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0551 YARMOUTH ROAD - Health
YAR-MOUTHROAP HYAN iS 345-002-001 I r . i i ° c No. 1 �J lJ Fee v THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 0(ppYiration for Disposal *pstrm Construction i3ermit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System .-ndividual Components Location Addregqss or Lot No. �� y a rA c9o�1 lam;( Owner's Name,Address,and Tel.No. _ Assesyy�l..'4'"�Gi S ss6r's lv>`ap/Parcel '- ._ _ / - Installer's Name,Address,and Tel.No. Designer's Na A,Address,and Tel.No. Type of ilding: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building C44,-:"q S�l No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 7 gpd Design flow provided— , / gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) l X) C ro r•1 N t tAbAcs 1�w l Q 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. �/� Sig � Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. .mil 0 9 Date Issued No. 2�(S V V 1 1 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered incomputer:� PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Rpplitation for Disposal *pstem Construchon Permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System L-Nndividual,Components Location Address or Lot No. $�( 'I a Ov h Tti Owner's Name,Address,and Tel.No. I��)cwnJt S Assess dr's Map/Parcel A 9 N 3 L-i 5 -00oZ_cot 1 ) �o Installer's Name,Address,and Tel.No. Designer's Nam ,Address,and Tel.No. v 170� G cQW 10_ mac. SO -000-7/ v 1 NY r✓ry /lL S - / Type of ilding: 4 Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building �/�(�,Jq S� No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) Gq gpd Design flow provided p2��, gpd Plan Date ��U1 •Number of sheets Revision Date Title �) "� �� Size of Septic Tank Type of S.A.S. / GN �(�+vlkof W t Description of Soil i r � � t / Nature of Repairs or Alterations(Answer when applicable) (N5kc. I d;-1eeyj e r' 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 B�ofHealt . Sign�d Date G /Z —' Application Approved by Date �// 1 / Application Disapproved by Date for the following reasons Permit No. 2 U 09 9 Date Issued V THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliante THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired Upgraded( ) Abandoned( )by � -6(owA a m C at s'57 t \ aonov R t . n11 has been constructed in accordance - r �p with the provisions of Title 5 and the for D sposal System Construction Permit No. a 0 l 0 0 0 dated L(b ( / r— Installer,k��xI4t A 7?6(bwA -�Zc_ Designer 1�n1S\4t—„oeyy� y�(�� #bedrooms Approved desigflowA gpd The issuance of this permit shall not be construed as a guarantee that the system will�f i;Nion as desig ed. Date / Inspector Y 1A A. --------------------------------------------------------------------------------------------------------------------------------------- No. 0( U 1r- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Disposal &pstetp/Construrtion Vermit Permission is hereby granted to Construct( ) R�e7pair( ✓✓) Upgrade( ) Abandon( ) System located at SS I �/u�Mav F h lS ��( &--y -V k,S 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:Construction must be completed within three years of the date of this permit. Date ��a // Approved by 1 DEEP.OBSERVATION HOLE LOG Hole.* _ Depth from Soil Horizon Soil Texture: Sotl`Color Soil Other Surface(in) .. (USDA)_ (Mansell) Mottling (Stnrcture,"Stones;Boulders: tDry -�3 C. M—c S 114 [d ( 7 4 . DEEP OBSERVATION HOLE LOG `Hole# , Depth from Soil Horizon Soil Texture Soil Color Soil Other Sorface(in.) t (USDA) (Munsell) Mottling (Structure„Stones,Boulderss. Q'(2 LL (� 7f2Y( -3� to ilk ►M_L S--n L r�1�jy DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consigency. Gravel) _ - DEEP OBSERVATION HOLE LOG - .Hole-#• -- r _ Soil Other - lor '1 Soil Co . ri So il Texture ' De th from �. Soil Hor►zo . . P .Surface(in.) (USDA) (Munsell) Mottling (Souc tu .Stones;Boulder s. Flood Insurance Rate Map: {" Above S00.year flood boundary No_ Yes , {. Within 500 year boundary No Yes Within too year flood boundary No L Yes Depth of Naturally Occurring Pervious_Material Does at`°least;four feet of naturally occurring pervious material exist in ail areas observed throughout the area proposed for the soil-absorption system? of naturally occurring vious material? If not,what ts--the depth p Certiflcata'on I certify that.on ( 1 (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 vrith . the required training,expertise and experience described in 310 CMR 15.017. Signature Date s l�(.116 } Q:\S.EPTRIPERCFORM.DOC Town of Barnstable P# 12 9.2,6 o+TME ' Department of Regulatory Services Public Health Division Date Zn 200 Main Street,Hyannis MA 02601 -` Date Scheduled 1 (o Time d M Fee Pd. - Soil Suitability Assessment for Sewage Disposal Performed By: �� M-z—F" Witnessed By: LOCATION& GENERAL INFORMATION Location Address 55 l YA,__,.w- Owner's Name 15�C V kor L,L C x,7CAV%0_r `(�l� Addressw®� 'c- Uo4 aZFi Z Assessor's Map/Parcel: 3 � 00- Engineer's Nana NEW CONSTR UCTION REPAIR . Telephone# _;i3g'— 73 7--4?-k& Land Use Slopes(%) -/ Surface Stones l.✓A�j'� . ti Distances from: Open Water Body ft Possible Wet Area �Z JLft Drinking Water Well_;? _ft Drainage Way_ //ICJ ft Property Line 7 d f/_ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands fn proximity to holes) ram.' Jew eN.ems . 1.: Parent material(geologic) 'Jc�i Depth to Sedrock /v1 Depth to Groundwater. Standing Water in Hole: �'" Weeping from Pit Face Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: _in. Depth to soil mottles: Depth to weeping from side of obs.hole: In. Groundwater Adjustm ant tt. Index Well# Reading Date: Index Well level --e, AdJ,factor Adj.Groundwater Level PERCOLATION TEST Thne.__-___. Observation Hole# Time at 9" Depthof Pere Time at 6" !mil L 2 Start Pre-soak Time® Time(9"•6") End Pre-soak Rate MinAnch. Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) 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 EPTIMERCFORM.DOC r r r WATER ACCOUNTABILITY Auto Bath of Cape Cod Oceanside Septic Services, pump-out quantities: January 5, 2011: 4,064.74 gallons deliver to Orleans Treatment Plant. February 25, 2011: 1,575.53 gallons deliver to Orleans Treatment Plant. March 18, 2011: 3,916 gallons delivered to Yarmouth Treatment Plant March 30,2011: 2,459 gallons deliver to Yarmouth Treatment Plant. Total: 12,015 gallons Water Usage from Hyannis Water System: December 21, 2010 to January 24, 2011: 46,500 gallons January 25, 2011 to February 25, 2011: 34,500 gallons February 26, 2011 to March 22, 2011: 15,700 gallons Total: 96,700 gallons I Number of Vehicles Washed: January: 3,495 February: 4,911 March: 3,724 Tank/Pit Capacity; #1 Wash Filter: 990 gallons with additional "Emergency" 448 gallons 42 Wash Settle: 1,110 gallons 505 gallons #3 Rinse Settle: 13110 gallons 505 gallons #4 Rinse Filter 1: 990 gallons 448 gallons #5 Rinse Filter 2: 1,110 gallons 505 all Totals: 5,310 2,400 gallons #6: Backwash and Emergency Holding 4,400 gallons !'/tit_ i� �l/0 j�S. U✓G I Telephone Notes to the File Date: March 31, 2011 Re: Auto Bath of Cape Cod Cynthia Martin, PHD Cheri, Oceanside Septic Service As a follow up to copies of receipts received form John Murray, owner of Auto Bath of Cape Cod, I called Oceanside Septic Services for pump-out quantities. The following verbal information regarding quantities pumped from Auto Bath was obtained: January 5, 2011: 4,064.74 gallons deliver to Orleans Treatment Plant. February 25, 2011: 1,575.53 gallons deliver to Orleans Treatment Plant. March 18, 2011: 3,916 gallons delivered to Yarmouth Treatment Plant or<pL TP March 30, 2011: 2,459 gallons deliver to Yarmouth Treatment Plant.or4 -T� -/-e, L Reportedly the "dump" slips are forwarded to the Boards of Health from the Treatment Plants. ' 8;<;E;•• f �y�} yy ; � (r:1(.a• 'a'qqn.�;,'-,..:`; "'{.1 f(,{:g ;���1§y:1'� .. I _ ':, f((•� `�8 aj1�,.�!I1a�} ��.adifd���. .Y }!I}tt; ,;IIhE 1. gvo,i, rtgv. ur.n y y.�,'i. �..''•".... �,•'f. `U f }(,:'diFS }ilYllr d3i: e•r,.r a ! - - �1 VIE, m .a;. hi.. •� co �( R I C7:' q .i '.' •(�;`.�; i..r Y nvwal�'ar r:�:: .I�4i�. .il U9 '7P'.'• �::C;E r ,. ;1&i.}�i •f11' { vl—' I { _, :i"1idi6 yi •.' � � � f;1E11i, r r,�• ,µ..,, .y` v.•. i� r.. O , I :iiiii ;. wi .. �� :111}Ya; s'!hod. f9a7. 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" � a��a ___ ••j �'L 1 , } 41 '{}ill '�}R- mldAif��1'?`y � r1:f1A1r •� .�, - .°� � ■ rani' ' iia�-.y�:+q is �,,d,�., � ; i i rota ,• �•i..a^1„�' 6Jr, i " i�j`�ii} „�1 �i1'eei •�y1 'Frir��� i �° i.";;tiij �i' o_ " \S 'C+1 r :� ij(�ki= �.;uliyi' ,�•I' -a .�� ..^91 __ •�`� 1''r• .:CA 1 �:• .,: .. ��: .''• All': �?; �i �. . m 'I. tiiid Wd6Z:TT ZZOZ 20 'add ZT2T 062 80S: ON Xd.:l W31SAS d31dM SINNUAH: WOd-d 15M2554482 TRITOWN SEPTAGE FACIL 14:05:35 04-07-2011 1!4 TRI-TOWN SEPTAGE TREATMENT FACILITY FAX COVER SHEET DATE: ` l TIME: T 5 FROM: i' NAME COMPANY: TRI-TOWN4EPTAGE TREATMENT FACILITY ADDRESS: P.O. BOX 2773, 29 OVERLAND WAY ORLEANS, MA 02653 FAX: (508) 255-4482 PHONE: (508) 255-41.90, (508) 255-1150 EMAIL: tritownplant®verizon.net TO.- NAME COMPANYCi. ADDRESS CITY STATE ZIP FAX (SbY) .� 9D `tG ?J Q PHONE ( ) MESSAGE: 1 Transmitting a total of pages including this page. If not received, please contact us immediately. Thank you. 15082554482 TRITOWPI SEPTAGE FACIL 14:05:42 04-07-2011 2 M �;�r a S .DE _ c� ,17ri-Town Septage Treatment Facility N_ l .SEPT ��Rvl 'L 29 Overland Way P.O.Box 2773 I t R, MA Orleans,MA 02653 Date. (508)2564190 Account No. j`_+�i-1.`_ h a ? Invoice No, p g 2 91 l t :_, Ticket No. f f,q2q 0 j Weighmaster Vehicle No. :40ij Time 40 Gross weight 9 '�00. Tare weight14i Net weight Signature -� Gallons r Total Payment Due Terms:Payment is due 30 days from the date of this invoice. Finance charge is 18%yearly on past due invoices. HAULER COPY:White DISTRICT COPY:Yellow Ua V 4 z C~ o y Q< z y O U ? O y W O > a — o o � f O y ct, C w CL _o' ?a w U n 3 ° � ow .r h r z u o a y 3 a E O a $ w o0 0 ❑ a v a ° U ° a a E o a. Z a D o. ci y M o n Q avi r° c ° R T Q O T r✓ a c a s se y Y Tri-Town-Septage Treatment Facility ' N co Driver Signature n a O � /. CIL £ + N ruler - ORIGIN OF'SEPTAGE � °' ` , :Z a, _ ' s " tom-- .» ^ o ddress of Property:No. J - C1RCi.E ONE. y - o Provincetown `- Brewster z )deans Truro N Ea_stham z A Harwich Weilflee n Chatham Other r _ > x C t BILLING INFORMATION tr zy w71 rT .� Name of Property Owner�-- O eD ro riate) •'• r n ZS Business Name{if app p a ao O Person Requesting Pumping w g FF 5R m Billing Address m 000. Code 0 `� � �' - • �, �0'Q Town/State/'Lip y a 1— a, Local Telephone Number eo yam , Aso PUMPING I ATION -� F 0 = w o Blockage�f overflow— l7 ^� Reason 1'or Pum in Mai enance < o eCp t a..' w Estimated Gallons Pumped Date Pumped -. vetted Cesspool r— Cesspool --- - ? S. �• o Septic'Cank__i--- L' Tank Grease Trap �--4 y C7 Holding — 0 R!R c' Leaching Pit --- Approval G o Grease CD Grease Load ; A p � Tank number(s)properties w/multiple tanks_�� o Z N OFFICIAL USE ONLY C7 (f Receiver i 1V Date Septage Recv'd �'� f— _ ColorOdor/Etc. pH -- Manifest Number 0 J }J W Actual Gallons Pumped R 9 n—.-rtv ID Number or Sticker� — - Tri-Town Septage Treatment Facility Ul Hauler !�._ S- Driver Signature `.e, ? °D ORIGIN OF SEPTAGE be�' Rr c t�Zh Address of Property: No.� Street � _S G7 r n C. m tint�z 22 CIRCLE ONE H +Gcn o Orleans Brewster'" Provincetown ra crn a z W m Harwich Eastham Truro Chatham v tD -V G1 Wellfleet .� t�-�00 N N —f T era«cc� rs,w Other-4 r CD ro PQ n >r H o o Ca n.:,kn rn BILLING INI.ORMATION B CO Name of Property Owner m Business Name(if appropriate) Q h b, y H m O oo Person Requesting Pumping o. o Billing Address Town/State/Zip Code �Ly, yo "� " Local Telephone Number 13 y ,b M `gam ID PUMPING INFORMATION C (D g. z t� Iwo A Reason For Pumping: Maintenance� OverFlow Blockage Date Pumped A v 3 Estimated Gallons Pumped „C ; �- . r n a Nil Septic Tank . Cesspool Converted Cesspool Leaching Pit Holding _ -A Tank Grease Trap t° 1 '� Grease Load _ Grease Approval m Tank numbers)properties w/multiple tanks r. C G N o 1•J OFFICIAL USE ONLY, t..14 ', © in Date Sept age Reev'd ocDReceiver PH ColorOdor/Etc._ A Actual Gallons Pum co Pcd��._1 Manifest Number 0 Property ID Number or Sticker Rev 7/09 AUT- OBATHJohn W.Murray,Jr. Proprietor of Caeca Cod 551 Yarmouth Road y :IOT Hyannis,MA 02601 I' Office:508-778-2828 _ L Cell:508-776-1216 Email:jwm@autobathcc.com www.autobathcc.com 4 OCEANSIDE SEPTIC SERVICES PO BOX 1306 BREWS'IT R MA 02631 W W W.00EANSIUESEPTICSERV ICES.C:OM 508 896 15.13 DATE NAAIE� PHONE STREET [ �aAmawb CITY% TIME TANK LOCATION SEPTIC'.TANK CESSPOOL LEACH FACILITY . DBOX GREASE SNAKE LINE RISER TEE WATERBLAST BACKFLUSH ROTOR-ROOT CAMERA OTHER MAINTENANCE FREQUENCY RECOMMENDATION 1 YEAR 2 YEAR 3 YEAR TOTALS r� PLEASE CALL'CHER.I IN TI- :1, OFFICE WITH ANY QUESTIONS OR CONCERNS.CUS I OMER SATISFACTION&RELATIONS IS OUR HIGHEST PRIORITY AT OCEANSIDE SEPTIC SERVICES. WE SINCERELY,THANKYOU 24 HOUR EMERGENCY SERVICES 508 237 6874 t%j FAX 774 323 0178 x rn tl OCEANSIDE SEPTIC SERVICES PO BOX 1306 BREWS]'E:R MA 02631 W W W.00EA.NSIDESEPTICSEiRV ICES.COM 508 8961513 DATE w 1247 NAME, Le _Y.IiONE STREET 1�L t C:.1\Vn-( �CCITY a ,rn I Z 1 TIME _TANK LOCATION _SEPTIC TANK _CESSPOOL _LEACH FACILITY DBOX _GREASE_SNAKE LINE VRISER_TEE_WATERBLAST _BACKFLUSH ROTOR-ROOT_CAMERA OTHER MAINTENANCE FREQUENCY RECOMMENDATION 1 YEAR 2 YEAR_3 YEAR i TOTALS $ DD Aj PI.EAS.E CALL CHER.I IN 111F, OFFICE WITH ANY QUESTIONS OR CONCERNS:°CUSTOMER SATISFACTION&RELATIONS IS OUR HIGHEST PRIORITY AT OCEANSIDE SEPTIC SERVICES. WE SINCERELY THANK YOU 24 HOUR EMERGENCY SERVICES 508 237 6874 FAX 774 3230178 a s • • t i. i OCEANSIDE SEPTIC SERVICES PO BOX 1306 BREWSTER MA 02631 W W W.00EANSIDESEPTICSERVICES.COM 508 8961513 1 J DATE 4 NAME PHONE STREET TY i TIME TANK LOCATION SEPTIC TANK _CESSPOOL LEACII FACILITY DBOX _GREASE_SNAKE LINE_RISER_TEE_WATERBLAST l _BACKFLUSH ROTOR-ROO'T_CAMERA�O"CHER MAINTENANCE FREOUENCY RECOMMENDATION —1 YEAR 2 YEAR_3 Y.EAII TOTALS $ n(--)k MIN PLEASE CALL CH.ERI IN THE OFFICE WITH ANY QUESTIONS OR CONCERNS. CUSTOMER i SATISFACTION&RELATIONS IS OUR HIGHEST PRIORITY AT OCEANSIDE SEPTIC SERVICES. WI!:SINCERELY THANK YOU 24 DOUR EMERGENCY SERVICES 508 237 6874 FAX 774 323 0.178 f f Flynn, Judith Wt. Crocker, Sharon Monday, December 08, 2014 4:31 PM To: Flynn, Judith Subject: RE: Letter-Septic Failure 551 Yarmouth Rd, Hy FYI, I received call today from New Owners (see below) and I put a note in the comments in db Septic Inspection. New owners, Balise, General Mgr Tony DeBar_rossccalled 12/8/14, cell 617-721-0038, will have core. request a BOH extension. Currently, the facility is,�non= operational 5teris:shut-off.!LGwners must dec_ide-what-0 do'-with now tt hat they realize'it'needs'so•mueh;septic;work:=sly fioev'0'2C SS A gate C a-,� S /At I 1 • Town of Barnstable Barnstable Regulatory Services Department BM s639. Public Health Division � B 200 Main Street, Hyannis MA 02601 200� SECOND NOTICE Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2851 4006 December 4, 2014, Scallop LLC PO Box 264 West Hyannisport, MA 02672 • The septic system located at 551 Yarmouth Road, Hyannis,MA was last inspected on 6/24/2014 by Joseph Martins, a certified septic inspector for the State of Massachusetts. The Health Division has determined that the system"Failed" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: • Backup of sewage into facility or system component due to overloaded or clogged SAS. You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH i Thomas McKean, R.S. CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\551 Yarmouth Rd Hy Jul 2014.doc I tic i Town of Barnstable Barnstable Regulatory Services Department AHMwkaCft i MASS� Public Health Division �- . 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL 7012 1010 0000 2851 4082 -" July 9, 2014, -G Scallop LLC ti PO Box 264 y West Hyannisport, MA 02672 6 The septic system located at 551 Yarmouth Road, Hyannis, MA was last inspected on 6/24/2014 by Joseph Martins, a certified septic inspector for the State of Massachusetts. The Health Division has determined that the system"Failed" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: • Backup of sewage into facility or system component due to overloaded or• . clogged SAS. You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH omas McKean, R.S. CHO Agent of the Board of Health i Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\551 Yarmouth Rd Hy Jul 2014.doc i 3 ! v JE htkp;Jjissgl2jintranetjpropdatajParcelDetaiLaspx7ID=23554 Live Search p Application center(3) ®Application Center(2) ®http--www,town,barnstable,,, 9 Application Center Suggested Sites• Web Slice Gallery ' avorites ®Parcel Detail a ' kiH •• r - v°4Q _�. UF t Own4 MASS. Logged A ParcelTuesday, Detail Parcel!gLkup T Parcel Info a Parcel Developer a ID 345-002-001 Lot LOT 1,2&3 r ' Location 551 YARMOUTH ROAD I Frontagel I � 9 i , Sec Sec , Road Frontage - -- Fire "i dtfiage HYANNIS JHYMINIS District Town sewer exists at this address Road Index 1890 No Asbuilt Septic Scan: Interactive ; 345002001_1 Map -tail,4I 3450020012 WIT v Owner Info . 1' 4 Owner SCALLOP LLC co-Owner %BALISE CAPE COD PROPERTIES Streetl 122 DOTY CIRCLE I Street2 City IWEST SPRINGFIELD I State NIA Zip 01089 Country I, a ,1 T Land Into - Acres 0.64 Use CAR WASH Zoning Nghbd CI09 -- j;[]l�I!� � Local Intranet ��. 100°l0All _ ---- -- - - -- - - -- r Start ,!j o Parcel Deta1 Windows I,,, Computer name : HEALTH899JF User name : flvnni Operatinq System : Windows NT (5.1) yI. °Flynn, Judith om: Crocker, Sharon vent: Monday, December 08, 2014 4:31 PM To: Flynn, Judith Subject: RE: Letter- Septic Failure.551 Yarmouth Rd, Hy' FYI, I received call today from New Owners (see below) and I put a note in the comments in db Septic Inspection. New owners, Balise, General Mgr Tony DeBarros called 12/8/14, cell 617-721-0038, will have corp. request a BOH extension. Currently, the facility is non- operational, Water is shut off. Owners must decide what to do with now that they realize it needs so much septic work.-slc • 1. �. �` �`� • . � ' 4----� v f, ..0 ri rq OFFICIAL u7 CCD Postage $ ru y 0� Certified Fee ! O d C3 rJ v Postmark~ Return Receipt Fee / N Here ty M (Endorsement Required) ( c»C Un Restricted Delivery Fee { p (Endorsement Required) Qt �o \�y Total Postage&Pees $ lp r� M1 CGM Realty Trust PO Box 518 Osterville, MA 02655 Certified Mail Provides: n A mailing receipt n A unique identifier for yourlmailpi e n A record of delivery kept by the Postal Service for two years Important Reminders: e Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. o Certified Mail is not available for any class of international mail. e NO I1`4SURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when.making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 ; • https://tools.usps.com/go/TrackConfinnAction.action?tRef=fullpage&tLc=1&text28777=&tLabels=70121010000028511661 English Customer USPS Mobile Register I Sign In / Service VSpl com Search USPS.com or Track Packac Quick Tools Track Ship a Package Send Mail Manage Your Mail Shop Business Solutions Enter up to 10 Tracking A Find Find USPS Locations Buy Stamps Sc d I Customer Service) C C .TraCkIngM Have questions?We're here to help. pLoo o ..-... Hold Mail .. -....... ..... __._ Change of Address Tracking Number:70121010000028511661•? i I Requested label is archived. i Restore Archived Details> 1 i Product & Tracking Information Available Actions I . Postal Product: Features: Certified Mail- ' r_ ° � = 4- j January 21,2014, ' y 11:35 am Delivered HYANNIS,MA 02601 i I_...__ _.._..-..... .� - _ __.....___ ... _ ....._ ..... .............. • Track Another Package 3 i What's your tracking(or receipt)number? i Track It LEGAL ON USPS.COM ON ABOUT.USPS.COM OTHER USPS SITES Privacy Policy> Government Services> About USPS Home) Business Customer Gateway> Terms of Use) Buy Stamps&Shop) Newsroom> Postal Inspectors> FOIA> Print a Label with Postage> USPS Service Alerts> Inspector General> No FEAR Act EEO Data; Customer Service) Forms&Publications> Postal Explorer) Delivering Solutions to the Last Mile> Careers) Site Index) MUSPSLO" I Copyright©d014 USPS.All Rights Reserved F https://tools.usps.com/go/TrackConfirrnAction.action?tRef=fulipage&tLc=1&text28777=&tLabels=701210100... 3/12/2014 r EVE Town ®f Barnstable Barnstable Regulatory Services Department 1�'��j r snxxsrnsILIA t.� MASS ,m� Public Health Division I. 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard Scali,Interim Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2851 1661 i January 13, 2014 CGM Realty Trust PO Box 518 Osterville, MA 02655 IMPORTANT NOTIC Map & Parcel 307-240 The Department of Public Works informed us that public sewer lines are now available in your neighborhood. According to our records, your property has a septic system. This letter directs you to connect your dwelling, at 51/55 Nautical Way, Hyannis, MA, to public sewer on or before 7/30/2019. The old septic system must be either removed or filled in due to future safety concerns. This may be done by the same contractor who connects you to the sewer. Septic Abandonment Permits ($ 25) are issued at the Public Health Division, 200 Main Street, Hyannis. Failure to comply with this Board of Health Order may result in a complaint against you, in a court of law. For additional information pertaining to the sewer connection, please see enclosure R ORDER OF THE B ARD OF HEALTH Thomas . McKean, R.S., C.H.O. Agent of the Board of Health Eric Q:\SEWER connect\Sample order letters for sewer connection\51 Nautical Way Hy Jan 2014.doc Parcel Detail http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=24780 w 1 E : g .. BARN9T any bLhSa Logged In As: Parcel Detail Monday, January 13 2014 Parcel Lookup Parcel Info Parcel 1307-240 ) Developer LOT 4 ID Lot Pri Location 151 NAUTICAL ROAD Frontage 100 —_ _ Sec ______.._ ___ __._ Sec Road Frontage Fire VillageHYANNIS T Distri t IHYANNIS Town sewer exists at this Road LLry address N0 Index' 10 Asbuilt Septic Scan: Interactive 307240_1 p u , .. ,, Owner Info Owner(CGM REALTY TRUST _ Co-(� Owner is StreetlP O BOX 518 Street2 � City;OSTERVILLE Statej A Zip.02655 Country Land Info Acres 10.18 Use lTwo Famil Zoning ERB Nghbd[0105 Topography Level —' Road Paved Utilities(Public Water,Gas,Septic Location Construction Info Building 1 of 1 Year,, —-- Roof Ext; 1971 Gable/Hip ( Wood Shingle Built Struct Wall - LivingRoof �� AC 12160 Asph/F GIs/Cmp ;None Area=- Cover Type Style Duplex Int Drywall I Bed Wall Rooms 14 Bedrooms ' _ __ Int I__. _ —_ _ Bath r-___._.._..._.___..._ «. lt Model lResidential j Carpet 2 Full Floor Rooms _ -� Heat - Total _— Grade Average Type Hot Air Rooms I8 Rooms :us 40 Heat Found-• Stories�2 Stories Fuel[—Gas ---- ation Poured Cone • Gross http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=24780 1/13/2014 https:Htools.usps.com/go/TrackConfirmAction.action?tRef=fullpage&tLc=1&text28777=&tLabels=70121010 00 002851.1661� a English Customer USPS Mobile Register/Sign In Service ausps.cm Search USPS.Com or Track Packac Quick Tools Track Ship a Package Send Mail Manage Your Mail Shop Business Solutions Enter up to 10 Tracking t Find Find USPS Locations Buy Stamps SC C."" r Tracking TM Customer Service Cal ul Have questions?We're here to help. Hold Mail _„ Change of Address Tracking Number:70121010000028511661 i Requested label is archived. i Restore Archived Details > i 1 Product & Tracking Information Available Actions Postal Product: Features: Certified Mail" s January 21,2014, Delivered HYANNIS,MA 02601 11:35 am .... _ ......... - .........-._..- ... .....__ ------------------- Track Another Package i What's your tracking(or receipt)number? Track It ........ . C LEGAL ON USPS.COM ON ABOUT.USPS.COM OTHER USPS SITES Privacy Policy> Government Services, About USPS Home> Business Customer Gateway> Terms of Use, Buy Stamps&Shop, Newsroom) Postal Inspectors, FOIA, Print a Label with Postage USPS Service Alerts> Inspector General, No FEAR Act EEO Data, Customer Service, Forms&Publications, Postal Explorer> Delivering Solutions to the Last Mile> Careers> Site Index> IlCoNf Copyright@ 2014 USPS.All Rights Reserved. • https://tools.usps.com/go/TrackConfirmAction.action?tRef=fullpage&tLc=1&text28777=&tLabe1s=701210100... 3/12/2014 TOWN OF BARNSTABLE LOCATION S Is'�v`s '� � SEWAGE# �Z© tO v 1�t VILLAG 'ASSESSOR'S MAP&PPARCEL 3YS'.001-00 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type)' 1eN (�Cm�tsize) NO.OF BEDROOMS V ' .. r mraS 10 3 0� J I Sb GPO OWNER PERMIT DATE: TM COMPLIANCE DATE: ' 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 G N 1 fly u l tv C� . G(l) No. ,., Fee too r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: .Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Application for Veposal &-pstem Construction permit Application for a Permit to Construct( ) Repair(,,-,Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. SS t 1/Ceflyl(�jF ner's Name,Address,and Tel.No. ll Assessor's Map/Parcel A p - .N. In Her's Name,Address,and Tel.No. Sos-q(aovs� Designer's Name,Address,and Tel.No. c�vsl�s A 'k�tdwra TNL_ F,�S�Neer;.NSWC11VS Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building CrAr WC-f No.of Persons Shower ( ) Cafeteria( ) Other Fixtures 0 0-n2p Iu IT �u 6— Design Flow(min.required /5-D gpd Lesign flow provided 9 Ll� gpd Plan Date S Number of sheets `' Revision Date Title _ Size of Septic Tank 11 Uvfi Type of S.A.S. Description of Soil a Nature of Repairs or Alterations(Answer when applicable) t 05rt A L.L of W S. A• S 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 Boar a th. Si Date �} Application Approved by Date Application Disapproved by Date for the following reasons Permit No.L Q v Date Issued o No. '� o r .., .:c_, g. ..—.�-�d: Fee /VU i j Y THE COMMONWEALTH OF MASSACHUSETTS 'Entered in computer: PUBLIC HEALTH DIVISION - TOWN'OF-BARNSTABLE, MASSACHUSETTS es 1plication for bisposat6pStem Construction Permit Application for a Permit to Construct( ) Repair( grade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. C� , � f M� h k� �ner's Name,Address,and Tel.No. Assessor's Map/Parcel A ) 395"- — G r In!st�aller's Name,Address,and Tel.N'o�;^ SC7$-y(�p-'y/g? r Designer's Name,Address,and Tel.No. 1�U-)S�c S rl �jlU' lA�l� _1-� FN51 N C P/1'V� wo(� S `' Y77�SzJ/ Type of Building: y Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building (t'f wG f No.of Persons _ Showers( ) Cafeteria( ) Other Fixtures 0 F �^ �c �( /�G r.����r <-'-t 86—?4 4' J Design Flow(min.required) �S� gpd Design flow provided a�I�(, I gpd Plan Date s''f] ) Number of sheets Revision Date Title Size of Septic Tank P i1� 00 e7, un Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) ) j`l A M e Lo S, A, 5 Date last inspected: Agreement: The undersigned agrees to ensure the construction an�`d 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 r Compliance has been issued by this Boar (-Health. Sign Date Al 8 ' "Application Approved by -„�, i`4 _Date 4. e Application Disapproved by Date for the following reasons Permit No.?G y Date Issued o THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( graded( ) Abandoned( )by JsaJ�►Gq l`XC)u)tfJ.�NC at (MGyf L, C ) t kJ Gn1nU's has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer ,_09,xI G s A k" (cam.,) Z rJ Designer (U WnAC #bedrooms Approved design flo 94ci. I gpd The issuance of s ermit shall not be construed as a guarantee that the system will un t' n as designed. Date v Inspector tvJ ,L�i.X --------------------- --/----- _ .a_ -_ No. d �� ' I / --— — - Fee w_ - THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposaf 6pstrm Construction hermit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at \1,,t(M cj r\a v tJL^1 rd I c 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:Co truction must be completed within three years of the date of this permit.o Date �„ 2 Approved by � , 72 i�2�ZT0WN a BARNSTABLE LOCATION SVA .. J��Cfit/�.S SEWAGE # 6 VILLAGE 11YANit!/S ASSESSOR'S MAP & LOT.1 yS.'L6er-vZ INSTALLER'S NAME & PHONE NO.1eAy/yivw,0 T/LD/° y77'-33�� ZSEPTIC TANK CAPACITY �DOU GAL— /,/-,Z CJ EACHING FACILITY:(type) lo/r 4000 641- (size)�� /� -at0 NO.OF BEDROOMS kVA1Z PRIVATE WELL OR PUBLIC WATER/V/91-/C BUILDER OR OWNER •S14NOW161 DATE PERMIT ISSUED: /,;2 �G DATE .COMPLIANCE ISSUED: /;? " ;Z VARIANCE GRANTED: Yes No )X D' t „ V a� n —` ' THE COMMONWEALTH OF MASSACHUSETTS ly BOAR® OF HEALTH ...............OF.....!)/. �!1110-120�.1...:..I�( .......:.......:...__ Appliratinn for Dispas al Hlorks Tonstrudiou 'llamit Application is hereby made for a Permit to Construct An or Repair ( ) an Individual Sewage Disposal System at L atio Add es o Lot No. __............. ��i�-L /� ,,ter U..... Owner Address Installer Address Type of Building r>i'�� �GRO f j Size Lot._ / -'� ..Sq. feet 4 U Dwelling—No. of Bedrooms................................ _Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures ...................................................... W Design Flow............................�,.'�__..._..gallons per person Der day. Total daily flow____ ........gallons. R: Septic Tank—Liquid capacity/V'.�..gallons Length_ _' .. Width...4/_Y Diameter__.__- -_- Depth___5._2"'�." Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area-----_-_..-__---_--•sq. ft. Diameter.............. Depth below inlet.. .__ Total leaching area. � Seepage Pit No.-------�•-------: ��----- P -- --6�-- g - ----sq. ft. Z Other Distribution box (A Dosing tank ( ) aPercolation Test Results Performed by.... i7 ----------------- Date----- f/ ------ a Test Pit No. 1 1.27...._2minutes per inch Depth of Test Pit-/Z............ Depth to ground water.._._��--_-----. Test Pit No. _ _ _....minutes per inch Depth of Test Pit---- K..._._. Depth to ground water------------------------ O Description of Soil.....—/P./�Y _. -3i [ ,wS�.P3�i�- % �3 !� '�; �aTrAtcr�7�i3��-iC_ _ • . . • • ----------••-- -------•- -•-------•--•••-•-•----•---------••-•-•-•••......--•--•----.-•_.. x .3a Viz" ..................................................iJ � �I" �'+Ls� . U --------------------------------------- 9 /, s� // Z -/414" <e7 f+56�Jby hY 91g'�9�9 R M .......................... ............................................. . _ -----_ �--_ ..__`.__..... ..`4.7/ ..... V Nature of Repairs/for Alterations Answer when applicable------------------------- -_1 .__.... ._..ROGER ° �OEJ/ !�/ 'sc /uCE� L6�G��vrJ� J ti ` �JPAUL Agreement: o� SC�ric ✓�%�re-y l�c�� cc' / L bU1e� ` ✓ / Tti •� °r No. 0420 The undersigned agrees to install the e escri d Individual Sewage Disposal Syste acc the provisions of IIT?,% 5 of the Stat anitary Cod The undersigned further agrees not to pl t operation until a Certificate of Com ance has be ss ed Signe ••. • -•--- Date Application Approved By--•••-•• • ••• - ---- - ----------------------- Date Application Disapproved for the following reasons:-------•-----------------------------------------------------•......-----------••--....._..---••---•---•....._ •--------•-------------------•---....-----...-----....-----------•--------•-------------•--•-•--..........-----•-----------------------------------------------------------------------------------•----- / / Date Permit No........ .•.. Issued-------------------------------------------------------- Date Fuic....... ........ THE COMMONWEALTH. OF MASSACHUSETTS BOARD OF HEALTH ................................................0 F.... Appliration for Disposal Works Tonstrurtion runfit Application is hereby made for a Permit to Construct 00 or Repair an Individual Sewage Disposal System at: W46-0-77-1---- Rez�po� ....................... ................................................................................................. !�. &No. ................................................................................................. owner ddress .......... .......... Installer - I-, Address T Type of Building R Size Lot_----4...*1z..?...0... feet I U Dwelling—No. of Bedrooms...........................................Expansion Attic Garbage Grinder ( Other—Type of Building ............................ No. of persons-------_----------_------- Showers Cafeteria ( Otherfixtures .......................................................................................................................... - --------------e ------------- Design Flow...........................15 _gallons per person der day. Total daily flow____ ........gallons 9 Septic Tank—Liquid capacity—'gallons Length-_- Width._..el..� Diameter__-_-_--2!!n---- Depth...... Disposal Trench—No..................... Width.................... Total Length._.................. Total leaching area--------------------sq. f t. Seepage Pit No---------/......... Diameter........ f--- Depth below inlet.__..STotal leaching area-Z�.71....sq. f t. Z Other Distribution box M Dosing tank ( ) .7 -r_PAI 4C- Date _..__ S........... Percolation Test Results Performed by.....e e.....5,11 Test Pit No. 1.!.............minutes2. perinch Depth of Test Pit-17!.......... Depth to ground water AO-4 izm----------- Test Pit No.,V_.!!��....minutesper inch Depth of Test Pit....Z;�......... Depth to ground water---------------------- ................................................. 7 0---- ---5 0 Description of Soil.....7F................. - -------------------------------------------------------------------------------------------------- �4 3? - !We,-414, eaA0_5,e.. 4� ............................................................................................................................. ................................... U ------------- -------------------------------------------------------- ...... ....................$------- -- . ........ �4 ---------- --- ....fWGER U Nature of Repairs or Alterations—Answer when applicable----------------- A"j PAU L ......................................... ........................ ............. .............f:K .r/ Agreement: CrIl , '7 MIC"NMIEWICZ ./S/Z 0-,,. . 0 No.30420 gr /6", , (,,., r/� The undersigned agrees to install the aforedescribed Individual Sewage Disposal System 1 CW1 IN f1L the provisions of TLITI 5 of the State Sanitary Code— The undersigned further agrees not to pla operation until a Certificate of Compliance has been issued by the board of health. Signed...................................................................................... .. . .................. ... Date ApplicationApproved By....... ............ .............................................. ... _�........... Date Application Disapproved for the following reasons:.............................................................................................................. .........................................................................................................................7.............................................................................. Date PermitNo......... L...........L 1(10---- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7v I- L-- j 7,14 ke c ..........................................OF...... ...............................;.......................................... (Intifiratr of Toutplittitirr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by - - . . ......... �. ...; ......._.. 4..4..1.1.. ..�. ..............VA.-�. ........................................................................... Installer ri / .916 1//j/, /at.......................... ............................................................................................................... has been installed in accordance with the provisions of TI!JZ 5 of The State Sanitary Code as describ in the application for Disposal Works Construction Permit No.._ dated-... .......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL TION SATISFACTORY. DATE................. ................................ Inspector......... ................................................................... DESIGNING ENGINEER MUST SUPERVISE THE COMMONWEALTH OF MASS AdHTu794L-LfsTION AND CERTIFY IN WRITING I AE SYSTEM WAS INSTALLED IN STRICT BOARD OF HEALTH, ,-OCiDANCE TO PLAN. OF.........C........... ..... V _#........................................ No,.:;. ...................................... FEE, ........... Roposal Permission is hereby granted................ .................RAI. .............................. ............................. to Construct or Repair L/ an Individual Sewage yst at No................... .................... ................................................................................ ............................................................ Street as shown on the application for Disposal Works Construction Permit .......... a�,. Dated.._ ............ ......... ............................ Board of Health b(, DATE-------------------- ....L 14.. ... ........................................ FORM 1255 H019BS & WARREN. INC., PUBLISHERS rvO�THEZARX TO�f, V>'J5�2 !:.!✓l�i�.i��TiL61f'Ii(' ��%��%fit" C��t YAsa 0o�a6S MAY `a 02601 COMMISSIONERS: (617) 775-1120 Ext. 123 KEVIN O'NEIL. CHAIRMAN JUHN J. ROSARIO. Vice CHAIRMAN ROBERT L. O-BRIEN fU�QpHTENDCNT TNOMAS J. MULLEN PHILIP C. MCCARTIN H. TERRENCE SLACK June 23, 1986 t Mr Matthew H Cavallini 75 Salten Point Road Barnstable, MA 02630 Re: Hanna Car Wash Systems Proposed Car Wash Yarmouth Road, Hyannis Dear Mr Cavallini: This department has reviewed your request for oil/grease trap pumpings being received at the wastewater treatment plant. Please be advised . that the floatable portion will not be accepted. The clear liquid component below the floatables will be accepted at the wastewater treatment plant and will be subject to an acceptable chemical analysis. The sand/grit portion will not be received at the wastewater treatment plant, but upon separation, may be deposited at the municipal landfill. Should you have any questions please feel free to contact me. Sincerely R RT L R11;N Superintendent WNM/RLO/bw LOC& ION E. PERMIT M0- • U (1 T N '0 FRONT SIDE of 4"x6" 'Vll_LpGE Lei/ ,I A N N. / S card IM5,TALLER'S UNM.E . AOCIRES.S 3 3 DUILOE.R S• W AME. 04 TE PERMIT 155UED :� "., rl ;DIN,"TE. COMPl_ Ak"CE. ISSUSD ; SIZE REVERSE SIDE f SNOW ARP-& FOn ` FU- URIE EXPANSION FOR SYSTEMS WITH PIT . T� �* ` . i NOU5s. .190s1'TIot4 Ojr WE%,L Po81TIMA AT wtu_ FOR SYSTEMS WITH LEACHING FIELDS "..HOUSE Slit roR FUTURE r%XPA►NEION � -1 �, � � c � - � _ �, t �, _ .. �_ � �� J � �� ," z o n ���� �; � ��_.` � o �t ,. �- ` ` 1 , � '� ��-, .. ,�� =� . �- ,�� -; -� - - � y - , Date: zlzo h 2 TOXIC AND HAZARDOUS M TER LS REGISTRATION FORM NAMEOFBUSINESS: BUSINESS LOCATION: MAILINGADDRESS: ,f/ �y ,� Jl' /� ryl Mail To: TELEPHONE NUMBER: U - / Board of Health CONTACT PERSON: Town of Barnstable P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: Hyannis, MA 02601 TYPEOFBUSINESS: As- Gr w/I Does your firm store any of the toxic or hazardous materials listed below, either for sale or for you own use? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Ir G f 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 f,4� Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor & furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids e-- (dry cleaners) Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS 3 ; n TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 2.Printers BOARD OF HEALTH satisfactory 3.Auto Body Shops v O unsatisfactory- 4.Manufacturers COMPANY &4V &A G,/' (see"Orders") 5.Retail Stores ADDRESS G'�`i 6.Fuel Suppliers SSA C18SS: C ' 7.Miscellaneous " ' TAlY�TITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR TERIALS� lam 7&mmmm IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers 1 ' k Miscellaneou : ?c 1 a pJ i"'.5' -So v - �j ��bl•Y-v � � DISPOSAURECLAMATION REMARKS: I 1. Sanitary Sewage 2.Water Supply f S 0 Town Sewer RPublic / .16o y4e*,,, �R'On-site OPrivate t., L,bU o G, 3. Indoor Floor Drains YES--)LNO 0 Holding tank: MDC 0 Catch basin/Dry well '�g On-site system 4. Outdoor Surface drains:YES NO ORDERS: ` 0 Holding tank:MDC U44,( e Catch basin/Dry well 0 On-site system 5.Waste Transporter Name of Hauler Destination Waste ' . � ' ;. YES NO 2. Person (s) Interviewed Inspector Da e •' (� 0 TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory g.A i Boa Shops COMPANY Q ,� � � � C� 0 unsatisfactory- 4.Manufacturersp (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS 5� Class: 7.Miscellaneous QUAkTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Dies Kerosene, (B) Heavy Oils: waste motor oil (C) new motor oil (C) OkA+Otj transmissio ydraulic Synthetic Organics: degreasers Miscellaneous: `I Dku C DISPOSALIRECI AMATION REMARKS: .O"7& f� YS I 1. Sanitary Sewage 2. ater Supply oo oa O Town Sewer C-o Public -��l r '*On-site q j`� OPrivate 3.Ind, or Floor rains YES-X—NO t H:olding tank:MDC 6 0 y0 _ O Catch basin/Dry well a O On-site system d S 4. Outdoor Surface drains:YES-X—NO "a Ar 6 O Holding tank:MDC4 /V O Catch basin/Dry well *On-site system _ . S 5. Waste Transporter Name of Hauler Destination Waste Product v . YES NO 1. r � 2. v Person (s) Interviewed Insp cto ate TOXIC AND HAZARDOUS MATERIALS REGIST Mail FORM ail To: NAME OF BUSINESS: �af � ��� �' B r Health MAILING ADDRESS: ZITown of Barnstable TELEPHONE NUMBER: P.O. Box 534 CONTACT PERSON:�ox Hyannis, MA 02601 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES ��NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: _ TELEPHONE: �� LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered lease put a check beside each product that you store: Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners 1/ Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business 1 MATERIAL SAFETY DATA SHEET NAVY BRAND MANUFACTURING CO. 5111 SOUTHWEST AVE. ST. LOUIS, MO 63110 k 5 � f HEAH LT 2 THE CHAMP � A . r o EMERGENCY TELEPHONE NO. 1-800-255-3924 CHEM-TEL PERSONAL PROTECTION C AND OTHER INFORMATION CALLS: 1-800-325-331 2 1-314-865-5500 SECTION 1``- HAZARDOUS INGREDIENTS OSHA OSHA LISTED AS A HAZARDOUS-COMPONENTS--- , CAS# ACGIH TLV PEL CARCINOGEN IN NTP ;'Sy ODIUHYDROXIDE 1310-73-2 2 M 2 M No SECTI6N::2 PHYSICAL AND CHEMICAL CHARACTERISTICS x`" 1 �` r. ., _ ..eR'.vn'F_ ..4. ....:. .. ', :xKe s).., aµ sR1WNzwy_Y..•.. .. .:. n•u,.a•.m �S.Y.lti of r_ �o.�f �'<R,r.�.+Kra'w. �^ r BOILING POINT ff): NE \ SPECIFIC GRAVITY(WATER=1): '� 1.09 FREEZE POINT(°F): NE ` PERCENT VOLATILE BY VOLUME(%): NE VAPOR PRESSURE(mmHg): UKN 1 EVAPORATION RATE..(BUTYL-ACETATE=1): NE VAPOR (AIR=1): >1pH�(AS=RECEIVED): 14 SOLUBILITY IN WATER: Complete E<,RANCE Arvo 000R: Y-ellow SECTIONS` PHYSICAL=SAND CHEMICAL HAZARDS , U �x "h _ ne � '�' ' ;. .::,.. .�, ., ..>;^-x,+.�a..,::;: �.�,:.:..r•., „, ,:. �� .x$..=, STABILITY: UNSTABLE❑ STABLE HAZARDOUS POLYMERIZATION: MAY OCCUR❑ WILL NOT OCCUR FLASH POINT(METHOD USED): None FLAMMABLE LIMITS(%IN AIR): LEL NA UEL NA EXTINGUISHING MEDIA: Dry chemical or alcohol foam SPECIAL FIRE FIGHTING PROCEDURES: None required CONDITIONS TO AVOID: None INCOMPATIBILITY(MATERIALS TO AVOID): Aluminum, tin, lead, zinc, acids, leather & wool , HAZARDOUS DECOMPOSITION PRODUCTS OR BYPRODUCTS: Carbon Dioxide, Carbon Monoxide 9 arcz..3 SECTIO A ;; Rr'e , =2ru� N 4 SPECIL P ROTECTION; INFORMATION x � h.w VENTILATION TYPE: Use in well ventilated area RESPIRATORY PROTECTION: None required PROTECTIVE GLOVES: Rubber, Neoprene EYE PROTECTION: Safety Glasses / OTHER EQUIPMENT: Safety shower, eye bath and washing facilities should be available. " 1 PRODUCT:-THE C,HA.MP SECTION.5 = HEALTH HAZARDS n �^ 5t INHALATION: Airborne ;concentrations of dust, mist, or spray may cause damage to the upper respiratory tract and even to the�lung tissue proper which could produce chemical pneumonia, depending upon severity of exposure. Chronic overexposure to spray or mist may result in irritation or tissue damage, and an increase susceptibility to respiratory illness. Remove from exposure to fresh air. Give artificial respiration or cardiopulmonary resuscitation (CPR) if required. If breathing is difficult, give oxygen. Keep warm and quiet. Get medical attention. EVE CONTACT: This material is destructive to eye tissue on contact. Will cause severe burns that result in damage to the eyes and even blindness. Immediately flush eyes with large quantities of water for at least a 15 minute period, periodically lifting upper and lower lids to ensure washing of entire surface. Washing eyes within one minute is essential to achieve maximum effectiveness. Seek medical attention immediately. Contact lenses should not be worn when working with this material. SKIN CONTACT: Immediately wash contaminated skin with plenty of water. If wearing goggles flush head and face thoroughly before removing goggles. Remove contaminated clothing under the shower. This washing may be followed with a rinse with vinegar or dilute acetic acid (3% solution) if available. If skin feels.slippery caustic may be present in sufficient quantities to•cause r,ash or burn, continue washing until slippery''feeling.is gone:. Remove contaminated clothing and footwear and wash clothing before re-use. Discard footwear which cannot.be decontaminated. Seek medical attention immediately. INGESTION: DO NOT INDUCE VOMITING. Give large quantities of water, if available, give several glasses of milk or acidic beverages (tomato or orange juice, carbonated soft drinks). Never give anything by rhouth to an unconscious person. If vomiting occurs spontaneously, keep head below hips to prevent aspiration. Seek medical attention immediately. . SECTION16, . SPECIAL`,PRECAUTIONS AND,SPILULEAK PROCEDURES k µfO�;, �,� HANDLING AND STORAGE: Store in COOT, dry, and well-ventilated area. Keep containers closed. SPILL AND LEAK PROCEDURE: This material is not classified as hazardous waste according to'Federal regulations. Check with your state environmental agency to determine if this material is regulated in any way. No disposal method should be used which would pose an environmental or human health threat including any which would contaminate ground or surface waters. WASTE DISPOSAL: Disposal should be made in accordance with Federal, State and local regulations. OTHER PRECAUTIONS: KEEP OUT OF REACH OF CHILDREN - FOR INDUSTRIAL USE ONLY Wash thoroughly after handling. Wash contaminated clothes before re-use. Launder work clothes separately from family clothes. Check protective clothing, particularly impervious gloves, for leaks before use. .r,._,�,, ,t r n + `„a� ,,q ( ,.�3 �P3.} o zs �. 'i yf, af..a+v SECTION �7 TR/1NsPoRTATjON DATA �� �� $� _ � � s°' ':° � ;r� a' T r.�,v,..m#`.,wY �a .� . DOT SHIPPING NAME: .COMPOUND, CLEANING LIQUID; CORROSIVE.