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°ptHE TO{y Town of Barnstable - Office:508-862-4644
Public Health Division Fax:508-790-6304
• BARNSTABLE.
MASS. g, 200 Main Street• Hyannis, MA 02601
ArEDMP+p`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT J Q
Business Name: l:( l 0,vr neS Date:
Location/Mailing Address: 07 r OU R `
Contact Name/Phone: r1
Inventory Total Amount: � SIDS: License#:
Tier II NIA Labeling: A Spill Plan:
Oil/WaterSeparator: Floor Drains: N/A Emergency Numbers:wJff�
Storage Areas/Tanks:
Emergency/Containment Equipment: All h
Waste Generator ID: Waste Product:
Date&Amount of Last Shipment/Frequency:
I� Licensed Waste Hauler&Destination:
Other Waste Disposal Methods:
LIST OF TOXIC AND HAZARDOUS MATERIALS
NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use,
storage and disposal of 111 gallons or more requires a license from the Public Health Division.
Antifreeze Dry cleaning fluids
Automatic transmission fluid Other cleaning solvents&spot removers
Engine and radiator flushes Bug and tar removers
Hydraulic fluid (including brake fluid) Windshield wash
Motor oils Miscellaneous Corrosives
Gasoline,jet fuel, aviation gas Cesspool cleaners
Diesel fuel, kerosene, #2 heating oil Disinfectants
Miscellaneous petroleum products: Road salts
grease, lubricants, gear oil Refrigerants
Degreasers for engines&garages Pesticides:
Caulk/Grout insecticides, herbicides, rodenticides
Battery acid (electrolyte)/batteries Photochemicals(Fixers)
Rustproofers Photochemicals (Developer)
Car wash detergents Printing ink
Car waxes and polishes Wood preservatives(creosote)
Asphalt&roofing tar. Swimming pool chlorine
Paints, varnishes, stains, dyes Lye or caustic soda
Lacquer thinners Miscellaneous Combustible
Paint&varnish removers, deglossers Leather dyes
Miscellaneous Flammables Fertilizers
Floor&furniture strippers PCB's
Metal polishes Other chlorinated hydrocarbons
Laundry soil &stain removers (including carbon tetrachloride)
(including bleach) Any other products with "poison labels"
(including chloroform, formaldehyde,
hydrochloric acid, other acids)
VIOLATIONS:
ORDERS:
INFO MATIO /RECOMMENDATIONS: A—neS notUirp- pefril
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Inspector:
Facility Representative:
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS