HomeMy WebLinkAbout0211 WEST MAIN STREET - Health 211 West Main Street, Hyannis
ACUUM & SEWING MACHINE HOUS
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TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
nters
BOARD OF HEALTH O satisfactory s:A to Body Shops
�Pcuu"
unsatisfactory- 4.Manufacturers
COMPANY �-Se�� , ee"Orders") 5.FuelReta Stores
6.Fuel Suppliers
ADDRESS all VV : H ST, a 7.Miscellaneous
(�Y)►1(� QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors)
MAJOR MAT IALS bo
IN OUT IN I OUT IN JOUTI#&gallonslAge ITest
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:
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D - /o
DISPOSALIR.ECLAMATION REMARKS:
1. Sanitary Sewage 2.FWter Supply
Town Sewer ublicO On-site rivate
3. Indoor Floor Drains YES NO,-
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
4. Outdoor Surface drains:YES NO ORDERS:
O Holding tank:MDC . b(,r&
O Catch basin/Dry well U —
O On-site system
5.Waste Transporter
•d
YES NO
1.
2.
q �
erson s) Inte wed nspector Da e
Date:
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAMEOFBUSINESS: v /~
BUSINESS LOCATION:
- MAILING ADDRESS: � - � Mail To:
TELEPHONE NUMBER: ` -� �-- � Board of Health
Town of Barnstable
CONTACT PERSON: i P.O. Box 534
EMERGENCY CONTACT TELEPHONE NUMBER: Hyannis, MA 02601
TYPEOFBUSINESS: ,.� eS a ��/✓el«S
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 gasoline asolineorcoolants systems)Y ) 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
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
Car wash detergents Jewelry cleaners
Car waxes and es polishes Leather dyes
Y
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 & cle
aning fluids
(dry cleaners)
Other cleaning solvents
Bug and tar removers
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
? J- 0092
'TOWN OF BARNjiABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
�Q�satisfactory 2.Printers
B OAR;D O F H T 3.Auto Body Shops
unsatisfactory- 4.Manufacturers
COMPANY �W� (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS .216, k✓` 1�� � Class: 7.Miscellaneous
_ ��
111,J QUANTITIES 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)
Diesel, Kerosene, #2 (B)
Heavy Oils:
waste motor oil (C)
new motor oil(C)
transmission/hydraulic
Synthetic Organics:
degreasers
Miscellaneous:
3 /
DISPOSAURECLAMATION REMARKS:
1. Sanitary Sewage 2.Water Supply
O Town Sewer �cPublic
O On-site OPrivate
3. Indoor Floor Drains YES NO X
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
4. Outdoor Surface drains:YES KNO ORDERS: O
O Holding tank:MDC 5'h�_.5
Catch basin/Dry well
O On-site system
5.Waste Transporter
Name of Hauler Destination Waste Product
YES NO
1.
2.
Per on(s) In rviewed Inspector T Date