`. DOT CLASSIFICATION: CORROSIVE MATERIAL DOT LABELS: CORROSIVE' UN NUMBER: NA-176O NOTICE: NO REPRESENTATIONS OR WARRANTIES, EITHER EXPRESS OR IMPLIED, OF MERCHANTABILITY, FITNESS FORA PARTICULAR PURPOSE, OR OF ANY OTHER NATURE, ARE MADE WITH RESPECT TO INFORMATION CONCERNING THE PRODUCT REFERRED TO IN THIS MATERIAL SAFETY DATA SHEET. The goal of defining precisely, in measurable terms, every possible health effect that may occur in the workplace as a result of chemical exposures cannot realistically be accomplished. The information and recommendations contained in this Material Safety Data Sheet are supplied pursuant to 29 C.F.R. 1910.1200 of the Occupational Safety and Health Standards Hazard Communication Rule. The information and recommendations set forth herein are presented in good faith and believed to be correct as of the date hereof. NAVY BRAND MANUFACTURING COMPANY, however, makes no representations as to the completeness or accuracy thereof, and information is supplied upon the express condition that the persons receiving same will be required to make their own determination as to its suitability for their purposes prior to use. In no event will NAVY BRAND MANUFACTURING COMPANY be responsible for any damages of any nature whatsoever resulting from the use of, reliance upon, or the misuse of this information. The information as supplied herein is simply to be informative and intended solely to alert the user of the substance which is the subject matter of this Material Safety Data Sheet. The ultimate compliance with federal, state or local regulations concerning the use or disposal of this compound, or compliance with respect to products liability, rests solely upon the purchaser thereof. CODES AND ABBREVIATIONS: A-Safety Glasses F-C+Dust Mask 0-Insignificant NA-NOT APPLICABLE P-ppm B-A+Gloves G-B+Respirator 1 -Slight NE-NOT ESTABLISHED M-mg/M3 C-B+Apron H-F+Goggles 2-Moderate UKN-UNIWOWN D-mp/F 0 D-C+Face Shield I-B+Respirator 3-High PEL-PERMISSIBLE STEL-SHORT TERM E-B+Dust Mask X-Ask Supervisor 4-Extreme EXPOSURE LIMIT EXPOSURE LIMIT DATE:1-7-93 25014 vrd, Afig a MAZER AL• SAFETY DATA SHEETA00 NAVY BRAND MANUFACTURING CO. 5111 SOUTHWEST AVE. ST. LOUIS, MO 63110 FORMULA CCW-25 FLAMMABILITY 0 EMERGENCY TELEPHONE NO. 1-800-255-3924 CHEM-TEL PERSONAL PROTECTION p AND OTHER INFORMATION GALLS: 1-800-325-3312 D 1,314-865-5500 EDIE mg _ OSHA OSHA LISTED AS A HAZARDOUS_CCMPONENFS- , CASH ACGIH TLV PEL CARCINOGEN IN NTP HYDROFLUORIC ACID __ 7664-39-3 i.5 M i5 M No SULFURIC ACID 7664-93-9 1 M 1 M No S11 OWNS G° C EMI` 'C Ate, .. h .. BOILING POINT(•F): 152 ESPEICIFIC GRAVITY(WATEP-0): 1i035 FREEZE POINT rF): NE PERCENT VOLATILE BY VOLUME l%1: 90 VAPOR PRESSURE(nvrft): 70 EVAPORATION-RATE-(BUTYL ACETATE=1):<1 VAPOR DENSITY(AIR=1): 2.0 FAPfPFE:ARANCE-AND-&)OR:--Water-White RECEIVED►: < 1.0SOLLA31UTY IN WATER: Complete liquid, odorless 5T,1�QNY5 ,D CFfEI11C ► D v STABILITY: UNSTABLE❑ STABLE 0 HAZARDOUS POLYMERIZATION: MAY OCCUR❑ WILL NOT OCCUR FLASH POINT(METHOD USED): None FLAMMABLE LIMITS(%IN AIR): LEL NE; LIEL NE EXTINGUISHING MEDIA: Noncombustible product; not applicable SPECIAL FIRE FIGHTING PROCEDURES: Use NIOSH/MSHA approved self-contained breathing apparatus where this product is involved in fire. CONDITIONS TO AVOID: �. .-. _ _ _Closed containers-mayrupture/explode when exposed to temperatures above 1200F._ INCOMPATIBILITY(MATERIALS TO AVOID): This.product will-react with metals, i.e. aluminum, tin and zinc to release flammable hydros nl' _gas. HAZARDOUS DECOMPOSITION �--� PRODUCTS OR BYPRODUCTS: Sulfur Dioxide,-hydrogen fluoride (Poison!) SECTION ; i7Ff OA�PROI,TtECTIO[ NFL RMATId Man+a.,".a-iW^3i e,. s'e VENnLATION TYPE: Sufficient to reduce vapors & mists to below TLV. RESPIRATORY PROTECTION: Vapor respirator PROTECTIVE GLOVES: Premium quality neoprene long gloves covering up to elbows EYE PROTECTION: Chemical Splash Goggles OTHER EQUIPMENT: Face Shield, Safety shower, eye bath and washing facilities should be available. PRooucT: FORMULA CCV-1-25 O � IFT�AZARD INHALATION: Inhalation may cause severe irritation of mucous membranes with nausea, vomiting, headaches, dizziness, drowsiness, coughing, labored breathing, shortness of breath, anxiety, slurred speech, anorexia, weight loss, edema, and convulsions. Contact may cause severe irritation with bums, ulcers, and scarring. Skin absorption may cause systemic effects as described under inhalation, ingestion may cause severe irritation, nausea, vomiting, anorexia, weight loss, anxiety, abdominal spasms, and restlessness. Remove from exposure. Give artificial respiration or cardiopulmonary resuscitation (CPR) if required. If breathing is difficult, give oxygen. Keep warm and quiet. Get medical attention. Ere CONTACT. This material is destructive to eye tissue on contact. Will cause severe bums that result in damage to the eyes and even blindness. Immediately flush eyes with large quantities of water for at least a 15 minute period, periodically lifting upper and lower lids to ensure washing of entire surface. Washing eyes within one minute is essential to achieve maximum effectiveness. Seek medical attention immediately. Contact lenses should not be wom when working with this material. SKIN CONTACT: Immediately wash contaminated skin with plenty of water. If wearing goggles flush head and face thoroughly before removing goggles. Remove contaminated clothing under the shower. This washing may be followed with a rinse with vinegar or dilute acetic acid (3% solution) if available. If skin feels slippery caustic may be present in sufficient quantities to cause rash or burn,continue washing until slippery feeling is gone. Remove contaminated clothing and footwear and wash clothing before re-use. Discard footwear which cannot be decontaminated. Seek medical attention immediately. INGESTION: This material is toxic and may cause damage and systemic poisoning of the following organs; liver, kidney and nervous system, swallowing causes burning pain from mouth to stomach, may be fatal. NOTE TO PHYSICIAN: Exposure to vapors and mist of this product may cause pulmonary imitation,dizziness, and nausea. Prolonged or repeated contact may cause various skin disorders such as dermatitis, folliculitis or oil acne. d• t...4 t K 7MY�Aaryz 4' . .' p kl"�dx1p.�14li.0 Y1�.w Et10 SPEGA GAUTlON D Pt EPROGEDi mra �.L., �ru �+��.:i� 3:s ..�. >, nc �n�Rsur.* rRt .+?rrisa, t HANDLING AND STORAGE: Store in cool, well-ventilated area. Avoid sparks, fire, or open flames and extreme temperatures. SPILL AND LEAK PROCEDURE: Contain spills and leaks to prevent discharge to the environment. Absorb spillage with clay, sawdust, or other absorbent material. Place all spilled material, contaminated sorbent materials, contaminated dirt, and other contaminated material in container for disposal. WASTE DISPOSAL: Disposal should be made in accordance with Federal, State and local regulations. OTHER PRECAUTIONS: KEEP OUT OF REACH OF CHILDREN - FOR INDUSTRIAL USE ONLY Wash thoroughly after handling. Wash contaminated clothes before re-use. Launder work clothes separately from family clothes. Check protective clothing, particularly impervious gloves, for leaks before use. ECTIa TRANSd ATION DATA r�e�+z:�'4c�. an#rt�aRn�P,�'xa�?ast _..�r^ DOT SHIPPING NAME: Hydrofluoric acid solution, not more than 60% strength DOT CLASSIFICATION: Corrosive, Poison DOT LABELS: Corrosive, Poison UN NUMBER: UN 1790 NOTICE: NO REPRESENTATIONS OR WARRANTIES, EITHER EXPRESS OR IMPLIED, OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, OR OF ANY OTHER NATURE, ARE MADE WITH RESPECT TO INFORMATION CONCERNING THE PRODUCT REFERRED TO IN THIS MATERIAL SAFETY DATA SHEET. The goal of defining precisely, in measurable terms, every possible health effect that may occur in the workplace as a result of chemical exposures cannot realistically be accomplished. The information and recommendations contained In this Material Safety Data Sheet are supplied pursuant to 29 C.F.R. 1910.1200 of the Occupational Safety and Health Standards Hazard Communication Rule. The information and recommendations set forth herein are presented in good faith and believed to be correct as of the date hereof. NAVY BRAND MANUFACTURING COMPANY, however, makes no representations as to the completeness or accuracy thereof, and information is supplied upon the express condition that the persons receiving same will be required to make their own determination as to its suitability for their purposes prior to use. In no event will NAVY BRAND MANUFACTURING COMPANY be responsible for any damages of any nature whatsoever resulting from the use of, reliance upon, or the misuse of this information. The information as supplied herein is simply to be informative and intended solely to alert the user of the substance which is the subject matter of this Material Safety Data Sheet. The ultimate compliance with federal, state or local regulations concerning the use or disposal of this compound, or compliance with respect to products liability, rests solely upon the purchaser thereof. CODES AND ABBREVIATIONS: A-Safety Glasses F-C+Dust Mask 0-InsignMcant NA-NOT APPLICABLE P-ppm B-A+Gloves G-B+Vapor Respirator 1-Slight NE-NOT ESTABLISHED M-nxyM' C-B+Apron H-G+Goggles 2-Moderate UKN-UNKNOWN 0-rrW D-C+Facs Shield I-B+Dust 6 Vapor Respirator 3-High PEL-PERMISSIBLE STEL-SHORT TERM E-B+Ouet Mask X-Ask Supervisor 4-Extreme EXPOSURE LIMIT EXPOSURE LIMIT DATE:1 1-03-94 41057 Y Town of Barnstable 914d °Eta� Regulatory Services 'j- I)r Thomas F. GeRer,Director C= C .BARNSTABU. Public Health Division ArfD MA'�A Thomas McKean,Director :�E N) T' .200 Main Street, Hyannis,MA 02601 > Office: 508-862-4644 Fax:..SO$-790-6304 Application Fee: $100.00 q ASSESSORS MAP AND PARCEL NO. -,,3 DA d�-P- Z/-) APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT a"' -e-- NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER SOLE OWNER: YES_NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL 9z IF APPLICANfi IS A CORPORATION: FEDERAL IDENTIFICATION STATE OF INCORPORATION FULL N HO RESS OF: PRESIDENT zrW..e, 6 Id 663 TREASPkER e.- CLERKIRA .� o IG ATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS ADDRESS "b 016 UL),A- is HOME TELEPHONE# !�a Haz.doc/wp/q M , Fee Number THE COMMONWEALTH OF MASSACHUSETTS 354 $110.00 Town of Barnstable Board of Health This is to Certify that Auto Bath of Cape Cod 551 Yarmouth Road, Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------- --------------------------- ----------------------- ------=------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 30, 2009 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/08 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health 0 h r ' C { t y n I d" d t S r 6 c k d _t 1 1131- TO BATH OF`CAPE 551 YARMOUTH ROAD ` 4 U1 a^ 683 . / t' ` ?p J 5 7017/Y110 `,1`p� PAY '� , ,r �• � ,• TO THE' W� ® `b"� \ .a.--✓ .+.\ Q-,�'`�^'�fiC�b `'�,• +"^ 4 '`� OO OV, DOLLARS, ® .'{a" :�y�/0� ,,. a"`y, "� J`' f '*,4f��. t�' J','^. rFc ��,/ • �y.`< `"+ ♦'' r.�SJ a !!',, a '` •� .'<.` f� r -+✓'rs "`r'y`� r �' � '%s.y "'' {r''.�°' ��,,�'.ytr�i'r,aJs'�`!a ! !'`11J4`` .t 41J',,t� 'c, !" � � i ✓y', / /�'�'`r'.'\�. ti,rT�;��a4 j I,� Massachusetts � ♦i �. r +,. °!. 'f !, *, r t < ..•.t ,Y"'� ``., r'/ �' "y .+ T`, y''-,,,rr� ♦� � � f'r�'� , r r V'+ <.,'�,} �.,.•� ''4 j,1i>��� a4!r.s fr `4✓ . ,� 1 Cf� /�`1iJ ,/`+� .�"`f ✓a1,/ _-r "�°.' '� > /< � �., f ,,� � J ` ® ,IF _.R�, ��\1V� > sr ff,•'. S e.L, ,� ,r't� I !,T f t ,f',.`'�,a�. _ ✓ !. �, ` r'• ,J f Nr 1. r' a t�`'t d � '4 � 4, A/s`., h.� J P /`` X". t L+. ✓,a` / w r+,r ,•1 J r ! , l`, ¢ .,.r J'� '; ,/�+..s.� A .,,< \'" ��.��• 1, C�^ f '..,.'..I'� ''�\1 hJ /" '■yh + J. ���• \/ Y ,,. 4'�`f'rt r� 1'Yi \,MY >'. f "�a 4i . r ✓h i�>i r� 00.LL3�� .�.2LL070 L:75 . L3 L015535'' pYt / ru <.l ,r'.,�,-/tom ,r qZ , 1t..,. a, / 1'�. y � /- c r a. r`c. J'�a < J _ r c�r+.>/'a'`^, f t`„l�'� r.°',',1�''> .. M1 r c :' �•, >a',,, ti . . .-,'' ,� • .�:�,". ,.,',�, ,,. .',°*. �,.ti .+',` .r, ✓, .',J.' ,\ " .'', 1, `.>'. .l.`e ``,,� ,1 .!'. it !.`�l.S \"'sti . .�`ti l,`*..'',,', 1. r Town of Barnstable ` Barnstable I' '°�ti Regulatory Services Department o ;erisac i Public Health Division �m + BARNSTABLE. 9� � 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. ..3 Dd�-/0,* DATE l� ode YS' APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT ► fv a, NAME OF ESTABLISHMENTCn ADDRESS OF ESTABLISHMENT S S/ C:) TELEPHONE NUMBER .� U7 SOLE OWNER: L�-KS NO m IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS F ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. OZI- A9Y yya'-�- STATE OF INCORPORATION �-- FULL NAME OME ADDRESS PRESIDENT be.:r '2 TREASURER CLERK C` SIGNATURE O T f r RESTRICTIONS: HOME ADDRESS aid d. rC 4 HOME TELEPHONE# 669-- Q:\Hazmat\Haz Mat Application2008.DOC fit• _. ., t y a��n Jh a e d- d o n t S z,c 6 n c A f d e t n i 1 s of TO BATH OF,'CAPE COD` os 07_ 1131 .551 YARMOUTH`ROAD e, 01 5-7017/2110 DATE c�E. .183 20 683 PAYTO THE1 } h, ORDER OF �'1'� �`. �f e Citizens Bank —'"'— a� Mas3achuzetts <� u'00L',13Lii' i; 2LL070L7 10L55353i i• . 6.1�LiW1lVMICO)(1'^]_el�i,N, Ot .P1IMm .➢mT ¢C+LafRQ L h-11' ii`23*'SL u1�hLIIlTa ipOn JCL , r 5 SPILLS IN CASE OF SPILLS LOG TIME AND DATE, FOLLOW PROCEDURES OUTLINED IN MATERIAL SAFTEY DATA SHEETS ( M.S.D.S.) 4 a T .. �U .......... El Section I-Manufacturer's Information Manufacturer's Name C.A.R. Products, Inc. Manufacturer's Address 630 Beaulieu St. Holyoke, MA 01040 Manufacturer's Phone Number Local 413-536-9900 Toll Free 800-537-7797 Emergency Phone Number Chemtrec 800-424-9300 Product Information C.A.R. Products 800-537-7797 Effective Date 2/l/99 Chemical Name Yellow Polish Foam Protectant DOT Shipping Description Cleaning compound liquid,NOIBN Chemical Family Acidic surfactant blend Chemical Comment This product does not have any chemicals reportable under section 313 of Title III of Sara Chemical Formula Surfactant mixture f Hazardous Materials Identification System (HMIS) FLAMMABILITY HAZARD RATING 0 4=EXTREME 3=HIGH HEALTH 1 0 REACTIVITY '2=MODERATE 1= SLIGHT 0=INSIGNIFICANT PERSONALPROTECTION N/E= Not Established or Unknown N/A= Not Applicable Date Printed: 04/29/08 Yellow Polish Foam Protectant Page 1 of 4 Section II- Hazardous Ingredient Hazardous Component CAS Number Hazardous % TLV (Units) Non-Hazardous Ingredients 100 No ingredients currently regulated as hazardous by 29CFRI910{ Section III- Physical & Chemical Data Boiling Point ff) >2120 Volatility/VOL (%) > 800 Melting Point (°F) N/A Vapor Pressure (mm Hg) N/E Vapor Density (Air= 1) N/E Solubility In H2O Complete Appearance/Odor Yellow liquid, lemon fragrance Specific Gravity(H2O = 1) .1.01 Evaporation.Rate Like water pH 2.40 Section IV- Fire & Explosion Hazard Data Flash Point ff) None Lower Flame Limit N/A Higher Flame Limit N/A Extinguish Media As needed for surrounding fire Special Fire Fighting Procedures None Unusual Fire Hazard May produce flammable hydrogen gas upon contact with reactive metals Section V-Health Hazard Data Routes of Entry Inhalation(mists), skin, ingestion Health Hazards Irritation or burns NTP No IARC Monographs No OSHA Regulated No Threshold Limit Value N/E,blended product. See section II for information on listed ingredients. Date Printed: 04/29/08 Yellow Polish Foam Protectant Page 2 of 4 Section V-Health Hazard Data continued Over Exposure Effects Skin Contact: Irritation or burns. Eye Contact: Burns. Inhalation: Inhalation of mists of product or solutions may cause irritation of .respiratory tract. Ingestion: Irritation of mouth, throat and stomach. Stomach upset, pain, nausea, vomiting, and shock symptoms. First Aid Skin Contact: Immediately flush skin with lots of running water for at least 30 minutes. Remove contaminated clothing and shoes. Wash before reuse. Eye Contact: Flush immediately with large quantities of running water for at least 15 minutes. Consult a physician. Inhalation: If affected, remove individual to fresh air. If breathing is difficult, administer oxygen. If breathing has stopped, give artificial respiration. Keep person warm, quiet and get medical attention. Ingestion: Do not induce vomiting. Call physician immediately. If conscious give lots of water or milk. Do not give anything by mouth to an unconscious or convulsing person. Section VI-Stability & Reactivity Data Chemical Stability Stable Conditions To Avoid Contact with incompatible materials. Incompatible Materials Strong bases, most metals, chlorine bleach Decomposition Products Oxides of carbon, nitrogen Hazardous Polymerization Will not occur Polymerization Avoid_ N/A Section VII Spill or Leak Procedure For Spill Small Spills, less than 1 gallon: Neutralize with sodium bicarbonate(baking soda), soda ash, lime, or general alkaline detergent. Flush to drain with excess water. Large Spills: Only knowledgeable and properly protected people should work with a large spill. Get professional assistance if necessary. Stop source of discharge if safe to do so. Evacuate unprotected personnel. Contain spilled material, and keep from discharging to surface waters. Recover to drum for later use,treatment,or disposal. Recover using acid resistant pump, scoops, absorbent material, or other,process as appropriate. Neutralize contaminated area with sodium bicarbonate (baking soda), soda ash, or lime, and flush to drain.Notify local, state, or national authorities if required. Date Printed: 04/29/08' Yellow Polish Foam Protectant Page 3 of 4 Section VII- Spill or Leak Procedure (cont.) y Waste Disposal Dispose of according to national, state, and local rules. Section VIII- Special Protection Respiratory Protection NIOSH/MSHA approved respirator where conditions may cause exposure limits to be exceeded, including mists. Ventilation' General or local to avoid exposure to irritating mists. Protective Gloves Acid resistant, impermeable. Eye Protection Goggles and/or face shield. Other Protection Acid resistant, impermeable apron and shoes. Section IX-Special Precautions Keep out of reach of children. For industrial or institutional use only. Disclaimer: This information is, to the best of our knowledge, current, accurate, and complete as of the date of this document. However, we make no representation as to its accuracy. Such information may not be accurate when product is used in any process or combined.with other materials. In certain circumstances additional information may be necessary. No representation(s), guarantee(s), or warranty, either expressed or implied, or of any nature, is made with respect to the product or data provided. -End of document- Date Printed.: 04/29/08 - Yellow Polish Foam Protectant Page 4xof 4 f x Section 1-Manufacturer's Information Manufacturer's Name C.A.R. Products, Inc. Manufacturer's Address 630 Beaulieu St. Holyoke, MA 01040 Manufacturer's Phone Number Local 413-536-9900 Toll Free 800-537-7797 Emergency Phone Number Chemtrec 800-424-9300 Product Information C.A.R. Products 800-537-7797 Effective Date 2/l/99 Chemical Name Blue-Polish Foam Protectant DOT Shipping Description Cleaning compound liquid,NOIBN Chemical Family Acidic surfactant blend Chemical Comment This product does not have any chemicals reportable under section 313 of Title III of Sara Chemical Formula Surfactant mixture Hazardous Materials Identification System(HMIS) FLAMMABILITY HAZARD RATING 0 4=EXTREME 3=HIGH HEALTH. 1 O REACTIVITY 2=MODERATE 1= SLIGHT 0= INSIGNIFICANT PERSONAL PROTECTION g❑ N/E= Not Established or Unknown N/A= Not Applicable Date Printed: 04/29/08 Blue Polish Foam Protectant Page 1 of 4 Section II- Hazardous Ingredient ' Hazardous Component CAS Number Hazardous % TLV (Units) Non-Hazardous Ingredients 100 No ingredients currently regulated as hazardous by 29CFR1910. Section III- Physical & Chemical Data Boiling Point ff) >2120 Volatility/VOL (%) > 800 Melting Point ff) N/A Vapor Pressure (mm Hg) N/E Vapor Density(Air= 1) N/E Solubility In H2O Complete Appearance/Odor Blue liquid, pina colada fragrance Specific Gravity (H20 = 1) 1.012 Evaporation Rate Like water pH 2.32 Section IV- Fire & Explosion Hazard Data Flash Point (°F) None Lower Flame Limit N/A Higher Flame Limit N/A Extinguish Media As needed for surrounding fire Special Fire Fighting Procedures None Unusual Fire Hazard May produce flammable hydrogen gas upon contact with reactive metals Section V- Health Hazard Data Routes of Entry Inhalation(mists), skin,ingestion Health Hazards Irritation or burns NTP No IARC Monographs No OSHA Regulated No Threshold Limit Value N/E, blended product. See section II for information on listed ingredients. Date Printed: 04/29/08 - Blue Polish Foam Protectant Page 2 of 4 Section V-Health Hazard Data continued Over Exposure Effects Skin Contact: Irritation or burns. Eye Contact: Burns. Inhalation: Inhalation of mists of product or solutions may cause irritation of respiratory tract. Ingestion: Irritation of mouth, throat and stomach. Stomach upset, pain, nausea, vomiting, and shock symptoms. First Aid Skin Contact: Immediately flush skin with lots of running water for at least 30 minutes. Remove contaminated clothing and shoes. Wash before reuse. Eye Contact: Flush immediately with large quantities of running water for at least 15 minutes. Consult a physician. Inhalation: If affected, remove individual to fresh air. If breathing is difficult, administer oxygen. If breathing has stopped, give.artificial respiration. . Keep person warm, quiet and get medical attention. Ingestion: Do not induce vomiting. Call physician immediately. If conscious give lots of water or milk. Do not give anything by mouth to an unconscious or convulsing person. Section VI-Stability& Reactivity Data Chemical Stability Stable Conditions To Avoid Contact with incompatible materials. Incompatible Materials Strong bases, most metals, chlorine bleach Decomposition Products Oxides of carbon, nitrogen Hazardous Polymerization Will not occur Polymerization Avoid N/A Section VII-Spill or Leak Procedure For Spill Small Spills, less than I gallon: Neutralize with sodium bicarbonate (baking soda),soda ash, lime, or general alkaline detergent.Flush to drain with excess water. Large Spills: Only knowledgeable and properly protected people should work with a large spill. Get professional assistance if necessary. Stop source of discharge if safe to do so. Evacuate unprotected personnel. Contain spilled material, and keep from discharging to surface waters. Recover to drum for later use, treatment, or disposal. Recover using acid resistant pump, scoops, absorbent material, or other process as appropriate. Neutralize contaminated area with sodium bicarbonate(baking soda), soda ash, or lime, and flush to drain. Notify local, state, or national authorities if required. Date Printed: 04/29/08 Blue Polish Foam Protectant Page 3 of 4 Section VII- Spill or Leak Procedure (cont.)