) provide the Health Department Director with daily readings of the water meter; and (d) limit the hours the facility is to remain opens (6) In the event that the Board of Health determines that the water use in the preceding month has exceeded 6,000 gallons, (or 6,200 gallons during a 31-day month period) and after the applicant had followed through with those steps as outlined in paragraph '6 ' above, the Board of Health may require the applicant to attend a hearing to consider further steps to limit the wastewater discharge. (7 ) In the event that the Board of Health determines that the monthly water usage has exceeded 6,000 gallons (or 6,200 gallons during a 31-day month) during two consecutive months or in any three calendar months within any six-month period, the Board of Health may require the applicants to attend a hearing to consider further steps to limit wastewater discharge including, but not limited to, closing the repair facility and limiting the number of hours that the facility is opened on a daily basis. (8) The septic system shall be pumped on an annual basis and the applicant shall submit written certification of said pumping to the Board of Health. (9) A licensed hazardous waste transporter shall collect, transport, and properly dispose of waste from the reclamation system. ( 10) Failure to comply with the conditions contained in this permission letter shall result in the revocation of the occupancy permit for that portion of the premises. occupied by the applicant. ( 11) This variance shall be recorded on the deed at the Barnstable County Registry of Deeds. Sincerely yours, Toa eph Ce Snow, M.D. rd of Health Town of Barnstable JCS/bcs cca Matthew Dupuy, Esq. �j YOU WISH TO OPEN A BUSINESS? For Your information: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. - it does not give you permission to operate.) Business Certificates are available at the Town i l Clerk's Office, 1" FL., 367 Main Street, Hyannis. MA 02601 (Town H 11). DATE: 7 I C� Fill in Tease: v APPLICANT'S YOUR. NAME: � �'�'� Ct_. �rI)'IGd1l��' �'()C_ � r s,. USIN"��oZl+vjO YOUR HOME ADDRESS: jLt G�W2�ij� -� UI 1 _ �a� -� b3 TELEPHONE e#� Ham Telephone Number: -6S (per p-a40 NAME OF'NEW BUSINESSIt I� t �V b j�l c - fYPc OF Bt1StNESS f. SS SITHISA 401lE CJC,GUPATION1?. YESI 'i1L0 u` 1 I) _ { !!,II.;ltli iiI! .;I,: i k -:'I t II _:! j ,III 1,'.,, { , :ou bePn c tvn a� �rov�l from the hu�;fd�nr dtvtston7 'PESO _y n 3 1:DJRcSS O; �USI;NESS": ' (' : al � ,/'r, ,i _ __ When starting a new business there are several things you must d ton 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 TO 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 inthis town. 1. BUILDING CO ONER'S OFFICE This indivi ual pee,. to o any pep, it requirements that pertain to this type of business. t �th KrIazed Si �ture"*COMMENTS 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain tq this type of business. Authorized Signature` COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual h been nor I ed of the licensing requirements that pertain to this type of business. CO iMENTS: �, ulhoi-ized 7 U r Town of Barns-table P CptME T � 200 Main Street,l-lyannis,Massachusetts 02601. y�^rass. � Growth [ aAIlgeAfAg Department Patricia Daley, Interim Director' �p'1 3MA. 367 Main Street, Hyannis,Massachusetts 02601 1'lione(508)862-4785 Fax(508)862-4725 ww%v.towii.barn stable.ma.us November 15,2007 Paulo [,. Gualberto d/b/a Route 66 Auto Sales 27 Shanunas.Cane Marsons Mills,MA 02648 Reference: Informal Site Plan Review 049-07Roui_es66Auto,Sales� Map 344, Parcel 01.6 '362AYaiinoutli Road Hyyaiunis�M� 2b01 ` k, �.. _ - Proposal: Class II Auto Sales business. Including a small office of 288 sq. ft,handicap parking space marking and signage. Dear Mr. Gualberto: - ©� Please be advised that the Buil.d➢rto, Commissioner,Tom Per? administratively a�, has admin roved b y � approved the above proposal subject to the following: 0 Approval.is based upon attached.plan dated November 15, 2007 depicting display vehicles as follows: 7 angle parking spots at the front of Lot 1 along Yarmouth Road, 2 parking spots inside the building, 2 parking spots at the rear of the building on concrete pad parked parallel With.the fence, and the furthest 3 parking spots along the side of the building where customer parking is located. 0 Striping and handicap sign per Town of Barnstable code will need to be provided for the one handicap space as depicted on attached plan. 0 2 customer parking spaces in addition to the handicap space must be provided as shown on attached plan. o Bathrooms shall be for private use only. lIntrance to the office will need to be made handicap accessible. 0 Repair of vehicles is not permitted in the Wellhead Protection Overlay District. 0 Applicant must obtain all other applicable approvals, licenses, and permits, including but not limited to signage. Sincerely, Ellen.M. Swiniarsk.i, SPR Coordinator i__Tom Perry.Building Cottunissioner Licensing Division BP:092e5-0294 .94-07-18 2117 443320 a Town og Branotable F Emsaisng Board of Appeals special Permit P`�' 17 i Decisiom and Notico appeal Mo. 1993-64 a3usisaa Granted with Comaitions _ Appeal No. 1993-64 Applicant/owner Robert C. Tivay Addreass 362 Yarmouth ]Road, Hyannis, Kk 02601 s` Asa®ssaor'e tap/parcel: 344/016 Zoning Distracts IB Business District Overlay Distract: W?, Well Protection Overlay District Applicant's Requests Special Permit to allow changes from one Non Conforming Use to Another, section 4-4.2 r Activity Request: To peumit construction of a 4,700 sq. ft. expansion to an existing 7,230 eq. ft. John Deere Product Diatribution Center, for ra total building area of 11,930 oq.ft. Srooss floor area. r; Procedural Provi©ione s section 5-3.2(2), special Parmito i @ achgrounds s This decision concerns the petition submitted by Robart C. Tivey, requesting a Special Permit to alla u cosastruction og a'4,100 eq. 9t. expansion to an exiating ?,230 sq. it. John Deere Product Dista:ibution Cantor. The applicant is�l seeking ity is createdin allow change in a �that the currentzoni.ngordinancae,i ty. The ct, Groundwater Protection Overlay ~ District Provision only allows a 50% lot coverage by imparviouw ourface. At t present 56rz of the lot area is covered and the propoo3d osrnaansion would coves 60t. A 10a increase over than allowed ama=t under the Ordinance and a 4% increase over what ©xistS. This appeal for a Special 1°araasit Was aOLght in the alternative to a Variance petition (Appeal No. 1993-63) which was denied by the Board. E � The site Plan Review Committee has given a Conditionally approved Site i'lan aB i, detailed in a hatter to Fr. Arne Oj4ala, Doran Cape Engineering, dated March 16, 1993. Procedural Sumarys The application was filed in the offices of the Town Coasts and at the Zoning E Board of Rppeals office on octoboz 1.3, 1993, A public heariaasg dump noticed under M.G.L. chapter 40-A was opened on Novembar 04, 1993, at which tsm the hearing era© closed and a decision was rendered by the Board. The petition was heard by Board Pemberts: Gail Nightingale, R.on iana5on, Elizabeth NlIsnon, Thomas DeRi©tales and Chairman, Richard Boy. 3 ` �P$09C35—a�35 9�-0?-18 2 n 1Z �i4�20 Appeal NO. MS-Sa o©c£aios rind. ^�otvcm Attorney Matthew Dupuy rapzoaonted the appeal before the S ard. sir. Tivey, and Robert Tivey, Jr. were present. Attorney Dupuy explained that the site coverage is presently at 56% and the applicant is seeking to e=taend that coverage to 60% in accordant© with the ibssuancea of a special Permit for expansion of the building if approved by the Board. He: cited that the present lot coverage and use of the site isa nonconforming with section 3-5.2, Groundwater Protection overlay Distract. He cited that motor vehicle repair in WP District is not a permitted use under the present Groundwater overlay District regulations. 1t has boon occurring on this rite since 1966, predating the enactment of the overlay district in 19>37. The primary purpose of the expansion is for more storage space and relocate the washing of vehicles .into the structure. A state of the art water recl=- atioa r-system is to be installed in the structure. The Board of Health has granted all the variances needed to proceed with the or:pansion. They have received conditional approval frogs the Town of Barnstable site Plan p,oviow. They are willing to abide by the conditions therein. What they are proposing is bettor than what is therm now. %t will be a «state of the art' reclamation system and in approved by the Board of Health, as it not only will be better protection for the ground water, but will Use losa water. without relief under the lot coverage, no expansion would be posoible. Attorney Dupuy explained that they were expanding they non-conforming use through vehiolo maintenance, as they need to wash the tractors before they are repairecl and part of the cz,pansion will be in the washing facility. The public was invited to speak, and no one spoke in favor or in opposition to the petition. c FSf� �Fd L�l'�?TSB M' Based upon the evidence submitted and the Testimony given at the public FN' hearing on Appeal No 1993-64, The zoning Board of Appzala unanimously found: 1. This activity is none-conforming in use given that it involves repair of tractors and other €ssechaniaad equipment which has been occurring on site since 1966, predating than 1987 Groundwater Prctaotidn overlay District Provisions amendment to the zoning ordinance, specifically the 'R? - Well field Protection District, which would preclude thia activity from this site. 2. The granting of relief sought, the expansion of the repair gacility, subject to site plan review critaria and conditions, could not be substantially detrimental or objectionable to the neighborhood involved. 3. Given the testimony hoard related to a new etats of the arts water reclamation system to be installed, this operation would, in fact, be of bonsfit to the community. a:®aacg�as i®sa¢ Accordingly, based upon the findings, a motion was duly rzde and €econded that Appeal Wo. 1993-64 for a special iPamit for a nonconformity to ohs Groundwater. Appeal No. 1993-616 BP;M9 85-0236 34-07-16 2=17 � 433Z'3 DeciBioaa and Motico I Protection Overlay District be granted in accordance with section 4-4.2, Won- conformities subject to the foilowing conditionst 1. The facility shall be built pursuant to plants and specifications submitted to Board. The petitioner shall conform with all the termo of said plan that have been listed can the plane 2. ' The petitioner shall comply with all conditions of site plan review, specifically that no more than 204 gallons of wastewater be discharged per day from the building. This wastewater di,aahargo shall be monitored, by water meter readingo 3. The petitioner shall provide the Board of Health with water water readings as required in their report. 4. The owner of Lot a will grant, forthwith, upon =piratican of the appeal period, an ca:eluaive easae at ao set fortb on plans for purpose of r eliminating curb cuto on Lrat a p 5. The a aorthaaotorn-noat curb cut one ya&=outh Road will be limited to 2;xiEt 2a-lY txafgic. A .nDo Not Zantera oign trill he :appropriately posted and an anit arrcra will hZ installed gos this curb coat and maintained. 60 The aNit/entrance arg s will be painted at designated positions as is required by cite plan revi©w procesae 7. All other torms and conditiono of the Board of Health shall be complied Frith. Thq.vote vem as folaowm a Aye; tail Nightingale, Ron Janaason, Elizabeth kailsson, Thomas DeRiemex and Chairman, Richard Boy Hay; None order a Appeal 40. 1993-64 gor a special hermit hza beam gr=ted with canditicaaa o appeals of thin decision, if any, shall be made purounnnt to MGL Chapter Ma section 17, and shall k* filed within twenty (20) shays after the data© of the filing of this decision in the office of the Town Clark. i 0 OP209285-0240-94-07-18 ?'.17 Wa20 gaga® a� Tjavaj by t;bj..q daajsj®sa may appe8L to %hg Sa=srable caug o w degCg bmd in 9ac-a-Igm 17 o2 ?taw NL 09 %he a�g�® cog •t as�t �� ak �� tb 911ad &n the ® �Srza flg ¢ka Twa clegho 0 0 • I LI �missa�¢acBa&a ��sssat��� ac aura¢%ga haTaby tagz5igy that g dais vm QLa,IPsad since. the Board 09 &ppmaM5 wemiewad. �g�: � . istan above antit Lad petition amd ¢fag � appeal o9' aai� dQ�_�`�.gm baz been Uanaa wd saalad thi a t day 09 a b_� � mwc L e awaac 'zwn. MCA am&ldimB QC3QG©> public NOTABLE REGISTRY OF DEEDS 6*e of -ToaWmOnt 0/ &W�r� PAUL T. ANDERSON Regional Environmental Engineer a.2�Gte►L%!%7JIlG� C�'l�749xlI,CLG, �LGG, a.iliGQ.'000LCILllae(.CO O.GJ�V 947-423-1, C.kxt 680-04 V 61 January 17, 1985 Gillis and Tivey, Inc. RE: BARNSTABLE--Hazardous Wastes, 362 Yarmouth Road Gillis and Tivey,, Inc. , Hyannis, Massachusetts 02601 326 Yarmouth Road, RCRA Compliance, 310 CMR 30.000 ATTENTION: Robert C. Tivey, Sr. , President Gentlemen: The Department of Environmental Quality Engineering, on January 10, 1985, conducted a follow-up inspection of your facility located at 362 Yarmouth Road, Hyannis, Massachusetts. The purpose of the inspection was to verify that your facility has complied with the deficiencies outlined in the "Notice of Violation" dated October 24, 1984, relative to the Massachusetts Hazardous Waste Regulations, as contained in 310 CMR 30.000. The follow-up inspection verified that the accumulation of waste oil observed on the ground in the general vicinity of the catch-all leading to the underground oil storage tank has been removed, the area scraped clean and the contaminated soil placed in secure drums and transported under manifest off site to a hazardous waste Treatment/Storage/Disposal (TSD) facility. In addition, the peripheral walls of the catch-all have been raised to construct a containment area around the drain to prevent oil spillover and a removable cover installed to prevent rainwater from entering and collecting in the catch-all. Furthermore, the 2,000 gallon underground storage tank has been pumped dry and the contents transported off-site under a manifest to enable Gillis and Tivey to effectively begin managing the hazardous waste generated at your company in accordance with Hazardous Waste Regulations. It was further verified during the course of the follow-up inspection that your company has continued to operate as a small quantity generator of waste oil. Please be reminded that as a small quantity generator, you must not accumulate at any given time more than 1,000 kg of waste oil and shall dispose of such waste using a transporter and Treatment/Storage/Disposal (TSD) facility licensed by the Department. As a result of the corrective action taken and in view of the company's operational status, the Department has determined that Gillis and Tivey is in compliance with the Massachusetts Hazardous Waste Regulations relative to "Small Quantity Generators of Hazardous Waste" as contained in 310 CMR 30.000. j U -2- Should you have any questions relative to hazardous waste management at your facility, please contact Mr. Kenneth Anderson