HomeMy WebLinkAbout0349 IYANNOUGH ROAD/RTE 28 - Health 349_1 ,4A _RD _H_.., _annis
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TOWN OF BARNSTABLECOMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
satisfa tory 2.Printers
BOARD OF HEALTH 3.Auto Body Shops
' factory- 4.Manufacturers
COMPANY �Dy (see"Orders") 5.Retail Stores r
�A� 6.Fuel Suppliers
ADDRESS be- :Z- K c3 c ass• 7.Miscellaneous
3q J` -- UANTITIES AND STORAGE (IN=indoors;OUT=outdoors)
MAJOR MATER
IALS Case lots 1
Cu Jf �� IN OUT IN OUT IN OUT #&gallons Age Test
Fuels:
\ Gasoline,Jet Fuel (A)
Diese erosene, #2 (B)
Heavy Oils: grn f r (�L,
waste motor oil(C)
�- new motor oil (C) S�
4
transmission/hydraulic,__ _!
Synthetic Organics:
degreasers
1 v"�
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Miscellaneous: 6
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DISPOSAURECLAMATION REMARKS:
1. Sanitary Sewage 2.yW�A ter Supply rAq 2AV 4 v&l
Town Sewer ;Public [ S
O On-site OPrivate
3. Indoor Floor Drains YES NO-
0 Holding tank: MDC
O Catch basin/Dry well
O On-site system Y
4. Outdoor Surface drains:YES /\ NO ORDERS:
O Holding tank:MDC
Catch basin/Dry well
O On-site system
5.Waste Transporter
Name of Hauler Destination Waste Product
1.
YES INO
`�
2.
C� 01
Person (s) Interviewed Inspector Date
Date: J _j
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAMEOFBUSINESS: 'Lk) C Qa (Q9 PA) 0
BUSINESS LOCATION: I
MAILING ADDRESS: P6 DZ��0 Mail To:
TELEPHONE NUMBER: Board of Health
Town of Barnstable
CONTACTPERSON: )rp P.O. Box 534
EMERGENCY CONTACT TiNPHONE NUMBER: Hyannis, MA 02601
TYPE OF BUSINESS: S�_P iS
Does your firm store any of the toxic or hazardous materials listed below, either for sale or for you own
use? YES O 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) &CYA Drain cleaners
NEW USED SVO Cesspool cleaners
0 Automatic transmission fluid 0 Disinfectants
n Engine and radiator flushes O Road Salt (Halite)
to Hydraulic fluid (including brake fluid) Refrigerants
' s Motor oils O Pesticides
P-**'NEW USED (insecticides, herbicides, rodenticides)
_ Gasoline, Jet Fuel 0 Photochemicals (Fixers)
Diesel fuel, kerosene, #2 heating oil NEW USED
_ Other petroleum products: grease, Photochemicals (Developer)
lubricants, gear oil NEW USED
) Degreasers for engines and metal 0 Printing ink
Degreasers for driveways & garages ® Wood preservatives (creosote)
Battery acid (electrolyte) 6 Swimming pool chlorine
Rustproofers 0 Lye or caustic soda
Car wash detergents 0 Jewelry cleaners
Car waxes and polishes 6 Leather dyes
Asphalt & roofing tar Q Fertilizers
Paints, varnishes, stains, dyes 0 PCB's
Lacquer thinners 0 Other chlorinated hydrocarbons,
NEW USED (inc. carbon tetrachloride)
Paint & varnish removers, deglossers
Paint brush cleaners � Any other products with "poison" labels
(including chloroform, formaldehyde,
0 Floor& furniture strippers hydrochloric acid, other acids)
_/ Metal polishes
_ Laundry soil & stain removers Other products not listed which you feel
(including bleach) may be toxic or hazardous (please list):
Spot removers & cleaning fluids
(dry cleaners)
Other cleaning solvents
_ Bug and tar removers
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS