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LOCATION SEWAGE #
VILLAGE ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type)o2-_ (size) %s% X
NO. OF BEDROOMS BUILDER OR OWNER Q AdFF '//
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PERMITDATE: f"/� ` COMPLIANCE DATE:/' °-00 m a✓
' Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
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Citizen Web Request Page 1 of 1
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�r Citizen Request Management
Request ID: 58715 Created: 4/12/2017 3:54:33 PM
Status: Assigned To Staff Assigned To: Lavelle,Timothy
" Health Office
Anonymous: No Category: Chapter 108
} Hazardous Materials
E.C. Date: 4/26/2017
Created By: Sousa,Vanessa Citations:
Health Office
Time Worked: 0 Response Time: 0
Request Location:
727 MAIN STREET(OST.)
Osterville, Ma 02655
Parcel Number: Map: 141 Block: 013 Lot: OOA
Request: .
Shared septic system with dentist office. Says septic failed and wants to know if there are
any chemicals and what kind going into septic system. Says chemicals are coming from
dentist office.
Request Work History'
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http://issgl2/InternalWRS/WRequestPr.intPub.aspx?ID=58715 4/21/2017
-� Healthcare; � .
Safety Data Sheet ,
Safety Data Sheet(incompliance with Regulation(EC) Date Issued: 29 September 2010
1907/2006,Regulation(EC) 1272/2008 and Regulation Document Number: 0021131MS
(EC)453/2010} Date Revised: 21 May 2014
_ Revision Number: 3
sIDENTIFI@ATION=OF THE,.StJMTANCE/MIXTURE AND OF THE
G
:*'C-0 IPANY/UNDERTAKING -
1.1 Product Identifier:
Trade Name(as labeled): Purevac SC ,
Part/Item Number: . 21135,21132,21131
1.2 Relevant Identified Uses of the Substance or,Mixture and Uses Advised Against: .
Recommended Use: Evacuation system cleaner
Restrictions on Use: For professional use only
1.3 Details of the Supplier of the Safety Data Sheet:
Manufacturer/Supplier Name: Sultan Healthcare
Manufacturer/Supplier Address: 1301 Smile Way°
York,PA,!USA
Manufacturer/Supplier Telephone Number: ' 1-201-871-1232 or 800-637-8582
(Product Information)
Email address: customer.serviceAsultanhc.com
1.4 Emergency Telephone Number:
Emergency Contact Telephone Number: 800-535-5053 (INFOTRAC)
1-352-323-3500
(Outside the United States'—Call Collect)
I. HAZARD(s)IDENTIFICATION,: '-
t
2.1 Classification of the Substance or Mixture: s
GHS/CLP Hazard/Danger Classification:
Health Environmental Physical
Eye Irritation.Category 2 None JFIammable Liquid Category 3
EU Classification:'Flammable
EU Risk(R)and Safety(S)Phrases: R10
Refer to Section 16 for the full text of the EU Classifications and R Phrases.
2.2 Labeling Elements:.
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Signal Word: WARNING F
Hazard Statements Precautionary Statements
H226 Flammable liquid and vapor P210 Keep away from heat,sparks and flames—No smoking.
H319 Causes serious eye irritation. P240 Ground container and receiving equipment.
P243 Take precautionary measures against static discharge.
P280 Wear eye protection.
P303+P361 +P353 IF ON SKIN(or hair):Remove immediately-
all contaminated clothing.Rinse skin with water.
P370+P378 In case of fire,use water spray,carbon dioxide or
alcohol-resistant foam for extinction.
P305+P351+P338 IF IN EYES:Rinse cautiously with water for
several minutes.Remove contact lenses,if present and easy to do.
Continue rinsing.
P337+P313 If eye irritation persists:Get medical attention.
P403+P235 Store in a well-ventilated place.Keep container tightly
closed.
P501 Dispose of contents/container in accordance with local and
national regulations.
2.3 Other Hazards: None
3: COMPOSITION AND INFORMATION ON INGREDIENTS;
a
F
Hazardous Components C.A.S.# IUPAC Name Substance Classification WT%
EC#
Water 7732-18-5/ water Not Classified as 40-60
231-791-2 hazardous
Propylene Glycol 57-55-6/ propane-1,2- Not Classified as 25-30
200-338-0 diol hazardous _
Isopropanol 67-63-0/ propan-2-ol F,Xi R11,R36,R67 .5-10
200-661-7 Flam Liq.214225;'Eye Irrit
2A H319, STOT SE 3
} H336
Sodium Bicarbonate 144755-8/ sodium Not Classified as 2-5
205-633,-8 hydrogen hazardous
carbonate'
1,3-Triazine-2,4,6-(111, 3H; 5H) — 17766-2676/ trisodium 4;6- Not Classified as 2-5
trithione,sodium salt 241-749-5 bis(sulfanyliden hazardous
e)-1H-1,3,5
triazine-2-
thiolate
Alcohols,C8-C10, ethoxylated 68603-25-8/". c8-10, Xn R22,R36 2-5
propoxylated Polymer ethoxylatedprop Acute Tox 4 H302;Eye
oxylated Init 2A;Aquatic Acute 3
H402
Fragrance Mixture None Not Classified as 0-2
hazardous
The exact concentration is being withheld as a trade secret.
Refer to Section 16 for the full text of the GHS and H phrases and EU Classifications and R Phrases.
4. .FIRST-AID MEASO&S
4.1 Description of First Aid Measures:
Routes of First Aid Instructions
Exposure
Eye Immediately flush eyes with large quantities of water for at least 15 minutes,holding the eyelids
apart. Get medical attention if imitation persists.
Skin Wash skin thoroughly with soap and water.Get medical attention if irritation develops or.persists.
Inhalation If symptoms develop,remove to fresh air and get medical attention-.
Ingestion Do not induce vomiting. Rinse mouth with water and give one glass of water to drink. Never give
anything by mouth to an unconscious or convulsing person. Get medical attention.
4.2 Most Important Symptoms and Effects,Both Acute and Delayed:
Causes eye and skin irritation.Inhalation of vapors or mists may cause upper respiratory tract irritation.
4.3 Indication of Any Immediate Medical Attention and Special Treatment Needed:
If eye irritation occurs,get medical attention.If large amounts are swallowed,get medical attention.
Note to Physicians(Treatment,Testing,and Monitoring): Treatment of overexposure should be directed at the control
of symptoms and clinical conditions.
5 FIRE=FIGHTING MEASURES "
5.1 Extinguishing Media
Use water fog or spray,dry powder,carbon dioxide or alcohol-resistant foam
Fire Fighting Procedures: Cool fire exposed containers and structures with water.
5.2 Special Hazards Arising from the Substance or Mixture:
Flammable liquid and vapor.Vapors may collect in confined areas presenting a fire;and explosion hazard.
5.3 Advice for Fire-Fighters:
Fire Fighting Procedures: Cool fire exposed containers,and structures with water.
Precautions for Fire Fighters: Firefighters should wear positive pressure self-contained breathing apparatus and full
protective clothing.
Recommended Protective Equipment for Fire Fighters:
EYES/FACE SKIN RESPRIATORY THERMAL
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6. ACCIDENTAL RELEASE--, 4 *
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6.1 Personal Precautions,Protective Equipment and Emergency Procedures:
Eliminate all sources of ignition and ventilate the.area. Wear appropriate protective clothing; gloves and eye protection.
Respiratory protection may be needed for large spills..
Recommended Personal Protective Equipment for Containment and Clean-up:
EYES/FACE SKIN RESPIRATORY THERMAL
�I
6.2 Environmental Precautions:
Prevent spill from entering sewers and water courses.Report releases as required by local and national authorities.
6.3 Methods and Material for Containment and Cleaning up: .
Collect using an inert non-combustible absorbent material and place in appropriate containers for disposal.
6.4 Reference to Other Sections:
Refer to Section 8 for Personal Protective Equipment and Section 13 for Disposal information.
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7. HANDLING AND STORAGE
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7.1 Precautions for Safe Handing:
Avoid contact with the eyes, skin and.clothing. Avoid breathing mists: Wear appropriate protective clothing and equipment.
Use with adequate ventilation.Wash thoroughly with soap and water after handling.Keep containers closed when not in use.
Keep product away from heat,sparks,flames and all other sources of ignition.
7.2 Conditions for Safe Storage,Including Any Incompatibilities:
Store in a cool,dry,well ventilated area away from incompatible materials.Protect from physical damage.
7.3 Specific End Use(s):For professional use only. e `
' 8:= `EXPOSURE CONTROLS/PERSONAL PROTECTION
8.1 Control Parameters:
Occupational Exposure Limits:
Propylene Glycol a 10 mg/m3 TWA AIHA WEEL
150 ppm TWA(vapor and particulates), 10 mg/m3 (particulates)TWA UK OEL
Isopropyl Alcohol 400 ppm TWA OSHA PEL
200 ppm TWA ACGIH TLV,400 ppm STEL'
200 ppm TWA DFG MAK
400 ppm TWA UK WEL,500 ppm STEL
400 ppm TWA INKS VLCT
400 ppm TWA VLA-ED,500 ppm VAL-EC
Sodium Bicarbonate None Established
1,3-Triazine-2,4,6-(1H, 3H; 5H) =None Established -
trithione,sodium salt
Alcohols,C8-C10,ethoxylated . None Established
propoxylated
Fragrance None Established
Biological Exposure Limits:None Established
8.2 Exposure Controls:
Appropriate Engineering Controls: Use with adequate general or local exhaust ventilation to maintain exposure levels
below the occupational exposure limits. '
Individual Protection Measures(PPE)
Specific Eye/face Protection: Chemical safety goggles should be worn where eye contact is possible.
Specific Skin Protection: Wear impervious gloves such as rubber if needed to avoid prolonged contact.
Specific Respiratory Protection:None required under normal use conditions.
Specific Thermal Hazards:Not applicable
Recommended Personal Protective Equipment:
EYES/FACE SKIN RESPRIATORY THERMAL
9. PHYSICAL AND,CHEMICAL PROPERTIES`
9.1 Information on Basic Physical and Chemical Pro erties:
Appearance: Light green liquid Explosive limits: LEL: 2.5%(isopropanol)
UEL: 12/o(isopropanol)
Odor: Slightly Citric Vapor pressure: 45.5 mmHg @ 25°C
(isopropanol)
Odor threshold: Not available Vapor density: >1 (air= 1)
PH at Concentrate:'9
PH: pH at Recommended Relative density: Not available
Dilution:—7
Melting/freezing point: Not available Solubility: Miscible
Initial boiling point and Not available Partition coefficient n- Not available
range: octanol/water:
Flash point: 105°F/40.6°C Auto-ignition Not available
temperature:
Evaporation rate: Not available Decomposition Not available
temperature:
Flammability: Flammable liquid Viscosity: Not available
Explosive Properties: Vapors may be explosive in Oxidizing Properties: None
confined areas
9.2 Other Information:None available
tO.STABILITY AND
REACTIVITY
LL
10.1 Reactivity:Will not polymerize.
10.2 Chemical Stability: Stable under normal use conditions."
t
10.3 Possibility of Hazardous Reactions:None known.
10.4 Conditions to Avoid: Avoid heat,sparks,flames and all other sources of ignition.
10.5 Incompatible materials: Avoid strong oxidizing agents,strong bases and strong acids.
10.6 Hazardous Decomposition Products: Thermal decomposition may produce carbon oxides,aldehydes;alcohols,
ethers and organic acids. -
A. TOXICOLOGICAL INFORMATION'"
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11.1 Information on Toxicological Effects:
Potential Health Effects:
Eyes: Causes severe irritation to eyes with redness,pain and tearing.
Skin:May cause skin irritation on prolonged contact.
Ingestion: Swallowing may cause gastrointestinal irritation.
Inhalation:Inhalation of mists may cause mucous membrane and upper respiratory tract irritation. Inhalation of high
concentrations of isopropanol vapors may cause headache and dizziness.
Chronic Health Effects: None known.
Carcinogenicity:None of the components are listed as a carcinogen by IARC,NTP, OSHA, ACGIH or the EU Substances
Directive. There is inadequate evidence of carcinogenicity of isopropyl alcohol in human and-animals. Propylene Glycol:
The carcinogenic potential of propylene glycol has been investigated in two long term feeding studies.No increase in tumors
was recorded in rats receiving the equivalent of 1,700 (males) or 2,100 (females) mg/kg bw%day over two years. Tumor
incidences were also unchanged in male and female Beagle dogs ingesting 20%propylene glycol in diet(equivalent to 5,000
mg/kg bw/day),again over two years.
Mutagenicity: Isopropyl Alcohol: In an in-vivo study, isopropanol did not induce micronuclei in bone marrow of mice. ..:
Studies conducted in mammalian cells in-vitro, it did not induce sister chromatic exchanges or gene mutations. Propylene
Glycol: Negative results were observed in bacterial assays, in-vitro mammalian cell gene mutation test, in-vitro mammalian
chromosome aberration test,mammalian erythrocyte micronucleus test,and a dominant lethal assay.
