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HomeMy WebLinkAbout0058 MILLRACE ROAD - Health 58 Millrace Road Marstons•Mills A = 047 — 145 I' Date: TOWN OF BARNSTABLE OXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: G�/1 l�dA� J_ iN yl- #FS7V - USINESSLOCATI 5�- �9�Gc C' R� `4sZIA INVENTORY MAILING ADORES L O O TOTAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON: -7-24,ow '14 ` G EMERGENCY CONTACT TELEPHONE NUMBER: ZD3"" ` 'tea 4- 3if MSDS ON SITE? TYPE OF BUSINESS:46A ? 44 ,Lh-JI 'G *L 10E.V7-04 71441 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. 9 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 tGAL 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) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: AY - TOWN OF BARNSTABLE TOXIC AND ,HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: &A' ktakpi�U6 USINESS LOCATION S9 /�9.��c�,q�� � .. lA/�s��rct- ��LS A4 INVENTORY MAILING ADDRESS- � 'fir' - � 70-6 ✓''F_ 4-b CT 04R 7 TOTAL AMOUNT: TELEPHONE NUMBER: 2 0.3- -3/3— 5//2 `F CONTACT PERSON: If4 ` &r'g EMERGENCY CONTACT TELEPHONE NUMBER: ZD3 —3 g" 3/�7) MSDS ON SITE? TYPE OF BUSINESS:kd/1 srz)447/Dlt/ INFORMATION/RECOMMENDATIONS: Fire District: 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 fol owing 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 fluid Di Automatic transmissionu d Disinfectants ectants 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 Pfor 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 s Car waxes and polishes Fertilizers 1 Asphalt & roofing tar PCB's G AL Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint& varnish removers,.deg.lossers. =: _ : _ _ _ -(including-chloroform-, formaldehyde, - i _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 Z PA27- ,C/�D.y y (including bleach) Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents _ Bug and tar removers ,. Windshield wash WHITE COPY-HEALTH DEPARTMENT I CANARY COPY-BUSINESS s� TOWN OF BARNNSTABLE LOCATION�B// ��' <� %/���° �'/�.6��SEWAGE # EO/ VILLAGE,/ /, k,s;G41S / �i ASSESSOR'S MAP 6i LOTa Y 7- 1If INSTALLER'S NAME & PHONE NO. Slp fpa ��J��/1A6� � ��✓��� SEPTIC TANK CAPACITY LEACHING FACILITY:(type) / (size) — /0 O NO. OF BEDROOMS - PRIVATE WELL O �UBLICWA�TER 'BUILDER OR OWNER oo:::: IjeO �y�S DATE PERMIT ISSUED: DATE .COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �� E-11'ieN ^, &ffN IX ' / L THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEAL.T 1 1 .O F........ fe ... Appliratilan for Disposal Warkii Tomitxn.etinn Famit Application is hereby made for a Permit to Construct V-1-or Repair ( ) an Individual Sewage Disposal System at*� -_ �.. 1'l5f a s8 S .............�?'1/.. �... .� .....0O.W�. Z.?D.P-.....m.�r��,� Location-Address or t No. Own d ess nstaller Address Type of Building Size Lot_ � �j(J,J_.Sq. feet �-, Dwelling—No. of Bedrooms.............. ...................Expansion Attic ( ) (Garbage Grinder ( j '` P4 Other—Type of Building a yp g _ � No. of ersons.......... . Showers � — Cafeteria P4Other fixtures --------------------.-------•-------------••-......-----------...--- W Design Flow............... .....gallons per person peg day/ Total daily low........ lo"s.j/ 134 Septic Tank—Liquid capacity. gallons Length____d.. Width__. -- Diameter................ Depth_. �_ W Disposal Trench—No............. .... Width...