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Home My WebLink About0355 FALMOUTH ROAD/RTE 28 - Health 355�Falmouth Road, Hyannis A= I Mid Ca a Medical Center r I I I TOWN OF BARN S TABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops 0 unsatisfactory- 4.Manufacturers COMPANY cve�f<. �GLN,� �- (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS 3 Class: S_ 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline Jet Fuel(A) Diesel,ese , Kerosene, #2(B) Heavy Oils: waste motor oil (C) new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers S Miscellaneous: .M.�--,cui.K o-c" 3 fj K C `13 X Lsez d 0 DISPOSAL✓RECLAMATIO i REMARKS: 1. Sanitary Sewage 2.Water Supply �',I ', 5 d- C-i-cefJ ceg ways�Q own Sewer 6Public &A,;, k 0 On-site OPrivate 3. Indoor Floor Drains YES I N04 0 Holding tank:MDC_ 0 Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES-)< -NO ORDERS: 0 Holding tank:MDC `423 • ' �-c ,6 lei bY- O Catch basin/Dry well On-site system 5.Waste Transporter �F 4. YES INO 1. 2. v � Pers n(s) nt ed Inspector Mate SPA TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory 2.Printers 3.Auto Body Shops I O unsatisfactory- 4.Manufacturers COMPANY J (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS � �OAV Class: 7.Miscellaneous i� QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATE IALS Case lot s Drums Above Tanks IN I OUT IN OUTI 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 Miscellaneous: Fly DISPOSAURECI.AMATIO REMARKS: 1. rla ?\161es anitary Sewage 2. Water SupplyAli O 0/(,S D� own Sewer Public 'A ULJIX�[N F-6c:rA On-site Private 3. Indoor Floor Drains YES INO O Holding tank:MDC Q� 0 1 mr,n- d CON-reo O Catch basin/Dry well MAN i A hm S O On-site system , b a "S 0 Q 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5. Waste Transporter �&axne of Hauler Destination Waste Product ja NO2. c erson (s) Interviewed Inspe for I � � . \v TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: MID CAPE MEDICAL CENTER Board Mail To: 355 IFALMOUTH RD. of Health MAILING ADDRESS: Town of Barnstable TELEPHONE NUMBER: 1. 71-4092 P.O. Box 534 NA CY NILAND R.N. Hyannis, MA 02601 CONTACT PERSON: i 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 xxxx 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 i as determined that the following products exhibit toxic or hazardous characteristics and must be registered 10 t &qase put a check beside each product that you store: xxx Antifreeze (for gasolin, or coolant-systems) Drain cleaners Automatic transmissio fluid xxx Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) xxx Disinfectants Motor oils/waste oils - Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, i 2 heating oil xxx Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal xxx 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 I 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 I (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) I xxxx Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) MEDICAL WASTE IS REMOVED BY Other cleaning solvents BFI EVERY MONTH. Bug and tar removers PHOA OCHEMICALS ARE REMOVED Household cleansers, oven cleaners BY BOSTON RECOVERY CO. EVERY MO. - White Copy- Health Department/ Canary Copy-Business TOXIC AND HAZ RDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: Mail To: BUSINESS LOCATION: T( ,9 3? t &e&ase51,11n1 Board of Health Town of Barnstable MAILING ADDRESS: �Stf'�L-VYI<7r>�L, r�r,�' �� c � P.O. Box 534 TELEPHONE NUMBER.CC ,Q 'TV f �'6 qo_*� Hyannis, MA 02601 CONTACT PERSON: A i % a Z: kW V EMERGENCY CONTACT TELEPHONE NUMBER: Does your firm store 'any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES � NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE:H LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid 0 Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (includi Ig brake fluid) Id Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel . Refrigerants Diesel fuel, kerosene, #2 heating oil )c2aZ_, Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal f�,C��f° hotochemicals (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 I Leather dyes T6f',l0ints, varnishes, stain I, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners . I (inc. carbon tetrachloride) Floor & furniture strippers . Any other products with,"Poison" labels Metal polishes I (including chloroform, formaldehyde, Laundry soil & stain removers . hydrochloric acid, other acids) (including bleach) I 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