~ , Waste Disposal Dispose of according to national, state, and local rules. Section VIII- Special Protection Respiratory Protection NIOSH/MSHA approved respirator where conditions may cause exposure limits to be exceeded including mists. r Venr_ilation General or local to avoid exposure to irritating mists. Protective Gloves Acid resistant, impermeable. Eye Protection - F Goggles and/or face shield. Other Protection "Acid resistant, impermeable apron and shoes. Section IX-Special Precautions Keep out of reach of children. For industrial or institutional use only. Disclaimer: This information is,to the best of our knowledge, current, accurate, and complete as of the date of this document. However,we make no representation as to its accuracy. Such information may not be accurate when product is used in any,process or combined with other materials. In certain circumstances additional information may be necessary. No representation(s), guarantee(s),or warranty, either expressed or implied, or of any nature, is. made with respect to the product or data provided. -End of,docurnent- Date Printed: 04/29/08 Blue Polish Foam Protectant Page 4 of 4 3- � n i Section 1- Manufacturer's Information Manufacturer's Name C.A.R. Products, Inc. Manufacturer's Address .630 Beaulieu St. Holyoke, MA 01040 Manufacturer's Phone Number Local 413-536-9900 Toll Free 800-537-7797' Emergency Phone Number Chemtrec 800-424-9300 Product Information C.A.R. Products 800-537-7797 Effective Date 2/1/99 Chemical Name Red Polish Foam Protectant DOT Shipping Description Cleaning compound liquid,NOIBN Chemical Family Acidic surfactant blend Chemical Comment This product does not have any chemicals reportable under section 313 of Title III of Sara Chemical Formula Surfactant mixture Hazardous Materials Identification System(HMIS) FLAMMABILITY HAZARD RATING O 4=EXTREME 3=HI0I4 HEALTH 1 O REACTIVITY 2=MODERATE 1= SLIGHT 0=INSIGNIFICANT PERSONAL PROTECTION N/E= Not Established or Unknown N/A= Not Applicable '1 Date Printed 04/29/08 Red Polish Foam Protectant Page 1 of 4 Section II- Hazardous Ingredient Hazardous Component CAS Number Hazardous % TLV (Units) Non-Hazardous Ingredients 100 No ingredients currently regulated as hazardous by 29CFR1910. Section III-Physical & Chemical Data Boiling Point(T) >2120 Volatility/VOL (%) > 800 Melting Point(T) N/A Vapor Pressure (mm.Hg) N/E Vapor Density (Air= 1) N/E Solubility In H2O Complete Appearance/Odor Red liquid,cherry fragrance Specific Gravity(H2O= 1) 1.014 Evaporation Rate Like water pH 2.40 Section IV- Fire & Explosion Hazard Data Flash Point ff) None Lower Flame Limit N/A Higher Flame Limit N/A Extinguish Media As needed for surrounding fire Special Fire Fighting Procedures None Unusual Fire Hazard May produce flammable hydrogen gas upon contact with reactive metals Section V- Health Hazard Data Routes of Entry Inhalation(mists), skin, ingestion Health Hazards Irritation or burns NTP No IARC Monographs No OSHA Regulated No Threshold Limit Value N/E, blended product. See section II for information on listed ingredients. Date Printed: 04/29/08 Red Polish Foam Protectant Page 2 of 4 Section VII- Spill or Leak Procedure (cont.) Waste Disposal Dispose of according to national,state, and local rules. Section VIII- Special Protection Respiratory Protection NIOSH/MSHA approved respirator where conditions may cause exposure limits to be exceeded, including mists. Ventilation General or local to avoid exposure to irritating mists. Protective Gloves Acid resistant, impermeable. Eye Protection Goggles and/or face shield. Other Protection Acid resistant, impermeable apron and shoes. Section IX-Special Precautions - Keep out of reach of children. For industrial or institutional.use only. Disclaimer: This information is, to the best of our knowledge, current, accurate, and complete as of the date of this document. However, we make no representation as to its accuracy. Such' information may not be accurate when product is used in any process or combined with other materials. In certain circumstances additional information may be necessary. No representation(s), guarantee(s), or warranty, either expressed or implied, or of any nature, is made with respect to the product or data provided. -End of document- Date Printed: 04/29/08 Red Polish Foam Protectant Page 4 of 4 Section V-Health Hazard Data continued Over Exposure Effects Skin Contact: Irritation or burns. Eye Contact: Burns. Inhalation: Inhalation•of mists of product or solutions may cause irritation of respiratory tract. Ingestion: Irritation of mouth,throat and stomach. Stomach upset, pain, nausea; vomiting, and shock symptoms. First Aid Skin Contact: Immediately flush skin with lots of running water for at least 30 minutes. Remove contaminated clothing and shoes. Wash before reuse. Eye Contact: Flush immediately with large quantities of running water for at least 15 minutes. Consult a physician. Inhalation: If affected, remove individual to fresh air. If breathing is difficult, administer oxygen. If breathing has stopped, give artificial respiration. Keep person warm, quiet and get medical attention. Ingestion: -Do not induce vomiting. Call physician immediately. If conscious give lots of water or milk. Do not give anything by mouth to an unconscious or convulsing person. Section VI-Stability & Reactivity Data Chemical Stability Stable Conditions To Avoid Contact with incompatible materials. Incompatible Materials Strong bases, most metals, chlorine bleach Decomposition Products Oxides of carbon, nitrogen Hazardous Polymerization Will not occur Polymerization Avoid N/A Section VII- Spill or Leak Procedure For Spill Small Spills, less than 1 gallon: Neutralize with sodium bicarbonate (baking soda), soda ash, lime, or general alkaline detergent. Flush to,drain with excess water. Large Spills: Only knowledgeable and properly protected people should work with a large spill. Get professional assistance if necessary. Stop source of discharge if safe to do so. Evacuate unprotected personnel. Contain spilled material, and keep from discharging to surface waters. Recover to drum for later use,treatment, or disposal. Recover using acid resistant pump, scoops, absorbent material, or other process as appropriate. Neutralize contaminated area with sodium bicarbonate (baking soda), soda ash, or lime, and flush to drain. Notify local, state, or national authorities if required. Date Printed: 04/29/08 Red Polish Foam Protectant Page 3 of.4 n f z. P f Section 1-Manufacturer's Information Manufacturer's Name C.A.R. Products, Inc. Manufacturer's Address 630 Beaulieu St. Holyoke, MA 01040 Manufacturer's Phone Number Local 413-536-9900 Toll Free 800-537-7797 Emergency Phone Number Chemtrec 800-424-9300 Product Information C.A.R. Products 800-537-7797 Effective Date 2-1-99 Chemical Name Dri & Shine DOT Shipping Description Not regulated, use product name Chemical Family Petroleum distillate micro-emulsion Chemical Comment Section 313 Supplier Notification: Indicated ingredients in Section II are subject to the reporting requirements of-Section 313 of the Emergency Planning and Community Right-to-Know Act of - 1986 (40CFR372). This information should be included in all MSDS's that are copied and t distributed for this material. Chemical Formula Micro emulsion. Hazardous Materials Identification System(HMIS) FLAMMABILITY HAZARD RATING O 4=EXTREME 3=HIGH HEALTH 1 O 2=MODERATE REACTIVITY 1= SLIGHT 0=INSIGNIFICANT PERSONAL PROTECTION a N/E= Not Established or Unknown N/A= Not Applicable Date Printed:04/29/08 , Dri&Shine Page 1 of 4 Section II- Hazardous Ingredient Hazardous Component CAS Number Hazardous % TLV (Units) Mineral Seal Oil 64741-44-2 <20 5mg/m3 Ethylene Glycol 111-76-2 < 4 25ppm/skin Butyl Ether 50ppm/ceiling Non-Hazardous Ingredients _ > 80 Section III- Physical & Chemical Data Boiling Point ff) 212 OF Volatility/VOL (%} > 70. Melting Point(°F) N/A Vapor Pressure (mm Hg) N/E Vapor Density (Air=.1) N/E Solubility In H2O Complete, Appearance/Odor Orange liquid, mild solvent fragrance Specific Gravity(H2O= 1) .944 Evaporation Rate Like water pH 7.68 Section IV- Fire & Explosion Hazard Data Flash Point(°F) None Lower Flame Limit N/A Higher Flame Limit N/A F Extinguish Media As needed for surrounding fire Special Fire Fighting Procedures Wear self contained breathing apparatus. Unusual Fire Hazard None Section V-Health Hazard Data Routes of Entry , s Inhalation, skin, ingestion Health Hazards Irritation or burns NTP No . IARC Monographs No OSHA Regulated No Threshold Limit Value N/E , blended product. See section II for information on listed ingredients. Date Printed: 04/29/08 Dri&Shine Page 2 of 4 Section V-Health Hazard Data continued Over Exposure Effects Skin Contact: Irritation possible on prolonged contact. Eye Contact: Irritation, possibly burns with continued contact. Inhalation: Inhalation of mists of product or solution—irritation of respiratory tract. Ingestion: Irritation of mouth, throat and stomach. Stomach upset. First Aid Skin Contact: Immediately flush with cool running water for 15 minutes. Remove contaminated clothing and wash before reuse. If irritation or burn develops and persists, get medical advice or assistance. Eye Contact: Immediately flush with cool running water holding eye lids apart. Remove contact lenses if present, and continue flushing for 15 minutes. Get medical assistance if irritation persists. Inhalation: Remove to fresh air. Immediately call for medical advice or assistance if breathing difficulty or irritation is severe or continues. Ingestion: Rinse mouth with large amounts of water. Drink water, milk or other fluids to dilute. Do not induce vomiting. Call for medical advice or assistance if difficulties and discomfort develop and continue. Section VI-Stability &'Reactivity Data Chemical Stability Stable Conditions To Avoid Contact with Incompatible materials Incompatible Materials Strong oxidizers Decomposition Products Oxides of carbon Hazardous Polymerization Will not occur Polymerization Avoid N/A Section VII-Spill or Leak Procedure For Spill Small spills: Flush to drain with excess water. Large spills: Stop source of.discharge if safe to do so. Contain spilled material and keep from discharging to surface waters. Recover to drum for* later use,treatment, or disposal. Flush residual to drain. Notify local, state, or national authorities if required. Waste Disposal Method Normally sewer disposal. Check with local authorities about any possible restrictions. Date Printed:04/29/08 Dri&Shine 'Page 3 of 4 Section VIII- Special Protection Respiratory Protection None normally required. NIOSH/MSHA approved respirator where conditions may cause exposure limits to be exceeded, including mists. T Ventilation General or local to avoid exposure to irritating mists. Protective Gloves Chemical resistant, impermeable, as needed to prevent excessive contact. Eye Protection Glasses, goggles and/or face shield where conditions may cause eye exposure. Other Protection Full body covering and shoes to prevent excessive contact. Section IX-Special Precautions Keep out of reach of children. For industrial or institutional use only. Disclaimer: This information is , to the best of our knowledge, current, accurate, and complete as of the date of this document. However, we make no representation as to its accuracy. Such information may not be accurate when product is used in any process or combined with other materials. In certain circumstances additional information may be necessary. No representation(s), guarantee(s), or warranty, either expressed or implied, or of any nature, is made with respect to the product or data provided. -End of document- Date Printed:04/29/08 Dri&Shine Page 4 of 4 Section 1- Manufacturer's Information Manufacturer's Name C.A.R. Products, Inc. Manufacturer's Address 630 Beaulieu St. Holyoke, MA 01040 Manufacturer's Phone Number Local 413-536-9900 Toll Free 800-537-7797 Emergency Phone Number Chemtrec 800-424-9300 Product Information C.A.R. Products 800-537-7797 Effective Date 2/1/99 Chemical Name Maxi Foam DOT Shipping Description Cleaning compound liquid,NOIBN Chemical Family Detergent Blend Chemical Comment This product does not have any chemicals reportable under section 313 of title III of Sara Chemical Formula Surfactant mixture Hazardous Materials Identification System(HMIS) FLAMMABILITY HAZARD RATING O 4=EXTREME 3=HIGH HEALTH 1 O 2=MODERATE REACTIVITY 1= SLIGHT 0= INSIGNIFICANT PERSONAL PROTECTION a N/E= Not Established or Unknown N/A= Not Applicable Date Printed:04/29/08 Maxi Foam Page,1 of 4 r Section II-Hazardous Ingredient ' Hazardous Component CAS Number , Hazardous % TLV (Units) Non-Hazardous Ingredients 100 No ingredients currently regulated as hazardous by 29CFRI910 Section III-Physical & Chemical Data Boiling Point(°F) 212 OF Volatility/VOL (%) < 75 % Melting Point(°F) N/A Vapor Pressure(mm Hg) N/E Vapor Density(Air= 1) N/E . Solubility In H2O Complete Appearance/Odor Red liquid, bland fragrance Specific Gravity(H2O = 1) r 1.034 Evaporation Rate Like water pH 9.71 Section IV- Fire & Explosion Hazard Data Flash Point(°F) None Lower Flame Limit N/E Higher Flame Limit N/E Extinguish Media As needed for surrounding fire Special Fire Fighting Procedures Wear self contained breathing apparatus Unusual Fire Hazard None Section V- Health Hazard Data Routes of Entry Inhalation(mists), skin, ingestion Health Hazards Irritation or burns NTP No IARC Monographs No OSHA Regulated No Threshold Limit Value N/E ,blended product. See section II for information on listed ingredients. Date Printed: 04/29/08 Maxi Foam Page 2 of 4 Section V-Health Hazard Data continued Over Exposure Effects Skin Contact: Irritation possible on prolonged contact. Eye Contact: Irritation, possibly burns with continued contact. Inhalation: Inhalation of mists of product or solutions may cause irritation of respiratory tract. Ingestion: Irritation of mouth, throat and stomach. Stomach upset. First Aid Skin Contact: Immediately flush with cool running water for 15 minutes. Remove contaminated clothing and wash before reuse. If irritation or burn develops and persists, get medical advice or assistance. Eye Contact: Immediately flush with cool running water holding eye lids apart. Remove contact lenses if present, and continue flushing for 15 minutes. Get medical assistance if irritation persists. Inhalation: Remove to fresh air. Immediately call for medical advice or assistance if breathing difficulty or irritation is severe or continues. Ingestion: Rinse mouth with large amounts of water. Drink water, milk'or other fluids to dilute. Do not induce vomiting. Call for medical advice or assistance if difficulties and discomfort develop and continue. Section VI-Stability & Reactivity Data Chemical Stability Stable Conditions To Avoid Contact with Incompatible materials Incompatible Materials Strong oxidizers Decomposition Products Oxides of carbon Hazardous Polymerization Will not occur Polymerization Avoid N/A Section VII- Spill or Leak Procedure For Spill Small spills: Flush to drain with excess water. Large spills: Stop source of.discharge if safe to do so. Contain spilled material and keep from discharging to surface waters. Recover to drum for later use, treatment, or disposal. Flush residual to drain. Notify local, state, or national authorities if required. Waste Disposal Method Normally sewer disposal. Check with local authorities. Date Printed:04/29/08 Maxi Foam Page 3.of 4 . Section VIII—Special Protection Respiratory Protection None normally required. NIOSH/MSHA approved respirator where conditions may cause exposure limits to be exceeded, including mists. Ventilation General or local to avoid exposure to irritating mists. Protective Gloves Chemical resistant, impermeable, as needed to prevent excessive contact.. Eye Protection Glasses, goggles and/or face shield where conditions may cause eye exposure. Other Protection Full body covering and shoes to prevent excessive contact. Section IX-Special Precautions Keep out-of reach of children. For industrial or institutional use only. Disclaimer: This information is , to the best of our knowledge, current, accurate, and complete as of the date of this document. However, we make no representation as to its accuracy. Such information may not be accurate when product is used in any process or combined with other materials. In certain circumstances additional information may be necessary. No representation(s), guarantee(s), or warranty, either expressed or implied, or of any nature, is made with respect to the product or data provided. -End of document- Date Printed: 04/29/08 Maxi Foam Page 4 of 4 Section 1- Manufacturer's Information Manufacturer's Name .C.A.R. Products, Inc. Manufacturer's Address 630 Beaulieu St. Holyoke, MA 01040 Manufacturer's Phone Number Local 413-536-9900 Toll Free 800-537-7797 Emergency Phone Number Chemtrec 800-424-9300 Product Information C.A.R. Products 800-537-7797 Effective Date 5/15/06 Chemical Name Braker DOT Shipping Description Compounds, Cleaning Liquid(Sodium Hydroxide) 8,NA1760, PGII Emergency Response Guide #154 Chemical Family Strong Alkaline Detergent Chemical Comment Hazardous ingredients in section 11 are subject to the reporting requirements of Section 313 of the Emergency Planning and Community Right to Know Act of 1986 (40CFR372). Chemical Formula Mixture of alkalies and wetting agents. Hazardous Materials Identification System (HMIS) FLAMMABILITY HAZARD RATING 0 4=EXTREME 3=HIGH HEALTH 2 0 2=MODERATE REACTIVITY 1= SLIGHT 0= INSIGNIFICANT PERSONAL PROTECTIONrc N/E= Not Established or Unknown N/A= Not Applicable Date Printed:04/29/08 Braker Page 1 of 4 r Al Section II- Hazardous Ingredient Hazardous Component CAS Number Hazardous % TLV (Units) Sodium Hydroxide 1310-73-02 < 15 2mg/m3 Ceiling Inert Ingredients .< 5 Non-Hazardous Ingredients > 80 Section III-Physical & Chemical Data Boiling Point(°F) >212 OF Volatility/VOL (%) > 75 % Melting Point(°F) N/A Vapor Pressure (mm Hg) N/E Vapor Density (Air= 1) N/E Solubility In H2O Complete Appearance/Odor Red liquid, pleasant fragrance Specific Gravity (H2O= 1) . 1.14 Evaporation Rate Like water pH 11.60 Section IV- Fire & Explosion Hazard Data Flash Point(°F) None Lower Flame Limit N/A Higher Flame Limit N/A Extinguish Media As needed for surrounding fire Special Fire Fighting Procedures None Unusual Fire Hazard May produce flammable hydrogen gas upon contact with reactive metals Section V-Health Hazard Data Routes of Entry Inhalation(mists), skin, ingestion Health Hazards Irritation or burns NTP No .IARC Monographs No OSHA Regulated No Threshold Limit Value N/E,blended product. See section II for information on listed ingredients. Date Printed:04/29/08 Braker Page 2 of 4 Section V-Health Hazard Data continued Over Exposure Effects Skin Contact: Irritation or burns. Eye Contact: Burns. Inhalation: Inhalation of concentrated mists-irritation of upper respiratory tract: possible burns, chemical pneumonia, and lung damage. Ingestion: Burns of mouth, throat and stomach:.pam, nausea, vomiting, shock symptoms. First Aid Skin Contact:. Immediately flush with cool running water for 15 minutes. Remove contaminated.clothing and wash before reuse. If irritation or burn develops and persists, get medical advice or assistance. Eye Contact: Immediately flush with cool running water holding eye lids apart. Remove contact lenses if present, and continue flushing for 15 minutes. Get medical assistance. Inhalation: Remove to fresh air. Immediately call for medical advice or assistance if breathing difficulty or irritation is severe or continues. Ingestion: Rinse mouth with large amounts of water. Drink water, milk or other fluids to dilute. Do not induce vomiting unless directed by medical personnel. Immediately call for medical advice or assistance. Section VI-Stability & Reactivity Data Chemical Stability Stable Conditions To Avoid Contact with Incompatible materials Incompatible Materials Avoid contact with strong acids, reactive metals,_ strong oxidizers, most organic material such as leather, paper, wool. Decomposition Products Oxides of carbon Hazardous Polymerization Will not occur Polymerization Avoid N/A Section VII- Spill or Leak Procedure For Spill Small spills, less than 1 gallon: Flush to drain with excess water. Large spills: Only knowledgeable and properly protected people should work with a large spill. Get professional assistance if necessary. Stop source of discharge if safe to do so. Evacuate unprotected personnel. Contain spilled material, and keep from discharging to surface waters. Recover to drum for later use, Date Printed:04/29/08 Braker Page 3 of 4 Section VII-Spill or Leak Procedure continued treatment, or disposal. Recover using alkali resistant pump, scoops, absorbent material, or other process as appropriate. Rinse contaminated area well. Notify local, state, or national authorities if required. Waste Disposal Method: Dilute solutions are normally sewer disposable; check local rules for any restrictions. Product is alkaline. Dispose of according to national, state; and local rules. Section VIII- Special Protection Respiratory Protection None normally required. NIOSH/MSHA approved respirator where conditions may cause exposure limits to be exceeded, including mists. Ventilation General or local to avoid exposure to irritating mists. Protective Gloves Alkali resistant, impermeable. Eye Protection Goggles and/or face shield. Other Protection Alkali resistant, impermeable apron and shoes. Section IX-Special.Precautions Keep out of reach of children. For industrial or institutional use only. Disclaimer: This information is , to the best of our knowledge, current, accurate, and complete as of the date of this document. However, we make no representation as to its accuracy. Such information may not be accurate when product is used in any process or combined with other materials. In certain circumstances additional information may be necessary. No representation(s), guarantee(s), or warranty, either expressed or implied, or of any nature, is made with respect to the product or data provided. -End of document- .Date Printed:04/29/08 Braker Page 4 of 4 Section 1-Manufacturer's Information Manufacturer's Name C.A.R. Products, Inc. Manufacturer's Address 630 Beaulieu St. Holyoke, MA 01040 Manufacturer's Phone Number Local 413-536-9900 Toll Free 800-537-7797 Emergency Phone Number Chemtrec 800-424-9300 Product Information C.A.R. Products 800-537-7797 Effective Date 9/26/07 Supercedes 3/8/04 Chemical Name Lightning DOT Shipping Description ' Compounds, Cleaning Liquid(Sodium Hydroxide) 8,NA 17603 PGII Emergency Response Guide#154 Chemical Family Strong Alkaline Detergent Chemical Comment Hazardous ingredients in section 1I are subject to the reporting requirements of Section 313 of the Emergency Planning and Community Right to Know Act of 1986 (40CFR372). Chemical Formula Mixture of alkalies and wetting agents. Hazardous Materials Identification System(HMIS) FLAMMABILITY HAZARD RATING 0 4=EXTREME 3= HIGH HEALTH Z O REACTIVITY 2=MODERATE 1= SLIGHT 0=INSIGNIFICANT PERSONAL PROTECTION a N/E= Not Established or Unknown N/A= Not Applicable Date Printed:04/29/08- Lightning Pagel of4 Section II- Hazardous Ingredient Hazardous Component CAS Number Hazardous % TLV (Units) Sodium Hydroxide 1310-73-02 < 10 2mg/m3 Ceiling Inert Ingredients < 5 Non-Hazardous Ingredients > 90 Section III-Physical & Chemical Data Boiling Point (°F) >212 OF ' Volatility/VOL (%) > 75 % Melting Point(OF) N/A M Vapor Pressure (mm Hg) N/E Vapor Density (Air= 1) N/E Solubility In H2O Complete Appearance/Odor Red liquid, mint fragrance Specific Gravity (H2O = 1) 1.093 Evaporation Rate Like water pH 11.60 Section IV- Fire & Explosion Hazard Data Flash Point(°F) None