Medical Conditions Aggravated by Exposure: Employees with pre-existing eye and skin disorders may be at increased
risk from exposure.
Acute Toxicity Data:
Propylene Glycol: Oral rat LD50 21,000 mg/kg, Skin rabbit LD50 20,800 mg/kg
Isopropyl Alcohol: Oral rat LD50 5,045 mg/kg,Skin rabbit LD50.12,800 mg/kg
1,3-Triazine-2,4,6-(1H,3H,5H)—trithione,sodium-salt: LD50 skin rabbit>2,000 mg/kg
Sodium Bicarbonate: LD50 oral rat 4,220 mg/kg
Alcohols,C8-CIO,ethoxylated propoxylated: Oral rat LD50 616 mg/kg, Skin rabbit 5,660 mg/kg,Inhalation rat LC50>8
mg/L/l hr
Reproductive Toxicity Data: Propylene Glycol:Effects on fetal development have been investigated_ in pregnant rats,
mice,hamsters and rabbits. Orally administered propylene glycol(gavage)was well tolerated with no adverse effect on
pregnancy parameters or maternal or fetal survival at any treatment level.There was no evidence of teratogenicity at any
dose level. Isopropanol:In a rat developmental study,female Sprague-Dawley rats were dosed by oral gavage.with either 0,
400, 800,or 1,200 mg/kg isopropanol during gestation days 6 to 15.Mortality was observed in the mid-(4%)and high-dose
(8%)animals and reduced maternal gestational weight gain on gestational days 0 to 20 associated with significantly reduced
gravid uterine weights were noted in the high-dose animals.Fetal body weights were reduced at 800 and 1,200 mg/kg.No
adverse maternal or developmental effects at 400 mg/kg.No teratogenic effects were noted at any dose tested.
Specific Target Organ Toxicity(STOT):
Single Exposure: Propylene Glycol: Clinical signs(loss of balance,marked depression,and analgesia)were reported in the,
rabbit and guinea pig only at extremely high doses that exceeded the established limit dose(5,000 mg/kg)for an acute oral
toxicity study. Similar effects were also evident in one study with mice only at doses that resulted in lethality(LD50 value of
24,800 mg/kg/day).Isopropanol:Inhalation of 400 ppm(1,000 mg/cu m)isopropanol by guinea pigs for 24 hours reduced
the ciliary activity in the nasal mucosa,but recovery was complete within two weeks.Higher concentrations produced s
damage that required longer to repair.
Repeated Exposure: Isopropanol:A 13 week inhalation study with rats found effects of narcosis at 5,000 ppm.These effects
were reversible at the cessation of exposure. A 73 week chronic study found male reproductive effects at 2,500 and 5,000
ppm and liver effects at 2,500 ppm. Propylene Glycol: Rats can tolerate a repeated oral daily dose of up to 30 mL/kg bw in
the diet over 6 months,while the dog is unaffected by a repeated oral dose of 2g/kg in the diet for 2 years.
tt
12.1ECOLOGICAL INFORMATIONY
m
12.1 Toxicity:
Propylene Glycol: Selenastrum capricornutum(green algae)18,100 mg/L,48 hr LC50 Daphnia magna 43,500 mg/L;96 hr
LC50 Pimephales promelas(Fathead minnow)46,500 mg/L
Isopropyl Alcohol: 96 hr LC50 Pimephales promelas(fathead minnow)6.12 mg/L
Alcohols,C8-C10,ethoxylated propoxylated: 96 hr LC50 pimephales promelas(fathead minnow) 13.3 mg/L;48 hr EC50
daphnia magna 12.3 mg/L; 16 hr IC50 bacteria 220-770.mg/L
12.2 Persistence and Degradability: Is Alcohol is readily biodegradable(95%,after 21 days). Alcohols,C8-C10,
ethoxylated propoxylated is readily biodegradable(70%in 28 days). Propylene glycol is readily biodegradable(100%after
9 days).
12.3 Bio-accumulative Potential:No data available.
12.4 Mobility in Soil: No data available
12.5 Other Adverse Effects:None known.
12.6 Results of PBT/vPvB Assessment:Not required
II'DISPOSAL
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13.1 Waste Treatment Methods:
Regulations:Dispose in accordance with local and national environmental regulations
Properties(Physical/Chemical)Affecting Disposal:None known.
Waste Treatment Recommendations:None
14:TRANSPO_ RT INFORMATION
14.1 UN 14.2 UN,Proper Shipping 14.3 14.4 Packing 14.5 Environmental
Number Name Hazard Group Hazards
Class(s)
DOT UN1993 'Flammable Liquid, n.o.s. 3 PG III No
(Isopropanol)
Note: Not regulated for transport in the United States. See aqueous alcohol exemption at 49CFR 173.150(e)
14.6 Special precautions for user:Flammable Liquid
14.7 Transport in Bulk According to Annex II of MARPOL 73/78 and the IBC Code:Not applicable—product is
transported only in packaged form.
15.'AkGUL=AT0RY INFORMATION
15.1 Safety,Health and Environmental Regulations/Legislation Specific for the Substance or Mixture:
U.S.Federal Regulations
Comprehensive Environmental Response and Liability Act of 1980 (CERCLA):.This product is not subject to
release reporting under CERCLA.Many other states have more stringent regulations. Report all spills in accordance
with local,state,and federal regulations.
Toxic Substances Control Act (TSCA): This product is a medical device and not subject to chemical notification
requirements:
Clean Water.Act(CWA):Not Listed
Clean Air Act(CAA):Not Listed
Superfund Amendments and Reauthorization Act(SARA)Title III Information:
SARA Section 311/312(40 CFR 370)Hazard Categories:
Immediate Hazard: Yes Pressure Hazard: .. No
Delayed Hazard: No Reactivity Hazard: No
Fire Hazard: Yes
}
This product contains the following toxic chemical(s) subject to reporting requirements of SARA Section 313
(40 CFR 372):
Components C.A.S.# ` WT%
None -
State Regulations -
California: This product contains the following chemicals(s)known to the State of California to cause cancer,,birth
defects or reproductive harm:
Components C.A.S.# WT %
1,4-dioxane 123-91-1 <1 ppm
Propylene Oxide 75-56-9 <2 ppm
International Regulations'
Canadian Workplace Hazardous Materials Information System (WHMIS): Medical devices are not subject to
WHMIS.
EU REACH: The substances in this product comply with the EU REACH regulation as applicable.
F =16:1OTHER;INFORMATIONi,-
Full text of Classification abbreviations used in Section 2 and 3:
F Highly Flammable
Xi Irritant
Xn Harmful
R10 Flammable
RI 1 Highly Flammable
R22 Harmful if swallowed.
R36 Irritating to eyes and skin.
R67 Vapors may cause drowsiness and dizziness.
S 16 Keep away from sources of ignition-No Smoking! e
S26 In case of contact with eyes,rinse immediately with plenty of water and seek medical advice
S51 Use only in well ventilated areas.
Flam.Liq.2 Flammable liquid category 2
Acute Tox 4 Acute Toxicity Category 4
Eye Irrit 2A Eye irritation category 2A
STOT SE 3 Specific Target Organ Toxicity category 3
Aquatic Acute 3 Hazardous to Aquatic Environment category 3
H225 Highly flammable liquid and vapor.
H302 Harmful if swallowed.
H319 Causes serious eye irritation.
H336 May cause drowsiness and dizziness.
H402 Harmful to aquatic life
Supersedes: : 8 February 2011
Revision Summary: Comprehensive review,new format
Date of SDS Preparation/Revision: 21 May 2014 _
4
Data Sources:US NLM ChemID Plus and HSDB, Substance SDS for components,IUCLID Dataset EU Chemical Bureau,
ESIS,Country websites for occupational exposure limits.
Technical F oa�pQ ca act Sheet. —
United States
Environmental Protection Agency 1 ,4-Dioxane
` .
January 2014
s
mo N N
Introduction
k
i This fact sheet, developed by the U.S. Environmental Protection Agency
= _ (EPA) Federal Facilities Restoration and Reuse Office(FFRRO), provides a
summary of the contaminant 1,4-dioxane, including physical and chemical
properties; environmental and health impacts; existing federal and state
guidelines; detection and treatment methods; and additional sources of
information.This fact sheet is intended for use by site managers who may .
address 1,4-dioxane at cleanup sites or in drinking water supplies and for
those in a position to consider whether 1,4-dioxane should be added to the
analytical suite for site investigations.
1,4-Dioxane is a likely human carcinogen and has been found in
groundwater at sites throughout the United States.The physical and
chemical properties and behavior of 1,4-dioxane create challenges for its
characterization and treatment. It is highly mobile and has not been shown
to readily biodegrade in the environment.
What is 1,4-dioxane?
• •- ••- • ❖ .1,4-Dioxane is a synthetic industrial chemical that is completely miscible
• - • - • - •• in water(EPA 2006).
• - •• Synonyms include dioxane, dioxan,p-dioxane, diethylene dioxide,
- • . • •. diethylene oxide, diethylene ether and glycol ethylene ether
•• (EPA 2006; Mohr 2001).
!„ ' -P ' - - • ❖ 1,4-Dioxane is unstable at elevated temperatures and pressures and j
may form explosive mixtures with prolonged exposure to light or air,
(DHHS 2011; HSDB 2011).
• - - ❖ 1,4-Dioxane is a likely contaminant at many sites contaminated with
•-- - -• -• • certain chlorinated solvents,(particularly 1,1,1-trichloroethane [TCA])
t � . • • - • • ', because of its widespread use as a stabilizer for chlorinated solvents
(EPA 2013a; Mohr 2001)
` ' ❖ It is used as: a stabilizer for chlorinated solvents such as TCA; a solvent
•. -• • • F
for impregnating cellulose acetate membrane filters; a wetting and
dispersing agent in textile processes; and a laboratory cryoscopic solvent
__ ,, _•'(' for molecular mass determinations (ATSDR 2012; DHHS 2011; EPA
y 2006).
.P. _ _ ❖ It is used in many products, including paint strippers, dyes, greases,
_ �' • �_ varnishes and waxes. 1,4-Dioxane is also found as an impurity in
antifreeze and aircraft deicing fluids and in some consumer products
- (deodorants, shampoos and cosmetics)(ATSDk'2012; EPA 2006; Mohr
' 1 , 2001).
Disclaimer: The U.S.EPA prepared this fact sheet from publically-available
sources;additional information can be obtained from the source documents.This
fact sheet is not intended to be used as a primary source of information and is not
intended,nor can it be relied upon,to create any rights enforceable by any party
in litigation with the United States. Mention of trade names or commercial
products does not constitute endorsement or recommendation for use.
United States Office of Solid Waste and EPA 505-F-14-011
' Environmental Protection Agency Emergency Response(5106P) January 2014
. 1
What is 1,4-dioxane? (continued)
❖ 1,4-Dioxane is used as a purifying agent in the ❖ Traces of 1,4-dioxane may be present in some
manufacture of pharmaceuticals and is a by- food supplements, food containing residues from
product in the manufacture of polyethylene packaging adhesives or on food crops treated with
terephthalate(PET)plastic (Mohr 2001). pesticides that contain 1,4-dioxane as a solvent or
inert ingredient(ATSDR 2012; DHHS 2011).
Exhibit 1: Physical and Chemical Properties of 1,4-Dioxane
(ATSDR 2012; Howard 1990; HSDB 2011)
Chemical Abstracts Service(CAS)Number 123-91-1
Physical Description (physical state at room temperature) Clear,flammable liquid with a faint, pleasant
odor
Molecular weight(g/mol) 88.11
Water solubility Miscible
Melting point(°C) 11.8
Boiling point(°C)at 760 mmHg 101.1°C
Vapor pressure at 25°C(mm Hg) 38.1
Specific gravity 1.033
Octanol-water partition coefficient(log Kota) -0.27
Organic carbon partition coefficient(log KoC) 1.23
Henry's
0 3
ry s la constant at 25 C(atm-m /mol) 4.80 X 10 6
Abbreviations: /mol— rams per mole;°C—degrees Celsius;mm H —millimeters of mercury;
9 9 p ,9 9
atm-m3/mol-atmosphere-cubic meters per mole.
What are the environmental impacts of 1,4-dioxane?
❖ 1,4-Dioxane is released into the environment from surface water bodies (DHHS-2011; EPA
during its production, the processing of other 2006). l
chemicals, its use and its generation as an •;•' Migration to groundwater is weakly retarded by
impurity during the manufacture of some sorption of 1,4-dioxane to soil particles; it is
consumer products.It is typically found at some expected to move rapidly from soil to groundwater
solvent release sites and PET manufacturing (EPA 2006; ATSDR 2012).
facilities (ATSDR 2012; Mohr 2001). - It is relatively resistant to biodegradation in water
❖ It is short-lived in the atmosphere, with an . and soil and does not bioconcentrate in the food _
estimated 1-to 3-day half-life as a result of its chain (ATSDR 2012; Mohr 2001).
reaction with photochemically produced hydroxyl As of 2007, 1,4-dioxane had been identified at
radicals (ATSDR 2012; DHHS 2011). Breakdown more than 31 sites on the EPA National Priorities
products include aldehydes and ketones (Graedel List(NPL); it may be present(but samples were
1986). not analyzed for it)at many other sites (HazDat
❖ It may migrate rapidly in groundwater, ahead'of 2007).
other contaminants and does not volatilize rapidly
What are the routes of exposure and the health effects of 1,4-dioxane? j
❖ Potential exposure could occur during production Inhalation is the most common route of human
and use of 1,4-dioxane as a stabilizer or solvent exposure, and workers at industrial sites are at
(DHHS 2011). greatest risk of repeated inhalation exposure;
❖
Exposure may occur through inhalation of vapors, (ATSDR 2012; DHHS 2011).
ingestion of contaminated food and water or
dermal contact(ATSDR 2012; DHHS 2011)."
2
i
i
What are the routes of exposure and the health effects of 1,4-dioxane?
(continued)
❖ 1,4-Dioxane is readily adsorbed through the Animal studies showed increased incidences of
lungs and gastrointestinal tract. Some nasal cavity, liver and gall bladder tumors after
1,4-dioxane may also pass through the skin, but . exposure to 1,4-dioxane(DHHS 2011; EPA IRIS
studies indicate that much of it will evaporate 2013).
before it is absorbed. Distribution is rapid and EPA has classified 1,4-dioxane as"likely to be
uniform in the lung, liver, kidney, spleen, colon 4- carcinogenic to humans" by all routes of _
and skeletal muscle tissue (ATSDR 2012). exposure(EPA IRIS 2013).
s• Short-term exposure to high levels of 1,4- The U.S. Department of Health and Human
dioxane may result in nausea, drowsiness, •�• Services states that 1,4-dioxane is reasonably
headache, and irritation of tfie eyes, nose and anticipated to be a human carcinogen based on
throat(ATSDR 2012; EPA 2013b; NIOSH 2O10). sufficient evidence of carcinogenicity from
❖ Chronic exposure may result in dermatitis, studies in experimental animals (DHHS 2011).
eczema, drying and cracking of skin and liver The American Conference of Governmental
and kidney damage (ATSDR 2012; HSDB Industrial Hygienists (ACGIH) has classified.
2011).
1,4-dioxane as a Group A3 carcinogen—
❖ 1,4-Dioxane is weakly genotoxic and confirmed animal carcinogen with unknown
reproductive effects in humans are unknown; relevance to humans (ACGIH 2O11).
however, a developmental study on rats The National Institute for Occupational Safety
indicated that 1,4-dioxane may be slightly toxic and Health (NIOSH)considers 1,4-dioxane a
to the developing fetus (ATSDR 2012; Giavini potential occupational carcinogen (NIOSH
and others 1985). 2010).
Are there any federal and state guidelines and health standards for , '
1,4-dioxane?
❖ Federal and State Standards and Guidelines:
■ EPA's Integrated Risk Information System The cancer risk assessment for 1,4-dioxane
(IRIS)database includes a chronic oral is based on an oral slope factor of 0.1'
reference dose (RfD)of 6.03 milligrams per, mg/kg/day and the drinking water unit risk is
kilogram per day(mg/kg/day) based on liver 2.9 x 10-6 micrograms per liter(pg/L) (EPA
and kidney toxicity in animals and a chronic IRIS 2013).
inhalation reference dose (RfC)of 0.03 EPA risk assessments indicate that the
milligrams per cubic meter(mg/m3) based drinkin�q water concentration representing a
on atrophy and respiratory metaplasia inside 1 x 10 cancer risk level for 1,4-dioxane is
the nasal cavity of animals (EPA IRIS 2013). 0.35 µg/L (EPA IRIS 2013).
■ The Agency for Toxic Substances and 1,4-Dioxane may be regulated as hazardous
Disease Registry(ATSDR) has established waste when waste is generated through use
minimal risk levels (MRLs)for inhalation as a solvent stabilizer(EPA 1996b).
exposure to 1,4-dioxane : 2 parts per million No federal maximum contaminant level
(ppm)for acute-duration (14 days or less) (
inhalation exposure; 0.2 ppm for MCL)for drinking water has been
intermediate-duration (15 to 364 days) established;however, an MCL is not
inhalation exposure; and 0.03 ppm for necessary to determine a cleanup level
chronic-duration (365 days or more) (EPA 2012).
inhalation exposure (ATSDR 2012). 1,4-Dioxane was included on the third
■ Oral exposure MRLs have been identified as drinking water contaminant candidate list,
5 mg/kg/day for acute-duration oral which is a list of unregulated contaminants
exposure; 0.5 mg/kg/dayfor intermediate- that are known to, or anticipated to, occur in
duration oral exposure; and 0.1 mg/kg/day public water systems and may require'
for chronic-duration oral exposure (ATSDR regulation under the Safe Drinking Water
2012). Act(EPA 2009).
3
f
Are there any federal and state guidelines_ and health standards for
1,4-dioxane? (continued)
❖ Federal and State Standards and Guidelines ❖ Workplace Exposure Limits:
(continued): The Occupational Safety and Health
■ The EPA has established drinking water Administration set a general industry
health advisories for 1,4-dioxane, which are - permissible exposure limit of 360 mg/m3,or 100
drinking water-specific risk level ppm based on a time-weighted average(TWA)
concentrations for cancer(10-4 cancer risk) over an 8-hour workday for airborne exposure
and concentrations of drinking water to 1,4-dioxane (OSHA 2013).
contaminants at which noncancer adverse The ACGIH set a threshold limit value of 72
health effects are not anticipated to occur over m /m3 or 20 m based on -
. a TWA over an 8
9 pp
specific exposure durations. The EPA hour workday for airborne exposure to 1,4-
established a 1-day health advisory of 4.0: dioxane(ACGIH 2O11).
milligrams per liter(mg/L)and a 10-day health The NIOSH has set a ceiling recommended
advisory of 0.4 mg/L for 1,4-dioxane in drinking water for a 10-kilogram child. EPA exposure limit of 3.6 mg/m3 or 4 ppm based on
also established a lifetime health advisory of a 30-minute airborne exposure to 1,4-dioxane
0.2 mg/L for 1,4-dioxane in drinking water
(NIOSH 2O10).
(EPA 2012). NIOSH also has established an immediately
■ The EPA's drinking water equivalent level for dangerous to life or health concentration of 500
p
1,4-dioxane is 1 mg/L (EPA 2012). pm for 1,4-dioxane (NIOSH 2O10).
■ EPA has calculated a screening level of 0.67 Other State and Federal Standards and
pg/L for 1,4-dioxane in tap water, based on a Guidelines:
1 in 10-6 lifetime excess cancer risk (EPA ■s Various states have established drinking water '
2013c). 1,2 and groundwater guidelines, including the
■ EPA has Calculated a residential soil k. following:
screening level (SSL)of 4.9 milligrams per Colorado has established an interim
kilogram (mg/kg)and an industrial SSL of 17 groundwater quality cleanup standard of
mg/kg.The soil-to-groundwater risk-based 0.35 pg/L (CDPHE 2012);
SSL is 1.4 x10-4 mg/kg (EPA 2013c). — -California has established a notification
■ EPA has also calculated a residential air level of 1 pg/L for drinking water(CDPH
screening level of 0.49 micrograms.per,cubic 2011);
meter(pg/m3)and an industrial air screening — rNew Hampshire has established
level of 2.5 Pg/m3 (EPA 2013c). reporting limit of 0.25 pg/L for,all public
water supplies (NH DES 2011); and
— Massachusetts has established a drinking
water guideline level of 0.3 pg/L (Mass
DEP 2012).
The Food and Drug Administration set 10
mg/kg as the limit for 1-4-dioxane in glycerides
and polyglycerides for use in products such as
dietary supplements. FDA also surveys raw
material and products contaminated with
Screening Levels are developed using risk assessment guidance 1,4-dioxane (FDA 2006).
from the EPA Superfund program.These risk-based concentrations ■" 1,4-Dioxane is listed as a hazardous air
are derived from standardized equations combining exposure pollutant Under the Clean Air Act(CAA) (CAA
information assumptions with EPA toxicity data.These calculated 1990)
screening levels are generic and not enforceable cleanup standards
but provide a useful gauge of relative toxicity. ■ A reportable quantity of 100 pounds has been
z Tap water screening levels differ from the IRIS drinking water established under the Comprehensive
concentrations because the tap water screening levels account for Environmental Response, Compensation, and
dermal,inhalation and ingestion exposure routes;age-adjust the Liability Act(EPA 2011).
intake rates for children and adults based on body weight;and time-
adjust for exposure duration or days per year.The IRIS drinking
water concentrations consider only the ingestion route,account only
for adult-intake rates and do not time-adjust for exposure duration or
days per year.
4
r
4 .
What detection and site characterization methods are available.for
1,4-dioxane?
•:• .As a result of the limitations in the analytical matrices by azeotropic microdistillation are 12 pg/L
methods to detect 1,4-dioxane, it has been difficult (reagent water), 15 pg/L (groundwater)and 16
to identify its occurrence in the environment.The pg/L (leachate) (EPA 2003).
miscibility of 1,4-dioxane in water causes poor EPA SW-846 Method 8260B detects 1,4-dioxane
purging efficiency and results in high detection •••limits (ATSDR 2012; EPA 2006). in a variety of solid waste matrices using GC and
mass spectrometry(MS). The detection limit
❖ . Conventional analytical methods can detect ' ' depends on the instrument and choice of sample
1,4-dioxane only at concentrations 100 times preparation method (ATSDR 2012; EPA 1996a)..
greater than the concentrations of volatile organic
compounds (EPA 2006; Mohr 2001). ❖ A laboratory study is underway to develop a
Modifications of existing analytical methods and passive flux meter(PFM) approach to enhance the
their sample preparation procedures may be • capture of 1,4-dioxane in the PFM sorbent to
needed to achieve lower detection limits for improve accuracy. The selected PFM approach
1,4-dioxane (EPA 2006; Mohr 2001). will be field tested at 1,4-dioxane contaminated
sites. The anticipated projection completion date is
High-temperature sample preparation techniques 2014 (DoD SERDP 2013b).
improve the recovery of 1,4-dioxane. These EPA Method 1624 uses isotopic dilution gas
techniques include purging at elevated ♦••
temperature (EPA SW-846 Method 5030); chromatography—mass spectrometry(GC-MS)to
equilibrium headspace analysis (EPA SW-846 detect 1,4-dioxane in water, soil and municipal
Method 5021); vacuum distillation (EPA SW-846 sludges. The detection limit for this method is 10
Method 8261); and azeotrophic distillation (EPA p9/L(ATSDR 2012; EPA 2001 b). a
SW-846 Method 5031) (EPA 2006). ❖ EPA SW-846 Method 8270 uses liquid-liquid
❖ The presence of 1,4-dioxane may be expected at extraction and isotope dilution by capillary column
sites with extensive TCA contamination; therefore, GC-MS. This method is often modified for the
some experts recommend that groundwater detection of low levels of 1,4-dioxane in water
samples be analyzed for 1,4-dioxane where TCA (EPA 2007, 2013a) '
is a known contaminant(Mohr 2001). ••• GC-MS detection methods using solid phase
s• NIOSH Method 1602 uses gas chromatography— extraction followed by desorption with an organic
flame ionization detection (GC-FID)to determine solvent have been developed to remove
the concentration of 1,4-dioxane in air. The 1,4-dioxane from the aqueous'phase. Detection
detection limit is 0.01 milligram per sample limits as low as 0.024 pg/L have been achieved by
(ATSDR 2012; NIOSH 2O10). passing the aqueous sample through an activated
carbon column,following by elution with acetone-
EPA SW-846 Method 8015D uses gas dichlormethane (ATSDR 2012; Kadokami and
chromatography(GC)to determine the others 1990).
concentration of 1,4-dioxane in environmental _
samples. Samples may be introduced into the GC EPA Method 522 uses solid phase extraction and
column by a variety of techniques including the GC/MS with selected ion monitoring for the
injection of the concentrate from azeotropic detection of 1,4-dioxane in drinking water with
distillation (EPA SW-846 Method 5031).The detection limits ranging from 0.02 to 0.026 pg/L
detection limits for 1,4-dioxane in aqueous (EPA 2008).
What technologies are being used to treat 1,4-dioxane?
❖ Pump-and-treat remediation can treat dissolved light or ozone is used to treat 1,4-dioxane in
1,4-dioxane in groundwater and control wastewater(Asano and others 2012, EPA 2006).
groundwater plume migration, but requires ex situ 4- A study is under way to investigate facilitated-
treatment tailored for the unique`properties of . transport enabled in situ chemical oxidation to
1,4-dioxane (such as, a low octanol-water partition treat 1,4-dioxane-contamined source zones and
coefficient that makes 1,4-dioxane hydrophilic) groundwater plumes effectively. The technical -
(EPA 2006; Kiker and others 2010). approach consists of the co-injection of strong
❖ Commercially available advanced oxidation oxidants (such as ozone)with chemical agents -
processes using hydrogen peroxide with ultraviolet that facilitate the transport of the oxidant (DoD
SERDP 2013d).
5 .°
I
What technologies are being used to treat 1,4-dioxane? (continued)
❖ Ex situ bioremediation using a fixed-film, moving- generate desirable enzymatic activity for
bed biological treatment system is also used to 1,4-dioxane biodegradation; (2) assess
treat 1,4-dioxane in groundwater(EPA 2006). biodegradation by methane oxidizing bacteria in
d• Phytoremediation is being explored as a means to coupled anaerobic-aerobic zones; (3)and
remove the compound from shallow groundwater. evaluate branched hydrocarbons as stimulants for
Pilot-scale studies have demonstrated the ability the in situ cometabolic biodegradation of
of hybrid poplars to take up and effectively 1,4-dioxane and its associated co-contaminants
degrade or deactivate 1,4-dioxane (EPA 2001a, (DoD SERDP 2013c,_e and f)
2013a; Ferro and others 2013). ❖ Photocatalysis has been shown to remove
❖ Microbial degradation in engineered bioreactors 1,4-dioxane in aqueous solutions. Laboratory*
has been documented under enhanced conditions studies documented that the surface plasmon
or where selected strains of bacteria capable of resonance of gold nanoparticles on titanium
degrading 1,4-dioxane are cultured, but the impact dioxide (Au—Ti02) promotes the photocatalytic4
of the presence of chlorinated solvent co-` degradation of 1,4-dioxane (Min and others 2009;
contaminants on biodegradation of 1,4-dioxane Vescovi and others 2010).
needs to be further investigated (EPA 2006, Other in-well combined treatment technologies
2013a; Mahendra and others 2013). being assessed include air sparging; soil vapor*
❖ Results from a 2012 laboratory study found extraction (SVE); and dynamic subsurface .
1,4-dioxane-transforming activity to be relatively groundwater circulation (Odah and others 2005).
common among monooxygenase-expressing ❖ SVE is known to remove some 1,4-dioxane, but
bacteria; however, both TCA and substantial residual contamination is usually left
1,1-dichloroethene inhibited 1,4-dioxane behind because of 1,4-dioxane's'high solubility,
degradation by bacterial isolates (DoD SERDP which leads to preferential partitioning into pore
2012). water rather than vapor.The DoD SERDP is
❖ Several Department of Defense Strategic conducting a project to evaluate and demonstrate
Environmental Research and Development the efficacy of enhanced or extreme SVE, which
Program (DoD SERDP) projects are under way to uses a combination of increased air flow,
investigate 1,4-dioxane biodegradation in the sweeping with drier air, increased temperature,
presence of chlorinated solvents or metals. decreased infiltration and more focused vapor
Laboratory studies will (1) identify microbial extraction to enhance 1,4-dioxane remediation in
cultures as well as biogeochemistry, which soils (DoD SERDP 2013a).
Where can I find more information about 1,4-dioxane?
Asano, M., Kishimoto, N., Shimada, H., and Y. ❖ Clean Air Act Amendments of 1990 (CAA). 1990.
Ono. 2012. "Degradation of 1,4-Dioxane Using "Hazardous Air Pollutants".42 USC§ 7412.
Ozone Oxidation with UV Irradiation (Ozone/UV). 4. Colorado Department of Public Health and the
Treatment."Journal of Environmental Science and Environment(CDPHE). 2012. "Notice of Public
Engineering. Volume A(1). Pages 371 to 279. Rulemaking Hearing before the Colorado Water
❖ Agency for Toxic Substances and Disease Quality Control Commission." Regulation No. 31
Registry(ATSDR).2012. "Toxicological Profile for and No.41.
1,4-Dioxane." www.sos.state.co.us/CCR/Upload/NoticeOfRulem
www.atsdr.cdc.gov/toxprofiles/tol87.pdf aking/ProposedRuleAttach20l2-00387.PDF
❖ American Conference of Governmental Industrial Ferro,A.M., Kennedy, J., and J.C. LaRue.2013.
Hygienists (ACGIH). 2011. "2011 Threshold Limit "Phytoremediation of 1,4-Dioxane-Containing
Values(TLVs)for.Chemical Substances and Recovered Groundwater." International Journal of
Physical Agents Biological Exposure Indices." Phytoremediation.Volume 15. Pages 911,to 923.
Cincinnati, Ohio. ❖ Giavini, E., Vismara, C., and M.L Broccia. 1985.
❖ California Department of Public Health (CDPH): "Teratogenesis Study of Dioxane in Rats.".
2011.. 1,4-Dioxane." Drinking Water Systems. Tozicology'Letters. Volume 26 (1). Pages. 85 to
www.cdph.ca.gov/certlic/drinkingwater/Pages/1,4-' 88.
dioxane.aspx
6
I
Where can I find more information about 1,4-dioxane? (continued)
❖ Graedel,T.E. 1986. Atmospheric Chemical . ❖ New Hampshire Department of Environmental
Compounds. New York, NY: Academia Press. Services (NH DES). 2011 "Change in Reporting
❖ Hazardous Substances Data Bank(HSDB). 2011. Limit for 1,4-Dioxane. '
"1,4-Dioxane." http://toxnet.nim.nih..qov/cgi-bin/ http://des.nh.gov/orcanization/divisions/waste/hwr
sis/htmlgen?HSDB b/sss/hwrp/docu m ents/report-lim its 1 4dioxa ne.pdf
❖ HazDat. 2007. "1,4-Dioxane." HazDat Database: ❖ Occupational Safety and Health Administration
ATSDR's Hazardous Substance Release and (OSHA). 2013. "Dioxane." Chemical Sampling
Health Effects Database. Atlanta, GA: Agency for Information. www.osha.gov/dts/chemicalsampling/.
Toxic Substances and Disease Registry. data/CH 237200.html
❖ Howard, P.H. 1990. Handbook of Environmental Odah, M.M., Powell, R.,and D.J. Riddle. 2005.
Fate and Exposure Data for Organic Chemicals. "ART In-Well Technology Proves Effective in'
Lewis Publishers, Inc., Chelsea, MI. Pages 216 to Treating 1,4-Dioxane Contamination."
221. Remediation Journal. Volume 15 (3), Pages 51 to
❖ Kadokami, K,Koga, M. and A. Otsuki. 1990. "Gas 64.
Chromatography/Mass Spectrometric U.S. Department of Defense(DoD). Strategic
Determination of Traces of Hydrophilic and Environmental Research and Development
Volatile Organic Compounds in Water after Program (SERDP). 2012. "Oxygenase-Catalyzed
Preconcentration with Activated Carbon." Biodegradation of Emerging Water Contaminants:
Analytical Sciences. Volume 6(6). Pages 843 to 1,4-Dioxane and N-Nitrosodimethylamine:" ER-.
849. 1417. www.serd :orq A/Pro ram-Areas/ -
p
❖ Kiker, J.H., Connolly, J.B., Murray,W.A., Pearson, Environmental-Restoration/Contaminated-
S.C.; Reed, S.E., and R.J. Robert. 2010. "Ex-Situ Groundwater/Emerging-Issues/ER-1417/ER-1417
Wellhead Treatment of 1,4-Dioxane Using DoD SERDP. 2013a. "1,4-Dioxane Remediation
Fenton's Reagent." Proceedings of the Annual
International Conference on Soils, Sediments, by Extreme Soil Vapor Extraction (XSVE)." ER-
Water and Energy. Volume 15, Article 18. 201326. wwwserdp.orq/Program-Areas/
Environmental-Restoration/Contaminated-Ground
❖ Mahendra, S., Grostern, A. and L.Alvarez-Cohen. water/Emerging-Issugs/ER-201326/ER-201326
2013."The Impact of Chlorinated Solvent Co- DoD SERDP. 2013b. "Development of a Passive
Contaminants on the Biodegradation Kinetics of Flux Meter Approach to Quantifying 1,4-Dioxane
1,4-Dioxane. Chemosphere.Volume 91 (1). . Mass Flux." ER-2304. www.serdp.ora/Program-
Pages 88 to 92. Areas/Environmental-Restoration/Contaminated-
Massachusetts Department of Environmental Groundwater/Emerging-Issues/ER-2304/ER-2304/
Protection (Mass DEP). 2012. "Standards and 4- DoD SERDP: 2013c. "Evaluation of Branched
Guidelines for Contaminants in Massachusetts. Hydrocarbons as Stimulants for In Situ
Drinking Waters'' Cometabolic Biodegradation of 1,4-Dioxane and
www.mass.gov/dep/water/dwstand.pdf Its Associated Co-Contaminants." ER-2303.
❖ Min, B.K., Heo, J.E., Youn, NX,Joo, O.S., Lee, www.serdp.orq/Program-Areas/Environmental-
H., Kim, J.H., and H.S. Kim:2009. "Tuning of the Restoration/Contaminated-Groundwater/
Photocatalytic 1,4-Dioxane-Degradation with E_merging-Issues/ER-2303/ER-2303
Surface Plasmon Resonance of Gold
Nanoparticles on Titania." Catalysis '•' DoD SERDP. 2013d. "Facilitated Transport
Communications. Volume 10 (5). Pages 712 to Enabled In Situ Chemical Oxidation of 1,4-
715. Dioxane-Contaminated Groundwater." ER-2302.
www.serdP.org/Program-Areas/Environmental-
Mohr, T.K.G. 2001. "1,4-Dioxane and Other Restoration/Contaminated-Groundwater/
Solvent Stabilizers White Paper." Santa Clara Emerging-Issues/ER-2302/ER-2302/(language)/
Valley.Water District of California. San Jose, eng-US
California:❖ DoD SERDP. 2013e. "In Situ Biodegradation of National Institute for Occu ational Safety and 4-p Y 1,4-Dioxane: Effects of Metals and Chlorinated
Health (NIOSH).2010. "Dioxane." NIOSH Pocket Solvent Co-Contaminants." ER-2300.
Guide to Chemical Hazards. www.serdp.org/Program-Areas/Environmental-
www.cdc.gov/niosh/npq/npgd0237.htmi Restoration/Contaminated-Groundwater/
Emerging-Issues/ER-2300/ER-2300
7
WPM.Wo
Where can I find more information about 1,4-dioxane? (continued)
❖ DoD SERDP. 2013f."In Situ Bioremediation of ❖ EPA. 2009. "Drinking Water Contaminant
1,4-Dioxane by Methane Oxidizing Bacteria in Candidate List 3—Final." Federal Register Notice.
Coupled Anaerobic-Aerobic Zones." ER-2306. www.federairegister.gov/articles/2009/10/08/E9-
www.serdp.org/Program-Areas/Environmental- 24287/drinking-water-contaminant-candidate-list-
Restoration/Contaminated-Groundwater/ 3-final
Emerging-Issues/ER-2306/ER-2306 EPA. 2011. "Reportable Quantities of Hazardous
U.S. Department of Health and Human Services Substances Designated Pursuant to Section 311
(DHHS). 2011. "Report on Carcinogens, Twelfth of the Clean Water Act. Code of Federal
Edition." Public Health Service, National Regulations."40 CFR 302.4.
Toxicology Program. 121h Edition. www..qpo.gov/fdsys/pkq/CFR-2011-title40-
http://ntp.niehs.nih.gov/ntp/roc/twelfth/rocl2.pdf vol28/pdf/CFR-2011-title40-vo128-sec302-4.pdf
❖ U.S. Environmental Protection Agency(EPA). ❖ EPA: 2012. "2012 Edition of Drinking Water
1996a. "Method 8260B: Volatile Organic Standards and Health Advisories."
Compounds by Gas Chromatography/Mass water.epa.gov/action/advisories/drinking/upload/d
Spectrometry(GC/MS)."www.epa.gov/osw/ - wstandards2012.pdf
hazard/testmethods/sw846/pdfs/8260b.pdf EPA. 2013a. "1,4-Dioxane."www.clu-in.org/conta
❖ EPA. 1996b. "Solvents Study." EPA 530-R-96- minantfocus/default.focus/sec/1.4-Dioxane/
017. cat/Overview/
EPA. 2001a. "Brownfields Technology Primer: ❖ EPA. 2013b:"1,4-Dioxane (1,4-Diethyleneoxide)."
Selecting and Using Phytoremediation for Site Technology Transfer Network Air Toxics Website.
Cleanup." EPA 542-R-01-006. www.epa.gov/ttnatw01/hlthef/dioxane.html
www.brownfieldstsc.orq/pdfs/phytoremprimer.pdf EPA. 2013c. Regional Screening Level (RSL)
❖ EPA: 2001 b. "Method 1624."Code of Federal Summary Table.
