Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0134 ROUTE 149 - Health
F - 134 RT. 149, Marstons Mills VII.LAGE GARAGE D 11 i I'� r 3 r ,•� Town of Barnstable ,Yy Regulatory Services Thomas.F. Geiler,Director �n Public Health Division Le Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508=862-4644 Fax: k8-790-6304 application Flee: $100:00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION.FOR PERMIT.TO.STORE.AND/OR UTILIZE.MORE.THAN. 111. GALLONS.OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT To my NAME OF ESTABLISHMENT ViLl A G •,4-1AS6 F ADDRESS OF ESTABLISHMENT 4• 135 " H RT5 TELEPHONE NUM R ` �p� 9017 SOLE OWNER: P YES NO f 1 IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF AL PARTNERS: AUG26REC'p By A 00 IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 5- STATE OF INCORPORATION /I/JA<W Q41V!;jr� FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK IGNAT'URE OF APPLICANT RESTRICTIONS: HOME ADD SS V6 oru/ HOME TEL' PHONE# Hazdoc/wp/q f r F' ra � 8 1 _( L L CONTINGENCY PLAN Emergency Coordinator, Name: Address: —OX EO R 1) , -kl VE C07-OCT Daytime Phone: ; Evening Phone: c� c �� `�--- Fire Department: Barnstable Public Health Division: 508-862-4644 DE.P 24 Hour Spill Hot Line: 888-304-1133 Waste Hauler: Name: .Phone: r-q79-6V9 801-3 r Building diagram indicating hazardous material/waste storage area,I location of absorbent scavenger materials, fire extinguishers, fire alarms (if present and evacuation route (if applicable). )' .Arm 014,S ,IV 640k M 1 /,1/ fC1L//16- f A i 5"EC-L RAP PV � dk57`itrci 3 111 OIL f' t A - ` ( bu Af L t, CEk BA Actions to be taken to control a spill or release and apreventing it from reaching a catch basin, sewer system or the ground. CONT_Aj0MEPji' 'BOU�VJJ �S' `FG1Q 01 )' 0RACt;' UfiffS ��� 616 41\1 ' i ; rod' Town of Barnstable °FTME r Regulatory Services Thomas F. Geiler,Director '" MASS. " Public Health Division 039. MASS. peg' Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE; ,'TORE THAN III GALLONS OF HAZARDOUS MATERIALS , FULL NAME OF APPLICANT 0k uvi i CrI/1Ch� �U NAME OF ESTABLISHMENT V l Ck- Imo- Sn(L— ADDRESS OF ESTABLISHMENT 17D�- I W� d40,VSbkQ �J TELEPHONE NUMBER D L/2 _ O 17 SOLE OWNER: YES (\ZNO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION P ASS FULL NAME AND HOME ADDRESS OF: PRESIDENT ec -7 Z 04--(;r8 Q r IV''L Q.O �ZCa TREASURER < CLERK 0 SI NATURE OF APPLICANT RESTRICTIONS: HOME AD RESS HOME TELEPHONE# Haz.doc/wp/q J � Town of Barnstable �� Regulatory Services Thomas F. Geiler,Director " B Public HealthDivision t6gq, 10� Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS e=aFULL NAME OF APPLICANT C� 1� Q NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT /4! (35- ,/`S � 9 �1 cr,-�f�n5 / TELEPHONE NUMBER \6�d SOLE OWNER: -1ES NO O L IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESSC0, ALL PARTNERS: u= co _ rn f IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. i STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT r4 Q, O a4-�ra--D f e V e- Co 4v1 M Aq p1&0� TREASURER ,� to CLERK �r. e2. i(�UfL SIGNATURE OF PLICANT RESTRICTIONS: HOME ADDRESS o k4x d HOME TELEPHONE# - oL Village Garage Inc. 135 Rte 149 Marstons Mills, 02648 July 11, 2007 Town Of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 Re: Hazardous Materials Contingency Plan; Waste Petroleum Oil Combustible Liquid NA 1270, PGIII is stored in a cement sealed storage container. Which is then transported and disposed by Autobody Solvent Recovery Corp, designated facility Murphy's Waste Oil Services, Inc. Sincerely, John M. Rojee President Village Garage Inc. Town of Barnstable �� °FIME, � Regulatory Services °s Thomas F. Geiler,Director IF). MAS& ' Public Health Division ArEOMA'�A Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT "JO IVA /?,D If NAME OF ESTABLISHMENT IIJI& -e ' ADDRESS OF ESTABLISHMENT/35 &g '0z< " TELEPHONE NUMBER 5O 9 7 -�DI:7 4- � `M SOLE OWNER: YES NO j� rr 1 IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL c PARTNERS: � ra rn IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INC ORATION si y FULL NAME A HO ADDRESS OF: PRESIDENT TREASURER CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS 7a ® x b Nj HOME TELEPHONE# �.a p -I►�( Q:\Application FOrms\HAZAPP.DOC MAIL-IN REQUESTS Please mail the completed application form to the address below. Also include a copy of your contingency plan (to handle hazardous waste spills, etc). In addition, please include the required fee of$100. Make check payable to: Town of Barnstable. Allow five to seven(7) working days for in-house processing. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FOR FAXED REQUESTS - Our fax number is (508) 790-6304, Please fax a completed-application form. Also, please fax us a copy of your contingency plan (to handle hazardous waste spills, etc). In addition, please mail the required fee amount of$100.00. Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow up to four days for in-house processing. For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page Q Upplication Fonns\HAZAPP.DOC F r Number Fee 206 THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that Village Garage Inc. 135 Route 149, MA 02648 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 30, 2007 unless sooner suspended or revoked. --------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. May 24, 2006 PAUL J. CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable °EtME T Regulatory Services Thomas F. Geiler,Director U� � MASMS Public Health Division 039.Ana+°i Thomas McKean,Director ' Ob 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: .508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE i 5�Z3 I APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT 1 I A9 e a C Aq f T1UC ADDRESS OF ESTABLISHMENT S P}e I A Ck M/t r SToN M 5 114A TELEPHONE NUMBER SOLE OWNER: YES NO � i c IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS 4F ALL PARTNERS: ZI C) �r '4 Cry b N t-- QD m IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION} FULL NAME AND HOME ADDRESS OF: _ PRESIDENT J (Z f y� o.�e r a ©.X r-o,, / I>! l �lQ Oa 6 � TREASURER CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME AD Ss M, e HOME TE EPHONE# 0 yao^ 1 ql Haz.doc/wp/q Town of Barnstable Hazardous Materials On-Site Inventory and Inspection FACILITY INFORMATION:rr Business Name: V/GGL.(-Cy 6 1��rC �i✓G. Business Location: dd OUTE,� � XfA,0eS7-PA15 /VAt CS ,0 Z&W Mailing Address: Xs A 60VE Telephone Number: J-4f' , Z r- 9Q77 Contact Person: �'_To/wr✓ 0�- e kVA1k'W1zq p-A/ACy4 Emergency Contact Telephone Number: Type of Business: 4a 7y /�I�P�/� / A41-iAf rc-VARiec HAZARDOUS MATERIALS (CHAPTER 108) Virgin Product Total Quantity Container Size(s) Storage Location Major Materials Gallons or Pounds Quarts,gallons, Shed,retail store, drums,tank,etc... cabinet,closet,etc AW17 J 4M-tz�Js -3+77veacs /6. J_,�*tZOAJs A��e7 A-P-A-;t e p 4*GL0/J3 Aa6vv 492O uv77�N� GAWA- 6- ,VD Q0A2i COAL MI J *,1Dq,+77C- 1-7eAA s 0AIF 41vA-P-1- d0&k77J->N6ZJ cost T" A4(SG �P-AG6 L_L)6 JLt CA 07S Al-tOAJ 0'vc-- i comas &Loscr - 1 - n FLOOR DRAINS (Chapter 381) Town Sewer Account Number: A(IA Indoor floor drains: Yes 90) If yes,circle one,does it discharge to a: holding tank dry well on site septic. Outdoor surface drains: Yes No If yes,circle one,does it discharge to a: holding tank dry well on site septic. FUEL AND CHEMICAL STORAGE TANKS (Chapter 326) Underground Storage Tank(s) on site? Yes G Age: Is removal required? Yes No If yes,when? Is testing required? Yes No If yes,when? Out of doors above ground storage tank on site? Yes No If yes,is it protected from the elements? Yes No If yes,how? Is it on a foundation larger in size than the tank? Yes No COMMENTS/RECOMMENDATIONS/CORRECTIVE ACTIONS A-C� Date: C. Public Health Inspector: Facility Representative: 51gjjS pAcDC u P 5y -J-DHJ O-A r2 MPbL 4I;x-1' To P05 L'A 6a-s TD 6E •F'I�Ov 8bc-b 15y WR Uj 94f.-++r. 11d5-D-S `tRIE Av/klta46LC o�j s I T-E. Gl2-l)b � .