Lower Flame Limit N/A Higher Flame Limit N/A Extinguish Media As needed for surrounding fire g g Spezial Fire Fighting Procedures None Unusual Fire Hazard May produce flammable hydrogen gas upon contact with reactive metals Section V-Health Hazard Data Routes of Entry Inhalation(mists), skin, ingestion Health Hazards Irritation or burns NTP No IARC Monographs No OSHA Regulated No Threshold Limit Value N/E ,blended product. See section II for information on listed ingredients. Date Printed:04/29/08 Lightning Page 2 of 4 ,A 6• Section V-Health Hazard Data continued Over Exposure Effects Skin Contact: Irritation or burns. Eye Contact: Burns. Inhalation: Inhalation of concentrated mists-irritation of upper respiratory tract: possible burns, chemical pneumonia, and lung damage. Ingestion: Burns of mouth, throat and stomach: pain, nausea, vomiting, shock symptoms. First Aid Skin Contact: Immediately flush with cool running water for 15 minutes. Remove contaminated clothing and wash before reuse. If irritation or burn develops and persists, get medical advice or assistance. Eye Contact: Immediately flush with cool running water holding eye lids apart. Remove contact lenses if present, and continue flushing for 15 minutes. Get medical assistance. Inhalation: Remove to fresh air. Immediately call for medical advice or assistance if breathing difficulty or irritation is severe or continues. Ingestion: Rinse mouth with large amounts of water. Drink water, milk or other fluids to dilute. Do not induce vomiting unless directed by medical personnel. Immediately call for medical advice or assistance. Section VI-Stability & Reactivity Data Chemical Stability Stable Conditions To Avoid Contact with Incompatible materials Incompatible Materials Avoid contact with strong acids, reactive metals, strong oxidizers, most organic material such as leather,paper, wool. Decomposition Products Oxides of carbon Hazardous Polymerization Will not occur Polymerization Avoid_ N/A Section VII- Spill or Leak Procedure For Spill Small spills, less than 1 gallon: Flush to drain with excess water. Large spills: Only knowledgeable and properly protected people should work with a large spill. Get professional assistance if necessary. Stop source of discharge if safe to do so. Evacuate unprotected personnel. Contain spilled material, and keep from discharging to surface waters. Recover to drum for later use, Date Printed:04/29/08 Lightning Page 3 of 4 ' . + ' P •mot � _ Section VII-Spill or Leak Procedure continued treatment, or disposal. Recover using alkali resistant pump, scoops, absorbent material, or other process as appropriate. Rinse contaminated area well. Notify local, state, or national authorities if required. Waste Disposal Method: Dilute solutions are normally sewer disposable; check local rules for any restrictions. Product is alkaline. Dispose of according to national, state, and local rules. Section VIII- Special Protection Respiratory Protection None normally required. NIOSH/MSHA approved respirator where conditions may cause exposure 7 limits to be exceeded, including mists. Ventilation General or local to avoid exposure to irritating mists. Protective Gloves Alkali resistant, impermeable: Eye Protection Goggles and/or face shield. Other Protection Alkali resistant, impermeable apron and shoes. Section IX-Special Precautions Keep out of reach of children. For industrial or institutional use only. Disclaimer: This information is ,to the best of our knowledge, current, accurate, and complete as of the date of this document. However, we make no representation as to its accuracy. Such information may not be accurate when product is used in any process or combined with other materials. In certain circumstances additional information may be necessary. No representation(s), guarantee(s), or warranty, either expressed or implied, or of any nature, is made with respect to the product or data provided. -End of document- Date Printed:04/29/08 Lightning Page 4 of 4 Date: 3 / 7 / oN TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: A6� -0 A0,07 SY7 Calu� Ctld BUSINESS LOCATION: �-�� ��-- • �-S INVENTORY MAILING ADDRESS: '/ OF TOTAL AMOUNT: TELEPHONE NUMBER: 6_0 CONTACT PERSON: # EMERGENCY CONTACT TELEPHON UMBER: MSDS ON SITE? es. TYPE OF BUSINESS: Ca- eat Aa_-4t-) INFORMATION/RECOMMENDATIONS: Fire District: geAl .S ® Waste Transportation: A1I,6 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 lice.. from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS l` 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) 2-0 *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 �ZO Car waxes and polishes Fertilizers Asphalt & roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) NEW USED ny 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:�' /Z3 / '-"AI fr TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: 4(A O 67&'9 ©F CAS C�vd BUSINESS LOCATION: NvApmi y 1 414, 6)2691 INVENTORY MAILINGADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: ��"v '36y.-e1836 c�af3->7�y28G8 ytb CONTACT PERSON: ti EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: CAA W,4s'L.Il 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) 7 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 aL Car waxes and polishes Fertilizers Asphalt & roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) NEW USED -2-0 *G 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 a : J TOWN OF BARNSTABLE ^PA-�S6v Date: l a l Dr TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: JuIV PC &0 BUSINESS LOCATION: IM A ,AIIJAE INVENTORY MAILING ADDRESS: A-5 A&rrE TOTAL AMOUNT: TELEPHONE NUMBER: � CONTACT PERSON: � �/R�- 6EA1&—r_*L A/4.41,**!f9 If EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: 1441771tff-77C d4p— /10 INFORMAT N/RECOMMEN TIONS: yex- AuSPEC770,J L-t_17M Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: A1h1"AfBex1.61aew*,&w-- Destination: Waste Product: U/15 ik-Ur2 Licensed? es No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed/Maximum Observed/Maximum Antifreeze (for gasoline or coolant systems) Misc. Corrosive 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 p Misc..petila R products: grease, Photochemicals (Developer) lubricants, gear oil 44o4 a,9 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 Gpup,J �'1�SC�LR��?�ys tCE_*Ng (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS I/ 9N�IHS1�igRd NVJVMMO' U • HVONAlV3 9NIHSI3 A73 AO SAVO S9E - --_---, !o v i flw_CL ------ jF ___ r T s� This on fishers,like onl s ook un e M 0 N w T y ' y p en fish Idaho's D AT Payette River,spend far. MARCH•19 9 8 more time studying the - - LABOUR DAY(VIC,AUSTRALU) o water and moving into .. z. o position than they do _ _ 4 casting. Constant random casting or noisy wading ' _ Town of Barnstable OF THE r Regulatory Services Thomas F. Geiler,Director Public Health Division BARNSTABLE, Thomas McKean,Director 9 MASS. $ 039. 1� 200 Main Street, Hyannis,MA 02601 ArFD MA`1 A Phone: 508-862-4644 Email: health(ako,wn.barnstable.ma.us . Fax: 508-790-6304 Office Hours: M-F 8:00—4:30 May 1,2008 Mr. William Baird, RE: Toxic and Hazardous Materials General Manager On-Site Inventory and Inspection, Auto Bath of Cape Cod Auto Bath of Cape Cod, 551Yarmouth Road 551 Yarmouth Road, Hyannis,MA 02601 Hyannis Dear Mr. Baird: On April 24,2008,a Toxic and Hazardous Materials On-Site Inventory and Inspection of the above referenced site were conducted by the Public Health Division(PHD).An On-Site Inventory and Inspection is a review of the sites storage,transport,utilization and/or disposal of toxic and hazardous materials as it relates to the Town of Barnstable Ordinance,Chapter 108: Hazardous Materials. This Ordinance was adopted to protect the public health and welfare,especially as it pertains to the public drinking water supply. The following is a description of the results of the Inventory(enclosed)and Inspection. MATERIALS INVENTORY AMOUNT AND PURPOSE: The Inventory of this site indicates the use or storage of approximately five-hundred and thirty-nine (539)gallons of toxic and hazardous material.This material is used in the automatic car wash and in the daily operation of the car wash. Please be aware that the Town of Barnstable has determined that a minimum of one-hundred and eleven(111)gallons of toxic and hazardous materials requires an annual license. GENERAL STORAGE AREAS AND CONDITIONS: • The detergents and cleaners used in the automatic car wash are stored in thirty-five to fifty-five gallon sized plastic drums,located on a shallow grate system on the cement floor of the car wash. These materials are automatically dispensed by control pumps to the various car washing equipment. • A separate"Pump Room"houses the two compressors for the car wash's' hydraulic equipment. The approximate combined hydraulic fluid capacity of the compressor/hydraulic system is eighty- five(85)gallons;there are an additional two,five gallons buckets of hydraulic fluid stored in this area:The facility utilizes Aquablue,an oil free hydraulic fluid. • The holding tank for the waste wash water has historically been pumped out by Joseph P. Macomber&Sons Inc.,however the facility may be changing waste water haulers to bluewater -2- • company(David J. Burnie Cape Cod Septic Services)The holding tank is equipped with an.' absorbent sock("Pig Oil—Only")which collects oil from the waste wash water.These socks are then bagged and discarded in the dumpster with normal solid waste. • An additional five gallons of gasoline and ten gallons of diesel fuel are stored in the car wash. These materials are used for the operation of facility maintenance equipment. SAFETY AND DOCUMENTATION: The Material Safety Data Sheets were not available upon request. Auto Bath of Cape Cod was in receipt of a License for Storing or Handling of 111 Gallons or More of Hazardous Materials;however a Contingency Plan and Spill Kit were not available. SITE FACILITIES: The drainage trench in the car wash floor is connected to a water recycling system and holding tank. Building septic waste is discharged to an additional on site sewage disposal system. Any deficiencies which were discovered in the course of this inspection with regards to the Hazardous Materials Ordinance are described below. CORRECTIVE ACTIONS TO BE TAKEN: Material Safety Data Sheets are to be made available for review. A Contingency Plan listing emergency contact telephone numbers,how a spill of any hazardous material will be responded to,and the location of the Spill Kit(absorbent material) is to be posted by a facility telephone,reviewed by all employees and a copy submitted to the PHD. Notify the PHD regarding your choice of waste water haulers and retain a copy of all holding tank pump- out records on site. The PHD appreciates your cooperation and acknowledges your intent to maintain compliance with the Hazardous Materials Ordinance.This office will conduct a follow-up inspection within four weeks to verify that all corrective actions have been taken.Please contact me at the above telephone number should you have any questions or comments regarding the Inspection of your site. 4Ha ly yours, �1 A.Martin us Materials Specialist All orders to correct violations of Chapter 108 of the Town of Barnstable Ordinance:Hazardous Materials. shall be completed upon receipt of this letter t!55sA. McKean, S,CHO Director of Public Health -3 - Enclosure: Toxic and Hazardous Materials On-Site Inventory Flynn, Judith Wom: Crocker, Sharon nt: Monday, December 08, 2014 4:31 PM To: Flynn, Judith Subject: RE: Letter-Septic Failure 551 Yarmouth Rd, Hy FYI, I received call today from New Owners (see below) and I put a note in the comments in db Septic Inspection. New owners, Balise, General Mgr Tony DeBarros called 12/8/14, cell 617-721-0038, will have corp. request a BOH extension. Currently, the facility is non- operational, Water is shut off. Owners must decide what to do with now that they realize it needs so much septic work.-sic • 1 �t Town of Barnstable Barn Regulatory Services Department '"RNSTABM MASSPublic Health Division I P i63�'� 2007 D1A 200 Main Street, Hyannis MA 02601 SECOND NOTICE Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2851 4006 December 4, 2014, Scallop LLC PO Box 264 West Hyannisport, MA 02672 The septic system located at 551 Yarmouth Road, Hyannis,MA was last inspected on 6/24/2014 by Joseph Martins, a certified septic inspector for the State of Massachusetts. The Health Division has determined that the system"Failed" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: • Backup of sewage into facility or system component due to overloaded or clogged SAS. You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH i Thomas McKean, R.S. CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\551 Yarmouth Rd Hy Jul 2014.doc Town of Barnstable Barnstable Regulatory Services Department MA Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 10 0 0000 2851 4082 July 9, 2014, Scallop LLC PO Box 264 West Hyannisport, MA 02672 The septic system located at 551 Yarmouth Road, Hyannis,MA was last inspected on • 6/24/2014 by Joseph Martins, a certified septic inspector for the State of Massachusetts. The Health Division has determined that the system"Failed" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: Backup of sewage into facility or system component due to overloaded or clogged SAS. You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH omas McKean, R.S. CHO Agent of the Board of Health QASEPTICVLetters Septic Inspection Failures or Future E0551 Yarmouth Rd Hy Jul 2014.doc Print Page http://www.townofbamstable.us/Assessing/printl4.asp?ap=0&searchparcel=34500200l ' Print this page �: . Owner Information - Map/Block/Lot: 345 / 002/ 001 - Use Code: 3350 Owner Map/Block/Lot GIS MAPS SCALLOP LLC 345 / 002/ 001 Owner Name PO BOX 264 Property Address as of 1/1/13 WEST 551 YARMOUTH ROAD HYANNISPORT, MA. 02672 Co-Owner Village: Hyannis Name Town Sewer At Address: No GIS Zoning Value: B . Assessed Values 2014 - Map/Block/Lot: 345 / 002/ 001 - Use Code: 3350 2014 Appraised Value 2014 Assessed Value Past Comparisons Building $ 261,300 $ 261,300 Year Total Asses: Value: Value Extra $ 0 $ 0 2013 - $ 498,800 Features: 2012 - $ 410,200 Outbuildings: $ 40,900 $ 40,900 2011 - $ 384,700 Land $ 194,800 $ 194,800 2010 - $ 386,500 Value: 2009 - $ 405,200 2008 - $ 314,100 2014 $ 497,000 $ 497,000 2007 - $ 314,100 Totals . Tax Information 2014 - Map/Block/Lot: 345 / 002/ 001 - Use Code: 3350 Taxes Hyannis FD Tax $ (Commercial) 13759.38 Community Preservation $ 122.56 Act Tax Town Tax (Commercial) 4,085.34 Fiscal Year 2014 TAX RATES HERE 5,967.28 . Sales History - Map/Block/Lot: 345 / 002/001 - Use Code: 3350 http://www.townofbamstable.us/Assessing/printl4.asp?ap=0&searchparcel=34500200l 7/3/2014 �Ij2���l1 �- �o ��� ���, .�rl` • f i ommonwealth ofi Massachi setts -&Ar itle 5 Official Inspection Form ubsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 Yarmouth Road Hyannis MA party Address r ScaRop LLC PO BOX 264 Cw na fWs Name information is required for ev �e ct r page frown Zip specbon results must be submitted on this form.inspection forms may not be altered in any ay.Please see completeness checklist at the end of the form. important:Men General Infiormation . f�out Toms I4-b o3� on the computer, use only the tab Inspector key to move your cursor-do not use the retum Name of inspector AEU �JepCheCIC key. CO1rpa"1f Name So Dennis, MA 0260 Company Address State Zip a Odyf raw D d r 2 ��L—Q S J ! 7 Codee JU '� �J sir License Number Telephone Number LL'J 1,Ja B. Certifications I certify that I have personally inspected the sewage disposal system at this address and that th1_.. t,a 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 an site'-"' sewage disposal systems.)am a DEP approved system inspector pursuant to S coon 15.340 of Title 5(310 CM R 15.000). The system: z—,t qvi o v V e ❑ Passes El Conditionally Passes Fails OVP1. � ❑ Needs Further Evaluation by the Local Approving Authority 47N01 s . GZ � /Y ctor-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 /'000 the same or different conditions of use. Tdle 5of8dal mspeellon For[Submwface Sexage 0h posal Sy0m•Page f of 17., 1$Rs-W3 ,. (0��/,I i ornrnonweaith of Massachusetts itle 5 Official Inspection Form ubsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 Yarmouth Road Hyannis MA party Address Scallop L.LC PO Box 264 Qv ner nees Name Informat+on Is 6/24/2014 required for every staort te � � Date of Inspeetion page. /Towrn . Certification (cons) Inspection Summary: Check A,B,C,D>Eay,salwaysplete all of Section ) System Passes: ❑ I have not found any information of the failure criteria described in 310 CMR 15.303 or in 310 CMfailure of not evaluated are indicated below. Comments: B) System Co itionally Passes: ❑ one or more system components as described in the"Conditional P s°section need to be replaced or repaired. The system, upon completion of the repla ent or repair, as approved by the Board of Health, will pass. Check the box for°yes°, "no"or"not determined"(Y, N, N for the following statements. If"not determined,"please explain. The septic tank is metal and over20 years old* he septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration ore ration or tank failure is imminent. System will pass inspection if the existing tank is replaced a complying septic tank as approved by the Board of Health. *A metal septic tank will pass in ction if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the nk is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): 151r6 3f13 M950ffieialbspeefiMFMMSubsurfaceSuxegeD'apasatSVMM-Page2&17 ommonwtalthof Massachusetts itle 5 Official Inspection Form ubsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 Yarmouth Road Hyannis MA party Address. Scallop LLC PO Box 264 lug Cw ner Her s Narre inforrretioni3n � 02672 6/24/2014 required for every State Zip Code Date of Inspection page. frown . Ceftcat�n (coat.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. 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 d' ution 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 repla ❑ Y ❑ N ❑ ND(Explain below): ❑ The system r uired pumping more than 4 times a yZHeafth): ed pipe(s� The system wil ass inspection if(with approval of the Boroken pipe(s)are replaced ❑ ain below): obstruction is removed ❑ lain below): C) Further Evaluation/efUrther e Board of Health: ❑ Conditions exist whievaluation by the Board of Health in order to determine if the system is failing ealth, safety or the environment 1. Systemw8l pasf Heatth determines in accordance with 310 CMR 15.303(1)(b)tha a system is not functioning in a mannerwhich will protect public health, safety and th environment ❑ spool 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 tsn3.3i13 Tde50%cW1mpXmFo=SubsrtmSewepDisp� Syom•Page 3of17 i omrnonwealth of Massachusetts Title 6 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 Yarmouth Road Hyannis MA party Address Scallop LLC PO Box 264 Qa r>erOwner's tame nformadon is West H annis ort MA 02672 6/24/2014 requked for every Slate Zip Code Date of Inspection page. Cilyfilown B. Certificafion (coat.) 2. System will fait unless the Board of Health(and Public Water Sup ' r,if any) determines that the system is functioning in a manner that prate a public health, safety and environment: ❑ The system has a septic tank and soil absorption system S)and the SAS is within 100 feet of a surface water supply or tributary to a surface er supply. ❑ The system has a septic tank and SAS and the SA s within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and t SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS an a SAS is less than 100 feet but 50 feet or more from a private water supply well"`. Method used t/, and dtermine distance: *�This system pa analysis, performed at a DEP certified laboratory, for fecal colitban bacteria he presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 other failure criteria are triggered. A copy of the analysis must be attached to thi 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 ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ 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 t5irs•3H3 TdIe50rficial lnspecSonFarm Submdaee SevageDlSposaI System-Page 4or17 I ommonwea of Massachusetts itle 5= Official Inspection Form ubsurface sewage Disposal System Form-Not for Voluntary Assessments 551 Yarmouth Road Hyannis MA perty Address Scallop LLC PO Box 264 -------------------- Odv na Div ner's Name information is 6/24/?014 required for every State ZipZip� Date of inspection page /Town . Certification (cost.) 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. ❑ D( 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 0 gpd- 10,000gpd. The system fiffls, I have determined that one or more of th bove failure X. Cy criteria exist as described in 310 CM 15.303,therefore system fails.The system owner should contact the Board of Health to d rmine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system ust 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" each of the following, in addition to the questions in Section D. t Yes No ❑ ❑ the system is within 40 et of a surface drinking water supply ❑ ❑ the system is withi` 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is I aced in a nitrogen sensitive area(Interim Wellhead Protection Area—IWP or a mapped Zone II of a public water supply well If you have answered"yes"to y question in Section E the system is considered a significant threat, or answered "yes"in Section above tho large system has failed. The owner or operator of any large system considered a signi ant threat under Section E or failed under Section D shall upgrade the system in accordance 310 CMR 15.304. The system owner should contact the appropriate regional office of the D artment. T9e5CdfKiallrapeUicnFormsu msevoseoispasalstem-PageSo!V tuns-3"3 t to :nwealth of Massachusetts Title 5 Official Inspection Form ubsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 Yarmouth Road Hyannis MA petty Address Scallop LLC PO Box 264 Qf✓ner nees Name requirefo ___MA 02672 6/24/2014 required for every West ILyaniliaport page. E!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 NIA) ❑ Was the facility or dwelling inspected for signs of sewage back up? �J ❑ 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: [� ❑ 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 15.203(for example: 110 gpd x#of bedrooms): a. t5ft•3M3 Title 50ffidW lnsMctionFom Sulsu we SmMe DisprSal SSGWM•Page 60f 17 ommonwealth'of Massachusetts itle 5 Official Inspection Form ubsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 Yarmouth Road Hyannis MA petty Address Scallop LLC PO Box 264 Oaf ner na's Name information is West nis ort 02 6/24/2014 required forevuy Shdte Zip Code We of Inspection page. /Town . System Information Description: Number of current residents: Does residence have a garbage grinder? ❑ Yes ❑ No Is laundry on a separate sewage syste (Include laundry system inspection ❑ Yes ❑ No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ❑ No Water meter readin , if available(last 2 years usage(gpd)): Detail: ❑ Yes No Sump pump? Last date of occupancy: Date Commercial/Industrial Flow Conditioners Type of Establishment: /5— 6 D Design flow(based on 310 CMR 15.203): Gallons per day(gpd) o4 ,�oLo��-e Basis of design low(seats/persons/sq.ft., etc.): - I Grease trap present? ❑ Yes No Industrial waste holding tank present? T L ❑ Yes No Non-sanitary waste discharged to the Title 5 system? G�u N 1�Y ❑ Yes ❑ No Water meter readings, if available: rMe 5 Ctficial taspectlon Fomr Subsurface&vege Disposal syom-Page 7of f 7 ors-3/13 ommonweaKh of Massachusetts itle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 Yarmouth Road Hyannis MA :ko sty Address Scallop LLC PO Box 264 Owner ner's Name information iswe ort 6/24/20l 4 required for everyst � � pate of 24/2ion Page frown state D. System Information (coat.