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2155 IYANNOUGH ROAD - Health
2155 Iyannough'Road/Route 132 r� West Barnstable '/ A = 215 -027 - 002' ' ' °p�HE Tpk� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 9B^"MASSB4E'� 200 Main Street• Hyannis, MA 02601 059. �A'FDMP TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: 6061 Date: Location/Mailing Address: -1,�Aarynlluv r in Contact Name/Phone: q " Inventory Total Amount: MSDS: License#: �l Tier II : N® Labelina. Spill Plan: _ Oil/WaterSeparator: ,��� Floor Drains: Emergency Numbers: Storage Areas/Tanks: CLOS K .0 1000 Emer enc /Containment E ui ment: 5 d` (�(� 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 SWWl I 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 ug and tar removers VHydraulic fluid (including brake fluid) indshield wash Motor oils Miscellaneous Corrosives -ZGasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: Q Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS t J? Number Fee 1150 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that MID CAPE MOBIL INC. ................................................................................................................................. 2155 IYANNOUGH ROAD, WEST BARNSTABLE, MA ........................................................................................................................................................................ Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. .................................................................................................................................................................... Restrictions: ............................................................................................................................................................•....... This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health 1~ Town of Barnstable sue Inspectional Services BARNSTABLE • �' ^ kNTAU 0EtVILiE•CONR•YY4ANI5 w Public Health Division MYS YISN'LLS•�SF0.VLL=•?kS B?FNSMBLE ]639y-72014 t' BAMMBLF, Thomas McKean, DirectorMAW ; ec 9. 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 ;' s, APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE e..r HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 Rvsr eAch�CATEGORY 2 PERMIT 111 —499 Gallons: $125.00tt CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ c� (p *A late charge of$10 00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. ,� I�� - as-+ - t'901 2. IS THIS A PERMIT RENEWAL? ✓YES_NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF • GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT:5. NAME OF ESTABLISHMENT: w1ek nn L I 6. ADDRESS OF ESTABLISHMENT: C r-'C At 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: SO , �6. -- b -4 I 9. EMAIL ADDRESS: 10. SOLEOWNER: y YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME v� PRESIDENT 1 TREASURER ')i CLERK >% .1 >> > > 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: • COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE �S Q\Application Forms\Haz Mat Appli Draft Jan2019.docx �i • i Number Fee 1150 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that MID CAPE MOBIL INC. 2155IYANNO UGH ROAA WES T BA RNS TA BL E, MA Is Hereby Granted a License For: Storing or Handling 111 -499 gallons of Hazardous Materials. ---------------------- ---------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2020 unless sooner suspended or revoked. -------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health Town of Barnstable Inspectional Services BARN;' LE � E � WPSTO%M1'.1.SE OTiT LLE,-'T&A 14.E Public Health Division :T=9-2LL1Q a : BARNSTABLE, ' Thomas McKean Director Ca MASS. 200 Main Street, Hyannis,MA 02601 , Office: 508-862-4644 Fax: 508-790-6304 ;-A APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALSL IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS DULY I st-JUNE 3 Oth). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons:. $ 50.00 ❑ -CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 9VE;�d C�V CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ � *A late charge of$10.00 will be assessed if payment is not received by Jules L ASSESSOR'S MAP AND PARCEL NO. a 15- - 02';k - 002 2. IS THIS A PERMIT RENEWAL? %YES_NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS • ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (p25 GALLONS)? YE-�S NO. lcJ(4. FULL NAME OF APPLICANT: .SeA e . I`-i • Cy1C�t 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: t S5" fnv�v, cA W y> 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: C.-DOS 3 bZ 620 1 9. EMAIL ADDRESS: tMiucc �4D tno., - Go L 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: 5-0-jr CORPORATION NAME PRESIDENT -" 4 CGS ' d� _ 1�h� -a16S3 TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT ATE Q:Appl:.cation Forms\Haz Mat App Revised 09-10-18.do x— d+ Number Fee 1150 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that MID CAPE MOBIL INC. 2155 IYANNOUGH ROAD, WEST BARNSTABLE, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------- ----------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2019 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF, D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2018 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health r Voeg8atorywof B rnsxable Services Richard V. Scali,Director ' THE Public Health Division BABSTABLE • • WNSAU-CENTER YII IF. -WMMS "'� 6aa"��S"��BARN&MBLF, Thomas McKean,Director 1 ; 4 i0lec 659. a`� 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st-JUNE 3 Oth). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 x v,s . CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. IS- 013 - oo;i_ 2. IS THIS A PERMIT RENEWAL? ✓ YES_NO. IF YES, SHIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGEIUSE OF • GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: Sa,eecX A . Onau r 5. NAME OF ESTABLISHMENT: m rl re e- f 1 o 4n; I I VI G 6. ADDRESS OFESTABLISHMENT: a1SS' , ZUG�V►N01CO1 � 0.tX .11�" .�I/L�lc 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: SD 3 61 - 3-1 1 9. EMAIL ADDRESS: ( �,Jaoe M015i1 ® yQ, 6 o o Co M 10. SOLEOWNER: YES✓'NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: �;0 8 18 1 O-4-4 CORPORATION NAME IA Cape_ mnk-Nj �Jl PRESIDENT Soee (n "e, - M -O1.b''3 TREASURER 11 1 i CLERK )7 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT �7— DATE Q:\Application FormsViAZMAT APP 2017 REVISED.docx r0ornd for►ld mov Zl®0 Town of Barns DTe Office:508-862-4644 °� Public Health Division Fax:Sos-Aso-ssoa BARMASS .1$!. 200 Main Street• Hyannis, MA 02601 A 039•p�0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rED MAC i 1 a � Business Name: ki i nC, Date: l9/1 qq Location/Mailing Address: J Contact Name/Phone: Qu .1 cl.l'h cl. Inventory Total A unt: SDS: V ®d License#: ® � s Tier i'I : 0 Labelina: 'es Spill Plan: Oil/WaterSeparator: Floor Drains: PT EmeraencvNumbers: . Storage Areas/Tanks: v OLS 1 (710 QW10f) Emer enc /Containment Equipment: e G Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: 0 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 t 0 Dry cleaning fluids Automatic transmission fluid..• Other cleaning solvents&spot removers Engine and radiator flushes ug and tar removers Hydraulic fluid (including brake fluid) � indshield washIS 4- for oils 9,0 4 �0, 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 V 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) sphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains,.dyes Lye or caustic soda Lacquer thinners k/ Miscellaneous Combustible aint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: "fti✓ ^L si a 'h Q�c�i�,�� t Inspector: Facility Representati WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS °F(NE Tp� Town of Barnstable Office:508-862-4644 ~0� Public Health Division Fax:508-790-6304 BARNSTABLE. MAS& g. 200 Main Street• Hyannis, MA 02601 A p t639 A., jvvlG M �. -Z- rEDMP+ TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT �,� Business Name: C 4 MOV I Date: Zs l$ Location/Mailing Address: Contact Name/Phone: D -2-7 04 6z1� Inventory Total Amount: A, 100141 SDS: ovOtva- kze-6 S License#: Tier II : 0 Labeling: &&all Spill Plan: Oil/Water Separator: Floor Drains: .? Emergency Numbers: Storage Areas/Tanks:' 2 + + , Emergency/Containment Equipment: c vas 4 k-o Waste Generator ID: AAV 0 ?-V It Waste Product: , Date&Amount of Last Shipment/Frequency: 1(4 !? 1 WX,4z,r Licensed Waste Hauler&Destination: Cyw Dt 5 ova �ov� 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. 2•-1 Antifreeze Vi Dry cleaning fluids (_ Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers 10 Hydraulic fluid (including brake fluid)% Windshield wash H 4 +I 10 Motor oils 5,Ik 3-1- +Z-5'1al Aryw-6 Miscellaneous Corrosives Gasoline,jet fuel, aviation gas �wbte-. 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 1J Miscellaneous Combustible 7- 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) !,D Any other products with "poison labels" (O L t ro l «k 2 k (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: Mou vy&da A.vc . 1 Q 4 t ewL Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS THE T°� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARNSTABLE. T; MASS. �, 200 Main Street• Hyannis, MA 02601 +639•e�0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rF0 MAC Business Name: I Date: S Z Location/Mailing Address: Zt A,f A-10 !Q-- Contact Name/Phone: o�Jwc-.r .�.e - y-1o66ro r- 1�4►�t4�1 - 2- «Z Inventory Total Amount: "- 21 5-4,k I+VSTS SDS: ke,4,c 5 License#: i 1 "O ['4A 2 Tier II : a — 1 Labeling: _ a Spill Plan: ? S Oil/WaterSeparator: q,4 Floor Drains: o Emergency Numbers: Storage Areas/Tanks: 1 950'\_6 - - %DY,, a cis i - d ,.e s SQ I.k 2-TS 4,1 Emergency/Containment Equipment: OL4 Ike Waste Generator ID: tMV o Zt( Waste Product: 61111o,l yo1, S Date&Amount of Last Shipment/Frequency: sT G-I 35o Ib 7 �L J, 45 A_R_-e_o4j2J nab 04&0f_ `t�aK IXlr r' Licensed Waste Hauler&Destination: C yw D� I $�",v,-, ►M�A Other Waste Disposal Methods: I LIST OF TOXIC AND HAZARDOUS MATERIALS !Vo I o'e clnaw�L I,, ,r�,k, onl s,hct �as-F ►v,ipae,+,,v•ti, 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) V Windshield wash V Motor oils a-w"t-e-- 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" 151 (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION RECOMMENDATIONS: u2s o� !2 avt. Inspect :_ . Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS oFt lok. Town of Barnstable Office:508-862-4644 o� Fax:508 790 6304� Public Health Division BARMASS. 200 Main Street• Hyannis, MA 02601 o'ru•+1, TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT �� ib SAA �v � Business Name: a I I Date: Location/Mailing Address: S� a a 2�✓ts b Contact Name/Phone: o - L i 4 a o(- - - C-P 62 J1 Inventory Total Amount: M� MSDS: License#: 11 SO Tier II : =0 Labeling: bb Spill Plan: ?/eg Oil/WaterSeparator: 10 Floor Drains: N C Emergency Numbers: ye- Storage Areas/Tanks: 3- 9--►o t - '5914 1OK 5 x ko ke 1 - a l -i �5fie o r1 Emergency/Containment E ui ment: d<q av r"k 4 b\-e- ovL 5 "4e-+ Waste Generator ID: 2-621 1 Waste Product: o, I Date&Amount of Last hipment/Frequency: c, .& S Our I a -� S ram, Licensed Waste Hauler&Destination: . k k kS / Other Waste Dis osal Methods: t a,1 i"t vtl 5 IST OF TOXIC AND HAZARDOUS MATERIALS ss��`�. 72��86 06) 6 /7-3$q-f�y5 NOTE: Under the provisions of Ch. 111, Section 31, ofggtFie General Laws of MA, hazardous material use, storage J and disposal of 111 gallons or more requires a license from the Public Health Division. -y S -- Antifreeze 3 D-k'0 Dry cleaning fluids Automatic transmission fluid G-V k� Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers �— Hydraulic fluid (including brake fluid)3�1 Windshield wash ?o k ZH Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes �— Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: No i5sy4S of I, - -�0 1✓�Cv, C�- ak�l y� (�1 Inspecto : • L.4.Vt_4\ , V So Facility Representative: 83(02�Z11 WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS �0 IKE fokh Town of Barnstable Office:508-862-4644 0 Fax:508-790-6304 Public Health Division BARMASS. .) 200 Main Street• Hyannis, MA 02601 �'DlF1639. � TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: MI CO MAO I Date: Location/Mailing Address: 1 Zk Contact Name/Phone: owK."- Sate. 6,Jr Ak r- Kt 11 6+ore- So -3b2-�ii 2 So Inventory Total Amount: MSDS: License#: I V50 - 1QY Tier II : 00 Labeling: U00 Spill Plan: yes Oil/WaterSeparator: N P\ Floor Drains: 0 Emergency Numbers: ye-s Storage Areas/Tanks: - S A&I c0--qae aAk,-- o,l abet Emergency/Containment Equipment: S 4 a� abl Waste Generator ID: MJ 000D I orb Waste Product: Date&Amount of Last Shipment/Frequency: As „t c — t`d ('{ r vt5 o V% - 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. 3 Antifreeze 30 Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) 40 Windshield wash No Motor oils ,o x3q-r40 S0 w-6k., 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" to nEF l`b (including chloroform,formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: OP 15 OALNJ tK 1a o t v 3 o -� A OK.. a CQ a- dd �2aCv�v`�J • ��<�M�� 1S J�� t 1�'� Inspector:--—, 0O t 5SV•2..5 O( SP-Co, A&"et'�ApvtS ; Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS TOWN OF BARNSTABLE, r Date: �'�SP4-�'�0� 3�l TOXIC AND HAZARDOUS MATERIALS REEGNMRATM FORM NAME OF BUSINESS: IM��C Ga,p,� IMob� °" c'� Fm< rf BUSINESS LOCATION: ZI Ss 4NHo041ti l2ie , �`��'�5f"''�0 L INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: ��8-3ro2 -6 � ►Z «ems 5�8-362""�'� A- 33(o gwllo�s CONTACT PERSON: ya, \ r JLwj DQ�2— 7 b(A HOE NMBER: MSDS ONSITE?EMERGENCY CONTACT TELE TYPE OF BUSINESS: "Y,o co ¢ t a, �S INFORMATION / REC MENDATIONS:` skc.A t la Fire District: wcoio- o,l u � 4 ' SJ�D,r►.9r AQS,M��'OLea�%c�-�, . jKelk— Waste T � < fin '• P'A'400Z►0STf- w: Last shipment of hazardous waste: 6 ,I(xI.27 rs Name of Hauler: Destination: AIucj66 u�4p -Q, B _ �o��c�,MA Waste Product: K)a4-e-0-1 Licensed es No /M��Db6�$S Dom NOTE: OTE: Under the provisions of Ch. 111, Section 3T, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month re uires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. _ t-,.Y;L? - 3 7 Observed / Maximum Observed I Maximum -11- Anti reeze (for gasoline or coolant systems) Miscellaneous Corrosive NEW31,AY USED Cesspool cleaners 6 Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts(Halite) S+uc Hydraulic fluid (including brake.flZid) Refrigerants gkil a-21 �7 I S$ Motpr Oils ,4 1 +S� Pesticides Q NEW v,kw USEDs� (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals(Fixers) Diesel Fuel, kerosene,#2 heating oil ❑ NEW ❑ USED Miscellaneous 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 y„ Miscellaneous 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 (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform,formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) b Miscellaneous. Flammables b xocD�,�ah'. Other products not listed which you feel a may be toxic or hazardous(please list): Floor&furniture strippers 2 Metal polishes � p 9*Ww4 s 22 - �rs Laundry soil &stain removers pp (including bleach) l-k5�vt��c��w�{ t-V414G �0 45k,>� . `1 -g-o-t�'sC.�e. Spot removers&cleaning fluids q (dry cleaners) ,�- u�,w.�4��1� - A-t ,F 6W10 Other cleaning solvents Bug and tar removers +� � f(A2lb j Q Windshield wash 2 WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staffs Initials T'bWN -OF BARNST�BLE�- UNDERGROUND FUEL AND CHEM I AL STO AGE REGISTRATION � vv '�)av-w4cl� MAP NO. PARCEL NO. Z /,') 0Z/00Z ADDRESS . OF TANK: A'/c fir r ) V I LLAGE: �r� %Yl'l�c. � ! C - Number � �tr��t MAILING ADDRESS ( IF DIFFERENT FROM- ABOVE) : OWNER NAME: A/ AS 1-//C W6 'lj S PHONE: INSTALLATION DATE: V,3,i �x / � BY: r�! GAS? I.�s - /'7c I^:STALLER AIJDRESS: C-'. 1�tX ��`L6 Pl V/l1/sYy&Phh CERT.NO. *TANK LOCATION: J�' ,5� >!C/C' � ''1't J1�)�(/tJ�AA DtYOR I a!Y'T'0AN1< L�✓OCAT I ON W I TN MkSPK.CT TO HU I l_D II Nm> CAPACITY i�j TYPE OF TANKJt- 0-t,/ k-K�' IAGE '(,t.YRS. FUEL/CHEM I CAL t7G S TESTING CERTIFICATION [ J PASS C J FAIL DATE L LEAK DETECTION [ ] CHECK IF N/A TYPE/BRAND ZONE OF CONTRIBUTION [ ] YES [ ] NO DATE TO BE REMOVED FIRE DEPT . PERMIT ISSUED [ ] YES [ J NO DATE ) CONSERVATION [ ] CHECK IF N/A DATE BOARD OF HEALTH TAG NO. C to ( ] DATE r Y r * PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD ThY#,3 An F),o n+ TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. PARCEL NO. C_'Z 7ot2r' ADDRESS OF TANK 1 (. `a ,��� C ( �Pt' ' ' �I � V ILL AGE: Number star dwmeb rloe MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : tsc)ttvr OWNER NAME: /0-:)ss PHONE: 6W 1.75' 1713 INSTALLATION DATE: U7, Intl BY: t�lid. c4 jl c I NSTALLER ADDRESS: 1 , Cif �nX ���C� P �,/m lJ c,1h r ,�j CERT.NO. *TANK LOCATION: 6-f 1C �/Ah (OKSCA I ON TANK` LOCAT��I O //N WITH KKOPKCT TO NU I LD I Nm) CAPACITY I a dd TYPE OF TANK&-0nc l-lC WlA'GE VC6.aYRS. FUEL/CHEMICAL S TESTING CERTIFICATION [ ] PASS [ ] FAIL DATE LEAK DETECTION [ ] CHECK IF N/A TYPE/BRAND ZONE OF CONTRIBUTION [ ] YES [ ] NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED [ ] YES [ ] NO DATE CONSERVATION [ ] CHECK IF N/A DATE 1 BOARD OF HEALTH TAG NO. [ ] DATE I * PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD _.�� r, T h r, �� ��s r��;�1 �fa�-�o� �v���- TOWW OF BARNSTABLE — UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. PARCEL NO. 21, 6Z 1002 ADDRESS OF TANK: 6 1,3 fi��- �?�,�c� ICS) C' V I LLAGE: i c 61, L` if Nurn bar Y do me t-A—It. r MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : OWNER NAME: ILa PHONE:.U. •,{ _ INSTALLATION- DATE: �� r _ �9C° I �aY / 3 TNSTALLER ADDRESS:. #r� c, &x I �1 l�,r �t-fc x.& t,,,_ E_CERT.pNO. *TANK LOCATION: c' C <DLYC/R i of TANK// LOCATI ON W I TN PIR.iJ�wcm TG4 au I LLD I NO) CAPACITY/�010() TYPE OF TANK��• -IC ?