of this office. Very truly yours, For the CorrQ dssioner, Christopher Tilden, Chief Hazardous Materials & Solid Wastes Section T/KA/re cc: Barnstable Board of Health Town Hall Hyannis, MA 02601 Robert C. Tivey, Jr. Gillis and Tivey, Inc. 362 Yarmouth Road Hyannis, MA 02601 i w - r,�tY _T0aW~1nZ 0/ omwlx�wl� AW4;51� PAUL T. ANDERSON Regional Environmental Engineer d�av�uc e c utccL o� c e, "A"uap"Z 02346 c p - t 680-6'(Y4 October 24, 1984 Gillis and Tivey, Inc. RE: BARNSTABLE--Hazardous Waste, 362 Yarmouth Road Gillis and Tivey, Inc. , Hyannis, Massachusetts 02601 362 Yarmouth Road, Notice of Violation, 310 CMR 30.000 -ATTENTION: Robert C. Tivey, Sr. , President Gentlemen: The Depai--mer.t of Environmei,tal Quality Engineering on October 5, 1984, :.onducted an inspection of your facility located at 362 Yarmouth Road, Hyannis, Massachusetts. The purpose of the inspection was to determine the status of your facility relative to compliance with Massachusetts Hazardous Waste Regulations as contained in 310 CMR 30.000. During the course of the inspection it was observed that Gillis and Tivey, 'Inc. h generates waste oil from servicing light and heavy equipment used in construction. Be advised that waste oil is a hazardous waste classified as M001 under Massachusetts Hazardous Waste Regulations. Therefore, the Department hereby requires that all waste oil generated at Gillis and Tivey, Inc. be stored and accumulated in accordance with 310 CMR .30.202(7) . Furthermore, be advised that a person who. generates waste oil, shall dispose of such waste using a transporter licensed by the Department as contained in 310 CMR 30.202(2) and 30.202(9) , respectively. In addition, a properly prepared manifest or log must accompany, each shipment of waste oil as contained in 310 CMR 30.202(3) and 30.202(4) . The inspection revealed that you are operating as a small quantity generator, i.e., oue who generates less than. 1000 kg. of hazardous waste per month. Please be reminded that as a small quantity generator you must not accumulate, at any given time, more than 1000 kg. of hazardous waste. (Reference 310 CMR 30.351(6)) . During the course of the inspection, an accumulation of waste oil was observed on the ground in the general vicinity of the catch-all leading to the 2000 gallon under- ground storage. tank. Be advised that the area surrounding the catch-all must be scraped . clean immediately and the contaminated soil placed in secure drums and treated as a hazardous waste. (Reference 310 CMR 30.524) . Furthermore, effective means for preventing rainwater from entering and collecting in the catch-all must be implemented immediately. �s r' -2- To ensure that compliance with the above-mentioned deficiency has been met regarding this Notice of Violation, a representative from this office_ will conduct,. ° a re-inspection of your facility. i As a result of this inspection and observations made, you are hereby advised that the above referenced deficiency constitutes a violation of the Massachusetts Hazardous Waste Regulations. These Regulations, as contained in 310 CMR 30.000, were adopted under the provisions of Section 27(8), 52, 57 and 58 of Chapter 21 or Sections 4 and 6 of Chapter 21C, of the General Laws as applicable. The Department hereby requires that compliance with the above-referenced violations be met by November 9, 1984 and notification, in writing, .shall be made to the Department in order that a re-inspection can be scheduled. Failure to comply with the above request will result in the Department taking appropriate enforcement action. If you have any questions relative to the Hazardous Waste Management at your facility, please contact Kenneth Anderson of this office. Very truly yours, For the Commissioner Christopher Tilden, Chief Hazardous Materials and Solid Wastes Section. T/KA/re cc: Board of Health. Town Hall Hyannis, MA 02601 Robert C. Tivey, Jr. Gillis and Tivey, Inc. 362 Yarmouth Road Hyannis, MA 02601 November 27 Fire _Gnief knew nothing about this ' matter. Peg talked to Mr. Robert Tivey ' . 11/27/84 at 10:55 A.M. : According to Mr. Tivey they will still use tank* Have had the tank tested and was tested air tight. Will send us a copy of the test results. 2,000 waste oil tank which was pumped dry according to their letter of 11/20/84 ti. s C�r Giliii a Tivey Inc. 362 Yarmouth Road • Hyannis, Massachusetts 02601 • Tel. (617) 775-1850 November 20th, 1984 The Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Quality Engineering Southeast Region Lakeville Hospital Lakeville, Massachusetts 02346 ATT: MR. CHRISTOPHER TILDEN, Chief HAZARDOUS MATERIALS AND SOLID WASTES SECTION Please be advised that Gillis and Tivey, Inc. , has complied with the requests contained in your letter dated October 24th, 1984. The following action was taken: 1. We immediately had a special cover made and placed over the catch-all leading to the 2000 gallon underground storage tank. This will prevent rain water from entering and collecting in the catch-all . 2. The 2000 gallon underground storage tank was pumped dry on 11/8/84. Nine hundred fifty (950) gallons of oil and water was removed by Western Oil , Inc. and disposed of by them. (Copy.of their invoice attached). 3. The area was scraped clean of contaminated.soil and the soil placed in secure drums by Western Oil , Inc. on 11/9/84. These drums were . disposed of by Western Oil , Inc. on 11/13/84 (Copy of their invoice attached). Gillis and Tivey, Inc. feels that we have complied with the requests of your department and .will welcome a re-inspection at your convenience. Very truly yours, GILL AND TIVEY, INC. by/ � / Rob t C. Tivey President cc : Mr. Kenneth Anderson Board of Health, Town Hall , Hyannis, MA 02601 enc: 2 0 JOHN DEERE nuMELITE CONSTRUCTION EQUIPMENT SALES, PARTS, SERVICE AND RENTALS LEM= �� THE p0 No.--------- OFFICE OF THE BOARD OF HEALTH i BARNSTABLE : OF THE MASS. oM39. TOWN OF BARNSTABLE, MASS. t j-Z7- ---';1'-- -------- 1 S E DISPOSAL PER.l�II Permission is granted to `' --------- �i"" ------ '- =' - - to construct - — ----— = k Upon the Premises of a etch ` ------ --------I — -- -------------------- - -- —- j In they Ilage of . - -- -- - V t 100 or re f' t from any source of water supply 20 feet from uilding 10 feet from property line Heat Officer. r Massachusetts Department of Environmental Protection For VP Un eny 10 51.-449 Permit No. -Transmittal T Transmittal Form for Application ReeelvedDete__.________ R . I and Payment P°�"°�`°�nbd y oedelon oe s FaClllly 10(!/knOWV Application Information i._B.rW.A P_J__L_WJ.O Al I INSTRUCTIONS Permlt,ApproPalorOtherCategory(sevencharactercodefromthefromMeNatpageofthedlrectlonsonHowtoftly).EnWfes:al4PA001.ORPttrV1,at. 1.Please type or Construct and install non—hazardous industrial wastewater holding tank. print. Use a Category&& separate Transmittal Closed loop wastewater recycling system installation. Form for each Brlef Prolert Descdpflon application. 2.Use an original, Applicant or Legally Responsible Official 3-part Transmittal Form for each Tivey Robert Sr. application. Last Hama Ffrst Aorne M/ddte Initial Photocopies will not 362 Yarmouth Road be accepted for any --- --— application or Addos payment.(You may Hyannis, MA 02601 ( 508) 775 - 1850 ext.use photocopies for City/Town We Bp Code Telephone Numftp"cWng&acode&Ww*nslm) reserve location, Robert Tivey Sr. , President where applicable.) Contact 3.Make check payable to Facility, Site or Individual Requiring Approval Commonwealth of Massachusetts. Gillis & Tivey, Inc. Please mall check HameofFxl//ty,S✓teorindlvlduat and yellow copy of _362 Yarmouth Road Transmittal Form to: Department of Address Environmental _Hyannis, MA 02601 (508 ) 775-1850 ext.-- Protection, Cpy/roa State Zlp Code Tel hmvMatwUnandfing&uc°°eWartemlw) P.O.Box 4062, Boston,MA,02211. , Application Prepared By(if different from section B) 4.Both tee exempt ConSery Group Inc. and non-exempt Mlddl ehrffel applicants must Last Name F1rsfAianre moll yellow copy of 110 State Road, Suite #9, P.O. Box 278 Transmittal Form to: Address Department of Sagamore Beach, MA 02562 (508) 888 -6555 ext.-- Environmental Protection, Clly/Tom state ZOCode rfthomMimder(IWWhgsrw code xdexterrslon) P.O.Box 4062, _Roy Catignani, President Boston,MA,02211. Contact LSPAkvher(Ior2fE0nty) Other Related Permits.11 you are applying for other permits related to this application,please list them below. Category Description None Amount Due Special Provisions: Cl Fee Exempt* (city,town,district,or municipal housing authority)(state agency If permit fee Is$100 or less) 1.1 Hardship Request(payment extension according to 310 CMR 4.04(3)(c) I 1 Alternative Schedule Project Request(according to 310 CMR 4.05 and 4.10) There are no fee exemptions for 21 E sites,regardless o/the applicant's status. Check No. Dollar Amount$ Date Make check payable to Commonwealth of Massachusetts.Please mall check and yellow copy of Transmittal Form to: Department of Environmental Protection,P.O.Box 4062,Boston,MA,02211 t�.�___vo.Ma. M.I.ew.vwn..wwwwiw 0—710A Massachusetts Department of Environmental Protection 105449 Bureau of Waste Prevention—Industrial Wastewter ihetrnNfurl♦ BWP IW 01 Permit to contract and Install noe-ba:ardons industrial wastewater Melding tads f Permit to convert existing tank to non-kn ordeal Industrial wastewater Melding tw&Foci*ID(N brown) BWP IW 28 ' Facility Information 1. Which permit are you applying for? 6. List,In descending order of significance,the four(4)digft Standard Industrial Classification(SIC)Codes which best Msitinii Instruction O gWP IW 01 O BWP IW 28 describe the facility producing the discharge in terms of the Returnthis principal products or services provided.Also,specify each application along with the whne copy 2. Applicant: classification in words. of a completed DEP Transmittal Form to Gillis & Tivey, Inc. SIC CODE' Description the Industrial ra uYN" 5082 — Construction and IPesteworer 362 Yarmouth Road Menspement t Mining Machinery and Equipment Propnm st the AMMA appropriate DEP Hyannis, MA 02601 Regional office. Clty/roww0paade e Same_ MallingAddlw(ll dllerenl from above) d *Note:SIC Codes can be obtained by contacting the MA crly/rowrt/llpoode Division of Occupational Hygiene at 617-969-7177 3. Facility work schedule in 8.5 7;30 4:00 7. Sources of Wastewater.List the amounts of wastewater,in gallons per day,above the name of the source. Also,check Rbas per day., fmm to off whether this amount is estimated or measured. Always 5 Monday Friday list total flow. Qrysperweek tam to tfafinatod. M6eetr/ell 9anonsroer 4. Facility receiving wastewater: s)sanhary(tankr,bnerx etc) O ❑ Barnstable W.P.C.D. h)coogng Tow Rbmba ❑. ❑ Name 617 Bearse's Way c)wror.Gbmt" ❑ O Address Hyannis, MA 02601 TO",stale,ZIP COW Coogng MAN ❑ O (Back Up) Yarmouth, S.T.F. S.Yarmouth, MA e)Nat-Conkd Caollrtg Water ❑ ❑ 5. List any pollutants which you know or have reason to believe are/will be discharged. For every pollutant listed, Indicate its approximate concentration in the discharge and gf�rocess ' O ❑ attach any analytical data in your possession which supports your statement. Additional wastewater analysis g)E9orprrte and olhefffl aerllrywasltdawn ❑ alnknanae Z ro ExI s s may be required as part of this application. Equipment Washing Dissolved road salt h)Aft lolmrroncmkmes O q waste sue Ck mm ❑ O Oil & grease 4 100 P.P.M. p leadW(ssdary.1WHal, ) ❑ ❑ Biodegradable Detergent A total/lbw — ® ❑ Dirt; Silt *Zero Excess Flow * Closed Loop System; Pump out to P.O.T.W 3-4 times annually at approximately 500 gallons per pump out Page 1 of 2 Rev.7/93 Massachusetts Department of Environmental Protection 105,449 Bureau of Waste Prevention—Industrial Wastewater Transmittal I BWP IW 01 Permit to construct and install non-haxordona Industrial wastewater Molding took I BWP 1W 28 Permit to convert existing tank to son-hazardors ladustrisl wastewater holding teak Facllity ID(if blown) Facility Information (coot.) 10.List raw material and products used.Include any and all 8. Type of holding tank prodnete or ehemieals used In p►eeeoeh>o,obanift ele„ ZEP — 940 - E O mobile tank trucks Hydrogen Peroxide 35% IN above ground ER in-ground If in-ground tank,provide name and signature of appropriate local board of health official: (M S.D S Sheets Attached) Barnstable Hea th D partment n ao 0. S 1° 11.Provide name and address of transporter(licensed septaget waste hauler): 9. Doestwill wastewater receive pretreatment? K) Yes ❑ No Bortolotti Construction, Inc. abw If Yes,is treatment 765 Wakeb Road ® continuous [Ibatch O both Add'w Marstons Mills MA - Clh/loerMDmdb 02648 : Engineer Information Name and address of Massachusetts Registered Professional Engineer designing the proposed Industrial.wastewater holding tank: George S. Peterson, P.E. S UN Pdnl Now P.O. Box 6144 Aderess No. - cl►y MA 02362 DO Sole (508) 888-6555 4i22683 Telephone - P.El Certification Gillis & Tivey, Inc. 'I certify under penalty of law that this document and all PtinrNama attachments were prepared under my direction or supervision Aufho�reaslpnalura In accordance with a system designed to assure that qualified president personnel properly gather and evaluate the Information submitted. Based on my inquiry of person or persons who fine manage the system,or those persons directly responsible for gathering the information,the information submitted is to the oa best of my knowledge and belief,true,accurate,and -Corporation complete. I am aware that there are significant penalties for TypeolAppfkvf(corporanon,c mpany,go►ernmenlag my cllyrtmWsMd,oOherJ submitting false information,Including the possibility of fine Massachusetts and Imprisonment for knowing violations.' skleofInwrporadon and pdnclpalavim 362 Yarmouth Road Hyannis MA "Ant Page 2 of 2 Rev.7/93 Fi 011 BARHSTABLE WPCD PHONE NO. +508 778 6280 Sep. 05 1995 12:56PM P2 Town of.Barnstable Department of Public Works le)0Z '`! , 367 Main Street, Hyannis, MA 02601 Office 508.790.6300 Thomas J. Mullen Fax 5081-790.6400 Superintendc»t September 5, 1995 Mr. Peter Sorrentino ConSery Group, Inc. 95 State Road P.O. Box 278 Sagamore Beach, MA 025622 i Re: Acceptance of Non-hazardous Industrial Wastewater from Gillis & Tivey ,Hyannis, MA., Dear Mr. Sorrentino: The Town of Barnstable,Water Pollution Control Division, has received your specifications for the RGF Environmental Systems, Inc.. The Ultrasorb.system seems a viable technology for the needs.of Gillis&Tivey, our eonce ie- Hance required to sustain its efficiency. The waste will be accepted at our Treatment Facility, but we must require a maintenance contract and some analysis be performed to verify compliance with our pretreatment regulations. If you have any questions, please feel free to call me at(508)-790-6336. • Very truly yours, John Quinn Pretreatment Coordinator I BORTOLOTT1 CONSTRUCTION INC. DRAINAGE LAND DEVELOPMENT SEPTIC SYSTEMS August 23, 1995 Gillis& Tivey, Inc. 362 Yarmouth Road Hyannis, MA 02601 508-775-1850 A 779V: Bob Tivey, Sr. RE: Equipment Wash Non-Hazardcnis Wastewater Holding Tank Bortolotti Costruction, Inc, agrees to pump the waste-water from the recycle system product water holding tank on a periodic basis as requested to do so. The waste-water will be transported to either the Barnstable W.P.C.D.. and at the Yarmouth W.W.T.F. We can be reached at 508-428-8926 or 508-771-9399 or FAX its.at 508-426-9399. S Robert Jolotti Presient Bortoloth Construction, Inc. 765 WAKEBY ROAD • MARSTONS MILLS,MASSACHUSETTS 02648 • (508)428-8926 H-20 COVERS AND RISERS - COVERS MUST BE 20" - - OR GREATER MIDDLE ACCESS s" H- 20 COVER and RISER to be BM T°F AT LEAST Finish Grade 98.9 ,¢a• 99.9 EL (assumed) within 6" OF FINAL GRADE GEOCLOTH on top of pipe and stone �4 PIPE TO BE LEVEL 2 Trenches 2' D x 3' W x 25' L ,c�o� � FOR 2' OUT OF D-BOX with 6' between the trenches -�`�' �% N vent Inspection port- 4" perforated pipe 110 4" SCH. 40 PERFORATED PIPE slope of .005' per foot on distribution lines with a cast iron cap to be placed 1` 95.24 into the stone to the naturally �i;-,•:::. ,`;; :; :-,:.; itit_�:.; ,{ ..• :ar;'"•��� :';`,;'?s=` occurin soil. The cap is to be "1.:7��r:.t:wl��Y:.^.:w7:�:�'r.;flz:�^=-5�;4....-.,I-4•'.'..7�4•'%-.+'i!.e.:.rr7�4:';:,..7�Y:':k-rr-..�..•.•..?!��•.-y Y--o..g:�i�-a:.,-..���a% 9 P 95.97 � .• -. 10" TEE � ::.,�:?...:r...:rr:..:�........: a,�-. .r..-..... .,-. .. .r..:r,v+. ... .?; ,..• .- :- k:, a..,,.,-:... ,:. r,: crr'• r'• . :.:r`...' 'r`-' ::� 'd •:.�.«. :.`r• .r;• within 3" of the final grade. existing min. v 14" TEE WITH 95.72 2'of 1 1/2"-3/4"Double Washed Stone .. t 93.37 4" sch. 40 pipe vented, inverted GAS BAFFLE u-shaped pipe (stone to be at top of pipe) 96.7 with a gas baffle 95.65 H-20 95.48 95.37 5.47' 01V RN D-BOX 4 e pld"i 4 - INCHES 19 INCHES H-20 (2 COMPARTMENT) 6" STONE OR 11 6' - 24 INCHES 1500 GALLON SEPTIC TANK COMPACTED BASE VARIANCE REQUEST: 87.9 -Bottom of TH 8' - 29 :NCHES34 NCHES (1St chamber 1000 gal + 2nd chamber --- gal) A variance is requested from 15.405 (1)(b),for in increase in the maximum allowable depth of components required, from LIQUID DEPTH IN DEPTH OF OUTLET TEE 36" to 72" below finish grade, providing that adequate venting SEPTIC TANK BELOW FLOW LINE and H-20 components r,e used. INLET TEE LENGTHS e 60°15'00�231�.85'231.85 gags k TEST HOLE LOG DATE: 8/1/12 _ TEST BY: Michael O'Loughlin S.E. S 60"15'00" E 231.85'231.85 WITNESSED BY: Don Desmarias / PERC RATE < 5 MIN PER INCH SOILS: Class LOADING RATE .74 TEST HOLE # 1 TEST HOLE 2 0" 98.9 EL 0„ 98.9 EL FILL FILL 27" 96.65 EL 24" 96.9 EL 9 B W L. S. B W L. S. 10YR 5/6 10YR 5/6 1p1 35" 95.98 EL 38" 95.73 EL N m C1 Course Sand Course Sand 2.5Y 6/4 C 1 2.5Y 6/4 a� 58" Perc 94.07 9°" 91.4 EL 90" 91.4 EL E 3 M. S. M. S. / OP � 0 C 2 2.5Y 7/2 C 2 2.5Y 7/2 JN to 0 120" 88.4 EL 132" 87.9 EL cn WATER NOT ENCOUNTERED WATER NOT ENCOUNTERED NOTE: The water line, that is 10' from existing waste pipe, must be sleeved. 1 ro 0Q s GENERAL NOTES DESIGN DATA 1. CONTRACTOR TO BE RESPONSIBLE FOR THE LOCATION OF ALL UTILITIES, ABOVE & UNDERGROUND, PRIOR TO 0 ANY EXCAVATION OR CONSTRUCTION. 2. SEPTIC SYSTEM IS TO BE INSTALLED IN COMPLIANCE Existing 471sgft Office: 75 GPD/1000sgft = 31.5 GPD WITH 310 C MR 15.00:TITLE V. 0 qj 3. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS Existing Detailing Bay (1): 150 GPD/bay PLAN IS TO BE USED FOR SEPTIC SYSTEM UPGRADE. Total required: 31.5 + 150 = 181.5 GPD 4. DESIGNER TO INSPECT & CERTIFY OVER- ORO, .� Minimum required: 200 GPD DIG, WHEN REQUIRED BY PLAN, AND FINAL INSPECTION BEFORE ® � �� G BACKFILL gQ�y 9 9 P Y ( ) REQUIIRED 5. INSPECTIONS.CTOR TO OVIDE 48 HOUR NOTICE FOR ANY Actual Water Meter Readings: 2011- 30,000 gallons per year 82 GPD 9 0 E 208.91'208.SI 2010- 17,250 gallons per year (47 GPD) 6. THIS SYSTEM IS NOT DESIGNED FOR THE USE OF A Existing cesspool 2009- 20,250 gallons per year (55 GPD) GARBAGE DISPOSAL. to be pumped out 208.91' Design Flow: 200 GPD 7. THE TOP OF ALL SYSTEM COMPONENTS SHALL BE MARKED and filled in. 00 Loading Rate: .74 ORDER TOWITH MAGNETIC LOCATIE RTHING TAPE OR A EM ONCE BURIEDOMPARABLE MEANS IN 99 Required sqft: 200 GPD / .74 = 271 sqft 8. IF SOILS ARE FOUND UNSUITABLE OR DIFFERING FROM THOSE �91 9 19 Septic Tank Required: 1500 Gallon 2-compartment H-20 Septic Tank FOUND IN SOIL LOG CONTACT DESIGNER AND THE BOARD OF HEALTH. 115' 9. IF UNSUITABLE MATERIAL IS FOUND IN THE PRIMARY OR THE GRAVEL PARKING AREA g 1st compartment =1000 gallon 2nd compartment =500 Gallon RESERVE OF THE S.A.S. AN OVERDIG REQUIRING CLEAN 99 t9 04 USE: 6 HOLE- DBOX H-20 GRANULAR SAND MEETING 310CMR 15.255(3) SHOULD BE USED i9 915 A SOIL ABSORPTION SYSTEM: AS FILL MATERIAL, 5' AROUND AND UNDER S.A.S.. 3 O (2) 4" pipes with stone trenches 3' x 25' x 2' in size. 10. ALL 4" PIPE CONNECTION AT SEPTIC TANK AND D-BOX SHALL O Bottom Area for Both Trenches: 6' x 25' = 150 sqft BE MORTARED IN PLACE. IF USING 18" PLASTIC RISER PIPES, q THESE TOO SHALL BE MORTARED IN PLACE. � ,,o o Sidewall Area for Both Trenches: 2( 6' + 25') x 2' = 124 sqft N BM TH 2 �r Total sqft Provided: = 274 sqft Office Space metal plate w 0>9 o ►�+ Total GPD: 274 sqft x .74 = 203 GPD 417 sqft in concrete 9S L ----------'t46� --------------- SLAB 99.8 °� GSS GRAVEL STORAGE O 00 AREA 90 CONC.PAD g W/OVERHANG o #' �' SEWAGE PLAN O y Auto Detailing Bay Z692 sqft s�9 LOC ATION: 362-A Yarmouth Rd, Hyannis, MA 7� 9R O OF su u ' s PREPARED FOR: Robert Tivey f�a � `S 7' I.P. I.P. d �'0 x1,S� _N SC ALE: 1" = 20' J, G 1rk 3 3 0 04 MAP: 344 PARCEL: 016 DATE: 8-7-12 1� al', a , rn Vent 9;4 1 J. O'LOUGHLIN INC. 714 MAIN STREET, YARMOUTH PORT, MA 02675 (508) 362-4942 /_\1 'r21 11111A 1-45C-AL-E CLOSED LOOP. EQUIPMENT WASH/RINSE RECYCLE SYSTEM AND CONVffST0N OF EXISTING OIL WATER SEPARATOR TO ' I 11-oh NON-1-1AZA1,T)OUS INDUSTRIAL WASTEWATER HOLDING TANK 4- + R 14, To&6.L-rf- '5W ITC H MIASSACHUSE'TTS D.E .P . PERMIT BWP IW 28 C- r Gillis & Tivey , Inc . operates a full time construction equipment sales and -I r service company and washes vehicles and equipment as a normal part of -0 preventative maintenance. The system described here is proposed to provide a 2 RF-0 C-C_ FZE_P method of recycling wastewater generated from the vehicle and equipment washing. Intermittent haul off to a POTW (of system product water) will occur V14 ozj`=r� TD for operating efficiency . fi Design assumptions are t�ken from information provided by RGF Environmental -------- 6,n Systems , with respect to recycle equipment operating performance; and Owner meetings with regard to intended on-site operating procedures . t< # _\9 -�,l /61WCT t6l(p wim,105. Currently, limited washing occurs in the existing building with the waste ------------------ stream passing into floo- drains , through a gravity oil/water separator and 5Y onto a leaching facility_ This proposal would convert the existing system to tp,v. Fwose_ f5e�ONO -t ,;,- a holding tank, allow closed loop recycling of the wastewater with .7 P L) H A,,. M Et>I:--R. 1 = 1 0 1 teIrmittent haul off to 1-ocal POTWS , and eliminate all discharge to the in f,:�r,T 10 N leaching facility. The resultant system is submitted for approval as a Non- T f� Nod 4 CA -,,A-2,0 FO�?- RL)V. P 6H^&A 5 iE:4-, Hazardous Industrial Was,,-ewater Holding Tank. 2. 7-)u I C)1,:Z ASSUMPTIONS Normal x ash and rins,� re estimates on a weekly basis are provided by the Owner. Opvc" -Are generally 5 days per week. NV. 4 vk�% 1, -161- LA 2 .kA i Pressur washer flow rate of current equipment is 4 . 0 Gal. /Min. or 240 Gal. /Hre. At 2 , 0(�O P. S. I . and is a Power America Model No . 