Regulations. Code of Federal Regulations.40 www.epa.gov/reg3hwmd/risk/human/rb-
CFR Part 136. Pages 274 to 287. concentration table/Generic Tables/index.htm
❖ EPA. 2003. "Method 8015D: Nonhalogenated ❖ EPA. Integrated Risk Information System (IRIS).
'Organics Using GC/FID."SW-846.www.epa.gov/ 2013. "1,4-Dioxane (CASRN 123-91-1).
osw/hazard/testmethods/pdfs/8015d r4.pdf www.epa.gov/iris/subsV0326.htm
❖ EPA. 2006. "Treatment Technologies for ❖ U.S. Food and Drug Administration(FDA). 2006.
1,4-Dioxane: Fundamentals and Field "Food Additives Permitted for Direct Addition to
Applications." EPA 542-R-06-009. Food for Human Consumption; Glycerides and
www.epa.gov/tio/download/remed/542rO6009.pdf Polyglycides."Code of Federal Regulations.21
❖ EPA. 2007. "Method 8270D: Semivolatile Organic CFR 172.736.
Compounds by Gas Chromatography/Mass ❖ Vescovi, T., Coleman, H., and R. Amal. 2010.
Spectrometry(GC/MS)." "The Effect of pH on UV-Based Advanced
❖ EPA. 2008. "Method 522: Determination of Oxidation Technologies- 1,4-Dioxane
1,4-Dioxane in Drinking Water By Solid Phase Degradation."Journal of Hazardous Materials.
Extraction (SPE)and Gas Chromatography/Mass Volume.182. Pages 75 to 79.
Spectrometry(GC/MS)with Selected lon
Monitoring (SIM)." EPA/600/R-08/101. '
Additional information on 1,4-dioxane can be found at
www.cluin.orq/contaminantfocus/default.focus/sec/1,4-Dioxane/cbVOverview
Contact Information
If you have any questions or comments on this fact sheet, please contact: Mary Cooke, FFRRO, by,phone at
(703)603-8712 or by email at cooke.marvt(a)epa.gov.
8 `
APR-26-2017 23:11 FROM:DR NELSON 150B429BB40 T0:15087906304 P.1/16
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Nelson Dentistry
From: Mary
To: TimothyLavc&
pag es:
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Re: Safe Data Sheets
WIANNO KN Lz
709 MAIN STR j ET
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PHONE: (508) 4 8-3744
FAX: (908) 428 8840
APR-26-2017 23:15 FROM:DR NELSON 15084288840 TO:15087906304 P.13/16
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4
SAFETY DATA
SHEET (SDS
Complies with OSHA's Haz4 rd Communication Standard 2012 and the obal Harmonized Standard(GHS).
Page 1 of 4
section-1: Identif cation
Product Identification: Sup r Vac 40 Plus Item N amber. 00138
Manufactured by:
EPR Industri s LLC. Telej hone, 1-856-48e-1120
4576 Crescent Boulevard
Pennsauken, NJ 0109 Emergency:In •Trac 1-800-636.5053
Product use: Cleaning of dental/medical evacuation syst erks
Section 2; Hazar s
Classification of the substance or mixture:
GHS Classification in eocordance with 29 CFR 1910 (O A HCS)
Not classified as ha rdous.
Hazard Summary: Product Contain surfactants and mixture of protease,lipase end arnylase enzymes along with multiple
enzyme forming bacterial spores, ry low hazard when used according to labe directions.
Section 3 : Com sition information on Ingredients
Hazardous Ingredlent(s) CAS 6 Exposure PI L,TLV,TWA %
Nonionic surfactant s 2
Proprietary EnzymetSpora Blend N -c 25
Section 4: First• 'd measures
EMERGENCY FIRST AID PROCEQ JRGS
SKIN: Flush area with water for 15 ninutes. If Irritation persists seek medical at gntion.
EYE: IMMEDIATE EYEWASH with water for 15 MINUTES, Seek immediate m dical attention.
INGESTION: induce vomiting. G' large quantities of milk. Seek immediate n edical attention.
INHALATION: Remove to fresh air If discomfort persists seek medical attentio .
APR-26-2017 23:15 FROM:DR NELSON 1508428BB40 T0:15087906304 P.t4/16
SAFETY DATA
SKEET (SDS
Complies with OSHA's Havird Communication Standard 2012 and the lobal Harmonized Standard(GHS).
pagre 2 of
Product Identification: Super Vae 40 Plus item Number: 00138
Section 4 cont--
Potential Acute Health.Effects
Skin: May cause irritation to skin On wntact.
Eyes: May cause moderate Irritation when contacting eyes,
Ingestion: Gastrointestinal dlscomfo 1,nausea,Irritation or mouth,nasal passage and throat,
Inhalation: Unlikely to cause health iffects.
Chronic uroi Not established.
Carchmenicily' Ingredients not lisittod as carcinogens.
Section 5: Fire-fi zhting measures
Flash Point: Not flammable Flammable limits:NIA LEL:NIA UEL:NIA
Extinguishing media: Not flammable. Unusual fir and explosion hazards:None
Special Fire Fighting Procedure: oducl not flammable. No special require nts.
Section 6: Accidental release measures
Personal precautions: Use ersonal protection per Section 8.
Environmental precautions: Prod jet is biodegradable.
Methods for cleaning up: Mop up spill or use Inert powder to soak up liquid and place in appropriate disposal container,
Section 7: Handling and storage
Handling: Use In well ventilated areas. Avoid contact with eyes
Advice on protection against fire and explosion: Product Is not flammable. Storage; Store in well ventilated areas at
ambient temp.Advice on common s orage: Do not store next to strong oxidiz re and acids,
Section 8: Ex o re control Zyersonal protection
Engineering Measures: Provide no irmal room ventilation.
Personal Precautions: Use protec live clothing as specified below, `
Eye Protection: Use safety goggle or approved safety glasses:
Hand Protection; Use protective g eves and discard after contact with product.
Skin and body protection: Pants,long sleeves,clinical Jacket.
Respiratory protection: Not normi illy required as long as adequate room vanti 4tion Is present.
Hygiene measures: Wash hands i fter using. Emergency aye wash station mu t be available.
Launder contar iinated clothing.
E osure ui lin t rm ne .
APR-26-2017 23:16 FROM:DR NELSON 150e4288840 TO:15087906304 P.15/16
SAFETY DAT
SHEET (SDS
Complies with OSHA's Hazz rd Communication Standard 2012 and the C lobal Harmonized Standard(GHS).
PaE,e 3 of 4
Product Identification: Super Vac 40 Plus Item Number: 00138
Section Ph sic I chemical eroeertles
Boiling Point: 225 F Specific Gravity: 1.01 0 1.03(0 20C Vapor Press re:(mm Hg)ND
Molting Point: NIA Evepore ion Rate : (n-butyl-I)ND Vapor Densl (Air= 1) ND
Solubility in Water, Complete pH, 7.0 v 8.0
Appearance and Odor: Clear,blue-g-een liquid with mint fragrance.
Section 10 : Stabilltv and reactivity
Materials to avoid: Avoid contact w h strong oxidizing agents,strong acids,haI ens,peroxides.
Hazardous decomposition produc : Product may produce carbon monoxide, arbon dioxide,
sulfur and nitrogen oxides under extr me heat
Hazardous reactions: May evolve aces if mixed with strong oxidizing agents a d acids.
Section 11: Toxico o ical information
Not listed as a carcinogen by OSHA, IARC,AGCIH,or NTP.
Section 12 : Ecological Information
Thera is no information available at tl is time for this product.
Section-13 ID11Rgsal consideration
Waste/Disposal Information: Observe all Federal,State,and Local Environme al Regulations when disposing
of this product.
Use and or alterations to this product such as mixing with other materials/chemic Is may significantly change
the characteristics of the matedal ant alter product hazard classifications and the proper disposal method,
Section 14 ; Transr ort information
-Product is not classified as a Hazardi us Material: (If NO,DOT Information no required)
DOT Proper Shipping name: Not reqL ired
UN-Number. Not reqi Ired
Class: Not reqi Ired
Packing Group: Not req fired
APR-26-2017 23:16 FROM:DR NELSON 15084268940 T0:1508790&M4 P.16/16
F SAFETY D
SHEET (SDS)
Complies with QSHA's Haza d Communication Standard 2012 and the G obal Harmonized Standard(GHS).
Pape 4 of 4
Product ldentlficatlon: Supe Vac 40 Plus Item Number: 00138
Section 1S : Regulatory Information
HAZARD RAIING H 1
4■Extreme HEALTH
3 a Mlgh F' 0
2 a Moderate FLAMMABILITY
1 a Slight R 1
0 Insigrilflcant REK—Way
t
Section 16: Other`i iformation
Date prepared:October 2014 Revision:1.00A
Information contained herein is fur Ished without warranties of any kind. ors should consider these data only as
supplements to other information obtained by them and must make indeper Pont determinations of completeness and
suitability of information from all sou ces to ensure proper disposal and use of materials for the safety and health of both
employees and customers.
APR-26-2017 23:11 FROM:DR NELSON 15094288840 TO:15087906304 P.2/16
r.
Uul Healthcare
W¢ cive 0riI w
Safety Data Sileet
Safety Data Sheet (in conripliance with Regulation (EC) Date Issued: 22 June 2009
1907/2006, Regulation ) 1272/2008 and Regulation } Docurnent Number: 0021 l 13MS
(EC)45312010) Date Revised:21 May 2014
Revision Number: 6
N: A
1"I' DER�AXCI'NG
1.1 Product fdentifier:
Trade Name(as iabcic ): Purevac Evacuation System Cleaner
Part(ltcm Number: 21113 ( ), 21115 (5L), EX21112 (2L), EX71114
1.2 Relevant Identified Uses of the Substance or.Mixture and Uses dvised Against:
Recommended Use: Lvacuati n system cleaner
Restrictions un Use: For prof sional use only
1.3 Details of the Supplie r of the Safety Data Sheet:
Manufacturer/Supplier Numu; Sultan H althcare
Manufacturer/Supplier Address: 1301 Sm le way
York,PA,USA
Manufacturer/Supplict Telephone Number: 1 201-811-1232 or 800-637-9582
(Product Information)-
Email address: auatome .service a cultanbc.com
1.4 Emergency Telephone Number:
lamergency Contact T Iephone Number; 800-535 (INFOTRAC)
1-352-3 -3500(Outside�053
he United States—Call Collect)
I•.,1 PLG"AT141V:."::
2.1 Classification of the S bstanee or Mixture:
GHS Classification: ~
Health Environmental Physical
Skin Corrosive Category I Not hazardous Corrosive to Metals Category 1
Eye Damage Category 1
EU Classification(1999/4 C as amended): Irritant(Xi)
ETJ Risk(R)Phrases:R3 /3t1
Refer to Section 16 for the full text of the EU Classifications and R Phrases.
APR-26-2017 23:12 FROM:DR NELSON 150e42ee940 TO:150e7906304 P.3/16
2.2 Labeling Elements: Cc ntains Phosphoric Acid,and Glycolic Acid
Signal Word: Donger
Bazar Statements Precautionay Statements
•14290 May be corrosive to t etals, P234 Ket . only in original container.
H314 Causes severe skin bL rns and eye damage. P260 Do of breathe mists.
P264 Wa h exposed skin thoroughly after handling.
P280 N ar protective gloves, protective clothing, eye
protectio ,and face protection.
P390 AN nrb spillage to prevent material damage.
P301 + 30 + P331 IF SWALLOWED: Rinse mouth. Do
NOT ind cc vomiting.
P310 I ediately call a POISON C> NTL"It, doctor, o
physicia
P303 + 361 + P353 IF ON SKIN (or hair): 'fake off
iirmedia 1y all contaminated clothing.Rinse skin with water,
or showe .
P363,W h contaminated clothing before roost:.
P310 Irrnediately call a POISON CENTER: doctor, or
physicia
P304+' 40 IF INHALED: Remove person to fresh air and
keep cniT Fortable for breathing.
P310 filr nediately call a POISON CENTER, doctor, or
physicia
P305 + 351 + P338 1F IN EYES: Rinse cautiously with
water fbi several minutes. Remove contact lenses, if present
And easy o do.Continue rinsing.
P310 [Trmcdiately call a POISON CENTER, doctor, or
physicia
t P405 Sto a locked up.
P406 Stn a in corrosive resistant container with a resistant
inner Iin
t P561 Ili ose of contents and container in accordance with
local an ational regulations.
2.3 Other Hazards: Non
.�.� ,- ,...�..........�.. ... �..w,.-.w- ...ate� ... ..
APR-26-2017 23:12 FROM:DR NELSON 15084288840 TO:15087906304 P.4/16
$ITIV�1 ANy3'.�..�+0 1%IATI01 (yN."INCRED1E1r1TS'.