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Alor Source of information: �[ Was system pumped as part of the inspection? ❑ Yes No If yes, volume pumped: sins ! 1 How was quantity pumped determined? Reason for pumping: Type of System: (� Septic tank, distribution box, soil absorption system J❑, Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system(yes or no)(if yes, attach previous inspection records, if any) ❑ Innovative/Altemative 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 VA system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5re-X13 rft5of jc3Whzpec#mFam[Sutsufaee SeMaPDsposal System•Page 8oft7 `Commdnweatth of Massachusetts 'Title 5 official Inspection Form 'Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 Yarmouth Road Hyannis MA Property Address Scallop LLC PO Box 264 Owner Ow nets Nacre information is n'��� (/1 /2()14 9eiredfor every drown West H, anni --State z Date of 24/20 ection D. System Information (corn.) Approximate age of all com onents, date installed(if known)and source of nformation: S-P rtC a r s� a PG VS Were sewage odors detected when arriving at the site? ❑ Yes (X No Building Sewer(locate on site plan): / h T` ' Depth below grade: feet Material of construction: ❑ cast iron ❑ 40 PVC ❑ other(explainy Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): / ti Depth below grade: feet Material of construction: (concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) Yes ❑ No Dimensions: Sludge depth: Uffi-W3 Title5OffidW InspeclimFomt SuhsurFxe Sewage Disposal System•Page9of 17 I On1=nweajth of Massachusetts itle SOfficial Inspection Form ubsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 Yarmouth Road Hyannis MA perty Address Scallop LLC PO Box 264 Qw ner 1v ner's Name information is West H annis ort MA 02672 6/24/2014 required for every ate Zip Code Date of Inspection page. mfrown . System Information (cons) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle r/ (0 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 How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.}: PbM Pg!6 rPcd,% A#AdP-d P\)c 1A1$ r 14-- _ .Qv)d-fvil'-Q- d9- P Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ poly ne �E] her(explain): Dimensions: Scum thickness Distance from top of sc to top of outlet tee or baffle Distance fro ttom of scum to bottom of outlet tee or baffle Date ast pumping: We tlrs•3f13 Tnle5offtWt 9pw icnFmn SUtmafam SevMODispasal Syfem•Page 10d 17 ommonweat8t of Massachusetts Title 5= Official Inspection Form ubsurface Sewage Disposal Sysbem Form-Not for Voluntary Assessments 551 Yarmouth Road Hyannis MA :koparty Address Scallop LLC PO Box 264 Cw ne 3Nnees lame mfometion is West H annis ort. MA 02672 6/24/2014 required for every State Zip Code pate of Inspection Page. frown System Information (cons) Comments(on pumping recommendations, inlet and outlet tee or baffle conditio tructural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at ti a of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explai ny Dimensions: Capacity: gapons Design Flow. gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in worlang order. ❑ Yes ❑ No Date of last mping: We Commen (condition of alarm and float switches, etc.}: i *Attach copy of current pumping contract(required Is copy attached? ❑ Yes ❑ No J 15in4.3l13 f MW50ffld2dirspectimForm submst a sewgeoispoad Svftm•Page 11 of 17 offumm alth�of Massachusefts itle 5 Official Inspection Form ubsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 Yarmouth Road Hyannis MA perty Address Scallop LLC PO Box 264 0✓una ner's rrarrle West H amnis ort MA 02672 6/24/2014 mformatan� requved foreveryr.f rNn State Zip Code Date of inspection page. ystem Information (cont) Distribution Box (if present must be opened)(locate on site plan}: Depth of liquid level above outlet invert 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.): Ll go d Leve�S 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 appurtena , etc.): *If pumps or alarms a of in working order, system is a conditional pass. Soil Absorpti System (SAS)(locate on site plan, excavation not required): If SA of located, explain why: TA0e50f ial i specomFcm[Submsrace Savage DISPo system-Page 12of T! t9ts•W13 ommonvuealth of Massachusetts Title 5 Official Inspection Form ubsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 Yarmouth Road Hyannis MA p"Address Scallop LLC PO Box 264 Cw r er n 's Narm information is West H anWs ort MA 02672 6/24/2014 inf required for every state Zip Code Date of inspection page. frown . System Information (coat) Type: ❑ leaching pits number. (� / s="Q?//(number. leaching chambers di Peit ❑ leaching galleries number. /ZX/3 2 X/(ssro»e- ❑ leaching trenches number, length: VS/V�t+� ❑ leaching fields number, dimensions: ❑ overflow cesspool number. ❑ innovative/altemative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): ro+/Z- e ql 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 cesspoo Materials of traction Indic 'on of groundwater inflow ❑ Yes ❑ No t •3n3 TMe50ffidal1mpecUWFarm Submim'. SetipageDisposal System•Page 13 d 17 I t ommonweafth of Massachusetts itle 5``Official Inspection Form ubsurlace Sewage Disposal System Form-Not for Voluntary Assessments 551 Yarmouth Road Hyannis MA party address Scallop LLC PO Box 264 Cw ner nets Dame information is West H annis ort MA 02672 6/24/2014 required forever State Zip Code pate of Inspection page• /Town . System information (coat) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.}: Privy(loca/siteMaterials o Dimension Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): LSins•313 Ti&50fficial tnspectionFomc Subuffface SmageDisposal systm e •Page 14 of V ommonwiwth of Massachusetts t he S OfficialInspection Form ubsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 Yarmouth Road Hyannis MA Pert„Address Scallop LLC PO Box 264 °ianer "W5arr�" 6/24/2014 information is West H annis ort M required for every � " state Zip Code Date of 6lspection page. . 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 ofthe boxes below hand-sketch in the area below ❑ drawing attached separately F Vv W W , 01 BSI CAS. 2 � � S > $ -17 63 04 NT S Tdb5crfcjd[mpec6mFarM Srhsrrlace SewWDisposal SVdem-Page 15d 17 t9rs-3M3 • Ommonweatit ..of Massachuseft lug .Title 5-:_Official Inspection Form ubs;urrace Sewage Disposal System Form-Not for Voluntary Assessments 551 Yarmouth Road Hyannis MA perty Address Scallop LLC PO Box 264 OH ner 3N ner's Name information is West H __MA 02672 f/24/2014 page• frown required for every State Zip Code Date of lrspection D. System Information (coat) Site Exam: M C/heck Slope /Surface water I,4 Check cellar Shallow wells Estimated depth to high ground water. feet Please indicate all methods used to determine the high ground water elevation: Obtained from system design plans on record Y JQ L 0 If checked, date of design plan reviewed: pate ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: S ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: t You must describe how you established the high ground water elevation: NO �� Before filing this Inspection Report, please see Report Completeness Checidist on next page. . f TMa5Of6chd[mpectianFWM SLhsvtacO SOVAgeDlspasal SVSMM'Page 16 Of17 t5ir5 3It3 1 i M i Commonwealth of Massachusetts 'Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 Yarmouth Road Hyannis MA Property Address Scallop LLC PO Box 264 O,vner Cwrnees Name kv I mforrrd y on is West H annis ort MA 02672 6/24/2014 page. C*Wfro m State Zip Code Date of hspecWn E. Report Compleleness Checklist [yinspection Summary:A, B, C, D, or E checked [� Inspection Summary D(System Failure Criteria Applicable to All Systems)completed L�J System Information—Estimated depth to high groundwater Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5m•3/13 TMe5Of rdW trtspacbmForm stmart"Sev"eDaposal System•Page 17 of 17 Town o Barnstable sarnstaie Regulatory Services Department n� ,cac�y Public Health Division m 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 70081830000205008901 12/30/2009 n Auto Bath of Cape Cod Inc. D PO Box 264 West Hyanmsport, MA 02672 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 551 Yarmouth Road,Hyannis MA was last inspected on December 30, 2009, by Douglas A. Brown, a certified septic inspector for the State of Massachusetts: The inspection of the septic system showed that the system "Failed"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Backup of sewage into facility or system component due to an overloaded or clogged SAS.- * Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS. You are ordered to repair or replace the septic system within Sixty (60) days from the date you receive this notification. Failure to repair/replace the septic systemwithin the deadline period will result in future enforcement action. O BOARD OF HEALTH as cKean, R.S.; CHO Agent of the Board of Health ;.� --A Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 YARMOUTH RD Property Address AUTO BATH OF CAPE COD Owner Owner's Name information is HYANNIS required for MA 02601 _ 12/30/09 every page. Cftyfrown 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 / forms the computer, r,use 1. Inspector: U only the tab key to move your DOUGLAS A BROWN cursor-do not use the return Name of Inspector key. DOUGLAS A BROWN INC Company Name � P.O. BOX 145 CompanyAddress F- CENTERVILLE MA 02632 Cityfrown State .� -• Zip Code 508-420-4534 S14297 Tele hone Number � � �� p License Number a c f° t . B 'Certification I certify that I 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. 1 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 12/30/09 InSp601S 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. t5lns•09108 Me 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 YARMOUTH RD Property Address AUTO BATH OF CAPE COD Owner Owner's Name information is HYANNIS required for MA 02601 , 12/30/09 every page. CItyffown 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: ❑ I 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 ❑ ND(Explain below): t5ins•OM8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts 42% Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 YARMOUTH RD Property Address AUTO BATH OF CAPE COD Owner Owner's Name information is HYANNIS required for MA 02601 12/30/09 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): y ( PP ❑ 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 t5ins-09108 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 551 YARMOUTH RD Property Address AUTO BATH OF CAPE COD Owner Owner's Name information is HYANNIS required for MA 02601 every page. City/Town D2 State Zip Code Datea of of Inspection B. Certification (cunt.) 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 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 ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® 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 Y day flow t5ins•ogroa 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 551 YARMOUTH RD Property Address AUTO BATH OF CAPE COD Owner Owner's Name information is required for HYANNIS MA 02601 12/30/09 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. ® ❑ 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 ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—I WPA)or a mapped Zone I I 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•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 't 551 YARMOUTH RD Property Address AUTO BATH OF CAPE COD Owner Owner's Name information is HYANNIS required for MA 02601 12/30/09 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: ® ❑ 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): t5ins-09/U8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 YARMOUTH RD Property Address AUTO BATH OF CAPE COD Owner Owner's Name information is HYANNIS required for MA 02601 12/30/09 every page. City/Town 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: CARWASH Design flow(based on 310 CMR 15.203): 150 GPD REQUIRED Gallons per day(gpd) Basis of design flow.(seats/persons/sq.ft., etc.): 10EMP X 15 GPD 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: t5ins•09M Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 o � Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 YARMOUTH RD Property Address AUTO BATH OF CAPE COD Owner Owner's Name information is HYANNIS required for MA 02601 12/30/09 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: 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-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 YARMOUTH RD Property Address AUTO BATH OF CAPE COD Owner Owner's Name information is HYANNIS required for MA 02601 12/30/09 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed(if known) and source of information: APPEARS TO HAVE BEEN INSTALLED IN 1987 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑cast iron ❑40 PVC ❑other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints,venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: feet , Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 GALLON H-20 Sludge depth: t5ins•09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 9 of 17 0 Commonwealth of Massachusetts upTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 YARMOUTH RD Property Address AUTO BATH OF CAPE COD Owner Owner's Name information is HYANNIS required for MA 02601 12/30/09 every page. Cltyrrown State Zip Code Date of Inspection D. System Information (cunt.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 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 How were dimensions determined? Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 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-09108 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 551 YARMOUTH RD Property Address AUTO BATH OF CAPE COD Owner Owner's Name information is HYANNIS required for MA 02601 every page. Cityrrown 09 State Zip Code Date ate 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•09/08 Title 5 Official Insp ection 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 551 YARMOUTH RD Property Address AUTO BATH OF CAPE COD Owner Owner's Name information is HYANNIS required for MA 02601 12/30/09 every page. City/Town 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 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:): BOX IS IN HYDRAULIC FAILURE AS WELL AS LEACH PIT 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: tsins•09N8 ' Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Y Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 YARMOUTH RD Property Address AUTO BATH OF CAPE COD Owner Owner's Name information is HYANNIS required for MA 02601 12/30/09 every page. CityrFown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ 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.): PIT IS IN HYDRAULIC FAILURE 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-09A8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 U Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 YARMOUTH RD Property Address AUTO BATH OF CAPE COD Owner Owner's Name information is HYANNIS required for MA 02601 12/30/09 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•09M8 Title 5 Official Inspection rronn:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 YARMOUTH RD Property Address AUTO BATH OF CAPE COD Owner Owner's Name information is HYANNIS required for MA 02601 12/30/09 every page. Clty/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 i t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 1 , a Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 551 YARMOUTH RD Property Address AUTO BATH OF CAPE COD Owner Owner's Name information is HYANNIS required for MA 02601 12/30/09 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: NONE ENCOUNTERED AT 12 FT feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) 0 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: OFF SEPTIC PERMIT#86-866 SEE ATTACHED F Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09jD8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 't 551 YARMOUTH RD Property Address AUTO BATH OF CAPE COD Owner Owner's Name information is HYANNIS required for MA 02601 12/30/09 every page. Cltyfrown 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 i t5ins•09 D8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Al j wA.S f� AGL F. g DESIGN CRITERIA.- DESIGN FLORA/ SO The BSC Group '. REQUIRED SEPTIC TANK: GAL. SEPTIC TANK PROVIDED: = ICE=3 GAL. Cape Cod Survey Consultants SIZE OF LEACHING FACILITY REQUIRED: DEMN PERC. RATE: .-.- G _...--- ----- .. _ MINJINCH All i ` SIZE OF LEACHING FACILITY PROVIDED: PROJECT T T L_ r + c t�f.E_P P_1 �� i �_ . : rz SEWAGE DISPOSAL c r �:3 : x SYSTEM DESIGN tA , a : S,3C USel }tS C� rn, � Etr; ..ni 0� Q iity; E11g� ,���a rin En it nrner,t� x"o MATTHEW H. CAVALL.INI ffi lrly ' '1( F E B. 2 8 , 1 0 8 6 �,� (• ., fie�s FIzs...... :.... ~ THE COMMONWEALTH OF MASSACHUSETTS X - BOARD OF HEALTH l J ,1 71 ....7. ........................OF.... :M.�-� ...... ApPrtttion fear Di-n-vn-gttl Wvrka Tgmitrnrfian Fumil Application is hereby made for a Permit to Construct 00 or Repair ( ) an Individual Sewage Disposal System at: .......c�.� / 1�3 _................................L ..._.......----. ------- ........ y�a�tio�i-Addres .. ._.. ................................ x Lot No Owner Address ZY Installer •-�• Type of Building v,b I•l I) .P �� Address 7 Size.Lot..A-Z-20 F=..Sq. feet = a Dwelling—No.:of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type of Building No. of persons__________________________ Showers ( ) — Cafeteria ( ) a' Other fixtures .....:................... Design Flow.................... ------- gallons per person per day. /C /�- W g P P y. Total daily flow__ __..:A--••:-_-- lr�._..._...gallons. WSeptic Tank—Liquid capacity/4.'f'f"galIons Length___':_ '._ Width....1-/--..c�L.. Diameter-_.--.---_-•- Depth.... x Disposal Trench—No. ............:....... Width.................... Total Length......._..._........ Total leaching area....................sq. ft. Seepage Pit No......../*......... Diameter....... --- Depth Depth below inlet._...,: Total leaching area.`-._?----sq. ft. Other Distribution box (,--I Dosing tank ( ) Percolation Test Results Performed b �.7� f � L a y..-. -- ......... --•- -• ••-•-•••-----•-----•-----.-•--- Date_...:J`�_ Test Pit No. 1_I.--'_-``_`--.minutes per inch Depth of Test Pit..h_____________ Depth to ground water_ _..! ........ G=. Test Pit No._-..�_:_Z-.....minutes per inch Depth of Test Pit..._ :._..._. Depth to ground water-..---�f�.------ .. . W .............................................--•-------•---...--•-••---...-----••- e; 3 LG��4y St U if r n-1r-�'� 3 f'.,� r y �. _ _ Descrtption of Soil..... ..........................................-? ice... v7 x ��.................................................�/t.U _ r ...-•----••.--- JZ y�y_ rJ' ;= is ? ��/ - ow Rb1 Q r V Mature of Repairs or Alterations— °s �'�' `''°°::1:' p Answer when applicable.......................... /� i -C__.._..._- d E-f- G SL/c.`«•rT� �•� �...._. PAW Agreement: vj` ,f C/>ri� J`,�/r�c--y /�41' cc- . v mrtet:�ctr��tr ..-,,.., G•Ii.oC= /�L '/-LGUa, ✓iP�c2` L�•� rGi No The undersigned agrees to install the , eescri d Individual Sewage Disposal System n acc the provisions of i:I i� D P of the Stat anitary Code The.undersigned further agrees not to pl t '�'is� operation until a Certificate of Comp ance has be iss ed t et -d-of-lre P E Signe2........ .................•.... - Date Application Approved By_ Date Application Disapproved for the following reasons:....................... .......................... --------•---•-•---•----------------•-------...--••-----...-------•••---•---•-----•--•---•--------------------•--- ........................ Date Permit No........ .� -=.-----..C��� Issued ............. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7( ............. .........y...............OF..... ' ' ... ......................... Trf ifirttbf � b P �' ( ) ( ) THIS IS TO CERTIFY That the Individual SI sa;e Disposal System constructed or Repaired � ; at 1 ............ -^--•-.............................•--.—.__..._..___..._._---••--•----.._._-•-----'---•--•'------ -'---•--._..__..__._..___.----•----.__------ has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as describ' -in the application for Disposal Works Construction Permit No.._c`..-r_ ��_��._ _.. :7 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT R4 CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL I UbI.CTION SATISFACTORY. DATE. ............... _.. ..sue7................................ Inspector........... -•--•- -•••-----•-- h EE,R 1v US 1 S L I E. THE COMMONWEALTH OF MASSACHLJSE_"f_1"l§-ION AND CERTIFY IN WRITIN !- !�,ySTEM WAS INSTALLED IN STRICT r- -7 BOARD OF HEALTH:.,... �"), 1,^r_ Pn PLAIN. 1\i o ..::................... FEE Permission is hereby granted ------ ------•------------- �_' p .J�>>v nl.1�.... I I=`�!�� to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at No. ,; .;. T Street -------•-------•--•--•--------•-_---- as shown on the application for Disposal Works Construction Permit No.._: ��L�_ Dated_._� j�.;:CA:�i'l•••••••_.- ....._-•.•-•-._ DATE. f J Board of Health ............................... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS AsBuilt Page 1 of 1 TOWN OF BARNSTABLE LOCATION S U 1>MC)\aft R:D SEWAGE# 2O t 0-- I ei VILLAGE ASSESSOR'S MAP&PARCEL 3q5--04'JO INSTALLER'S NAME&PHONE NO. J�GJ ,�t �jfcy�nf N SEPTIC TANK CAPACITY 000 LEACHING FACILITY:(type)I S�p�(--rJ C��(size) NO.OF BEDROOMS N r woS Jr1 10 t rp10)w) ; 15D 6 PA OWNER 45�'r a H A 0 L, L- C PERMIT DATE: COMPLIANCE DATE: 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 xo 2. L j {gyp, c FRONT chRwA,s h � it 2- 3 y http://issgl2/intranet/propdata/prebuilt.aspx?mappar=345002001&seq=2 3/26/2013 - 3 - t FLOOR DRAINS (Chapter 3 81) Town Sewer Account Number: Yet Indoor floor drains: Yes No If yes, circle one, does it discharge to a: holding tank dry well on site septic. C n -7x7 c,4 &ACpa1c_&7ue-)u-reb 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 require? Yes No If yes, when? Is testing required? Yes No If yes,when? Out of doors above ground storage tank on site? Yes,(To 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: w Town -of Barnstable o� ,AMST" Regulatory Services 9c6 "9. �0� Thomas F. Geiler,Director A Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 DATE: NUMBER OF PAGES TO FOLLOW: TO: FROM: ( &A/ A.l �13 Tl-( lV PHONE: PHONE: (508)862-4644 FAX PHONE: FAX PHONE: (508)790-6304 cc: NOTE OMMENTS: �-� �L A,416t A 5 0 5� Q:\Fax Form.doc I Town of Barnstable Regulatory Services Thomas F. Geiler,Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-8624,644 Fax: 508-790-6304 5 —'XZ-0' ) Date: ! Sewage Permit# 90 "/ 3 Assessor's Map/Parcel OD? Installer&Designer Certification Form m Designer: 'vtq i�4�M'`S W�'�'`s . k C - Installer: , �'����^� c Address: n- W. Cr*4 Sty'-_1 cA Address: On was issued a permit to install a (date) (installer) P septic system at -s_Yg �d �—based on a design drawn by (address) �-e M.C..E►. r--eA T f dated i U (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the ,4 distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. 