HomeMy WebLinkAbout0247 MAIN STREET (HYANNIS) - Health 247 MAIN STREET, HYANNIS
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TOWN OF BARNST-ABLE
LOCATION, �- 7 / "a "° 14f Mv' SEWAGE #
VILLAGE O -3 7 ..'�-�`' 6
ASSESSOR'S MAP & LOTJ 7
INSTALLER'S NAME & PHONE NO.
SEPTIC TANK CAPACITY '' S 1�' ° '
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LEACHING FACILITY:(type) :;L-5-0 (size)
NO. OF BEDROOMS PRIVATE WELL O/RR PUBLIC WATER
BUILDER OR OWNER E
DATE PERMIT ISSUED: / j
DATE COMPLIANCE ISSUED: gvz/
VARIANCE GRANTED: Yes No,
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TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAME OF BUSINESS: . Mail To:
BUSINESS LOCATION: X) Board of Health
Town of Barnstable
MAILING ADDRESS: ?` ,0/Z P.O. Box 534
TELEPHONE NUMBER: :2 0 ;2 �7�' Hyannis, MA 02601
CONTACT PERSON: /3 013 :?2�^es
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 o alling, at any time, more than 50 gallons liquid volume or 25 pounds dry
weight? YES NQ�
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:
Quantity/Case Quantity/Case
Antifreeze (for gasoline or coolant systems) Drain cleaners
Automatic transmission fluid Toilet cleaners
Engine and radiator flushes Cesspool cleaners
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 6F;(k
Bug and tar removers IA%W
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Household cleansers, oven cleaners d' 40*
40-11 Aeeel at 7,y� 9k
White Copy- Health Department/ Canary Copy-Business 07
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