+ R4,L), =Esr rop, T� Afs Pos,,-�oP' W�� oil- �A� PK-ov d� t �IZ�j� . i I r Misc.Geft+ugt� S"KA-6E l-64 5�� �5 SP xIS ('�OSET Misc. Corrosives Misc.Reactive Misc.Toxics Inventory Total Amount: Hazardous Materials License Posted?Yes No /_�C�iUSf p�itJ %,�pv/AL-7J Contingency Plan Posted? Yes� �N� 41Z11D Fire District: C ©AIH l� Fire Extinguisher Service Date: Metal Covered Rag Bin: No Absorbent Material Available? es No Type of Absorbent: peedy D ' Pads Pigs Other: V 1..66 .a-" 6 P-D ER--n+TZoU444 W MSDS on site? Yes & Hard Copy Computer Access Hazardous Waste Handling Hazardous Waste Generator Identification Number: 1 P6-10P efa O/� Type(s) of hazardous waste-Product(s): WASTE' 0/4- Gz-V't-Arr Date of last hazardous waste shipment,type of waste and quantity: ���E�2K1oi2/( NOT AVAI A&C DA S/TF Hazardous Waste Transporter(s): Ob SO ojT K �ep Designated Hazardous Waste Facility: P TV,-0/t Hazardous Waste Storage Area Description: Is hazardous waste storage area labeled: Yes Are tanks/drums/containers labeled with the words "Hazardous Waste",the tyDe of waste and the associated hazard (i.e. ignitable,corrosive,reactive or toxic) Yes o If hazardous waste is stored out of doors is it covered from the elements? Yes No All Is it in 110% containment? Yes No If hazardous waste is stored indoors is it on an impervious floor es No - 2 - Date: � / 9 / 0�f TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: a BUSINESS LOCATION: Ll INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: J Og - L1 2-8 c'D'`7 CONTACT PERSON: 64 o e e- EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON all TYPE OF BUSINESS: 4zcx,4o se-iriVj ee. INFORMATION/R COMMENDATIONS: e- �a s Fire District: /5Qo5e_ jT . rAJaqA-e_ wiq44-,.ih. 34) ata-tAS. La�beJ I(WM: AtOi..s �.0 e �a�c��l-5 4�bX/C �i� l�( C> 7V-5 W19-s'7Z-::7� Waste Transportation: i4 e,2- Last shipment of hazardous wa e: Name of Hauler: OAA It Destination: Waste Product: ( oz: Ye l Licensed? s No OTE: nder the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use, Itera'Te 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 Z°1 ,PIEW -2*' sion ED Cesspool cleaners Automatic trans fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ,3LO 20 ED (insecticides, herbicides, rodenticides) t$ Doo Gasoline Jet fuion gas Photochemicals Fixers .3 400 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 541 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) 6 Other cleaning solvents Bug and tar removers Windshield wash tv WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS JOHN ROJEE Village Garage Inc. Foreign &Domestic ALL GENERAL REPAIRS MASS INSPECTION • TOWING • SNOW PLOWING ALL MAJOR CREDIT CARDS (508)428-9017 ROUTE 149 MARSTONS MILLS ,ems ey Date: '7 / 9 / 0c/ L TOWN OF BARNSTABLE dam'' TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTOU NAME OF BUSINESS: 170 BUSINESS LOCATION: '1$ INVENTOR MAILING ADDRESS: `� TOTAL AMOUNT: TELEPHONE NUMBER: S®gL1 2-$ Of 01°7 /Oo`? 17 �an CONTACT PERSON: Q- - A i e Q EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? /!'i�7e TYPE OF BUSINESS: �ra/L �-�asln°u� � S('�vVi CL. ,--�, ctwe3tSi ia/e INFORMATION/R COMMENDATIONS: e- e -s- Fire District: ��� s ruu.�-e .f�G�c�► 5�.��1TbX/C�� _ rg @�t�llLW h� aru s m a.Z '/LcW Cast P,,tfn. w8 0 Waste Transportation: 1. en- shipment of hazardous wa e: G''�'y Name of Hauler, Destination: Waste Product: Licensed? Yes No OT nder the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use, e 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 Z-EW 2 Aspon 0 UED Cesspool cleaners Automatic trans fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides 13 ID EW 20 SED (insecticides, herbicides, rodenticides) Gasolineue'I, A Jet f 'iation gas Photochemicals Fixers —32 000 Diesel Fuel, kerosene, #2 heating oil NEW USED "Misc. 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 —M 5d, Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Misc. Combustible r 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 .A (including bleach) Spot removers &cleaning fluids (dry cleaners) 6 Other cleaning solvents Bug and tar removers 34 Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Town ofl3arnstable-Health- l5epartment Page 1 � • HAZARDOUS MATERIALS INVENTORY SITE VISITS O ! DBA: Village Garage,Inc. Cl S 5 i5 Corp Name: Mailing Address Location: 135 Route 149,Marstons Mills Street: 135 Route 149 mappar: City: Marstons Mills Contact: �,> State: Ma Telephone: 508-428-9017 ` �ei� Zip: 02648 Emergency: erson Interviewed: / Business Contact Letter Date: 7/1/2004 Category: Miscellaneous e °C,� Inventory Site Visit Date: 7/8/2004 d Type: Auto Repair Follow Up/Inspection Date: public water ❑ indoor floor drains ❑ outdoor surface drains ❑ license required ❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc 0 currently licensed ❑ town sewage ❑ indoor catch basin/drywell ❑ outdoor catch basin/drywell expir -- - on-site sewage ❑ indoor on-site syste El outdoor 6/3/2004 outdoor onsite system ------ -- ------- Cinta services used for rags&uniforms fire ext.serviced annually. PPE compliance: available. Oil filter crushed&disposed with Cyn Oil. Parts washer Satisfactory servied by Safety Kleen. Batteries are also included. `�� ' �5 wW r Page 2 Town of Barnstable-Health Department HAZARDOUS MATERIALS INVENTORY Chemicals: ❑ Zero Toxic Waste Materials ❑ gty's>25 Ibs dry or 50 gals liquid but less than 111 gals d❑ gty's 111 gals or more description: qty: - unit,of meas,ur'e„', gasoline 18000;gallons _._._._....._.�___.._.__......_....._._..._ ._....._....._..._........._...._...........--._-_.__._......_..........._..............._�..._..._.._.__...._............._......................._........_.............. .__.._��___ diesel fuel,kerosene,#2 heating oil 3000 gallons waste oil 2750 gallons motor oil 5cases ._._._.._.__..__......_._....._...._._.._..........__...__......__._......_............................._..................__...__.........._,_.......__...........;...._._................__..__............_.........._........_......._...... antifreeze(for gasoline or coolant systems) 3cases waste antifreeze ! 110gallons Waste Transporter: Fire District: iCOMM Last HW Shipment Date: I Waste Hauler Licensed: No 5- A Town. of Barnstable rO L� Regulatory Services ti 2 Thomas F. Geiler,Director o Public Health Division 9� M Wig' . Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Cr Office: 508-862-4644 Fa : 508-7 -6 0 1 Application Fee:$100.00 0 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION.FOR PERMIT TO. STORE.AND/OR UTILIZE MORE THAN 111 GALLONS.OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT .7 A)C.. JO 4y _ r NAME OF ESTABLISHMENT ' f� t� 641'/�F C Z NC. ADDRESS OF ESTABLISHMENT p t C i M N h P S T 0"3& TELEPHONE NUMBER 'Sot- Y a s-' go 7 a r cp SOLE OWNER: YES NO O. M IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. ®Y3 I STATE OF INCORPORATION ( Y )A • -- _ FULL NAME AND HOME ADDRESS OF: d PRESIDENT -J-bi 9\ R®TeC. 2a ( xi--01c Or. 37-u l MA- TREASURER CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADD SS HOME TELE HONE# `�6 ��O -11f7 Haz.doc/wp/q R MAIL-IN REQUESTS Please mail the completed application form to the address below. Also include a copy of your contingency plan(to handle hazardous waste spills, etc). In addition,please include the required fee of$100. Make check payable to: Town of Barnstable. Allow five to seven(7)working days for in- house processing. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FOR FAD REQUESTS - Our_fax number is (508) 790-6304. Please fax a completed application form. Also, please fax us a copy of your contingency.plan (to handle hazardous waste spills, etc). In addition, please mail the required fee amount of$100.00. Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow up to four days for in-house processing. For further assistance on any item above, call(508) 862-4644 III TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair satisfactory 2. Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY V 11 N.a e_G��G- _ (see"Orders") 5.Retail Stores � l 6.Fuel Suppliers ADDR `ESS `5 Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT &gallons 777 Test F JAY Gasoline Fuel (A) Diesel, Kerosene, #2 (B) iIOU Heavy-Oils: _ waste motor oil (C) -1- � � 1 new motor oil (C) X transmission/hydraulic Synthetic Organics: degreasers �"( ' Miscellaneous: DISPOSALIRECI AMATION REMARKS: nn 1. Sanitary Sewage .Water Supply (VI �, Y�- � I S O Town Sewer ublic 1(zt Qx l On-site Private 3. Indoor Floor Drains YES__NO G O Holding tank:MDC I 2 I I C O Catch basin/Dry well _�Vl ' O On-site system 4. Outdoor Surface drains:YES NO ERS:O Holding tank:MDC c— O Catch basin/Dry well lws ��-F� (0 d)z O On-site system � +S►� l�`���.O , 5.Waste Transporter IT)f\)c Name of Hauler Destination Waste Product CUV-) AA1 'P8 INO Mfl 2. 11`Vt�U2il�t ��1 CSS �s eL' Person (s) Interviewed Inspector Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: 67 . -f7 4- Mail To: BUSINESS LOCATION: /_7a �' ,. ,� Board of Health Town of Barnstable MAILING ADDRESS: d_�55. y;4� P.O. Box 534 TELEPHONE NUMBER: �/ 7 Hyannis, MA 02601 _ CONTACT PERSON: 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 qyaglities 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: antity/Case Quantity/Case 3 Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business _r Mao :t4,a� eye lo4&r-t TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 2. nters BOARD OF HEALTH O satisfactory 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY rj f '-�/�/' (see"Orders") 5.Retail Stores 6.Fuel Su iers ADDRESS I �e- 3"' Class:- / 7. scellanelous _� Mi P,� UANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN I OUT IN OUTI IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) < azes �bdyU #2 (B) Heavy Oils: waste motor oil (C) ulkvi new motor oil (C) transmission/hy4rgtdie- Synthetic Organics: degreasers Miscellaneous: Wd f�XA, /01 'fete � - 4.77 DISPOSAL/RECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply trw O Town Sewer OPublic On-site OPrivate r" _ 3. Indoor Floor Drains YES NO r O Holding tank:MDC O Catch basin/Dry well ' _ ., 40 O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system lr-,• 5.Waste Transporter Name of Hauler Destination Waste Product ? � Af, j1 Ago 2. - 61� Person (s) Int sewed Inspector Date Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection Southeast Regional Office William F.Weld Govemw 0 PY Trudy Coxe ,EOE David S.Struhs commWai0 r August 1, 1996 Donald MacEachern, Trustee RE: BARNSTABLE--WSC/ASM-4-0801 Nova Realty Trust Village Garage c/o Liberty RE. 135 Route 149 2956 Falmouth Street RESPONSE ACTION OUTCOME Marston Mills, MA 02648 STATEMENT, M.G.L. c. 21E and 310 CMR 40. 0000 Dear Mr. MacEachern: The Department of Environmental Protection, Bureau of Waste Site Cleanup (the "Department") , pursuant to the 1988 Massachusetts Contingency Plan (MCP) at 310 CMR 40.537 (12) hereby acknowledges receipt of a class A-2 Response Action Outcome (RAO) Statement relative to the approved waiver application for the above- referenced site. In accordance with 310 CMR 40. 0630(2) (g) and 310 CMR 40.1.000 in the revised MCP, this RAO Statement also provided an opinion by Paul F. Reiter, a Licensed Site Professional associated with Environmental Reclamation, Inc. , that a Permanent Solution has been achieved. The date of acceptance of the Waiver Application approval was February 24, 1992 . The RAO Statement was submitted on July 19, 1996. Please be advised that this acknowledgement of receipt of the RAO statement shall not be construed to mean approval of or concurrence with the remedial response action selected or decisions based thereon. Be further advised that this office may conduct an audit of this site which may include review of the response actions, required documents, and the completeness and adequacy of each relative to the 1988 MCP. If you have any questions regarding this matter, please contact Deborah A. Marshall at (508) 946-2888. All future communications regarding this site must refer to site number: WSC/ASM-4-0801. Very truly yours, Joseph F. Kowal, Chief Audit and Site Management Section 20 Riverside Drive a Lakeville,Massachusetts 02347 0 FAX(508)947-6557 9 Telephone (508) 946-2700 -2- K/DAM/ka CERTIFIED MAIL NO. Z 276 549 891 RETURN RECEIPT REQUESTED cc: Board of Selectmen Town Hall 367 Main Street Barnstable, Massachusetts 02601 ATTN: Warren J. Rutherford, Town Manager Board of Health Post Office Box 534 Hyannis, Massachusetts 02601 ATTN: Brian Grady, Chairman Environmental Reclamation, Inc. 446 Waquoit Highway Waquoit, Massachusetts 02536 ATTN: Paul F. Reiter, LSP DEP-SERO ATTN: Regional Enforcement Office Data Entry 10 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: V+ c l e-- Ju. Q e- 1&2bl Mail To: BUSINESS LOCATION: /� '; �P l ''� Board Health Town off Barnstable MAILING ADDRESS: 4,rSton 5 In,d v P.O. Box 534 TELEPHONE NUMBER: 00 i Hyannis, MA 02601 CONTACT PERSON: 71"m 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 qpaDfities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES Z 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: �Ct, VK �- 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) O Drain cleaners Automatic transmission fluid ,e7oilet cleaners Engine and radiator flushes fK0 Cesspool cleaners Hydraulic fluid (including brake fluid) -)0920SM Disinfectants _ ,_M(otor oils/waste oils Road Salt (Halite) O� -Gasoline, Jet fuel Refrigerants 0o0 Diesel fuel, kerosene, #2 heating oil ��` Pesticides (insecticides, herbicides, Other pelroleurnproducts: 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 --a�-Car waxes and polishes Jewelry cleaners _Asphalt & roofing tar Leather dyes _ Paints, varnishes, stains, dyes 01 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 ydrochloric acid, other acids) (including bleach) Other products not listed which you feel may _,_a�-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 JOHN ROJEE Village Garage Inc. Foreign &Domestic ALL GENERAL REPAIRS MASS INSPECTION • TOWING • SNOW PLOWING ALL MAJOR CREDIT CARDS ROUTE 149 (508)428-9017 MARSTONS MILLS TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marina,Gas. tations,Repair satisfactory 2.Printers BOARD OF HEALTH 0 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY 1�i�1G3.e �}cv�a�2 �C. (see"Orders") 5.Retail Stores ^v�a 6.Fuel Suppliers ADDRESS � � iY9' /r91,41I, Class: 7.Miscellaneous To &.- 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 # 3 Heavy Oils: waste motor oil (C) new motor oil (C) I0 at-r t c-s transmission/hydraulic Synthetic Organics: degreasers A-�,4�f ��A.e 2 37 �C �.w gGs Miscellaneous: Z wG�S K ,a 4 DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply O T wn Sewer �blic Vn-site OPrivate 3 Indoor Floor Drains YES NO s�'O�tK 1ng tank:MDC 1 t° ��� �( "pCatefi basin/Dry well On_-site system AI la 0 -71 �2 4. Outdoor Surface drains:YES_NO ORDERS: O Holding tank:MDC (,t m*41 IAlv� (Z fc/y U, Cl"d- O Catch basin/Dry well _ O On-site system 5.Waste Transporter /! Narne of Hauler Destination Waste Product1 YES NO 9,crA_ Person (s)qpterviewed Inspect r Dat TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH Satisfactory 2.Printers 3.Auto Body Shops unsatf ctory- 4.Manufacturers COMPAIV /p�� C .� &"Is 5.Retail Stores 6.Fuel Suppliers ADDRESS V �. Class: � 7.Miscellaneous QUANTITIES AND STORAGE (I1V=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) �f new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers' Mi eellaneous: 1V ` 2 ice Il . lovs Ali r R VISPOSADRECIAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply T O Town Sewer ublic Won-site OPrivate 3. Indoor Floor Drains YES NO O Holding tank: MDC ,•:,O Catch basin/Dry well j O On-site system i 4. Outdoor Surface drains:YES NO ORDERS: t Q Holding tank:MD.0 Oatch basin/Dry w arell 0 bn-site system ~- 5. Waste Transporter ] Name of Hauler Destination Waste Product MOO* YES NO 2. Person (sOnterviewed V Inspector .�, Date TOWN OF BARNSTABLE CO MP[.lANCE: CLASS: 1. rine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY ` e')`Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS _ Class: f 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUTI IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) 41 a, new motor oil (C) 4-6 transmissions 145 Synthetic Organics: degreasers Miscellaneous: 4 / 7- Al DISPOSAL/RECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply ,t=f 4y 0 Town Sewer ublic AOn-site Private r rev? 3. Indoor Floor Drains YES NO �� il5 0 Holding tank: MDC ��''� 0 Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES 1"NO ORDERS: 0 Holding tank:MDC ''Catch basin/Dry well O On-site system 5. Waste Transporter Name of Hauler Destination Waste Product YES No 1. 2 Person (s) Interviewed Inspector Date as'�,a r -\ / , wl lwow� TOWN F :�.•. :�IABLc Daniel S.Greenbaum Commissioner Gilbert T.Joly G�` 2�� &kaA- , PAR Regional Director Nowls A�Opy. EEMWWffl�-MEIWAL EPARTMENT'OF February 1 PROTEC770N %o NOVA REALTY TRUST RE: Barnstable WSC/5A-4-0801 225 Old Falmouth Road Village Garage Marstons Mills, Massachusetts 02648 135 t Roue 149 NOTICE RESPONSIBILITY/ NON-PRIORITY DISPOSAL SITE M.G.L. , Chapter 21E and ATTENTION: Mr. Donald MacEachern MCP, 310 CMR 40.000 Ms. Deborah Schilling Gentlemen: The Department of Environmental Protection (DEP) , Bureau of Waste Site Cleanup, (the "Department") has determined that Village Garage located at 135 Route 149 in Marstons Mills, Massachusetts (the "site") is a non-priority disposal site as defined in the Massachusetts Oil and Hazardous Materials Release Prevention and Response. Act (M.G.L. , c. 21E) . The cleanup of disposal sites is governed by M.G.L. , c. 21E and the Massachusetts Contingency Plan (310 CMR 40.000 et se . , the "MCP") . , Because this location has been confirmed as a disposal site, it will appear on the next "List of Confirmed Disposal Sites and Locations To Be •Investigated" published by the Department. The date on which this location was confirmed as a disposal site was September 29, 1989. The information contained in the report, "SITE REPORT RELATIVE TO OIL AND HAZARDOUS SUBSTANCE RELEASE ON PROPERTY INCORPORATING THE VILLAGE GARAGE", prepared by JRS Environmental Management Consulting of East Falmouth, Massachusetts, for,, NOVA Realty Trust of Marstons Mills, Massachusetts, indicates that a release of petroleum hydrocarbons has occurred resulting in the existence of benzene at concentrations ranging from 165 to 260 parts per billion (ppb) , toluene at concentraions ranging from 110 to 195 ppb, and xylenes at concentrations ranging from 2,400 to ,4,090 ppb in the ground water at the site. Based upon the available information, the Department has reason to believe that you ("you" refers to NOVA Realty Trust) are a potentially responsible party (PRP) with liability under M.G.L. , c. 21E, Section 5. - Section 5 makes the following parties liable to the Commonwealth: current owners or operators of a site where oil or hazardous materials are located; any person who owned or operated a site at the time hazardous materials was, stored or disposed of; any Original Printed on Recycled Paper 2 person who arranged for transport, disposal, storage or treatment of hazardous material to or at the site; any person who transported ' hazardous material to a transport, disposal, storage or treatment site from which there is or has been a release or threat of release of such material; and any person who otherwise caused or is legally responsible for a release or threat of release of oil or hazardous materials at a site. This liability is strict, meaning it is not based on fault but solely on your status as an owner, operator, generator, transporter or disposer. It is also joint and several, meaning that you may be liable for all response action costs incurred at the site, regardless of the existence of any other liable parties. You may be liable for up to three (3) times all response action costs incurred by the Department. Response action costs include the cost of direct hours spent by Department employees arranging for ` response actions or overseeing work performed by PRPs or. their contractors, expenses incurred by the Department in support of those direct hours, and payments to the Department's contractors. For more details on cost liability, see the cost recovery regulations at 310 CMR 40. 600 et se . . The Department may also assess interest on costs incurred at the rate of twelve percent (12%) , 'compounded annually. To' secure payment of this debt, the Commonwealth may place liens on all of your property within the Commonwealth. To recover the debt, the Commonwealth may foreclose on these liens or the Attorney General may bring legal action against you. In addition to your liability for up to three (3) times all response action costs incurred by the Department, you may also be liable to the Commonwealth for damages to natural resources caused by the release. Additional liability may also be imposed under M.G.L. , c. 21E, section 11 and other laws for each violation of M.G.L. , C. 21E or other laws, or under M.G.L. , c. 21A, section 16, for violations of c. 21E , and other statutes, regulations, orders or approvals. The Department encourages PRPs to *take response actions to assess and cleanup contamination at sites. By taking the response actions, you avoid liability for costs incurred by the Department's contractors in performing these actions. If you do not take the necessary response actions or fail to perform them in an appropriate or timely manner, the Department is authorized by M.G.L. , c. 21E sections 3A(j) and 4 to have the work performed by its contractor. Furthermore, the Department requires you, as a potentially responsible party with liability for the release or threat of release at the site, to take the steps outlined below: 1. Provide the Department with a written response within fourteen (14) days of. your receipt of this Notice indicating whether you accept responsibility and intend to take remedial response actions at the site. 3 - 2. Continually evaluate the site relative to the development and/or discovery of an imminent hazard as defined in 40.542 of the MCP. Should any condition arise that constitutes an imminent hazard, you are required to notify the Department immediately and submit, for approval, a Short Term Measure (STM) proposal designed to eliminate or prevent the imminent hazard. At this time, due to personnel constraints the Department is not able to assign a project manager to the site. Moreover, in accordance with the MCP, you may not conduct further remedial response actions at this site that require Department approvals unless a waiver is granted. The actions requiring Department approvals are specified in 40.536 of the MCP. Also, be advised that since Phase II - Comprehensive Site Assessment and subsequent phase actions including remediation at this site can only continue with specific Department approval, you may wish to submit a waiver application pursuant to 40.537 of the MCP. Approved waivers allow assessment and remediation to continue at non-priority disposal sites by waiving the requirement of specific Department approvals of five (5) remedial response actions referenced in 40.536 of MCP. A waiver application can be obtained by contacting the Department of Environmental Protection, MCP Waiver Program, located at One Winter Street, 5th Floor, Boston, Massachusetts, telephone number (617) 292- 5545. Your cooperation in this matter is appreciated. Should you have any questions regarding this Notice, please contact Henry Cui at (508) 946-2862. In any correspondence to this office, please refer to case number WSC/SA 4-0801. Very truly yours, J66eph F. Kowal, Chief Site Support Section K/HC/lm CERTIFIED MAIL IP707 036 520 RETURN RECEIPT REQUESTED cc: DEP - Boston - BWSC Division of Response and Remediation JRS Environmental Management Consulting Town and Country Shops Plaza East Falmouth, Massachusetts 02536 -3- wA. i cc: . DEP - SERO - Data Entry DEP - Boston - BWSC : Waiver Unit Hunter, Inc. P.O. Box 284 Lincoln, MA 01773 ATTN: Alton Stone Barnstable Board of Health Town Hall 367 Main St. 3 Hyannis, MA 02601 Barnstable Board of Selectmen Town Hall 367 Main St. Hyannis, MA 02601 y f Q > .fY &T�� 0( c_ T �o Daniel S. Greenbaum Commissioner — /j 02c5`47 Is in - FEB 1 B 1992 I - TOWN OF BARNSIAbLEF bruary 11, 1992 Nova Realty Trust RE: BARNSTABLE--WSC/SA 4-0801 225 Old Falmouth Road Village Garage Marstons Mills, MA 02648 135 Route 149, Marstons Mills WAIVER APPLICATION APPROVAL ATTENTION: Ms. Deborah Schilling M.G.L. , Chapter 21E and Mr. Donald MacEachern 310 CMR 40.000 Gentlemen: The Department of Environmental Protection ("DEP") , pursuant to the Massachusetts Contingency Plan ("MCP") , 310 CMR 40.537, hereby approves the Waiver Application for the referenced non- priority disposal site subject to the conditions of the Waiver Application, the Disposition form and the following: 1. The Waiver Application Disposition form (Section VIII) must be countersigned and returned within ten (10) days of receipt of this letter to the DEP, Southeast Regional Office, Lakeville Hospital, Lakeville, Massachusetts 02347, ATTENTION: Site Support Section-Waiver Unit. Please keep a copy of the form for your records. 2. All document submittals, sent to this office must be referenced as a QOWaiver Site'' with t e DEP case .number. 3. You shall submit a biannual progress report describing the status of all remedial response actions conducted at the site in the previous six (6) months. The first report will be due in August 1992. 4. The Phase II - Comprehensive Site Assessment shall fully delineate the extent of contamination in the soil and ground water both on and off the property. All remedial response actions shall be in accordance with the phased MCP process. Ground water samples collected during the next sampling round shall be analyzed by EPA test method 8240. 5. Any proposal to transport contaminated soils from this Original Printed on Recvcled Paver i -2- site to any other location in Massachusetts must be approved by this office. Unapproved off-site disposition, including treatment, reuse or disposal, may constitute a "release" of oil or hazardous material and create a new "site" . Approval of such a proposal should not be construed as approval of the Final Remedial Response Plan for this disposal site. Soils contaminated only with virgin petroleum oil may be handled in accordance with DEP's "Management Procedures for Excavated Soils Contaminated with Virgin Petroleum Oil, " under Chapter 21E, Policy #WSC-400-89. Soils contaminated with other oils or hazardous materials require site-specific approval. Remedial response actions such as on-site treatment or reuse at approved asphalt batching plants are preferred. In-State landfill disposal will only be considered if documentation is provided that all available and applicable treatment or reuse options are not feasible. Proposals to treat, reuse or dispose of contaminated soils outside of Massachusetts must conform to all applicable in-State and out-of-State regulatory requirements, but do not otherwise require approval from the Regional Office. 6. You and your agents must continue to evaluate the need for a short term measure ("STM") as defined in 310 CMR 40.542 and notify the Department immediately if an "imminent hazard" exists at the site. You must submit a proposal to perform the STM if one is deemed necessary. No STM may be commenced without prior Department approval. This evaluation must continue throughout the remedial response action for this site. 7. This office may conduct detailed audits of selected waiver sites on a random basis which shall include review of the remedial response action(s) , required documents, and the completeness and adequacy of each relative to the MCP. -3- . Should you have any questions regarding this. matter, please contact Dan Crafton of this office at (508) 946-2880. Very truly our bert E Do ovan, egional Engineer for Waste Site Cleanup D/DGC/rr Enclosure: Waiver Application Disposition Form CERTIFIED MAIL #P253 147 822 - ATTN: Ms. Deborah Schilling RETURN RECEIPT REQUESTED CERTIFIED MAIL #P253 147 823 - ATTN: Mr. Donald MacEachern RETURN RECEIPT REQUESTED cc: BWSC - Boston ATTN: Waiver Unit (Enclosure) Board of Health Town Hall . 367 Main Street Barnstable, MA 02601 Board of Selectmen Town Hall 367 Main Street Barnstable, MA 02601 SERO - BWSC - Data Entry I :. s a ion r '—;.7?"-'^^•--r-^.s^'+-qr-'S�-.=;...�...fi—v=-'—r.+-.— +—'° --- �_LO3 -�a'.tr.. ,. x-a—:- vF BARNSTABLEANCE• CLAS5• Marine,Ga St t' s RFpa'.factory Printers -BOA ;' D OF HEALTH 3. Auto Body Shops 6sfactory- 4. Manufacturers COMPANY o see"Orders") 5. Retail Stores 6. Fuel Suppliers. ADDRESS'` 5 / c� Class:_ 7. Miscellaneous QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors' MAJOR MATERIALS Case lots Drums AbdveTanks Undetgroued Tanks IN KQ UT I IN OUT # 6 gallonseTest? Fu b� Gasoline .;et Fuel (A) � 0 00<! Y =Diesel, Kerosene, #2 (B) �p© Heavy Oils: waste motor oil (C) new motor oil (C) �® transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: �—AVe- c)(J)d - 90 /offA�L III' WIN DISPOSAL RECL ION REMARK , 1. Sanitary Sewage 2, Water Supply 61 w OTown Sewer Pub Iiic -D �' �On-site Q Private 3. Indoor Floor Drains: YES --J C) NO- -- _ .�_ � _,✓ Holding tank: MDC O r _i O Catch basin/Dry well , 0. On-site system QWMW.l !� 4. Outdoor Surface drains-.YES NC__ C� ke�0 O Holding tank: MDC p � � ' = I la.46 Catch basin/Dry well OOn-site system S. Waste Transporter IiAte 0JA3 4 1qAV� Licensed? Name of Hauler- bDs- i nat i on Nas_to Product V,of Htfi 12 23 81 P r on nterviewe Inspector D to _ 6 STATE•OF CONNECTICUT DEPARTMENT�OF=ENVIRON"MEVTAL PROTECTION S _ T�:��)►an PROTECTION""-,"! •; gyp, Hazardous Waste MANIFESTTROGRAM;IState;Office Building,Hartford,CT 06106: -{°"a� ':':" ( 4,r ..,•.,.,.7.,.>,.... , •1,,^o,.n....,n.l'n� ,,. ;.:r,11c.•- ,•.tl,'..,�,n:•,)_)r^:'nh,^nI !'nvr•� ,I nibanjNJfgJi•t) 7 2r i r.'.., •. .; ' Please print or type. (Form,designed{or use on eLtG(12;pitchJ typewnter.J, UNIFORM HAZARD:OUS,&"--1,12Generator'sUS EPOo. " Manifest' • 2.Page 1 " Information in theshaded areas-is not \^)d >•"hqn n:n„n•)•!nr•n,!!rf 'r 7d Ir nr rninOu W!';, DociNehl Nb.> re Hired n Federal law. brit trig be WASTE MANIFEST o; requiredgb 31a1elaw. y n Generator's Name and ailing: ddress ,b A.State Manifest Document Number' ni lcl N nriW!,1RI='.Jli)n)t.'(1^� n ••;II T ,,1 , ' ! t R 1 _ T -•'�jrin-,:1..*Dln:f rtt' t V•1 lU T 1 '�) O )r.)7n I?gmno`'r•n•rpi li ! . 9 C.�, 018730 j 3 I d 0A N .'•p v!•Irnw I1 rw n:r.!nr40,vq,e,artn+� I . :t::,nr •1.ID, :.1 t>) lu..,•� iBState Ger`iMD'IPT V].t !.M fAI).171 d I,.'..•'a nD 1'gy,M 1_ur•,r,'I., .,;y r.W I 1 �iP•nnnr'�9'it nl r1 N'!•(,i^]a 1 r in .^,1 I.••,,ingm n(1 7 r r•^•.n I nE9 1• ,D eRd 9C}E:1.ve.I r 011 V. nUJ`]f T�1,DSI' lIi A lbl_jr, ,c_f`I 4. Generator's Phone,(' _ )" - •,t b o 'z.+%i¢„Tnr,1 + t.• ,., !,1 r os idi0 F.'{1 n.•!w to T;I n)r I s'. CS 9 v r,•„ ,. t 7 t .. - - ran�g�p3or er„ g'ompanye a}�me wI�11 - , d! , qo• ! 6 , /UPS EPA ID Number ! Ct StateTran )D�. { A l a f•, „1 ;) ,� 'rWiL ^ tArtd,�i. .: ��'ei►�t. ..,°nW nlrL.,t2n tb' 'S _.-,. -ftoi .,. _ D:Tran.Ph on P- l ransporter Company Name EPA ID Number - ' ' k E.SlafeTren ID ?n,nD7,?id,ot VDOJ n'dt a, •.J nd,nl;Dry-•)!,•;nr'I !n,-rw Qilr Tn,r, r HD O 10. US EPA ID Number G.State Facility's ID It All 'jI es��nated Facilit Name and Z Site Address �I,Ly�AArt,�I r rn�hlmo•3 VIIrneillUrnJl,ndrnun no!;ID,htnpb,lq,ih;l qa 1,:'Ur,•': .1! OYry.�Tr^,ya3lt L1P 71fa ll,r1Q , I0 i : ris �1 Q 11.`e'! `+>'i�,it �•+,�Fr •�$ ,rti+ef lR• p9)z,admun poi>ns,o•, v!ta'wn•n sz11 t 1 nrm znE or,lair.;fi uny I^-hr + '7M 7TY���r fTilt i�'!r Air Yv 9 .. _� D.�4'ii!"r' I!! n:j. ^,�n .3J T:)v_ A r.,?I0nr1E!noise un dnnp In ^nnJn.• ,. ) n .1 iv,i'9•u L G•• , ?:r" ♦ ,. O w,[i7v . f Ilu+ Ur,i Ir�+7 1 r j- q? - qm•, ; Y!�!�@,jt0�t�y �}al' r f om;'0 7 d.ID rr]r .ton ^ I .n-. {.� ❑ it t, I n LJC m a :.1'QI rag n.,.. b'•, Idn,r•�'.. ..n l w .(.:.•,.:. I:^:!r 1.!r ..an t,•.r+} •n,n.. ,r' ., ,:. •cI :r .I 11 le�c1 ty s Pho C ,nr-' r+..p o - = - - em M F_ ! , ,d D.,n,n•61,a?"I t-t,", D r :,•,,, .,; 12 Containers,, 13. .... 14 rn 1 n1 1JD .r>,m; D nr L) 11. US DOT(1Description pnc{uding Proper,Shipping Name„Hazaid Class,aifd,ID Number,n fl nh �,,;! Total Unit yi;tl Waste a`"' ti ndr hn•,•,r,u iW r,' n' n I No.. Type Cluantity• Wt/Vo 2 i ~ nr17 y r n t 17 C^I ;:c+:nII to,n.rnur,nJr,a n } .ra. :D ma Z E � .., a I ! s (+ ! ' I•, } IRgt G��el�w��Ue�s�lr ►ttc� �R ' ti t l a$/4AITY�r UJITJ !! , :i.J1V A y� ''!UM Tu: i0-n uj F E til1'.Er'i!*.�T,IIF4,. n!: 2: +:d ). -moI nrf nn+*&'FA!- Ir or Dill:r r o r t , 1 tlrnr Urns O 'N, ,;,fan :r!,1 dIliw Uri r, / 4l,"]nl hpit,l0 rID •. 7 J ("y °', �. -A o R „•,• y f- A b. C m^,I r•I bnrhtnob'Io,inD cr !bnS ndt II,,nd , I c i I 1-) ,.^'t, ••;•;I;• P!ii JI A 17_I� -e mr• '--( wZ T qn-d]iq o,l;0dcrn o,ngau pnlod nl.lid•ty•••!1:a u•'i:,•_a nni•{na�.:.is!:yv nr't,ot Ind•nuo,trl, _•soil b no,lnl'r p, 1n^.I '�n . . , r ,.1 1 b,4!AA i-iiT AT6' :3 inn rn .b9^ace,ao / !nru l0 1L b ,n;llua ua 1 nn nlndN 9f:nD F9`a rl tiw,n(;m url Door'•; b.1 0 I 7 ! ., ,,.. '. n3I nC)a. tAn7 - i9 art:, Z O ':bbR etia ,it nd tamn?a:,bbn 9.11.tan'n,n rn>,dt n.U. �I n!,n r/III!!nv,n,., 11 J) rr:•D-rib !C7^I ndt to An"T n,hnili too i O ( 1 nm•;, ••,.mm�,^ ':r.,r,:n •I; 1,1 LI:7T4ttE i23o :e my O R r.i il•-;Inn rt]idw•, ':Cn.^ao:bhn pn'URI•,r,r'R(C motl ni Usta,q zz9-U^r ^Il;r••lu,r,rn bon unl srbnnrr,rm lliw lRdln ..nl,!!)n(I MUO,U ai','1l: -IT.IQ7 •'(' '1J1 i. "" •!f• (IJF,7A-+ I'hTZ :0 thi w H :nri E'lnlr ^•,fig CL 3 m 9 !ro b?,rl stznw n,lf nviD]n t btI% P, b 1( .,1: }qH9 J}SJI R1 H ma (n :1—tI113 ni bnunt vur,nz.r)Ci t :Ct a.n1B1)P,1 •t oll f!! I r p l lo ,unr+)700 :U?:In , _1 ••' +' ' In�290 7vrJdU- f�M3 0,00 ni,r()n 111Ih. I,,f I, i mr.•_t 1As•,r.•I,lo.�1:91••,r ril Atl'•.Ni!I!n':+e n'I, - d, .bo2u, ,;,r•^]' •o u'f'a'(er•r!v1)1319AT mod aa;ytr. ".dn ntr.„n :n4rU,brr.N- ,tI, .!,. f. Ic O,Dl ri &W" G) . 1 „1 i nc, .:,r• •,'; - ,rl• ,; ! li pn?r,1lA:rt0,1 •57'rn!f: (D O 39yT nIMAW03•13Ja0.T , 7 LL (z!1,.-Iln,JOn:I r ;, ... „ rf I,-!nr., r.1;) _-_ - ___- ,1 n:7.,.•I r,r__'�T .. (D J r IAddihonal Descnptwn jR5 alerSal; Isle (� 914�;9 a0 is` K` 'nd ing Cbd6s for Wastes'Listed Above tV y ., T i hr {•1 , '� t ,/.k flp9ii D -niq,D n l ,fD,i'+ 1,1 0 �.,sq1� Eped bllkin try ,9gaq.rt tp.qnl 8 AB 1�,<` ".s.f`'t.'�`` •pa iaU,f gmu0:r TQ- .. ,,< - A 1 •' iebnc!�;T 't;? f '� . e a "r`•'fi�>rk I.., rt+? +s.. 4 ' f, is Will, 9i¢aw'10 t tnr nP!r ro .irlC )n 0T t rdb! bad at.,TON w (it pontltsb r woe .0 6,11 0dr,d 'I (jn_V_!l r)V71N_U'.:er mv1 co b ;rf'.(^ t.+' ;fry p -.i ,;s{ d S xt�'t, bd.. O ` � - ., �•tn,eV uidu0 'y " v� ° .' '- - •(vino ebw III e,:itr.+ - 1r�,. r,lnn. hd m,nnunC7+ 0 15. Special Handling Instructions and Additional Information """'9'' cc znoi � vwr:n7YLlla:�:�i'; �,rw'1'a'V-�•,-...• J'nail'?,:q7!'r^nri, 1 � '� !.•��t * �q a fi �'z w ' .;s •� '- r , Q rnr.I,r r,,rnl 7l' tt •uv,l1•..,Inn.^ 9:r' Anl nn r. �4 'l1' l Q' Xar�'-. ! 1. ,r' 7 _I•: O ,, 2 ' 3•',-rtIt a D r 9 .p(.ws•. aMd'.u.r..i..+yw.w+wr.:.i I CD U L n.� I"It'nu 1 ) .. .. .. ,I, � )1. ).!r,!.I^:7„!r:)c I oft U n P is t ; "... .I-- � .: ., J 16.'`GENERATOR'S CERTIFICATION:1 hereby declare that the contents of this consignment are fully'and accurately described above by ' .f1 proper shipping name•and,are,classified,packed,,marked,,and labeled;'arid are ih'"all'res'pects in pibper conditiori'for transport by highway ! v,according to applicabl00 e"Igternational and.national,goverTirrienLr`.egulattos„and all.app)icablA State laws arid.regulations. „ =,_ z w It I am a large quantity generator,I certify#hat I have a prtigrarn in placa to reduce the volume grid tbxidityof waste generated to the degree I have determined to be vDrl;economically practicable,and thatl have selected the practicablemethodottreatmentIstorage„or disposal currently available to me which minimizes the present Q z .,oi,>,and,f h R uturethreat to human ealth and theenvironment;O ;if I am'asmall quantity generator; a good faith effortio minimize.my waste generation and O a select the best waste management method that is available to me and that 1 can afford. w Printed/Typed Name Signature Month Day " Year r,n bndilu,nb nronv/9A;10 n?n,;q',:iA nD}19!NK)^�';I'Ii ^.Iv1+n(l toll* tt'( ,:'Indt" ?fh tp ticd^Ir nlrr,W•dlDnJga9]n nn.. ,•I"pmm�, ,I,•!q,' , '+•.