Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
3821 FALMOUTH ROAD/RTE 28 - HAZMAT
Q5 `1 -Uv� UPC 12543 'z o No. 53LOR �- MOR��unO 41J • ROOTS Specializing in Hidden Lights Corrective and Creative Cutting and Colour 3821 Falmouth Rd.,Route 28 Bldg 8,Suite B Marstons Mills 02648 phone 508-420-1512 text by Appointment Only www.rootsunlimited.com info@rootsunlimited.com ® SALE I SAUE $79 SALE I SAUE $198 • KD SallyMate'"' <>=�- 8300 Plastic Shampoo Bowl .- Trolley B7 t�•Y- • Equipped with 570 single handle - fixturel(sprayhose,strainer • Compartmentalized top l ass__mbly,and mounting bracket � • 4 removable trays = limensions:l9"WTO"iro'n1 to-back • • • Textured finish ! x 9 75 D SALE SAUE g99 . d!mensions:l3"Wx 1-��- 14"DWARRANTY(voided itthe detect is _ ®. ' , 1 • Assembly required aresult ol.applying petroleumor nail care produces Blackg965620 to the bowl) -- - Black#876330 3'x 5'Marbleized Mat Optional Vacuum Breaker sold separately. • Wit-thick Checwplumbing requirements in your area. • Punciure-resistant #926120................................................ - _. 1 YEAR WARRANTY Black;Marbleize Rectangle#578015 "�"`"`' Bla k Maibleized Half-Circle#578017 SALE I SAUE �149 U-1 Recline Shampoo Ghair t- Lar a Beaut Case • inside seat wl`d-fh 19" �- Iwo C s in one! Pebco Nail ToDI • 71it'al h'elght 31^ • assern y required Adjustable shelves • 5 di2mard b,rs mc,udr". , • Minimalj • 3 YEAR WARHANT,Y ( • Multi-storage compartments - • 'Je fable mgtorispeed 5,non 20 OOO Rriv"„ Black#920978 i s • Travel wheels and out handle 1 YEAR WARRANTY i "© • Lockable cloes #993500 Clear Chair Back Cover I 1 YEAR WAR sur RANTjY #911978........................ I • Dimensions:14 KW x 28.5"H x 9.5"D � • • Black#209956 _ SALE I SAUE g99 - � SALE SAUE �l 89 ART2i10 P,o�rtable Shampoo Bow O P_UM BIN l- —NG REOUIREDi ® ' � r= Oeluxe plastic howl with 5'drain hose - J^ �� .r o • Height adjusts from 31.5"to 49" ® ® equine KD132241 Sin le St tin Vanit • fiequlreslseparalewatersource �a,.� 9��,.Y 9 Y Small Beauty Case _ • 1 YEAR WARRANTY Includ.eesydrawer,purse shelf,and storage • Removable cPoin artment store e�lra ! Black g94o521 cabinet wlthT2 shi Ives. 9 Y ` f)imenslons:42iW x 36"H x 16"D • froel wheels and telescopic.pull Handle \ • Assembly required • Lrockable closures • Mirror sold se aratel • Dimensions:14.5 W xQ1.5"H x 9"D(front-to-back) � SALE I SAUE g5995 ^K. Black#923620 P Y • 1 YEAR WARRANTY Black#209957 -• t � 1 �. TH CmidSafaSeat60Q 5 days only, Ma��7 3 - 7, 2010 Fits virtually any r hadesign. t I l I Dimensions:19i5"1�J x 6"HTx 12"D. Prlices are valid in store only Blasl:.ug4"sot SALE - • ; . SALE G R E AT SALE G R EA 59 - 129 value value ea. - ,. .;: ea. 129 ea. . Satin Smooth t �" KD Platform Base Table Top Facial SALE Salon-Mate" Dryer Chair Y431 Professional Dryer \. Steamer >. �t Cutout fits Highland n' � Extra large hood • Ozone feature $139 dryers measuring 980 Watts/8.5 Amps/ • Essential oil ea. 12.25"W x 23.75"H �_ ` Heats up to 145 degrees `. compartment ,�,3 Golden Supreme x 6.5"D • 60 minute timer with 3 minute • 90 degree rotating wand • Assembly required cool-down cycle - and steamer spout HE100 Heat Exxpress 1 YEAR WARRANTY� Three heat settings:Low/Medium/ �� 1 • 3 minute auto shut-off Thermal Styling Kit Black 9920431 High when water reaches Includes Stave and Stand,plus 13 styling tools t,z Dimensions:12.25"W x 23.75"H minimum water level and thermal traveling bag.1 YEAR WARRANTY. is 6.5"D • 1 YEAR WARRANTY #899500 1 YEAR WARRANTY #928480 (Due to health codes,this product cannot be returned it used). Black with Smoke Hood#876350 / Dryer Wheel Set with Handle UICKSHIP � sku� #940402............... 36.95 Ca. —�. Sncon E(ZSw1 trn'r SallyBeautyxom 800-ASK-SALLY Dater 61 a71 7z TOWN OF BARNSTABLE TOXIC AND ZA DOMATERIALS ON-SITE INVENTORY NAME OF BUSINESS: ' BUSINESS LOCATION: N ,/I 95- . & v-P. 9AI'A�ays/�i�� INVENTORY �• n�E y, [�✓I;yl (te r ' MAILING ADDRESS: .a) A-V f I- �a� /c . TOTAL AMOUNT. TELEPHONE NUMBER: .7711' 036`' y.SV CONTACT PERSON: � /�1�11 MmLOA— EMERGENCY CONTACT TELEPHONE NUMBER: '�A k3,!�- 3<1.51 MSDS ON SITE? TYPE OF BUSINESS: INFORMATION/REC MMENDATIONS: 6'M&t0-d --Al 74' 061' Fire District: In i Al Waste Transportation: Last shipment of hazardous,waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed/Maximum Observed/Maximum vI Antifreeze (for gasoline or coolant systems) 0 _ Misc. Corrosive i� NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants © Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED Misc. petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) r. Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Misc. Combustible Car wash detergents Leather dyes Car waxes and polishes ® Fertilizers Asphalt & roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor &furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) 0,017 / Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS IKE Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMA�,S. 200 Main Street• Hyannis, MA 02601 �prEOMP�p`0 TOXIC ZAID HAZARDOUS MATERIALS INSPECTION REPORT Business Name: C � s Date: Location/Mailin Addre . 2t ViO Smote.. -76 Contact Name/Phone: I Z0- -LLZ- Inventory Total mount: j SIDS: 4V � °`��' License#: N Tier II : AJO Labeling: of-f-'tiO Spill Plan: Oil/WaterSeparator: /J Floor Drains: o Emergency Numbers: Storage Areas/Tanks: S,4� 1sBr o1,s►�re Emergency/Containment i ment: ��^c�. t;A1 .r 5V 4,, v Waste Generator ID: NIA 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 r' "t 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 (I—f \ Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables A�,Q,�ow Fertilizers Floor&furniture strippers p:v.�,Wv PCB's Metal polishes a6;1k%Ll� Other chlorinated hydrocarbons Laundry soil &stain removers �� (including carbon tetrachloride) (including bleach) �`���"�' Any other products with "poison labels" Nw I (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: JX1 A 15114 0- gccv A&4 r\ t KrS q,r,r— at 2-0— iri o 5,Ag Ovl -k — S o mil. s�!-:e aV a. 1" INFORMATION/RECOMMENDATIONS: a jf erC oK. k V, aM4, o �� s o o ► ��OSkr Inspector: ' , l� Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS ASSESSORSMAPN� PARC N � l TOWN OF BARN 6TABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair ` BOARD OF HEALTH O satisfactory 2.Printers 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY lc1f�.� %�/, c• ,-S�1r� :� (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS .-�'.�2, Ir��n r,•`7i tClass: 1' 7.Miscellaneous CQUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALSCase lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) • Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: DISPOSAVRECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply O Town SewerOPublic � O On-site OPrivate 3. Indoor Floor Drains YES NO ? O Holding tank: MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank: MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 1. 2. f n Person (s) Interviewed Inspector Date -I TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: -sae ado Aof ' 6-1,50Z Mail To: BUSINESS LOCATION: A�� S � ��—� /� Board of Health MAILING ADDRESS: 3b--1 ��' 7` C� Town of Barnstable �. P.O. Box 534 TELEPHONE NUMBER: J'19 r- Hyannis, MA 02601 CONTACT PERSON: &2144, v A,1 EMERGENCY CONTACT TELEPHONE NUMBER: `' Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallonsliquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Qu ntity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal qo Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD QF O'LE LTH 3.Auto Body Shops ..� ,�, O unsatisfactory- 4.Manufacturers COMPANY V � (see"Orders") 5.Retail Stores -�• 6.Fuel Suppliers rZr VI -2 Class: 7.Miscellaneous )hr, :M�QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALSCase lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons 777 Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers lu Miscellaneous: DISPOSAURECI.AMATION REMARKS: 1. Sanitary Sewage 2. Water Supply O Town Sewer Public r IV On-site OPrivate 3. Indoor Floor Drains YES NO O Holding tank: MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES VINO ORDERS: O Holding tank: MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product 1 YES NO 2. & /5,Ae, Perso s) Interviewed riispector Da e d. na� as ojtA �)D pv-A�ql ._, � Cb Cow �� J I"E'O"" Town of Barnstable ABA. # Regulatory Services 9� 039. Public Health Division ATED MA'�'A _ _ 200 Main Street - Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 TOWN OF BARNSTABLE RESIDENTS ONLY Over the Age of 9 ADULT VACCINE ADMINISTRATION RECORD Name (Last, First, Middle) _ Age: Street Address: Town State Zip , .,� cc n: y� S xp' 1 t f 1 uM x h � Jan 25 10 04:27p louis fox 508 7475935 P.1 I� I , ; Page 1 of 1 Subj: MSDS Date: 1/25/2010 12:54.33 P.M. Eastern Standard Time From: cgauvain@tropicalproducts.net To: foxjr18@aol.com Hello Lou, Attached you will find the NISDS as requested. Have a great day Cheryl Cheryl Gauvain Tropical Products,Inc. ph:(978)740-5665 x101 8)740-8718 j IM H6 fl-ye jJ i,? R O L T f�1 ftij Monday,January 25, 2010 AOL: FoxJR18 I tJan 25 10 04:27p louis fox 508 7475935 p.2 F-off;- 01/2512010 16:20 #408 P.001/008 MATERUL SAFETY DATA SHEET Effective Date: January 25, 2010 Trade Name&Syno a1 ,-' alon Magic Conditioner 1. GENERAL INFORMAuoN Chemical Name&Synonyngs N/A Chemical Family MIXTURE Proper DOT Shipping Name N/A DOT Hazard Classification tiUA Manufactured by Tropical Products,Inc. Address 220 Highland Avenue Salem,MA 01970 Phone Number (978) 740-5665 2. INGREDIENTS Principal Hazardous Percent Threshold Limit Value(units) This product contains no hazardous substance listed on the Massachusetts substance list or OSHA Hazard Communication Program. 3. Pn'YSICAL DATA Boiling Point 206°F Specific Gravity(Water-1) eJan 2ET 10 04:28p louis fox 508 7475935 p.3 From: 01125/2010 16:21 #408 P.002i008 Page 2of4 Vapor Pressure(NM—HQ. No Data Percent Yolatile By Volume (%} 55-70 Vapor Density(AIR= 1) NO DATA Evaporation Rate(WATER— 11 I Solubilityin Water COMPLETE pH OP-CONCENTRATION: 6.8-7.0 Appearance& Odor Green Liquid,Rain Fragrance 4. FM &.EXPLOSION HAzARD DATA Flash Point(Test.Method) NONE Auto Ignition Temperature N/A Flammable Limits NIA Extingmishing Media CARBON DIOXIDE,WATER,DRY CHEMICALS Special Fire Fighting Procedures NONE Unusual Fire&Explosion Hamards NONE Jqn.25 10 04:28p louis fox 508 7475935 p.4 From: C112512010 16:21 #408 P.00V 008 Page of 5. HEALTH HAZARD DATA Exposure Limits NOT ESTABLISHED Carcinogenicity THE INGREDIENTS IN THIS MATERIAL ARE NOT LISTED AS CARCINOGENS BY IARC,NIP, OSHA, OR ACGIH. Principal Health Hazards (Includes significant routes,effects,symptoms of over-exposure, medical conditions aggravated by exposure.) F,ffeets of Overexposure EYE IRRITANT,HARMFUL IF SWALLOWED Emergency and First Aid Procedures IN CASE OF EYE CONTACT,FLUSH WITH WATER FOR AT LEAST 15 MINTUTES. GET DJMEDIATE MEDICAL ATTENTION. 6. REACTIVITY DATA Conditions Contributing to Instability. Incompatibility STRONG OXIDIZING AGENTS Hazardous Decomposition Products WILL NOT OCCUR Conditions Contributing to Hazardous Polymerization MATERIAL WILL NOT POLYMERIZE 7. ENVIRONMENTAL PROCEDURES Steps to be taken ifmaterial is released or spelled CATCH SPILL AND RETURN TO CONTAINER.USE ABSORBENT TO REMOVE REMAINDER OF SPILL. USE PROPER DISPOSAL PROCEDURES. Waste Disposal Method FOLLOW LOCAL, STATE AND FEDERAL GUIDELINES. r i it II .Jan•2a 10 04:28p louis fox 508 7475935 p,5 From: 01125i2010 16:21 #408 P.0041008 Page 4 of 4 8. SPECIAL PROTECTION INFORMATION Yenulation Requirements NONE Respiratory NONE Eyes IT IS RECOMMENDED THAT WHEN POURING LIQUID, WEAR SAFETY GLASSES_ Gloves NONE Other Protective Equipment IT IS RECOMMENDED TO WEAR SAFETY GLASSES IF REPOURING TEB MATERIAL 9. SPECIAL PRECAUTIONS (Includes Hygienic Practices in Handling&Storage; Precautions For Maintenance of Contaminate Equipment, Other Precautions) Special Mixing and Handding Instructions NONE 10. SECTION 313 SUPPLIER NOTIFICATION This Product contains the Following Toxic Chemicals Subject to the Reporting Requirements of Section 313 of The Emergency Planning and Community Right-To-Know Act of 1996 and of 40 CFR 3'72: NIA CAS N/A II r Jan 25 10 04:29p louis fox 508 7475935 p.6 F,roo: 01/25/2010 16:21 #408 P.0051008 r MATERIAL SAFETY DATA SHEET. Effective Date: January 25,2010 Trade Name&Synan . s:Jojoba Shampoo 1. GENERAL LNFoRMATION Chemical Name & Synonyms NVA Chemical Family MIXTURE Proper DOT Shipping Name NIA DOT Hazard Classification NIA Manufactured By Tropical Products,Inc. Address 220 Highland Avenue Salem,MA 01970 Phone Number (978)740-5665 2. INGREDIENTS Principal Hazardous Percent Threshold Limit Value(units) This product contains no hazardous substance listed on the Massachusetts substance list or OSHA Hazard Communication Program. 3. PHYSICAL DATA Boilinz Point 206OF Specific Gravity(Water— 1) ,d I� Jan 25 10 04:29p louis fox 508 7475935 p.7 From: W25/2010 16:21 #408 VONi008 Page 2 of 4 _Eapor Pressure(M M HR.) No Data Percent Volatile By Volume(%) 55—70 Vapor Density(AIR= 1) NO DATA Evaporation Rate(WATER—1) 1 Solubility in Water COMPLETE PH OF-CONCENTRATION: 6.9-7.0 Appearance& Odor White Pearlized Liquid, Coconut Fragrance 4. FIRE &EXPLOSION HAZARD DATA Flash Point(Test Method) NONE Auto I,enition Temperature N/A Flammable Limits N/A Extinguishing Media CARBON DIOXIDE,WATER,DRY CHEMICALS Special Fire Fighting Procedures NONE Unusual Fire&Explosion Hazards NONE I Jan 25 10 04:29p louis fox 508 7475935 p.8 F:om: 01/2512010 16:21 #408 P.0071008 Page 3 of 4 5. HEALTH HAZARD DATA Exposure Limits NOT ESTABLISHED Carcinogenicity THE INGREDIENTS IN THIS MATERIAL ARE NOT LISTED AS CARCINOGENS BY IARC,NIP, OSHA,OR ACGIH. Principal Health Hazards (Includes significant routes,effects, symptoms of over-exposure,medical conditions aggravated by exposure.) Effects oLOverexposure EYE DZR.ITANT,HARWUL IF SWALLOWED Emerg ena and First Aid Procedures IN CASE OF EYE CONTACT,FLUSH WITH WATER FOR AT LEAST 15 MINUTES. GET IMNIEDIATE MEDICAL ATTENTION. 6. REACTIVITY DATA Conditions Contributing to Instabili y Incompatibility STRONG OXIDIZING AGENTS Hazardous Decomposition Products WILL NOT OCCUR Conditions Contributing to Hazardous Polymerization MATERIAL WILL NOT POLYMERIZE 7. ENVIRONMENTAL PROCEDURES Steps to be taken if material is released or spilled CATCH SPILL AND RETURN TO CONTAINER.USE ABSORBENT TO REMOVE REMAINDER OF SPILL. PLACE ABSORBENT IN STEEL CONTAINER USE PROPER DISPOSAL PROCEDURES. Waste Disposal Method FOLLOW LOCAL, STATE AND FEDERAL GUIDELINES. r I II Jan 25 10 04:30p louis fox 508 7475935 p.9 ,F a 01125;2010 16:21 #408 P.0081008 Page 4 of 4 8. SPECIAL PROTECTION INFORMATION Ventilation Requirements NONE Respiratory NONE Eves IT IS RECONMIENDED THAT WHEN POURING LIQUID,WEAR SAFETY GLASSES Gloves NONE Other Protective Equipment IT IS RECOMMENDED TO WEAR SAFETY GLASSES IF REPOURING THIS MATERIAL 9. SPECIAL PRECAtM0 S (Includes Hygienic Practices in Handling& Storage,Precautions For Maintenance of Contaminate Equipment, Other Precautions.) Special Mixing and Handling Instructions NONE 10. SECTION 313 SUPPLIER NOTIFICATION This Ptoduct contains the Following Toxic Chemicals Subject to the Reporting Requirements of Section 313 of The Emergency Planning and Community Right-To-Know Act of 1936 and of 40 CFR 372: N/A CAS 4 N/A i I r YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates(cost$30.00 for'4 years . A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission 'o�eTst8. Business Certificates are available at the Town Clerk's Office, 1`FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: Fill in please: APPLICANT'S YOUR NAME/S .��rlrcl �hI1nS[m - t�1P LSCrr1 BUSINESS YOUR HOME ADDRE�SS: Ib 6 i i74 r'�vnn r_ fZ d eo TELEPHONE # Home Telephone Number 501k -yzo-o7 9 NAME OF CORPORATION: , NAME OF NEW BUSINESS TYPE OF BUSINESS GAY- Caju rov i -ec-I)6 C e4n i ctd.S IS THIS A HOME OCCUPATION? YES NO!, ADDRESS OF BUSINESS Z F' Z Ss (VL4,is-/rnS /V// MAP/PARCEL NUMBER C� 7 - D o 7 [Assessing] When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. ,You MUST GO TO 260 Main St. - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally ope�ite your business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type.of business. Authorized Signature* COMMENTS: 2. BOARD OF HEALTH This individual ha n informed of the p r it requir enps�pertain to this type of business. / 162-41-7-1 Authoriz d Signa re** - COMMENTS: oZ/— G 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: G T poi YOU WISH TO OPEN A BUSINESS? ISTERS AME in town r:::�Informa which tion: Business certificates (cost$30.00 for 4 yearsl A businesstificateslfaretavOaillabl eatGthe Town C ek!s Office, 1 FL(367 M.G.L.-it does not give you permission tri oj5e� e. Business Cyannis, MA 02601 (Town Hal DATE: i Oc Fill in please: YOUR NAal ME S: APPLICANT'S .� YOUR HOME ADORE S: _ BUSINESS -� R y Home Telephone Number v .p. TELEPHONE # NAME OF CORPORATION: TYPE OF BUSINESS NAME OF NEW BUSINESS IS THIS A HOME OCCUPATIO YES NO _ _ V�ti► U����MA��PARJGEL NUMBER (Assessing) ADDRESS OF BUSINESS starting anew business there are sev4ral th�ngs you must do in order to be in compliance with the rules and regulations of the Town o When 9 - orner of you UST GO ain St Barnst able. This form is intended to assist you in obtaining the information licenses required toNlegally opera a yourMbus ness to this town.armou �. Rd. &Main Street] to make sure you have the appropriate per 1. BUILDING CO ISSIO ER'S OF C This individu I ha e n infor e f an p mit requir ments hat pertain to this type of business. 1 A horized Si gnat �* OMM NT BOARD OF HEALTH _ —f th pe uire e rmit re men_ts th atp am ert .G.Q.this.typ.. This individual his b� �0 Auth rized Signature' ' ' - , `� ►^ `�� i` �v COMMENTS:V211 I 1 11 1 a,lloA zvF:l( n�1- cQ ��SI'ov,�17Fr 8\S cr ' 5�,,, ��srtz.f7Q d���� .�iuJ o� l s cS.� — P(Z , ( Leo n Q h cz e lQ P�2 —ey, �'LLB-^ `�/13 0 3. CONSUMER AFFAIRS(LICENSING AUTHORI ) ments that pertain to this type of business. This individual h n inf ed of the i v sirit uthorized Si nature** - es COMMENTS: YOU WISH TO OPEN A BUSINESS? =Yourormation: Business certificates (cost$30.00 for 4 years . A business certificate ONLY REGISTERS YOUR NAME in town (which by M.G.L.-it does not.give you permission to a e. Business Certificates are available at the Town Clerk's Office, 1s`FL., 367 , Hyannis, MA 02601 (Town Hall) j DATE: 1 a t Fill in please: fmr i .sxaste'*s�3' "' APPLICANT'S YOUR NAME/S: BUSINESS YOUR HOME ADORE S. Home Telephone er p hone Numb ate 's T TELEPHONE #. NAME OF CORPORATION: TYPE OF BUSINESS / gip NAME OF NEW BUSINESS /7Gj L�% IS THIS A HOME OCCUPATIO ? YES NO.; hlC (Assessing) �t/J R � r NUMBER ADDRESS OF BUSINESS " VI��%t�Cn MAP/PARCEL N A ' ewith the rules and re ulations of the Town of be in com lianc 9 When starting a new business there are several th�ngs you must do m order to p Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth the appropriate ermits and licenses required to legally operate your business in this town. Rd. &Main Street) to make sure you havep 1. BUILDING CO ISSIO ER'S OF C This individu I had e n iftfof e fan p r mit requir ments hat pertain to this type of business. Au hoi�ized Si nat OMM NT i BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the.licensing requirements that pertain-to this type of business. Authorized Signature* i CO MMENTS: YOU WISH TO.OPEN A BUSINESS? For Your Information: Business certificates(cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town(which siness Certificates are available at the Town you must do by M.G.L.-it does not give you permission to operate.) Bu Town Clerk's Office. 1`FL.367 Main Street,Hyannis, MA 02601 (Town Hall) DATE:_/I -l 3 d Fill in please: APPLICANT'S YOUR NAME: f N �� u� ��T BUSINESS YOUR HOME ADDRESS: l C` 0 y TELEPHONE # Home Telephone Number 6_0g NAME.OF NEW BUISINESS L TYp1r 0 r BUS11V1=SS A 5 (.a IS THIS.A:140ME OCCUPATION'S Have yciu h'ean given. roval frwin.the buildin .di Asi6n?. YES NO /� ADDRESS OF BWSINiE$S. Z) n�ourt, iRa 1 M�tans MAP,/PARcrrl:N.UMSER When starting anew business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd.&Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this-town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed.of any permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: 2. BOARD OF HEALTH. This individual has b n informed of the permit a irements that pertain to this type of business. uthon ed Signa re* � COMMENTS: 3. CONSUMER-AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: + r Hazardous Materials inventory Sheet Checklist Date Physical Street Address-Check database to ensure it exists Aorking Phone Number ctual Amounts-(le.gas being used to fuel machines,thinner to T clean brushes all count as hazardous materials) V Storage Information-location of storage,how long Is storage for? f none,note that. Disposal Information-where and who?If none,note that. ;Applicant Signature-understand what is listed and noted Staff initial-any questions,know who to ask Vehicle Washing/Rinsing? -provide a vehicle washing policy and /explain it-note that It was given V Attach the Business Certificate with your sign off and comments "The inventory form should explain what the business consists of and the procedures : they are doing. Notes need to be left to explain what you discussed with them. Date: Ak /t� / a�► TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF b\jN4LA BUSINESS LOCATION: JAL F1LMo47-4 r'/). 1 A IN MAILING ADDRESS: MA86T67Q� (M%i LL-_s, MA - TOTAL AMOUNT: TELEPHONE NUMBER: -500 �'20 6216D_ CONTACT PERSON: `f to ti6 . —kkA y QU+ EMERGENCY CONTACT TELEPHONE NUMBER: �Og 360 (4 MSDS ON SITE? TYPE OF BUSINESS: K�k-c (ems S"LokJ INFORMATION/RECOMMENDATIONS: Fire District: a.o Waste Transportation: Last shipment of hazardous,waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed/Maximum Observed/Maximum Antifreeze (for gasoline or coolant systems) Misc. Corrosive NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED Misc. petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Misc. Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt & roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) NEW _USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor&furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers 1611 rh C; L PP) 5lk C n) awe (including bleach) cvA hA-Av Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents i Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS.YOUR NAME in town (which you must do by M.G.L..