// A^1�GE /MU," YRS.I FUEL/CHEMICAL [Die Is r I TESTING CERTIFICATION [ ] PASS [ ] FAIL DATE LEAK DETECTION [ ] CHECK IF N/A TYPE/BRAND ZONE OF CONTRIBUTION [ ] YES [ ] NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED [ ] YES [ ] NO DATE CONSERVATION [ ] CHECK IF N/A DATE I BOARD OF HEALTH TAG NO. [ ] DATE PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD `k L-rl �31 � as NYc#J fzftoL, w� Number Fee 1150 THE COMMONWEALTH Of MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that MID CAPE MOBIL INC. 2155 IYANNOUGH ROAD, WEST BARNSTABLE, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. ---------------------------------- ----------------------------------------------------------------------------------------------------------------------- ----------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2018 unless sooner suspended or revoked. PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health r TUN-02-2017 08:39 From:BARNST HEALTH 915088624713 To:5083626211 P.2/3 twr of Bvnstablegu ataxy Services r Richard V. SCAH, Director ' Public Health. Division. . . . $ MAR Ae w., STABI�E Thomas McKean, Director eoan i a 200?vl,airi 5[Cek,T-Tyaiuus, MA. 02601 0 (>fficr. 508-86�2-4 X. rssa508-790-6304 APPLICATION FOR PERMIT TO STORR, AND/OR UTILIZTI',,5 ° HAZARDOUS MATERIALS � IN ACCORDANCE WITH TI fI TOWN OF BARNSTABLE 0ENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATFRIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MA'I'ERIAi S GREATER TITAN HOUSEHOLD QUA.NITFILS ARE RCQUTR D TO OBTAIN AN ANNUAL PERMIT(RUNS DULY Ist—JUNE 30th). 1 RY 1 PERAPPLICATION FEES CA1'Efi. MIT 26— 110 Gallons: $ 50.00 [] CATEGORY 2 PERMIT 111 —499(jallons; $I25,00 z J/f CATEGORY 3 PERMIT 500 ur more Gallons, $150.00 11 *A Iute chair e of$ 0.00 will bo assessed i1 vayment is not received by July Ist. I. ASSESSOR'S MAP AND PARCEL NO._4]S�..—. 2. IS THIS A PERMT RENEWAL? V VES—NO, IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS FI.AS ZON1NGI RIUDING A-PPROVAI,FOR HAZARDOUS MATERIALS,STORAGE/tISF,OF • GREATER THAN IIOUSEHO)LD QUANTITIES(25 GALLONS)?�Y>FS NO, 4, FULL NAME OF APPLICANT; C�f j9 9�� 5. NAME OF ESTABLISHMENT: /y 6, ADDRF,SS OF ESTABLISHMENT: l� �'-y�/1// pc)6r141 ?. MAILING ADDRESS(IF T)IFFERENT FIIOM ABOVE: S. 'TELEPHONE NUMBER OF Ia,STA2LISHMENT: 9. ,MAIL ADDRESS: 10. SOLEOWNER: YES vN07!1~'NO,NAMF; OF PARTNER; 11. FULI,NAME, HOMF, ADDRESS AND TE EPIIONk;# F: . �` CORPOILATION NAME / o 1 / PRESIDENT TREASWTk;R _ 5 6 CLERK Ile 12. IF PREPARED BY OUTSIDE PARTY: ' NAME: TELEPHONE#: .COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT Q;;Apprc�tion RLVISED. ucx 4 ��e: 05 8-86�44 cF ok, Town of Barnstable Public Health Division Fax:508-790-6304 • RARNSTARLE.)' 200 Main Street• Hyannis, MA 02601 Fo�'Ap+ TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: /'kkZ _ A0 l Date: 07 3o,20;�o Location/Mailing Address: �y -- Contact Name/Phone: 36 Inventory Total Amount: MSDS: License#: �I�D Tier II : 06 Labeling: Spill Plan: Oil/Water Separator: 14 fA Floor Drains: 116 Emergency Numbers: Storage Areas/Tanks: ' 6 rDiate& /Containment Equipment: ° erator ID: s ? Waste Product: unt of Last Shipment/Frequency: aste Hauler&Destination:e 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 — ie' Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives (creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform,formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: , . " L� INFORMATION/RECOMMENDATIONS: Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number Fee 1150 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that MID CAPE MOBIL INC. 2155 IYANNOUGH ROAD, WEST BARNSTABLE, MA 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 06/30/2016 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2015 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health Town of Barnstable Regulatory Services Richard V. Scah,Director ` Public Health Division Ec►q" 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&3-D)7—Do Z DATE �'✓?® ` Z�l� APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN Ill GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT A ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER SOLE OWNER: YES "1/N0 IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION �f� ���Tj FULL NAME AND HOW ADDRESv �J 7� PRESIDENTS „y TREASURER CLERK_, �( ell, 1 0. r • NATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS �✓1.�1 �/� �� �!�/ � C� HOME TELEPHONE# C:\cache\Temporary Intemet Files\0LKD3U1AZAPP Rev2015DOC BIKE r, Town of Barnstable Office: 508-862-4644 Fax: 508-790-6304 • Regulatory Services Department HARNM8LF, Public Health Division MASS. Thomas A. McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt ,Hazardous Materials Payment received: $100.00 (Check) on 7/8/2015 Permit number: 1150 Check number: 5903 Check amount: $100.00 Name on check: Mid Cape Mobil Inc. Business: MID CAPE MOBIL INC. Owner: COMMONWEALTH OF (HIGHWAY) Address: 2155 IYANNOUGH ROAD/RTE132,West Barnstable ,y M' Number Fee 1150 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that MID CAPE MOBIL INC. 2155 IYANNOUGH ROAD, WEST BARNSTABLE, MA 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 6/30/2015 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 2/4/2015 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable Barnstable Regulatory Services Department Public Health Division + SABtv8TA8LE. � 200 Main Street,Hyannis MA 02601 fit• r" 2007 Thomas F.Geiler,Director Office: 508-862-4644: I:j7 FAX: 508-790-6304 Thomas A McKean,CHO .. f�7 ND Application Fee: $100.00 L NO.<D 1 S-- 0 o a�-DATE © ASSESSORS MAP AND PARCEL � � APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT S Q Q , C 6 au Y ti I NAME OF ESTABLISHMENT f i C'c�P e M o V1 L ADDRESS OF ESTABLISHMENT 1 SS - �0��� TELEPHONE NUMBER Sas SOLE OWNER: YES V NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO..= STATE OF INCORPORATION ma S_sa c 1n,A1o.� FULL NAME AND HOME ADDRESS O : PRESIDENT A Gno. hVi Q cln M A, TREASURER to h w CLERK V SIG, F-APPLICANT RESTRICTIONS: HOME ADDRESS rl- C�rc�v►�ie�t� �� , ���"'�'� 3 HOME TELEPHONE# } J:linspection handouts\Haz Mat Appligtion2008.DOC Number Fee 1150 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that MID CAPE MOBIL INC. 2155 IYANNOUGH ROAD, WEST BARNSTABLE,MA 02668 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 6/30/2014 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 4/18/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable Barnstable Regulatory Services Department Public Health Division MUMSIABLL MASS& b�0 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO �I LJ Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT /0 1,2 G � 11,1P 13IZ— zF 1 N� ADDRESS OF ESTABLISHMENT Y15 � '`� '` `���� TELEPHONE NUMBER SOLE OWNER: YES V NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO..)l /Mw1 d STATE OF INCORPORATION �ss� y�� s FULL NAME AND HOME ADDRESS OF: PRESIDENT 5446 ,4 C'/��//l�iy/`I' �/ �i� /II % G/, �� f4 All)t-V11.1,- IM 0a.-6� TREASURER IV CLERK SIGNATURE OF APPLICANT _ RESTRICTIONS: HOME ADDRESS �6:&1iU�f// A/ Si9olz6e/,� HOME TELEPHONE# e M rT ,9,)'7 J:\inspection handouts\Haz Mat Application2008.DOC r' a SPILL CONTINGENCY PLAN Emergency Coordinator,Name: Saeed Chaudhry Address: 2155 Iyannough Rd, West Barnstable, MA Daytime.Phone: 5 0 8-3 6 2-6 211 ,r Evening Phone: 5 0 8-2 7 4-6 6 6 6 } Fire Department: West Barnstable Fire (508) 362-3241 Barnstable Public Health Divisidn: 508 862-4644 DEP 24 Hour Spill Hot Line: 888-304.4133 Waste Hauler: Name,.` Clean Harbors Phone: 800 .444..4244 Building diagram indicating hazardous material/waste storage area, location of absorbent scavenger materials, fire extinguishers, firiz alarms (if present), and evacuation route (if applicable). ** See attached Site Plan l a spill or release, and preventing it from Actions to be taken to contro reaching a catch basin, sewer system or the ground. Station personnel have been trained to respond to all spills by using speedy-dry to clean up the spill . In the event of a larger spill . Speedy-dry will be used as a dam to prevent liquids from entering catch .basins i , { i 6 , -.a, ,nw:.......,,> .. L.a... _ _ m,%. ,. -..-.+.•. -.... .c, n..«a � .. .. fl _. ..,. w'}aw>.au:as 3, , E l ; { } A � .A ' C O T.... _..,...-.,._. ,,,n_... ..,�_"., ..> n...,.,-,- .� .,.,,..�. �..: ..-n _;._..,_ .�...,,-h ., .rat « .,._$..>,....».q. , .� ,.....<§-•«-^ 'r 8 t 2« > > E > £ r � a g i [ Y e LEv §. M> 04 W� 3 F ' 1 S t , 3 � t m , m a ......... 7i; , } } i { i 3 a { .a• �I r F �\ COMMONWEALTH OF MASSACHUSETTS ` EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS.<< ; r- DEPARTMENT OF ENVIRONMENTAL PROTECTION SOUTHEAST REGIONAL OFFICE . `' FHB 14 PI ;' 2 20 RIVERSIDE DRIVE,LAKEVILLE,MA 02347 508-946-2700 MITT ROMNEY s'. 