+"q,"""."•'�"'•"^^^.,. •rP. ._ ._ .. .. p T 17.Transporter 1 Acknowledgement ,of Receipt of Materials < A Printed/Typed Name Si azure "' Z N n��_h••su:u!Y^!�•a''tGj�•e0v ^ivmunn)v ;7;t r...p ni D9'•^ll nroew r....,.:n!y91iab1 r,; g((yy,,r+. n• of ;ba'!it r Month Day Year LLIs ' j { t ,. i-- P ti H 18.Transporter 2 Acknowledgement of Receipt of, Matetii315 r}o}rT 3rA ayiJnt n}a z.3aOJ 22370n9_1713J QAT a Printed/T ed 'Name'or :,„,n,n;a-;c,': :.wa nV.:. - ._.... T- ... T Printed/Typed Signature,: ;,;,r: ;11.^, •,,.,, z E Ilrin rn7(•I!DIl;d a�[I,U?)r.go ,r,na yL•.r)gz"rv!1Q't-nl ,rdl LU-r p(:nm!•nunr,•, 1). Month Day Year 1 ,IG,nni. O -r.(!ion.,2..,(':!',i�nQ I yr ?'In,1?•tr N! It ^ + 1;9.Discrepancy,lndication Space J .. .ip!. , :n:^J.,.. lllr airil rl^..:n 7al vi,,n; qp,O n'uU 2V;ili:,q1 nn:r•npi;..b n'if�. :,g;r,9'):T, ^tit;:It, •'t: ,, .. ... ,., r... E r !nn,v9,oV.,M.j,arlrJ Oilrnllggn tnq nlr,af,nt . „1!Innr'1'=.nga,,_.,•n'nnp,!aDib,+nAdhw DnM•:gr+rr l•nlad 9,Ibr, .:rl•, n:•1••+1)^It•vr r.r In F .vnnv a A rnnl',r burn no^rig'nnT 9oi T.b.tarp?.. ••1:• ' nrlt'o,la,lnn no ntrr W^dJ nr•ht•.+,9 nn'.,n•7^ru It,nnv',1 9 'Iv , u,i' i t -t I;, -.•\' i O C nl{r'b`tlh0'tl, nnH l(il)(1^,r:,)9nnf,IgnJ:,fs a^IGYfnll lr':•Or 1 t'.,. od;Jr.^d'tn I!nnplt9dT IC'.❑�n:nritlonfabnrli '1;.,.._r,VI!I:;,ftt•:DI'Y,":• _ 11. ,.. :n t . , Z L .,..roc.n -. n,.. .,.;.•,,, ,r n•n. ,-nn•r,u, "c • wT 20.Facility Owner or:',Operator:"Certification-of receipt''of',hazardous materials'covered,[by'this!manifest-except as-noted in Item 19.' F y Printed/Typed Name YJJATOT 38 TBUM •S natura-iT 10 171600 8 JJA J1391. p 1,•:,?ft Month Day Year z EPA Form 6T00.22(Rev,9.66) Form Approved OMB No.2050.0039.Expires 9.30-68• Previous edition is obsolete. COPY 7: GENERATOR STATE - Mailed by Generator EPHM-2 REV.9/86 ,.-.- 'STATE OF CONNECTICUT j DEPARTMENT OF ENVIRONMENTAL PROTECTION Hazardous Waste MANIFEST PROGRAM;State Office Building,Hartford,CT 06106 s Please print or type. (form designed for use on elite(12-pitch)typewriter.) r UNIFORM HAZARDOUS 1.Generator's USEPAJD,No,.'y Manifest 2.Page1 Information in the shaded areas-is-not WASTE MANIFEST Document No. of required by Federal law, but may be I re uired by State law. 1? 3. Generator's Name and ailingF ddress r. A.State Manifest Document Number r } ', .«` ' CT C 01873 00 . r - - � B:State Gen.ID a 4. Generator's Phone (' r ran�rs�porter y= ompany ame -6. US EPA ID Number C.State Tran,ID f t' w �€ #. of 91tichc t v; ! D.Tran.Phon J p I. transporter 2 Company Name 8.•`, US EPA ID Number E.State Tran.ID n w F.Tran.Phone o Designated Facilit Name and Site Address 10. US EPA ID Number G.State Facility's ID o + ' 4 w H.Facility's Pho Z o m 12.Containers 13. 14. �J 0 11. US DOT Description(Including Proper Shipping Name,Hazard Class,and ID Number) - Total Unit I D 0 No. Type Quantity Wt/Vo Waste No. a G a Z O E nvmtl$ "Reaux4to +Sif�yr r 7D U N F A b. m U Z T - 't z O t O R O y - - J J FLf d.ir a CD o J. Additional Descriptions for Materials listed Above K.Handiirtg Codes for Wastes listed Above iV ar. c ' x:.. a. c. o u: 15. Special Handling Instructions and Additional Information w D 16* ti C) to 16. GENERATOR'S CERTIFICATION:I hereby declare that the contents of this consignment are fully and accurately described above by 00 o: proper shipping name and are classified,packed,marked,and labeled,and are in all respects in proper condition for transport by highway m according to applicable international and national government regulations,and all applicable State laws and regulations. w If I am a large quantity generator,I certifythat I have a program in place to reduce the volume and toxicity of waste generated to the'degree I have determined to be w economically practicable and that I have selected the practicable method of treatment,storageor disposal currently available tome which minimizes the present Q z and future threat to human health and the environment;OR,if l am a small quantity generator,I have made a good faith effort to minimize my waste generation and CD o select the best waste management method that is available to me and that I can afford. ran Printed/Typed Name Signature Month Day Year Lu ir - Q M ?� r p T 17.Transporter 1 Acknowledgement of Receipt of Materials-,. R a A Printed/Typed Name a Signature "" Month Day Year " - t+ _ $ .r 1.«L y/ /.' �'•_. r• ;P tee {' F P .. .. - O 18.Transporter 2 Acknowledgement of Receipt of Materials a R r T Printed/Typed Name Signature Month Day Year z E " U R , 19.DiscrepancyIndication Space , IL rn F a A lL C O LI Lu w 7 20.Facility Owner or Operator: Certification of receipt of hazardous materials covered by this manifest except as`noted in .Item 19. i Y Printed/Typed Name Signature ,• Month Day Year f_ J • - z EPA Form 8700-22(Rev.9-86) Form Approved OMB No.2050-0039.Expires 9-30-88. Previous edition is obsolete. COPY,7: GENERATOR STATE - Mailed by Generator STATE.OF CONNECTICUT DEPARTMENT OF ENVIRONMENTAL PROTECTION HAZARDOUS WASTE MANAGEMENT SECTION EPHM-2 REV 9/_86(BACK) :INSTRU:CTIONS, FOR COMPLETING THE CONNECTICUT.UNIFORM'HAZARDOUS WASTEMANIFEST, IMPORTANT:.R EAD ALL INSTRUCTIONS BEFORE COMPLETI NGTHIS FORM.ALL 8 COPIES MUST:BE.:TOTALLY LE(iIBLE.`-. ' 1 - 'fit ` i:.. I -3r+^.><►-`faSi,: .-. . GENERAL INFORMATION , The Hazardous Waste Manifest is designed to track waste from the point of generation to final disposal("cradleto grave").In order to accomplish this goal,it is essential that all items on the manifest be completed correctly. Incomplete,incorrect ori9egibie manifests are violations of the law.and could subject you to.civil or criminal liabilities as specified in•Connecticut Hazardou Waste Management Regulations--; The Connecticut ri7amfest contains 8''copies ALL COPIES MUST BE LEGIBLE!(illegible manifests submitted fo the State will qe re0rnedto&enerator for propjr completion),,Th sform is designed or useon a 72 pitch -(elite)typewriter.A firm ball point pen may also be used only if you press down HARD:,,The eight copies must be filed with the appropriate�parties as{they are completed' COPY DISTRIBUTION is as follows" _.. ,�a.. -• _:> „`•"'__ "d-"-"". �'•_"".�„'.. "'""^ _ _ ^"""•...(-'' COPY 1: -DESTINATION STATE Mailed by TSDF This original teys with the shipment from generahon`q cbmp�tlon by theT DF When the manifest is completed,the TSDF must mail this copy to the State where his' facility is located. - t •- _t• COPY 2: GENERATOR STATE-Mailed by TSDF:When the TSDF_has completed his section of the manifest,he mails this copy to the State where.the waste was generated. r I COPY 3: GENERATOR COMPLETED COPY:When the TSDF has completed his section of the manifest,he mails this copy back to the Generator of the waste,who must retain it on-site for his records. COPY 4: TSDF COPY-Retained by TSDF:When the TSDF has completed his portion of the manifest,he keeps this copy for his records. ._COPY,5: .TRANSPORTER 1.-.Retained by,Trans a porter;When transporter has of manifest.and trans.tars,the..waste.to,the.TSDF,.hc:keeps this copy-for his recortls ti,...,,,,,,,,' -.t' Y NOTE:If a CONTINUING TRANSPORTER is used,the Generator is responsible'for sopplying'him with a legible photocopyof the manifest,which must contain signatures where required.- I' COPY 6: DESTINATION STATE-Mailed by Generator:When therGenerator has completed his section otthe-manifest and transfers his waste to the transporter,he mails this copy to the State where the designated s acuity ITS OF)is locatad t . -. , . t GENERATOR STATE-, ailed,by the Generator:When the-G enerator has completed his section of them stand transfers his waste to the transporter,-he mails-this copy to theStatewhere the waste was Y generated. .- .ur . .•• , .a., -• - r COPY 8: GENERATOR-Retained by Generator:When the Generator has completed his section of the manifest and transfers his waste to the transporter,he keeps this copy for his records. GENERATOR'SECTION w'( Item 1: GENERATOR'S US EPA ID NO-MANIFEST DOCUMENT NO-Enter U.S.EPA 12 digit identification number(Conditionally Exempt Small Quantity Generators who have not obtained an EPAID number shouldl r enter the word"SQG"here).Then enter.a UNIQUE 5 digit number you assign to this manifest.Use of serially increasing numbers leg.00001,00002,etc.)is recommended. t ' Item 2:' PAGE 1 of-Enter the total number of pages used to complete this manifest,i.e.,the first form plus the number of Continuation Sheets if any.Any CT DEP approved Continuation Sheet may be used provided _ S distribution and completion meet Connecticut manifest requirements. 