-it does not give you permission to operate. ou must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st FI., 367 Main St., Hyannis, MA 02601. (Town Hall).and get the Business Certificate that is required by law.,. DATE:OS i `1 Fill in please: :�i.'.:5 li:i:?I'.17°JJ:}M1rL}'l 1{• -•• G e�c APPLICANT'S YOUR NAME/S: ' BUS NESS I YOUR HOME ADDRESS: G,oc ' �x J e ' 9liall:Ys'O::;.:r TELEPHONE # Home Telephone Number t o !at'idv�Jifi`i�4�.d OR EIN #: 1.. Q '� c V;•.:.1 E—MAIL: C'h YOU U NAME OF CORPORATION: NAME OF-NEW BUSINESS TYPE OF BUSINESS "5u3 IS THIS A HOME OCCUPATION? . YES NO pp�©2�32 , r ADDRESS OF BUSINESS. a2>1 o v'C�— �\ MAP/PARCEL NUMBER U5 — D0 (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regul'ations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM SIO ER'S OFF E This individu I h e in ed o a pe. t e uire Brits that pertain to this type of business. Au or zed Signat * COMMENTS 2. BOARD OF HEALTH This individual he een informed of th rm' requirements that pertain to this type of business. Al Juth rized Sign ture** COMMENTS:� S �� /✓1 /)l cal 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: `--� COMMONWEALTH OF MASSACHUSETTS DIVISION OF PROFESSIONAL LICENSURE ' OFFICE OF INVESTIGATIONS Application for Complaint 617-727-7406 www.mass.gov/reg Date Received(stamp): Entered into the Database(Date): / / Docket#: - - Acknowledgement letter sent(Date): / / Signature: Please complete this form as fully as possible.(PLEASE DO NOT WRITE ABOVE LINE.)Please type or print legibly in ink. SUBMITTED BY: //�� V Name: 1"0 I 1/OOA zle Last Name d First Name p� M.I. /�> Address: o() 6 1Y 3 o r �o !/l/" Number Strut Daytime Phone Y4 913 City State Zip Code Evening Phone Best way to reach you: ❑Evening Phone 4aytime Phone ❑E-mail: nn(tea lord, d adklnmae0�!, LICENSEE SEEKING COMP AINT AGAINST(use separate f rm for each licensed individual): Name: IG')�I hl A Last Name First Name M.I. Address: Number Street Daytime Phone City 0 State Zip Code License Number/Type Class Business Nam W MILL - Business Address a Da ime Phone o /W #G S40P City State Zip Code Business License if/Type Class Please check the trade or profession that this application for complaint pertains to Accountant Funeral Director Optometrist Aesthetician Gas Fitter Physical Therapist Architect Hair Salon Physical Therapist Assistant Athletic Trainer Hair Stylist Plumber Audiologist/Speech Language Health Officer Podiatrist Pathologist Psychologist Hearing Aid/Instrument Barber Radio/TV Tech. Barber Shop Home Inspector Real Estate Agent/ Chiropractor Land Surveyor Broker/Salesperson Landscape Architect Dietitian/Nutritionist Real Estate Appraiser Dispensing Optician X Manicure Salon Rehab.Counselor Drinking Water Manicurist Sanitarian Ed. Psychologist Marriage&Family Therapist Social Worker Electrician Mental Health Counselor Veterinarian Electrologist Occupational Therapist Engineer Occupational Therapist Fire or Burglar Alarm Assistant Pagel of 2 Description of the incident(s): Briefly describe the incident(s) that led to your application for complaint and note the times and dates that events occurred.List the names of all individuals involved.Please attach additional pages if needed4 E w �� L � s c ® rvj,e6i � ms s 6ei-s- 40 WA5 6RL64ew TO W" uWals b-1 As a� TZA/V COMP1,16-D 0 MA� pLD HAV46 i�4 tl In A TO 6wt) —Od Qr6a (Please use a separate sheet if necessary.Do not write in the margins.) Additional information or materials attached /Yes ❑No To speed up the application for complaint process,submit legible copies(not the originals)of all relative documents supporting your application(e.g.contracts,medical records,cancelled checks,etc.).You will receive an acknowledgement letter notifying you if a complaint is issued based on your application.If a complaint is not issued, you will receive information on additional resources that may be available to you. AUTHORIZATION FOR RELEASE OF RECORDS AND FORM REFERRAL My signature to this form,or a photocopy thereof,authorizes the Division of Professional Licensure to: (1)receive copies of all medical,dental and mental health records relating to my application for complaint,and(2)to refer my application for complaint to other appropriate law enforcement authorities to investigate and/or prosecute. Please note that all applications for complaints are examined to determine their factual basis. The act of filing an application for complaint does not assure or imply that disciplinary action will be taken against the licensee. I att that the informatio rod ed isQtrue,correct FRd complete to the best of my knowledg Signature Date Mail this form to: Division of Professional Licensure,Office of Investigations 239 Causeway St.,Suite 400 Boston,MA 02114 Page 2 of 2 oFTHE A o Town of Barnstable , SM Regulatory Services 9e� MAS& Thomas F. Geiler,Director A FDN1 public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 INF K DATE: r NUMBER OF PAGES TO FOLLOW: 1 TO: D� /O� FROM• PHONE: PHONE: (508)862-4644 f FAX PHONE: FAX PHONE: (508)790-6304 cc: NOTES/COMMENTS: QAFax Form.ddc j1appy Rails 4 Complete JVail Care for Xaclies!*Gentlemen Gel • Silk • Acrylic Pink &White Spa Pedicures &Manicures Business Hours: Mon.-Sat. 9:00 am-7:00 pm Gift Certificates Available 508-420-6262 Wind Mill Square,Marstons Mills,MA 02648 �01.1HE Tp� Donna Z. Miorandi, Rs N�@ ~� Health Inspector BA"sTABM Towel of Barnstable poo 039. `0� Department of Regulatory Services CFO MA'S e PUBLIC HEALTH DIVISION Office Hours: 200 Main Street,Hyannis,MA 02601 8:00-9:30 a.m.Daily Tel: (508)862-4644 3:30-4:30 p.m.Daily Fax: (508) 790-6304 i Email: donna.miorandi@town.barnstable.ma.us II � U� RTE,z NAic� IQUi� � � m � ry � GR6��NT5 pap! fo l�N� o�� ' x YZ A41W A Cr( ytC;/ axyef�y, FLRs}J PoiN1" �a� � ����N���PRoDUta'176dC AMOA[6 Uhl �o�o �S ,ll'lls rIJI - , cr) r �- r. MATERIAL SAFETY DATA SHEET I. PRODUCT IDENTIFICATION TRADE NAME (as labeled) PEDI-REDI PLUS MANUFACTURER'S NAME MAXIM, LLC. Address (complete mailing address): PO BOX 11798 GLENDALE, AZ 85318 Phone number for additional Information: 623-580-8422 OR 1-800-313-7706 Date prepared or revised 2/10/95 Name of preparer' Dr. William H. Berger, PH.D. 11. HAZARDOUS INGREDIENTS Chemical Names . CAS Numbers Percent' Exposure Limits In Air (indicate unit: n=sodium—n—chloro—para—toluenesulfonamide ACGIH TLV OSHA PEL Other (specif% (Active Component) CAS #:127-65-1 EPA Reg. #: 10575-1 ACTIVE INGREDIENT: Chloramine—T is a safe, broad spectrum disinfectant, germacide and deodorant. It's purity is 99.5%. •`NO INGREDIENTS KNOWN TO, BE HAZARDOUS ARE. PRESENT. The identity of the individual components i� regarded to be a trade secret. In accordance with 29 CFR 1910. 1200 we have to assume that thf= mixture presents the same health hazards as the individual components when they are present ai greater -than 107, concentration. .. Active, component is covered by 21 CFR 178.4010. " III. PHYSICAL PROPERTIES Vapor density (air= 1 ) Not Determined Melting point or range, OF At 95'C. melting starts Specific gravity Not Determined Boiling point or range, OF Not applicable Solubility In water 15% at 25°C. Evaporation rate (butyl acetate = 1 ) Not Determined Vapor pressure, mm Hg at 20 °C Not Determined Appearance and odor Aqua-Blue Crystalline powder withra—Peppermint odor. HOW TO DETECT THIS SUBSTANCE(warning properties of substance as a gas, vapor, dust, or mist) A Crystalline Powder 'Not a required category. NOTE: All required categories must be addressed. If any.-item is not applicable, or no information is available, the spat.n must be marked to indicate that. f M • ..�� - / _;� .. a Y. t ;! .., This-voluntary form' is provided by'Cal/OSHA to assist MSDS preparers and users. Any format may be used as long `ii contains all 'the required information. (Rev. 5/90) THE INFORMATION CONTAINED HEREIN IS BASED ON DATA CONSIDERED ACCURATE. HOWEVER, NO WARRANTY, EXPRESSED OR IMPLIED, IS GIVEN REGARDING THE ACCURACE OF THESE DATA OR THE RESULTS TO BE OBTAINED FROM THE USE THEREOF. ACCORDINGLY, MAXIM, 1.1C. WILL NOT BE RESPONSIBLE FOR DAMAGES RESULTING FROM USE OF, OR RELIANCE UPON THIS INFORMATION. r o. Y 1 FIE Flash Point, °F (give method) 192°C. (CLO EDC AND EXPLOSION Auto Ignition temperature, OF Not Determined Flammable limits In air, % by volume: lower LEL : NOD" ( ) upper (UEL): N/D Fire extinguishing materials: water spray X carbon dioxide f other: oam X dry chemical Special firefighting procedures: As in any fire, prevent human exposure to fire, smoke, fumes or products of combustion. Evacuate non-essential personnel. Unusual fire and explosion hazards: Self ignition temperature and explosion hazards not applicable. V. HEALTH HAZARD INFORMATION SYMPTOMS OF OVEREXPOSURE (for each potential route of exposure) Inhaled: May cause respiratory distress. Contact with skin or eyes: May be irritating to skin or eyes. Absorbed through skin: May cause mild irritation from prolonged exposure. Swallowed: Aspiration hazard if ingested. HEALTH EFFECTS OR RISKS FROM EXPOSURE. Explain in lay terms. Attach extra page if more space is needec Acute: None Known. Chronic: None Known. Reproductive: None known. MEDICAL CONDITIONS AGGRAVATED PY EXPOSURE May cause skin irritation in a small percentage of hypersensitive individuals. May cause respiratory irritation, cough and asthmatic symptoms. POTENTIAL OR SUSPECTED CANCER AGENT? __L NO. This product's ingredients are not found in the lists below. YES. The ingredients below are regulated or listed as potential cancer agents by the indicated agency. Ingredient: _Federal OSHA _NTP _1 A R C _Federal OSHA _NTP _I A R C NOTE: California em to ers using Cal/OSHA—re ulated carcino ens mus—Federal register wit ith Cal/OSHA.— OSHA_i A R C FIRST AID—EMERGENCY PROCEDURES Eye Contact: Rinse immediately with plenty of water for at least 15 minutes. If irritation persists, seek medical advice. Skin Contact: Wash with plenty of soap and water. Seel: medical advice in serious cases of skin irritation. Inhaled: Remove individual to fresh air, allow to rest in upright position. In serious cases seek immediate medical attention. Swallowed: Rinse mouth and give individual large amounts of: water to drink. Do. not induce vomiting. Call. Poison Control. Center for additional advice. VI. REACTIVITY DATA Stability: X Stable Unstable Incompatibility (materials to avoid): Hazardous polymerization: _May occur X_Will not occur Conditions to avoid: Unstable under humid (acid) conditions. Hazardous decomposition products (including combustion products): In case of fire, toxic fumes of Cl /HCI and N-and S-oxydes might be formed 2 VII. SPILL, LEAK, AND DISPOSAL PROCEDURES Spill response procedures (include employee protection measures): Collect as much as possible in a clean container for reuse or disposal (preferable). Flush the remainder with water. Preparing wastes for disposal (container types, neutralization, etc.): Containers should be tightly closed after collecting spillage. Do not incinerate. Safe to nature, readily biodegradable. NOTE: Dispose of all wastes in accordance with federal, state and local regulations. VIII. SPECIAL HANDLING INFORMATION Ventilation and engineering controls: Store in a cool dry place with good ventilation. Maximum storage temperature 140°F. , 60'C. Respiratory protection (type): May require personal respirator usage. Eye protection (type): Dust tight protective eye wear. Gloves (specify material): Rubber or other impervious material. Other clothing and equipment: Long sleeve clothing may be used to minimize skin contact. Wo rk practices, hygienic practices: Avoid inhalation of dust. Avoid food contact. Keep out of reach of children. Do not mix with other substances. May cause sensitization to persons prone to allergic asthma. Other handling and storage requirements: Store at room temperature away from heat protect againstphysical damage to container. Protective measures during maintenance of contaminated equipment: Prevent exposure to excessive heat. This product is not defined as flammable or combustible, however may decompose if exposed to excessive heat. Cily.N r _ — Ncwhun Park.CA Black T ^s, o "r2 0-K4'-0220 805.499.678z 02c- • ,2111 UK " FZX 702.817-02i0 Fu 8(1ir499-5633 11A` IAL SAFETY • • 4� --D����A � SHEET PF�DifiICT IDENTIFICATION Nail Liquid (EMA 15 ppm MEHQ) Monomer f Hazard Ratina Scale f Toxicity 2 A•ErTP.eME 3 HIGHMSDS Date 01/07/92 Fire 27MOD �. 3 7-MOOERAtE' Reactivit �"NSI (T i y 2 0•INS,GNIFICANT ! Special COMPONENT INFORMATION No. CAS REG NO. ANITA) 1 Ethyl methacrylate . . — - 2 Methyl methacrylate 97-63-2 98 MIN 3 Other ester adducts . . . 80-62-6 1 ?0 MAX 4 MEHQ Not Required C.60 MAX -- 150-76-5 0.002 MAX, EMERGENCY RESPONSE INFORMATION FIRST AID PROCEDURES .tr�ation Move subject to fresh air. - Give artificial respiration Call a physic.lan if..,breathing has stopped ,Eye-Contact Flush eyes with a large amount of water for at least 15 minutes. Consult a physician If irritation persists. Skin Contact Remove c 'r 'ninated clothing. Wash skin thoroughly with soap and water. Wash contaminated Ciothin; hvroughly before reuse. See a physiciaK Ingestion If swallowed, give 2 glasses of water to drink. Never give anything by mouth to an unconscious person. See a physician. .A 't �:g � y�v: e. .� � , • AN. S.t•4.1 a} 1��������fe� t9- �i` 5 ,y!µ r a RE FiuHTING INFORMATION a casual Hazards Vapors can travel to a sou•ce of gnition and Nash back. Heat can cause Polymerization. Heated containers cS explode. tinguishing Agents Use the following extinguishirg medic when fighting fires involving this material: polar solvent (alcohol) foam - carz:on dioxide - dry chemical - water spray rsonal Protective Equipment Wear self-contained breathing apparatus {pressure-demand MSHA/NIOSH ap- proved or equivalent) and full protective gear. ecial Procedures EXPLOSION HAZARD. Fight advanced fires from a protected location. Use water spray to cool containers exposed to fire. ILL OR LEAK HANDLING INFORMATION st Protection Appropriate protective equipment. must be worn when handling a spill of this material. See the PERSONAL PROTECTION MEASURES Section for recommendations. If exposed to material during clean-up operations, see the FIRST AID PROCEDURES Section for actions to follow. )cedures Keep spectators away. Eliminate all ignition sources. Contain spills immediately with inert materials (e.g. sand, earth). Transfer liquids and solid diking material to separate suitable containers for recovery or disposal. Contaminated monomer may be unstable. Add inhibitor to prevent polymerization. See.WASTE DISPOSAL Section for.Information regarding the disposal of contained spills. NOTE: Spills on porous surfaces can contaminate groundwater. CAUTION: Keep spills and cleaning runoff out of municipal sewers and open ' bodies of water. t PAGE 2 of 9 I 10-25-1993, 02:22PM i=RDN K01 TO 12134E56310 P•03 HAZARD INFORMATION HEALTH EFFECTS FROM OVEREXPOSURE Primary Routes of Exposurs Inhalation ' Skin Contact Eye Contact Inhalation Inhalation of vapor or mist can czise the following: - irritation of nose and throat Repeated or prolonged exposure can cause the following: - headache - nausea - drowsiness - unconsciousness Eye Contact Material can cause the following: slight irritation Skin Contact 1 — Malarial can cause the following: - moderate skin irritation - skin sensitization Ingestion Material is possibly harmful If swallowed. Delayed Effects Prolonged or repeated exposure can cause the following: - allergic skin reaction Prolonged or repeated overexposure to methyl methacrylate at near lethal con- centrations can cause the following: r - kidney damage .-. liver damage FIRE AND EXPLOSIVE PROPERTIES Flash Point . . . . . . . . 160C/61°F Setaflash Closed Cup Auto-ignition Temperature . . . . 393°C/739°F Lower Explosive Limit . . . . . 1.8% Upper Explosive Limit To saturation AA PA ��� �y. •` ..- ', 4 4� �`.elrk'�.� gqN, d�;Yr,�K� ,:..�.."l t4"' 6 .'Y :i i ir - _+ 4t .,. fi�t[}n•yys.�. -fig. - - - ' ' - 5' ORMATION This material is considered stable undue s and/or use. See STORAGE AND HANDLING IfNFORMATION Section ied conditions of storage. shipment conditions. However, this material can or specified Hazardous Polymerization for conditions to undergo hazardous polymerization. See ;ardous Decomposition Products There are no known hazardous deco osition mP products for this material. ardous Polymerization Excessive aging, heat, contamination with atmosphere, inhibitor depletion or ultraviolet Polymerization light (sunlight) may oxyga cause Polymerization. An uncontrolled polymerization may produce a rapid release of energy with the Potential for an explosion of tmvented closed containers. Avoid contact with the following: - oxidizing agents - reducing agents - UV light IRONMENTAL IMPACT . n�� j Fate/t3iodegradatton ', Rapidly hydrolyzes at basic pH, _ .r now CCIDENT PREVENTION INFORMATION OMPONENT EXPOSURE INFORMATION omponent Information `- No. CAS REG NO. AMT.W 1 Ethyl methacrylate 97-63-2 98 MIN 2 Methyl methacrylate 80-62-6 1.80 MAX 3 Other ester adducts Not Required 0.50 MAX 4 MEHO . . . . . . . . . . . . 150-76-5 0.002 MAX :xposure Limit Information Component OSHA ACGIH No. Units TWA STEL TLV STEL ppm Nore None None None 2 ppm 100 None 100 - . None 3 a a a a 4 mg/m3 5 None 5 None P. Not Required PERSONAL PROTECTION MEASURES Respiratory Protection A respiratory protection program meeting OSHA 1910.134 and ANSI Z88.2 re- quirements must be followed whenever workplace conditions warrant a respirator's use. None required if airborne concentrations are maintained below the TWA/TLV's listed in the COMPONENT EXPOSURE INPORMANION Section. Up to 10 times the TWA/TLV: Weer a MSHA/NIOSH approved (or equivalent) , half-mask, air-purifying respirator. Up to 100 times the TWA/TLV: Wear a MSHA/NIOSH approved (or equivalent) full-faceplece, air-purifying respirator. Above 100 times the TWA/TLV or Unknown: Wear a MSHA/NIOSH approved (or equivalent) self-contained breathing apparatus.in the positive pressure mode, OR, MSHA/NIOSH approved (or equivalent) full-faceplece airline respirator in the positive pressure, mode with emergency_ .. R. PAGES of 8 r JATION escape provist^ns. Air-purifying respirators sh uld be equipped with organic vapor cartridges. ;ye-,opotection Use chemical splash goggles (ANSI Z-87.1 or approved equivalent). Eye protection worn must be compatible with res=iratory protection system employed. land Protection The glove(s) listed below -nayrvide p �_ protections against permeation. doves of other chemicaily resistant mate-•als may not provide adequate protection: - Butyl rubber Rinse and remove gloves immediately after use. Wash hands with soap and water. Gloves should be removed and replaced immediately If there is any indication of degradation or chemical breakthrough. NOTE: Material is a possible skin sensitizer. )Iher Protection Use chemically resistant apron or other impervious clothing to avoid prolonged • or repeated skin contact_ ACILITY CONTROL MEASURES - — fentilation. Use local exhaust ventilation with a minimum capture velocity of loo ft/min. (30 m/min.) at the point of vapor evolution. Refer to the current edition of Industrial Ventilation: A Manual of Recommended Practice published by the American Conference of Governmental Industrial Hygienists for information on the design, installation, use, and maintenance of exhaust systems. )ther Protective Equipment Facilities storing or utilizing this material should be equipped with an eyewash facility and a safety shower. iTORAGE AND HANDLING INFORMATION forage Conditions Store out of direct sunlight in a cool place. Avoid temperature extremes during storage; ambient temperature preferred. Material can burn; limit indoor storage to approved areas equipped with automatic sprinklers. Ground all metal con- tainers during storage and handling. Total absence of oxygen will Inactivate the inhibitor. Do not store under oxygen-free environment. Leave air space over CONTINUED PAGE 6 of 9 �rINUATION i liquid surface in all contaners irarodocin g air i periodically If stored more than 6 months. Use monomer wN6in : year. Handling Procedures This material Is a potential skin sensitizer. See the PERSONAL PROTECTION MEASURES Section prior to handling. Other CONTAINERS HAZARDOUS WHEN EWTY. Since emptied containers retain product residue Ivapors and/or liquid) follow all MSDS and label warnings even after container is emptied SUPPLEMENTAL INFORMATION TYPICAL PHYSICAL PROPERTIES Appearance Clear Color Colorless State Liquid Odor Characteristic Fruity odor Viscosity . . . . 0.92 CPS Specific Gravity (Water = 1) . . . 0.91 C� Vapor Density (Air ■ 11 > 1 Vapor Pressure . . . . . 15 mm Ng @20OC/68°F Melting Point -170C/1 OF- Boiling Point 119OC/246°F Solubility In Water Slightly soluble Percent Volatility 100% Evaporation Rate (BAc 1) > 1 TOXICITY INFORMATION Acute Data The information shown In the HEALTH EFFECTS FROM OVERIXPOSURE Section Is based on toxicity profiles of similar materials or on the components present In this material. Skin Irritation - rabbit: moderate'Irritation Eye Irritation - rabbit: slight irritation Toxicity data specific for this product are listed below. Dermal LD60 = rabbit: 9,100 mg/kg Oral LD60 - rat 13,300 mg/kg Inhalation LC60 - rat: 2,700 - 3,200 ppm for 8 hr. CONTORM PAGE 7 of @ 1 •25-19'33 ' 02:26PM FROM KOIVE TO 1213485231 0 P.07 F 4V NTINUATION :ageniclty Date Ames mutagenicitr. Negative Mouse lymphoma Point Mutation: Positive isitization Data Allergic response observed. .STE DISPOSAL icedure After the addition of excess inhibitor. incinerate liquid and contaminated diking material In accordance with local, state, and federal regulations. GULATORY INFORMATION )RKPLACE CLASSIFICATIONS This product is considered hazardous under the OSHA Hazard Communication Standard (29CFR 1910.1200). This product is a 'controlled product' under the Canadian Workplace Hazardous Materials Information System (WHMIS). ANSPORTATION CLASSIFICATIONS US DOT Hazard Class . . . . . FLAMMABLE LIQUID The above information applies to the U.S. DOT classification of this material (49 CFR 172.101). Various exemptions and/or restrictions may apply. IERGENCY PLANNING & COMMUNITY RIGHT-TO-KNOW (SARA TITLE 3) e ctlon 311/312 Categorizations (40CFR 370) This product is a hazardous chemical under 29CFR 1910.1200, and is categorized as an immediate and delayed health, and flammability and reactivity physical hazard. ction 313 Information (40CFR 372) This product contains a chemical which Is listed In Seddon 313 above de minimis concentrations. The following listed chemicals are present: (luentity present Is found elsewhere on this MSDS.) - Methyl.methacrylate. (80-82-6). a '. -....•D-✓•aM►�+,tii�i�jt���LYJ�1Y�';c CJP-sPy�:�iSl+s'�,... �+} `4 � `.. •r s.. ist t 7rr gLC r. F7 1 14310 f t h�,.