'ELI;EN ROY HERZFELDER UV Governor Secretary KERRY HEALEY ROBERT W.GOLLEDGE,Jr. Lieutenant Governor Commissioner / February 9,2005 Sayedd Chaudry RE: BARNSTABLE—BRPWP63 - Midcape Mobil,Inc. Subsurface Sewage Disposal- 310 CMR. -, 2155 Iyanough Road 15.000—2155 Iyanough Road, Transmittal Barnstable,Massachusetts 02668 No. W058997 Dear Mr. Chaudry: Pursuant to Title 5 of the State Environmental Code, 310 CMR 15.412,the Southeast Regional Office of the Department of Environmental Protection has completed its review of the above-referenced application. As part of the application,the Department received a plan consisting of four sheets the first of which is titled as follows: "REVISIONS PLAN OF PROPOSED IMPROVEMENTS PREPARED FOR: . MID CAPE MOBIL,INC. 'SAYEED A. CHAUDRY 2155 IYANOUGH ROAD,BARNSTABLE DATE:NOV. 15,2004 LAST REVISED: 01/05/2005 HOLMES AND MCGRATH,INC. 362 GIFFORD STREET FALMOUTH,MA 02540" The submitted plan shows a"proposed modification to the existing septic system.Two septic tanks will be added. After a technical review of the submitted information,the Department hereby approves the proposal in accordance with 310 CMR 15.000 of Title 5,subject to the following provisions: 1. Construction shall be in accordance with the approved plans and Title 5 of The State Environmental Code.No further changes shall be made without the prior written approval of this Department. 2. IA/ritten certification that the system was constructed in accordance with the approved plans shall be submitted to this office with a copy to the Board of Health. Said certification shall be submitted by a Professional Engineer who is registered in the Commonwealth of Mas- This information is available in alternate format.Call Aprel McCabe,ADA Coordinator at 1-617-556-1171.TDD Service-1-800-298-2207. DEP on the World Wide Web: http://www.mass.gov/dep Z�'a Printed on Recycled Paper C 2 i sachusetts.Nothing in this provision is intended to interfere with the right of the Department to inspect the system at any time during construction in order to assess compliance with the final plans approved by the Department. 3. The system shall not be used until the Department has issued a Certificate of Compliance. 4. This approval pertains to the discharge of sanitary waste only.Non-sanitary waste shall not be discharged into the proposed system. The issuance of this approval does not relieve the involved parties from complying with any applicable Massachusetts and local laws and regulations. Should you have any questions regarding this matter,please contact Christos Dimisioris at (508) 946-2736. Very truly yours, 5A , Brian A. Dudley Bureau of Resource Protection D/CD/ cc: Michael B. McGrath,P.E. Holmes and McGrath,Inc. 362 Gifford Street Falmouth,MA 02540 Barnstable Public Health Division P.O. Box 534 Hyannis,MA 02601 ecc: DEP Watershed Permitting Program, Title 5 Section, Boston r V : Commonwealth. of Massachusetts i City/Town of Bourne N°b8997 Disposal System Construction Permit Form 2A M 5v0y`0 DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. Permission is hereby granted to: Important: Sayedd Chaudry Midcape Mobil, Inc. When filling out forms on the Name Name of Company computer,use 2155 lyanough Road only the tab key Address to move your cursor-do not Barnstable MA 02668 use the return City/Town State Zip Code key. to perform the following work on an on-site sewage disposal system: ® Construction ❑ Repair or replacement ❑ Repair or replacement of system components 2155 lyanough Road Facility Address Barnstable MA 02668 City/Town State Zip Code Midcape Mobil, Inc. (508) 362-6211 Owner Telephone Number The work to be performed is further described in the Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions: All construc on st be completed within three years of the date below. February 9, 2005 Approved by Date Environmental Engineer Title TO ALL NEW BUSINESS OWNERS: Fill in below: NAME OF NEW BUSINESS:� � TYPE OF BUSINESS IS THIS A HOME OCCUPATION? Z ADDRESS OF BUSINESS �� EY— Z`. �✓�`Y/ MAP/PARCEL NUMBER If you are starting a new business there are quite a few things you need to do in order to be in compliance with all rules and retulations of the Town of Barnstable. Once you have been checked off on this sheet you may apply for a business certificate at the Town Clerk's office (Ist floor-Town Hall). 1. GO TA BUILDIN CTOR'S OFFICE(4TH FLOOR TOWN HALL) This i 4Wdual is f co plionce and has been explained the procedures needed to start a business ) ( OM Budding In ct 's Signature 2. GO TO BOARD OF HEALTH(3RD FLOOR TOWN HALL) This individual has been informed of any permit requirements that pertain to this type of business. Health Inspector's Signature 3. GO TO CONSUMER AFFAIRS(LICENSING AUTHORITY)-(3RD FL SCHOOL ADMINISTRATION BUILDING This individual has been informed of any licensing requirements that will pertain to this type of business Licensing Authority Signature After being checked off by all of the above-remernber'to return to the Town Clerk's office to actually obtain your business certificate. I I Weston & Sampson Five setts 010_- Peabody, Massachusetts 01 o�r__935 E N G I N E E R S l N C Tel'(978)532-1900 Fax: (978)97 i.i 00 IWILV Environmental Consultants since 1899 Massachusetts Highway Department WSE Job Number 96180.A January 29, 1998 James P. Tinsley, CPA Barnstable Town Manager Barnstable Town Offices 367 Main Street Hyannis MA 02601 Re: Response Action Outcome Statement RTN 4-12670 Massachusetts Highway Department-Barnstable Right-of-Way Route 132 and,Route 6 Barnstable,Massachusetts Dear Mr. Tinsley: On behalf of our client, the Massachusetts Highway Department (MassHighway), Weston & Sampson Engineers, Inc. (WSE) submitted a Response Action Outcome (RAO) Statement for the above-referenced facility to' the Department of Environmental Protection (DEP). The RAO proposed for the site is a Class A-2 RAO, which indicates that residual contaminant concentrations at the site are below acceptable levels, as defined in the Massachusetts Contingency Plan (MCP) 310 40.0000. Residual contaminant concentrations at the site are below the Method 1 Risk Characterization cleanup standards (310 CMR.40.0970). Method 1 cleanup standards are regulatory levels based on conservative risk, assumptions, therefore residual contaminants at the site are not considered to pose a significant risk to human-health or the environment. The RAO Statement Report was sent to DEP in November, 1997 and is available for review at DEP's Southeast Regional Office in Lakeville, Massachusetts. If you have any questions please do not hesitate to contact this office at(978) 532-1900. Very truly yours, WESTON & SAMPSON ENGINEERS, INC. r _ r George. Naslas - Project Manager,- cc: Mr. Thomas McKean,Barnstable Health Officer Mr. Michael Clements,UST Coordinator,MassHighway _ Ms. Julie Hutchinson, DEP - SERO File J:\SUTTOMISWEIamstable.doc Officers: Leo F.Peters Michael J.Hanlon Alan M.Silbovitz Peter M.Smith -Francis W.Yanuskiewicz Patrick J.Connelly Paul G.Sutton John D.Jolls F Associates: Ranthus B.Fouch,III Kenneth W.Carlson Prasonta K.Bhunia Michael J.Scipione Bruce W.Adams Paul E.MocNevin x®a rr- , Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protectio Q Southeast Regional Office ,J pPi Is 1997 William F.Weld 1 Tru e Governor na tary Argeo Paul Cellucci A B✓ ruhs Lt.Governor U missioner FIDD NT LEGAL MATTER: PROMPT ACTION NECESSARY —V, ERTIFIED MAIL: RETURN RECEIPT RE UESTED January 14, 1997 Thomas F. Broderick RE : BARNSTABLE--BWSC Acting Chief Engineer MHD Right of Way, Massachusetts Highway Department Route 132 & Route 6 Ten Park Plaza Release Tracking #4-12670 Boston, Massachusetts 02116-3973 NOTICE OF RESPONSIBILITY M.G.L. c . 21E, 310 CMR 40 . 0000 Dear Mr. Broderick: On November 18 , 1996, the Department of Environmental Protection (the "Department" ) received an Oil and Hazardous Material Release Notification Form ( "RNF" ) which indicates that a release of oil and/or hazardous material has occurred at the location referenced above . The Massachusetts Oil and Hazardous Material Release Prevention and Response Act, M.G.L. c . 21E, and the Massachusetts Contingency Plan (the "MCP" ) , 310 CMR 40 . 0000 , require the performance of response actions to prevent harm to health, safety, public welfare and the environment which may result from this release and/or threat of release and govern the conduct of such actions . The purpose of this notice is to inform you of your legal responsibilities under State law for assessing and/or remediating the release at this property. For purposes of this Notice of Responsibility, the terms and phrases used herein shall have the meaning ascribed to such terms and phrases by the MCP unless the context clearly indicates otherwise . The Department has reason to believe that the release and/or threat of release which has been reported is or may be a disposal site as defined by the M. C. P . The Department also has reason to believe that you (as used in this letter, "you" refers to the Massachusetts Highway Department) are a Potentially Responsible Party (a "PRP" ) with liability under M.G.L. c . 21E §5, for response action costs . This liability is "strict" , meaning that it is not based on fault, but solely on your status as owner, operator, 20 Riverside Drive • Lakeville,Massachusetts 02347 • FAX(508)947-6557 • Telephone (508) 946-2700 ♦�� Printed on Recycled Paper -2- generator, transporter, disposer or other person specified in M.G.L. c . 21E §5 . This liability is also "joint and several" , meaning that you may be liable for all response action costs incurred at a disposal site regardless of the existence of any other liable parties . The Department encourages parties with liabilities under M.G.L. c . 21E to take prompt and appropriate actions in response to releases and threats of release of oil and/or hazardous materials . By taking prompt action, you may significantly lower your assessment and cleanup costs and/or avoid liability for costs incurred by the_D_epartment in taking such actions . You may also ~_ avoid the imposition of, the amount of or . reduce certain permit and/or,annual._compliance-assurancewfee.s .pa_y_able_under 3.10 CMR4-__00. — Please refer to M.G.L. c . 21E for a complete description of potential liability. For your convenience, a summary of liability under M.G.L. c . 21E is attached to this notice . You should be aware that you may have claims against third parties for damages, including claims for contribution or reimbursement for the costs of cleanup. Such claims do not exist indefinitely but are governed by laws which establish the time allowed for bringing litigation. The Department encourages you to take any action necessary to protect any such claims you may have against third parties . Information provided on the RNF indicates the following conditions exist at this disposal site : 1 . Four (4) subsurface soil samples were collected and analyzed for Total Petroleum Hydrocarbons (TPH) and Polynuclear Aromatic Hydrocarbons (PAHs) . The following compounds exceeded the Reportable Concentration for Soil Category-1 (RCS-1) : CHEMICAL CONCENTRATION RCS-1 DETECTED TPH 870 ppm 500 ppm PAHs: Benzo (a) anthracene 22 ppm 0 . 7 ppm Chrysene 26 ppm 7 . 0 ppm Benzo (a) pyrene 18 ppm 0 . 7 ppm The Department has located .the following information which pertains to the removal of the underground storage tanks (USTs) from the site back in 1989 . The Department' s notification form, spill number SE89-0781, indicates that on November 8 , 1989, contaminated soil was encountered around the fill area. A total of nine USTs were removed. The Department issued a Notice of Responsibility on July 3 , 1990 , which required that a preliminary -3- assessment/interim site classification be submitted in sixty days . No assessment reports have been located to date . Sample analysis results for the 750 cubic yard stockpile was also located. This information is available for your review. The Department requests that .copies of any assessment reports and/or other information pertaining to the past activity at this site be provided for review within 30 days of receipt of this notice . This deadline constitutes an enforceable Interim Deadline established by the Department pursuant to 310 CMR 40 . 0167 . The site shall not be deemed to have had all the necessary and required response actions taken —for it unless and -until . all substantial hazards _,presented by the release and/or threat _ of release have been eliminated and a level of No Significant Risk exists or has been achieved in compliance with M.G.L. c . 21E and the MCP. Specific approval is required from the Department for the implementation of all Immediate Response Actions ( "IRA" ) or Release Abatement Measures ( "RAM" ) , pursuant to 310 CMR 40 . 020 and 310 CMR 40 . 0443 , respectively. Assessment activities, the construction of a fence and/or the posting of signs are actions that are exempt from this approval requirement . Unless otherwise provided by the Department, potentially responsible parties ( "PRP' s" ) have one year from the initial date of notification to the Department of a release or threat of a release, pursuant to 310 CMR 40 . 0300, or from the date the Department issues a Notice of Responsibility, whichever occurs earlier, to file with the Department one of the following submittals : (1) a completed Tier Classification Submittal; (2) a Response Action Outcome Statement or, if applicable, (3) a Downgradient Property Status . The deadline for either of the first two submittals for this disposal site is November 18, 1997 . If required by the MCP, a completed Tier I Permit Application must also accompany a Tier Classification Submittal . The MCP requires that a fee of $750 . 00 be submitted to the Department when a Response Action Outcome ( "RAO" ) statement if filed greater than 120 days from the date of notification. You must employ or engage a Licensed Site Professional ( "LSP" ) to manage, supervise or actually perform the necessary response actions at this site . The Department has Prasanta Bhunia, PhD. with Weston & Sampson as the LSP of Record for the site . i -4- If you have any questions relative to this notice, please contact Julie J. Hutcheson at the letterhead address or at 508-946- 2852 . All future communications regarding this release must reference the following Release Tracking Number: 4-12670 . Very truly yours, -Z— �-Lin Qa-as'�- Richard F. Packard, Chief Emergency Response / Release Notification Section P/JH/j t CERTIFIED MAIL #Z001 192 891 RETURN RECEIPT REQUESTED Attachments : Summary of Liability under M.G.L. c . 21E CC : Town of Barnstable Town Manager 367 Main Street Hyannis, MA 02601 Board of Health Town Hall 367 Main Street Hyannis, MA 02601 Fire Department 3249 Main Street Barnstable, MA 02630 Michael .G. Clements Project Manager Massachusetts Highway Department 10 Park Plaza, Room 3510 Boston, MA 02116 DEP - SERO ATTN: Andrea Papadopoulos, Deputy Regional Director Robert Fagan, Regional Engineer for Resource Protection DEP - Boston ATTN: Willa Kuh DEP - SERO ATTN: Data Entry Number Fee 1150 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that MID CAPE MOBIL INC. 2155 IYANNO UGH ROAD, WEST BARNSTABLE, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------ This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2017 unless sooner suspended or revoked. 1: ---------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2016 JUNICHI SAWAYANAGI v� THOMAS A. MCKEAN, R.S.,CHO Director of Public Health �f r • Town of Barnstable Regulatory Services Richard V. Scali,Director Public Health Division iN Thomas McKean, Directors200 Matn ,.txeet, Hyannis, MA 02b01 I, O£ficc: 508 862 4G44 1 n3�'1 Fax: 5U$-79U-6'9 W APPLICATION .FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERXA.LS IN ACCORDANCE.wrm THE TOWN OF BARNSTABLE GENERAL ORDINANCE,,CHAPTER 1.08, HAZARDOUS MATERIALS"ALL BUSINESSES THAT TIANDL F,OIL STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOI.,D QUANTITIES ARE REQUIRED TO OBTA.W AN ANNUAL PERMIT(RUNS J ULY 1st-JUNt, 3Oth). APPLICATION FEES CATEGORY .l. PERMIT 26- 110'Ga11ons: $ 50.00 ❑ CATEGORY 2 PER.MIT 111 —499 Gallons: $125.00 l V'S CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ A late charge of$10.00 will be assessed if payment is not received by JulyIst. ASSESSORS MAI'AND PARCEL,NO..11 6 69AATE FULL NAlV1E Ok'AP}'I,:[GANT: SAPcX IR, C.lnaur� N NAME OF ESTABL ISIl1VIENr e 0-0mm i 1 ADDRESS OF ESTA13LISRWNT: a0 (�00. MAILING ADDRESS(IF DIFFER.EN1): TELEPHONE NUM2ER OF ESTABLISHMENT: 1F;MAIL ADDRESS: _)n -X!e- nno�V o neo -C4 SOLE OWNER: ✓•YES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS, AND TELEPHONE#OF: CORPORATION NAME rni PRESTDENT TREASURER CLERK n Or - IF PREPARED BY OUTSIDE PARTY: SIGNA31CU OF APPLICANT Name: Company Address : Telephone#: Email: QA Apphort on Porm%\HA22APP Rev 16.docx Pap i Ot 2 j� TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM b NAME OF BUSINESS: Mks i. ,41 � k"&, 6 o f-R-t. Mail To: BUSINESS LOCATION: L,°i�,,�e„6s �� � 2T; 1 4- R4;e g 3 " ,, � , , Board of Health MAILING ADDRESS: i ®aa Cov Y4- aa Town of Barnstable 7 P.O. Box 534 TELEPHONE NUMBER: 6 ) a ZI — G G 3-7 pf� �f Hyannis, MA 02601 CONTACT PERSON: j!ftdAel .C� 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 YES N This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants �- - Motor oils/waste oils Road Salt (Halite)V� Gasolin6, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, ; Other petroleum products: grease, lubricants rodenticides) j 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 gA' 1,;2 ass/0)--1/00 2. .01 OF a f . Route 6 & Route 132 ' .West Barnstable Sunoco i i i II 0 r THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) M A- TOW1V .Or BARNSTABLE UNDERGROUND' FUEL AND CHEMICAL STORAGE SYSTEMS - 3 S/, - ASSESS ORS MAP NO• PARCEL N0. 1 2 VILLAGE: Barns a e30 �l�J �2DRESS. Route. 6 and Route 3 Iv�AME:._...t�tlf.Ser�ics._�tation (Sneed Ch�.z_dhry-Manager) (617). 