4 e 1.,a Item A: STATE MANIFEST DOCUMENT NUMBER-Number preprinted by CT except on the Continuation Sheets.Enter this number on each of the Continuation Sheets attached to or part ofa manifest under Item L.' i R Item 3: GENERATOR'S NAME&MAILING ADDRESS-Enter toe name(as notified to EPA A)&mailing address of the,Generator.This address should be the location that will manage the returned manifest forms. F:• -- ^-+(However;amanifest copy-must be kept at the actual site).=r .•ter --+---•}.•�- -• -► t- Item 4: GENERATOR'S PHONE NUMBER-Enter"a telephone number with-.area code where an authorized agent of the Generator can.be reached in an emergency " Item B: .STATE GEN ID'=The State Generator is the STREET ADDRESS of the Generator's pick-up location.If the mailing addressand the street address are the same;enter'same"in this block! ` i A-111 •.{.'.. Item 5: `TRANSPORTER 1 COMPANY NAME-Enter the company name(as notified to EPA)-of the first transporter who will transport the waste. I' " a Item 6: US EPA ID NUMBER Enter the U.S.EPA 12 digit identification number of the first transporter identified in Item 5. -'-""' ` •'-• -" "" "' - --- [ ••Item C: STATE TRANSPORTER ID-Enter the State of registration;&the license plate number of the waste-carrying portion of the vehicle being used to make,the pick-up. NOTE:ALL HAZARDOUS WASTE TRANSPORTERS OPERATING IN CONNECTICUT MUST HAVE A VALID CONNECTtCUT-TRANSPORTERS PERMIT. Item D: TRANSPORTER'S PHONE-Enter a telephone number with area code where an authorized agent of the transporter can be reached. " Item 7: TRANSPORTER 2 COMPANY NAME-If applicable,enterthe company name(as notified to EPA)ofthe 2nd transporter who will transport thewaste.If morethan 2 transporters will be used,use aCT approved- ' Manifest Continuation.Sheet&list the transporters in the order they will.be transporting the waste.._ _ �.,, ., Y, ;. _. ___,__,. •_ __ - .'c. Item 8: US EPA ID NUMBER-If applicable,enter the U.S EPA 12 digit identification number of the 2nd transporter identified in Item 7. It .'Item E: STATE TRANSPORTER 10-It applicable,enter the'26d:transporter's State of registration&license plate number for the waste-carrying portion of the vehicle being used to make the pick-up. { ``c •Item F: TRANSPORTER'S PHONE-If applicable,enter the 2ha transporter's telephone number with area code where an.authorized agent of the transporter can be reached. Item 9: DESIGNATED FACILITY NAME&SITE ADDRESS-Enter the company name(as notified to EPA)of the TSDF designated to receive the waste Its'ad on this manifest.The address must be the site address, ° x which may differ from the mailing address. l t i " ? A?C Q t Item 10: US EPA ID NUMBER='Enter the U.S:'"EPAA 2`dlgit identification number of the designated TSDF-identified in,item 9: •-' -- ^--•--_:. _ 4 •Item G: STATE FACILITY'SID-Enterthe MAILING ADDRESS ofthe TSDF.This address should bathe location that will manage the returned manifest.Ifthesite address(listed in Item 9)&the mailing address arethe same,enter"same". r i _ Item H: FACILITY PHONE-Enter a telephone number with area code for the TSDF gesignated to receive the waste listed on the manifest. - Item 11: US DOT DESCRIPTION All the following informat'r'on must be entered:The Correct US DOT(Dept.of Transportation)name for the waste as identified in 49 CFR Parts 171-177(usually found in Column 2 of ! " Section 172.101),theassigned DOT Hazard Class(usuatlfy in Column 3)&the'4 digit UN/NA ID n_umber(Colum_n3A).(E_xa_mple:Waste acetone,f_lammab_Ia quid,U_N_1090.)(FO.O_3)US DOT requires the word y- .Waste"before o,in the shipping name of all hazardous waste. - - - - "r Item 12: CONTAINERS NO.&TYPE Enter the number of containers for each waste and the appropriate abbreviations from TABLE 1 below for the type of container used. 4( ) (below) Y. ' t s TABLE I-CONTAINER TYPE 1 ti r , f w p OM=Metal drums barrels,kegs l tTP=Tanks,portables CM=Metal boxes,cartons,cases(Incl.roll-offs) y s 'DW=Wooden drums.barmis`kegs' `' - "TT'Cargo Tanks(tank trucks)• `.." CW=Wooden'boxes,canons,cases s OF=`fiberboard or plastic drums,barrels,kegs TC=Tank Cars CF=Fiber or plastic boxes cartons,cases f • CY=Cylinders _ ,' :DT=Dump Trucks BA=Burlap,cloth,paper,plastic bags Item 13: TOTAL QUANTITY-Enter the total quantity of waste cescribed on each line;relative to the units used in Item 14. t Item 14: UNIT(Wt.Vol.)-Enter the appropriate abbreviation from Table II(below)for the unit of measure used in determining the total quantity of waste described on each line.DO NOT use fractions. r ' . . r TABLE 11-UNITS OF MEASURE- P � 7�p -Gallons(liquids only) • 4 i T-T - -L„Liters(liquids only)— Y=Cubic Yards I P'Pounijs - `� _ K=Kilograms •-..•'".�_ • ""� .'-' -.�N=Cubic Meters .� _ y Y=Tons'(20001b.) M=Metric Tons(1000 kg.) `;Item l: WASTENO.-Enter the 4 digit EPA hazardous waste nuritber as it appears in 40CFR Part 261,Subparts C&D.(Note:if anon-RCRA,STATE REGULATED waste is being manifested,enter the State waste coiie ¢ d( here.If both the Destination&Generator States have assigned codes,"se,th'e Destination State Code.If there is no EPA State code,enter"None".Do NOT leave blank. n NOTE:Place an asterisk(')after the waste no.for wad to e which generars believe qualifies for exemption under Generator tax act C.G.S.22a-132 and cite reason for exemption under Item J. i !C Item .J;,,,,•..ADDITIONAL.DESCRIPTIONSFOR MATERIALS LISTED ABOVE-` Mdr description(ghemical names,constituentpercentages,,etc)forany,was_t<-;which has a US DOT shippingname.endi_gmN,O;S.If ft" E ST. P .� Y pP g O ( ( ) f ) y ( ) r••, . .you entered aaBTATEDESIGNAT DWA ECODE in Item I; rovide d$ tlon,or note an a Iicable EPAHazard Codesi nitabie t;Corrosive C):Reactive R,EP,Toxic E,Acufel Hai ardoua H.Tozic _(T).Enter specific gravity-if other than 1.0.Any additional desired waste descnption,may be entered here.. - �qr `Y• r ,nr; -tR'•.'`5 F• ••-x.' - J,_-'!Item15:, SPECIAL HANDLINGINSTRUCTIONS&ADDITIONALANFORMATI,.-Usethis'space toindicatespecialtransportation.treatment,storage or disposal or Bill ofLadmg mformation,ltanalte'rnatefaclity,is � designated,note it here.For INTERNATIONAL SHIPMENTS,the Genefator mustetiter`here the point of departure from the U.S.through which the waste must tr6ef before entering'foreigri country(Cityt& ( } y., }State)-.This space may also bausedfor emergency response numberij,nand other information the Generator wishes to.include about the shipmentt "` *t{+c, f-•ltem N: HANDLING CODES-TSDF completes this section-see"Designate'd_Pac(lity Section .(below)` • Item Ili: "GENERATOR'S CERTIFICATION-The Generator mustread,'sign(b;hir dIA date the certification(wi[h date of transfer to transporter)'ifi�a mode olht>rthari highway is used,the word"Highway"should'be a y r "i lined.out&the appropriate mode`(rail7water,=or air)inserted in the sp9_90e1ow If another mode-In addition to the highway'mode is used,enter the`apropriate mode(e•g "and rail•')"in'the space below.' TRANSPORTER SECTION 'Item 17: TRANSPORTER I ACKNOWLEDGEMENT-Print ortypethe nameofthe person accepting thewasteon behalfofthe 1sttransporter.That person must acknowledge acceptance of the waste described on the c {manifest by signing&entering the date of receipt. t .} F i t.ni •^�TRANSPORTER'2 ACKNOWLEDGEMENT--r-If applicable:follow instruchons forltem 17 forTransporier 2..'�•'*�-•+^-•^ � - - -•+ -•�• •-•- --•ry.« d t DESIGNATED FACILITY{TSDF)SECTION —, -, _ . _ r r-:.�. niT,�� a -�..r' R rt '�L x •�• r�._..,_ M1 w_ •Item K: HANDLINGCODES(TSDFCOMPLETES)-Enter the ULTIMATE handling method employed at the designated facility for each waste listed in Itemli.Only the following process codes may beused.(Sam}as I Biennial Report form codes). - . u ' taw.-x ...{,,. - ..-...r _.,....,. ,�i..,.... - _ _ � ` -.i..,.,..«.,,.,.--•--....� ..«.v-_........ .r......x.......�.•f .. '•,'•9 - • •.+� _ TABLE Ill PROCESS CODES/HANDLING METHOD CODES,Q? tq - trt< T tr ti ro- a rrt, } nt_ F e 1 1x. S ORAGEJ S01(Containers),_ S02(Tank) a—. S03(Waste:Pile) - SO4(Surface Impoundment) - - 'SOS(Other,.Specify)- TREATMENT: TOt(Tank) T02(Surface Impoundment) T03(Incinerator) T04(Other-specify code from 40 CFR D84(Surface Impoundment) ; ~_ DISPOSAL: DBO(Injection well) D81(Landfill) 1 082(Land Application) 26 5 Appendix 1.) D85(Other-Specify) �tthe . 083.