3.2 Mixture
Hazardous Componei its C.A.S.#r IUPAC Nam CLP/CIIS/EU wil%
EC# Classification
1.272/2008 1999/45/E
Phosphoric Acid 7664-38-2/ Phosphoric C: 1,04 e-20
231.633-2 Acid Skin Corr, 1 (H314)
Metal Corr. I 11290
Glycolic Acid 79-14-1 / 2-hydroxytioct c Xi,Xn K22,R41,R38 <10
201•180.5 acid Skin Corr, 1 (14314)
Acute Tox.4(H302)(H332)
Metal Corr. i (H290
Isopropyl Alcohol 67.63-01 propan-2•ol F,Xi R11,R36,R67 c5
200-661.7 Flam,Liq,2(H225)
Eye Irrit.2A(14319)
STOT SE 3 336
Surlactsnt Mixture Not applicabl Xn,Xi R22,R36 <5
Acute Tux.4,(H302)
Eye Irrit.2A H319
The exact concentration i being withheld as a trade secret.
Refer to Section 16 for the full text of the EU Classifications and R hrases.
i
9'I dp ,Ikl.vMh
U[{
4.1 Description of First Aid Measures:
Routes of Ex Firs Aid instructions
sure
Eye imm diatc;ly flush eyes with large quantities ofA ater for at least IS minutes,holding the eyelids
apart Get.immediate medical attention.
SIdu Rem we contaminated clothing,Wash skin thoro ighly with soap and water.Get immediate medial
atten ion. Launder clothing before reuse.
inhalation If syi riptorns develop,remove to fresh air.Get m dice)attention.
Ingestion Do n t induce vomiting,Rinse mouth with watet and give uric glass of water-to drink.Ncvcr give
en t in by mouth to an unconscious or convulsil ij person.Get immediatc medical attention,
4.2 Most Important Symp torns and Effects,Both Acute and Delayu
Causes severe eye and skin irritation or burns,inhalation of mists may ause raucous membrane and upper respiratory tract
irritation or burns with pas.,ible pulmonary edema.Ingestion may caul burns to the mouth throat and stomach.
4.3 Indication of Any Imr iedlate Medical Attention and Special Tr atment Needed;
If eye or skin contact occur ,get immediate medical attention,If swall ed, get immediate medical attention.,
APR-26-2017 23:12 FROM:DR NELSON 15084288840 TO:15087906304 P.5/16
• i
4
Note to Physicians(Treatment,Testing,and Monitoring); Treatwcri of overexposure should be directed at thi;control
ofaymptoms and clinical c ditions.
l
=:. i :Ir II.
-
a{�1J.
5.1 Extinguishing Media
Use media appropTiate,for rrounding fire.
5.2 Special Hazards Arisi g from the Substance or Mixture:
Contact with metals ma f flununable h dro•en gas.'
5.3 Advice far Fire-Fi ht
Fire Fighting Procedures Cool fire exposed containers and dructures with water.
Precautions for Fire Fighi ers: Firefighters should wear positivu I ressure scif-contained breathing apparatus and full
rotcctive clothing.
Recommended Protective Equipmeu for.Fire Fighters:
EYESMACE SKIN SPIRATORY 'THERMAL
h :
`.. NTA
I.- ,� =A
b t.l ' � I li �I I•, II.::;...I. illui :li II' I.: III
'4M!, b' I�':d'-:r „„il-I;i...�I;,',:1:1,. .,6`,:,.:;.,•. !''I' I'li:.. :•.rl" .... '
M
;6':
,
6.1 Personal Precautions, otective Equipment and Emergency Pr cedures:.
Wear Appropriate protective clothing,gloves and eye protection.
Recort mended Personal Protective Equipment r Containment and Clean-up:
EYESIFACE SKIN ESPIRATORY THERMAL
r'
6.2 Environmental Preculutions..
Prevent spill from entering sewers and water courses. Report reieascs at required by local and national authorities.
6.3 Methods and Material for Containment and Cleaning up:
Collect using an ineft non-combustible absorbent material and place in propriate containers for disposal.
APR-26-2017 23:13 FROM:DR NELSON 15084280940 TO:15087906304 P.6/16
6.4 Reference to Other Sec ions:
Refer to Section 8 for Persoi al Protective Equipment and Section 13 for isposal information.
: � , .�,y,,,n��:blfi,ll`e��i• •, 4^1 ,Sr'
.. ..:6'; Q I.9 "Y,'•.Y,. ;7;j U:'I t I;c' i
�l: i .i' il�. Pli!U 1;�;•�..;: : ; jai:••
I. 'ii ;�Ir"
7.1 Precautions for Safe F[ nding:
Prevent contact with the eye and skin.Do not breathe mists. Wear appt 3priUte protective clothing and equipment. Use only
with adequate ventilation. %ash thoroughly with soap and water after he id)ing.Keep containers closed when not in use.
7.2 Conditions for Safe Sto 7age,Including Any Ineampatibilifles:
Store in a cool,dry,well ver tilated area away from incompatible materii Is.Protect from physical damage:
7,3 Specilk End Use(s): For Professional use only.
RE ..
•I,..i.•. ,,.'.
.•„�� •,". : ,H..,... .,. � .., '�lQ YRAS•�NAI '•pl� '�1�CTIQ�T .
�OL'• i.I:;'I r.. •„ .. ... .. ...
N.� L$
,r.
•
L.
83 Control Parameters:
Occupational'Expasure L mits:
Phosphoric Acid nited States 1 mg/m3 TWA US OS 1A PEL
1 mg/m3 TWA ACON TLV,3 mghn3 STEL
ermany 2 mg/m3 TWA,4 mg/i 13 STEL DFG MAK(inhalable)
nited Kingdom 1 tnglrn3 TWA,2 rnb/ 3 STEL UK OEL
rance I mg/m3 TWA MRS E,2 mg/m3 VLCT ,
pain 1 mg/m3 TWA VLA- ,2 tng/m3 VLA-EC
taly 1 mg/m3 8 hr Value L it,2 mg/m3 Short Temt
urupean Union None Establishcd
Glycolic Acid nited States None'Established.
Cnnany None F5tab1)shcci
United Kingdom None Established
rand" None'Established
Spain None Established
taly None Established
European Union None Establishcd
Isopropyl Alcohol United States 400 ppm TWA OSHA FEL
200 ppm TWA ACGII I TLV,400 ppm STEL
Gem-any 200 ppm IVA,400 p n STEL DFG MAK
United Kingdom 400 ppm TWA UK 01 L,500 ppm STEL
France 400 ppm TWA 1NRS"LCT
Spain 400 ppm TWA VLA- D, 500 ppm VAL-RC
APR-26-2017 23:13 FROM:DR NELSON 15084288940 TO:15087906M4 P.7/16
aly Nuns Established
uropean Union None Established
Surfactant jilited Statcs None Established
,ermany None Established
nited Kingdom None Established
Trance None Established
pain None Established
taly None Estahl ished
z.uropean Union None Established
Biological Exposure Lima s;
Isopropyl Alcohol Acetone in wine 40 mg/L,end of shift at o d of workweek (ACC'('H)
81 Exposure Controls;
Appropriate EngineeringControls; Usc wilh adequate Seneral or 1 cal exhaust ventilation to maintain exposuro levels
below the occupational exp sure limits.
Individual Protection Measures(PPE)
Specific Eye/faceProtection:Chemical safoty goggles and fa eshield should be worn whero splashing is rossihle-
Specifie Skin Pr tectian: Wcar impervious gloves such a butyl rubber. Recommended glove: butyl rubber.
Consult glove supplier for thickness and breakthrough times.
Specific Respiratory Protection: None required under norms use conditions.
Specific ThermalHazards:Not applicable
Recommended Personal t'rotec ve Equipment
EYES1NACE SKIN ESPIRA7'DRY THERMAL
NO lip
GAI::: C t PRE
P
9.1 Information on Basic Physical and Chemical Pro ertios:
Appearance: Clear pink liquid Explosi a limits: Not applicable
Odor: Alcohol Vapor ressure; 24 mmHg Q ZPC
Odor threshold: Not available Vapor 4 ensity: Not available
pH at Concentrate:0.S•1.5
pH: pH at Recommended Relativ density: 1.097
Dilution:-4
.�.�.... �.....�....r.♦r�r -r r-•mow.... �0�,. ... ..
APR-26-2Oi7 23:13 FRON:DR NELSON 15084288EHO TO:15087906304 P.8/16
Melting/freezing point; Not available Solubili : Miscible
Initial boiling.point and 12'F/ 100"C Pardtio coefficient, n• Not available
range: octane!/ ater:
Flash point:. 200"F!93.3°C Auto-ig tion Not available
tempera ure:
Evaporation rate: Aecomp sition 0.4 temper lure; Not available
Flammability: Not flammable Wscosit, Nut available
Explosive Properties: None OxidWr g Properties; None
9.2 Other Information N ne available
°
y'i' •.f.:C.
103 Reactivity:May reac with strong bases and other incompatible n aterials.
10.2 Chemical Stability: &ablc under normal use conditions.
1o.3 Possibility orHaxar ous Reactions;Will react to some metals t form flammable hydrogen gas.
t0.4 Conditions to Avoid Avoid high temperatures.
10.5 incompatible materials., Avoid strong oxidizing agents,strong ases and reducing agents.
10.6 Haznrdons T1'eenmp sition Products:Thermal decomposition y produce carbon and phosphorus oxides.
4. a'9Y° ,,.I 'I•f °j C i
Woff; .1cN: .
ft
of ' ;;y,'ti.,;
11.1 Information on Toyleoloarical Effects:
Potential Health Effects!
1?yes: Causes severe irritation or burns with redness,pain,tearing and I lurred vision.May cause permanent damage.
May cause severe irr tation or bums.
Ingestion:Swallowing ma cause sore throat,abdominal pain,nausea i hd severe burns to the mouth,throat and stomach.
Tnh la n: inhalation of trusts may cause bums to mucous membrane z nd upper respiratory tract irritation with possible
cheinical pneumonitis.
Chronic Hettlth Effe—etp I lone expected.
APR-26-2017 23:14 FRCM:DR NELSON 15084288840 TO:15087906304 P.9/16
Car—Onozentelty; None of he components is listed as a carcinogen b I'ARC,NTP, OSHA, ACOIH or the ETJ Substances
Directive.There is inadequi to evidence of carcinogenicity of isopropyl lcohol in human and animals.
Mutaeenieity; IsopropylAlcohol: In an in-vivo study, isopropanol dic not induce micronuclei in bone marrow of mice. ...
Studies conducted in mamrr alian cells.in vitro,it did not induce sister c romatid exchanges or gene mutations.
edieal Conditions A r voted h N:x rosure: Employees with pre xisting eye and skin disorders may be at increased
risk from exposure_
Acute Toxicity Data:
Phosphoric Acid:Oral rat' 50 1,530 mg/tng;Skin rabbit i,050 2,740 1
g/kg;Inhalation rabbit LC50 1.689/L/1 hr
Glycolic Acid:Oral rat LD 0 1,950 mg/kg'in rat LC50 7.1 mg 4 hr
Isopropyl Alcohol:Oral rat LD50 5,045 mg/kg,Skin rabbit LD50 12,8 mg/kg
Surfactant:Oral rat LD50-6 6 mg/kg,Skin rabbit 5660 mg/kg,Inhalatic i rat LC50>8 mg/VI hr
Reproductive Toxicity Doi a:When glycolic a6d is given to prcgnant s by mouth on a daily basis,it induces
malformations at high,mat rnally toxic doses. In another study,a mar nal increase in fetal abnormalities was seen at a
dose associated with margi al mutcrnal toxicity,with no effects on few development seen at lower doses.
Specific Tareet Orean Toxicity T
Single Exposure:Glycolic r cid:Ina study with rats,a 70%solution at 000 mg/kg was fatal tog of 10 rats.A dose of 500
mg/kg produced no deaths. t the completion of the study,animals wer,found to have increased kidney weights and lesions
in the stomach,liver and kii Incys.
Rorleatcd Exposure: lboprol yl Alcohol;A 13 week inhalation study wit L rats found effects of narcosis of 5,000 ppm.These
effects were reversible at th cessation of exposure.A 73 week chronic tudy found male reproductive effects at 2,500 and
5,000 ppm and liver effects at 2,500 ppm. Glycolic Acid:In an oral stu ly with male and female rats,0"5%, 1%and 2%
glycolic acid was administe ed orally l'or 218-245 days.Decreased gru th weight and liver and kidney effects were
observed in the male rats.No effects were seen in the male hats given 0. %and all the temalo rats.
_!: . :.�.:,: r,iai ,:, :'lZ: U ta► t �P;[ N"
wro � i. .I ad' iarjegiwwcl•. 41ni+is+ISY, C,. ,:{: '!' :I. .•I..i,
12.1 "Toxicity:
Phosphoric Acid: No data vaitable
Glycolic Acid:96 hr LC50 brachydanio rerio}5000 mg/L;48 hr EC5C daphnia mabna 141 mg/L
lsopropyl Alcohol:96 hr L '50 Pimephales promelas(fathead minnow 6.12 mb/L
Surfactant:96 hr LC50 pint phales promelas(fathead nninnow) 13,3 m ;48 hr EC50 daphnia magna 12.3 ntg/L;
16 lir•IC50 bacteria 220-77 mg/L
12.2 Persistence and Deg adability:Phosphoric Acid:The,acidity m be reduced by water hardness but the phosphate
may persist indefinitely, Siactant is readily biodegradable(370%in 8 days).1sopropyl alcohol is readily biodegradable
(95%after 21 days).Glyeo is acid is readily biodegradable($0%in 14lays),
12.3 Bio-accumulative Po ntial:The potential for glycolic acid to bi accumulate in aquatic animals is expected to bo low.