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. Stripout(if required) was inspected and the soils 6we and satisfactory. 0F MgsscyG 9 PETER T. tn. ler's lgnature) WEN TEE CIVIL No.35109not esiner's Signature) e ffi D �b e) PLEASE... TURN TO B STAB E PUBLIC HEALTH DIMS N. CE KTT ATE O C.O LTANCE L NOT BE ISS UNTII,"BO F101, B R, E D`BY THE T L'E 21— PTJB IC AL D �►1rlK YWU gAoffice fonnAdesipercertification form.doc 6 '; - 2CCGl�GL�Pi C.E', c/enI aCfI en&l VjP,1Ad. ` \4 �� J %'e�uz<<�n2e�zC n��riUuk�rzrrner�a.Gual� �Z�ZeC�usu�. S. Russell Sylva Jc�cG�PcraG� arL Commissioner �Za.�se�u�leL �iiCcc� oZ�cz. ctr�l� , czclurv���i- 023/�7 RECEIVED AUG 5 1980'" August 4, 1986 BSCICCSC The BSC Group RE: BARNSTABLE--Subsurface Disposal 3261 Main Street of Industrial Waste, Proposed Route 6A Industrial Waste Holding Tanks for Barnstable Village, Massachusetts 02630 Hanna Car Wash, Yarmouth Road ATTENTION: Stephen A. Haas, E.I.T. , Project Manager Gentlemen: The Department of Envirormlental Quality Engineering is in receipt of your letters dated 27 May and 27 June 1986, and plans dated 27 March, 9 June, 16 June and 12 July 1986, concerning the construction of a modified Hanna Car Wash System. The plans consist of five (5) sheets the first of which is titled: fr SITE PLAN OF LAND_ IN BARNSTABLE, MASS. (HYANNIS) PREPARED FOR MAT= H. CAVALLINI SCALE 1"=20' FEBRUARY 28, 1986 B.S.C./CAPE .COD SURVEY CONSULTANTS 3261 MAIN ST./ROUTE 6A BARNSTABLE VILLAGE, MA. 02630 JOB NO. 03-1738.00 DWG. NO. 1080 SHEET 1 of 2 " The plans propose the construction of a tunnel car wash utilizing a closed loop system which contains gravity oil-water separators in Wash Settle Pit #2 and Rinse Settle Pit #3 with capacities of 1100 gallons each. it is further proposed to construct Pit #6, Backwash and Emergency Holding, to contain wastes generated from the filter backwash. cycles with a capacity of 4400 gallons. The Department hereby approves the plans subject to the following provisions: 1. Disposal of the waste oil will be accomplished by the method described in the contract for the disposal of hazardous wastes with Inland Pollution Control, Inc. a A�y I 2. Recycle backwash water and the grit and sand are to be disposed at the Hyannis Wastewater Treatment Facility and Municipal Landfill respectively by All Cape Towns Punping Service. Grit and sand shall be bulked with suitable material to a solids content of 18 to 20o prior to disposal if necessary. 3. Copies .of -the contracts for pumping are to be submitted to this office upon renewal with the haulers. 4. Construction shall be in strict accordance with the approved plans and Title 5,' 310 CMRR 15:00 of The State Environmental Code and no further changes shall be made to the approved plans without prior written approval from this Department. 5. A Disposal Works Construction Permit must be obtained from the . Barnstable Board of Health prior to the start .of construction. .6. Written certification that the proposed system has been constructed in accordance with the approved plans and Title 5 of The State Environmental Code must be submitted to the Barnstable Board of Health, with a copy to this office, by the Registered Professional Engineer who stamped the plans. Nothing in this provision is intended to interfere with the right .of the Board .of Health to inspect the facility at any time during construction. 7. The system shall not be used until a Certificate of Compliance is issued by the Barnstable Board .of Health. No Envirorunental 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. Enclosed herewith are stamped approved copies of the plans, a copy of which must be kept on site and be used for construction purposes. If you should.have any questions .or need additional information, please contact Brett Rowe at the above telephone number. Very truly yours, Rb ert P. agan Deputy Regional Environmental Engineer F/BR/lm Enclosure cc: Board .of Health Town Hall Barnstable, MA 02630 Matthew H. Cavallini 75 Salten Point Rd. Barnstable, MA 02630 r -3- v cc: Department of Public Works Hyannis, MA 02601 ATIN: William Maravell, P.E. DEQE - Southeast Hazardous & Solid Waste--Section AT1N: Gerald-Monte Gregg Hunt i i /> :,,,,oF,�"F rof- �Ct!G��Z l�'J✓�'J�72.1�Crt���' i, B1HHS:YBL$ i 9L=' a,& w e71/e c_f Tt' C•G/i�i /''(/Tl��11�/ f MAS& ado,o� 1639. 'E0 MAY h• .��annul, ✓ulir�sacf:.uJcfli 02601 COMMISSIONERS: (617) 775-1120 Ext. 123 KEVIN O'NEIL. CHAIRMAN ROSERT L. O'BRIEN JOHN J. ROSARIO. VICE CHAIRMAN SUPERINTENDENT THOMAS J. MULLEN PHILIP C. McCARTIN H. TERRENCE SLACK June 23, 1986 Mr Matthew H Cavallini 11 75 Salten Point Road Barnstable, MA 02630 Re: Hanna Car Wash Systems Proposed Car Wash Yarmouth Road, Hyannis Dear Mr Cavallini: This department has reviewed your request for oil/grease trap pumpings being received at the wastewater treatment plant. Please be advised that the floatable portion will not be accepted. The clear liquid component below the floatables will be accepted at the wastewater treatment plant and will be subject to an acceptable chemical analysis. The sand/grit portion will not be received at the wastewater treatment plant, but upon separation, maybe deposited at the municipal landfill. Should you have any questions please feel free to contact me. Sincerely /R MLRTCL *RN Superintendent WNM/RLO/bw o �ypF THE s BAB.ISTAEL : ! � aa1/l,>!>�>1�C ��ff<�tfC Wle/ll/.) . �toM,,Y V� �(��rvrsai� a//Cl7JflJN7ttJ��� 0260/ COMMISSIONERS: (617) 775-1120 Err. 123 KEVIN O'NEIL. CHAIRMAN ROBERT L. O'BRIEN JOHN J. ROSARIO. VICE CHAIRMAN SUPERINTENDENT THOMAS J. MULLEN PHILIP C. MCCARTIN H. TERRENCE SLACK June 19, 1986 TO: Robert L. O'Brien Superintendent, DPW . FROM: William N. Maravell , P.E. Supervisory Project Engineer SUBJECT: Proposed Hanna Car Wash System Yarmouth Road Per your request I called Phil Ripa of SEDEQE regarding disposal of material from oil/grease trap. Mr. Ripa has reviewed several such systems and advises the following: 1. The system should be equipped with a visual and audio high alarm; 2. The floatable component should be skimmed and hauled away by a hazardous waste contractor; 3. The remaining clear liquid may be pumped and disposed of at the WTP; 4. The sand/gr.it should be removed to the landfill provid ed ed it contains at least 18,6 solids. ' WNM/mf a Inland Dol lutionI, Inc. "SERVING THE NORTHEAST " GREATER BOSTON AREA PORT OF ALBANY f. 34E Ouir1C}• fa-;?^�_ _ may • Qi FirvP.,'S.u? wBnuB Brain;n:e, r:^ ssacnuse.:s 02181 (6171 843— 71110 _ / '518) 49^ 1537 1 t617! 843 - 7; ,i i5181 _ 8% 6/13/86 Mr. Bob George Yarmouth Rd. Barnstable, MA. Dear Mr. George: In accordance with Massachusetts Code of Regulations 300, Inland Pollution Control, Inc. is pleased to make available our services to pick up and properly dispose of oil and grease trap waste from .y6ur Willow St and Yarmouth Rd. car wash in Barnstable Massachusetts. This waste material will be picked up on a fully permitted Inland vehicle and transported under a Massachusetts Uniform Hazardous Waste Manifest. Inland will transport this material to NESR Lawrence, MA. This TSDF facility is licensed and permitted by the Commonwealth of Massachusetts and the Federal Environmental Protection Agency. Once again, let me thank you for the opportunity for Inland Pollution Control, Inc. I to service your environmental protection needs. Very truly yours, Inl id Pollution Control, Inc { oseph V. Polsinello President 1 i Braintree office. I s enclosure { r 0 • r • May 12 , 1986 Mathew Cavallini Hobert George a RE : Willow Street Car Wash Willow Street Hyannis, NIA 02601 Specifications: Pump out, recycle water as deemed necessary, also remove sludge from the t :o thousand (2,000) gallon tank as deem- ed necessary. =Pans: Price shall be determined on com- pletion of the building. Thomas J. Rorke All-Cape Town 's 0 Customer Copy i „ TELEPHONE: 398-2121 c. P.O. BOX 901 SOUTH YARMOUTH, MASSACHUSETTS 02664 SERVICE AGREEMENT h I/we, the owner(s), of the premises mentioned below, hereby contract with and authorize you as contractor, to furnish all necessary materials, labor and workmanship,,to install, construct and place the improvements according to the following specifications, terms and conditions, on premises below described. Customer's Name Mathew Cavallini & Robert George Telephone X Billing Address Willow Street City Hyannis, State PIA 02601 Service Location Willow Street Car Wash City Hyannis, State KA 02601 Telephone TERMS AND' CONDITIONS This Agreement shall include sanitary pumping and disposal of sanitary waste generated by Customer excluding radioactive, volatile, highly flarnmi able or explosive material. All title to the sanitary waste shall be vested in the .Company when such waste has been loaded into Company's trucks. Customer acknowledges that Company shall not be liable for any damage to pavement or driving surface resulting from its trucks servicing an agreed upon area, This Agreement is for a term of one year and shall be renewed from year to year without further action by the parties, but may be terminated at the end of any annual contract period by either of the patties, hereto by not less th,,an 60 days prior written notice (certified mail). The Monthly Charge may be adjusted by Company from time to time upon 30 days notice subject to approval of Customer prior to the effective date of the adjustment. NEITHER PARTY HERETO SHALL BE LIABLE FOR ITS FAILURE TO PERFOR-Ni HEREUNDER DUE TO CONTIGENCIES BEYOND ITS REASONABLE CONTROL INCLUDING. BUT NOT LIMITED TO, STRIKES. RIOTS, FIRES, OR ACTS OF GOD. TERMS: S IN WITNESS WHEREOF, the parties have hereunto signed their names this 12 th day of J-^ay 19 86 Ac d/ AL -TOWN, C Per -7 Accepted (Customer) ------- Customer Copy r t, red :. ESTER CRITERIA: jDES'IGN FLOW; Z t y co.n The BSC Group i REQUIRED SEPTIC TANK: — —'-- GAL. a. SEPTIC TANK PROVIDED: _ GAL. Gaffe Cod Survey Consultants t SIZE OF LEACHING FACILITY REQUIRED: DESIGN PERC. RATE: ._.G_- -----... .. MINJINCH - ------ - _------ - J_,� :is r• L't v,:.•. 1 is QRCJ(=CT TITLLE SIZE OF LEACHING FACILITY PROVIDED: Pip _ -Eom> 79 S-6 A ;G 73 4-1-?b : .. b 1a sachu �e'tts D � artr= �n � a> En it nrnental QLia its: Er��� f;��i Ir N c? ate— a �d MATTHEW H. CAVALLINI + m� lk �il S- t,14 '�' °�d . DAB E_ FE B. 2 8 19 8 6: ut�ii.� sr. r: �U/L,O/�tl(�- i _ - •mar i10 _ - GAL to I-OA p r No.r am-•` _. - �p (,'� ej Fmc............... THE COMMONWEALTH OF MASSACHUSETTS Y BOAR® OF HEALTH AP ira ijau fvr D't,qValias ur1� 1� I S'1�CttD1<t Px�ztifi Application is hereby made for a Permit to Construct (, � or Repair ( ) an Individu Syste al Sewage Disposal m.at: ov ...................... L atio Add es "_" """' .._.. ^ Lot No. • fZl / // Owner j u ... •.75X_ _ ________ _____ _Y--•• .�- . _ ���. dress / Ad Installer U Type of Building P`, �D 1�!) `SRO 1 F Address Lot_.��_�� :=� �-+ Dwelling—No.:of Bedrooms_____________________________ Size. �:-Sq, feet Expansion Attic ( ) Garbage,Grinder ( )Other Type of Building :----•...................•-• No, of persons............-._.,__ Showers ( ) Cafeteria ( ) Q Other fixtures gallons. Design Flow_:--•---•--..... _ _ - ._. W g ---- ,l�_,____gallons per person er day. Total dailyflow.... l W' Septic Tank—Liquid capacity/4'- gallons Length_.�-�-. .• \�Vidth.._ .-�G 'Diameter..___._.---_•_. Depth_..:gallons. x Disposal Trench—:PTO- -------------------- Width............ Total Length -____-_._ Total leaching area--------------------sq. ft. Seepage Pit No.._.._../._..._.._. Diameter.._.._.�C%_...•.. Depth below inlet.....�_ _7•• Total leaching area_25._�-_-- Other Distribution box (� Dosing tan ( ) s ft. k q Percolation Test Results Performed b _ : /-' "G .. Date-__.. f� '" Test Pit No. 1-.Z- 42minutes per inch Depth of Test Pit_d� ' ____ w Test Pit No..?. �_.?:_._.-nimutes per inch Depth of Test Pit.._ ( Depth to ground water.. �� O .___. Depth to ground water ;:_.:-_-- ................................. Description of Soil ._� _.._?l.�__:�j.._3:�...__��? `� 5� � ;�� � W -- �Z / �/" ceYF;�'Sf'Slip�r�' i9X�, jp�3 fy� U Nature of Repairs or Alterations Answer when aPP licable.._...:- •-...__•. •� l•�f✓J •f L/C"<<i7.J c J 1•ri•�le:-f +'c� CEO o\ t Agreement: vh -SC-/uric g J rc-> l��4p cc'�r�r ._.f�s/�iic.�., r,� ►�Fj�JfUL y wrcA ....... The undersigned agrees to install. the e escn d Individual Sewage Disposal Syste n acc No °cdzo the rovisi.ons of i I: P 5 of the Stat anitary Cod The.undersigned further agrees not to pl t operation until a Certificate of Comp ance has be lss ed t Signe Application Approved B Y ..._._. _`G . __ s: Date -: Applicatio Disapproved for the following reason ...................... Date Date Permit.-No........1�.4=.......... _(( ..•.. Issued_............ ................ ................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...O F.........:> .a THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed or Repaired ( ) 4�,' lli.,. by...................... ....--•--....... ,,7 Installer at ---___---=---'----____:.--•---•-•--••-•••-••----- •--------- ---------------------=-•-------•..__.....---._._. has been installed in accordance with the provisions of TIKE 5 of The State Sanitary Code as desscrib• ".in the application for Disposal Works Construction Permit No -` G % -- dated---'""�_) l= 1 -.?---- �_ ' S;SIIANCE OFK'CO"115 CERTI:�FICATE Sh1A'LL N®7 6E"CON51�R11ED AS A GUARANTEE THAT YI°18: 57STE�d V►/ LL" CTION `SATISFACTORY:. _ - DATE ........... --- ............ Inspector- - =p -------•- •--- ......................................... !.'•lall�lEEIR MUST SLIP :ViVl .i.� THE.COMMONWEALTH OF MASSACF{USL±YbTION AND CERTIFY IN WRITING r-�- BOARD OF HEAL'THI SYSTEM WAS INSTALLED IN STRIC''- ..�^,r - ..c , - r )U TO PI-AN; Now OF..........` �....t "..t� .......... �� FEE v. - Raps t1 War ha: Perrnlssion is"hereby,granted . - •--••� �! v N l� t� to Construct ( ) o.r Repair ( ) an Individual Sewage Disposal Systesp at ��. r , c c- -- -•---................................. Street as shown on the.application for Disposal Works Construction Permit No .5`� Dated_._t_.' ` ................ -((,,,�/ -DATE.. ............ . V 6 Board of Health FORM 1255 HOBBS & WARREN, INC., PUBLISHERS TV� , i ^.y, •ti. • f a � 4 �'�. _ • •' �� _, - •\... �� • `i" I -p •� � _ .s c- i G r I e � � .t.. •t. yr i • y .may raw ���. i o~' L j f l Town of Barnstable Hazardous Materials On-Site Inventory and Inspection C P � FACITLITY INFO ON: Business Name: Business Location w ¢ " Mailing Address: . ,�_ ,,�;. Telephone Number. Contact Person: Emergency Contact Telephone Number: f Type of business: N Tee AZA S MATERIALS (CHAPTER 108) Virgin Product Total Quantity Container Sizes) Storage Location Major Materials Gallons or Pounds Quarts, gallons, Shed, retail store, drums, tank, etc... cabinet, closet, etc lip Y. C�) a zz 94- ---.------_. OOR DRAINS (Chapter 381) �TwlSewerAccount Number: ----__. n oor floor drains: es No If yes, circle one, dops it discharge tc'a: holding tank ry well on site se is ------�' r 1 or surface drain : es 'No If yes,'circlejone;'do-s'if discharge to a holding tank Z on site septic. tic. l� EL A D C El CAL STORAGE TANKS (Chapter 326) nderground Storage Tank(s) on'site? Yes �No ge: Is removal require? Yes _ Nb�I f yes, when? Is testing required? Yes No -•If yes,,when? Out of doors above ground storage tank on site? Yes No 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 r { Date: ` '. . �•,,w . - _�._ Public Health-Inspector: Facility Representative: R s y t Misc. Combustibles Misc. Corrosives Misc. Reactive Misc.Toxics Inventory Total Amount: Hazardous Materials License sted? Yes No Contingency Plan Posted? e No eeal9' Fire District: !tiI Fire Extinguisher Service Date: Metal Covered Rag Bin: YesWbsent Material Available? Yes No Type of Absorbent: Speedy DOther: MSDS on site? Yes Hard Copy Computer Access Hazardous Waste Handling Hazardous Waste Generator Identification Number: 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 frdzm'the elements? Yes No Is it in I I % containment? Yes No If hazardous waste is stored indoors is it on an impervious floor? Yes No 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 the 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, I` FI., 367 Main St., Hyannis, MA 02601(Town Hall) and.get the Business Certificate that is required by law. 1141.0 r1a M. Fill in please: DATE: IV 2.3. -Z I f APPLICANTS YOUR NAME, Qua I �� �`'� (U/� y; fN� 1ti , BUSINESS YOUR HOME ADDRESS: _ �, 0� f�vx Z'G y 509-77B-28i8 W� N✓/tN��s�oET /-4-1 `oz67 2- TELEPHONE # Home Telephone Number: 09- L.1/,-% 3 NAME OF NEW BUSINESS fq of C',4, c Cvcl TYPE OF BUSINESS CA a .(i_ 481i�yy= .�'. Dr7A�Ltiviy IS THIS A HOME OCCUPATION? YES NO Have you been given approval from the building division?:YES NO ADDRESS OF BUSINESS 37,571 ,4g,,06,yt , -jvg ,v�p / ¢ O�Gu( 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 individua ha n rme of e p quirements that pertain to this type of business. MUST COMPLY WITH ALL Authorized Signature ** HAZARDOUS MATERIALS REGULATIO^IS COMMENTS: • 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has informe he licensirequ e e hat pertain to this type of business. Authorize Signature** _ ___COMMENTS: ._ _; Town of Barnstable �OFTHE T Regulatory Services P �W,la Thomas F. Geiler,Director *. *. Public Health Division sAxxsTAsLE, Thomas McKean,Director COO MASS. GbA 1639, ��, 200 Main Street, Hyannis,MA 02601 Phone: 508-862-4644 Email: healthAtown.barnstable.ma.us Fax: 508-790-6304 Office Hours: M-F 8:00—4:30 December 29, 2004 Auto Bath of Cape Cod Attention: Anthony and Elizabeth Carsallini 551 Yarmouth Road Hyannis,MA 02601 RE: Hazardous Materials License Required and OVERDUE Dear Mr. and Mrs. Carsallini: It has been 120 days since your.Toxic and Hazardous Materials Onsite Inventory was conducted.: . The inventory total from August 9,2004 shows that you have approximately 416 gallons of toxic. and hazardous materials being used/stored/generated/disposed of at your place of business (Please refer to the enclosed copy of the Toxic and Hazardous Materials Onsite Inventory). Our records indicate that you.have not paid for the Hazardous Materials License. The Town of Barnstable Board of Health has determined that using, storing, generating and/or disposing of over I I I gallons of hazardous materials per month requires businesses in the Town of Barnstable to obtain an annual Hazardous Materials License. A permit to store/handle 111 gallons or more of hazardous materials a month must be obtained by your business as soon as possible. You have 14 days to comply. A follow up inspection will take place to check on your compliance. Passing your Hazardous Materials Inspection and obtaining your license will keep your business compliant with the Control of Toxic and Hazardous Materials ordinance (Article 39). Following the recommendations given after your annual inventory can prevent contamination of Barnstable's existing and future drinking water supply,prevent environmental contamination which can bankrupt site owners,lead to future regulatory, and possibly, legal problems, lower or destroy land values, drive out residents and industry, depress local economies and endanger public health. You will receive your Hazardous Materials License certificate after you have passed your inspection and paid the license fee. Your continued cooperation is greatly appreciated. If you have any questions or need further information,please do not hesitate to contact the Public Health Division. Thank you, Thomas A. McKean,RS, CHO Director of Public Health Alisha L. Parker Hazardous Materials Specialist enc. Hazmat license application Citizen Web Request Page 1 of 1 ;R y ( j ' � �� Citizen Request Management Request ID: 34211 Created: 3/21/2011 9:25:07 AM Status: Assigned To Staff Assigned To: Martin, Cynthia Health Office Anonymous: Yes Category: Chapter 108 Hazardous Materials E.C. Date: 4/4/2011 Created By: Wadlington, Ellen Citations: Health Office Time Worked: 0 Response Time: 0 Request Location: Car Wash 4t-YARMOUTH ROAD Hyannis, Ma 02601 Parcel Number: Map: 345 Block: 008 Lot: 000 Request: Reported that car wash is dumping water in street drains and not using holding tank. 5 .. http://issgl2/InternalWRS/WRequestPrintPub.aspx?ID=34211 3/24/2011 Health.Complaints 03-Oct-01 Time: 6:11:00_AM Date: - 6/11/01 Complaint Number: 2891 - Referred To: Taken By: DANIELLE STOETER - Complaint Type: GENERAL Article X Detail: UNSANITARY CONDITIONS Business Name: Car Wash _94u_kb RAC Number: 551 Street: Yarmouth Rd. Village:. HYANNIS Assessors Map-Parcel: Complainant's Name: - Address: Telephone Number: Complaint Description: Was in the car wash on Fri. Smelled stagnant water, he believes it is coming from under the car wash, as if some water is being held here and is stagnant. A^tions Taken/Results: 6/15/2001 3:10PM-1 spoke with two employees and they did not know when the under tanks had been pumped. There was a strong odor from the car wash area and entrance. Come back Monday when manager/son is here 3:10PM. 6/18/2001-Talked to Tony(owner's son) . New con-sery ozone-based treatment and three filter system MODEL VT to be installed. in July 2001 ($250,000)system. Owner will send copies of specs of new system in the mail to office. Tanks were pumped by Macomber on Sat. 6/16/20.0.1-Two full loads Investigation Date: 6/15/01 . Investigation Time: 3:10:00 PM ly EXIT 7 RT.6 RT. 6 N ` < q D LOCUS ��' OR, i . a $ o P Q4 0 ^ �O •° gvG�p. e t ?e ti 0�PG ---—-—-—-—-—-—-—-—-—- ' ------ Lewis Bay .LOCUS MAP N/ - M.B. A. RAILROAD NOT TO SCALE T. S 29731'04" W Z ' ' ' ' i 732.41' rn I EXISTING BUILDING(#551) I PAVED AREA ENTRANCE LOT 3 , N N 01— LOT(CARWASH) 2 AP 345-002-00 6 61 N w '__ _LO,-- ----------------- APN 345;�002-0 2 968738.F. 64'30 w 345-002-001 571.40 ' TOTAL AREA-27,787*S.F.(LOTs 1, &3) S 14'• EXI T 9063tS.F. � N 9' 9 1 ' Edge of pavement GENERAL NOTES: YARMOU TH ROAD 1, ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL BOARD OF HEALTH AND THE DESIGN ENGINEER. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: SEE SHEET 2 —310 CMR 15.405(1)(b): 20 SCALE 1) A 1' variance to the 3' maximum cover requirement, for 4' . of max. cover. S.A.S. shall be H-20 and vented. ' 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. �� OF MAss9cti 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN ( o� PETER T. s ENGINEER BEFORE CONSTRUCTION CONTINUES. McENTEE 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. o� CIVIL 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF No. 35109 THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF FO HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. °pF REGI ZEDS 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. f AL 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS G� l AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE DIRECTED BY THE APPROVING AUTHORITIES. PROPOSED SEPTIC SYSTEM UPGRADE PLAN 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. 551 YARMOUTH ROAD, HYANNIS MA 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS 'g Prepared for: D. A. Brown, Inc., P.O. BOX 145, Centerville, MA, 02632 IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO. 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE _ SCALLOP LLC Engineering Woks, Inc. 1"=60' P.T.M. 149_1 B INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL P.O. BOX 264 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET N0. IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. W. HYANNISPORT, MA 02672 (508) 477-5313 5/28/10 P.T.M.` 1 Of 3 5 , LEGEND —— 98 —— EXISTING CONTOUR BENCHMARK x 100.98 EXISTING SPOT GRADE SEPTIC TANK INLET W EXISTING WATER SERVICE RIM EL.=99.05 TEST PIT EXISTING SEPTIC TANK BENCHMARK ITO (OU�=95.42 N/F M.B. T.A. RAILROAD EXISTING D-BOX ITO N (OUT)I N9 V. 4.58 . . . . . . . . . . . .. . . .. . . . . . . .. . . .. . .-f '97;41 . . . .. . . . . . . . . . . ... . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . ------------------------------------------9& -------------------------------------------98-------------------- i l [ Edge of pavement 98.59 895[ 99.03 Edge of pavement 99.04 ZPA VEO AREA 99,03 S 29'31'04" W - -- - - - PROPERTY LINE 732.41' PAVED AREA N 345-002-001 2 3 i 54 - PROPOSED S.A.S. �� > > EXISTING( BUILDING (#551) i RIM- -13.2'� • 98.73 TOTAL AREA=27,787±S.F.(LOTS 1,2 & 3) _ 99.03 ��� M 98.90 .•TP-2 .j Leach Pit 1 TP1-1•: ..� CBN �Solid�Gatchbosin v'�Drainoge) �_ ® 98,51 IM�98,74 R -98,$3 � i 99,20 DBEB �X I _ ROOF OVERHANG i RIM= 99.01 �`-- ' 98, q i t L-- ------------------------------------ Edge pav't 99.26 Ede of avement 98,78 `� _ .� 98,95 Edge of pavement N VAC r ,c-H�, VAC � VAC VAC 0 VAC X 99.60 RR Tie _ VENT 571.40 98,92 R 99.35 N 29'29'10" E PROPERTY LINE 99,23 99,57 Edge of pavement 99.18 EXISTING LEACH PIT TO BE PUMPED, FILLED W/ YARMOUTHROAD SAND & ABANDONED F OF 4,4ss9� PETER T. PROPOSED SEPTIC SYSTEM UPGRADE PLAN Mc 551 YARMOUTH ROAD HYANNIS MA o CIVIL CIVIL N o. 35109 '. R 10 Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 £GISZE �� OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO. SCALLOP LLC Engineering orks, Inc. 1"=20' P.T.M. 149-10 ` P.O. BOX 264 g g YY S� 1 �� W. HYANNISPORT, MA 02672 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. (508) 477-5313 5/28/10 P.T.M. 2 of 3 NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL:94.5 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. ®®®® ® ® ®® PROPOSED S.A.S. ®®®®®® ® ® ®® INSTALL H-20 RISER, FRAME & COVER OVER CHAMBER F- 37:' SET TO FINISH GRADE TO SERVE AS INSPECTION PORT � w EaT.O.F. I F.G. EL: 99.1 f(MAX.) N z • EXISTING F.G. EL.=99.0t F.G. EL: 98.9t VENT — lop 102" L31' 17%w ® S=1% (MIN.)4'SCH40 PVC 2" LAYER OF 1/8" TO 1/2" •- � •' 6• DOUBLE WASHED STONE io'I (OR APPROVED FILTER FABRIC', 4" KNOCKOUT Ba O as 14" s BaaaE30 INV.=95.42 aaa6aaa 20" DIA. COVER EXISTING 48" LIQUID EXISTING —3/4" TO 1-1/2" DOUBLE LEVEL 4' 5.2' 4' WASHED STONE GAS BAFFLE INV.=94.75 INV.=94.58 a 4" KNOCKOUT / 4" KNOCKOUT 62" ' EXISTING EXISTING EFFECTIVE WIDTH =i 13.1 EXISTING D-BOX INV.=94.00 1 EXISTING SEPTIC TANK 1-500 GALLON LEACHING CHAMBERS SURROUNDED WITH STONE AS SHOWN 4" KNOCKOUT H-10 RATED f TOP CONC. ELEV.=95.1 BREAKOUT ELEV.=94.50 aBaa 500 GALLON CAPACITY, H-20 LOADING INV. ELEV.=94.00 ease NOTES: 1) CHAMBERS SHALL BE SET LEVEL AND TRUE TO easeTP aB CHAMBERSGRADE ON EXISTING SUITABLE SOILS. 6aaaaaa BOTTOM ELEV.=92.00 2) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE 4' 8.5' 4' N.T.S. AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. 5' MIN. ABOVE BOTTOM OF EFFECTIVE LENGTH = 16.5' T.P. EXCAVATION OR G.W. DESIGN CRITERIA LEACHING SYSTEM SECTION NO GROUNDWATER, EL.=87.0 r SEPTIC SYSTEM PROFILE . DESIGN FLOW: (APPROVED—ORIGINAL PERMIT) 10 EMPLOYE x 15 GPD/EMPLOYEE = 150 GPD N.T.S. I ALLOWED UNDER 330 GPD/ACRE REGULATION 0.64 Ac. x 330 GPD/aC. = 210 GPD I SOIL LOG GARBAGE GRINDER: NO DATE: 1. MAY 14, 2010 (REF#12,936) LEACHING AREA REQUIRED: (210) = 283.8 S.F. MAG, NAIL SET SOIL EVALUATOR: PETER McENTEE (SE#1542) .74 98.95 WITNESS: DAVID STANTON R.S. EXISTING SEPTIC TANK: 1000 GALLON CAPACITY HEALTH AGENT ELEy. TP-1 DEPTH ELEV. TP-2 DEPTH DISTRIBUTION BOX: EXISTING 98 5, 0" 98.5 011 USE 1 -500 GALLON LEACHING CHAMBERS IN SERIES FILL FILL SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES 98.0 A � 12" 98.0 A 12" s SANDY LOAM SANDY LOAM SIDEWALL AREA: 2(13.2' + 16.5') X 2 = 118.8 S.F. 44 3'' '6+) 97.7 B 10YR 4/2 16" 97.7 B 10YR 4/2 16„ BOTTOM AREA: 13.2' x 1 6.5' = 217.8 S.F. EXISTING BUILDING (#551) I �• TOTAL AREA:..............................................................336.6 S.F. SANDY LOAM SANDY LOAM j (CAR WASH)/ j S2 6'3 1�13_2:�1 10YR 5/8 1OYR 5/8 I � O' �� 95.5 36" 95.5 36" / I PROP. �� c j: C DESIGN FLOW PROVIDED: 0.74(336.6) = 249.1 G.P.D. I 54.6 S.A.S. : PROPOSED SEPTIC SYSTEM UPGRADE PLAN ROOF OVERHANG --- I 54.7 ——————————————————————————— 67 8' ' ______'1 M fC SAND M—C SAND 551 YARMOUTH ROAD, HYANNIS MA 10YR 5/4 10YR 5/4 Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 87.0 1 t 138" 87.0 138" Engineering by: SCALE DRAWN JOB. NO. PERC' RATE <2' MIN/IN. ("C" HORIZON) Engineering Works, Inc. NTS P.T.M. 149-10 S.A.S. LAYOUT , (PERC RATE ON FILE) 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. NO GROUNDWATER ENCOUNTERED (508) 477-5313 5/28/10 P.T.M. 3 of 3 I EXIT 7 l RT.B N RT e f o � LOCUS 1 �Q• O O f 0 M JG� P �i • R gorPG ----------------------------- Lew15 Bay P LOCUS MAP N/F M.B. T.A. RAILROAD NOT TO SCALE S 29'31'04" W � 732.41' � rn EXlS71NG BUILDING(#551)� li PAVED AREA ENTRANCE LOT 3 (CAR WASH) LOT 2 I AP 345-002-00 6� N to APN 345-002-002 9�7t&F. 66 W N `------- Q - ---------- 9W7*&F. ' wN 345-002-001 571.40 cork u -z7,767*sF.�LOTs,. 3) 5 14�4% EXI T 9063*s.F. N 9' 9 Edge of pavement ^ A T/� GENERAL NOTES: /�/f I R/V/OU / /-7 ROAD 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL BOARD OF HEALTH AND THE DESIGN ENGINEER. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: SEE SHEET 2 —310 CMR 15.405(1)(b): 20 SCALE 1) A 1' variance to the 3' maximum cover requirement, for 4' + of max. cover. S.A.S. shall be H-20 and vented. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE qS DESIGN ENGINEER. �F M9� 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN o PETER T. ✓ ENGINEER BEFORE CONSTRUCTION CONTINUES. 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. U McEN " o CIVIL 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF No. 35109 THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF /SSF��� HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. A� 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. � l( 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS C� t AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE r DIRECTED BY THE APPROVING AUTHORITIES. PROPOSED SEPTIC SYSTEM UPGRADE PLAN 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY i� THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. rjrj'I YARMOUTH ROAD, HYANNIS MA 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS Prepared for: D. A. Brown, Inc., P.O. BOX 145, Centerville, MA 02632 IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO. 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE (• SCALLOP LLC 1"=6O' P.T.M. 149-10 PRIOR TO BA KFI Engineering Works, Inc. INSPECTED BY DESIGN ENGINEER C LL. P.O. BOX 264 DATE SHEET NO. 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND I 12 West Crossfield Road, Forestdale, MA 02644 CHECKED N 0 IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. I, W. HYAN ISPORT, MA 2672 (508) 477-5313 5�28/10 P.T.M. 1 Of 3 II LEGEND — — 98 —— EXISTING CONTOUR BENCHMARK x 100.98 EXISTING SPOT GRADE SEARC TANK INLET W EXISTING WATER SERVICE RIM; EL.=99.05 TEST PIT 1� BENCHMARK EXISTING SEPTIC TANK (TO,, REMAIN) 95.42 N/F M.B. T.A. RAILROAD INV.(OUT)=EXXISTIISTI NG D-BOX (TO REMAIN) IN V.(OUT)=94.58 96.91. .. .. .... .. . . .... .. . ... .. .. .. .. .. . .-. .97.09. . .. . . . . .. . . .. . . . . . . . . . . .. . . .. . . . . . .. . .... . . .. . .f.97;41 . . . .. ... . ... . . . .. . . .. .. . . ..---- . . .. .. --------------- ---98------- . .. .. . :. .. ... . ----------------- -------------------------------------------9°,------------------- ! Edge of pavement 8.9 5 T ' 99,03 Edge of pavement 99,04 t PA IVED AREA 98,59 99,03 S 29'31'04" W PROPERTY LINE 732.41' PAVED AREA APN 345-002-0019293 EXISTING BUILDING 4551) ' PROPOSED S.A.s. � (CAR WASH) � RIM- 54, - 98,73 TOTAL AREA=27,787tS.F.(LOTS 1,2 & 3) _ :<�a 99,03 ��� �rM 98,90 j;''. -'''�-2• j Leach Pit // i TPi-1•: "ta rn CBN So -Catchbasin ��Oroinoge) 99,20 RIM= DBDX 98, J U,_ ® 98,51 �� M`98.74 �� R-M=98,83 ROOF OVERHANG 99,01 _ -------------- 99.26 Ede of avement -- 31 98 8\�� �//Edge pov't - 98,95 Ede of pavement o �}„VAC VAC C�j VAC VAC c5t� VAC N IZSI 99,35 X 99,60 RR Tie VENT 571.40 98,92 RR N 29'29'10" E PROPERTY LINE 99.23 99,57 Edge of pavement 99,18 EXISTING LEACH PIT TO BE PUMPED, FILLED W/ YA RM O U TH ROAD SAND & ABANDONED OF 44sn o� PETER T. ti� PROPOSED SEPTIC SYSTEM UPGRADE PLAN McENTEE CIVIL N 551 YARMOUTH ROAD HYANNIS MA o. 35109 A R£GISTE�``� �Q Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 `� OWNER. OF RECORD SCALE DRAWN JOB. NO. Engineering by: SCALLOP LLC Works, Inc. -ZF) W. HYANNISPORT, MA 02672 rossfi 1"=20' P.T.M. 149-10 P.O. BOX 264 Engineering cJ 12 West Celd Rd, Forestdole, MA 02644 DATE CHECKED SHEET NO. Road, i (508) 477-5313 5/28/10 P.T.M. 2 Of 3 ` t NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL:94.5 FOR�A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. PROPOSED S.A.S. yI ®®®® ® ®®® INSTALL H-20 RISER, FRAME & COVER OVER CHAMBER ®®®®®® ® ®®® ® 37" T.O.F. SET TO FINISH GRADE TO SERVE AS INSPECTION PORT N > ® EXISTING F.G. EL: 99.1 f(MAX.) Z ®Qm®®® F.G. EL.=99.Of F.G. EL: 98.9f �. VENT — A 102" L = 31' ® S=1% (MIN.) 2" LAYER OF 1/8" TO 1/2" 6 - 4"SCH40 PVC11. DOUBLE WASHED STONE 4" KNOCKOUT 11 as as (OR APPROVED FILTER FABRIC is"I is 6 aaa$aaa 20" DIA. COVER •. INV.=95.42 aaaBaaa EXISTING 48" LIQUID EXISTING �3/4" TO 1-1/2" DOUBLE LEVEL 4' 5 2' 4' WASHED STONE GAS BAFFLE INV.=94.75 INV.=94.58 4" KNOCKOUT / 4" KNOCKOUT 62" EXISTING EXISTING EFFECTIVE WIDTH 13.2' 1 EXISTING D—BOX INV.=94.00 L EXISTING SEPTIC TANK 1-500 GALLON LEACHING CHAMBERS SURROUNDED WITH STONE AS SHOWN 4" KNOCKOUT TOP CONC. ELEV.=95.1 H-10 RATED BREAKOUT ELEV.=94.50 500 GALLON CAPACITY, H-20 LOADING INV. ELEV.=94.00 a®®a NOTES: 1) CHAMBERS SHALL BE SET LEVEL AND TRUE TO aeaBa aaBaa CHAMBERS GRADE ON EXISTING SUITABLE SOILS. aaaa aaOaa BOTTOM ELEV.=92.00 FF 2) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE 4' 8.5' 4' N.T.S. AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. 5' MIN. ABOVE BOTTOM OF EFFECTIVE LENGTH = 16.5' T.P. EXCAVATION OR G.W. DESIGN CRITERIA LEACHING SYSTEM SECTION NO GROUNDWATER, EL.=87.0 SEPTIC SYSTEM PROFILE DESIGN FLOW: (APPROVED—ORIGINAL PERMIT) 10 EMPLOYESS x 15 GPD/EMPLOYEE = 150 GPD N.T.S. ALLOWED UNDER 330 GPD/ACRE REGULATION 0.64 Ac. x 330 GPD/aC. = 210 GPD SOIL LOG GARBAGE GRINDER: NO DATE: MAY 14, 2010 (REF#12,936) LEACHING AREA REQUIRED: (210) = 283.8 S.F. MAG, NAIL SET SOIL EVALUATOR: PETER McENTEE (SE#1542) .74 98.95 WITNESS: DAVID STANTON R.S. EXISTING SEPTIC TANK: 1000 GALLON CAPACITY HEALTH AGENT ELEv. TP-1 DEPTH ELEv. TP-2 DEPTH DISTRIBUTION BOX: EXISTING 98.5 0" 98.5 0" USE 1 —500 GALLON LEACHING CHAMBERS IN SERIES FILL FILL SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES 98.0 A 12" 98.0 A 12" / i S SANDY LOAM SANDY LOAM SIDEWALL AREA: 2(13.2' + 16.5') X 2 = 118.8 S.F. 4 , " 10YR 4/2 10YR 4/2 BOTTOM AREA: 13.2' x 16.5' = 217.8 S.F. 97.7 16" 97.7 16" EXISTING BUILDING (�#551) 4 `3 ��. B e SANDY LOAM SANDY LOAM TOTAL AREA:..............................................................336.6 S.F. I�13 2'.y_ I (CAR WASH)// j S2 63 __ 10YR 5/8 10YR 5/8 95.5 36" 95.5 36" �' �• � S OS i� C c DESIGN FLOW PROVIDED: 0.74(336.6) = 249.1 G.P.D. 54.6A. : 0) PROPOSED SEPTIC SYSTEM UPGRADE PLAN ROOF OVERI-IANG ' ------- i 54.7 b ----------------------- �1 M-C SAND M-C SAND �551 YARMOUTH ROAD HYANNIS MA 67•8� 1OYR;5/4 1OYR 5/4 Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 87.0 138" 87.0 138" Engineering by: SCALE DRAWN JOB. NO. PERC RATE <2 MIN/IN. ("C" HORIZON) Engineering Works, Inc. NTS P.T.M. 149-10 S.A.S. LAYOUT I (PERC RATE ON FILE) 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET N0. NO GROUNDWATER ENCOUNTERED (508) 477-5313 5/28/10 P.T.M. 3 of 3 �I t t yy S H REV DWG N .0 _ _6 5 1 , 7 - 8 : t REVISIONS , . i RE V V DESCRIPT ION N DA TE . .A PPROVED ED I , I , l r J i t: w� k Y OF { - I -r�/p 1"1"r I V4 31 —cl 1— r.=J L D , E } I 1` I , , D { 5 D , , 4 I l a ....... I x , ( I 1 } ` f k 3 f 1 I 1 C 1 �m et` 1 � I �/t RINSE. PIPES�J i i I j I TYP I ' I } ; i I ( i I E � i , l „ - _...�WW..�.�-..�..v........;..,..x.�--,-•A u�..,.._.......__.._a, �...,......�.,_-....,w.,.__.�..._..a.._.........�.......,._.�..- 43 0 I i f ; a , I r , R , or TYP I , t , A 4 M 4% t w . » i i A I a ,{ } A 3 V , ., ... a, ,. ,. - _ : .. ...: «: .. r w ew ✓. Iry ry . r ,,. ,Mz. d "l r a:r�. 1 w a.ry n 4. '�v N t .n-mw„.,,W ie+^ w'r. a-.. ,✓. , y. o�. +.. ..' t s y¢J1 t I �a� M em"w y C M a r , rSeT , , i f o � m �. NOTE k v i (,qE - 1 r ; x I , I ,IRa r ♦ d ^?d � i q e evg I Y I A L EVE i r s 1 , : .. _«.«.......,+».,v-.-,o...,awr..+iw�,..+•„ww.w.,A.ea..»-mow ,: -. xn.+n+w+,yw.. +w+.rs:x+n-vr..w,.�-.mn.,........,�w .y. ..w-,•... w ' o < n b: a a t cz s 9 a i N t _.. d i 1 1 j E a I (�/'�j ON , N T � t F TO 1-71AINNA CAR "' ! Ag r t i t i "�"" VW TH E 1 • ALL f t _ N �f f Y' AND �R r ` �"��'�" V I ! L E r G.r o � � B B I ..W s HI GH WA 3 : FIT a l i • r CAPACITIES . s e t 1 l s. 'ea„s' #. a ^fir E ,. rr v b FJ =i { a l a qq e a f • i WASH F TER 990 e !' ' TTdry.... //'''�� ' �ws' l _. .... _- -u�... _:. } y I I .�w _ } , { a t i { r (1{. b Y Q 1�3- RINSE ?1 s • 07 dry. �. >. L Y .a 0 ,Q. 'Environmental tt t� I � t 1 1_d U i r O fi ACT ,J1/ l k-u y i P/ T 3 , • a f M DWG SC _ I PART N0. ` DE R(PTI N DESCRIPTION R D R R R D MATERIALP - IT E E D E D E ECIFICATION ITEM Q Q S Q Q No slz E r PARTS AR LIST T. w . N . S S CUS DWG. 0 1 I an. , J M , UNLESS 'OTHERWISE SPECIFIED TOLERANCESU L S RNfN D f ' . � 9 R� FA MACHINED SURFACES a CH A � L . 1 I� +w CHK 1DIAMETERS N�. �U 2 t• fii LI AND IT T E, .005 ! > �V. ',X%X .0€l5 T IR 1 _; GUT _ �— f 0 1 X% ' ; E i 02 '�7 .X L... „ /�' , r t✓ ; r C 005 AN E � 1 Gl .. MFG. a 4;1. 1 002 /IN. m l A n Q 002✓IN. I - 20 t v FILLET,RADI I ,OiO 0 v MA l SPEC SIZE F M NO REV .00 T SC R 5 1 _ K CORNERS 00 R COR BREAK ` E 1 ,/ , r, RR FREE PER 510 8 D 3 , BURR R ANSI Y14.5 � DRAWING PER S FINISH SPr:C INTERPRET D IN E I , :H 8 R HANDBOOK, 2 THREADS PEt . _R N XT ASSY 106 REF E , SHEET,:: zt. k SCAR r f �m , . 4 3 2 1 , , S , . c i i I a , C IQ LOCATION MAP F � o S CA L E 2, 0,53 rt � � � � �w ZONE • BUSINES ASSE,.5S0RS MAP 3 4 o ASSESSORS LOT 2 I y Oco l I � A. P / f r 1 T ` � � BM HIGH POINT ,r ,r f ' =` ,M., OF CB/OH FND. NOTES ,i '� f' ,T ,. EL. 99.93 (ASSUMED) I) PROPERTY LINES SHOWN HE:REON WERE COMPILEDVS k1T f f N 4 FROM A PLAN RECORDED AT THE BARNSTABLE COUNTY REGISTRY OF DEEDS IN PLAN BOOK 390 PAGE 27 AND DOES NOT REPRESENT AN ACTUAL SURVEY ON THE GROUND. r ITS A 2)THIS TOPOGRAPHIC SURVEY WAS MADE ON THE GROUND BY TRANSIT AND S TT ARIA MET HCD. 3b T'H I{j P L.A M S tom-,} ►� l�� S E .:,� J J �k� �,( N\A c, L / ra 9 8 2ry As A -ZEC' iP-Cur_ATl�V ,' f /j ' .� N A 0 Q A�-' cAiP- w AsN SYST E" -5 LOT 'S I Z Aga Tv ►.3T c� c�� � I , ToTA L �P-E A ' 2'', 78 '. Rt J z. �. ALL 1>R-A 1 0/ C, �. �S TU E C.)QT AI V)E-b 461 * } 0 . All � ew-� ,, �, \v� r ¢ . ,� Zu PP-0FknS�Z> 5Por ELEVA77C0 ,t /`'IIgA/N6L-E 60VE,- Td r—.,AJi SA) 4;R-4D4:- fI STo/vEtK STo�L M WATF-J. ILOLA 1 Di IZGiC ?6 t)- jv qOGER r A P'o)L l J / a W C C1VJL l ' i • D 4/ �I hyf; PRC1FES !(?IG',4L v:IJilll Ur !%E fr' t «;7,tVA 3 z7 8� �vVA E D A 70E At IV ' r T P . r 4 0 ci s 2 a. v SITE PLAN O,'� -� RGVt BA R AV *5 8, L At"' VA Aw Y 11 ,. �' �.s• Y F' 43 er E3T: 'f?EPAF'E"G �C?F MA T THE'✓✓ H. CA VA L L fNI IJ LIST N �r --�f f �p 3'-9. IsT vac, `-20 ' -Et3HUARY 28, 1986 fRaw `tom ! ddsEZ S _ 3 r 8$ <� CA %E COL. 5 RJR VE Y C 0 V SOL TA lit T y ':y -- 3261 AWA/ill Sr / R!9tJTE 6A NDERGR a;`�D U T H!TIES WERE COI PILED FROM AVAILABLE '; '5AR.NSTA8`E VILLAGE, MA. 02630 RECCRD P1 At4 OF UTILITY CO PANiES .AND Pt LIC• AGOiCIES AND 4RE .zF°'Iw'ROXIMATE ONLY. BEFORE DESIGN AND CONSTIRUC T ION CALL " 0116 SAFE" I - SOO - 322 -4,6 4 . `�P Av'C7 738. 0o uWo NO. 1080 SOIL TEST PIT DATA: , INDICATES � INDIC/►TI^•5 SEPTIC TANK DETAIL: i �% ....".��- ,<. NOT To s '` -- - ISTRIBUTION BOX DETAIL. LEACHING PIT _DETAIL. REVISION.. PE RC. --�_`-- GROUNDWATER NOT TO SCALE TEST c3RouNOwraTER CALF NOT TO SCALE ��;, , Ail NOTES: 1. SEPTIC TANK SHALL BE STEEL 4 INLET AND OUTLET TEES TO BE CAST IRON OR TP ' TP SCHED. 40 PVC. TEES TO BE CENTERED UNDER � 4. BROUGHT TO OR PAVEMENT ' TP # }, TPO�` REINFORCED CONCRETE. E --� COVER OR PAVEMENT GRD. EL. _`� �_� GIRD. EL. ��•_�_ GRD. EL 38_'�._ GRID. EL. _ ! 2 SEPTIC TANK TO WITHSTAND H 10 LOADING NO. OF OUTLETS: __�__ � � ^ MANHOLE CO FINISH GRADE MANHOLE COVER. T- NOTES GW. EL. _ —__ GW. EL. _- -. GW. EL, GW. EL. _ -__- UNLESS UNDER PAVEMENT, DRIVES OR i i. DIST. BOX TO WITHSTAND H-10 LOADING 21MIN.OF I/8 1 TRAVELED WAYS,WHEREIN H-20 LOADING ��� ��� M +�1 }G I;. =£r- p�---� SHALL APPLY. I t UNLESS UNDER PAVEMENT, DRIVES OR TO HE y �� I■ paw 1 PRECAST I TRAVELED WAYS WHEREIN H-20 LOADING WASHED 12'MIN. FILL pIST I I SHALL APPLY. STONE ' 3. ALL PIPE CONNECTIONS AND CONCRETE MANHOLE COVER �1 6 1 1 CONSTRUCTION TO BE WATERTIGHT. BROUGHT TO FINISH GRADE ) BOX � 2. PROVIDE INLET TEE OR BAFFLE WHERE SLOPE OF - - - - -� • ���" �� Q t ~ c r I r I , INLET PIPE EXCEEDS 0.08 FT./FT. OR IN PVC INLET PIPE ° 'a o o 0 o a j - - - 11_..t- a r,„ rr_::__:: y. _ 1 o. 1.7 � R.► �' G' L/1 � �� 1 tti I 1�,�� _...r� � 5 L.r 11. I 1 - —_— i T - a o� - 1 "MIN 1F� fiPfi� PUMPED SYSTEM. T �� n - z' MIN ---r 7---J r 'S ❑ � o o ro L71 CM 0 ❑ �°� NOTE' I L..O A R J --- --_ covEN 3. LE OUT OF OIS C A1 ' a LEACHING T GENERAL NOTES + _ BOX TO BE LAID FIRST TWO FEET OF PIPE T = s I LE �f+ - _ _ PLAN VIEW I TO LEVEL. o WITHSTAND H-10 LOADING �"" M ti Eta/IM C O li I R F� -1 c i 1a �� --- --- -- o PRECAST oI. e jO �] . �' 4 ,� a d To UNLESS UNDER THIS PLAN IS FOR DESIGN AND ��� ^' -- - NORMAL WATER LEVEL �'I -�� ?EMOVEABLE- /!-, ,-'-'T"TJ-'^4------- r'�'"r7�- � I �� � , fj�o �� j PAVEMENT,DRIVE OR CONSTRUCTION OF THE S WAGE y f UEt. - - - - - - - - - - - - - - - - - �� ------ - COVER w 3/4 TOt-II2` ❑ la c7 L� c1 oa ❑ E ,I TRAVELED WAY WHEREIN DISPOSAL FACILITY ONLY. O FIN15h GRADE DOUBLE LEACHING PIT Oe H- 20 LOADING SHALL T i I I t• -U v WASHED APPLY. 2 ALL CONSTRUCTION METHODS AND T T _.-- / _ __- - 2.7 I _ I I-�/Z �_ ❑ o c� c� o n o RA V e PROVIDE STONE o MATERIALS SHALL CONFORM TO MASS. i t fI /! INLET TEE ' '^ j�y jr' COA�2 ,I ob _�____ I WATERTIGHT X w (no f inesg� D.E.Q.E. TITLE 5 AND LOCAL BOARD e^ 1j ' ►RECAST _ I•. `----- --- c[ t� JOINTS(tYC) .I I' •I I• LL o m n o � ca o 0 ❑ �' + - OF HEALTH REGULATIONS. SA N)6 �(V�` SEPTIC I, 4 •0" MIN. OUTLET � 7 �F-1 � SEE TANK N UOUID DEPTH - TEE '' 4 ,I NOTE 2 '`I ' ° s - - I ' 4' INLET _ I I tr o 3. ALL PIPES LOCATED UNDER PAVEMENT UV T M I .I �` '}L�J �- �• 4' OUTLET r _q _ I� o o OR TRAVELED WAY SHALL BE U '] CI C� C7 II ,t I - {- 1. p o ��Q. a SCHEDULE 40 OR EQUAL. . , 13AN D5 ___ -__ 8� I 'I� `�_-.__-� �� �/ \�, - j ^ r,. jJ , __ PIA BOTTOM ON LEVEL STABLE BASE J4�;r - y nJ - -BOTTOM CIN 3 G' op�• k = o`o, LEVEL STABLE _ �' DIA -- -� �RAV E L SAND ;%C� ir-✓ir�y; 3 CROSS-SECTION - - 4 r i - � r/.�- BASE PLAN VIEW CROSS-SECTION VIEW ' 144 r r3 , r44' g6.� i44" 84. CROSS-SECTION ~ 7 -_ A T��' lV C W A T`6E I� _.._. .. -- DATE DATE: DATE: DATE: _ CONSTRUCTION NOTES: - INVERT ELEVATIONS: TEST BY. TEST BY. TEST BY: TEST BY, ? SVirC�t�.LI_ .`ip WAR G Ka.Ir EC3 ARP KE�.I_ - -__ - .-- - INVERT AT BUILDING WITNESSED BY WITNESSED BY: WITNESSED BY: WITNESSED BY- INVERT AT SEPTIC TANK(in) I-At-11ES�tI�t')ki SAME - �LON JAN� L'Ur 111LOt\1 _ - -- _ ,� INVERT AT SEPTIC TANK out) cj PE RC. RATE' PERC. RATE. PERC. RATE: PERC. RATE ` 1 MIN./INCH - --° PV9IN.-ONCH _�_---- MINANCH _MIN./INCII- D`'HE.Av''l oLrry � � I ©I "REPV'{DOTY HhoRcxx- INVERT AT DIST. BOX(in) c1G Fsu,I.1 rv_ :;;�r� c.,-c�a•T-�_ J i F� I � cc>v�:u_-tc, �t tti�►sH INVERT AT DIST. BOX(out) DATU , 24" t►x,SoR �izl�K hfJD f�uQeCgAes-�- '� �'�b*� INVERT AT LEACHING PIT _ .5-7 ►ta wu L_: c,� �� BOTTOM OF LEACHING PIT 901w 4 r~u 1_.'POLY, ----- - VERTICAL DATUM: A 5 5 tJ' !`=\ �. %,.` I'toRrAiz_ ' --Y 4 U .S.G. S. MAXIMUM GROUND _ „PEASTo NE 7-c cT►+t;�. WATER ELEVATION _ _- FRE_GA {ZRcf? I'4bJ6L. -► + `' ==_=- OBSERVED GROUNDWATER 'E+A:�1�.� — - :.-. _ TIP` G.� 'J6 ,. B E h l.. rin A R}'� L�S E C : ��`_.. �"..... - ..LL �T�1F-Itl.1- � ,.o �y +�0.�' L D 3,_�" a f (T.rP) §, E L E VAT 10 N SUMP 3/4"-.�/ WA6np : .�i 'e,E t76'jiGt t-�E 1� Fotz_ F1.2o Litt u AM-0 u Sz 1;-U ro r�t<-r To 8E , I i I SUbsU FA(-E. DESIGN CRITERIA.- A. S� L_E DESIGN FLOW: -------�c— � The B S C Group REQUIRED SEPTIC TANK: — --- GAL. y SEPTIC TANK PROVIDED _ �� GAL. SIZE y Consultants OF LEACHING FACILITY REQUIRED: Cape Cod Survey I DESIGN PERC. RATE: G-._�� _ _-- _._ _ MINJINCH j __ - ---- ------ — --------'. - - - �1oute 6A 61 /—------ SIZE OF LEACHING FACILITY PROVIDED: PROJECT TITLE � t�c.fp PytT-_ ��., . -- -- SEWAGE DISPOSAL ---� SYSTEM DESIGN VVk -t,-- � T=��-/aid■- 1•d' ----- - ------ y 1' i✓�42.Ih1C:+ C.u.��S�e. 2y 81Nt��. cvvac.S�_ t a sachusetts D �p tl' En it nmEntal Qualit„ Engfneertit� IZ'� G,oMP /i�Tl~'1r7 G, R..A+J r�L IF C,60 P�Lr�AI,En I_�� _T y P 1 C A I_ DR 1 V� \Aj/�.,Y AN[D PATS.K I tic, GR.oS_5 ' 3EC.`T'10� MATTHEW H. CAVALLINI WO 3tAl.E - 00 RbGIaR PnuL cy .M1CF:P;IWIII2 a;w20 DATE FEB. 28 , 1 9 8 6 CIVIL E7�4 ' ,I COMP DESIGN. S A H CHECK DRAWN FIELD FILE NO. DWG NO 1080-1 SHEET ---_-._ .------ - 5 JOB NO 3 - 1 7 3 8.00 2 0" 2 ,.w...®.....e.+a�.�_..w. q ' e..s 1 ■ I *� ...�� ...+,+...rw�swn.,.....w_a.ae.++_....awvn^.� sxv':u Y PARTS LIST 1 REVISIONS ITEM QTY DESCRIPTION PART NO. NO. DESCRIPTION DATE BY AjPP'D /V 0rE 5 7' .5 V.,7r-1,0.7 1-4 L/R -4- -7<'� 7K&--:L TL) 4 1� 7r A/jO 6- -5 S A G . W IR /A/ G //0 11A;- 2+ voc loe TO WALL 4 M)Ekculle 14k Ci us et nee , % m3ss 'nMental Q'3 "92T J.map. ORWN CHK'O P*Oi 3. DIMENSIONING AND TOLERANCING TITIA PER MIL-STD-ANSIY 14.7-1973 Cr) "'4 2. PART TO BE FREE OF BURRS TOLERANCES MArL-sftc- PER MBC ES1018 OC UNLESS OTHERWISE SPECIFIED evil# .xxx 1.01M 0 1..& 1 REV.. CLASSIFICATION TYPE FRAC�0.6 11/44 AMOLKS *112a KT. DRAWING NO. DRILLED MoLE '*03 1. DO NOT SCALE DWG. "LLET RADII.0061 CORNER RRXAK%0'*4M/0"10 z NOTES: RUAFACCS ';�� I1CALJE I )VC)N C �11 =- :^="q*'^" I Taft I.L .0" r= I I IX ISMET CW im I C p NOTICE: This drawing contains designs and other information which are the property of th any,except for rights expressly granteci t)v contract This dfavviog rnaV not, in whole or in part,be duplicated or disclosed or used for manufacture of the part disclosed iier,in vvitt)oui ie prior written oerrnis%ion of thp— --Iglg@MNMW 4e'111