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T 4 )�y"1I Nl f` 1 - f f r' _�'I F L { / Y 1,e„ va+-v , t 0 s, l ," * [3 ,j r '� , v }y-{lwi '�i ,,. , „ .,a'ua .s�.t..n .z W, Town of Barnstable Office:508-862-4644 • °� Public Health Division Fax:508-790-6304 BARMS�LE. 200 Main Street• Hyannis, MA 02601 2639. �0reoran+°�0� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Ra"A /`7 `�0` o `�h.Pn.vw Date: I Location/Mailing Address: S V1AA Contact Name/Phone: Inventory Total Amount: MSDS: License#: Tier II : Labeling: Spill Plan: Oil/WaterSeparator: Floor Drains: Emergency Numbers: Storage Areas/Tanks: Emergency/Containment Equipment: Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: _ LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil&stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, drochloric acid, other acids) VIOLATIONS: �� S h Olt W VC—(.� C k ORDERS: JIQ INFORMATION/RECOMMENDATIONS: fT Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS f•