12A Mobility in Soil:Gly olio acid is expected to have very high mo liry in soil.PhosphUric acid is expected lu dissulvc
in the sail but a significant mount of the acid will mUvc in the directiol of the gruundwater flow.
12.5 Other Adverse Effe :The low pH of dais product will cause ef cots in aquatic systems and eco-systems.
12,6 Results of PB'r/vPVE Assessment:Not applicable
APR-26-2017 23:14 FROM:DR NELSON 15084288840 T0:15087906304 P.10/16
WIT
NS
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'i:i'I yy cM :d,
?EiJ � "�,y` al-r�l:
I• 1
.,.
ww :1 r
,fr.bw,.rin.JeKI'.MWI I.
13.1 Waste'rreatment Me hods:
Regulations- Mpose in ac ordance with local and national cnvironme -al re ulatiom
Properties(Physical/Che ical)Affecting Disposal:None known.
Waste Treatment Recommendations;Dilute with water and neutraliz with a sodium bicarbonate.
' :1rNF4 '�IATI01N
?1a:;.;i'h"r-.:I..ri. i• fill'' y .r.�,r
r
r .
,
.. r
r.;
14.1 VN 14.2 UN Proper Shipping 14.3 14.4 Packing 14.5 Environmental
Numbe Name Haza rd Group Hazards
Class s
DOT UN326 Corrosivc Liquid,Acidic, 8 PG TH No
Organic,mo-s.(Phosphoric
Acid,Glycolic Acid)
ADR/RID UN3266 Corrosive Liquid,Acidic, 8 PG M No
Organic,n.o.s.(Phosphoric
Acid,Glycolic Acid
IMDG U14326 Corrosive Liquid,Acidic, 9 PG III No
Organic,n.o,s.(Phosphoric
Acid,CI colic Acid
TATA/ICAO UN326 Corrosive Liquid,Acidic, 8 PG III No
Organic,n,o,s.(Phosphoric
Acid,Glycolic Acid
14.6 Special precautions foi user: Corrosive Liquid
14.7 Transport In Bulk According to Annex II of MARPOL 73/78 an the 1BC:Code:Not applicable—product is
transported only in packaged orm,
.
o .
.F PYY hll�llh+ :�'llll a "r,li:i'• 91r
r I. qqi •'I, . f. ^i:r1r. !•. . .RS.H.;.Ir
4.1 J'
rly': rrl'r .II.I I.
14.1 SafejL Health and Ei vironmental R relations/ i l ion q e (tic for the Sabatance or Mixture:
U.S.Federal Reaulatlons
Comprehensive EnvirDnrr total Response and Liability Act of 1980 CERCLA):This product has an RQ of
5,000 Ibs based on the RQ f phosphoric acid of 1.000 lbs present at<2 %. Many other states have more stringent
regulations. Report all spills in accordance with local,state,and federal regulation's.
Toxic Substances Control Act(TSCA):All of the ingredients in this 1.roduct are listud on the EPA TSCA
Inventory.
Clean Water Act(CWA): {ot Listed
Clean Air Act(CAA):Not Listed
Superfund Amendments mnd Reauthorization Act(SARA)11t1e rHinformation;
SARA Section 311/312(4( C;IN 370)14azard Categories;
APR-26-2017 23:15 FROM:DR NELSON, 15084288940 TO:150e7906304 P.11/16
Immediate Hazard: Yes Pressur Hazard: No
Delayed Hazard: No Reactiv ty Hazard; No
Fire Tfa7ard No
This product contains the rallowing toxic chemic.al(si)subject to rep rting requirements of SARA Section 313
(40 CFR 372):
Components C.A.S. V"%
None
Stslte Re ultrtinn.
California:This product cc titains the following chemicals(s)known to he State of California to cause cancer,birth
defects or reproductive ha -
Components . C.A.S.4 WT%
1,4•Dioxane 123-91.1 <2 ppm
Propylene oxide 75-56-9 <0.2 ppm
Ethylene Oxide 75.21-8 <0.2 ppm
Ethylbenzene 100-41.4 s-9 ppm
X.pterantional_12egul�t�ons
Canadian Workplace Hazardous Materials Information System IS): Class E(Corrosive)
EU REACH:The substanc s in this product comply with the 2U REA H regulation as applicable,
�y
c t I .I ?r 1�'I.p!Iar'��'dm psi.
.,... is _ . ...,,.....•,.,::..
Full text of C11maification at brcviations used in Section 2 and 3;
C Corrosive
F Highly Flammable
Xi Irritant
Xn Harmful
R11 1'Tighly flamrnablc
R22 Harmful if swallowed.
R34 Causes burns.
R36 Irritating to cycs.
R36138 Trritating to cycs a skin,
R38 Irritating to skin.
1141 Risk of serious damag to eyes.
R67 Vapors may CAUse dro Nsiness and dizziness.
Acute Tox.4—Acute Torcic ity Category 4
Flamm, Liq, 2 Flamniablc Liquid Category 2
Eye Irrit.2A 2ye Irritant C tegory 2A,
Metal Corr. I—Corrosive to Metals:Category 1
Skin Corr 1 - Skin CQrrosic n Category 1
STOT SC 3 Specific Tar et Organ Toxici —Sin lc Exposure Catc o 3
APR-26-2017 23:15 FROM:DR NELSON 15W42eee40 TO:15oe7906304 P.12/16
y
H225 Highly flammable liq jid and vapour.
H290. May be corrosive to i etals
H302 .Harmful if swallvwc
H312 FTannful in contact w th skin
H314 Cauvcs severc skin bt ms and eye damage
H319 Causes serious eye in itarion,
H332 Harmful if inhaled
M336 May cause drowsines or dizziness,
Supersedes: :24 June 2013
Revision 5uananury:Compr aunsm;rcmw,ncw-furmal,
Dato of SIDS Prcparation/Rcvision: 21 May 2014
Data Sources: US NLM ChemID Phis and HSDD,Substance SIDS for c ponents, IUCLID Daumset EU Chemical Bureau,
ESTS Country websims for iccupational exposure limits.
x SMEAD
No.2-153LY
UPC 12M
amaad com - Made In USA
ARM%
SUSTAINABII<
FORESTRY
ldTwm
caue.e�are
f , `
No. �`T SO�I Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: �!C
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
Zpprication for Migooal *pgtem Con.5truction Permit
Application for a Permit to Construct( . ).Repair,( tXVpgrade( )Abandon( ) O Complete System Ekf vidual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.
r7,?, 07,#jA. 37' c, 57— pv ti-4er £lr/lo�'r�
Assessor's ap/Parcel Q ?3 /N14 /v S, G ST
Install 's Nam >Address,.and Tel.No���'— Designer's Name,Address and Tel.No.
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title i�
'Size of Septic Tank Type of S.A.S. r'� C,
Description,of Soil -: t J
CD
C F xi
Nature of Repairs.orAlterations(Answer when applicable)
Date last inspected:
Agreement: t
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of he Enviro 1 Code and not to place the system in operation until a Certifi-
cate of Compliance has been i d b t ' of alth.
Sig d Date 9 Xaa
Application Approved by Date "U
Application Disapproved for the following reasons
Permit No: lc__3�w q v 0� Date Issued 9
xf
No. G"� SO�� ! . . i Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: �C
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
Rpprication for �Digoml *pgtem Congtruction.Permit
Application for a Permit to Construct( )Repair( ky pgrade( )Abandon( ) ❑Complete System, J irvidual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.
r13 P pY14>.v 3 T c, 3 7- av 44, '_���o�"',�'
Assessor's Map/Parcel �p ?3 1414 i zv 5 c, 3-r
V t
Install 's NarnA Address,and Tel.No 7'�S'��.d'co Designer's Name,Address and Tel.No.
CJi /V C
s T w-A� -y,9,f
�
Type of Building: "
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
�.. Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan_ Date Number of sheets Revision Date 1
{ J Title �• ,
Size of Septic Tank Type of S.A.S. 41
Description of Soil:
Nature of Repairs or Alterations(Answer when applicable) cv
- t
Date last inspected:
. Agreement:
i The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of he Enviro al Code and not to place the system in operation until a Certifi-
cate of Compliance has been ' su d b s of alth. Q l
- Sigd Date
Application Approved by 1 Date
\ Application Disapproved for the following reasons
r �e
Permit No.` ``� �✓ Date Issued 9
s THE COMMONWEALTH OF MASSACHUSETTS
F BARNSTABLE, MASSACHUSETTS
Certificate of Compriance
THIS IS TO C//E��RTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( L-Y'Upgraded( )
Abandofeli( )by�/`t ?f+� C d A"C D 3.3y W/1/� 'T` Gt�-
at // 3 W141A TT Q ST- has been constructed in accordance
with the pryv1sions of Title 5 and the foTpisposal System Construction Permit No. dated
Installer Des(at
r
The issu nce of this s all ,oyf be onstrued as a guarantee the system ill un do as designed.
Date � '� / Inspeetac
------- — ---- — ---- -- . -
d .
No. �./�-^� I � —— — — ——— Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
1fgpoar *pgtem Congtruction Permit
Permission is hereby granted to Construct( )Repair( �--)=Upgrade( )Abandon( )
System located at 3 i�/N 5 T 0 S7—
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided:Construction must be co pleted within three years of the dEbyy
this pe i
5. o 07 —�.
Date: 4 Approved
0
No. i Fee 50
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer.
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
01ppricartion for M!5paal 6petem Construction Vermtt
Application for a Permit to Construct( )Repair(X )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.
Asse38rslvfap/PanCelSt" Os erville Nancy Leghorn
a6
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Wm. E. Robinson Septic Service
P O Box 1089, Centerville
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title _
Size of Septic Tank Type of S.A.S.
Description of Soil Sand
2S x 1J.1, X-Z/
Nature of Repairs or Alterations(Answer when applicable) Title-5 septic system
consisting of a 1 , 500 tank, D—box and 2 preca-st leach chambers
with stone all around
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by this Bo of Health.
Signe d k o Date ® j
Application Approved by Date
Application Disapproved for the following reasons
Permit No. Date Issued
T� 4
�- Fee$50
-
No.
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS -�
'AppiYication for Mie;pogar *p5tem Con.5truction Perri'it
Application for Permit to Construct( )Repair(X )Upgrade( )Abandon( ) ❑Complete System El Individualplo'mponents
Location Address or Lot No` Owner's Name,Address and Tel.No.
738 Main St. , Osterville Nancy Leghorn
Assessor's Map/Parcel a �j
�/ )6 t
Ins Ier's N e,Address,and Tel.No. Designer's Name,Address and Tel.No.
M. f: Robinson Septic Service
P O Box 1089, Centerville
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ),
Other - Type of Building No.of Persons Showers( +`)'Cafetena( )
Other Fixtures A `
Design Flow gallons per day. Calculated daily flow gallons. {'
7Plan Date Number of sheets Revision Datelie
Title
Size of Septic Tank Type of S.A.S.M5 SEE
oil Description of S
Sand 5 X 1'3.1 X 2
when Title-5 septic system
Nak Mo.fiPff Fp4 raeratiops� wetan p�lic�bl0e anct 2 precast leach chambers
wi. n stone all around.
Date last inspected: -
Agreement:
The undersigned agrees to ensure,the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Envintal Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by i Bo d of Health.
Sign j o
/1 Date S—1��`"0 1
Application Approved by ° ' Date
Application Disapproved for the follo ing reason
i
A
- 3
Permit No. t Date Issued 7
THE COM WEALTH OF ASSAZHUS1r.U$
BARNTBLE MASSACHUSE4TTS 1
Leg�orn J
? Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal Syst b7tru ted( )Repaired( X )Upgraded( )
Abandoned( )by Wm. E. Robinson Septic Servi e G Q
at738 Main St.. , Osterville h s e^n constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction`Permit N•. dated S— I — 2-00 f
InstallerWm. E. Robinson Sr-. Designer
The issuance of thi permit shall not be construed as a guarantee that thersystem�will function as designed.