__... .._._._.. Total Length.................I Total leaching area....................sq. ft. x Seepage Pit No.........I--------- Diameter...........6..... Depth below inlet.........di........ Total leaching area...2t.9 sq. f Z Other Distribution box ( � ) Dosing tank ( ) t.t. a Percolation Test Results Performed by..... " CP k.....1,1,67 e.I.Y! ..1, Date.. . . , .... � Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground wa r..�. ,_ fZ4 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water;�'. L.7_-/ / .. O Description of Soil x�..- ,�.. �_.-_ ----� Y:Z. V .....•--•••-----•-----------------•---...-----•--•-------------•----------•........-•------•----•----------•-----------••--•-------------------------•---•-------------------.........----•-•-----------. W x .............. .............•--•------•--•-•---------......-----------•-•------------•-...--------------•--------------------•-•-----••---------•--•---------••---••----------------......------•------- U Nature of Repairs or Alterations—Answer when applicable................................................................................................ ------------------------------------•--------------------------------------...----------...------------•-----------------------------------------------------------------------------------------•----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with ° the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued by the bo r f healt . Signed �- Application Approved By.................................-- ------------- T�.......................... ........... D to Application Disapproved for the following reasons: ---- --•-------------------------•------------•---•----....------------------------------------...---------------------------•----•---•--------------------------•-------------•---•--------•--•------------- Date PermitNo.............. .'.. ..................... Issued........................................................ Date -- - -- =...- ..��... - ---------------- THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) m � C IL DATA No...... ...__...... F . ........................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliratinn for Disposal Works Tons rnrtinn rrntit Application is hereby made for a Permit to Construct ( r) or Repair ( ) an Individual Sewage Disposal System at:, Location-Address - or Lot No. Owner n _Address :.. Installer Address UType of Building Slze Lot.._:'... r..`...p_...sq. feet 1-1 Dwelling—No. of Bedrooms..............y�..........................Expansion Attic ( ) Garbage Grinder ( ) p,1 Other—Type of Building No. of persons......... ............... Showers Cafeteria ( ) .�� Other fixtures..----- ---•---- -----•---r v ---...•---- --�- -• -r-•------••••-•--------•-----•-----••-- --�'?ti-----•--------•.................•---- + Deign Flow..._..... .... . nPe'r�ayTotal dolly..fl_o.w._ .W :;. .. ...... ._.. allonsPerPeoc7X :. r ....................gal gallons. WSePtic Tank—Liquid acit..�! :()gallons Length__...... Width Diameter__________ ____ Depth.f.._?_.._ x Disposal Trench—No. ................... Width-...._..,....._._.. Total Length................=.. Total leaching area....................sq. ft. Seepage Pit No.........t........... Diameter.........._..{_.. Depth below inlet........ ........ Total leaching area...A14_.°'r.- sq. ft. Z Other Distribution box (� ) Dosing tank ( ) ,n Percolation Test Results Per by...., �..t7 ✓-.--_--/ ........'-t=_ ��! !�� 'l .� � Date.;7c1= '`'' rr Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.._ _._/....... 1.'.1 J �4 4�, w Test Pit No. 2................nI>nutes per Inch Depth of Test Pit.................... Depth to ground water./:, - /-f- P4 ..............--------r-- •-----_----_-f-•_••-----•- --_•_....ti-:...-----•_. �..._.... _ ------ D Description of Soil..-------_•--_-_ '-)�:: �•/j=-= f-�= t l!'� ......=S......�-�'��------_. ....... x U --- •----------------------------------------------- ........ _-------------------- *....... W UNature of Repairs or Alterations—Answer when applicable............................................................................................... ...--•---------------------•--------------------•--------•-•------•------------•-----••----•---.....---_-_--...--•---------------_---------------------_---------•-•---------------------------•--•----• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health.-'� Signed... ' -s.. Ai',f�'/"r�?�-l/ff�✓ _` Application Approved By.................................................... ��: _ . DI Application Disapproved for the following reasons:---•--_.. ------•••••••_-•-•------•_•--•---_-••---_----••...-_•••-------_-•---__-•-•-••-•--•- ----•..................•-••_••-•_--•-_•••-•-----•_-...---___•...••••---__•••---•__••.._......--•--_••-__•..-_-_-_•-••---•--_-••-••--_••-••-••-----•_.................................................... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .. r�...... - r` A .:: ..K ...O F................... ...... Tn#if iratr of fauntpltanrr THIS IS TO CERTIFY, That the�In Individual Sewage Disposal System constructed ("f) or Repaired ( ) by....._.... .._ ./' ........ .. c=! •=jil i _1 i', ................................................ --------------------------- ------------- .. -- Installer at...................-................................. ` c ---_m l _.r}_......_ .J- L _? /!/_.:: ----------------- ............... has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated_-_..___._.______.______.___.__..___._..._...... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ��'`� DATE........................ ^fit..—.�. .......................... Inspector.......................... ;-•d....,[-..................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r - 9- I 1 f •..?.'......OF.............j....s........;:..': .:._1..f..-. (o...r. .a..:'" ... FEE........................ Disposal lVorks,�nns#r uan rrutif Permission is hereby granted...... _.."r j to Construct ( ) or Repair ( ) an Individual Sewage Disposal System u at No.-_ 1 + > ----•--------------•_•.-••----•------------•-----_------••-------_•=---••--_-_......•-• = = IY Street as shown on the application for Disposal Works Construction Permit No. '_6_" Da te am---------------•__-••-_-___•••_-_---_•-_.... ... 9. r Bo fHalthDATE = /v• _... s FORM 1255 A. M. SULKIN, INC., BOSTON v /TOWN OF BARNSTABLE �I LOCATION �d/ l// ��l° AAVSEWAGE # ,Fu VILLAGE�y,fevs / �i/� ASSESSOR'S MAP & LOTD L/'7- /V S� J � ,p � am INSTALLER'S NAME PHONE NO. S/y�yo /djt'�/��,���5' ��g��"/o SEPTIC TANK CAPACITY / a -� LEACHING FACILITY:(type (size) - ,/0 O 6 -4, NO. OF BEDROOMS PRIVATE WELL O UB=WATER Q.'BUILDER OR OWNER 1I eo !Ca-,t 6;7,4 DATE PERMIT ISSUED: DATE .COMPLIANCE ISSUED: s- -G VARIANCE GRANTED: Yes No o V IX I J JP I_ Ir f3E/V ERA 4,, IVO T,E,, A44. E1,Eli.9TiONS SHOWN ARE" � T�f s. I /� a r7 c-rJ VA-�'u ►'1. Z P/TCH A 4, LINES A M!NIAI 144 OF '18'1FT. O ZIN�,ESS` OTHERWISE SPECIFIEP ME-D, T� �?