362-3207 or 362—8922 P�aussachusetts Department o t lic or � QONTACT PERSON M. Ana�ian PHONE NUMBER t617) 973-7945 CAPACITY: TYPE OF FUEL. . AGE: TYPE: LEAK LOCATION OF TANKS:. OR CHEMICAL% DETECTION SYSTEMt d 8 000 gal Gasoline U_ 4teP1 jAso vti` QQO gal Gaso=2 7 Steel 3 S,QOQ dal Gasoline 7ys Steel QOO gal Ca_A0,1jnp 7vr�C+.mil rib 3 10,000 gal Diesel UK Steel 5pp gal Used Oil UK Steel (Not Used) 8 1,000 gal Heating Fuel UK Steel DATE OF PURCHASE OF. EACH: 1. 2. 3• 4. 5. DATE O FI.RE DEPARTMENT PERMIT: TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS 'See Attached PLEASE PROVIDE A SKETCH. SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD.' �,, --------- -- W j .. .v - J i 2 m _� J S rvice St3.ti.on ;tout ,c 112 LL AH/GfT C Hari s ale, MA 02630 Operatgr: MobashAr Lafar (617) 3`62-3207 Day/Night Telephone Owner: f •� � Massachusetts Department of Public works A (617) 973-7910 Day Telephone (617) 973-3100 Night.Telepho Ve /1Rr�.��ACRGi • I IF — d •a-wcsr flews ROUTE C CA]T Pour-0-+ Tank Capacities and Contents: �_:UK orItowy w. } IcuwQ 1•.. Gasolie ew food 1. 8,O fell 4surr. I l 2. 5,000 gal. Gasoline Coated 3-5-81 . 3. 5,000 gal. Gasoline t` 3-4-81 - ,� 4. 59000 gal. Gasoline a 2-26-81 o 3 (► `� 1 5. 5#000 gal. Gasoline it u 3-8-81 i 6.10.,000 gal. Diesel 7. 500 gal. Used Oil R) 8 - ,boo GHQ• VkSAy-tkG TpWN OF BARNST.A'BLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. PARCEL NO. 2 ,�.�� 7�'��.-'.�. ADDRESS OF TANK: VILLAGE: MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : "` ._ �tmc 1 OWNER NAME: PHONE INSTALLATION.. DATE: Vod _ z i BY:L 3 � y ..r, , i � NSTALLER ADDRESS:. '� ..) Ksi /�! :L�i T KJ *TANK LOCATION: DKOOR i ON /TANK LOCAT Z ON W ITN A' i�S� aU 2 LD I NO> CAPACITY 4 G'00 TYPE OF TANK, l �/ AGE ,/�V YR�.J FUEL/CHEM I CAL 1- TESTING CERTIFICATION [ ] PASS [ ] FAIL DATE LEAK DETECTION C ] CHECK IF' N/A TYPE/BRAND ZONE OF CONTRIBUTION [ ] YES [ ] NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED C ] YES C ] NO DATE CONSERVATION. [ ] CHECK IF N/A DATE HOARD OF HEALTH . TAG NO. C TJ ] DATE d * PLEASE PROVIDE, A SK:ETCH..SHOWING THE TANK LOCATION ON THE- BACK OF THIS CARD ,aa I L-rx h K 2 �25 Ta,h r ,1 S f-2 1 1 0 L, F w�ai' TdWN ©F BAR NSTABLE -.: UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. PARCEL NO. S0 Z/0C ADDRESS .OF TANK: Z 'i�" i VILLAGE: ✓ �"-as MAILING ADDRESS ( IF DIFFERENT FRO . ABOVE) : � � f' OWNER NAME: hzl ?.53 Ll4ol c f t:4 //C . G PHONE: / ��.3' INSTALLATION DATE:. ii l' B Y.•. o! '" -�J G' .�/'> �a C I^!STALLER ADDRESS:�""i � . . X ��`' { 4�11!1fN 411, /11A CERT.NO. *TANK LOCATION: J• 'l e; L • ��.. �, c4 4 Dt�OPt S p 1 CATION W I TM RkSPKCT TO WU I L-0 X NO> CAPACITY f� , _ TYPE OF TANKSt• 6lre VAGE RS. FUEL/CHEMICAL c7.- 5 _� - TESTING CERTIFICATION [ ] PASS C FAIL DATE c► ��`L LEAK DETECTION [ ] .CHECK IF N/A TYPE/BRAND. ZONE OF CONTRIBUTION [ ] YES C ] NO DATE TO BE REMOVED FIRE. DEPT. PERMIT IE.SUED C ] YES L ] NO ' DATEr CONSERVATION C ] . CHECK IF N/A DATE . BOARD OF .HEALTH. TAG NO. DATE # .PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION .ON THE BACK OF THIS CARD T),A Fj/ h2S -ram r,#� N. OF SARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. PARCEL NO. Z J{:c ADDRESS 'OF. TANK.: E t C:. [r ( t� C� i VILLAGE: J i'/i",e Numta�r �tr��t r_. MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : OWNER NAME: kl r, PHONE: ri`✓/ T J} /� ✓.S INSTALLATION DATE: 117 BY: / �,� fc'sS�C' / JII�� h` ,f'f CERT.NO. INSTALLER ADDRESS: ��� r J *TANK LOCATION: (DiiCR I St TANK OCAT I ON WITH RK="KCT TO aU I LD I NO) �'� ' . .; f_'1AGE 0 YRS S. FUEL/CHEMICAL % CAPACITY t TYPE OF TANK # , 'TESTING CERTIFICATION [ ] PASS C. ] FAIL. DATE LEAK DETECTION [ ] CHECK IF' N/A TYPE/BRAND ZONE OF CONTiRIBUTION [ ] YES [ ] NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED . [ ] YES C ] NO DATE CONSERVATION [ ] CHECK IF N/A DATE 1 . BOARD OF HEALTH TAG NO. [ ] DATE * PLEASE.,PROJIDE. A SKETCH SHOWING THE TANK .LOCATION ON THE BACK OF THIS CARD T Ir #z � TYoh� Search for Map/Parcel i 215027002 !i Town of Barnstable i For Parcel Number.1215027002 Rental Property(Y/N) r;F Business Name. i MA DEPT OF PUBLIC WORKS Zone of Contribution Y/N I ! __ . _ SI ( ): Area w _ - - ... _ Number Contaminant Rel Y/N Phone: 1508 13626211,a Fuel Storage Tank Permit: Ir� Card On File. j Disposal Works Perc Test Well Permit Construction - - - File/Permit No: rp Issuance Date: _7 7 ;I Completion Date: ', Size of Septic Type/Size of SAS:' I Tank: - Comments: THREE TANKS ON PROPERTY-10,000 EACH INSTALLED 90 ° mappar. 215027002 ;';Owner: MID CAPE SERVICE CTR INC ii proploc: 2155 IYANNOUGH ROAD/ROUTE1: r Innovative/Alternative Technology Septic Systems Single or - Clustered I/A Type:) rt I/A Service Type: a E add delete records? I ' Find Map/Parcel 1215027002 i Town of Barnstable Health Department Health System *� Map/Parcel: J 215027002 ,c Tank Nbr: 1.01 Tag Nbr: 0�0315 Installed: 01/01/19681� Location: �i Test Notification Date 06/14/1993E Status Date Removal Notification Date: Test: r Abandon: Removal: F 09/01/1989` Variance: r Fuel Stored: FG— Fuel Storage Reason: Capacity Construction Leak Detection Cathodic Detection: Storage Tank Info J 008000 SS Additional Details 'ASSUMED 20 YRS. 1988 Y i Add Change A —11 Find Map/Parcel 215027002 Town of Barnstable Health Department Health System Map/Parcel: (215027002 Tank Nbr: 02 Tag Nbr: j 00316 Installed: 03/05/1981 Location: F Test Notification Date: i Status Date Removal Notification Date: IF Test: �rl' II : Abandon: rr' ' Removal: r 09/01/1989 Variance: Ir Fuel Stored: 'JG Fuel Storage Reason: Ir Capacity Construction Leak Detection Cathodic Detection: I a Tank Info 9 i Storage 005000 l (SS __. �I �I Additional Details jAdd Change I '� Find Map/Parcel 215027002 Town of Barnstable Health Department Health System r Map/Parcel: j215027002 Tank Nbr: :'03 Tag Nbr: 00317 Installed: 03/04/1981 Location: iF Test Notification Date: Status Date Removal Notification Date �— Test: � - - Abandon: II i, Removal: r IF 11/01/1989I Variance: F Fuel Stored: I� Fuel Storage Reason: llo Capacity_ Construction Leak Detection Cathodic Detection: Storage Tank Info;005000 SS IF Additional Details Add Change I ' Find Map/Parcel r215027002 Town of Barnstable Health Department Health System Map/Parcel: 215027002 rr Tank Nbr: 04 Tag Nbr: 0 18 Installed: 02/26/1981 Location: !B F — Test Notification Date: �_ Status Date Removal Notification Date: ! r � Test: Abandon: Removal: 11/61/1989 . � .� Variance: ` Fuel Stored: JrG Fuel Storage Reason: Capacity Construction Leak Detection Cathodic Detection: Storage Tank Info 1005000 pS ;r, lr Additional Details - Add Change 00 Find Map/Parcel J 2150270102 Town of Barnstable + Health Department Health System -� _. Map/Parcel �215027002 r� g (l �' Installed: 03/0811981 I Location:Tank Nbr: 105 Tag Nbr: 00319 ! Test Notification Date �' Status Date Removal Notification Date Test: `I 1; Abandon: u -1 Removal: j 1 1/0111 989 Variance: Fuel Stored: r�'' Fuel Storage Reason: 1r6 Capacity Construction Leak Detection Cathodic Detection: 005000 'SSStora a Tank Info rr rr' Additional Details Add Change Find IJlap/Parcel !215027002 4 Town of Barnstable Health Department Health System Map/Parcel: ;215027002 ` -_-- Tank Nbr: 06 Tag Nbr: p0320 Installed: [FT 1/01/1968!i Location: B �. Test Notification Date: 06/14/1993 Status Date _ Removal Notification Date ry Test: Abandon: I Removal: 1F 11/01/1989" Variance: ( ; Fuel Storage Reason: i� Fuel Stored: i�; j Capacity Construction Leak Detection Cathodic Detection: I— rr Storage Tank Info 1010000 SS I Additional Details (ASSUMED 20YRS.AGE NOT GIVEN. _ � Add Change � I '� Find Map/Parcel I215027002 Town of Barnstable Health Department Health System Map/Parcel: 11715027002 Tank Nbr: 10 Tag Nbr 00321 Installed: 01/01/19681 Location: f B Test Notification Date: 06,'14/1993?' �� .1 Status Date Removal Notification Date: F Test- Sri � , Abandon: �I '1 ;F Removal: F. 11/01/1989 Variance: Fuel Stored: BW Fuel Storage Reason: Flo Capacity Construction Leak Detection Cathodic Detection: Storac,e Tank Info 1000500 Additional Details `UNKNOWN AGE.ABANDONED.WASTE... f Add Change F.-W Find Map/Parcel 1215027002 Town of Barnstable _ _ Health Department Health System Map/Parcel: 215027002 Tank Nbr: 08 Tag Nbr: 0322 Installed: 1 01/01/1968 Location: Test Notification Date: ( 06/14/1993 Status Date Removal Notification Date. �� Test: Abandon: r' Removal: �I 11/01/1989 Variance: r Fuel Stored: (I� Fuel Storage Reason: .rj Capacity Construction Leak Detection Cathodic Detection: Storage Tank Info j 001000 SS - -I— - ..__ _ _.._ _ [I_. Additional Details JASSUMED AGE 1968/AGE NOT GIVEN p1 Add Change I '� Find Map/Parcel 1215027002 Town of Barnstable Health Department Health System Map/Parcel: i 215027002 Tank Nbr: 09 1 TagNbr• 0 27 Installed: r 01/05/1990 Location rB I�__ _ l _.._ Test Notification Date: Status Date Removal Notification Date: Test: Abandon: rr j . Removal: I Variance: J,_ Fuel Stored: G Fuel Storage Reason: ) Capacity Construction Leak Detection Cathodic Detection: r r Storage Tank Info j 010000 SD Additional Details r Add Change I '� f Find Map/Parcel 215027002 Town of Barnstable Health Department Health System c Map/Parcel: 215027002 Tank Nbr: 10 Tag Nbr: 01028 Installed: 01/05/1990+', Location: Test Notification Date: I� Status Date Removal Notification Date: Test: Abandon: r Removal: „ . Variance: Ir,' Fuel Stored: !� Fuel Storage Reason: Capacity Construction Leak Detection Cathodic Detection: Storage Tank Info�1010000 J SD Additional Details - 1 Add Change I '-J Find Map/Parcel 215027002 Town of Barnstable Health Department Health System Map/Farcel: �215027002 Tank Nbr: I11 Tag Nbr: (01029 ') Installed: ' 01/05/1990,1 Location: 'u" Test Notification Date: _ Status Date Removal Notification Date: i�_ fr,� Test: Abandon: Removal: �� O3/17/1995 F r� Variance: Fuel Stored: 'l Fuel Storage Reason: j B Capacity Construction Leak Detection Cathodic Detection: - -- r Storage Tank Info 1010000 SD - ir'i Additional Details i ,( Add Change 001 I to 2r G6d"I.LC/WWM yew gaxk 94�f m, 02 16 a3973 April 29 , 1988 .RE: 1988 , BARNSTABLE Board of Health Underground Fuel and Chemical Storage Systems Mr. Thomas A. McKean, Acting Director Town of Barnstable Board of Health 367 Main Street Hyannis, Massachusetts 02601 Dear Mr. McKean: Enclosed, kindly find completed Underground Fuel and Chemical Storage Systems report for the State-owned Gasoline Station located at Route 6 and Route 132 in Barnstable as requested in your letter of February 1988 . This Station is leased to Energy Distributors, Inc. , P.O. Box 2747 , Danbury, Connecticut 06813 . P e ft5a Lsed ,tha-t the ,requirements for .the issuance of a z Permit from ahe Fire De ` ' ` partment hdv'e: been submitted and a copy y will Abe:forwarded to'' you':as soon as it is. received by us from the - �� 7r �5 "�='}T �I1s diT``advise Mr Saeed' Chaudhry, the Manager of the Station in � k at he may ,pick up the applicable brass valve tags. . yy k.° H - b? A: Fanale, 'Director � , t grl of-, way Bureau Enclosure/Certified Mail-Return=Reeeip.t=Reques.te-d-- .-=.-. ,� MA/yb TOWN Or BARNSTABLE ' UI`'IiERGROUND FUEL Al,vD CHEMICAL STORAGE SYSTE IS NAME j q ADDRESS --- ti z.s 6 --VILLAGE LOCATION OF TANKS: - CAPACITY: TYPE OF FUEL AGE: TYPE: OR CHEMICAL / e 3. ' / (Give saine information for any additional tanks on reverse side of card) DATE OF PURCHASE OF EACH: L __ 2. / 3-4 _— 4.. DATE OF MIRE DEPARTMENT PERMIT: —� --- STING CERTIFICATION SUBMITTED: � PASSED _DID NOT PASS y / 67 00 NAME LOCATION - Atlantic Richfield Company Rte. 132 & Hinckley Rd. 140 Lee:'Burbank Highway Hyannis _"Revere, Mass. 02151 Y. BOOK & PAGE - DATE LICENSE GRANTED AMOUNT OF STORAGE 77/132 June .23, 1964 . 4 tanks - 20,000 gals. . Tota1 1 tank - 1000 gals.Fuel 0i1 DATk, PAID 1 -tank - 500 gals. Waste Oil 1973 may 2 APR 18 1N8 044 MAR '1 197 t f r a 6 Au9u6t': 4 , 108.0 ..y. .. ,ki- •': 4 .t` ( tt t t. !. "'V8"tj •,,+ri'.... `'. $ .• �• i.i t • i.. .} • L t m '" eTh 9 Manager` Atlanta c—Richfield Servc®°Station . ' Rte.. 6 an ,.. d .132 West Barnstable, Ma° 0268 ' ` Dear Sir: ' y _ ( r �. S'-►. a _,y The information" ou"returned to us n icated ,the -age of six , < ' of your underground fuel• tanks :as .being twenty-:four"yoars oid y a . 4 You must have these tanks , ested.r using..the° ICent Moor 'Pressure Tebt, by� November 20, 1§866* Please submit.:,testi:ng yresults. and • their nterpretatign!,to "t2iis f£1ce N �$.p o" =prior to ovember '.2a,.; 7. addition, this test .mus.t;be performed;.annually and ='the "y ty D. results sent For your convenience, tie have enclosed a',litt ng of Companies who perform•,.th l s testing. ^You may also ut lize any otkier cerns qualified 't6".perfarmr,'this`.tes.t ng. fY eAb'y" ti'u.4y »y©ur17, i ,i,y k Ak• J s { k r Jo'nn M. KoiC 4 . . . 9 dl a .. D'reef f Pub +FI x or o 1ic ealth .. . ;. . _ JMIC IT Aft b { , : s , a► Energy Distributors, Inc, a distributor of petroleum products May 2, 1985 Mr. John M. Kelly Director of Public Health Town of Barnstable 36g7Main Street Hyannis, MA 02601 Dear Mr. Kelly: I am in receipt of your letter dated April 29, 1985 concerning the underground gasoline tanks at our location at the Sunoco Station, Routes 6 and 132 in West Barnstable. In the petroleum industry, any underground gasoline tanks that have been glass armoured insaccordance with the petroleum 7industry, is- considered to be new from that day forward. The 10-year guarantee dated April 20, 1981 is attached. Therefore, the gasoline tanks would have to be tested by a 5 PSI Air Pressure Test on or before April 20, 1991. The 1,000 gallon fuel oil tank and the 550 gallon waste oil tank were tested on December 21, 1984. Therefore, they would have to be Air Pressure 'tested on or before December 21, 1985. Finally, all the tanks were tested on December 21, 1984 based on your July 53 1983 letter which stated that a 5 PSI Air Pressure Test was permissible. Very truly yours, Paul N. Minichiello President PNM/rs 40 Lake Ave. Extension e P.O. Box 405 ° Danbury, Ct, 06810-0405 ° (203) 797-1004 r � ��a fi1 •r 'e�.a /� rrr�.::•.. as�Yw ,rr� .`a\ �r /cv."' L\\"�\ ,r^...;:�+\ 0+ ,,•/r q;::� ,r; \ diL,.•r `a �'! , 6, � ,: + t y J OF HIM tt Jr f f..t �M. y' � t 1 ' t \a j • ,y ;; .r ZIte.Bridgeport Qiemical Corporation FMnchlse Applkator. signed below J r.{, ?sU that the,:Glm Armored+steel.storage•tmuk(as described on the.nverae �i cps mkum•,f*hl is hpiby teed,Pr 4,.period of ten t' le?N."i�rh4'a 'r .. �' '�{4�, r,K; �'c, � y 1,. , yw, + �.e�,>eatffJtP.' AR a 4.Py �!\4T .�iY¢i! .� .,.,rt ,T, rhr � y� t t c.'SY+ t13fl' ,1�10. #' }'7 #<a8?'r:",ai st rH JtK3t-5`'jY+ynk.5 ''� �" µ+• i"•S'`"F� �,.�'Cr 'fkas �1 /ram jam.. }r K'3�,J ~ ,.� t' o)t �is 3'r �t►n;or ap'' uiar to.-tmid fM/!!.- fi nt�W k t dgf�'. rfd+l,yiv c[a Y$... , 4%.. it .•a 7 t '4rS �'rS.t ;r y' r {^,5,a �....,..�y.N ,fl�� }( •"" r rx r �•! 1 k�r �, t 5a, 1 ri � tnater/alararkmmrslu . Any,such deject welt be opal► witlwuttaost.;by �� C, '� � r. dYx +:6 •. 3 3 y Jr �' a� ' the ptstallvig r hired Apptteator provided ' the tank W mode available t ♦•,..+^. }ri'^_Jr :;a )<,?c'r t t- , < t t C •c �1 - K •• \''+ ,�i�Ea'•� '#�Y.1 to �i't rk 1 �.. .'' ti n,... 1 . .-.. ; '_, .:' • Af. 3 : . The lrsbilityFranchised Applicator is lirdted Ca the repair off'the :•:•' °tank AnyS liability, direct or indirect, rEsultuig from the use o>•applkation of A. ' Armor products not the rponstbitlty ofBrldgeport Chemical Corporotton. �s r • i ��\•'° . t 'Y This guarantee is not valid unless.certilled by the 'ranchlsed Applicator '• ,!Y i k , '•.• _. ._xrx�V 7.7. 1 t ��� 1{ r a � �rl •.r r.-_ � ..��• \� .• t _ the;uriden�lgrted'1FYanchised App16z4or :further certijtes that said.sleet '� sto►•r�e tiuik has'been Glass Ovid,in:oc Bridgeport r Al,',,r)*tti} speeijlcation inchaUn$the follOWirlgi s \�,�� ,* � L r� < r c 1 , yl r '"`, t .3 • ,-.;gyp 'I. '. y. • a, S, Y, y i t. 4 'r - , .. { v} - �.t '] �� '�' [.}P a �'ti t �• �lk SSurjace.PreparatPon sand blast to"whitE metal"�\, r & Coating Application !23 �Sumils average thccknesa <} •• � • ~yr_ r ► + � 1 t/41{ t i'y.� �iL3Tky t"•�.t , t s_ �t .".+. i. "�f+: '`r t t fi •ag ,' ♦ i� 5-�, w <.. 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Ta 'Y ..,r, "•,}I * '�..;r 4 J rf`' ,V t r ,f `"!r^l ra�Y d'j,2F9 i*r ,t t c ;"t r. r` a• a ''1r.�. ��',yt�*�' to - ,J, .s "a °•y r, r ..; 3 x ,"-,'* 6 -., ., %1 k� .i' .tea` kfr ;.11 t < .�._ 7'r�t J, +;:.:.; t;ro ' Ss,"". *,r. rrcl+ys,£%* A. ,�� +,`' '•'v�'$ f 'u're t ,tr '4 :`51 •�t, r ..' _ 5,, '+, r t ,y? r.f I l4 h,. i+ ,# t G F• t`! 5 *§ .y # e r 4 •i S:..,,,,Q t n .tr-'•. .,-qr,u +r r. ;;l f'tk+: Mr• Thomas?Venezia tg q r .v'fx �'i G ,a u 1 i- + d•2�. ,% t ro r t ;, W ; < ,Ener aFuel Stope*r , ,,, ,��I ' f r. + `.,J `� a �} _? p Y � a +� xf r , , ' ,fit} §!# ;� Ytt+t OyYg, ..-a ../,.i.rJC +a .r ''t,s.r L a� ,r t=.' .S '+ �! ,�,# d a� ry, r rt::. +. 4 ' a .�':r w'}� at °Y+t' rT : '�"�• V.iBox�202¢:,•. �:- C,j M` r,t l'> It «.{ 't 4r ,? ,f%. °"r'f ,.Yr r k ' +' ro. ll` ,,� ` +A L.+ xk7:.isr. 1.+ � t.. f t.� tFf r s q ..-, ,a 4<•. -e6 , , ° 'e rr+! .• a 'r ra ht } Y. a� :Yw ", 1r' , F .1,y r�, .Barnstable"FMa.}"02630- �" , r A, t: a' a4 ,• , d dl•�'k S r ti '':r�? ttG-' �? 1 ,l'.w. 1 / ♦`> i�3?' �' d J i r• 4+%,.�h. „f ' -Y�',$µre r ' �' Y t 't E'Lr #it,+,'a H ., .fit "'t 't'k:Y✓ i`%laiw a...'L..t_,.+1 ry"' �r;� .,Sd r 4 1. dA o G'. " rJ i.' 'R sa" I. �.,! v�"r:Cr. .?� ?,. a + F'`ey° 'S ., �r �'' 1*h t r Y. ,rt +` �. ,. - -Re:�rYour4sorvici, station at."'Rte''s:.64 and•a132, WestBarnstablet " , r :' ,4; '. w ` �., 1. •4t+..r a`� at'3 Wr ; r 't>a z `*,`*-G� ', n h r4 °.¢i - ' '+ a rs" rJ :: .�. 3. .a•"jar,3 ... 4 F Q,=s,y, �, `,f f, �F � . ,t C .. %t, ..'. Y S 4 ! .S .'4= -1 r tT '3. F ,,F, , .:l 5 . 3 '�.♦ `K ¢ 'r'F .`S ,+�' F, r.,,w .� .aY ? y < „* `C ry° r (r� ,'A ,4 3 k4T o Dear :Mr 'V �� ',� t ,r s s? Y y . ehOiia2. � , s i. L r+ r- r i at w r.'-,e + '.'a c a +,a Y n: 'SCa+r,-•y. ar+" ! j F.: k 'w•Y p` Y J i�w ':c. '' �.f c R *+1. y`. *, r w.:.:M .,• r r . w r� }' ':, t ,+�, a � . ASa'1• ^n , a. ,r A. rj y..�. I,dt' 7. ..S t + *�ux 4 , -k- . t,ty�? C. K 4 *r r "s:.• ,•.. ,! �..4-':, ,n i, ., { ,OL r f,o. w.,,,+,-. r , t r,R ` •a.