Date (� �t 0 v Inspector`�_ �r-.�(.
ez
No.���1 ------------------------2 Fee $50
i,,O� --
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
� 1
ar ngtruction Permit
�ig�og �p�tetn �o
Permission is hereby ranted to Construct( )Repair(X)Upgrade( )Abandon( )`
System located at38 Main St. , Osterville
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided:Construction ust be o leted within three years of the date of this pe
A Date: Approved by--A��--=,
ti / 7
r
•r" Y• u6M
NOTICE: This Form Is To Be used For the Repair Of ailed
Septic Systems Only. -
CERTIFIt�+►TION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS_CONSTRIICTION PERMIT(WITHOUT DESIGNED PLANS)
Will iain E. Robinson,S certify that the application fir disposal works
coasuuction permit signed by we dazed S/Y—® f , concerning the
property located at 738 Main St O s t e ry i l l e metes all of the
fouotring criteria:
• The fiaked system is connected to a[esdenual dwelling only. "There are no commercial or business
WSW with the dwebr4g.
The soil dassiftod as CLASS 1 and the pmala ion rate is tees man or equm to 5 mimeses per inctL
Thcrc ar no wetlands within 100 feet of the pwpowd srpac kwacm —
There no private wdk within 150 fact ui the proposed septic s)veui
T but is incsrase in flow andlm cbauV in use proposed
• Tb a no vanances n wpmsted or noodod
• The of the praI f abW wilt W be iacared 1m than 6vt feet above the
may adjosiod pundwater table demma- [Adju►st the 8roundwmcr table using the Fnmptor
when apphcw*l
• if the :_S_will be kcawl with 250 Fact of any vqpawd wt tmk the bottom of the proposed
1 'facility will no be located kw than four[ear 141
tfeet abate tltr ma.amttm adjusted
eater table elevation.
Pie eomplstt:the Mewing,,
A) Top of Gwand abort lu sWg GiS Wocmaijua) 2 p
B► G.W.Elevation Or +the MAX. Nigh,G.W. Adjt t
DIFFERENCE BETWEEN A and B —
SIGNED: �� DATE: `G
(Sketch proposed plan of system on hadcj
,� .
. .--;.
4
� Sr„oJ L'l.
----
��1�
typ •-,+�...v..i ��d,"L Y' h.� sbx Mx L ira k .i,.�E .� } t~c-r32 Ye
�� 'IOVi OF BA��TA]8LE
SEWAGE #
VII.fiAGE ASSESSOR'S MAP & LOT
,>
j INSTALLER'S NAME&PHONE NO. 5 .�:.dlrd
{ SEPTIC TANK rAPACM g'—G
LEACHING FACILITY:.(type)•4"— (size) !J
NO. OF BEDROOMS
BUILDER OR OWNERt
1
PERMITDATE; 7COMPLIANCE-DATE./t%
Separation Distance Between the.
Maximum Adjusted Groundwater Table to.the Bottom of Leaching Facility . Feet
Private Water Supply Welt and Leaching Facility (If any wells exist -
on site or.within 200 feet of leaching.facility.) Feet
Edge of Wetland and Leaching Facility (If any wetlands exist_
w thin'3(;d feet of leaching facility) Feet
Furnished by
10
Le
J4
r
: E .
1
1 "
_� .:
._. ,.
w -
_ : -�-F. ..:.. .. .. +n --n.:. ^r.,.. .;...a..��1!?ma-.!'^�^+.s°".!s^1!7".n...•ra .. et.
TOWN OF BARNSTABLE BAR-W
Ordinance or Regulation
WARNING NOTICE
' ^� ,a ,' 1 .
Name of Offender/Manager "4"�'
Address of Offender # tt ` MV/MB Reg.#
�` <"N, � `
Village/State/Zip � Y�i ..
Business Name s �0.00.- /pm, on 12- 20 17
,,� 44
Business Address 3,, 4,(, '.LOy�5 -
Signature of °Enforcing Officer
Village/State/Zip ` `4 VkV\I
Location of Offense 44- t t�`�'r tl't
-' Enforcing Dept/Division
Offense X ' C ! P?v /!/t lAe _, C 5 ce.bt—e_ . a` t ore, " . T'e v t a
FactsAA
}
This will serve only as 'a warning. At this time no legal action has been taken.
It is the goal of Town agencies to achieve voluntary compliance of Town
Ordinances, Rules and Regulations. Education efforts and warning notices are
attempts to gain voluntary compliance. Subsequent violations will result in
appropriate legal action by the Town.
WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT.
. J .._ _.. _ .. .,-..,. �.-ram.._ •;_,v...-..,..: __...,-r.... ��.-.-.i._
_ 'lam`-
!�
TOWN OF BARNSTABLE BAR-W r
Ordinance or Regulation
WARNING NOTICE
Name of Offender/Manager �,��i ` u
3 r Address of Offender MV/MB Reg.#� � �" � F � 5 i� � "�
Village/State/Zip °- --
Business Name �- r '' r I rs°am/pm, on 'g h' 20
Business Address
Signature of 'Enforcing Officer
Village/State/Zip ` , %4 V
Location of Offense
Enforcing Dept/Division
Offense , ° : w I , 't'�
Facts Vk 1 " { t� ; VI �>�4"s�•� - 1��, �t��':, ;r
V W• { .} i i'f} �t S f !A it i-)lv# irk... • L.� + ! r+ . I L..F/ 'e u.J Y '4 � ''a"'.
This will serve only as a warning. At this time no legal action has been taken.
It is the goal of Town agencies to achieve voluntary compliance of Town
Ordinances, Rules and Regulations. Education efforts and warning notices are
attempts to gain voluntary compliance. Subsequent violations will result in
appropriate legal action by the Town.
WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK`-ENFORCING OFFICER GOLD-ENFORCING DEPT.
—'----— NAME OF OFFENDER f�( A D
78733
TOWN OF ADDRESS OF OFFENDER p
BARNSTABLE CITY,STATE,ZIP CODE
p4t"WE MVIMB REGISTRATION NUMBER
OFFENSE
NAXMATAXIk:• ' C W
.639. `�g t C) ti" I p4L k n -• A a 4 <' Ofx A � "2, oq t kv,/:a Y� o
Ara N %
td it A I k kt ;2! 49-w a' k+.�+ 1 >
TIME AND DATE OF VIOLATION / LOCATION OF VIOLATION )j f,��' .. W
NOTICE OF 2Z- (A.M. P.Me ON 0 20 )
VIOLATION, SIGNATUR OFEN RCINGP SON ENFORCING P.. tt BADGE NO. N
OF TOWN
i HEREBY ACKNOW1 GE RECEIPT OF CITATION X a
ORDINANCE J'Unable to obtain signature pf offender.
THE NONCRIMINAL.FINE FOR THIS OFFENSE IS S
Date mailed t 1
ul
OR YOU HAVE THE FOLLOWINGIALTERNATIVES WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTION(1)OR OPTION(2)WILL OPERATE AS A FINAL a
DISPOSITION WITH NO RESULTING CRIMINAL RECORD. w
REGULATION you ma elect to a the above fine,either b appearing in person between 8:30 A.M.and 4:00 P.M.,Monde y through Frida legal holidays excepted, Q
before:The Barnstable Clerk,200 Main Street,H is,MA 0201,or by mailing a check,money order or postal note to Barnstable Clerk,P.O.Box 2430, —J!
Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE DATE OF THIS NOTICE. a
�2)US
f you desire to contest this matter in a noncriminal proceeding,you may do so by making written request to DISTRICT COURT DEPARTMENT,FIRST
ARNSTABLE DIVISION,COURT COMPOUND,MAIN STREET BARNSTABLE,MA 02630,Attn:21D Noncriminal Hearings and enclose a copy of this
citation for a hearing.
(3)If you fail to pay the above offense or to request a hearing within 21 days,or if you fail to appear for the hearing or to pay any fine determined at the
hearing to be due,criminal complaint may be issued against you.
❑ I HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$
Signature
._".-^'^'i'rwi'>;"-;?' -�...,.-.4,•+.n.r:T-.X7t•^`^. r%^T r?�- sy.n.;�y..-.:a"Y".ST""^':'c"y' �"..^w
TOWN OF BARNSTABLE BAR-W 9, 17.8
Ordinance or Regulation
WARNING NOTICE
Name of Offender/Manager t+u + r -
Address of Offender MV/MB Reg.#
Village/State/Zip
.--
Business Name '-c tQ- r, % � �1:w) am m, on 0/2 t 20 1 (.
Business Address 41 Vt 4
f 11 Signature o�Enforcing Officer
Village/State/Zip t j7e-CV
Location of Offense r; A1.)44
Enforcing /Dept/Division.
Offense Vihj,'4,�,A ,,� th!'- q. t��,► fvv r� � Vt�t+- i�f. r��� i.XJ� tvfr.,- %t`r�_1 �� ( ��o
� t r
Facts l-rz C Ca.11)ta r10 yL ref �4 741r�r>�'a ►V � �,�C"'. Is �`�r+Cry/; tl 7��►'� �-� , ��a t ��f.� �i t�✓L
`��C �,�^�t,+3 1 �L/a���►t, �'� !� r•��(����- �.1��`�,{f,!/��:� f'1��"��'�./s ���u i.�!�f'Y'� la�+'�+r N �C� r'� J i
This will serve only as a warning. At this time no legal action has been taken.
It is the goal of Town agencies to achieve voluntary compliance of Town
Ordinances, Rules and Regulations. Education efforts and warning notices are
attempts to gain voluntary compliance. Subsequent violations will result in
appropriate legal action by the Town.
WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT.
.. _.� ,- -�_ ..,,.-.. ..,-r...... ...w"..NW" ••-V.�,.+^"Fr^.,.r+^'[4nw+;+A.'Sw�r•.�.-f•tijft^..n. 'w..+ra-w:.w+^'+.xuw-.Ur;r+-s+..i-'Y..+...+.r-'^y. •w-.w^,-r...yP-.�
TOWN OF BARNSTABLE BAR—W "s17.8
Ordinance or Regulation
WARNING NOTICE
s �
Name of Offender/Manager . �F^ � !V. r
Address of Offender MV/MB Reg.#
Village/State/Zip
Business Name t f y.) Llpm, on Ilk ' 20 1 lm
7
Business Addresst-
Signature of.,Enforcing Officer
�A ^ ,
Village/State/Zip '. ' -'
Location of Offense t;° 's"�m-l
y �. ,Enforcing Dept/Division
Offense !+r�1 is h ifs}i, < ' �y�. , "f lei,' " /
Facts
� � : �{,..j �,�/ i $ �'�. 4' "�r� k'E 1� � �'t{+• �J ;, fit" rT. �` � r p!, �, ,E � 1l` �, {t+( #�.� `'.rt,�,
This will "serve only as a warning. At this time no legal action has been taken.
It is the goal of Town agencies to achieve voluntary compliance of Town
Ordinances, Rules and Regulations. Education efforts and warning notices are
attempts to gain voluntary compliance. Subsequent violations will result in
appropriate legal action by the Town.
WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT.
te►ok� Town of Barnstable Office:508-862-4644
Public Health Division Fax:508-790-6304
• RaRMBTMRLE.g• 200 Main Street• Hyannis, MA 02601 _
TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT
Business Name: �jaf le- Date:
Location/Mailing Address: 'N 16 M aiw S4- L Qs fe�f Jt I le— me,4 1-
Contact Name/Phone: 5�08 2 - oDS3 �a�'Ji �(�0��✓e �o� Cz11 5pg-�/DD-71?q
Inventory Total Amount: MSDS: License#:
Tier II : Labeling: Spill Plan:
Oil/WaterSeparator: Floor Drains: Emergency Numbers:
Storage Areas/Tanks:
Emergency/Containment Equipment:
Waste Generator ID: Waste Product:
Date&Amount of Last Shipment/Frequency.
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:
INFORMATION/RECOMMENDATIONS: &C o 15 M Ve-55 . Ott P
oc A •�li r c e
1t-Z S a V- 7 �atvlST � Inspector:
�P
Facility Representative:
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
L
°e IKE jog '- Town of Barnstable �^* Office:508-862-4644
Public Health Division Fax:5o8aso-ssoa
eARMAs B'E'g I 200 Main Street• Hyannis, MA 02601
or3u9 1 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT
Business Name:, /V'J ��, Date: 101211h,16
Location/Mailin S+ a O s 4e r 0 l le._ me,1
g.,Address: ?y G�A�i� '
Contact Name%Pl one: SfD Z - OnS3 ,(� 01,Je c� cz11 �� y00-'?►�t4
Inventory Total Amount: MSDS: License#: 'I
Tier II : Labelina: Spill Plan:
Oil/Water Separator: Floor Drains: Emergency Numbers:
Storage Areas/Tanks:
Emergency/Containment Equipment:
Waste Generator ID: Waste Product:
Date&Amount of Last Shipment/Frequency:
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
1 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:
4.1 rr
INFORMATION RECOMMENDATIONS: ( L� `JU�CC�e- 0-V 1 /X1(e155 TAte vL
4A os _ t� fiir AS Ci v n(�A, ) trvl �b �5 Vl . "' I,-1 u P i.0-po-( te_ .51
(�t�� 'j'•5#�c ,(¢-00, RC,�S �.� fq�, . Inspector:
Facility Representative:
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
S M E A D
No• 103?A
?_-1531_
MApF_IN U.$A
T np .4NIZED AT wrAn 1ny