�; -4 i� :, ..: � J Y . �77�; v�r'S Vh�� .. `s' � i G"• .�'' 1, ..:4 `tXi'� :a��' ♦ 0' .1�1..y �. 0 <'C LA INFORMATION (40CFR 302.4) This material has a component or components with a reportable quantity under the Comprehensive Environmental Response,-PCompensation, and Liability Act (CERCLA) and the Superfund Amendments and Reauthorization Act (SARA) Title Ili Section 304. The components, CAS numbers, and reportable quantities are listed below. Spills of a component In excess of Its reportable quantity must be reported to the National Response Center (1-800-424-8802) and to the appropriate state and local emergency response organizations. Methyl methacrylate 180-62-6) 11000lbs. Ethyl methacrylate (97-63-2) 1000lbs. RCRA INFORMATION When a decision Is made to discard this material as supplied, It is classified as a RCRA hazardous waste with the characteristic of ignitablilty, hazardous waste number: D001 CHEMICAL CONTROL LAW STATUS All components of this product are listed or are excluded from listing on the - _ U.S. Toxic Substances Control Act (TSCA) Chemical Substance Inventory. ABBREVIATIONS: ACGIH a American Conference of Governmental Industrial Hygienists OSHA a Occupational Safety and Health Administration TLV c Threshold Limit Value PEL a Permissible Exposure Limit TWA a Time Weighted Average STEL ■ Short-Term Exposure Limit BAc a Butyl acetate Bar denotes a revision from previous MSDS in this area The information contained herein teiates only to am *Pacific eats:al idontitisd. KarrrVntpnrvien bAlavee that sueh Information Is aectuate and j~ls a of the data of *is ntasaafel Lafaty data shee6 Out no representation, vusrentN or warranty, atpaaaa v imputed. is mach as to Uts seeursay, fail ill err eorrrpletenose of ibe Information. K♦wrCarpraam apes parsons rseeMng this Inlamatlon to Ask# theit own determination as to the InformatlaWS astabl1hy sad eortepltlsMsa la their particular ap- plieatien. •4C': PAGE 9 of 9 International Export and Trading Enterprises PO BOX 7913,ATLANTIC CITY,NEW JERSEY 08404 7013,USA. TEL(609) 344-1487. FAX(600) 372-1308 1 TZIUAL SAFETY DATA SHEET I-- PRODUCT IDENT ATI4N Product: Acetone CAS Number: 67-64.1 ji- TRANSrMTATXtJN DATA U.S. De met of TrangpMfion ~- 49 C.FR. Proper Shipping Name: Acetone Hazard Class/Division Number: 3 ID Number: UN1090 Packing Group: II Label Required: Flammable Liquid Placard Required: Flammable Reportable Quantity: 5,000lbs Marine Pollutant: Not Listed Emergency Telephone Number: Chemtrec 800-424-9300 Internati-grW Maritime prganiaatic3,n___ IMDG - Proper Shipping Name: Acetone Hazard Class/Division Number: 3.1 ID Number: UN1090 Packing Group: . II 4- Label Required: Flammable Liquid Placard Required: Flammable Marine Pollutant: Not Listed IViDG Page: _ 3102 Emergency Telephone Number: C he- mtrec 202-483-7616 [call collect] y 7 l Page 1 i c !II • HAZARDOUS IN fiRE�DIENTSIIOENTITY INFQRMATIOPI Chemical or Common Name Percent Exposure Limits Acetone (CAS# 67.64.1) 1ao% OSHA PELT 750 ppm -ACGIH TLV: 750. ppm - OSHAIACGIH Short Term Exposure Limit(STEL) for acetone is 1000 Pp. NIOSH recommends a limit of 250 pprn. IV - PHYSICALlCHJMICA—L CHARACTERISTICS Boiling Point'(@ 780 mm Hg): 56.11°C Vapor Pressure (mm Hg): 181.70 @ 680E - Vapor Density (Air-1): 2.00 Specific Gravity (H20=U .786•388 @ 770F Evaporation Rate: 14.40 V - FIRE AND EXPLQSION HAZARD DATA. Flash Point: 18.3°C Flammable Limits LEL: 2.5% UEL: 12.8% Extinguishing Media: Alcohol foam or carbon dioxide and carbon monoxide, etc. Special Firefighting, Procedures: Weer self-contained tained breathing apparatus with a full facepiece operated in the positive pressure demand mode when fighting fires. Water may not be effective for fighting fires. Water may be used to keep fire-exposed containers cool until fire is out. — Unusual Explosion Hazaids: Never use welding or cutting torch on or near drum (even empty) because product (even just residue) can ignite explosively. All five gallon pegs and larger metal containers including tank cars and tank trucks should be grounded and/or bonded when material is transferred. Material is highly volatile and readily gives off vapors which may travel along the ground or be moved by ventilation and ignited by pi{ot lights, other flames, sparks, heaters, smoking, electric motors, static discharge. or « other ignitlon sources at.locations distant from material handling point. Page 2 , - i ------------- . 2 t. f t ;YI - REACTIVITY DATA Stability: ( ! Unstable l X 1 Stable Incompatibility: Strong oxidizing agents, and acids Hazardous Decomposition or By-Products: May form toxic materials:, carbon dioxide and carbon monoxide, etc Hazardous Polymerization: ( ) May Occur ( X ! Will Not Occur VII - PRECAUTIONS FOR SAFE HANDLING G AND USE Steps To Be Taken In Case Material Is Spilled Or Released; ' Small spill; Absorb liquid on vermiculite, floor absorbent or other absorbent material. Large spill: Eliminate all ignition sources (flares, flames including pilot lights, electrical sparks). Persons not westing protective equipment should be excluded from area of spill until clean-up has been completed. Stop spill at source. Prevent from entering drains, sewers, streams or other bodies of water. Prevent from spreading. If runoff occurs, notify authorities as required, Pump or vacuum transfer spilled product to clean containers for recovery. Absorb unrecoverable product. Transfer contaminated absorbent, soil and other materials to containers for disposal. Waste Disposal Method: Small spill: Dispose of in accordance with all local, state, and federal regulations. Large spill: Dispose of in accordance with all applicable local, state and federal regulations. a Page 3 ----"------------------------------:---------------�-------------------------- _ - t. .. 2 a :.vt, Pregautions To Be Taken in Handling And Stora-ge: Containers of this material may be hazardous when emptied. Since emptied containers retain product residues (vapor, liquid and/or solid), all hazard precautions given in the data sheet must be observed. WARNINGIN Sudden release of hot organic chemical vapors or mists from process equipment operating at elevated temperature and pressure or sudden ingress of air into vacuum equipment, may result in ignition .-without the presence of obvious ignition sources. Published "autoignition" or "ignition' temperature values cannot be treated as safe operating temperatures in chemical processes without analysis of the actual process conditions. Any use of this product in elevated temperature processes should be thoroughly evaluated to establish and maintain safe operating conditions. Vill - HEALTH HAZARD DATA Primary Routes) of Entry: Ingestion: (X1 Inhalation: W Skin Contact: W Eye Contact: (X} Medical Eonditions Aggravated By Exposure: Pre-existing skin disorders can be aggravated by exposure. Signs & Symptoms of Exposure: In a ati Irritation (nose, throat, respiratory tract)-pre-existing lung disorders, ex. asthma-like conditions may be aggravated by exposure to this material. Cough. Central Nervous System Depression (Dizziness, drowsiness, weariness, fatigue, nausea, headache, unconscioumess) and other CNS effects. Coma. Mouth and throat irritation. Gastrointestinal irritation (nausea, vomiting, diarrhea). CNS depression (dimness, drowsiness; weakness, fatigue, nausea, headache, unconsciousness). High blood'sugar. Coma. Page 4 I Precautions To Be Taken in Handling And Storage:. Containers of this material may be hazardous when emptied. Since emptied containers retain product residues (vapor, liquid and/or solid), all hazard precautions given in the data sheet must be observed. WARNINGIi! Sudden release of hot organic chemical vapors or mists from m process-equipment operating at elevated temperature and pressure or sudden ingress of air into vacuum equipment, may result in ignition without the presence of obvious ignition sources. Published "autoignition" or "ignition" temperature values cannot be treated as safe operating temperaturesi in chemical processes-without analysis of the actual process conditions. Any use of this product in elevated temperature processes should be thoroughly evaluated to establish and maintain safe operating conditions. VIII HEALTH HAZARD DATA Primary Route(s) of Entry: ingestion: (X) inhalation: (X) Skin Contact: W Eye Contact: M Medical Conditions Aggravated By Exposure: Pre-existing skin disorders can be aggravated by exposure. Signs, & Symptoms of Exposure: Inbalatio Irritation (nose, throat, respiratory tract)-pre-existing lung disorders, ex. asthma-like conditions may be aggravated by exposure to this material. Cough. Central Nervous System Depression (Dizziness, drowsiness, weariness. fatigue, nausea, headache, unconsciousiess) and other US effects. Coma. Ingestic : Mouth and throat. irritation. Gastrointestinal irritation (nausea, vomiting,. diarrhea). „CNS depression (dirtiness; drowsiness,-weakness, fatigue,-nausea, healache, unconsciousness).' High blood``sugar.- Coma. _ Page 4 V0 Effects of Acute Exposure to Material: an a tion: Single dose oral toxicity is low. Swallowing small amounts during normal handling is not likely to cause harmful effects; swallowing large amounts may be harmful. Inhalation: Breathing small amounts during normal handling Is not likely to cause harmful effects; breathing large amounts may be harmful. kin Contact; Exposure may cause mild_skin irritation. Prolonged or repeated exposure may dry the-skin.. Symptoms may include redness, burning, drying and cracking, and skin burns Eve Contact: Eye irritation. Symptoms include stinging, tearing, redness, and swelling. - Effects of Chronic Overexposure: This material (or a component) shortens the time of onset or worsens the liver. and kidney damage Induced by other chemicals. This material (or a component) has been shown to cause harm to the fetus in laboratory animal studies harm to the fetus occurs only at exposure levels that harm the pregnant animal. Overexposure to this material for its components) has been suggested as a cause of the following effects in laboratory animals, and may aggravate pre-existing disorders of these organs in humans: mild, reversible liver effects, mild, reversible kidney effects. m r enc and First Aid Procedar, s: S�+n: Remove contaminated clothing. Wash exposed area-with soap and water. if symptoms persist, seek medicat attention. Launder clothing before reuse. Eye Contact: Move individual away from exposure and into fresh air. Flush eyes gently with water for at least 15 minutes while holding eyes apart. If symptoms persist or there is any visual difficulty, seek medical attention. Ingestion: Do not induce vomiting. This material is an aspiration hazard. If individual is drowsy or unconscious, place an left side with head down. Seek medical attention. If possible, do not have individual unattended. .t Page 5 Inhalation; If symptoms develop, immediately move individual away from exposure and into fresh air. Seek immediate medical attention. Keep person warm and quiet. If person is not breathing, begin artificial respiration. If breathing is difficult, administer oxygen. Note to physician: this material (or.a component) has produced hyperglycemla and ketosis following substantial ingestion. Carcinogenity listings: OSHA: ( } No_Information NTP: O No Information IARC: ( ► No Information IX - CONTROL MEASURES Personal Protective Equipment: . _ Respiratory Protection: If workplace exposure limits) of product or any component is exceeded, a NIOSHIMSHA approved air supplied respirator is advised in absence of proper environmental control. OSHA regulations also permit other NIOSHIMSHA respirators (negative pressure type) under specified conditions (see you industrial hygienist). Engineering or administrative controls should be implemented to reduce exposure. Ventilation protection: Provide sufficient mechanical (general and/or local exhaust) ventilation to maintain exposure below TLV(s). Protective gloves: Wear resistant gloves (consult your safety equipment supplier). Eye-putection: Chemical splash goggles-in compliance with OSHA regulations are advised:- However, OSHA regulations also permit other type safety glasses. 01,her Equipment: Wear impervious clothing and boots to prevent repeated or prolonged skin contact; r Page 6 X REGULATORY INFORMATION_ This chemical appears on the following lists: (X) SARA Section 313 (X) DEA Regulated XI • A00171O�i_NFORMATION ALWAYS COMPLY WITH ALL APPLICABLE INTERNATIONAL, FEDERAL, STATE AND LOCAL REGULATIONS REGARDING THE TRANSPORTATION,STORAGE. USE AND DISPOSAL OF THIS CHEMICAL. Due to the changing nature of regulatory requirements, the REGULATORY INFORMATION listed in Section X of this document should NOT be considered all inclusive or authoritative, International, Federal, State and Local regulations should be consulted to determine compliance with all required reporting requirements. The information in this MSDS was obtained from sourcea which we believe are reliable. HOWEVER, THE INFORMATION IS PROVIDED WITHOUT ANY WARRANTY, EXPRESS OR IMPLIED, REGARDING ITS CORRECTNESS. The conditions or methods of handling, storage, use, and disposal of the product are and to beyond our control a y y a be beyond our knowledge. FOR THIS AND OTHER REASONS,WE DO NOT ASSUME RESPONSIBILITY AND EXPRESSLY DISCLAIM LIABILITY FOR LOSS, DAMAGE OR EXPENSE ARISING OUT OF OR IN ANY WAY CONNECTED WITH THE HANDLING, STORAGE, USE OR DISPOSAL OF THE PRODUCT.- This MSDS was prepared and is to be'used only for this product. If the product is used as a component in another product, this MSDS information may not be applicable. Revised: July 31, 1995 v i Page 7 i r MATERIAL SAFETY DATA SHEET To comply with OSHA Hazard Communications Standard 29 CFR 1910. 1200 Date of last revision : 5/1?/88 EMERGENCY TELEPHONE NO. MANUFACTURER: MISS PROFESSIONAL NAIL PRODUCTS, INC. 213/538-5975 ADDRESS: 2121 W. 139TH ST. CITY, STATE: GARDENA,._ CA 90249 DATE PREPARED: 6/01/89 . SECTION 1 IDENTITY CHEMICAL NAME: METHACRYLIC ACID PRODUCT NAME: Miss Super Primer, and Miss Primer 10. .SECTION 2 INGREDIENTS EXPOSURE LIMITS CAS NUMBER VAPOR PRESSURE OSHA MANUFACTURER NONE 20ppm 79-41-4 lmm(25C) Ul Substituted Phenolic Polymerization Inhibitors s 100-1450ppm SE^T I ON .3 PHYS I CAL-..DADA c,)APORATION RATE: (BuAc=1 ) 0.07 VAPOR DENSITY ('at 60F, 1 ATM. ) 2.97 , SOLUBILITY IN WATER: Infinite. PERCENT VOLATILE: 100% APPROXIMATE BOILING RANGE: 322F at 760mm Hg DENSITY: 1 .020 (60F) FREEZING POINT: 61F SECTION- 4 FIRE AND EXPLOSION HAZARD DATA Fl-ash Point(method used) : 154F ( TCC) APROX. FLAMMABLE LIMITS: 1.6 - 8.7% EXTINGUISHING MEDIA: Foam, carbon dioxide, dry chemical , water fog(by trained personnel ) Special fire fighting procedures: Full protective equipment, including self- contained breathing apparatus, is recommended . Cool containers of material exposed to heat with cold water spray , eight fires from a safe distance or protected areas. Unusual fire & explosion hazards: Sealed containers exposed to elevated temperatures may rupture explosively. due to polymerization. Vapors are heavier than air and may travel to ignition source. -1 Pg 1 primer i SECTION 5 HEALTH HAZARD DATA Route(s) of Entry : Symptoms/effects of overexposure and first aid. Ingestion : Get prompt medical attention . Drink toxic but is corrosive to tissue. plenty of water. - Blighty Inhalation : Vapor may cause irritation of the eyes, nose, throat and respiratory tract . Remove to fresh air. Call a physician. If having breathing difficulty , administer oxygen . administer artificial respiration. sici If not breathing, p Call a physician . ' SKIN OR EYE CONTACT: Corrosive to the skin and eyes . May cause permanent e e injury . May cause skin sensitization . In case ofleye or skin contact, y immediately flush with plenty of water for at least 15 minutes; call a physician . Carcinogenic Potential : None known at this time. ,.>, SF^T I ON 6 REACT I.V IZY__DATA �Ibility : Stable L'Vonditions to Avoid : Heat and ignition sources •avoid contact with mild steel .or alkalis. ' product is strongly acidic, Incompatibility (materials to avoid ) : Reducing and oxidizing agents. Ma has strong solvent properties and -can- soften paint or rubber, terial HAZARDOUS DECOMPOSITION: Hazardous decomposition products: CO, CO2, smoke. HAZARDOUS POLYMERIZATION: May occur. CONDITIONS TO AVOID FOR HAZARDOUS POLYMERIZATION: Excessive heat, storage in absence of inhibitor; inadvertent addition of catalyst. See E-53033 for details on inhibitors and storage stability . Avoid freezing that may result in uneven distribution of inhibitor. SECTION 7 SPILL - c OR LEAK PROCEDURES. STEPS TO BE TAKEN IN CASE MATERIAL fIS RELEASED OR SPILLED: Remove sources of ignition. Prevent skin contact and breathingcoftvapor. Confine and absorb with dry sodium carbonate or absorbant. WASTE DISPOSAL METHOD: EPA characteristic hazard waste. Do not allow material to contaminate ground water systems. Incinerate in a facility which complies with federal , state and local requirements. Do not incinerate i :losed containers. 09 2 primer 7-% v SECTION 8 SPECIAL PROTECTION INFORMATION RESPIRATORY: When levels exceed 20 PPM, wear self contained breathing apparatus. VENTILATION: Provide sufficient ventilation in volume and pattern to keep airborne levels below ' 20ppm. Use explosion proof equipment. PROTECTIVE GLOVES: Neoprene gloves are recommended . EYE PROTECTION: Splashproof goggles and face shield. OTHER PROTECTIVE EQUIPMENT: Neoprene boots and coveralls. SECTION 9 SPECIAL PRECAUTIONS PRECAUTIONS TO BE TAKEN IN HANDLING AND STORING: Product freezes at 61F. To thaw before using , drums should be placed in a warm room (at least 65F) for several days, and rolled to melt and mix contents. AVOID LOCAL OVER-HEATING which might initiate uncontrolled polymerization . Do- not use flame or live steam. Be sure to vent both drums when emptying. KE away from he�t-;7d-irect sunlight, sparks and flame. Closeecontainerlons after col use. Ground containers when pouring , See E-53033. Regulations related storage of flammable liquids should be followed. OTHER 'PRECAUTIONS: Permit air space to exist inside storage containers Material stored more than 3 months should have inhibitor level checked and maintained at the original level . TRANSPORTATION: DOT Class: Corrosive Liquid, N.O.S. UN1760. . NOTICE: The data in this material safety data sheet relate only to the specific material designated herein and do not relate to use in combination with any other material or in any process. This information has been compiled from sources considered to be dependable and is, to the best of our knowledge, accurate and reliable as to the date compiled. However , no guarantee or warranty is made as to its accuracy , reliability and/or suitability of the product for the intended particular purpose or use. All risks of the use of the product are therefore assumed by the user. Appropriate warnings and safe handling procedures should be provided to handlers and users. To co MATERIAL SAFETY DATA SHEET I a mply with OSHA Hazard Communications Standard 29 CF Date of last revision: 5/12./88 R '310. 1200 EMERGENCY TELEPHONE NO. MANUFACTURER: MISS PROFESSIONAL NAIL PRODUCTS,, INC. 800-255-3924 ADDRESS: 2121 W. 139TH ST. CITY, - STATE: GARDENA, CA 90249 DATE PREPARED: 3/12/89 c PRODUCT CODE: M27-01 ` CHEMICAL NAME: NITROCELLULOSE LACQUER PRODUCT NAME: SATION NAIL ENAMEL CHEMICAL FAMILY: CELLULOSE ESTER Principal Hazardous Component(s) s)' % Threshold Limit• Value(u. PIGMENT CAS •9004-64-17-5 Nitrocellulose 4 1 '- 67-63-0 Isopropanol 10 - 5 -_ 123-86-4 Butyl Acetate 5 - 10 20 _ ,,, 400 14.8-78-6 Ethyl Acetate 25 150 _.108-88-3 To-luol 20 - 25 400. iP •Y1 Phthalate 20 - 25 100 to 1. 4 - nesulfon 7 amide Formaldehyde Resin 4 - 7 -' Boiling Pt: 150 - 260 (Range Deg F) ;Specific Gravity Vapor Pressure (mm Hg) : . 27 MM Y (H2O=1) ; .92 Vapor Density (Air-1) : >1 . !Percent Volatile by Volume (X) : 90% Rvapotation Rate ( !Solubility in Water: Slight .Reactivity in Water: Slight Butyl Acetate 2,0 _ Ippearance & Odor: Amber with Characteristic o Clash Point (deg F) : 68 dor Flammable limits in Air X by Volume: >2.0(lower) 10.7(upper) a extinguisher Media: CO2 & Dry Chemical luto-Ignition Temperature (deg F) : 407 special Fire Fighting Procedures: ,& 02 fir supplied rescue equipment FOR CO2 &, DryAREAS Chemical ENCJnusual Fire & Explosion Hazards: FLAMMABLE LIQUID. Pg 1 SECTION 4-DUVCTOAr HA7ARns ability: Stable Incompatibility (Materials to Avoid) : ' OXYy-1011 & Strong Oxident. Hazardous Decomposition Products : Carbon Monoxide if not burned- completely.. Hazardous Polymerization: Will Not Occur. 4. SECTION 5-H ACTH HA7ARnS Threshold Limit Value: 260 PPM Signs & Symptons of Exposure 1 . Acute Overexposure:Move to fresh air-Artificial Respiration, Oxygen 2. Chronic Overexposure:Call Physician, move to fresh air, Artificial Respiration, Oxygen. Chemical listed as Carcinogen or Potential Carcinogen: NO ,, . National Toxicology Program: NO. . ; I .A.R.C. Monographs: NO ,,. . OSHA: NO ; OSHA Permissible Exposure Limit: 260 PPM ACGIH Threshold Limit Value: 260 PPM Emergency 4nd First Aid Procedures:o 1. Inh fiodal R,� irk► or} & len. 2. Eye id , ` t open lus l plen$!ifer w 3. Ski Wash ar s aff 'ecteff itt, pl Y of '� r. 4. Ingestion: If oncious, have victim drink or milk. S It ,pira t_ ,,,. Arm J1 A4nn of respirator oil t, ado . � vtio . ..Vehtil . Equ �outside. ; Local Exhaust: --- •Mechani general) : Explosion' Proof - No Smoking or open flames., Protective Gloves: Synthetic rubber gloves. Eye Protection: Safety goggles or fire shield. SECTION 7-SPFrTar pj5rCA(jT r & SP r r✓tag PRnrvnriPvQ ".Precautions. to be Taken in Handling. torage: Keep away from hdat, sparks, and open flames. Keep Container •°-:•Other Precautions: Use only with ad a �+' area. Avoid prolonged & repeate nta�ct w�t e n cool covered ,.S-teps. to be Taken in Case Materl.al is Rel.e.ased__or s Spit ed:_. Pp Feo.ple ..away, remove all ignition sources, recover free liquid, ventilate enclosed sp�acee Waste Disposal Meth o lids and. inci rate. Run off to water way creates fire ,had rd. �IU AND H ENCIE S. This in ormat on ha n ompile from sources considered to be dependable .. and is 4best - kn le compil� H ever, �"' curate and reliable as - to the data g ranter a anty is made as -to its accuracy, reliability d/or suitability of the oduct .for the intended particular purpose or use. Appropriate warning and safe handling procedures should be provided to handlers and users. y pB 2 s precautions None. J 8 CONTROL MEASURES - - story Protection In case of dust formation wear dust mask . ition I :al Exhaust May be used. :hanical (General ) Not necessary . !cial Not necessary . ier Not necessary . ,ive Gloves Not necessary . itection Goggles. 