3420 . -V 1-011 .3 . Wash Water Usage Per �Ieek: 2 Hours x 240 CPH 480 Gals . /Week V I F_ V-4 4 . Average Daily Flow - (480 Gallons 5 days per week) 96 Gals . per day. R164HT L_0,&Q1 W-a OF A 5 MT 5 . Daily Rinse Water Additions (Potable Water Use) - Using past experience it H t> 2,0 44 W/ S,Ck-)O 11 CZDNC- C.� 2-6 'i�.NEJ_ 4 60T 51) /-\T 2t' is estimated that approximately 15% of the Average Daily Flow is consumed 3 6)R, 4- in the rinsing proces.i . 96 GPD x 15Z = 14 . 4 GPD) H2,�M F- ..74 6 . Percentage of wash and rinse +water recycled on a daily basis is 1002 The VI-4,V XX FL-0,1,7 SYV CYC-H C-,14 system is a Closed Loop . 2. 111-6q A,�5 Jt4P)C#,TF_P Fy-�,W + NN AT I &,," 4- L 1. H o\kj TOP e_-o V a F_ Ft-X Q L";z-VIEL 1 4 11 IL 7 . Anticipated daily evaporative and carry off loss is estimated as an average of 15% of the Average. Daily Flow. TGFTAL OF _TAt,� K 1)0 6P 0 �NC)VK) w6R CIA.P. OF T,,t,�-,N 1.4, 7 7 -3 61)o%L 1 5% x 96 Gallons 14 . 4 GPD average daily evaporative loss . �L) 'J v,�rrH /:,,,,T-4`41 k 0 r r_>CT 91&% C-,b,F 0 F T k4 21 S -7 N 8 . Net Dail Flow 4 . 4 Gals . (Daily r-*-nse water addition) Less 14 . 4 Gals . evaporative loss 7- CN \N),T C_- is the Net Ddily F.-Low of Zero gals . T 9" . .... J T Note : Syst,::m automatically injects fresh water to maint:ain minimum required operating levels . B. ) Sea_, oiial (i.e . Winter) temperature and humidity, snow or moisture carry-in wi11.1* effect this estimate . 7+_ 9 . Normal operating volume of the RGF Model LD2 Recycle System is 678 Gallons . Total (above slab) s,, stem capacity is 820 Gallons . LD2 Droduct water storage tank has available free storage volume of appro:.;mateiy 107 Gallons to accommodate rinse '(potajle) Water addil ions and occasional snow melt . out discharge POTW) frequency anticipated 4-6 times per year. 7/� our i: volume r..acln tLine will e 550 gallons (Maximum) from Product Water I_lcoragt.- Tank. 11 . Used filtratior-. medir, , filters , absorption filters , sump pit water and contaminaced s,.tdirierlr,; shall be properly disposed of in accordance with 310 CMR 19 . 00 ran ,. 310 CMR 30 .00 as required. it CALCULATIONS 0 1 . Overall System Contai-Tifflent. Capacity (In gallons) : Normal 4,11 System Operating Excess Storage Components lull Cap . Levels Available t it t Z RGF Storage Tank 5 5 9 . 0 443 . 0 107 .0 PLAN viEVI RGF Series 11 Skid 20 . 0 20 . 0 - 0 - RGF Series I Tank 0 215 . 0 35 . 0 6P TOTAL ABOVE GROUND 0 . 0 _6_�o 142 . 0 Floor Slab 45'J 455 . 0 6 x 10 Tank 106(- . 0 773 . 0 287 . 0 4 x 6 Tank 71t . 0 300 . 0 418 . 0 Total Below Ground''_7 0 Maximum Above Gro,-ne Itorage Capacity = 820 . Gals . x 1101A, (Safety Factor) Underground Storage Cii1par-i-ty Required 0.-0 7- Therefore 1160 '.,'ais . Provided 902 . 0 Gals Required _-_5 EC-T 10 N VIEW R1 4a HT SIDE V I F*-',1/, O.K. i. NOTE : 107 of eyress storage is 6" PfZF-,-:AST GONG, WITH DC_!tj16"W OF: *-,A-._15HT0 pruviec( -ound pro(luct LaIlk f(I ZjddiLioxis of rills,- Water H 4-4 W I-I-H 00 0 P.-5. 1, �L, 0, 2 6 5 - C. i�TAL (,c snow melt. _4Z T E_ oil Average Daily Flow) : X V. L FE, -�5 L, 9 V F_ 4 I-->;C:AJ I F_ Fofz C. P1 P1 A. Average Daily F.,-cw 96 Gals . x 500% 480 Gals . required. Capacity Provided; "0 TA-L, OF -r#.WK = 7 9), 6qA%L. warz-14-1 NCa cAepcl-v-r c-:)FTA- NV, = 3Ck:) 6,&.L- A. Above Ground Exce (Product Tank, 107 Gals . F_XT 1Z A., CAI Or Tp- KI Ve, +18) B. Undergrou,�! Stoma 1160 Gals . I 1267 Gals . Therefore : 1'.i` Gals . Piovided 480 Gals . required O.K. P OF T7:17-7-1 T ---- .3" Is r Ir r M W ,w TIIEDvW NAnONAL NO. 18dA-24X36C-' .................... m a x, . AE'•d3810NS t- G� j , I � � fi I I j I { I I _ i ! J . I- I w� I - a � i 1 P In I I . t _ 10 —s _ . i �1_ 1 rot tj t i I I i i � — --- - n p; 7. X - 7 . I i ► • I it � � �� \ k. l r�i ;'.n :�N G. r,�, f'�F � To �'� M/�,1 lam} VA I t f i U — 0 f Wt"_ram vi LCP�I GDNG. �5t� ems) ' : _ t f '- t i - I - k - _ ..-_ E_ � --_- -- - - _ _ - -- -- _--- N.� C7 �JI�Y�PL 5 I2 1 ,__� r �, , '� •.� � �-°. .F_'R�.?�J:��-�t� _�LPIa _�D�1TlONI ► Q u �•,�/ G�(�F►--c'.�/ P>Z-i'=VF► f -.'V __ ._ _ ---_ ___--------._----- - - _______ _ _ ___ _...,., e _ ---------- �-'''-' - ___ EQUIPMENT & ITEM LIST 3 F F QL)I PT. I TF-4,A L-1 ST PAY Ov c 14 fF-FZ 1 i k 1 ` ',� X 4 ' L X 3 ' 9" H -- 1 . aerie:, I - I Working Capacity - Gallons 215 d I j,c z-ics T T S�:lc � �. 3 2 � ;�orkinK Capacity uallons 20 �-•- � •-.. 1 ., 11A h- - �toragp Tank - 4 ' X 4 X 6 S _ 443 fL Working Capacity Gallons �� •' �, +� - TLC ��_} �l _ �' �/' 4� �;oncre've Tank - 4 ' x 6 x 4 I 2 Working Ca acit - Gallons 300 <:> p y . 2 ' 10�� \ \ c�;��a;:: 'lank x 1.0 ' x ;orking Capacity. Gallons 773 � � i U_ `ill - 1/3 H.P. Su mer r _e Electric Sup Pump with float switch . - I 1 y _.____—_ F �•J �I ---+ ._ 7� 4" .V.C. Sc�hedu 40 pipe for conduit to carry 1 1/?_ P .V. C . pipe and S,a fi P 1 d electric cox- --- G S 4" P .V.C . Schedule 40 pipe drain to tank No. 5 w/stub ups at skid No . 1 , P P II '� PT1�E. iN� i e 1 V� ✓A N�rat — _ . ; 1 - _-_ '4" P.V.C. Schedule 4 0 p p DRAWN 0 . Electric junction box 1/Phasennect for skid 2 . CHECKED �! ! , t ) 2 2 0 V 3 0 AMP 6 0 h _ p DATE Alarm Panel - 110 - 15 AMP. rt (12 . Potable water supp.i y to skids 1 , 2 & 3 w/back flow preventerQlf A�� NQ-� Ep and shut off as approved by local plumbing inspector and r ,. JOB �a / 1_O o. InI(� I � \9 water company. Provide 2 potable water hose bibbs as shown. 3/4" P.V. C. Schedule 40 non-potable water line and hose bibb ; entire line SHEET mu t be 1 ab e 1 e d non-potable . ( Y dw N EcZ) T E 1 N 'K I t= �2� : i ii _._�r_ 5�" ��-� .� ___-- i4 Connection to Ow:xer' s pressure washer. SAECTS l 4 a. pNMLYRAi.n.'NJRLi:' 4r,• •WC 7Y1EDYW NXrK)NAL No. 166A-2AX36"'. - REVISIONS BY V ' _ s I ` 4 i I `YrW FL,0VJ { 2-" OF sEtrS., � O, i I I 3 _ 4 n d ' I 12_ x i4" v N- c� �2-x14- �-'M Qq / 4VIA a OL 0 �� 0 Iu-L . I OLI P5 ' ' �Cv vti N _ ..>�' . � l- �1.Pla �•,i�C�I j !c:.>!� - ._ ! ,.. w/ -a Ft Pfz-F 4 F F u ---- ------ _ - --- 5�-E" Ecsu►PT. `� lT>~ pit �,-I 5T EQUIPMENT � ITEM LIST FAY USN tI I*}K' 2 — 2 i - �� �i_O►i— _ —___ - - -- ------ - - - -- -- --- - 1 . Series I Tank - 2 U X 4 L X 3 9 H . � Working Capacity - Callons 215 � SEsrie:; 11 Skid 3' s" x 3 ' 2" x 6 ' Working Capacity - Gallons 20 Q Q 1 (y Storage Tank - 4 ' X 4 ' X 6 ' 8" �- Working Capacity - Callons 443 7 ' '► 10- .. _-- \ f F 4 . Concrete Tank - 4 ' Y 6 ' x 4 ' {-- .7 ' 0 Working Capacity - Callons 300 � -ALLB to lv , 1 P. Coitcre[.e T tnk - 10 x 2 10 __ Z PtY ✓vv NFL �- \ _ = Working Capacity - Callons 773 }- 2 CL C>i, C' ' c• C) TLEY _ p �` -4 -4 _ 6. 1/3 N.P. Subtaersibl€ Electric Sump Pump with float switch. 4" P .V. C. Schedule 10 pipe for conduit to carry 1 1/2" P.V.C. pipe and .J� --- - - etc ctzic curd. H e�. 4•L.A�2ti�, P.�.+���t- 11 . —" _ _- _ ) 4 P . . .C . Schedule L0 pipe drain to tank No. 5 w/stub ups at skid No. 1 , ! I o v, 5 A P. = Pc�TP•i3 g HLO- — --- - � .� 2 5 3 . TIE IN 4" P.V.C. Schedule 10 pipe DRAWN 10 .Electric junction bcx w/disconnect for skid 2 . CHECKED 220 V, 30 AMP , 60 H, 1 Phase DATE 11 Alarm Panel - 110 - 15 AMP. TO SV-) D NO. Z i �_•c�ct 5:` 12. Potable water suppl; to skids 1 , 2 3 w/beck flow preventer j��, r.1SCALE vTEp and shut off as appi,aved by local plumbing inspector and water company. Provide 2 potable water hose bibbs as shown. Boa No. 3!4" P.V.C. Schedule 40 non-'potable water line and hose bibbi entire line SHEET — - I -- ------- ___ `_._ .