(Ocean.Disposal)._ -item IS: DISCREPANCY INDICATION SPACE The authonzed,representative of the:designated facility's owner or operator must note in this space any significant discrep cy between the wastatlescrtbed on manifest&thewaste actually received at the facility'Anyreiected materialsshould be listed here,along with an indication of the disposition of the rejected materials.Any applicable Discrepancy or Exeeptlon ' reporting requirements must also be complied with:FBderal&State regulations vary. j t Item 20: FACILITY OWNER OR OPERATOR CERTIFICATION-Print or type the name of the person accepting the waste on behalf of the owner or operator of the designated TSDF.That person must acknowledge' F R -acceptance of the waste described on the manifest by sighing(by hand&entering the date of the receipt.The signature ofthe authorized TSDF agent indicates acceptance(except for items specified in item lg):: r: &agreement with the statements on this manifest. NOTE:.<FOR.ANTERSTATE..SHIPMENT.S.(between.different states).YOU.MAY.BE,REQUIRED.SO.COMPLY.WITH,THE,MANIFESTING..REOUI,REMENTS OF.BOTH-THEDESTINATION.&GENERATORST,ATES t, •-, • REGARDING-THE COMPLETION,OF-SPECIFIC INFORMATION-INCLUDED IN LETTERED ITEMS A-K..You maywish tp,contact State agencies for more information on this,subjectlg •,yrF•,e. �tlIfm;i :�•.w:,�,� ' 'Y ` ' REMINDER:ALL 8 COPIES OF THIS FOAM MUST BE TOTALLY LEGIBLE. t.,,eale.�t.rrMsNw�_.,asrc,rasww. swwc-<«r.r'w�tiK�e.= ` ... :>�raxanrc.-e....e,�,,...._..N,..�eve.,;...........�•H.. e �i - ,•. ,r-. , ,'C . ..., ., to(i r.+,^.6.3!t.a`L:`.._•f4 9 .r .t. Eid,(C•' Lr ,r J.F.^' ,r '"J 3 Ei.-2-F:. Wl]$„-.i°Ira.. Or''f.,f� "'"- . - � .•e A•A! r TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM 1 NAME OF FIRM: tt inn`"o MAILING ADDRESS: Qoute :140 TELEPHONE NUMBER: `furstotle Mills. Mam 11 �839t��i - CONTACT PERSON: D DM41-0 T. 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 y time, more than 50 gallons liquid volume or 25 pounds dry weight? YES N0 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 ,flollowing products exhibit toxic or hazardous characteristics and must be registered when s>tored in quantities tot lling more than 50 gallons liquid volume or 25 pounds dry weight. Please put a check beside each product that you store: Antifteeze (for gasline or coolant systems) Refrigerants Automatic transmission fluid w Pesticides (insecticides, Engine .and Radiator flushes. . . herbicides,rodenticides) ydraulic fluid (including brake fluid) Photochemicals ;Gasoline, otor oils/waste oils Printing Ink Jet fuel Wood preservatives Diesel fuel, Kerosene, #2 heating oil (creosote) Other petroleum products: grease,lubricants Swimming Pool chlorine Degreasers for engines and metal LYe or caustic soda Degreasers for driveways & garages Jewelry cleaners Battery acid (electrolyte) Leather dyes Rustproof ers Fertilizers (if stored �''� - Car wash detergents PCB' s outdoors) Car waxes and polishes Other chlorinated hydro- Asphalt & roofing tar carbons, (inc.carbon Paints, varnishes, stains, dyes tetrachloride) Paint and lacquer thinners Any other products with Paint & Varnish removers, deglossers Paint brush cleaners "Poison" labels (including chloroform, formaldehyde,. Floor & Furniture strippers Metal polishes hydrochloric acid, other i Laundry soil & stain removers acids) (including bleach) Other products not listed which you feel may be Spot removers & cleaning fluid E C E N V E ® toxic or hfeel may be ase (dry cleaners) HEALTH DEPT. Other cleaningsolvents list) : TOWN OF BARNSTABLE Bug and tar removers Household cleansers, oven cleaners Drain cleaners Toilet cleaners Cesspool cleaners MAY 1 4 1981 Disinfectants Road Salt (Halite) 2;C) TOWN OF BARNSTABLE BOARD OF HEALTH t CONTROL OF TOXIC AND HAZARDOUS MATERIALS - INSPECTION SHEET FIRM ` t ADDRESS--'.. / )C,f 1 - .J Major types of materials: 1) 4 2) 3) 4) S) 6) I. Description of material (s) use: II. Storage (denote. product by number isted above) A. Containers e t a I glass paper plastic cans,bottles,jars drums,barrels / 0 y� aboveground tanks r � . underground tanks \!^ a d S M ./dt n bags,boxes open,loose,uncovered inadequate labelling B. Storage Facility �/or•# Remarks/Recommendations 1. Indoor a) separate, contained room b) stored: in general work area :-i)' inadequate ventilation= ii)..floor drains b nadequate fire protection ` 2. Outdoor a) uncovered, exposed to weather _ b) `pervious_surlace/Eatt.Hs-]iasins - III. Disposal- A. Reclamation/Recycling unit B. On-site disposal 1. Town- sewer _ 2. Regular septic system �. 3. Separate holding tank C. Off-site disposal 1. hauled by own firm 2. hired hauler f i a) name of hauler (,C1rt b) address or disposal site Person(s) Interviewed _ _� �. — — — Inspector,'' - - — Date THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA TOWN OF BA R N STA B L E COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repai.r satisfactory 2. Printers BOARD OF HEALTH 3. Auto Body Shops Q unsatisfactory- 4. Manufacturers COMPANY ��L� 1 G� �rt��1 � (see"Orders") S. Retail Stores 6. Fuel Suppliers ADDRESS el(.r �� n�'� Class: 7. Miscellaneous QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums AboveTanks Undetground Tanks fIN IDUT IIN IOUT IN UT # & gallgne est? Fuels: Gasoline, Jet Fuel (A) 4 Diesel, Kerosene, #2 (B) i Heavy Oils: 1 waste motor oil (C) I It new motor oil (C) transmission/hydraulic 17J4 'e)`' Synthetic Organics: i Z. i degreasers — � ZO Miscellaneous: DISPOSAL RECLAMATION REW RKS: 1. Sanitary .Sewage 2. Water y OToASewer Public ar/On-site O Private 3. Indoor Floor Drains: YES NO 4 Holding tank: MDC r O Catch basin/Dry well On-site system 4. Outdo ur`face drains.YES L NO H«ldinL. tank: MDC Catch`basin/Dry well oOn-site system S. Waste Transporter Licensed? Name�� Detesting ;on Waste Pr ct u f . t i2 si Person(s) Interviewed Inspector Date rOWN -r "�•l.UP1Y W AI`II.Ca:�ns.i. �. ..�-----►- ��F BAi�N`�' l?/a1BLE : . L. 2. Printers-- - B OA R OF H E LTT )0 satisfactory . • 3, Auto Body Shops ( { Qunsatisfactary- 1, 4. Manufacturers (see"Orders") S. Retail Stores COMPANY 6. Fuel Suppliers ADDRESS Class: 7. Miscellaneous - L QUANTITIES AND STORAGE (INnindoors; OUT=outdoor 6fAJOR�MATERIALS R e Case. lots Drums AboveTanks Undetground Tanks IN r e ram+ duel s: ". Gasolin Jet Fuel (A) Diesel, Kerosene, A2 (B) n Heavy Oils: waste motor oil (C) new motor oily , transmission/hydraul� Synthetic Organics: • ti de reas..ers A— MIS 11 a us: J DJSPU5AL RECLA ArIUN REME.RKS: 1. Sanitary Sewage 2. a r Supply Town Sewer Public - On-site Q Pli4ate ' •3. Indoor Floor Drains: YES O Holding tank: MDC O Catch basin/Dry well . � On-site system A Outdoor Surface drains:•YES ( Q "uldinL. tank: MUC OCatch basin/Dry well ------ COn-site system S. Waste Transporter Licensed? . yu �;-•C�,;��G ;r -trot.. 1 IV _. u of ers s) -Int-ei-Viewed Inspector Uate P�pf THE T��♦ ®. - b�g��a� ta. OFFICE OF = DAANAZL L a BOARD OF HEALTH 367 MAIN STREET HYANNIS,MASS.02601 TO: Martin J. Flynn, Chairman Board of Selectmen FROM: Thomas McKean, Director Health Department f RE: Village Garage, Route 149 Marstons Mills/Update I am in receipt of your memorandum dated February 21, 1990 concerning your request for an update of the contamination found at the above referenced site. I telephoned Henry Cui, DEP Inspector, on February 22, 1990 and obtained the following details: - .Donald MacEachern applied for a loan, and according to M.G.L. 21E, a site investigation was required. - September 29, 1989, DEP received a report entitled "Site Report Relative To Oil and Hazardous Substance Release On Property Incorporating the Village Garage", prepared by JRS Environmental Management Consulting of East Falmouth, MA., for NOVA Realty Trust of Marstons Mills, MA. The following petroleum hydrocarbons were found in the groundwater at this site: Benzene - 165 to 260 ppb/MA and EPA Limit is 5 ppb. Toluene - 110 to 195 ppb/MA ORSGL - (Office of Research and Standards) Limit is 2000 ppb. Xylene - 2,400 to 4,090 ppb/MA ORSGL Limit is 1000 ppb. The property is now defined as a "Non-Priority" Disposal Site by DEP. This means the property is not located near any private wells and is not located within any zone of contribution to public water supply wells. However, the contamination must be removed regardless of it's classification. - On February 14, 1990, DEP sent a Notice of Responsibility to Donald MacEachern and Deborah Schilling. S/he is to provide DEP with a written response within 14 days indicating whether s/he accepts the responsibility and intends to take remedial actions at the site. - The consultants, JRS Management, could not find the source of contamination. However, they believe the contamination is due to overfilling of the Tanks during the gas shortage in 1972 or 1973. The four (4) underground fuel storage tanks were replaced in 1987 according to our records. They are double-walled fiberglass and meet all the Town and. State Regulations. The consultant did not find any leaks in the tanks. (See enclosure) If you have any questions, please do not hesitate to call. Enclosure Copy: Warren Rutherford Barnstable Board of Health Town Hall Hyannis, MA 02601 Barnstable Board of Selectmen y Town Hall Hyannis, MA 02601 DEP - SERO - Data Entry y