'rotective Clothing- or Equipment No special protective clothing .necessary . gienic Practices Follow the standards of good, industrial - hygiene. formation has been- compiled from sources considered to be dependable the beat of our knowledge, accurate and reliable as to- the `date d.w However, no guarantee or warranty is made as to its accuracy, ty and/or suitability of the product for the intended particular or use',- All risks- of the use of the product are therefore assumed .by r. Appropriate warnings and safe handling procedures should be provided lers and users. r 7 . ous Decomposition or Byproducts On thermal treatment irritating acrylic monomers may be formed. ous Polymerization bill not occur. editions to Avoid None known. i � 6 (HEALTH HAZARD DATA 0 of Entry -- ialation Only in case of dust formation . n No route. estion None on normal use. Hazards (Acute and Chronic) Products is essentially nontoxic. There is only a slight mechanical irritating effect Of fine particles to be expected . 'genici ty Not listed . Monographs Not listed. a R9gulated Not listed . 1d _. Ymptoms -of Exposure I Possible slight mechanical irritation by fine No effects . particles. tlation Possible slight mechanical irritation by- fine particl rstion No effects to expected. es. Conditions Generally Aggravated by Exposure None Known. ;y and First Aid Procedures Immediately flush eyes with eyelids retracted with plenty of water for at least 15 minutes. Consult a physician. None. lation In case of dust, inhalation consult er stion In case of ingestion of la•r physician . physician. g quantities consult r F PRECAUTIONS FOR SAFE HANDLING AND USE , ---- I Be Taken in Case Material is Released or Spilled N as Sweep up meghanically and dispose 'cposal Method prescribed. ' Product may be disposed of according and local regulations in an a g to federal ,state or an a approved incineration unit ill n to Be Taken in Handllingvand lStoring . Avoid dust formation. Keep away from sources of ignition. Protect from exposure to fire and heat . II , f MATERIAL SAFETY °DATA SHEET fo comply with OSHA Hazard Communications Standard 29 CFR 1910. 1200 Date of last revision : 5/ 12/88 EMERGENCY TELEPHONE NO. ;v 213/539-5975 ANUFACTURER : MISS PROFESSIONAL NAIL PRODUCES. INC. DDRESS: 2121 W. 139TH ST . ITY , STATE: GARDENA , CA 90249 VA-1E PREPARED: 1/12/89 ECT I ON�1. IDENTITY HEMICAL NAME: ACRYLIC POLYMER based on Ethyl Methacrylate . RODUCT NAME: Miss Acrylic Powder ECTI0N_2 PRODUCT/ INGREDIENTS 'azardous Components OSHA ACGIH Other PEL. TLV Limits NONE ;ECTION 3 PHYSICAL/CHEMICAL CHARACTERISTICS ___ -------' loj -'ng Point Not applicable ►ap- Pressure(mm Hg ) Not applicable ►apor Density ( air = 1 ) Not applicable specific Gravity (water=l ) 1 . 16 lelting Point About 70 C ( softening) .vaporat.ion Rate ( Butyl Acetate=l ) Not applicable solubility in water Insoluble appearance White Powder Idor Faint odor SECTION 4 FIRE AND EXPLOSION HAZARD DATA -- -lash Point( method used ) Above 250 C (ASTM D-1929-68) 'lammablility Limits Not applicable _xtinguishing Media Waterspray , foam, dry chemical , carbon dioxide` Special Fire Fighting Procedures No special procedHres needed Jnusual Fire and Explosion Hazards F None SECTION 5 REACTIVITY DATA t Stability Stable Conditions to Avoid Heating at temperatures above 250 C Innpatibility (materials to avoid) 11 None known �tOwOE� �� OP9028 1011 1 DEMERT & DOUGHERTY, INC. 15:27:20 MATERIAL SAFETY DATA SHEET -------------------------- BR73655 - NAIL DRY 12/14. 60Z UPC PAGE 1 OF 3 Section I : General Information CHEMTREC DeMert R Dougherty, Inc. -_ Emergency Phone : 800-424-9300 Five Westbrook Corporate Center Information Ph#: 708-409-9000 Suite 900 Date Prepared : 02-14-94 Westchester, Illinois 60154 Revision : 001 Code : 9999 Product is predominantly an alcoholic solution expelled by hydrocarbon propellants (see Section II for amounts) . N. M. F. C. : Toilet Preparations, N. O. I. , In Boxes, NMFC Item 600000, Class 70 NFPA Class III Aerosols Section II : Hazardous Ingredients/Identity Information Hazardous Components (Specific Chemical .Identity/Common Name) OSHA PEL ACGIH TLV X SD Alcohol (comprised of) { 2. Q (Ethyl Alcohol CAS#64-17-5 1000 ppm 99. 7) (T-Butyl Alcoho1 ; CAS#75-65-0 100 ppm 0. 1 ) Propane CAS#74-98-6 800 ppm ( 31. 0 Butane CAS#106-97-8: 800 ppm ( 66. 0 Health Hazards : Health - 2 Fire - 3 Reactivity - 0 Other - 0 (N/K= Not Known N/E= Not Established WAS Not Applicable) } Section III : Physical/Chemical Characteristics Boiling Point : (of cone) N/E Specific Gravity : (of cone) 0. 84 Vapor Pressure (mm Hg) N/E Melting Point : N/A e Vapor Density (AIR=1) : > 1 Evaporation Rate (H20=1) : > 1 Solubility in Water: Complete Appearance and Odor: Concentrate (conc) . is pale yellow to clear frag.ranced liquid. OB9028 1 1 1 DEMERT & DOUGHERTY, INC. 15:27:20 BR73E55 - NAIL DRY 12/8. 50Z 11/15/' UPC PAGE Section IV : Fire and Explosion Hazard Data Flash Point : (.,:,OF (FHSA) * I Flammable Limits : LEL 1. 83* UEL 8. 4* Extinguishing Media: CO2 or dry chemical for small fires. Foam for 1"arge -fires. Special Fire Fighting Procedures : Addition of water, fog will aid in reducing burning rate and cooling exposed containers. Use of NIOSH self-contained breathing apparatus in con- fined areas. Unusual Fire and Explosion Hazards : Flammable vapors may travel along floor, to be ignited by distant ignition sources. Fire exposed containers may develop Sufficient internal pressure to rupture with explosive force. Carbon oxides formed- when burned. (* For, pure hydrocarbon propellant) Section V : Reactivity Data Stability: Stable . Conditions to Avoid : Keep away from heat or ignition sources. Incompatibility : Keep concentrate away from strong oxidizing agents. 'Hazardous Decomposition or Byproducts : Combustion of liquid/gas may form oxides of carbon and nitrogen. Hazardous Polymerization: Will not occur. Conditions to Avoid: None known- when used as directed. } r 1 019028 101 1 DEMERT & DOUGH`RTY, INC. 15:a7:80 11/15/` BR7G655 - NAIL DRY 12/8. 50Z UPC PAGE 4 ' Section VIII : Control Measures Respiratory Protection (Specific Type) : None necessary when product is used as directed. Avoid prolonged or repeated breathing of vapors. Ventilation : For Salon or Home use always provide adequate ventila- tion. Local exhaust preferred. Mechanical exhaust acceptable. Protective Gloves: None necessary when product is used as directed. Eye Protection : Avoid contact with eyes. None necessary when product is Used as directed. Work/Hygienic Practices : Normal safe working practices. +---------------------------------------------------------------+ The information contained herein is based on the data available to us and is believed to be correct to the best of our ability. However, DeMert & Dougherty, Inca makes no warranty, expressed or implied regarding the accuracy of this data nor assumes any - res,ponsibility for injury from the intentional or non- intentional misuse of this product. +---------------------- -------------------------------------- P r••.<r�'t Pg 1 i z ql.l 1.d RALUUTAZ.ABD DA 1 A.--- ---- ------ ._.. Ro-vte( s) of Entry: Symptoms/effects of overexposure and first aid . Ingestion: Induce vomiting and get prompt medical attention. Low oral toxicity Inhalation: Overexposure may cause eye , nose and respiratory tract. May cause central nervous system effects such as dizziness, headache, nausea, and loss of conclousness. Remove to .fresh Aix'.. if liay.irlg bz•eatlrJ.rrg difficulty, administer oxygen. If not breathing, administer artificial respiration. Call a physician . I High airborne levels have caused nonspecific effects such as irriati.on and moderate blood changes in laboratory animals. SKIN OR EYE CONTACT: Vapor mak cause irritation of the eyes, liquid may cause moderate irritation. Repeated or prolonged contact may cause allergic skin ra811, itching, swelling. In case of eye contact, immediately flush with plent::v of water for at least 15 minutes; call a physician. In case of skin contact, wash with soap and water. If irriation occurs, . contact a physician. , .r , Carcinogenic Potential : None known at this time. . 1.:1:Y__11A'1'A Stability: Stable Conditions to Avoid: Heat and ignition sources; contamination. sstorageRe under inert etmoR��lrer•P: Incompatibility(materials to avoid) : Reducing and oxid.izin agontR. Materi.al has strong- solvent properties and can soften paint or rubber. -. HAZARDOUS DECOMPOSITION: Hazardous. decomposition products: CO, CU2, smoke. HAZARDOUS POLYMERIZATION: May occur. CONDITIONS TO AVOID FOR HAZARDO(J S POLYMERIZATION: Excessive' heat, storaga in absence of inhibitor ; inadvertent. addition. of catalyst. See E-5:3033 for details on inhibitors and storage s�ability. --- STEPS TO BE TAKEN IN CASE MATERIAL IS- RELEASED OR SPILLED:—Evacuate area. . MATERIAL SAFETY DATA SHEET scomplY 'with OSHA Hazard Communications Standard 29 CFR 1.910. 1200 Date:;of'l rev ast isioh: 5/12/90 • •.� - EMERGENCY TELEPHONE NO. MAI•_.FgCTURER: MISS PROFESSIONAL NAIL PRODUCTS, INC. 800/255-3924 ADDRESS: 21'21 W:. 139TH', ST. CITY, STATE:,..:GARDENA; .CA 90249. DATE PREPARED: 3/01/91 :SfiGTTON 1 TDENTtTY :CHEMICAL NAHt"I`ETHYL METHACRYLATE PRODUCT NAME: a Liquid Monomer S . TTON TNf;RfiDIFNTS �ISXPOSURE LIMIT I„ CAS. NUMBER . VAPOR. PRESSURE bSHA MANUFACTURER ,NONE 100 1h , Pp " 97=63=2. 14mm(20c)` • :Substituted Phefiolic ''Poiymdfii ation Inhibitors.• 1, -100ppm .qRQTION 3 HYSICAL DATA A now" VAPOR DENS#TY••.J.f:t•gt 60Fi 1'•ATM:•),-:3.94 , low 'SOLUBILITY' IN WATER: :; 0:5. 911ams/100 gt*hs" 'p$RCEIVT�VOLATILE , i00%• . 'APP xifMATE :'$OILtNG RANGE: 243F at 760mm Ng'.:"'`' DF• ITY: 0 9i8 _,, , ' ' . .. FRtIZING POINT' SECTION 4 FtRF s*in Z'Ybrl1 *r+►1 unrlA rc„D DATA lV n n i -- •-- hash Point(ma•tho* d used) - : 70F', (TCC) APROX. FLAMMABLE LIMITS- `.•1:8 SAT ( �:� 101f MINC3.ABW-A.: ••Foani;. dioxide dr carbon ) :•: ;:,;;, ::. y. chemical; water fog(by trained ' ecial f�r�f' s ef 6 �aonnol") P :£tghtiti�. .prtietlues: Full protectitre equipment, including self= contained. hreathing 4pparatud.;•`. is recommended: ' Cool containers of material O*posed. td hedt'.With. cold water, spray: Fight- fire protected ardas, . es' from a safe distance or , Jnusual fire &,' exPlosion: hazards: Sealed containers exposed to elevated Temperatures ,nay- rupture eXplb81vely due -to; polymerization. Vapors are ,wavier' than air, and may'. travel to ignition source.. • let MATERIAL SAFETY DATA-SHEET comply`with OSHA Hazard Communisations Standard 29 CFR 1910. 12 • � Date.. of''aast reviaioh 5/12/90 00 .�. ►= � EMERGENCY. TELEPHONE NO. -:MA1,eACTURER: . :MISS' PRO FESSI0OAL NAIL PRODUCTS., INC. 800/255-3924 ADDRESS: 2121 W:• i39TH•,* ST. CITY,' STATE:,:.GARDENACA .90249:` DATE PREPARED: 3/01/91 , :CHEMICAL NAMEETHYL METHACRYLATE PRODUCT NAME:'' Mies tiqu' d Monomer , :SECTION 2TNc;REDI •NTS �bSHAEXPOSURE LIMIT r " CAS.. NUMBER VAPOR. PRESSURE MANUFACTURER T ,NONE . :100p irh': 97 63-2; 14mmt206 15iAbstittited- Phefi0 6'. P02yimeii•ization Inhibito) .�. ;. rs i, -100ppm. •GTTON 9 P14 AgIQnt DATA OVA ' PORATION' R DENS "T �BuAc-i)•�•'i':v .t .-VA OR ZTY.,r;.�'gt 60F M );;3.94 ; lot O `.SOLUBILITY••I � ; 1AT _'N: WATER 0'4 5.°grams/100 grains . f''pERCENT'VOLAI L -. ;00 'APP ',KIMATF:'$OfLING RANGE 243F at 760mm ;H ' �`•D� �ITY: ;{ : g FREEZING. .„•4t..'. � POINT.;:,• �<=58F �;,; ;; •�• ;:;,;,�:.' • . _ p:•; 7eD DATA v Plash Point(meth6d used) 7OF'.(TCC ',APROX FLAMMABLE. LIM•IT5 •`;,1 8 SAT. ()%VOL) :F '�f11UUIOffIfBt ;°;.119D1A:: :•Foa ;: urban dioxid. . . -...;.,;t...#:,;.,� Y,....; a 'dry;;bhemical; water fog(by trained Special fire 'f 1 .'' ghting.> rbSeNures Full prc5tact ire: equipment, including self--. Contained, breathingi apparatud.;`: is recommended:-: Cool containers of material ;:exposed. td hegt'.Wi.th cold water. spray..,'*..: Fight,:fires ' from a safe distance or ;protected aregsa Unusual •.;.�'f-:. , ., ":'t .':' •': . c:. •.•�' . ^, fire & explosion.: Hazards: Sealed: dontainers exposed .to el6va£ed temperatures may rupture eXplbsively due, to; polymerization. Vapors are 'heavier• than 'air. and may.:trayel. to . ignition, source.. . pg 1 I iqui.d te( s) of Entry: Symptoms effects of overexposure and first aid. gestion: Induce vomiting and get prompt medical attention. Low oral toxicity nhalation: 'Overexposure may cause eye, nose and respiratory tract. May cause central nervous system effects such as dizziness, headache , nausea, and loss of conciousness. Remove to fresh Air. Ii: havi►ag breRthi.ng •difficulty, administer oxygen. Ifnot breathing, administer artificial respiration. Call a physician. High airborne levels have caused nonspecific effects such as irz•iati.on and moderate blood changes in laboratory animals. SKIN OR` EYE CONTACT: Vapor maSr cause irritation of the eyes, liquid may cause i moderate irritation.. Repeated or prolonged contact may cause. allergic skin rash, itching, swelling: In case of eye contact,- immediately 'flush w.it:h pleat! of water for at least 15 minutes; call a physician* . In case of skin contact, wash with soap and water. If irriation occurs,, contact- a physician. ' Carcinogenic Potential: None known at this time. 3 SE..... - Stability: Stable Conditions to Avoid: Heat and ignition sources; storage under. inert atmosphez•P contamination. ' c ! Incompatibility(materials to avoid) : Reducing acid oxidizing agc't�tg. Material. has strong. solvent properties and can soften paint or rubber. HAZARDOUS DECOMPOSITION: Hazardous decomposition products: CO3 •_CO2, smoke. HAZARDOUS POLYMERIZATION: May occur. CONDITIONS TO AVOID FOR-.HAZARDOUS POLYMERIZATION: Excessive hedt, -storage in absence of inhibitor; inadvertent addition of catalyst. See E-5:3033 .for details on inhibitors and storage stability. ��J�Qd 7 SPILi� OR LEAK PRO FDURF„S — �- r SPILLED: ED: Evacuate area. STEPS TO BE TAKEN IN CASE MATERIAL IS RELEASED OR �P c •�,nove sources'of ignition. • Prevent in contact and breathing ofk vak,oi.. m' -)nfine and remove with inert .absorb skin Ventilate area. Pg 2 liquid. -. TE DISPOSAL METHOD: EPA listed hazardous waste under low material to ,contaminate gx'ound water systems. Incinerate ing) . DO not <:iahich complied.•With 'federal; : state and local requirements. Do not i facility . i.n closed coritainere: incinerate :�EC'1'ION 8 SUFr'r n r nn►,rr,,.., MA:LZQN -- �:RESPIRATORY: Wheri, levels:. exceed 100 PPM; . wear, self. c epparatus: contained breathing WENTILATEoN: ::. .; ..: r.; Prdvide' sufficient ventilation �in volume and rairborne . leve' ls.: below loo-in::: Use explosion Pattern to keep' proof equipment. 'PROTECTIVE GLOVES: Neoprene gloves are recommended. ,EYE' PROTECTION: Splashproof- .gogglea. 'yOTHER PROTECTIVE EQUIPMENT: : Neoprene boots and coveralls. pp 2RECAUT1 Na `.. PR' IUTIONS TO BE TAM-Zg HANDLING AND STORING: Observe 1 A I. �ITYp away from heat; direct sunlight, sparks and flame. ClOselcontainer as. :c,ach use. Ground containers when _ aft(. yto storage of flammable�.liquidB shouldibe��foliowed53033. Regulations related ;JOTF}F.R PRECAUTIONS: Permit Aitr epace' 'to"`exist• inside ,Material stored more than 3 months ahould' have inhibitor..lev containers- stored at the original-level a el checl�ed and TRANSPQRTATION DOT. Class: : Flammable Liquid) UN1993. NOTICE: The •data in this material safety data sheet relat ' e only to the . :'_specific material .designated herein and do no•t relate .to 'use. in combinat9.on ...with any other 'material .or in any Ptocess. F .� :This infof-mation has been coitipile&-from sources considered And is, to the best.•of our knowledge; accurate. and reliabletasbt� dependable compiled. However, no .guarantee or warr4nty; i8 made as• to -its accuracy, the date :reliability And/or; suitability.'of"the 'Producb"'for: the intended ar racy, }purpose or use. All risks of 'the use .of. the ' ' P ticular :.,the- user. Appropriate warnin s and safe. haridl•induct' are�'therefore assumed by $. g g procedures should be provided k i. Date: —'l --- o� TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS:—( AZTEC REPROGRAPHICS BUSINESS LOCATION: 3821 Route 28 f . Box 4A•#6 Windmill Sq Plaza Mail To: MAILINGADDRESS: MARSTONS MILLS, MA 02648 1 TELEPHONE NUMBER:` (508)420-1880• Fax(508) 420-0130� Board of Health C �� Town of Barnstable CONTACT PERSON: P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: `�_ � �]� Hyannis, MA 02601 TYPEOFBUSINESS: 0_01p\f ( &J C Does your firm store y of the toxic or hazardous materials listed below, either for sale or for you own use? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity O Antifreeze(for gasoline or coolant systems) 0 Drain cleaners NEW USED 0 Cesspool cleaners ® Automatic transmission fluid 0 Disinfectants O Engine and radiator flushes 0- Road Salt (Halite) 6 Hydraulic fluid (including brake fluid) 0 Refrigerants 0 Motor oils 31='Pesticides,Kwip 1ki -rk, e " to NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel o Photochemicals (Fixers) O Diesel fuel, kerosene, #2 heating oil NEW USED O Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED 0 Degreasers for engines and metal © Printing ink ® Degreasers for driveways & garages 0 Wood preservatives (creosote) 6 Battery acid (electrolyte) 0 Swimming pool chlorine ® Rustproofers . 0 Lye or caustic soda © Car wash detergents O Jewelry cleaners Car waxes and polishes (0 Leather dyes ® Asphalt & roofing tar Fertilizers ® Paints, varnishes, stains, dyes PCB-s Be-tacquer thin_ ners IR"ctI# j6*cq tUS O Other chlorinated hydrocarbons, NEW USED (�asTr-` tewrTtWj M — (inc. carbon tetrachloride) O Paint & varnish removers, deglossers Any other products with "poison" labels 0 Paint brush cleaners � Floor & furniture strippers (including chloroform, formaldehyde, / hydrochloric acid, other acids) 6 Metal polishes - Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): O Spot removers & cleaning fluids jjpff-ox C (944— op= Awe®"IjII 14 (dry cleaners) Poe-- mcq l g� O'�J L -z ® Other cleaning solvents © Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY QZP�_o_�� t (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS 301 V Class: � 1 7.Miscellaneous V kt;l_ QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel(A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: Oouk"M Pa cd X DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O Town Sewer ;&Public >VOn-site OPrivate 3. Indoor Floor Drains YES NO O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO - "9EM O Holding tank: MDC Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product 1. YES INO 2. Person (s) Interviewed Inspector Date X iJ REPROGRAPHICS A Full Line of Copying Services Color Copying•Business Cards Architectural and Engineering Supplies Sales Manager Business Manager Joel A. LaSalle John J.Whyte 508-420-1880 9 Fax 420-0130 Unit 6,Rte.28•Windmill Sq.Plaza•Marstons Mills,MA 02648 ASSESSORSMAPND;, �_� -- - '` PARCB.N� TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers > BOARD OF HEALTH O 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY � _75*,:� (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS ` F1_ '!�!/ !ii%.;; :'- Class: 7.Miscellaneous ,,"/J ��c - > QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: t Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) I' Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: Wr DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply �,f O Town Sewer OPublic f;h f O On-site OPrivate j 3. Indoor Floor Drains YES NO ✓ ,� ' �� f/••:��f 6st•I Sig ` . 7 ' "� l O Holding tank: MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES i NO ORDERS: O Holding tank: MDC O Catch basin/Dry well O On-site system 5. Waste Transporter p Name of Hauler Destination Waste Product YES NO 1. 2. 1 Person (s) Intery iewed Inspector Date TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory 2.Printers 3.Auto Body Shops Q unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores ^—r 6.Fuel Suppliers ADDRESS 39'7 1 P1 .>,r s Class: Z. 7.Miscellaneous - aj QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel(A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers &54-, Miscellaneous:: '"5 Y YOM rls (� s,P-o-� ad Lai t u� 5lQ�sc6 j,P,�, I P 4- CC V" 12— TOO _rS � I rCr DISPOSAURECLAMATION REMARKS: yJ����a►-�w� 1. Sanitary Sewage 2.Water Supply Z610 M,&ti �-0,0,6, O1 O Town Sewer OPublic X0 t� Goa e &JAJ fi)�On-site OPrivate 5cuq A4S QJ-'.S A, f�� 3. Indoor Floor Drains YES N0__L(,_ O Holding tank:MDC_ O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES N0Le, ORDERS: nn O Holding tank:MDC f�df 1�'C6� Up w•17a.1P_ O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destinatiom Waste Pr I oduct Licensed?,' YES N0 1. 2. Ile Perso ntdrFv Inspector Date FA Z T E C RE-PR0GRAPHICS Full Line of Copying Services Scanning•Plotting•Color Copying Architectural and Engineering Supplies Joel A.LnaSalle Johner oJ.Whyte wner Tel: (508)420-1880 • Fax:(508)420-0130 _email:aztec@cape.com Unit 6,Windmill Sq.Plaza• Rte.28,Marstons Mills,MA 02648 TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair Q satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY �� s. (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS 1,11P,` :;� 4 Class: 7.Miscellaneous S ''� --` `;?-$ -IES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALSUnderground IN OUT IN OUT IN OUT #&gallons Age Test F ls: GIlsoline,Jet Fuel (A) /, Dies 1, Kerosene, 2 (B) Heavy Nmtor s: waste o' (C) new mot it(C) trap missio draulic Sy hetic Orga ics: egreasers i Miscellaneous: !ll - 114AW Al y4 DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O Town Sewer 9'ublic Yon-site QPrivate y 3. Indoor Floor Drains YES N0_kf O Holding tank:MDC_ O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORD RS° Q Holding tank:MDCl O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 2. Pe on (s) Int rviewed Ifisoctor � 'Y�Date��� TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: !`l -Z %�� ez. lv�ff Mail To: BUSINESS LOCATION: t'j.p( SG_ n).9'Lo- M. M"'i It 09,�g� Board of Health Town of Barnstable MAILING ADDRESS: �w A K ►��.i l S ��.bNk P.O. Box 534 TELEPHONE NUMBER: 1 h o Hyannis, MA 02601 CONTACT PERSON: kc EMERGENCY CONTACT TELEPHONE NUMBER: ) &,O Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO �✓ This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) m1 c�,va�o2 Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business 1 ti �T6` � � ' TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY,g!tr.p2!�G►C�e e Lis Orders") s.Flui Stores ues s ADDRESS Class: 7.Miscellaneous �104� �ow„g /�i1./,QUANTITIES AND STORAGE (IN=indoors;OUT-outdoors) MAJOR MATERIALSUnderground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic 01 Synthetic Organics: degreasers Miscellaneous: '00V �a DISPOSAUR.ECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O Town Sewer 4fPublic ` On-site OPrivate N 3. Indoor Floor Drains YES N0_�l O Holding tank: MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES-NO P/ ORDERS: O Holding tank: MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES INO 1. 2. 6 Person (s) Interviewed Inspector Date e" THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I m DATA ..'"SS OWNERS: P� 'Of DO� h : Fill in below. 1 `profession0-all breed Dog&'Cat.grooming Diane Gingras .Windmill Square 332 Route 28,Building 5B ' MarstOnsNlills,lNi� `02648 ' 509-420-9.600 ,set all 47atrral prb&4 -_ DoC TYPE OF BUSINESS n IS THIS A HOME OCCUPATION? C) ADDRESS OF BUSINESS A-u2�� MAP/PARCEL NUMBER t quite things need to do in order y a few thin s If you are starting a new, ere are business h q to be in compliance with all rules and retulations of the Town of Barnstable. Once you have been checked off on this sheet you may apply for a business certificate at the Town Clerk's office(Ist floor-Town Hall. TO BUILDI G IN CTOR'S OFFICE(4TH FLOOR TOWN HALL) T s individu is in•coenpl' nce n has been explained the procedures needed to start a busine spector's—Signature \ w 11 SS ` I OF HEALTH 13RD FLOOR TOWN HALL) be informed of any permit requirements that pertain to this type I (J5Health Inspectors Signature oq 4 4 'MER AFFAIRS(LICENSING AUTHORITY)-(3RD FL SCHOOL / Z ZING been informed of any licensing requirements that will pertain to this _ co 0 ( i !, Licensing Authority Signature q25 .r all of the above-remember to return to the Town Clerk's office siness certificate. 0 UU OY (TV i I t -DOG Professional all breed Dog&Cat grooming .. Diane Gingras Windmill Square 3821 Route 28,Building SB Marstons Mills,MA 02648 � t s "U!e use all gatural produets" 508-420-9600 TOWN OF BAR STABLE C MPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS /YI � 7.Miscellaneous oo QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIUS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet uel (A) Diesel, Kero ne, #2 ) Heavy Oils: waste moto oil ) new motor oil(C) tran issio ydraulic Sy hetic Or anics: degreasers I f Miscellan us: n, DISPOSALIRECI AMATION REMARKS: 1. Sanitary Sewage 2.Vjqter Supply Xown Sewer ublic on-site OPrivate 3. Indoor Floor Drains YES NO-z�_ O Holding tank:MDC_ O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO Z ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 1. I 2. 1 Person(s) Interviewed Ins ector Date 1 of he -DOG . Professional all breed Dog&Cat grooming Diane Gingras * Windmill Square x 3821 Route 28,Building SB Marstons Mills,MA 02648 "We use all gatural produets" 508-420-9600 TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH P 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY t (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS �KZ► (Lf-ZLgLd3 �/a Class: 7.Miscellaneous M'0 QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel(A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: lea l jX 1-53 AV.Cz DISPOSAL/REC:LAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply 14 U'S qr5 a,.c d�a 6",dea s i6tcj51 c_,& O Town Sewer 0,Public S L �� 67 S Jroe Won-site O Private 3. Indoor Floor Drains YES_—NO O Holding tank:MDC_ O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO Y ORDERS: O Holding tank:MDC 0 O Catch basin/Dry well O On-site system 4>1e44 aMX. 5.Waste Transporter Natne of Hauler Destination Waste,Product. Licensed?i YES NO 1. 2. /V4 i Fersonw Intervyi ed Ins ctor ate TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair Q satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops d/J ))//�,,.^^ )9 unsatisfactory- 4.Manufacturers COMPANY A4`J-(aw ,ICT IJK& M§O (see"Orders") 5.Retail Stores t 6.Fuel Suppliers ADDRESS 3f Z l J2� Kr J'vf�� 1(2 Class: 7•Miscellaneous AIillp.) (-'"��'/�//,-&QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) (, MAJOR MATERIALS 4t4-jlots UndergroundAbove Tanks Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel(A) Diesel, Kerosene, #2(B) Heavy Oils: waste motor oil (C) new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: wr:c P ZSL x i.U,) 1-15 K `"-` a C,,� q—t' V DISPOSALRE;LAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply - f66y Cc4_4cu4-& � VEU O Town Sewer 6Public f f QS r at,r QST&I POn-site OPrivate 3. Indoor Floor Drains YES NO O Holding tank:MDC O Catch basin/Dry well L� Co c( �v d r`�o•— d� l i^ O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC S4e-p 1/4, O Catch basin/Dry well -�'j ,r• J —Si' O On-site system 5.Waste Transporter Name-of Hauler Destination Waste Product YES NO 1. a �?rt�c✓ �t1a �G/f 2. erso s) Interviewed Inspectoe Date o� Date: 1 f- V TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: An", BUSINESS LOCATION: MAILINGADDRESS: Mail To: TELEPHONE NUMBER: Board of Health CONTACTPERSON: Town of Barnstable P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: Hyannis, MA 02601 TYPEOFBUSINESS: Does your firm store py of the toxic or hazardous materials listed below, either for sale or for you own use? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners L Automatic transmission fluid ,vol Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils oZ ppprrr"""D Pesticides NEW USED T (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel _ Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil ---'-NEW USED Other petroleum products: grease, - Photochemicals (Developer) lubricants, gear oil ✓NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor & furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids (dry cleaners) ' Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Mark I Reilly,DVM Barbara J.Kmiecik,DVM MID CAPE �' MAL HOzSPITAL 382Y Route 2& Windmill Square Plaza a � g• � 1 Marstods Mills,'MA 02648 (508)428-2989 y M HAS AN APPOINTMENT — Ia. AT A.M. P.M. IF UNABLE TO KEEP APPOINTMENT KINDLY GIVE 24 HOUR NOTICE 1 t ` i TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers � 6 f�b�"� (see"Orders") COM 5.Retail Stores 6.Fuel Suppliers ADDRESS �2/ (;lass• ? 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIALS Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) s: waste 4 new motor oil(C) transmission/hydraulic SynthrtirOr—g—d-n-17s: Mlaneous: DISPOSAIJRE(;LAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply Y✓ O Town Sewer Oublic ,O�On-site OPrivate t 3. Indoor Floor Drains YES NO O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES___LNO—Z ORDER O Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of 1. i'/i/ /E .rl d a��7' .Cd'"-•�r//f/ YES NO 2. Person(s) I rvie ed Inspector Date t w .•.��y.,..�r.a�ld.../1fI*;,.!?+'t....�„y..u...t'4�;?"��l!."'�..,hI.P�'�-,^�^14+e =_�'y��—�._:.a1w...`+"'q.�/�.'.+a✓'..��y� L:1 N'�Tr! _..1"�.J'•-,.""`r_�.f^.J� M1'r'4�1y'tir•`�,r TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 2. nters BOARD OF HEALTH satisfactory 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY ? �'2 Z O (see"Orders") 5.Retail Stores �� 6.Fuel Suppliers ADDRESS 3A'.21 f' GuoZ/ /�(/ Class: _ 7.Miscellaneous r'h/M QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel(A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil(C) transmission/hydraulic -- Synthetic Organics: degreasers Miscellaneo . (�ol�—c sa lva� v 4t /V pa LTh — .. , /Vt' L"4 - DISPOSAL/RECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O Town Sewer 'Public ,131On-site OPrivate 3. Indoor Floor Drains YES NO O Holding tank: MDC 4 -�e O Catch basin/Dry well �- - ��' O On-site system 0rv— ��. 4. Outdoor Surface drains:YES7�LNO ORDE : O Holding tank:MDC MS Ll 0 Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 1. 2. A/A xlrl� P rson (s) Interviewed Inspector Date TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair nters BOARD OF HEALTHsatisfactory 3.A2. uto Body Shops _ O unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores 6.Fuel Suppliers Class; �__ 7.Miscellaneous M Y L1 QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: PrKlollq 1(�eOk c �r- 1 X PLA DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply 0-14 y O Town Sewer )2Wublic AOn-site OPrivate 3. Indoor Floor Drains YES No 0 Holding tank:MDC 0 Catch basin/Dry well 0 On-site system 3 4. Outdoor Surface drains:YES >C" NO ORDERS: 0 Holding tank: MDC -Catch basin/Dry well 0 On=site system 5. Waste Transporter Name of Hauler Destination Waste Product � YES NO 2. Person (s) Interviewed Inspector Date r:7kv , .-....a rv..{. TOWN OF BARNSTABLE CPMPLJANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY�/I °f/�/,,.�/ �6-9i1,/G� (see"Orders") 5.Retail Stores ,./ ,I.Z , 6.Fuel Suppliers ADDRESS �fC185S. � 7.Miscellaneous /l?L /U,� ANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Tanks Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) Pa .. n�nr gj1 C+1f��, Synthetic Organics: degreasers !ilalydC��l rA7,,�0:7 A /,Sop n1 Z Xleo-�,6 Z_ i ellaneous: 9 i�0.3 P' /60,03 XIL t, DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply ' 0 Town Sewer Public 9fOn-site OPrivate 3. Indoor Floor Drains YES NO 0 Holding tank:MDC O Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YESI"' NO ORDERS: 0 Holding tank:MDC 0 Catch basin/Dry well 0 On-site system 5. Waste TransporterName of Hauler _` Destination YES NO 1. 2. Person (s) Interviewed Inspector Date I TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: ALL SE1956A/S TgLyA//A16 S Lo w Mail To: BUSINESS LOCATION: / Ri T,;zf Board of Health Town of Barnstable MAILING ADDRESS: P.O. Box 534 TELEPHONE NUMBER: ��O �_�/gf 9 / 70 _Hyannis, MA 02601 CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: Y�_7 O- V&4,p6, Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO r This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) j g Z . Disinfectants Motor oils/waste oils (/ Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business la TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops I d-, - Q unsatisfactory- 4.Manufacturers COMPANY (see Orders ) 5.Retail Stores 6.Fuel Suppliers ADDRESS 39—Z1 —,T-7' Class: 7 7.Miscellaneous OWTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic /A I I I I I Synthetic Organics: degreasers Miscellaneous: DISPOSAUR.ECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply d t' O Town Sewer Public T On-site OPrivate 3. Indoor Floor Drains YES—NO O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank: MDC O Catch basin/Dry well O On-site system 5. Waste Transporter Name of Hauler Destination Waste Product 1. NO 2. Person (s) Interviewed Inspector Date 1 ��oN.I OCT ,� �WT 1929 Pierce Arrow �l a I _ _ rr _ . 1 t .. ' � i r � . . _ �.�, ,- ,_ . �� �, ; A#- AMIL OF FIIL'f: Wo /5 o Mail to: �i4I LING ADDRESS: ��i / F Board of Health Town of Barnstable TELEPHONi NUMBER: p k� P.O.Box 534 a¢�Ye, ?� �° Hyannis, MA. 02601 CONTACT PERSON. _ -Does your firm store any of the toxic or hazardous materials listed below., ; ..either for sale or for your own use, in quantities' total Iing,{�a,�any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES x'� NO -' This form must be returned to the Board of Health regardless of a YES or NO answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailin address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS TIATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities totalling more than �0 gallons liquid volume or 25 pounds dry weight. Please put a check beside each product that you store:" Antifreeze (for gasline or coolant systems) Refrigerants Automatic transmission fluid Pesticides (insecticides, Engine and Radiator flushes herbicides,rodenticides) Hydraulic fluid (including brake fluid) Photochemicals ., Motor oils/waste oils Printing Ink Gasoline, Jet fuel Wood preservatives Diesel fuel, Kerosene, #2 heating oil (creosote) Other petroleum products: grease, Swimming Pool chlorine lubricants Lye or caustic soda Degreasers for engines and metal Jewelry cleaners Degreasers for driveways & garages Leather dyes Battery acid (electrolyte) Fertilizers (if stored Rustproof ers outdoors) Car wash detergents PCB' s Car waxes and polishes Other chlorinated •hydro- Asphalt & roofing tar carbons, (inc.carbon Paints, varnishes, stains, dyes tetrachloride) y Paint and lacquer thinners Any other products with Paint & Varnish removers, deglossers "Poison" labels (including Paint brush cl aners chloroform, formaldehyde, Floor & Furniture strippers hydrochlori acid, other _ Metal polishes acids) �1211C{ . Laundry soil & stain removers (including bleach) . Other products not listed = which you feel may be Spot removers & -cleaning fluids . toxic or hazardous (please (dry cleaners ) � Other cleaning solvents , list) : _ Bug and tar removers Household cleansers, oven cleaners Drain cleaners Toilet cleaners Cesspool cleaners Disinfectants Road Salt (Halite) WN or- BAR NSTABLE COMPLIANCE: CLASS: 1. Marine�Gas StationsoRepair Q satisfactory 2• Printers R p ' O HEALTH 3. Auto Prody Shops Q unsatisfactory-" 4. rlam�facturers COMPANY seeOrders" S. Retail Stores ( ) 6. Fuel Suppliers ADDRESS �.� , .' ;r' 1 �4� - It . 1LJ�C rl'! Class: vi 7. Miscellaneous �.' • ," :'/ ` I' =�- QUANTITIES AND STORAGE (IN-indoors; OUT=outdoor. MAJOR FWTHRIALS • Case. lots Drums AboveTanks Undetgro.11nd Tanks [� )l OUT OUT 9 gel lone &m [fit Fuels: • Gasollne, Jet Fuel (A) Diesel, Kerosenet 02 (B) , Heavy Oils: ,- waste motor oil . (C) ' new motor oil (C) transmission/hydraulic - Synthetl.c Organics: degreasers • •Miscellaneous: ISPOSAL RECI. FIAT ON RBV.RKS: 1. Sanitary Sewage 2. Water Supply Town Sewer Public r On-site 04 Private 3. Indoor Floor Drains: YES NO A Holding tank: MDC O Catch basin/Dry well ORVE � 0 On-site system 4. Outdoor Surface drains:YES NO Q IloldinL tank: MDC O Catch basin/Dry, well OOn-site system S. Waste Transporter Licensed? Ngm�uf_llas:ig� nestinatinn_- jfaste Product- DES _W_ r A 12 1�k 81--Person(s) Interviewed Inspector Date 5 t 7Fal rna. 12d- ift—mv ' (Y1 . idsQD -� s M E A KEEPING YOU ORGANIZED No. 10230 H163 " MIN.RECYCLED T MRIATIVE CONTENT 10% Cei:aea POST-CONSUMER swmavo MADE IN USA GET ORGANIZED AT SMEAD.COM �� YOU WISH TO OPEN A BUSINESS? [For YOU!' Information: Business certificates (cost$30.00 for4 years). A business certificate ONLY REGISTERS YOUR NAME in town [which u must do by M.G.L.-it does"not give you permission•to ope.rate.) Business Certificates are available at the Town Clerk's Office, 1' FL., 367 ain Street, Hyannis, MA 02601 [Town Hall) sne sax c7Wa mthl!11g�' c,••• • o.4TE• V C �l ; a Fill in please: APPLIGANT•S �' ' • - YOUR NAME_�E ` BUSINESS YOUR HOME ADDRESS; 977 UDC X/✓. TELEPHONE # Home Telephone Number c� NAME OF NEW BUSIINESS � � TYPE OF BUSINESS n 1S THIS A HOME OCCOPATION? . YES NO :. - �. _. ADDRESS OF BUSINESS . �— ° ` mot �' MAP/PARCEL NUMBER . When starting a new business there are several things you must do in order-to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you [may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street). to make sure you have the appropriate permits and licenses-required to legally operate your business in this town. R 1. BUILDING COM ER'S OFFICE This individua ha n Vo d- f ny permit requirements t at pertain to,this type of business. Authprized Si ture** COMMENTS: 2. .BOARD OF HEALTH This individual has Mn inform d per re ments that pertain to this type of business. t, Authorized Si ature** ( YWM� COMMENTS: . � • EQ 3: CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature.* COMMENTS: f t • Hazardous Materials Inventory Sheet Checklist i `Z----Date L—Physical Street Address-Check database to ensure it exists ��Working Phone Number L.—.Actual Amounts-(ie.gas being used to fuel machines,thinner to clean brushes all count as hazardous materials) L___Storage Information-location of storage,how long is storage for? If none,note that. Disposal Information-where and who?If none,note that. -__L---Applicant Signature-understand what is listed and noted Staff Initial-any questions,know who to ask Vehicle Washing/Rinsing? -provide a vehicle washing policy and explain it-note that it was given Attach the Business Certificate with your sign off and comments "The inventory form should explain what the business consists of and the procedures they are doing. Notes need to be left to explain what you discussed with them. YOU WISH TO OPEN A BUSINESS? 1 For Your Information: Business certificates(cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M,G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: 'Iv 3 (D Fill in please: APPLICANT'S YOUR NAME/S: h "a 11 SIN S YOUR HOME ADDRESS: "J TELEPHONE # Home Telephone Number NAME OF CORPORATION -V NAME:O0..NEW BUSINESS PE OF BUSINESS IS.:THIS A.HOME OCCUPA N? YES NO ` ADDRESS OF BUSINESS. m MAP/PARCEL NUMBER r ' (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd.&Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM ISSIO R'S OF PPE This individu I ha e i o e �peiiiquir ments that pertain to this type of business. ut orized Signatu G / �" n�IME ITS. _ (�Ml U N 2. BOAR F HEALTH This individual has been informed of the i requirements that pertain to this type of business. Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: f 5 � C)z a`�� C1 Gss no��s J n6 nmd�2 ,VOW �, i'1'�i YOU ? . - H T❑ ❑pE1il 1� BllSIIVESS. For`Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (whioh you ` must do by.M.G.L--it does not give you permission to operate-) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Tale the completed form to the Town Clerk's Office, 1 st FI-, 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: 0 S-0`I-�(� Fill in please: APPLICANT'S YOUR NAME/S:_ _ 'U FAtst G F-t a,;' %+ BUSINESS YOUR HOME ADDRESS- ) it _ + 7�`1-Yg7-S9°la fi>1 �� TELEPHONE # Home Telephone Number 50A :�6 NAME OF CORPORATION: NAME OF NEW BUSINESS L "l PE OF BUSINESS_�a,SSc� IS THIS A HOME OCCUPATION? YES NO ADDRESS OF BUSINESS_ ���1 �wimn�.4� r SL��� '7q yf�" MAP/PARCEL NUMBER Assess(n When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the.information you may need. You MUST GO TO, 200 Main St. — (corner-of Yarmouth nd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. - 1. BUILDING COM IS 10 Is ❑FFI This indivldu I he a in or d f any ar requirements that pertain to this type of business, ut orized Slgnet * , COMMENT drj .2. BOARD OF HEALTH This Individual has,been I med ofthe mi qu it •Znts that pertain to this type of'business, uthorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This Individual has been informed of.the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: P ' Town of Barnstable OF THE Tp� Regulatory Services * lARNSTABLE, Richard V. Scali,Director 1 - a•�� Public Health Division 3. Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Massage Therapist Registration Year 2015 / 26 / . STATE LICENSE/PERMIT# / 3 7 Name C'S Business Name 0-ot, d f'eLc,6 Business Address Business Telephone Home Address G fi Mailing Address (If different from above) r Q:\Application FormsWassage Therapist Registration Oct2013.DOC f �• e C) .�OMIVtONWEA�TH�O.FINI�ASSa��II�S.E-� �t4��MASSRGETHE�Ai� F ' I SSIIE ' THE FOLLOW'W".4G yL I CENSE l$ AM{1$SAGEFTHER LF- r 132 E I L��N ST s � SNa "AftMUTNp(# T JA 02675 2009 • • • 4 � 'CE" .. l CONTROL# J 418 5 .. IMPORTANT If your license is lost,damaged or destroyed;,is inaccurate;or needs to be corrected,visit our web site at mass;gov/dpl for instructions to ensure the proper mailing of your Renewal Application and any.other correspondence. This license is subject to Massachusetts Gerieral Laws and regulations.Your license is.a privilege,an8tAnot be lent or assigned to any person or entity under penalty of law.Keep this license on your person or posted as required by law and/or regulations. YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: S Fill in please: Y a. ..�:r� wa ;+ APPLICANT'S YOUR NAME/S: S(NES YOUR HOME ADDRESS: 1 ' i ++--�( fri TELEPHONE # Home Telephone Number ;31 � f NAME OF CORPORATION: NAME OF NE,W.BUSINESS TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES. N (YKi.B`O -0O ADDRESS OF BUSINESS MAP/PARCEL NUMBER (Assessing); When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMA I SIO ER'S 0 ICE This individual h e n inf m d f a y p mit requir ments that pertain to this type of business. Au ri ed Signat COMMENTS JJP I- 22/- .2. BOARD OF HEALTH This individual has been informed of t7Z21_11_ ' irements that pertain to this type of business. Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: 4�/ Town of Barnstable �pF THE Tp�� - yP o� Regulatory Services BAHNSfABLE, Richard V. Scali, Director 9� MASS ,g 1639. Public Health Division �0 Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 . Fax:. 508-790-6304 Massage Therapist Registration Year 2015 Z 5 �AeO -1a(' I Z` `1 STATE LICENSE/PERMIT# Name DEI(,I)n M c 0 1-je a 122C . Business NameOLOQ 0' C Ij Business Address ` 97 MoL � -1 � R)fflf�' Business Telephone Home Address rn(k Ml��s Mailing Address (If different from above) P Q:\Application Forms\Massage Therapist Registration 0ct2013.D0C THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) m �(,�G:,---�7iioj FE D,ATA Date: 0 1 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: BUSINESS LOCATION: MAILINGADDRESS: `� ail To. TELEPHONE NUMBE �S —� 3l oard of Health jrsaleorforyouown n of Barnstable CONTACT PERSON: 0.�-' -- Box 534 EMERGENCY CONTACT TELEPHONE NUMBER:� nnis, MA 02601 TYPEOFBUSINESS: C��g Does your firm store any of,the toxic or hazardous materials listed below, either use? YES This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site otherthan your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(for gasoline or coolant systems) Drain cleaners / ✓NEW USED Cesspool cleaners y Automatic transmission fluid Disinfectants _Engine and radiator flushes _ Road Salt_(Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor.oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda —� Car wash detergents Jewelry cleaners °✓ Car waxes and polishes �� Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon"tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor &furniture strippers Metal polishes hydrochloric acid, other acids) Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids (dry cleaners) • Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS i Date: 4d © �_ TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: T H E' N N r L— L- orT BUSINESS LOCATION: .611 en 11 S a`jam-p ' 3_2a 1 R i-.Q Er H arslan Adis s A 0.q,&q k ' MAILING ADDRESS:-rAejA,1 I L,&,+ ,3Q 1 R,t _Q 14 t5'10 I3 11A Mail To: TELEPHONE NUMBER: --5-o Board of Health Town of Barnstable CONTACT PERSON: Q,0r e,-t h1 ,�P„r dan I P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: '4!;7- 73 D Hyannis, MA 02601 TYPE OF BUSINESS:_ adoll Does your firm store y of the toxic or hazardous materials listed below, either for sale or for you own use? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site otherthan your mailing address: N ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(forgasoline orcoolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Q-A s Disinfectants � k)a ' Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink 9 9 9 � Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Cad•waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor & furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS i CFSJTERVILLE-OSTERVILLE-MARSTCOS MILLS FIRE DISTRICT 1875 ROUTE 28 CErATERV ILLE,, MA 02632 (508) 790-23801FAXO(508) 730-2385 OILIHAZARDOUS MATERIAL RELEASE FORM F.A.# 14 C2 LOCATION: ADDRESS OF RELEASE 19 :It it _c or- DATE OF RELEASE: L_- �— PRODUCT RELEASED: : .s 4 ESTIMATED QUANTITY: I CORRECTIVE ACTION TAKEN BY RESPONSIBLE PARTY 42 .—" ... NOTIFICATIONS: FIRE DEPARTMENT: YES( ) NO( ) DATE: TIME: NATIONAL RESPONSE CE YES( ) NO( ) DATE: TIME: DEPT.OF ENVIRONMENTAL PROTECTION YES( ) NO(X.) DATE: TIME' OIL SPILL COORDINATOR: YES( ) NO(X) DATE: TIME: TOWN BOARD OF HEALTH: YES( ) NO( ) DATE:—TIME TOWN HARBORMASTER: YES( ) NO?x) DATE: TIME: OTHER AGENCIES: Z` COMMENTS: A - --lot 1 I ►fin r 0 4 1 A ♦ 1 f.+• �/ � ndl +{'� it I L —1 {Y� YV/ti� �af� rF/�'f^� $"+veyi r—�r Y i +'",,,.. ea ^•��iY...i..f a., +4 1.i- '?r}:,,,,n,,,, .-�- �y -.r. 1 4� .:al r• L t r5�t.�►Jh �fr'��1 1� tq. �:r, .,,.n,.r. �-..���. .n..-,'fir r•h i`�,d`,ti 1 f - REPORTED BY: ! i fir.-.-f' c e., DATE• -234 - WHITE COPY-FIRE DEPARTMENT YELLOW COPY-D.E.P. PINK COPY-BOARD OF HEALTH C-O-MM FORM #58 -6�6jp Request par Tuvoin of Bamstabie Citizen Reauest Center t 8!23.f20114:27:42 A,'4 Citizen Request / Feedback x-<s Request Information rr � w lfl�h Of Re 5508�862-460 �- SL Sewage ' r s An if Plaza 3dssr'rs Req estor Information cc{"m5tvi vE-117niiS: The vet fit? s-£fl t_'x is- doing I ggoem4ig and tw-septic systefiv i-s-not laW enoug4 tG accomtoaaie im type of business,1 Efftal4, was.emkied beaume of the hKk of sewage,but new there is a dog grooming.beiag ni rued by the FLOW vet.tnt thi- cf�.FY�I lee QE I�.�r�l 4Qt[C�JQ[Ll L�€CC signs iiave come down for dog wa- Nirrig. However,thot arc S-L"191 gi oo i die ig dfcgs.Caller will ski n'tact ca ffer is;urstrateu the new��la am al to awduct V15 bus Men mHer was not. Track Request dress } s.�f r .. iS���Tnjifr roe �i �riisn.�iFii�.�e.0 rtPi-Morc? n�tiii?aiil-142 'ft C[t��=l i�#G! Q12'31 Z-FE I " T o6kup P e st age 2 of 2 -aest Work .Ewtory: €nWed on%115/EQt1 9:00 37 Last modifies gn aii5/2-0119:30: AIM �t oT["' iirnane{dia{tely notifred�Ythe Mo�r^JvCner�oyf.the building, S.wparrt+Bo�r.,n�s-�teiin�.pby telephone.an,,... 3//G1rG�ers�f011,p�.1h fool din e-m. off vvs�i..7�s�E�'t/t tV/f�"la on, S rnstei1{.}it(.G�V�"Good ll`ternWI Aa Vt r f 1h�ip5.� �a o !tiny I rF4�veJ some new info r11�bo 1 from a citizen the,he t--i g 1e4erina Y�c4 t,Vtii offers dog groom—services.These services were not previously offered there before.A sign was posted outflows promoting the new,business.The existing septic systems were in hydraulic failufe and unable-te�aceernmodate any additions floes for dog gfooming.The veterinary office septic systern is connected to"Phase W of three failed septic system projects located at this complex in Marston Mills.A repair plan was submitted to the board as proposed by the professional engineer Michael Pimental(plan crated 116t05).The three please plan was approved by the bard of H-eatth, However, bases 11 and 11 were not cons4vcted as of this dam,As noted in the letter ftom the Board of health dated January 30,2004...any applicants proposing to open dentist onrces,animal grooming,hair salons,or food estab meats.shaft be informed by the owner that they are not authorised to be located within any oftiiese buildings.Please advise as to what actions were taken or will:be taken in this.regard._'Urlcu4e,Thomas McKean'A few days later,Aaron notified TM that the Vet`s Office was notif"ted to stop. Entered ore 8115/2E3114:14.29f*A14 The sigTY was removed-advet ushig dog grooming'them. Entered or}B/1:5/2811 g:31:3&Af4- Last modtfiied on 8/15(24119:31:53 AM Ott 811512014 TM sent a second e-mail to Aaron_Bornstein requesting:follow-up with.the Veterinary ice. Main Page `gip://W__I `W tOWn.bMMt �� �f �e .as `� =' & 'ass= 5:64 YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS THE BUSINESS NAME in town (which you must do by M.G.L.- it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. 1�- Fill in please: Date: j.I I&II i M 1 - APPLICANT'S NAME: Jocb' j -e 4l YOUR HOME ADDRESS: d?3 'Thoj.,Ps l� idcl/eba,-�o ;bra GZ3yc� ehE;i BUSINESS TELEPHONE # HOME TELELPHONE #: NAME OF CORPORATION: /�'!�o( �"„H ,'�S�o, e i L FID # J�o b 7 y NAME OF NEW BUSINESS lqn,,4 gyp, It TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES _NO ADDRESS OF BUSINESS ,74 2oi• c 2,K !f'�n���c.c S . �- Y�lti-Jl p4,(/J MAP/PARCEL NUMBER D5 7-C0 (Assessing) .� 9444 M'4 ,zc,yy When starting a new business there are sevOral'thiln'gb you must do to be in compliance with the rules and regulations of the Town of Barnstable. This form is to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of.any permit requirements that pertain to-this type of business. , Authorized Signature** COMMENTS: 2. BOARD OF HEALTH This individual has been�fq med of the permit requirements that pertain to this type of business. � r Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: YOU WISH TO OPL-i A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 years . A business certificate ONLY REGISTERS YOUR NAME in town(which you must do by M.G.L.-it does not give you permission-tarap-elwtlej Business Certificates are available at the Town Clerk's Office, 1"FL, 357 Main Street, Hyannis, MA 02601 (Town Hell) DATE: ! O Fill in please: APPLICANT'S YOUR NAME/S: BUSINESS YOUR HOME DDR TELEPHONE # Home Telephone Number NAME OF CORPORATION: NAME OF NEW BUSINESS TYPE OF BUSINESS aw IS THIS A HOME OCCUPATIO ? YES N rJO ADDRESS OF BUSINESS MAP/PARCEL NUMBER Assessing) c� When starting a new business there are sevhrall things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd.& Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING CO ISSIO ER'S O C �. This individ I h Vn Wftffnel m re qui ments hat pertain to this type of business. V, \ � A horized Si nat * _ MM 1 4.0, J AA cjn:�) BOARD OF HEALTH This individual h e f th permit requirements that ertain �bis�yp®e� 0 ( /1_ 4 rr Se I per. CL► Auth rized Signature', ' «, �' COMMENTS; W�S�'ouu�b6 c�iv�d.cJ a.n1 Sty[( n�1- cam at(a a 4 or ;-AS ca�s}e ll r,7 CKCF.0 p� —F1C,S c� �(u J D t�+�s 3. CONSUMER AFFAIRS(LICENSING AUTHOR clC'^J-4 'V1g , Zl This individual h gen in eel of the li si i rents that pertain to this type of business. d.o uthorized Si nature'`* i es COMMENTS: ✓1 S �- r U 3 i i i f. i JAN-28-201.0 11 :41 AM JCENGINEERING 508 273 -0.-736'7 0' 01' r l-27 -10 �(�\'Y1 , K(('v t�Z( 1 1 M Z o t S.' 1 l✓ '�- ( �rr n 1 J/J� S(� V\/'� 310 C1'IR' I)EPA RTMENTOF ENV IRON MENTAI�PROTFCTION (�/ toilet and hand washing waste, is not considered a change in the type of establishment' and does not require the addition of flow for the purpose of designing the system, r "• Housing fcr the elderly exceeding two bedrooms per unit shall be designed based on 110 gallons per day per bedroom, Hin. alku"'aWe_ (3) COMMERCIAL u C- ep (if sNs le p �-- -^ is C s t ,°1 4 i 8 / Airport �" p per passenger 5 Barber Shop/Beauty Salon per chair 100 U ZA� Bowling Alley per alley 100 4—ul' Country Club, dining room per seat -10 W Country Club snack bar or 0^9- lunch room per seat 10 Country Club. lockers and showers per locker 20 rJ1" ' 2 �C,,,tr Doctor Office per doctor 250 .T Dentist Office per dentist 200 jf Factory, Industrial Plant, Warehouse„ or Dry Storage Space without cafeteria per person 15 Factory, Industrial Plant, Warehouse or Dry Storage Space with cafeteria per person 20 Gasoline Station per island"""'" 75 300 with service bays per bay 125 Plus flows for bays, if any KennelVeterinary Office per kennel 50 Lounge,Tavern per seat 20 Marina per slip 10 500 Movie Theater per seat 5 Non-single family/ per washing 400 automatic clothes washer machine. Office building 1014. Retail Store (except super ma sq.ft, Restaurant per seat 35 1000 Restaurant, thruway per seat 150 1000 service area Restaurant, Fast Food per seat 20 1000 Restaurant, kitchen flow per seat 15 [for sizing of grease trap only) Service Station per bay 150 450 [no gas] Skating Rink per seat 5 3000 Supermarkets per 1000 sq.ft. 97 Swimming Pool per person 10 75 ie I °F 4'wxea�,. i \k 1�. (r:ry ., f P_`� [.l of ivi SHE Town ®f Barnstable Barnstable OF Tp� Board ®f Health �ericaC BABNMBLE, 9 �. g 200 Main Street, Hyannis MA 02601 W� �°'°jfo MAC aye 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. 3unichi Sawayanagi March 12, 2010 NOTICE TO OWNERS OF ALL BEAUTY SALONS AND BARBER SHOPS i CONNECTED TO ONSITE SEWAGE DISPOSAL SYSTEMS IN THE TOWN OF BARNSTABLE I ' On April 13, 2010 , at 3:00 p.m., the Town of Barnstable Board of Health will be considering adopting the attached draft policy which would require the installation of tight tanks at existing barber shops and hair salons before a particular date, which is to be determined. Also, it is proposed that signage be required at each sink in the hair salon or barber shop. This policy will not apply to hair salons and barber shops that are connected to the public sewer system. You are invited to attend this meeting which will be held in the second floor Hearing Room at the Town Hall, 367 Main Street, Hyannis. You will be given an opportunity to provide input during the public.comment session of the meeting. I _Should you have any questions, please contact the Public Health Division at 508-862- 4644. i I I BOARD OF HEALTH i TOWN OF BARNSTABLE i i i I ' I Q:\TIGHT TANKS\DISCUSS.TIGHT TANKS-HAIR SALONS MAR2010\LETTER TO HAIR SALONS MAR 2010.doc x YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates.(cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it. does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1-FL., 367 Main Street, Hyannis, M 02601.(Town Hall) .k � �� s. DATE: E 9:1 .. Fill in please: APPLICANT'S YOUR NAME: .BUS INESS YOUR HOME ADDRESS: 4:� '3 TELEPHONE # Home Telephone Number NAME OF NEW BUSINES _TYPE OF`BUSINESS IS THIS A HOME OCCUpATION! YES NO. �- Have you been given.approval from the_building divisions YES NO ADDRESS OF'BUSINESS �3 �J�.,li�rroc;c_ Q ,;._ MAP/PARCEL NUMBER 05.-2 dU'y When starting a new business there are several things you must do in order to be in compliance with the rules.and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST .GO TO 200 Main St. - (corner of.Yarmouth Rd. & Maim Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: 2. BOARD OF HEALTH This individual has be M infor=Ad of ermit requirements that pertain to this type of business. thorized ni6nature* COMMENTS: S&*k ae c -z- matwee-Z 3921 r 1evt V, :Ra_ 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: Date: Q5 TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: /,t.e, , '>�A- - U1�iA,.I BUSINESS LOCATION: INVENTORY MAILING ADDRESS: '' Ixotzi-, 1f-_X� M,4- 60,d,—� TOTAL AMOUNT: TELEPHONE NUMBER: ��o - 2:2i -n4;7oZ _ --� CONTACTPERSON: Z/1�.69,-J ��, EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: -7 VV:12 G 1?2/_4 INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous.waste: Name of Haulers Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed/Maximum Observed/Maximum Antifreeze (for gasoline or coolant systems) Misc. Corrosive YT� NEW USED Cesspool cleaners NEW transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED Misc. petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Misc. Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt & roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor& furniture strippers I Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers r,✓hP�.S S i f�eS 116 &Z 1211.0<-� (including bleach) Spot removers & cleaning fluids ?� • �� C (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Health Complaints 17-Nov-05 Time: 12:15:,00 PM Date: 11/15/2005 Complaint Number: 18549 Referred To: DONNA MIORANDI Taken By: ELLEN WADLINGTON Complaint Type: GENERAL Article X Detail: PRODUCT INTEGRITY A;1 Business Name: Happy Nails L' Number: 3821 Street: Falmouth Road A�� ��� ' Village: MARSTONS MILLS Assessors Map_Parcel: �! ' Complaint Description: Fumes going through into other business from the nail salon Actions Taken/Results: We don't have a hazardous waste inspector. Nail salons are licensed by the state Board of Cosmetology. 11/16/2005-DZM inspected and took pictures. Inspected all the facilities chemicals and did not find MMA but did find an MSDS sheet for it. Phan is the licensed person. However, there was another woman doing a pedicure that did not produce a license to me. There wasn't an odor at the time but there was a strong odor of mold and a visual presence of mold. Ordered Mr. Phan to bring me in copies of his MSDS sheets and the woman's license from his Orleans office. Investigation Date: 11116/2005 Investigation Time: 1 - �- COMMONWEALTH OF MASSACHUSETTS 1 x5 ? DIVISION OF PROFESSIONAL LICENSURE OFFICE OF INVESTIGATIONS m� Application for Complaint 617-727-7406 www.mass.gov/reg Date Received(stamp): Entered into the Database(Date): / / Docket#: - - Acknowledgement letter sent(Date): / / Signature: Please complete this form as fully as possible.(PLEASE DO NOT WRITE ABOVE LINE.)Please type or print legibly in ink. SUBMITTED BY: Name: ffl �D i ZA Last Name First Name �}p M.I. Address: 00 /Y J t! o (/D — Num er Strut �, n Daytime Phone City State Zip Code Evening Phone Best way to reach you: ❑Evening Phone aytime Phone ❑E-mail: (�.a j" /O/TI i LICENSEE SEEKING C OpMP AINT AGAINST(use separate f rm for each licensed individual): Name: ?T f1VP Last Name First Name M.I. Address: Number Street Daytime Phone City (� // State Zip Code License Number/Type Class L� Business Nam Business Address, o Daytime Phone 3 INA16d 49 SHOP City State Zip Code Business License 9/Type Class Please check the trade or profession that this application for complaint pertains to Accountant Funeral Director Optometrist Aesthetician Gas Fitter Physical Therapist Architect Hair Salon Physical Therapist Assistant Athletic Trainer Hair Stylist Plumber Audiologist/Speech Language Health Officer Podiatrist Pathologist Hearing Aid/InstrumentPsychologist Barber Radio/TV Tech. Barber Shop Home Inspector Real Estate Agent/ Chiropractor Land Surveyor Broker/Salesperson Landscape Architect Dietitian/Nutritionist Real Estate Appraiser Dispensing Optician X Manicure Salon Rehab.Counselor Drinking Water Manicurist Sanitarian Ed. Psychologist Marriage&Family Therapist Social Worker Electrician Mental Health Counselor Veterinarian Electrologist Occupational Therapist Engineer Occupational Therapist Fire or Burglar Alarm Assistant Page 1 of 2 _. 1 Description of the incident(s): �O�jD� n t the times and dates t11'at I Briefly describe the incident(s) that led to your application for complaint and note e events occurred.List the names of all individuals involved.Please attach additional pages if needed5rr-, A-r Pro VG--1 0 wee AIM, "/V -6L.C- -ro pf-on)(-'e rilml/f e fWAA1 '0/2 - wi�V , A5 opf)6� TO A/ !,0 � L-3, a 6�:-M 40 (V , . D &6 61 a . 1 . [// - / " IQ V A Ak MU u' r) N, -, ---- d Man ia ,1 (Please use a separate sheet if necessary.Do not write in the margins.) Additional information or materials attached Yes ❑No To speed up the application for complaint process,submit legible copies(not the originals)of all relative documents supporting your application(e.g.contracts,medical records,cancelled checks,etc.).You will receive an acknowledgement letter notifying you if a complaint is issued based on your application.If a complaint is not issued, you will receive information on additional resources that may be available to you. AUTHORIZATION FOR RELEASE OF RECORDS AND FORM REFERRAL My signature to this form,or a photocopy thereof,authorizes the Division of Professional Licensure to: (1)receive copies of all medical,dental and mental health records relating to my application for complaint,and(2)to refer my application for complaint to other appropriate law enforcement authorities to investigate and/or prosecute. Please note that all applications for complaints are examined to determine their factual basis. The act of filing an application for complaint does not assure or imply that disciplinary action will be taken against the licensee. I att that the informatio rod ed isstrue,correct and complete to the best of my knowledg lo5 9. Signature Date Mail this form to: Division of Professional Licensure,Office of Investigations 239 Causeway St.,Suite 400 Boston,MA 02114 Page 2 of 2 y Town of Barnstable Regulatory Services SrABM Thomas F. Geder,Director ArED A Public Health Division O�� Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 � ;� �¢N ' .3,:p'�' - ' p�,;,si,..c •2.;.Y*R4sm..7Pci,+r�_•�.:'.e:''t�3.as— y.�.��- ...N,�� � �'�w� �� DATE: NUMBER OF PAGES TO FOLLOW: TO: FROM• 0 PHONE: PHONE: (508)862-4644 FAX PHONE: FAX PHONE: (508)790-6304 i cc: - NOTES/COMMENTS: i 3 4 QAFax Form.d6c I t r DO( Yrotessional all bleed Dog'8 Cat grooming Diane G>ingras S821 Route 28;Building aB p` Narstons Mills,MA 02648 '= Ve use all gatural produets" 508-420-9600 TO ALL NEW BUSINESS OWNERS: ( �� ��� '1'r1cc�S-t7n'�S ► ( Is WA- Fill in below: 02100 NAME OF NEW BUSINESS: Do G TYPE OF BUSINESS n IS THIS A HOME OCCUPATION?�l C� S W;((s ADDRESS OF BUSINESS 38 UZ IdG 5� Sy, � uZ(,yr MAP/PARCEL NUMBER If you are starting a new business there are quite a few things you need to do in order to be in compliance with all rules and retulations of the Town of Barnstable. Once you have been checked off on this sheet you may apply for a business certificate at the Town Clerk's office(Ist floor-Town Hall). 1. TO BUILD G IN CTOR'S OFFICE(4TH FLOOR TOWN HALL) T s individu s i •cornpl' nceano,has been explained the procedures needed to start a busine uilding Inspector's—Signature \ 2, GO TO BOARD OF HEALTH(3RD FLOOR TOWN HALL) This individual has be informed of any permit requirements that pertain to this type of business. A0 e- Health Inspector's Signature 3. GO TO CONSUMER AFFAIRS(LICENSING AUTHORITY]-(3RD FL SCHOOL ADMINISTRATION BUILDING This individual has been informed of any licensing requirements that will pertain to this type of business /� dl�u p b Licensing Authority Signature After being checked off by all of the above-remember to return to the Town Clerk's office to actually obtain your business certificate. { TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair BOAR OF�gEALTH � satisfactory 2.Printers 3.Auto Body Shops Ele,, ! O unsatisfactory- 4.Manufacturers (see"Orders") 5.Retail Stores COMPANY �� -� 5' Zvi 6.Fuel Suppliers ADDRESS Class: 7 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIALS Case lots-- Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: 9 DISPOSAIJRECLAMATION REMARKS: n 1. Sanitary Sewage 2.Water Supplyi O Town Sewer A&ublic xOn-site OPrivate 3. Indoor Floor Drains YES NO O Holding tank: MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5. Waste Transporter Name of Hauler Destination Waste Product 1. YES NO 2. Pers n (s) Interviewed inspector Date YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (c(Dst$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you, must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form 'at.200 Main St., Hyannis, :i•; *' Take the completed form to the Town Clerk's OffiCe;.1 st FL, 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law- DATE: (0 Fill in'please: L.ul4Jir��•J5i C1.',�y l:` Vf' 1�.%%.Lr ` _ .: . . 1f;;;uL.c.;�ti:N;,1 y ;�e: ►: i i . APPLICANT'S YOUR NAME%S: Jodi p krWb;M.T llr���- i `'` 2.� BUSINESS YOUR HOME ADDRESS: 2�r I —TYi o r.,n c 4fi�uCj>fy '1yJ e w� d d�z b o✓� rvl A Gr2 3 TELEPHONE # Home Telephone Number :n NAME OF C R • ' ">+:: :....:.. .......... :.. . .: .:......... ...... ..... ......::T1(.PE.OF:BUSINESS:.:...1/e 'trr�:Y:.�:: T�r�s�.a.� .:M':':...5: • NAME.OF'NEW BU51NE5S5,' -•r:- . • ..:......:... . .;: ., CCU .ATION •"'`• 15 T IS A HO1�ilE O P N .,,. _ '';:�.;�:: _ • t. . ..,,. .. .. . ... ' �:• :• `i? ..�•��?i�.�, sass n'•i ._ham MAPt PARCEL';IVUIVIB�R ;AO.DRESS:OF:'B1�51NESS ��,"�t- �i.: � �.:;,�rfUv�s •!'N /,. . . ,.. • When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you.may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to-make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM SIO ER'S OFF E This Individu I h e n in edB an ern-A re uirements that pertain to this type of business: . ' �. rized Sig at COMMENTS: 2. BOARD OF HEALTH This individual fpr �' thfe permit requirements that pertain to this type of business. u orized Sig ature* COMMENTS: h! z�C S. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** ' COMMENTS: f YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates(cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town(which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 plain St.,Hyannis. Take the completed form to the Town Clerk's.Office,1st FI.,367 h1ain St.,Hyannis,MA 02601 (town.Hail)and get the Business Certificate that is required by law. tb 15 _ F DATE: Fill'n lease ,.. .: APPLICANT'S YOUR NAME/S: MivM D'Hk.M A� lb C�19r -f l— ScAtr"-C- �r + BUSINESS YOUR HOME DDRESS: °)I AA ILNCH rN*H CAs i r I,nn�-rrl nnA OtRfMto v_ TE -77 LEPHONE # Home Telephone Number 714-7(32S—R2 NAME OF CORPORATION:—Ti-G 1 (.L NAME OF NEW BUSINESS TYPE OF BUSINESS )r) IS THIS A HOME OCCUPATION?�_Y�S NO* ADDRESS OF BUSINESS�c1I-f2Q1YY) d Z-M MAP/PARCEL NUMBER (Assessing) V&L'1'5rth5 w tj s " Od-49 When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St.-[corner of Yarmouth Rd.&Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSION�=EThis individual has beeny rmit requirements that pertain to this type of business. Authorized Signature* COMMENTS: 2. BOARD of HEALTH MUST COMPLY WITH ALL This individual ha�bf ecd�of the er ' rrry e fements h pertain to this type of business. HAZARDOUS MATERIALS REGULATIONS Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: 1 mom/ � Ga " Mail To: BUSINESS LOCATION: oZ J a Board of Health MAILING ADDRESS: /1-1 44 STOti 5 Al I'LL_S /21 ►'?- Oc? to u� Town of Barnstable P.O. Box 534 TELEPHONE NUMBER: So V o) 0 // o s. Hyannis, MA 02601 CONTACT PERSON: O b ex Z�q4, Nie,< EMERGENCY CONTACT TELEPHONE NUMBER: 5 0'CR Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages G4 1. Printing ink -10.1ve0, Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: 1 mom/ � Ga " Mail To: BUSINESS LOCATION: oZ J a Board of Health MAILING ADDRESS: /1-1 44 STOti 5 Al I'LL_S /21 ►'?