-- --___--- mast be labeled non-•potable. <&`f CrWNWOL) TIA1 i+d SK1l0(-1) l' r Connection to O+woer ` s pressure washer. r < - ` �� _ , �NF- TWO -- ` ' OF BHEET8 ' 1r78EYMkg0NAl NO. 144A-24X34C-' REVISIONS BY C�NGRE I F �'� N1� '8'`=�'_p C ,OSED LOOP EQUIPMENT WASH,%RINSE RECYCLE SYSTEM AND - ----- -- CONVERSION OF EXISTING OIL WATER SEPARATOR TO _ Ilt•ON ___ N aN A%IZhA0 NON-HAZARDOUS INDUSTRIAL WASTEWATER L N ANK i 4�'� P,v•G. / TDd%C.L,F- SWITGN MASSACNt'SETTS D.E . P . PERMIT 8WP IW 28 Fort H02L! ON/ oFF Gillis fi Tivey , inc . operates a full time construction equipment sales and �9 DI�aRN+IsD service company ind washes vehicles and equipment as a normal part of IIO St)►�P PEA preventative maintenance . The system described here is proposed to provide a 2 Rip C-o1.OREp nnethod of recyclin� wastewater generated from the vehicle and equipment T^NK T/''NK -/1 LA,RM L.-lG,HT5 washing . Intermittent haul off to a POTW (of system product water) will occur OI S1 52 t ^���� WI " P TD 1�4NSLFa�, for :>perating efficiency . n I- it (pN �� �91 9uMP OVQRFu�W A"5 INPK.J,TF--0 �9 Tv.r�1�S Ft�2 L[�C.oTlc.i► 1 . Design Assumptions are taken from information provided by RGF Environmental PUI,AP WARldIN4 teu) 1 , with respect to recycle equipment operating performance ; and Owner isA.I LoZI! .Lh meetings with regard to intends d on-site operating procedures . - 4 vT F y - `��� M/�1.1L) riirrenrl y , f it ; • ed washing occurs in the existing building with the waste i'�•N� L i-'i= :�I��N .�lM1LA-iZ >� �-h�UPLTD M(�f�l- /4CT 1 ,51(� tream pass : �:b floor drains , througl•, a gravity oft/wat•�r separator and -- t3Y DV1•►JC. D C-!�NTR1�� 7 'IIKUL1�Ca'f) � zz-olMI W�TUN )MN , ' _n ' „ --------- - --- onto a leaching facility . This pr,posa woo convert the existing system to 4 P•V•L• PLAN \/ IEW ' a 1 1 n discharge ' SSG T IU N l t�l- • OF SUM P PU M P C rl A M r3�R i " I " a ho- ding � ank allow clo5•�d loop recycling o the wastewater with 1 '� ' intermittent ha,_1 off. to local POTW: , and e imi ate all to the w - hind facility . The resultant system is subm.tted for approval as a Non - (IDM I DI-UI' "� c� r< '? NOTE '. T�E� CAN1CA M•2.0 FUR PF-Tp.ILr5 OF PUMP GHAM6FL2 T /--N K ;1 ; (4,is Industrial Wastewater Holding Tank . --- --T r-ST F l- L Ff M Ic- WITH RE-f,�ADL,f- %4 4,1 P,V. C F RV I CC CG N U U 1 T F OfZ ASSUMPTIONS I r l r =p I II 64A, PI-sk.TE (�)VF_fZS C2.) 11/2"� P' G• PIP 6a4-1. co 1 II v ( 55URE c'tuN4�E I I 1 M P.VL • VN ION M�K-1~ `7PAC E P:�T W E!�N 'y� I 30 P1¢Lr h I . Normal ash and rinse gallonage estimates on ,I weekly basis are provided t� i }I 5ET t ►C)P.S.1. W� vAwff "T1.NK_ 4 4N vNDuIT E1.LC) TIC)OI by the Owner . Operations are yenvral ly 5 (lrlvl: per week . Y_. _- -- (,�S. - - 1't .•Iry wionher flow rate of Ili 1 fiat t•4II1i pinctlt %� 0 G;41 /Min or �iO G'a ; . .'Hr . 41 t : , (Marl P . S . I . :Ind 1'I)wt• ( A(ne • i I I htotle I No . '4 4 20 . n 1 II 1-v u t\ I I?V, W %.11�cL.+L VaUl� ---- - - n t ;,_. ,�)plrl}.e I'trr W4.4Tk : it it x 240 (;Pli 48U (;u 1 : ;Wt ,•K GV'05`O EGTIUN VIEW ►r'. lG �-IT �,IDr= y1EW _ w Y t 8( Gallons 1 y Itr wet-1 - 96 Calu pel it y - - -- --- Avg 4i�cr^ [1ai 1 F 1ow 4 1 b tp►,NK Pa.Qf•� I � �� - -�T �v►.AP �►.AP ►AILuR� -- - '! --_ c) l ' i n :; , • , • pR15C�T coW_ TPPNK W/ DF51G N l-Ob►D1 ►� :A OF A�+. 5 "T L) EINKI PR�w1REDTJ ALARM HSZv- 44- W/ 5jl.Y�C� P, ,;, II GONG `� . Daily Rinse Water Additions (Potal)le Water Uset, - Using past experience it � Z� DP-� ., o FJZ0,V1► E 5TCF� l i is estimated that )> > > oximatel 151 of the Average Dail Flow is consumed _ f�•.N Et_ U v OT 5-1, /\-T 2�t� I F r y g Y FV,A M� Few 3 OR 4 hEMUYAN-1--- PLATF Le-NFIt' Fezt-NIPF t/b'( - - -- - - - - ----�I � in the rinsing process . 96 GPD x 151 - 14 . 4 GPD) p,er vF_ 13c;T. .aF TP.►-w- E MUy AP I .F l I Y I�I L)N _ __ -� ��- ►'c P Y•C• �L•l, It `� -- - II I 6 . Percentage of wash and rinse water recycled on a daily basis is 100,. The FA►GH Ft-t�.l E . PRCCT/l P� ��t`� E v E A`� ► N I�IGAZ E P Fc>Q �} L. t I _ `-�.va SLT GE-ww - - P�/• C . pIPI NG -�NI�W►�lo TOP G1�V�R 1�-�7E I �J i I "HI- \4��E �! F��? SwI� �► 1 � LE, � � system is a Closed Loop . p.' L. F9,AmiE wcuR1= SET AT I CL" A,Px�i. �F is,►! k NOT '!�AACYw 1,1 . Otij aVAL I �: 7 . Anticipated dai 1N evaporative and carry off loss is Estimated as an average TOTAL C.,A.PAGI TT OF TAtJ K I10690 L--4 L. - of 15b of the Average Daily Flow. WORKI N GAP F N I� ►�� _�-- �,P 'E)L)5 tI-Z E51-E C- �-• 15". x 96 Gallons = 14 . 4 GPD average daily evaporative loss . J U o TA 3 .aA�. r oFF LI-VLL SUMP PUMP WITH 477*441F n t=xTRP. �At? OF TP.N1� � a7 aAl. , < W (L.oN GORP For- (2_Eti1U/Al. , 8 . Net Dail Flow : I �� 11 4 .L r:R (Dai lv rinse water addition) Lgss 14 . 4 Gals . evaporative loss l_ - - --_-�]_ �l.Ol•�T �WI�C11 :OFF lvEL 1'ic,w of zero gall; . `SET 6,7 aP Olt` - - " � ' T, CIF 1 t�•,►•11•' _ 1� ,5 Notre : A . ) System automatically injects fresh water to maintain minimum required operating levels . G �•L .U• F'o.71 (-.� P._.L-�►G►.' t} ><vlxl� i? ) Se , ;,,Il ( i . e . W41ri'*ur) temperature and humidity , snow or moisture carry-in will effect this estimate . � � � �• t J�0 ,i �C� SAL V ---- _ i r . Normal operating volume of the RGF Model LD2 Recycle System is 678 a Gallons . Trral (Above slab ) system capacity is 820 Gallons . (` 1.D2 product water storage tank has available free storage volume of approximately 107 Galinns to accommodate rinse _ ns and : �casional snow melt . MODEL - LD2 10 . Pump out discharge ( to I'O7`w') frequency anticipated 4 -6 times per y(:3r . I 11 Pump out volume each tirle will be 550 gallons (Maximum) from Product Water -0 SERIES I TANK STOMA" VANN Storage Tank . T 1 �-- 4" 4) P V,c . 1 -. FROM WASH MANvrAv ---- - i t . Used f i itraL ion media , , 1 i ers , al'!;,,rption f i l ters , sump pi t water and t PAD AFRATI(N/1OWFR -)ntarLt+t nYd sediments shall be properly disposed of in accordance with CMR 19 . 001 11nd 310 CMR 30 . 00 as required . INCLIN( POIY('nOrrIFNE .Y - = TURF COA,L S(On O r,rt SMIIAMFH CALCULATIONS 1 \ N(:A :ARGOPRFR 1,,ho.e1 � 11 IJ.V'G -1 MICRO MATRIX COALSF.COR(below) \ _ 4 / 1 . Overall Svstum Containmc,nt Capacity ( In gallons ) . I - J 1 11 MIDI TI-MEDIA �Q 3 - ^ - - - % FILTER TANK TAK I EVFL - • �� -Sf Normal SIf;Nt TURF vl +'V• System Operating, Excess Storage (;omponents Full Cap Levels _ Available L E1 1 9 KGF Storage Tank 550 . 0 443 . 0 107 . 0 z r P rA VI RGF' Series II Skid 20 . 0 20 . 0 - 0 - CAP,(A - - CoI-oil �Dn 5i UII _ \ {Ifs RGF Series I Tank 250 . 0 15 . 0 _ 35 . 0 t ) ..f j TOTAL. ABOVE GROUND- -_711 9_. ( 0 �- _.__..__ Floor Slab 455 455 . 0 F'�1tY IANK 9KIh �'fv 1 T lI1Ml1(A`f,n 6 x 10 Tank 1060 . 0 773 . 0 287 . 0 I (�� fi 1II„111,t 4 x 6 Tank 718 . 0 3�0-0� . 0- 418 . 0 n I I t11f I ra.,. Total Below Ground .,� . v r J . u 11607 �Maximum Above Ground Storage Capacity s 820 . Gals . I ` S OI r� x_ 1101 ( Safety Factor) tJ 11c1rierr .rnc�rlti Capacity Required j o a ((IN 111t,t PANF I 0 <' (INN A,r,,, ,,,;,,,.. OPTIONAL Therefore 1 160 Gals . Provided > 902 . 0 Gals Required RO�J`> EGT I c�N �/ I E W RIU NT 1--5I DE VIEW uvt.F . REMOTE LOCATION O.K . - - - -- - 1 11 - - ► CONTROL_PAN - _ PRE<=AST GONG. TA 1TH Dt:ICxN l- )A,0 /tl,,ItIN(. tI(IIt( . - ►�C�► OF AASHTD ! •� � '�„ � L' �,r`I ' ', excess storage r; - � NK W I • ,•11, „N1111„I I (l �:=� I � Iflf'1t1,NAt1 (�' 1j: C' H.( ry!,r)VI: \' :l)Unli j-,- HS 20- 44 WITH 5000 P.S. I. �ONc• D 2t 5 . PFOVIvE -5TIrF , l� f t".Ir , r.Irlt i..I.• tit, 1 ! itltil "�,1�( 2 t uvcA,Al,Itf 1 V,. ;' Oc,, 1 ,,ional snow melt . L �- F►z^ME Fov- 212emovA-mm Lr PL-.