} /?� ' .3 4),L, PIPES rO ANC IN THE SYSTEM SHA4k (D 0 O O O BE CAST IRQN OR SCHEPI-11-E 40 PVC. C, A.e E- O O O `� 4 4k4, SEPTIC Td/VNS, P/STR/BUT/ON BOXE�; " ,q G' ,t/INS PIT SiYA�£. BE G'E,SICi,NEt"i J ► , _ --- �, � O o O CD TO EAR S q lZ Ate'*-t_ f.t ; '�'`J - °� M. :. - - - r t� i O FOR H-ZO WHEEd, 4 0.4PIAIG S WIVS-N iy - fi I � i f (D O � O © O 0 (D �9 IINPER P,4 t�/NG 5 TEMJVE 44,1- <JNSUlTAB�,E MA,TERIAJ., Q O � O O O C� BE�IEA Ti4ir T.IE I.'ioYEi'P? E�.FYAT/UNS - } Q (D �D O 0 O 0 0 0 OF THE OlFFU5lJR5 FOR A P16 TANC E OF T /. SANITARY TEE I: (J ) 10 A NP BAC'K'F/4 4, W/TH CLAY-FREE a _ � am4 00 . SANP .4NP GR4VE,C �,4Y/N EG A P4C04,4T/ON T Y`Pi�A P/S IT 1 IS&T14N �3OX k J RATE OF Z AfINUTES PEW INCH OR X.ESS ;.vr.�T Tc� �sC'A,�..E TYP/G'A�;. ,GEACN/N.(�� P/T . 6. THE► AC#J-_M►p_.,t�o.4RP 4F HEA,C,TH MTUS - .�_....._ � �..�..____:.ice.•:." ..,� r ,vOTE ����5'TR/BUT/ON BOX ANF G,414.. �, NOT TO SC4LE BE NG?TIF,E� YHEN THE S YSTEA-!/S NEsfR QZ3,5E9V,4T101V P17-5 _ REINFORCE-1' SEPTIC TA.NA BY TYPI A141 /500 G41,. �jEP,Tit�,. TANK cINLESS 07_H _RTDBQ.4k4, 5y,5T ` � �, r-; •- - ,- - A.NE_fs'/C.�t;'V /"Fc'Er,:�IST UR E-QUAD -- -- 7 UN,�,ESS UTHERWiSE NOTED,AL.�. SYSTEM ERc 4.r;.. , . O,ti" RA E - L M s•� ; I► rt NOT TQ SCAB.E , OBSEif'Y.4 T/ONS �Y' J Q�CS c�a�I i r:>► t CO.�HF'ONt�"NTS SHAD„(, BEE /IbST.4�„�EO /N d AVO E TANfC"S RE/NFORCE"0 THROUGHOUT 4CC01f 4NCE W/TN T/T�,E _" OF THE STATE FR BOA,fP OF HE,4'"TH W/TH El.ECTRlC PVE4.DE 49 `F'/R N E '/TH z4- %? SAN/TAR Y COPE AND ANY I,OCA4, R/_/4,ELS ► cc - A/f/fOW E.IIGINEER/NG /NC STEED.. RUI9S /N TOPS 80TTOM, W�,VICII4f94Y APF'''kY. PATE; Jeri!y e? I >:-, - CONCRETE /S 4.UDO PS/ TEST R NOTE ACCE55 M4NF/0,_E5 To ,,E,,0T/C TiQN,K z IIZ. ov A ND Z,EACH lNG PI TS TD BE SIJI,C_T LJP TD /yam f-rb I Z '' 3,CLOW F/N/SN G,QAa,E. 3 • — E.C.EV � F- —F/N/Sti c�RAP OYEf? 74rV,K � � F/N/SH GPAD,E D✓E Q -0_T E F/N/ fr viPA�E y 5 E1,EV=4°?t�o J,&t6o 1 Ol'E V 7- = ► r --_— _ � E,GE . _� z LEAGN/NG P/ �� PEAS:ONE - - u.'Y r Le�,�ti�Uv V 4 � C O O a # '" moo GAc. 1 INi/-._.. Obi _ /' 9614I /N -= isr BoxID, m �� o ® � 000 C,QUSNEO STONE ' 6110 C � + REiNFORcep (TO BE zzxzz o� N ' 4NCAtf-7-E , (r) U s i 07 F.f '���o — �. L 07 SEP77C TANK � Sao 0 O O 0 J Mff- ro � t30T TOM OF FA I T s 4yEe ( BE .+C,cve4 F ST.4.84, . -- , ,E �v _ 37 c ' 43.4 S " cu/�L«lC> `` - - - ---- r7 # '1a40. �;' i EACH/NG PJT s ( TO BE L-E VEL � 5 TA B,c.E J i ate' TYPICAL SEWAGE S Y5 T E M P�DIc_I L E f TYPICAL NOT To 5CALE (f -.NAi' SEC T%ON PARCE{, kO T A©ORESS _ C .ZONIAIG P/STiPICT_ F400,P H.4ZZ,49P .ZONE ti �Ny t-25�&A Tom" " 4�(' 4,2 i f SEAP .40C,4 T/ON OF PMEZ ZING o � �PROF�, 3FWA6E AX5100JQ4 SYSTEM � ;VJMBE'R OF EX/ST C �EDROUM,� :t�._ CJNTOUR _- _ __.__ _- 8 �`.' _ .�y� �� PER'501V.5 PER BEPRC-04f 2_.._ PROP06FP CON7`OC/R � 1 GA/, 40/11e5 PER PERSCIIV PER PAY _ RAYNCrAV EXIST SPOT EkEVA77101� r�w4 t EACNItvG RE"QU/RED 44 C:f'D P,F't?PC1SE0 SPOT Et,EVATIUN d t© �' ,pr +� r� Niz- q - --- tACNING Plr0V/DEG Lo"_SPr, PERCOI-ATIOIY TEST .4PP�,/C�1/V T EN�`/N�'Ef? N f O P/SP06A4, OBSERVATION P/r ' cAJ co. =- d 25 Cie Fln;,to vc. 60 E. F,44*04YTY HW Y, ..w %'�` �l=t$ERT � _�0 1�.2► +F�c.l-(`N -, M� S' y?' /r DES/G/ �� E. FA��f-/OtfTH,A1.d.0253& --- n�q�uc, _ �a tie VsKi0 SCAM E PATE SHEE 7 B0 r7-o 61 -r; a s�f E �sik4` > AS NOTEP �p2 EC,2 71-`� 5�2 APPLlC'.8.MQAp roc . 4-74� T47'AI- LA PR,4WIV 8Y CNECATP BY: A?f'P B Y: RX-4N NQ. - • �vJEat .i�/z frb