- Oc? to u� Town of Barnstable P.O. Box 534 TELEPHONE NUMBER: So V o) 0 // o s. Hyannis, MA 02601 CONTACT PERSON: O b ex Z�q4, Nie,< EMERGENCY CONTACT TELEPHONE NUMBER: 5 0'CR Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages G4 1. Printing ink -10.1ve0, Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business 'll 1� 1 A S 1 0 . 4 �l [F d f F jy b n K-V ASSOCIATES INC. ' ' Groundwater Systems 281 MAIN ST., FALMOUTH, MA 02540 r A � H it 1 w 1 l 1 1 1 1 1 1 1 1 1 � I 1 1 1 1 1 1 i t t t t t SITE REPORT RELATIVE TO tHAZARDOUS MATERIAL ON PROPERTY LOCATED AT ' WINDMILL SQUARE MARSTONS MILLS t t t t . t Prepared for William Carey Falmouth National Bank ' P.O. Box 687 Falmouth, MA 02541 t ' Prepared by K-V Associates, Inc. 281 Main St. ' Falmouth, Massachusetts ' June 1988 Job # 609 1 . i SITE REPORT RELATIVE TO ' HAZARDOUS MATERIAL I� The report is being addressed to (Name and address of title insurance company) ' with respect to the real estate situated at Windmill Square, Marstons Mills ' A. The undersigned, based on experience and knowledge, states that: 1. The investigations of the site described in this report (together ' with the site assessment summary attached hereto as Exhibit A and incorporated herein by reference) were performed by: Steven Mateus, geologist Jon Soderberg, Chemist • I (Name(s) , title(s) , qualifying discipline(s) ) (hereinafter the "Site Investigator" ) who is (are) qualified to make the investigations and formulate the opinions herein set forth. ' 2. The Site Investigator is familiar with the provisions of Massachusetts General Laws ( "M.G.L. " ) Chapter 21E (as it may from time to time be amended) and the applicable implementing regulations under said law, including the mater- ials which fall within the definitions of "oil" and "hazardous material" there- under. (References in this report to oil and hazardous material refer to said terms as defined in M.G.L. 21E and implementing regulations) . ' 3. The Site Investigator has reviewed the history of the site and has considered the potential for the generation, use, treatment, storage or ' disposal of oil or hazardous material by (a) the uses presently associated with the site and (b) to the extent ascertainable by inquiry as noted in the site assessment summary the uses previously associated with the site. ' 4. On S/9A F/7 ti/R (insert dates of investigation) the Site Investigator investigated the site and, except as qualified in the site assessment summary, the areas adjacent to the site to assess the possible ' presence of oil or hazardous material on the site. This investigation included the research observations, explorations and testing described in the site assessment summary attached to this report as Exhibit A. ' B. Based upon the foregoing (including the research, observations, explorations and testing described in the site assessment summary) and subject to the qualifications set forth below, the undersigned is of the professional opinion ' that at the time of said investigation: Check appropriate statement: ' 1. No evidence exists that oil or hazardous material is or has been present on the site. 2. Evidence exists that oil or hazardous material is or has been present on the site or on areas adjacent to the site. The ' following summarizes this evidence: This site lies adjacent to and downgradient from an old gas station, now Pecks Boatyard. i ' g 3. Evidence exists that oil or hazardous material is being, has been or might have been released into the environment from or at the site. The following summarizes this evidence: ' Groundwater samples which were obtained from monitoring wells at the site contained .levels of perdln.oethylene which exceed limits allowable under M.G.L. c. 21E. ' C. The following qualifications apply to the undersigned's opinion: I 1. Except as otherwise noted in Exhibit A at Page 6 (insert page ' reference to .Exhibit A, if applicable) , no test pits or borings were made, nor were observation or monitoring wells installed and observed. ' 2. Except as otherwise noted in Exhibit A at Page 6 (insert page reference to Exhibit A, if applicable) , no soil, water or air samples were taken, nor were chemical or other analyses performed. ' This report is dated this day of 19 88 and is P �7 -d• ' signed by an individual who is duly authorized to do so. K-V Associates, Inc. ' Name of Firm ' Steven Mateus, Geologist Jon Soderberg, Chemist By: Name and Title 281 Main St. Falmouth, MA 02540 Address 617-540-0561 ' Telephone Number -1- INVESTIGATION REPORT FOR ' SITE CERTIFICATION RELATIVE TO HAZARDOUS MATERIALS Site Ownership and Location 1. Site Owner: Name: Cotuit Property Management and Development Address: 3821 Rt. 28 Marstons Mills, MA 02628 ' 428-1985 Telephone No. . Date of Ownership: April 1985 topresent 2. Site Location Address Windmill Square ' 3821 Route 28 Marstons Mills, MA 02628 ' County Barnstable Assessor's Plat: 57 Lot: 4 ' U.S.G.S. Quadrangle: Cotuit, MA 1974 (Locus plan from U.S.G.S. map attached) See Figure 1 ' II. Site Description and Environmental Characteristics 1. Brief description of subject site (existing conditions, including topography, grassy or wooded areas, built-up areas, ponds or streams, ' marshes or swamps, floodplain information, other site-specific features of note) : ' This site is listed as lot 4 on the Town of Barnstable Assessors Map ##57 and consists of about 2.5 acres of commercially developed land, known as Windmill Square, on Rt. 28 at the Putnam St. lights. Windmill Square is 20 non-industrial or clean businesses set in ' a triangular fashion with a courtyard in the center. The property, much of which is paved, is well drained to catch basins. The landscape is healthy and well-attended. There are no streams, ' ponds, wetlands or floodplains on or abutting this site. I i 1 1 Z\l oii rr p 8'l v�MARSTOrJS CM��C .{ '^ 0 \`,.•,\ .r \v O - .., ^� \a; •• a'r' S \�c M GN 01,0 �' �6'�•�':,,°"-'�,^. I `j� / I _ 4I '/ 44 V�i /�11 � \,V�f��, ',\'S C��^L• of (J)/�10 1.11� ''CK'-' �\\��IG al�tens •"� C�J. 15• i7 MILS 1'17' 23 MILS I I ' 0 O I 41 © a 1 r �azi, o -Bogs-„ �l Lovells \t,,`/i's.{ `; - '(orLOCUs ;) Cam, ='� :1 J Pond 28 �-, % ,,vj^Io � \ F IV Ci �•• .�•• 'J I %f` ) i�til't ;ii 50`I /,A\ -� l� /,% .\, I �i%:�� j 2/�"�� �`-r�\� I -> � y,••\,��7 r r, �t.,p :1�':-i' r_F_ Can zoo C ,ot o `R '1 \, Cranb `c\ 1t i,1f n 1 1 "t\1.(rY —�fi r U•,��/.-�J�.Ing �� Y1:\` �,Q II l_�rD/I� .hl-•J.T.B t Islan ion \�)� g0 9,°.\\ O hpa n il', V ��� I 0 - t• 9 >) � ,�\\ ���<•`/ �t` Ili^r�l��p �.'-�\�•J;, Pt u \ ti i \ ,:12 �in n'�'h0 �`,``\➢: i :�,.: �Fi;J Isabella Public Figure 1. U.S.G.S. Topographic Map with site locus. " 1 -2- ' 2. Site layout information (see attached site plan prepared from existing maps) : ' Approximate property boundaries: See Assessors Map, Figure 2 Building and parking area locations: See site schematic, Figure 3 ' Site utilities: gas, electric Ponds and floodplains: zone C on the Flood Insurance Rate map (F.I.R.M. ) indicating a zone, of minimal flooding. Fencing: None ' Streams: None Marshes or swamps: None ' Wells: None I Easements: None Power lines, etc. : overhead and underground 3. Site-specific waste/wastewater information (see attached site plan ' showing known or suspected waste/wastewater conveyance, storage or disposal areas) : ' Catch basins: 11, See Figure 3 for locations ' Septic tanks/leaching fields: See Figure 3 for_locations ' Sanitary sewers: none Underground oil tanks: None Lagoons: None Pits: None r lbo ROJAD yo \ y `.oL.�• 0%PP 0st"�` O O 1vi Loo CA Ck MN GN 0 4 267 MILS 1'1T .� 23 MILS. e • st_ ;ir>=> M O - n J. -4 1 +. `• AC a 4 5-Gr {.00� d9 ✓ L Z 1IA•A 0 I.IB -4 . Figure 2. " Town of Barnstable Assessors Map with site cross-hatched. " III I R T 28 Q / 1. w 0, O O . O t ,I, d• O i O 0 t � G Figure 3. " Site sketch showing. approximate locations of: " ' O Dumpsters OSeptage areas. ' 0 Catch basins -�' Monitoring Wells Groundwater flow direction indicator Commercial Buildings t ® paved area grassed or landscaped areas ' r,w t .. f -3- ' Drainage lines: None ' Sumps: None ' Ditches: None Other: None ' 4. Environmental characteristics relative to hazardous materials (see attached site plan) : ' Topography and surface water drainage patterns:Flat-lying and level. This site is graded to convey all runoff to catch basins. ' Soil types and permeabilities:Mostly glacially stratified sands. Permeablilities associated with these deposits are high. (See Figure 4) ' Su rEicial and bedrock geology: Mashpee pitted plain deposits; mostly gravelly sands with pebble to cobble gravel. Locally includes boulders. Bedrock ' is reached at about 330 ft. below M.S.L. (Oldale) . Groundwater flow direction: east or southeast towards Mills River and Princes Cove (See figures, 1 & 5) ' Depth to groundwater: About 45 ft.- Ponds, streams, wetlands and f loodplains:None On-site and other drinking water supplies (surface or underground) ' within 1,000 feet of the site: This area is facilitated by a municipal water supply. Condition of vegetation:healthy and well-attended Other: This site lies adjacent to and downgradient of an old gas station ' now Pecks Boatyard. This site lies outside of the Zone of Contribution to Barnstable municipal pumping stations. III. Site history and use ' 1. Zoning: Present classification and dates: VBA Prior classification and dates: ' 2. Current uses of site: Industrial X Commercial Agricultural ' Other I ' Rocks Unconsolidated k k K K K deposits (darcy) (cm2) (cm/s) (m/s) (gal/day/ft2) 105 10 3 102 1 - 104 10�4 106 10 10-1 - > 5 f c� 10 10 10-5 1 10-2 3 I 4 o,a I I 102 10-6 10-1 10-3 10 N 103 10 10-7 10-2 10-4 0� 0 E " 1 10-8 f0-3 10-5 Y L =3is I o_ U a�a�I 10-1 10_y 10_4 10-6 ::::::::::� E`::': - c N 0 o a - ;:::•::> -Q0,o E c o I 10 2 10"10 10-5 10-7 ..... ' 0E -)22 _ 10_�::.. ........ LL I E-00 a . cn 10-3 10-11 10-6 10-8 J 0 to ' I 10-4 10-12 10-7 10-9 0 10-3 s 0co 10 5 10 13 10-8 10 10 ' o -4 0 s c o` 10-6 10 i4 10-9 10-it 10 V U D E 0 o ip-s v y N 0 0 0 10-7 10-15 i0 to t0-1 0 c 0 c I 13 1T � .Q 1011 10-16 t011 10- ' +� 10-7 Table 2.3 Conversion Factors for Permeability ' and Hydraulic Conductivity Units Permeability,k* Hydraulic conductivity, K ' cm2 ft2 darcy • m/s ft/s gal/day/ftz cm2 1 1.08 x 10-3 1.01 x 108 9.80 x 102 3.22 x 103 1.85 x 109 ' ft2 9.29 x'102 1 9.42 x 1010 9.11 x 105 2.99 x 106 1.71 x 1012 darcy 9.87 x 10-9 1.06 x 10-11 1 9.66 x 10-6 3.17 x 10-5 1.82 x 101 m/s 1.02 x 10-3 1.10 x 10-6 1.04 x 105 1 3.28 2.12 x 106 ft/s 3.11 x 10-4 3.35 x 10-7 3.15 x 104 3.05 x 10-1 1 5.74 x 105 gal/day/ft2 5.42 x 10-10 5.83 x 10-13 5.49 x 10-2 4.72 x 10-7 1.74 x 10-6 1 *To obtain k in ftz, multiply k in cm2 by 1.08 x 10-3. tFigure 4. " Ranges in permeabilities and hydraulic conductivities for various rock and soils with site ranges bracketed. " Ilk r� * spa .F. •J ��s �- f i �e •J�-`\. ��¢ ��.•, •',)� i-�... �°`' �.' .Qa -// _z;; i` ! JY6u �• O1 /�`�i`. _ 7,'Yr-' Q d .+'�''- 0^ •ti `-`+4 T'/-��._`t` "�` lip e/ /�•.��- ��---' ^Q'` O. L •.. .�� Ye '��.1- •�� � t / c �' Let. ram••/�,���.�..�`� K ��t `�.\,.� �a , i1• f.- \ 'l°`f' a BLS— :` •;. / 1.n�`-1 a .''a �` 0 1~ r+t 4ljif-e 4 .2 P°.,d CE ° fie.... :i .edr r_ `�_2 l e"'d , !i. e. •.� i' \ \. •� V:, 72 I 26 L.. P°.d , Y\') -�; = °.• •-:+• ° -:� 17.0, ,E �. ' CO 59- .35.3 ° \' t. �• i // ` ..11(' ��-y' •:e.r r� . � ;2J `�-• �u • o (" .� �C E 15 8�--%i� �—�aj�':..�. 24.3 •107. '; CO 369 °Q ` ., E ....n� .e EdSt u Aa V1f 325-3�9 - �.''�_�- _ y �r �'��.� A` . c i�;.:,•:.. .;i.;....:._2.. � OSTFRV ILLE a_.� ..�! :. .. 4.•. Figure 5. " U.S.G.S. Hydrologic Investigations Atlas Map with site locus" Groundwater contour Presumed flow direction indicator _4_ 3. Brief description of current uses (products made, materials used, ' wastes generated, etc. ) : This site is known as Windmill Square; a collection of about 20 businesses. None of these businesses produce any wastes within ' the purview of M.G.L. C.21E. t 4. Brief description of former uses of site (type of usage, dates of such use, and other information relative to waste generation and ' disposal) : Previous to 1984, when construction for Windmill Square was started, ' -this property was undeveloped and wooded land. 1 1 ' S. Current and former uses of surrounding properties: This site is abutted to the: ' North by Pecks Boatyard previously a gas station, since the 50's and J.L. Lawrence Funeral Home. East by Putnam Ave. then residential and wooded areas; ' South by residential and wooded areas; West by Putnam Ave. then wooded- areas. 1 1 1 -5- ' 6. List of environmental permits held by current and former site owners: ' None 7. Summary of prior citations of fines for violations of environmental regulations: ' None ' IV. Summary of Site Inspection and Investigations 1. Persons interviewed relative to site history and use (names, addresses ' and telephone numbers) : Joe Breen/Jim Waskiewicz, 3821 Rt. 28 428-1985 ' Chief Farrington, Centerville/Osterville Fire Dept. 428-2467 Thomas McKeon, Barnstable Health Dept. 775-1120 2. Surface soil and sediment sampling locations, methods and analytical results (see attached site plan) : Surface soils: All surface materials and vegetation was inspected . for stress, odors, staining or discoloration as evidence of surficial contamination. Sediments: ' Test pit locations and logs (if any) : ' Analytical results: Interpretation of results: See conclusions i 1 3. Surface water sampling locations and analytical -results (see attached site plan) : N/A Ponds or lagoons: ' Streams: ' Springs: Springs or .leachate breakouts on slopes: Analytical results: Interpretation of results: 4. Subsurface soil and groundwater samplings, locations and analytical ' results (see attached site plan) : See Figure 3 for well locations. Boring locations and logs: See Appendix ' Monitoring well locations, elevations and logs: 3 monitoring wells were advanced to the watertable and groundwater samples from each well was ' analyzed for purgeable hydrocarbons. Subsurface soil sample depths: ' Groundwater flow rates and directions: Direct flow,measurements indicate flow to be southeast at approximately 2-3 ft/day. See Appendix Analytical results and interpretation: See conclusions 5. Other sampling locations and analytical results: N/A Underground tanks: ' Discharge lines: .. . . . . i ' Lagoons and pits: ' Analytical results and interpretation: %i.I - �•,t iii°' a _- - _ r _ - 'e�' -; .�i�.', .i.^:;. 1., i 'L.. i.; .c zn po \ �• �•' - •`yam=:- ..:��..-.• P .l� Ha mblin -} :Ea:i _::ir. •� ¢;::.. Pond ::=`!;,•..i•. PA 21 3 Q kS.. '7�•:. a :\', 'c:. :Yr» 'c:�:: :.�:.. �?t•�.r.^'�A'••i r;- .O.• ..e:, .PD71/I �. ,. . ... - z r' ay pEBY- - f: 93 0 -•-i7f 1 R.. R. - O 1: Qv oLD :• :�' y�♦J� jjf _ 1 _ oD. .Fi - 1 f :13 'a ............. ••o i / f _ 1 .N: •:•V. vvv - 1 anbesl 5c •/• r - :•c:Fc:• Bois. Y7r: - •� :i 0' 1 n-: t t ad ., n•. r •t is 5• O - -:L w I.' C , al x•- t t Y .a 1 - iC a t' ,}�' '�e'i'::;::.F.!-:oily• ,•. .Q:c: .0. ::.�•;:. QY- Sii - :.-��''�•::-� ��i 11" 1• y P,n• 1 Rn0 .1 I Lr.o r r b .J /h _ l Y• 9 St Mar Y ,•f•: Isl•no 0 �t P t ll 1 .. Y I d\ q 11 •o s De a :r^ I i .I� 1 a l _ i . J„ •■ � :,fir: :�i�•:. _ 6 '�•9: :p4 : "F- / i:`n%�::�,?:}.:; ? � � `Qom`• �. .i •ii' •:'j)::i:t.Y '[ `v\` _ L i t t l e l a l a rl d `.�`/F � � •����.' �:::�• fit:� LmHand wr i 7St• f /} �iuu e s. Noir J G� Htrt]ors •' .1 n Figure 6. C.C.r.E.D.C.. Map with site locus: • Municipal pumping stations 1 QZone of Contribution (stippled) ' -7- 6. Results of other geophysical investigations conducted (if any) : N/A Magnetometer survey Seismic survey: ' Electrical resistivity survey: ' V. Conclusions 1. Indentification of persons conducting the site inspection and ' investigations: Address or Name Affiliation Qualifications Steven Mateus K-V Associates, Inc. Geologist Jon Soderberg K-V Associates, Inc. Chemist 2. -Conclusions of the inspection and investigation (including any ' limitations thereto) : ' It is the finding of K-V Associates, that by the rigorous application of standards which are within the purview of M.G.L. C 21E, the site is presently impacted from a release of tetrachloroethene (PCE) . Because Cape Cod has . been designated as a sole source aquifer, any groundwater, regardless of its ' not being in a designated zone of contribution to a supply well, must nevertheless be considered. at least a potential source of drinking water, and must therefore meet primary drinking water standards. Under the. 1986 ' ammendments to the Safe Drinking Water Act, the maximum level of PCE allowed in drinking water is 5 parts per billion (ppb) , whereas a level of 60 ppb was found in groundwater at the site. Although the site lies outside of. the zone of contribution for municipal supply wells, the assessment is complicated by the fact that domestic supply wells are located downgradient from the site. . A thorough assessment ' of the public health/environmental impact of this finding would require identification of downgradient private water supplies and concomitant analyses of water quality. ' Of major concern in terms of potential liablility considerations is establishing the source of the PCE release. Of immediate concern, in terms of 21E certification, is proof that the release did not originate ' at the site, but instead has been passively impacted. In the event of a release, it is the policy of DEQE, under c. 21E, to designate a responsible party rather than implicate the victims of a release. 1 The use-activity of the site is well known as described in this report, and it lends little support to the probability that there was a release of PCE from the site. Upgradient of the site, on the other hand, there are, and have in the past been, a number of activities which could be associated with the mismanagment of PCE. PCE is an excellent solvent for degreasing and paint removal, and it is difficult to prevent its ' clandestine use in engine maintenance. PCE is also the most commonly used dry cleaning solvent. It should be noted that upgradient, across Rt. 28, are a marine engine maintenance and a painting shop of a boatyard, a dry cleaner, and a former salvage yard that stored a catholic variety of government surplus material. It is therefore recommended that additional monitoring well(s) be installed across Rt. 28, and upgradient groundwater analyzed for PCE. If comparable levels of PCE should be found, it would indicate that the present site is not the source and that it would not be considered ' liable under c. 21E. t 1 ' SERVICE CONSTRAINTS ' Much of the information provided in this report is based upon personal ' interviews and research of all available documents, records and maps held by the appropriate government and private agencies. This is subject to the limitations of historical documentation, availability and accuracy of pertinent records, and the personal recollection of those persons contacted.. ' An initial site investigation took into account the natural and man-made ' features of the site including any unusual or suspect phenomenon. These factors combined-with the site's geology, hydrology, topography and past and present land uses served as a basis for choosing a methodology and location for subsurface exploration as well as groundwater and subsurface soil sampling. The subsurface data generated is meant as representative overview ' of the site. The location and analyses of soil, groundwater and ,surface water samples was based upon the same considerations listed in the paragraphs above. The samples were analyzed for those parameters unique to the site as determined ' from the preceding site evaluation. The results indicate the condition of the subject site at the time of the investigation only. 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 PURGEABLE HALOCARBONS-METHOD E,01 -------------------------------- Windmill Sq . Ai ndmi 11 Sq . MW-1 MW-2 1 . BROMODICHLOROMETHANE ' L BROMi iFORM ND<2 ND<2 3, BROMOMETHANE ND<5 ND<5 ' 4 .. CARBON TETRACHLORIDE ND<1 ND<1 5 . CHLOR.OBENZEh•lE h1D<2 ND<2 G . GHLOROETHAtdE 7 . 2-CHLOROETHYLYINYL ETHER ND<5 ND<5 S . CHLOROFORM ND<2 ND<2 ' 9 . CHLOR.OMETHANE 10 . D I BROMOCHLCiF:.i=METHANE ND<'2 h•.JD<.'2 ' 11 . 1 ,2-D I CHLOR BENZENE ND f 2 h•D:2 12 . 1 , -DI CHLOROBENZENE h1C?<2 NC?<' 13 . 1 , 4-D I i_HLORC BENZENE ND<2 ND<2 ' 14 . DICHLORODIFLUOROMETHANE rJD<2 h.Jr;<;2 I 15 . 1 ,1-DI CHLOROETHAtdE hlD<2 ND<2 ' 16 . 1 ,2-DICHLOROETHANE ND<1 ND<.1 17 . 1 ,1-DI CHLOROETHYLENE M1JD<1 hJC?<1 ' 18 . t r an=.-1 , 2-D I CHLOR�METHYLENE t•' D e 2 ND<2 19 . 1 , -DI CHLORC iPROPINE ND<2 ND<2 ' 20 . cis-1 ,3-D I CHLOR.+�PROFENE r..lD<2 ND<2 21 . trans-1 ,3-DI CHLOROPROPENE 04D<2 ND<2 22 . METHYLENE CHLORIDE ND<2 ND<2 pIIR.GEABLE HALOCAR.E I-%IS—METHS D 601 -------------------.------------- 4,iindmill sq . Viindmill Sq . --t-111-1-1--- --r — --- ' ' TETR.ACHLOROETHANE ND<-2 t•ID<22 23 . �— i C 24 . TETRACHLOROETHYLEtAE G ' t,.ID{'2 t.IC:2 25 . 1 ,1 ,1—TRI CHLOROETHANE ' 2G. 1 , 1 ,2—TRI CHLOROETHANE t�JL?:'2 t--.lD!2 PdGti;;1 [AD C1 27 . TRI CHLOR.OETHENE ' _ ' T t lD:2 ND`2 F:I C'HLOROFL��i-�F;�=�t�tETHHPJE I NYL CHLi iR I UE t c I PURGEABLE HALOCARBONS—METHOD G01 -------------------------------- ' Win drnill Sq . NW-3 ' I . BROMODIC:HLOROMETHANE ND<2-- �. EROMOFORM ND<2 3. BROMOMETHANE ND<5 ' 4. CARBON TETRACHLORIDE ND, 1 . CHLOROBENLENE ND<2 ' 6. CHLC iR OETHANE ND<5 ' 7. 2—CHLOROETHYLVINYL ETHER ND<5 S. CHLOROFORM ND<2 ' 9 . CHLOROMETHANE ND<5 10 . DIBROMOCHLOROMETHANE ND<2 ' 11 . 1 ,2—DICHLOROBENZENE ND<2 12 . 1 , —DI C:HLOROBENZENE ND<2 ' 13. 1 , 4—DICHLOROBENZENE- ND<2 ' 14 . DI CHLi�R.ODI FLUORi METHANE ND<2 15. 1 , 1—DICHLOROETHANE ND<2 ' 16 . 1 , 2—DICHLOROETHANE ND<1 17. .1 ,1—DICHLOROETHYLENE ND<1 18. trans-1 , 2—DI CHLOR!iETHYLENE ND<2 ' 19. 1 , 2—DICHLOROPROPANE ND<2 20 . cis-1 , "3—DI CHLOROPROPENE ND<2 ' 21 . trare._-1 , 3—DICHLOROPROPENE ND<2 . METHYLENE CHLORIDE ND<2 PURGEABLE HALO=ARBONS-METHS D 601 -------------------------------- Windmill Sq . Mw-3 23 . 1 ,1 ,2, TETR.F-`CHLOR ETHA E ' 34 . TETRAC:HLOROETHYLENE r 25 . 1 ,.1 ,1-TRIrHLOROETHANE ND<3 ' 2-6. 1 ,1 ,c-TRIDHLOROETHHN� ND<3 2'7. TRICHLOROETHENE ND<1 28 . TRI CHLOROFLUOROMETHAtilE ND<'1 ' 29 . VINYL CHLORIDE ND<1 PURGEABLE AROMATICS—METHOD 602 ------------------------------- Windmill Sq . Windmill Sq ' ----JJ-1--- ---- ' 1 . BENZENE ND;1 ND<l 2 . GHLOROBEN=Et',JE ND<l N D<I ' 3. 1 , 2—DI GHLQRQBENZENE ND<l ND<l 4 . 1 ,S—DI GHLOR iBEN12EENE ND<1 ND<l ' 5. 1 , 4—DI i_HLOROBENZENE ND<l t' D%l cam. ETHYL BENZENE ND<l ND<l 7 . TOLUENE ND<l tJD<1 ' 8 . :<`(LEt.JE_' ND tJ1)<1 I, 1 1 PURGEABLE-AROMATI CS—METHOD-602 Windmill $q . 1 MI-1-3--- ---_ 1 . BENZENE' ND41 1 2 . CHLOROEENZENE ND<1 3 . 