-T E GW Et -;'x4' PFZc�v1 E CIIAMIIIfi • l,llf MI(.At IN of I I I011 x 2 k 4 R p►�.�✓A-.81-6 PL,44 E w 1-T a Il - - - - - N (p LLI P L- ( X 12 x 2" I-C.► I uMr } � 11 VR(a.F';ti rUMr I � I N 1)€I t l v I' l t�W) F�tyV i D F 51.6$5 V E.r A5 ► t4 01C kT 1=17 Fc�2 4- P' V.C. P I P I SNOW1�1e ToP �v� 2 F1.�-T�5 FMEWORK NOT �N(�WN . SERIES II SKID A . Average Daily FL(,w 96 Gals . x 5001 = 4nl) Gals . required . TO Tar.- Gp1,F* G 1T'IC oF TP►tJ K = 7/f.3 Ca�.�. �-�.% ' Capacity Provided: WOft IL1 ►-1� CAPp.0 IT,r o F TA NK 3U� G1A.L.. TO PRESSURE F-xT'RA C1 _ CFCsrSTEMPUMP ruRBONYOROZONE* WASHER �� A. Above Ground EXLess Storage (Product Tank - 11 � i 5 . AP O F TA NK �}-I � C�P.L.. P, . 11nd(•T-around Stnras•e Tank - 1160 Gals . DRAWN - r ,, , It 550 W. POLY TANK CHECKED 8406 I TAM 2"W X 4'L x ID'H A 7 GAL. POLY TANK sERla N 3'2wx3' 2-txst+ SING Therefore : 1267 Gals . Provided 480 Gals . required O .K . T POLY DATE pRAQ TANK 4'W X 4' X 6-8-H q p V 1 FITLR '2 ,� D IA SCALE _WJMftT(AP/A.QLL K PVC%AMSTAKE _ CFC Y1TEM PUMP T CI A T p y Aw3 CIf pY r�( TF I% a o B NO. vw fSINti eCE PUMP __ 1 1� l�n SyLyNililFllllAL P Y P 9lNG!1 I M FILTER KRYPTONI(aUAR11 cwrY1CAL NI JlCT19l�E T ~ -- y _ 10�xn Ct1N1 C)1()NF t71�3f HARrE TU*ING -_ LIV PR(71E(,TFU PVC 1 r(.XY TU"90"r�0= _. SHEET MAMI,tAf tlrtRH c,/:r{.hvt�. leq l,upit 1„MAP NMNLf W111NM11 Nr,il, T W'O OF SHEETS 11l`TELDYTENATIONAL NO. 166A-24X36C' ' I i I i i NOTE: THERE ARE NO SPECIFIC CURB CUTS ON OPPOSITE SIDE OF STREET BARNSTABLE YARMOUTH THE ENTIRE PARKING LOT IS OPEN TO THE STREET MUNICIPAL f-ReA AIRPORT d • PROPOSED SIGNS T ENrffJr BENCHMARK.• Locas-� of YARMOUTH ROAD HYDRANT TAGBOLT ELEV. 41.82 TEST HOLE LOGS EXISTING ENGINEER: JAMES C. JODICE CURB WITNESS: JERRY DUNNING (B.O.H.) CURB (coNCRdra) 93 SIDEWALK SIDEWALK DATE: MAY 25, MI SIDE WALK PER C. RATE: <2 MIN/INCH I 4 ;, 0' dL. 39.2 T + t ST E r s� PROPOSED I EXISTING BUFFER ARB� SANDYY �[AIN y ® � FILL EASEMENT �Q TO BE LANDSCAPED I 86 s.� EL. 98.2 `.`' ,zs•'aa° V, 99-91, CLEAN FINE aDGI_OF PAVEMaNVT 1 INSTALL HANDICAP S'N'DLOCATION MAP (NO SCALE) PROP. PARKING STALL 5' EL. 34.2AND SIGN - / MED. BUILDING ZONE: B PROP.SEPTIC TAN / ,',� / SAND SETBACKS: 20 CAL. SdPTIC TANK ,� � / ,�, PARCEL 17 /' A /' EXISTING CHAIN SIDE = 0' Kj LINK FENCEREAR 0' ROBERT TIVSY // Uj O i, 13, EL. 26.2 FLOOD ZONE C O C � O O s 0. '�/ WA TER ASSESSORS MAP 344, PARCEL 16 O q FOUND PLAN REFERENCE BK 137, PAGE 55 EXIST. CESSPOOLS ', 04 q ,' DEED REFERENCE BK 2396, PAGE 236 TO BE PUMPED 2�. © Q, �/ PARCEL 15 -_-- LOT 1 (30,850+\- AND REMOVED STEPHEN C. JONES, TRS. EXISTING BUILDING = 7230 s.f. CAMP STREET TRUST gOX y , ,� / , , EXISTING BUILDING COVERAGE = 23% O (ALL PRO TRANSMISSION - AUTO EXIST. AND PROP. BUILD. COVERAGE = 39% EXISTING SALES AND REPAIR) PROP. BUILDING = 11,930 s.f. BUILDLVC 7 WP DIST. MAX. IMP. COVERAGE = 50% �\ _ • •,a ••• / SEPTIC DESIGN EXISTING IMPERVIOUS COVERAGE =-56% _ EXIST. AND PROP. IMP. COVERAGE - 60% j DESIGN FLOW: 569.5 GPD FA e N SEPTIC TANK DESIGN: 569.5 GPD (1.5) = 854.25 GPD USE A 1500 GALLON SEPTIC TA:YK OPEN I PROP. EA ., y• Co io LEACHING: / E-20 LEACH ; / - PARKING �� i PIT WITH 3'l:'. � •'�• / SIDES: 12 n 6' (2.5) = 565.5 GPD OF STONE •• BOTTOM: 36n (1.0) 113. 1 GPD REPAIR AND CLEANING AREA: 4 EMP. (1 SPACE/1.3 EMP.) = 3 SPACES cr r •dl?STING . „ CONCRars EXISTING BUILDING TOTAL: 492.8 s.f. 678.E GPD RETAIL SPACE: 750 s.r (1 SPACE/200 s.f.) = 4 SPACESf;�, s PiD • sarBAcB = .14' OFFICE SPACE: 985 s.f. (1 SPACE/300 s.f.) = 4 SPACES °' "' ' n UES (1) PRECAST 6'x6' LEACHING PIT WITH 3' OF - STONE ALL AROUND. TOTAL SPACES NEEDED = 11 SPACES TH1 TOTAL SPACES PROVIDED = 13 SPACES PERC. PROPOSED CONCRETE EXISTING CHAIN WHEEL STOPS O ;/,' ,',' ' ' ' ' '/';' '• - LINK FENCE SEPTIC PR O FI L E PROPOSED , -20 --- e o ', ; ', ADDITION � , , a.. •. //i / i , i /� / (NOT TO SCALE) COVERS AND FRAMES '�� �,� ',/ TO WITHIN 1 OF - -- - -- - - © j FI VISHED GRADE / ---- -- 24' l/'/' / �' /' / �' /' ' - --TRAVEL - -- PROPOSES BUILDING \ , , ,, /, , / SETBACK = 1.49' ---- -- -- 39.4 \ WAY ice/ , /�/ , ��//, i / �,� //�/ ! J9.8 ® , ,��/ , ,��/ ,��// , ,i �/ , , / , -EXISTING CONCRETE -- - - - -- ---� EXISTING CATCH BASIN - � / / / / � / - PROP. EDG i / i / � / � / � / / - ------------ - 7- GRATE dL. 37'.95 �OF PAVEMENT ',',� ' ' /,,/,// ' ,� ,��,/ PAD TO BE REYDYdD �-2" PEA STO.VE 77 d ^' •, r ��,' -_�Qu�_ I 1500 ;AL. �� 35.91 T - __t SEPTIC TA:YK '1� zs.s• �� _ i I 36.67 o °.°p o= o I o ° -L__-- EXISTING 2 1000 GAL. TANKS --DUMPS l_ o I °o AND 2 LZA CH AND S T O BE WITH AREA �' - J 6 -6 34.50 oapO LEACH °p0° A EATER RECLAIMING UNIT �� TEE SIZES: - / �, o a o PIT a o 00 H C/ I� ` INLET DEPTH = f0" `_'_ 3f1.1'. 6" CRUSHED _� °oaa° 2e.so INSTALLED INSIDE ADDITION. sr,•F, tom-*•r'K�.:` ` -' --- � --� OUTLET DEP'H = 19" DT 9 Y C'.VDER - -- --- KL� Y _ --�. IL DEPTH OF FLOP = 4' 12, ...... { �,� -� �r ~ 3114" TO 1- 1 2"- � PROP. SHRUB - ~ �� �! CLE.4. 'FASH,"D OWNERS BNGINEER TO VERIFY SUITABLE p i SOIL TO ELEV. 24.5 EXIST. CONTOUR- D �'ARl�iOL'TH ROAD �� STONE PROP. CON'TOUR--o-----o FOUNDATION -_ - 12'---- SEPTIC TANK 12' - --- D' BO.Y --_- -- --- -- 50, ---- LEACHING FACILITY PROP. GRADIs..............$� JLaTER LINE --W- -1►- ONE PROPOSED LEACHING CATCH BASIN (12' EFF. PROPOSED BERM-- NOTE: GROL'NDWATER IS APPROXIMATELY 20' BELOW DLAMETBR B. 6' DEEP) GRATE EL. 38.4 (SEE DETAIL) GRADE ACCORDING TO THE GP.OUNDWATER GAS LINE -G C - PROPOSED ENTRANCE TO BE PAVED WITH LANDSCAPED AREAS ON EACH SIDE MAP OF CAPE COD. EXIST. LIGHTING ••°•••............••• LEACHING CATCH BASIN DETAIL NOTES HXAV spar. SITE AND SET AGE PLAN ---EEA�Y DUTY BAST IRON / FRAMS LLD (RATS 1. DATUM NGVD TAKEN FROM BARNSTABLE QUAD MAP. 2. MUNICIPAL HATER IS AVAILABLE. Ili" THE TO WN OF: I 4' or PEASroNS � 3. PIPE PITCH TO BE 1/4" PER. FOOT. OL Q ?.(�'')'L cape e 12g in e e ring, inc. 4 MIL OF POLY r MIN. 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO-H 20 . HYANNIS BARNSTABLE, 5. PIPE JOINTS TO BE MADE WATERTIGHT. 11A T e e e ° ° e•D•o°'oho a 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE .PASS. - Oo00000oD00 �OQOp000�00 CIVIL IL ENGINEERS S •eve0000000l (--�- `-� ;0000g�000e� ENVIRONMENTAL CODE TITLE V. 7. THIS PLAY FOR PROPOSED WORK ONLY AND .NOT TO BE USED PREPARED FOR: s s ro°°e:e.0000a (e°000000eeo ` , t LA��• D S L R V E YOR S °oaooaaoo logooEgoe o FOR LOT LINE STAKING. e s o 0 o a e s o 0 0 u000aaeouoa 000eooD000 o•o°e•e°�•a 6' BY 6' le°o°o°a°o° 8. SCH 40-4" PVC TO BE USED THROUGHOUT SEPTIC SYSTEM. R OBER T TI YE Y R t e 6 a YA R CIO L�TH 1�IA °°°°°°e°°Da � �•°•°°°°•e• .P z 3AS Tp ,/� ,go;ggoe;;a LddCHING 1,.gogos0009 9. OWNERS ENGINEER TO VERIFY 4' OF SUITABLE SOIL BELOW LEACH PIT. WASHED STONE-� '°.•:•a•oo•°eo°� PIT yea°°eou000aa] . •: +P T.s_.�r•.�;� e s e e e a � �•o•o°o°o•e •'� °a ; �� °o °� f 0. OWNERS ENGINEER TO INSPECT ALL SITE WORK. °°°•° °•e•e°°o°o SCALE: 1" =20 DATE: JL L Y 1� 19 91 0 0 0 0 ° O • o 0 0 '� f r r K � •O.O.O°O°O � I.O°O.O°O.Oq ~ �' °°°°°°•o°D °°•D°D°°°° 11. ALL DRAINAGE TO BE KEPT ON SITE. f �. � ��,-, •e•e°°•e° � •e°°•°•e°eq RE�'7SED: 8-6-91 r � •°°°°°°°°°yg 12. CONCRBTE WHB'EL STOPS TO BE YSTA. LED A. .ALL GRAVEL ARNE �`�y�•, > i 4f�NE ��' °o°o°o°o°o ire°o°o°000°' l �. T 1 0-21 -9 3� OJA(A ` M. �•^O^Ov4o9� ._ �4e9°e4a3:9d PARKA YG STOPS. C7wl �� oJk1 ,11►0 'o r. • l o. ;, e• ( S, 13. CONTRACTOR TO VERIFY LOCATION OF ALL UTILITIES PRIOR 2-24-92 q 4 c, rEs� TO CONSTRUCTION. ¢-23_92 ECOVE -- -- ------- --�y► -- r I fo• i 9- 15-92 r� JUN 2 8 1993 1 AR:-• OJA E. R.L. S. DATE --� ' ' 10-29-92 TMOF JL'�'�E 4, 1993 „" h 91