1 ,2-D I CHLOROBENZ ENE ND 41 i '_C 4 . 1 ,3-DICHLOROBENZENE ND<1 ' 5 .. 1 , 4-DI CHLOROBENZENE ND<1 6 . ETHYL BENZENE ND<1 1 ? . TOLUENE ND<1 8 , /X LENES ND<1 1 1 1 1 i 1 1 1 i GROUNDWATER FLOW WORKSHEET For use with K-V Associates, Inc. Groundwater Flowmeters, 4 channel probe 1 Table of LCD Readout ' 1-�N A B C Operator: ftl '<' S Date: 61 el-1 ' Probe Station: h1/� w 7 _ Time:�� •e ,e- pair a CF ,"o ? i Y•;'" `'u Location: +1/-6 Soil Conditions: / 7 O 0 ,. Depth to Measurement: '�%� +3/-8 1 b �' +4/-9 �p ►.cin Z9 ,of ?nf— s 0 ON ' 340' 20 ROTATE PROBE 1800 AT SAME DEPTH 9 320 2 / 40 D E S F G e Probe 4300 60 ' &/ N-S pair o2 e F +1 /_6 �� 17a l3 i3� ��� 280 80 +2/-7 /Z �l3 t 7 ,2 3 ® W E �3 -r +3/-8 0 / 13 1 113 i�I 6 260 100 +4/-9 ko1 ( 25 ' 240 .50 120 15 220 140 7 4 Use of Table goo - 200 160 COLUMN G - Divide each reading in 180S column F by the largest absolute value. Draw these 4 vectors on the circle ' chart according to the scale provided Vector Resolution to Determine Direction (i.e. strongest vector 1.00). . 1. Use KVA Vector Addition Program(Ti-se/s9•HP41C)Calculators OR ' Cosine Test Shows Uniform Flow 2. Solve graphically by placing 4 individual vector 71 segments sequentially head to tail. (See manual Vector end "oo for detailed instructions). points will closely fit a circle in- .71 ' scribed about the Velocity Determination longest vector. Refer to your calibration curve of readout versus Values in column G FLOW 'will approximate vector preferred units of flow (e.g. feet per day). lengths shown at right. Direction: 1/1 Velocity: 1 _77 Form 104 available from your local K-V Associatel,( le la er. - Copyright 1981 K-V ASSOCIATES, INC., Falmouth, MA 02540 9/82 i i K-V ASSOCIATES, INC. 281 Main St., Falmouth, Ma Test Pit Number �w?i PROJECT DATE PROJECT NUMBER tLOCATION v COMPLETION DEPTH BELOW GRADE ' SURFACE ELEVATION TOP OF WELL ELEVATION WATER TABLE ELEVATION 6 0o / ' Sampe Depth D apth Sample Soil nd SOIL DESCRIPTION screen REMARKS Number Porosity ' length �/2�� j% �cc.v✓� ' �j / I iJ2&n 6'J-vorz (y SQ 5-I)q-v\c3 dl CL-o GvV\C� C'- —14 rLe ' Proportions Used:Trace = 0-10% Some = 10-35% And = 350-50%. TYPE WELL SCREEN INSPECTOR it K-V ASSOCIATES, INC. 281 Main St., Falmouth, Ma Test Pit Number Mu-)I- PROJECT DATE PROJECT NUMBER 60 1 LOCATION r COMPLETION DEPTH BELOW GRADE �111 1 SURFACE ELEVATION TOP OF WELL ELEVATION WATER TABLE ELEVATION 60 1 Sampe Depth Depth Sample Soil SOIL DESCRIPTION screen REMARKS Number Porosity length 1 s A,d 1 7 2 a C-T b2�l � ,-�c� -vc, 1 1 ll lnn-e i 1 _ 1 1 1 ' Proportions Used: Trace = 0-10% Some = 10-35% And = 35'-50°; TYPE WELI, SCREEN INSPECTOR i ' K-V ASSOCIATES , INC. 0F9) 0 L LQ)(0 281 Main St., Falmouth, Ma Test Pit Number /!ice ' PROJECT DATE PROJECT NUMBER ' LOCATION COMPLETION DEPTH BELOW GRADE ' SURFACE ELEVATION TOP OF WELL ELEVATION WATER TABLE ELEVATION ' Sampe Depth D epdth Sample Soil SOIL DESCRIPTION: screen REMARKS Number Porosity ' length A S`2v" L'�'w cw 1 � Yt,1 ., cl� n v\ , P-z>-d 'S?�, IM -G �2ct. C-C C- C J \ ' � � �r5�►�� Vv,c �sf� � �- - weed `.� ' 1 1 ' Proportions Used: - , * PER = 0-10% Some = 10-35% And - 35w/.-50 . TYPE 4,ELL SCREEN I.l S- I K-V ASSOCIATES , INC. 23O0 L LMR 281 Main St., Falmouth, Ma Test Pit Number /�I� tPROJECT DATE PROJECT NUMBER ' LOCATION COMPLETION DEPTH BELOW GRADE SURFACE ELEVATION TOP OF WELL ELEVATION WATER TABLE ELEVATION 1 Sampe Depth Depth Sample Soil and SOIL DESCRIPTION screen REMARKS Number Porosity length 0 4-y�� � F 2wv I ' Proportions Used: , INSPECTOR Trace = 0-10% Some = 10-35% And = 35%-50% TYPE WELL SCREEN 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ' K-V ASSOCIATES, INC. tSteven Mateus Geologist ' EDUCATION 1981-85 - Boston College; B.S. Geology. 1984 - S.E.P.M. Course; Mechanics of Sediment Movement, Southard , J. , ' Middleton, G. 1979 - Northeastern University; Geology, Oceanography. 1978 - Framingham State College; Chemistry, Computer Science. ' Areas of Study: Hydrology, Structural Geology, Geophysics. POSITION HELD ' 1987- - Geologist - K-V Associates, Inc. , Falmouth, MA 1986-87 - Physical Science Technician U.S. Geological Survey, Woods Hole, ' MA. Prepared core samples and concentrated and isolated invertebrate fossils ; maintained, curated and stored paleontologic and sed imentologic collections; worked with field data to produce bathymetric maps of continental shelf and ' slope structures. 1985-86 - Sedimentation Laboratory Technician - U.S. Geological Survey, Woods ' Hole, MA. Prepared bulk samples and performed size analysis using sieves., centrifuge, Rapid Settling Analyzer and Coulter Counter and interfaced data with sed lab computer software; performed mineralogical analysis using x-ray tdiffractometry; trained personnel on sed lab equipment and procedures. FIELD EXPERIENCE ' 9/86 -'R/V OCEANUS (U.S.G.S., W.H.O.I.) Continuation of an environmental impact program monitoring the hydrocarbon exploratory drilling on Georges Bank using Niskin sampling bottles, gravity as well as hydraulically damped corers and sediment grab samplers. 7/86 - R/V . EDWIN LINK (U.S.G.S. , N.M.F.S. , N.O.A.A.) Determination . of ' sedimentary processes, currents, fauna and habitat on Georges Bank using a submersible vehicle (Johnson Sea Link) , side-scan sonar, high-resolution seismics and sediment sampling (grab samplers and corers) . 4/86 - R/V GLORIA MICHELLE (U.S.G.S., N.M.F.S.) Reconnaissance bathymetry of Corsair Canyon using a high-resolution seismic reflection profiling system and ' a Northstar Loran-C navigation system. 10/85 - M/V FARNELLA (U.S.G:S. , I.O.S.) Ocean bottom mapping of the Exclusive ' Economic Zone (E.E.Z.) in the eastern Gulf of Mexico using GLORIA side-scan sonar, a gravimeter and high-resolution seismic reflection equipment. 1 tPUBLICATIONS/CONFERENCES 1987 - Bathymetry and Surficial Geology of Corsair Canyon; Valentine, P.C., Mateus, S.J. (in press) . 1985 - Conference on Science and Policy of Boston Harbor and Mass Bay. 1985 - Geologic Society of America, Sectional -Meeting. ' 1983, 1981 - New England Intercollegiate Geologic Conference. II G i 1 KN ASSOCIATES, INC. V ANALYTICAL SYSTEMS ' 1 281 MAIN STREET FALMOUTH, MASSACHUSETTS 02541-9981 508-540-0561 ►9C6FD Greg 11clsaac ' Windmill Square Rte. 28 -1STDn5 �1S Centerville, MA 02632 1 Dear Mr. Mclsaac; The following is an addendum to M.G.L. C. 21E site investigation conducted by K-V Associates and dated June, 1988. In July, 1988 a fourth groundwater monitoring well' was installed 1 on, the north side of Route 28, directly across and upgradient of the monitoring well on the Windmill Square property which was most. highly impacted by tetrachloroethene. A groundwater sample was obtained and. analyzed for volatile chlorinated solvents by EPA method #601. As was the case at the downgradient location of Windmill Square, the only detected 1 contamination was tetrachloroethene at a concentration of 2 ppb. (See location map certificate of analysis attached) . 1 It is the judgement of K-V Associates that there is at least a 95% probability that the tetrachloroethene detected in ground water at ' Windmill Square and upgradient north of Route 28 are manifestations of the same source of contamination which was not due to release from Windmill Square. This judgement is predicated on the following i observations: 1. The only contaminant out of the total number of compounds which 1 are identifiable within the EPA method n601 matrix was tetra- chloroethene (PCE) found in both locations. 1 2. PCE found north of Route 28 could not be a result of migration against the groundwater flow directions from a release in the ' Windmill Square site_ but conversely PCE found at Windmill Square could be the result. of a release from numerous potential upgradient 1 sources. 3. Directly upgradient from the Windmill Square site the following activity was observed which in the judgement of K-V Associates ' would have significant potential of engendering a release of PCE. 1 a. The boatyard directly upgradient of the site maintains active engine repair and painting activities with conspicuous storage of painting solvents and lubricants/fuel/solvent chemical storage in drums, buckets, and cans. ed. repair and maintenance activities, during a b. In addition to manag field inspection on July 14, 1988, it was observed that customers ' boats were cleaning/repairing boat hulls and engines with stored after normal working hours in what appeared from a distance to be ' unsupervised activity. c. There were numerous surficial stains on the: unpaved ground at the rear of the boatyard that appeared to be related to boat maintenance. pgradient of the boatyard, north of Industry Lane, a single d. Directly u ' toring business commercial complex houses an antique furniture res as well as a commercial painting business. Antique furniture restoration typically involves stripping of old varnish and paint ' and the most effectiveg agents used for this purpose are chlorinated solvents such as PCE and trichloroethylene. e. Also directly upgradient are remnants of a building and construction salvage yard which in the past was well known to have stored various military surplus solvents/fuels/paints. f. Another activity directly upgradient is a cast-iron stove ' commercial outlet. Many stove castings are made in the Far East and shipped to the U.S. packed in cosmoline-type grease. Degreasing solvents ubiquitous .to the metal finishing industry are chlorinated solvents such as PCE. g. Upgradient, and slightly laterally to the. west is a dry cleaning shop. The standard solvent used in dry cleaning is PCE, where the solvent is typically furnished in 50 gallon drums. ' Given these observed upgradient potential sources of chlorinated solvents, it should be noted that in order to produce contamination at the 60 ppb ' level as seen in one well at Windmill Square, an upgradient release of a large fruit juice can of waste PCE is sufficient to contaminate a downgradient section of groundwater 100 feet wide by 1,000 feet long by 10 feet deep at the 60 ppb level. . 1 1 1 _ e objectives for establishing condition of non-liability in a M.G.L. 1 c. 21E site investigation is a determination that an uncontrolled release of oil or hazardous materials has not impacted the property, or if found, that there is unequivocal evidence that the site has been passively and innocently impacted by an off-site source. Had comparable levels of PCE been found at the upgradient well, MW-4, as was found on the Windmill 1 Square property, the second condition would have been unambiguously . fulfilled. While the lower levels found preclude such a direct deduction ' on its own merits, the circumstantial evidence that Windmill Square is not the responsible party is most convincing. 1 Additionally, there is no justification for even contemplating any form of remedial action with its concomitant expense on the strength of ' the level of groundwater contamination found at Windmill Square regardless of responsible party designations. The only justifiable reaction would be ' to further monitor the level of PCE in groundwater at the site to attempt to provide documentation that the observed phenomenon was a transitory impact from upgradient released contamination. 1 It is therefore suggested that because the findings of assessment strongly imply, at whatever degree of seriousness, that a more expansive groundwater quality problem has been revealed than simply' a provincial impact upon the client's property, it is therefore recommended that ' quarterly monitoring of groundwater at the site be undertaken in cooperation with the Centerville-Osterville Water Department until there is either no further evidence of contamination at the site or a responsible party is ' identified. It would be expected that sufficient information to un- equivocally establish site conditions could be obtained within a year ' at most, and probably much sooner. For K-V Associates, Inc. , 1 'Jon Soderberg ' Project Manager 1 - GROUNDWATER FLOW WORKSHEET For use with K-V Associates, Inc. Groundwater Flowmeters, 4 channel probe Table of LCD Readout � ' Operator: � Date: N A B C ' Probe W41b Station: W Lf P�'6r_' Time: ypair Location: Soil Conditions: +2/-7 + 6 /IL 1 y Sy Depth to Measurement: Lt +3/-8 - ON ' 340' 20 R TATE PROBE 1800 AT SAME DEPTH 9 320 / 40 2 S D E S F G e obe 4. a ° N_S k 300 60 it c } a e 4i 2 F �. 1 / 6 a� � /I 280 80 2/-7 +� LLL+ — I2y� ® W E Q 3/-8 �� —`I + -77 _ 260 5 100 4/-9 S— �`f .`� a-� ' ll -2 v r 240 120 7 220 140 A� 0 e of Table 200 160 COLUMN G - Divide each reading in 180S column F by the largest absolute value. aw these 4 vectors on the circle rt according to the scale provided Vector Resolution to Determine Direction .e. strongest vector.= 1.00). 1. Use KVA Vector Addition Program(Ti-sa/s9-HP41C)calculators OR %sine Test Shows Uniform Flow 2. Solve graphically by placing 4 individual vector Vector, end .71 segments sequentially head to tail. (See manual t.00 for detailed instructions). points will closely Ja circle in- .'t Velocity Determination ibed about the longest vector. Refer to your calibration curve of .reado.ut versus VIgths ues in column G FLOW preferred units of flow (e.g. feet per day). 1 approximate vector shown at right. n -T Direction: N1 M AJ Velocity: 1 12� Form 104 available from your local K-V Associates, Inc. dealer. iQgi -_V AR 1; INr__ FAIMniIth_ Ma._ nordn aitt9 ASSOCIATES, INC. 09AL LQ)0 281 Main St., Falmouth, Ma Test Pit Number M PROJECT DATE PROJECT NUMBER �E of -P CA0M _ Z 1 F A �� o C/-liq LOCATION C011PLRTION DEPTH BELOW GRADE SURFACE ELEVATION TOP OF WELL ELEVATION WATER TABLE ELEVATION Sampe Depth Depth Sample Soil and SOIL DESCRIPTION screen REMARKS Number Porosity length CvA�JF SA �� D STA��v►,VG S v--t C ]- /cu ?dcFS. o IL E T-f FI�vl=- Proportions Used: Trace = 0-10% Some = 10-35% And = 35'-50`; TYPE WELL SCREEN INSPECTOR i BARON CONSULTING CO. HARRY AGAHIGIAN,Ph.D.,DIRECTOR analytical services . P.O. BOX 663,ORANGE CT.06477 ' July 18, 1988 To: Mr Jon Soderberg KV Associates Inc ' 281 Main Street PO Box 574 Falmouth, MA 02541 t Re: Analysis of 1 water sample (recheck) ' BC# 60607 The sample was analyzed as per EPA method 601. Results are listed on the following pages in ug/l (ppb) . ' If you have any questions please notify us. Timothy Fusco ' Chemist TF/dc encl 1 This report h. toduced for advertising or other purposes over our signature without express writte 'ng the use of these results. 130 DAYS AFTER RECEIPT OF REPORT ' Laboratory No.0440 EPA Number CT015 LABORATORY LOCATED AT 273 PEPE'S FARM ROAD, MILFORD, CT 06460 (203)874-5678 FAX: (203)874-7863 PURGEABLE HALOCARBONS-METHOD 601 ' -------------------------------- RESULTS ARE IN PPS. SC# 60607 ' MW-4 609-1A ' 1 . BROMODICHLOROMETHANE ND<2 2 . BROMOFORM ND<2 3. BROMOMETHANE ND<5 4 . CARBON TETRACHLORIDE ND<1 ' 5. CHLOROBENZENE ND<2 6 , CHLOROETHANE ND<5 ' 7 . 2-CHLOROETHYLVINYL ETHER ND<5 ' 8. CHLOROFORM ND<2 9. CHLOROMETHANE ND<5 ' 10 . D I BROMOCHLOROMETHANE ND<2 11 . 1 ,2-DICHLOROBENZENE ND<2 1 12. 1 ,3-DI CHLOROBENZENE ND<2 13. 1 ,4-DICHLOROBENZENE ND<.2 t 14 . DICHLORODIFLUOROMETHANE ND<2 ' 15. 1 ,1-DICHLOROETHANE ND<2 16 . 1 ,2-DICHLOROETHANE ND<1 ' 17. 1 ,1-DICHLOROETHYLENE ND<1 18. trans-1 ,2-DICHLOROETHYLENE ND<2 ' 19. 1 ,2-DICHLOROPROPANE ND ,2 ' 20 . cis-1 ,3-DICHLOROPROPENE ND<2 21 . trans-1 ,3-DI-CHLOROPROPENE ND<2 ' 22. METHYLENE CHLORIDE ND<2 IRON CONSULTING CO. 273 PEPES FARM RD. , MILFORD, CT 20.3-874-5678 1 i PURGEABLE HALOCARBONS-METHOD 601 ' -------------------------------- PAGE 2. RESULTS ARE IN PPB. 1 ' MW-4 609-1A ' 23. 1 1 2 2-TETRACHLOROETHANE ND<2 t24 . TETRACHLOROETHYLENE 4 25. 1 ,1 ,1-TRICHLOROETHANE ND<2 t26. 1 ,1 ,2-TRICHLOR.OETHANE ND<2 27. TRICHLOROETHENE ND<1 28. TRICHLOROFLUOROMETHANE ND<2 ' 29. VINYL CHLORIDE ND<1 1 1 1 t RON CONSULTING CO. 273 PEPES FARM ROAD, MILFORD, CT 203-874-5678 i+%- �c. =��.�. K.��� _�• ?i��a`3�a`�`"�F-('r*�''A 7 m. v��� .f '•'s__i C � ,}�i s � \;' _ 7 r �� ',�ry'•�-y„�^�• 1��..et � HK-VYKASSOCIATESINC.' Z�, - � ,F_.a.-r-e. - a � L v.K^e -' •'iS '� a• >k- , fA s; ANALYTICAL'SYSTEMS" - ...._,rxta.:a._...�J 281 MAIN STREET • FALMOUTH,MASSACHUSETIS 02541-9981 • M540-0561 ' Greg McIssac August 25 , 1988 windmill Square 3821 Route 28 ' Building 11 , Suite 8 Marstons Mills, MA 02648 t SUBJECT: Chapter 21E Site Assessment Update , K-V Contract # 609 . This . letter-format report should be considered an 'addendum to, and be included with the Chapter 21E Site Assessment for ' Windmill Square which was prepared by K-V As 1988. sociates in June, ' SCOPE OF WORK On August 10, 1988., three (3) monitoring wells which were ' installed during the course of the original site assessment and the upgradient monitoring well installed during the first round of additional work, (K-V contract of July 6 , 1988) were sampled and the groundwater was analyzed for purgeable ' chlorinated hydrocarbons by EPA Method # 601 . (Well locations, see Figure 1 ) . RESULTS ' The results of the analysis are given in Table I . .t TABLE I SAMPLE TETRACHLOETHYLENE CONCENTRATION (ppb) MW-1 ND MW-2 17 MW-3 ND MW-4 5 It should be noted that the concentration of ' tetrachlorethyene found in groundwater at MW-4, 5pp6 is at: the maximumiDer issilble level which is allowable .under DEQE guidelines . While the evel found in MW-2 , 17 ppb exceeds ' that allowable under the guidelines , it is considerably less than the maximum concentration allowed by EPA in municipally supplied potable water. (40 ppb. ) ' DISCUSSION • The observed pattern of low-level concentration of tetrachoroethylene in the impacted wells, and the changes ' observed fr om the results of previous sampling is in full . accord with the conclusion submitted by K-V Associates and expressed in a letter report dated July - 1988• - Viz: Low levels of groundwater contamination are being observed at Windmill .Square as a direct consequence of the site being passively impacted by upgradient source(s) . Furthermore, the situation is dynamic with discrete slugs of low level contaminated groundwater impacting the site. This is shown by the fact that MW-1 , which in the first round of sampling and analyses had the highest level of contamination is now free of contamination, and MW-2, which previously showed no tetrachoroethylene, is now impacted with a low but substantive level of tetrachloroethylene. In addition MW-4 up gradient of the site has show to P9 n w levels of tetrachloroethylene contamination on both rounds of. sampling. Furthermore, MW-2 is immediately downgradient of the Cotuit ' Commons Shopping Center rather than Pecks Boat Yard, and thus would imply that some contamination might be originating from the shopping center or- even further upgradient. CONCLUSION ' It is the best engineering judgement of K-V Associates that there has not been a spill , release or other mismanagement of oil , chlorinated solvents, ar other hazardous materials at this site. Furthermore, while the site is being passively ' impacted by unknown- upgradient source(s) , the present levels and - areal extent of groundwater contamination do not pose a sufficient threat to warrant that further immediate action be ' taken . It is therefore recommended that the results of this ' investigation be provided to the Centerville/Osterville Water Department as a background information on regional groundwater quality, and that, if concerns are raised about water quality for the domestic wells located downgradient of t Windmill Square, that a more comprehensive monitoring program be inititated by the Town of Barnstable. ' Prepared by; ' Jon Soderberg Environmental Chemist K-V Associates, Inc. ' JS/kg 1 1 Mw ' RT 28 o J. i, mw a o I, 4z i 0 4 1 O � 0 1• o ,1, a •t� P�� • ' Figure l . " Site sketch showing approximate locations of: " Dumpsters 1 O Septage areas_ Q Catch basins ' Monitoring Wells Groundwater flow direction indicator ' ® Commercial Buildings paved area grassed or landscaped areas W W . . ...._. CO. „Ph.D.,DIRECTOR analytical services P.O. BOX 663,ORANGE CT.06477 August 18, 1988 ' To: Mr Jon Soderberg KV Associates Inc 281 Main Street t PO Box 574 Falmouth, MA 02541 samples . Re: Analysis of 4 water sam p BC# 61269 The samples were analyzed as per EPA method 601. Results are listed on the following pages in ug/1 (ppb) . If you have any questions please notify us. ' Timothy Fusco Chemist ' TF/dc encl 1 This report is submitted with the understanding that it is not to be reproduced for advertising or other purposes over our signature without express written permission from us. We do not accept any liability concerning the use of these results. NOT RESPONSIBLE FOR SAMPLES LEFT OVER 30 DAYS AFTER RECEIPT OF REPORT Connecticut. Public Health Laboratory No.0440 EPA Number CT015 ' LABORATORY LOCATED AT 273 PEPE'S FARM ROAD, MILFORD, CT 06460 (203) 874-5678 FAX: (203) 874-7863 RESULTS ARE IN PPB. ,:- BA 61269 Windmill Windmill Windmill Windmill Sq MW-1 Sq MW-2 Sq MW-3 Sq MW-4 BROMODICHLOROMETHANE ND<2 ND<2 ND<2 ND<2 �. BROMOFORM NL►<:2 ND<2 ND<;2 ND<2 BROMOMETHANE ND<5 ND<5 ND<5 ND<5 4. CARBON TETRACHLORIDE NDQ NDQ NEK1 ND ::1 �. CHLOROBENZENE ND<2 ND<2 ND<2 ND<2 6 CHLOROETHANE ND<5 ND ND.<5 ND 5 '. 2-CHLOROETHYLVINYL ETHER ND<;5 ND<5 ND<5 NEK5 CHLOROFORM - NEK2 ND<2 ND :'2- ND<2 CHLOROMETHANE ND<5 ND<5 ND<5 ND<5 I F. DIBROMOCHLOROMETHANE ND<2 ND<2 ND<2 ND<2 11 . 1 ,2-DICHLOROBENZENE ND<2 ND<2 ND<2 ND<2 I. 1 ,3-DICHLOROBENZENE ND<2 ND<2 ND<2 ND<2 1 ,4-DICHLOROBENZENE ND<2 NEK2 ND<2 NfK2 DICHLORODIFLUOROMETHANE ND<2 ND<2 NEI<2 ND<2 ` 1 , 1-DICHLOROETHANE ND<2 ND<2 ND<2 NEK2 16. 1 ,2-DICHLOROETHANE NDQ NDQ NDQ NDQ 1 , 1-DICHLOF;OETHYLENE ND,::1 ND<::1 ND<:1 ND<:1 trans-1 ,2-DICHLOROETHYLENE ND<2 ND<2 ND<2 ND<2 1 ,2-DICHLOROPROPANE ND<::2 ND<2 ND<2 ND<2 cis-1 ,3-DICHLOROPROPENE ND<2 ND<2 ND<2 ND<2 21 . trans-143-DICHLOROPROPENE ND<;2 ND<2 ND<2 ND<2 METHYLENE CHLORIDE ND<2 ND<2 ND<2 ND<2 Air ON CONSULTING CO. 273 PEPES FARM RD. , MILFORD, CT 203-874-5678 - ETHOD 601 ----------------------------- PAGE 2. RESULTS ARE IN PPB. Windmill Windmill Windmill Windmill --------- -------- S - �_ -.,.. ' q MW 1 Sq MW- - - Sq MW-3 S MW-4 --------- --------- 1 , 1 ,2,2-TETRACHLOROETHANE ND<2 ND 2 ND:2 ND-:: 24. TETRACHLOROETHYLENE •.- 17 NL�.:..2 NL . 1 , 111-TRICHLOROETHANE ti =.;2� ND'•••2 ND<2 ND•:::2 • 1 , 1 ,2-TRI CHLOROETHANE ND<<2 ND<2 NU<2 NU< . TRICHLOROETHENE ND<1 NEK-1 ND 1 ND<l TRICHLOROFLUOROMETHANE ND<2 2 NU::2 29. VINYL CHLORIDE NDQ NDQ ' NDQ ND•r:1 RON CONSULTING CO. 273 PEPES FARM ROAD, MILFORD, CT 203-874-=678 —^— _ ., �, � I �� r a d � 1 fl �� '' '. r�-: �' '. �� � ,,i '. , � � �� � t} �'� � y � � I m ��, �� �� �, ���� ��� � � ,, 1 �� o �� 5 �� �I e 0 1 1 a � j f� �9 � r � � � �e