`i, {''�,r r i T a•` . r " gg,, +` •bvy�.,i+s.•'tit a,.'r• Z` ?x '.':.,r- +'t44',."'°rx .M.. r�` 't't,:Z'+ *d T- "�t c y . "'p-.;.,• },{•r .'v,: i+ ',. Tyn,'6 .`•e t 1{ ar ,hr ». ,, , ,, k�You�are rdirected to have � , r iii ,� e'g , T ` , °,�, a r�•...i 4 n,. .__,t„1,,�,,� {yaur two Lunde ground�f el tanks =oa asol `n tank r '$}+ >r .I* . ,•xt a4:x, Y,��28,years61old� andr'one jwaste offl:tank. 28-years„ old).tested� byr Novembef,,T,':'1983'; $f >M, r r a . '� rend �a coPYafthe'`results�.eent".to"this off ti P �. 1983. .* J�.:. ,,�` s •` 3ce�' rior •to Nove b ,'H h L Y.,e � ^:t],i `,. 1,--Y , { 4 J M ember r• 1 'k • `T• Ja .� t fir#+•°.'+'.�t °!" C a a4a�+. { k a «.''^., . r _, r. %n , ;, .�,,,e' ,ar'r r' t A-:f- ''�` z$ �,�v, ! '.4, `[`� r1 y. y. ` ? .t,`S X 't s' A + � srd ✓as , 7A I, Aa',-A y,,4 Y' h ,r5.� }''nLt,. Neb of .5' i '.F•Q t t Totan Re ulat'i`ons�require ral°lunderground`fueT.itanks, ;' "„ '" k ir~ ti ar �:'° ri *I,� 6 . .8 I. - ,,- .. , ' twency�gesrst of age �`� , ; �;c.. . t�. n t�Y,,� -" older;'that a ca acit of over OU ' , r rr"$ "- �'• . �,A �- �._- h vex . P.. Y _ .. ;S gallons amust be tested teach:year ,, 4y �, ;•for=.leaks. tR t Pressure"Teet'i'is the`Pre 'test `hove .' r1 {� The en -Moo , } . ," , ed . eir 56 rep r If ,. ,� J K ,fan empty,tan , can}be tested4.by a S.PSI Air-Pressure Test° el'd,'for,a minimum •,' •, I i * ` `t° ".iti*, i{k. t t,„yrr •r'ne: ?. I w'r.'•Gsri`.- 't� 'ett4„ ,.* .* "!! yr ro. �. ; r :+ ti g•,.of two fi5,u;,�,, .The:air pressure`tesfi,�can only b redone on; n.3emgty; tank.ands r ; ;-''nt A. . .' ,' s.r -•,ra i`s'' not:.thl' preferred 'test. s,ram. ,`- p {�-?„�, +.y,� "At,"j v' .. ,r,.gyp at tti,: r 1 4 ,d . Xa`. n. , . ,a , y y "t , to .. Y, t 4.'.5 .i h s * "T, L '::A{s'�a '� r 'rn."4, i a " .,,'Lt is r -� ttt4• '� �, ' Y V .1 t lj'J T h . + • Y y R" .t 11 ,1 t �' ,e.. ,t I em F'* '{',,• 3ta +Y '4� ,,-p,, ,: t ".L 1 t f� n+>•t A, r r#M "C ,o- '.� '{.,a 1 i t-A'I '-4F' r.r N,;rti .., I., y, Failuie t0=.have u�l'dfre8ult' n a. ia'"has ' �,' 'a ° ?:r'_, .;the Cai►ks tested: co fine of notmore than ' r ',, a rt,: . r• - t > [ n a?,. 1%, p�,:. .. .}, ,, t S ",'I. ,..:. v Y�,i. i-.r(i i . �f(,, ` 1, 0_ ;Each a I rate'xciay's=.failure I.to comply„wi th:'an order shallF conetituta �` � ` ,� +J r 'a.separated`-�ziolatioa, . '`},�`r �` y a..,; *M?,.' ;n p .. ' ;, ` ,D ' .° J pi _ •' ,a 5r ;A °'� +. .s r ,,r 4 , rr 4.vy"'1; * y, J , `,Tr.`4°' Y •r. ~LMi.�,. ( �J , * } '�,a •. i. r t+ r. � r �^i :,� +�4. 1 f.', {i ,3,.,'+-,t"t ° •r ° t, ro K ',n -^. .Yy �..`+ T F �r ,yy , i�, x"f'r ., ; i '#�+ t{'�.v' r: ;r� r '. s' Fa ty„' , »+, v, i-'� l•' 'u"' ,,, 7 ,tttt f t' I ns 4r r' i •�•. + .. ''� .x^7r`; ' u t{i. } r,. '.";.:L r 1. t .., �? ti7 ,s ..:.a. r, ,�'v v •, +. �[r^ k .S, :. t J M`� ;F %":4 I' �" would :appreei,atekyour coopetation`kin this Araattet`,so`eitel 'to"public safety 'rmg �' �•,,,r, r.+"F"S` JI`, v'-'r .'k. .:�M, + -;r,` $ $ ,i, d:" ,,y 'w. t , ,. .a €.,. y F � ; and the awater;;quality 'of a thec,totan x ,,, �°trc „v ! } st5*a *f. % ?t t. .:'yz r,,� •, r * a'. °} r' a rr+ �k rsF 7.::w a 2�'a'x�as r'�{'G 'dr r ?. St rY. }- sC {� ''r n �.� •+ . y rr r ° r!`�.. � t'. s.*Y X Y' 4 ti _+ : t Yt t.;` G J,Y 4 4 t „{,. t ' q ;Pleas'e`cat if`it t : ` R. 1.G �� f ,you have an' ques°bons = x7e75 1r120 eitension` 182. +� . 4. ;3, y a ' ", +r� t, 4 ' 11 ' t'yd •r,. - a, `r Y f e, �� u r „ri- i7 ! tik ,° .,,«�...t; yr u: ;t: 't�`5 r, R ,t'{' M r A.C" `{ E ..,irl, tr +n at , rr j-' �' , 4 ;''I, F a= 7.p 'F'tA cT ..,+'• y d.; :..r ,,e s 4. 't - - t i,° 3 _J .. Y vi f,. Y.. ,a u S:,w',+. ; ,,,, _ yr -!.�41M er ^y ... *1 '9' ,'1,:ia x° �"' ,rk'. , b2Y%�I� i y� _:.� r 4 fV,O ry�t�ib ly.Yours4j:r *�r��'�. �,I i;�' Its L4{ ay ,f r ,_,k '" �'' :+" Y r. '"fr . Ssr FL•-.�Q" + a.,�, '✓" � �! Ft: . '*r yy a '�. .:s C.. v ;d 4,, t w'kr r 4..: ya v �''', .. r' i 3#r'`�ia,7e A':+r,i.+• vAA+r.i't "`"p' i. a`i.. �, -'i I r ♦ r. •,r ,,{' ,",Zr1" „ = r 1�,r* - '` Y �u r,ry T-j.:. " t, `..: 'i: *, tiTv J ' e n 1. Y�. f, , Ae rR, t #Y 1'�e..4a. n,Y`."S+ R'..f'*wfi2 `r.,l t +. rt "J"�h 2 L r r e T c "-:r '' —1,: t T r # A' 't..t.• Y. roFf, y 3^ ,it',' ,'r+ j k!^ "!` , ..k' rt`,. ,, .. .f,}fy r k,:, ..J *4.. as`# §r N. - '" ~;r-,...'R -,rr,,. ' ,,rV':? f pt:ert , - }"',.- i -�!. ¢ r 7 , :. a + a r P +.. g n... ., a J -r ` t y t�+, .t , f 7, f T 't c -at*. 4,7� �:`, yy5'"i ro _.iE �` 'i r.$ .e a t.,:y 4 ,t 'Tl,}..vs .r';! t,; v- ;r5�tt r. •' ,yr'? .F ','],,"!t., 'F >r,h . t r a�} t ! JohtV M`,Ae l ly >b y kr> y-Y , ' t,p.. �: ° i,;7r�" i y �' �,,} +. t�,'y 4 D�'.r f f �t '.}.r ,•N'. t>. t,,x '%k. f �k�J <r „ r "a sue, �r•z a . 4 I , fP ':Director' of Pu l ! > J&ytT , Y fy N,hi gf3*• ,is 1. �- y t ° rctvfi e }.�4t "ram ` r':r y�:tr rd ,t t r, )�. r, Health � r(iy d [jMr , r r r• ti ., Y*;;,I, "� . `�.,_ n L r, r t o ' "t sr v s# x- n's 2. c t .t "y, , � x�, r ax x� . k . '�' 4 v.'11f Or �"- , ,a` f,t �. Viz;y,$, .. i. ''d'F;A;&g :]�pMp Fi.:T } .. r f Si y;" *'§" ,r,','�' 4 - +`` r x4 ,, C Y rx �r. #r' „',r"'t ..1+v�tr r 1.. .'r`'` \" tL ,.(r J, - ,*",O '°..t,, t°FAy ,,¢0 ty. >^3 .V:V 1 .'I r t *' • -r .r` ^ :.s* �. k by ,�Childss•�Ch`airmati r .y ap r • � i 4� �,,-t �, �,J`:,a, :: :rF, :1 '` t� r@ 'hRobert `�'`` +3'J. ,V,. y.1r `1 *. le�, f' 4a`\ #,... 'b "L:� 4" Ja:''J. t r �+ . .v r L r YtT. , a. r S .,r � ..t,A 4 r �{t.e G''s I j t ,%,,4 .-- tN . .," � +," Xti ' � }a a# �. '.,r ',t. ;r ry z :,,,Ann" Jane Bs:hb gf� '�at' ,;., r� ,A, 9 f +`• w� ��a r y a 0:.. x3 r ti r n ,4,I' a 1` - i r �J� ,0 yA.G.,r'.t, a.r, "S,,,,�+,�`a�;+dyy r?�,rx'�+*t sr' "� �,k 4�i�; + F r. r S..y,L!" S e. �,',t�.A�r� t' ;,,a ' ., H:- F:;.Inge.', M�k1. D. t•. _,j:.l4, tr rtyr'r�� 1 :TYS i�y"ki� 'r{' � t ;d+� tS'<F Pw x' r t"� t + �t�.'� .� �"L+ ,I "��BOARD ,'HEALiA " �'Pt�r`•rr,�r 4 ,ry:ai w+S;-4 er,!k r_v,�'W a,.-*'( i,q >,, .r^} It'�. i4 ix �'ti r• A t'��"+ „� .�aI. *,, [ 74, r, .I. 'a't aA 4 x�,•� k Y' 'v w7'E53' /� n w: r r r�,% ., % I. ,4 ,� *,# , ,$ } ``t , , •t 1 t r'q `": :Y'` r. t '�':,r., a, y �.�. t 11 �N1 S - .+,.�f� �`{ , TOWN. QF B�iRNSTABI E °% % .J,' F 1� F.,,k -,M $!t A y� }9}� t r.•;. ✓I A A .} 3r. ro r,,.,s I.MIq .•�-r � t ��• r A":• r 4, f .,j.�s r 'y. .a _" a ''"+ {'..*y "Yr'� y , y Y 'k.'. ♦'',� •t,, , ' t S r+P r "{ aS' n,ya L i' ° �I •.;_+;f b 4 r,, ,r+ tiL +-}" ap 3,") t3"r`7.5 6 �, , * ,a ,. 4 n b, '� F r a , Y y' S t t�.w;` `4' "r t G ?4: p 4 .t car,:` a y a :,�5 t ca i Y r a ♦ .r .r ,4,. r S .M,. Sr ♦ Y t'r r? .. r• ccf, ° r / ��. S a i -.'i h ro ., -•ttr"rt }' ., ^ >',+'} 1 s i 1 '6 r4 " r/tw'k^ ;c * ;-y e,.' .r <+ry r.v..�' s C ,.r,; N., +tix.r, 3 t {ry=j ,iY F- �? S'� `f r .t ,i'=d".: �,,}'r ,fir c•I._ , a� *'y ,`r O ,.}'M r {t #F fir,^1 a, 4 + - 'T'4 2 � 7 r u + # P ,t ! - ;. ', t i raz'"4 fin..r. I. wt c y+ n ti i ),% r,r ..{ + F f. €, ,'• - ., .,,r.'"ra Yde';,�((,• e !'r `a r "L! r . i ,F, 2..,�, ',sy aS'a i, • :: �" r E"� *.- • ',i.. r r ;'r t ,;- y�.ny,Y; r a,y7i r ri , r a S 4 , �k a x : ,.`. yrw . �' 3 . r `� F v eS . „ . 1 ` Y 'ta,1 ems; £ . ?r !fie;+# x`„a t '. , ., x x-ri t\, r I . 4 w- { {t 4w r. 5y, a t.t'ti'' tF i • .- } '4t ..-.��,,��,� ss�� �:. t t,, `rr�:Z ri,;� ° 6 i)�. r i 4 ; `t{t� 'l r + r p# r ♦.. cF 5:, �,S,.: r t 1 - - f r . 1 't ' ,7yT .rr f" ',� ; f �, y t y:,% 't,r. K, r 2;v a`¢-} r.+' 1a 4,.sr +,+ ..;,�„- r .ty.-. 3 r x ,;. P .,,r Af `,+r '�. 't4' 't r,3...ti YS 'uK•r^ x. t ?. ,�"Lr ,,i ' r y°'1' re: � :'r z 3 -;i r r ° a{+ t 2e+ t 4' ' r '�'- r ! �,t` + �• -'ti 1�.. ' ! r , t - r' a r f `5 W t+• ''„�G t i 'y Fle.1 r -1, .• �`•Ott t ,, s e r ' li , '3SY e F '�..,,11,gip{ rr'�y>~ rra - I, .- r J r r �+y` w ,pt, r "`" Y , , r rs,j t r sW 3'rt 4 t r �,, '!,ti 44r t?[ ` ♦ J ., ".r y Y )1 tf. �T e 1il* j,.c� / ,�` 6�q t' m c ,S - ,. ,r,, e .. • 1.7 s1.,r#`,., 'Y "'I+'.'t :t' . a. W.;. r.+ e,,,� L I-, ,ry I.: yr a"- ''. ne o� �. � � '��'� ����% �3d �i.c�� cl�eQ� ��� `� ��� �,� J F Byron Manager Boston Division Sunoco Marketing \`„�. Sun Refining and qQW 6 � PO BoMarketin 988 Company Framinggham MA 01701 617 8751371 July 11, 1983 Town of Barnstable Office of Board of Health 367 Main Street Hyannis, MA 02601 Attention: Ms. Peg McKeen Dear Ms. McKeen: In answer to your letter of June 30th relative to the Sunoco service station located at Routes 6 and 132, West Barnstable, MA. , kindly be advised that this station is owned by Energy Services Inc. of New England, Lake Avenue Ext. , P. 0. Box 405, Danbury, CT 06810. By copy of this letter, we are forwarding your letter of June 30th to Energy Services for their further handling. I hope this will answer any of your questions. Y ly, ra n Sales Manager sg cc: Energy Services - w/attachment UNUC THEt ,�' TOWN OF BARNSTABLE OFFICE OF HASd9TO8L = 9 a BOARD OF HEALTH iM 367 MAIN STREET�MAY�"� HYANNIS, MASS. 02601 June. 30, 1983 �" " i�L h K 6 /V Sunmark Industries Div. of Sun Oil of Pa. tiV P. 0. Box 988 1L L 0 Framingham, Ma. 01701 Re: Your service station at Rtes. 6 and 132, West Barnstable Dear Sirs: You are directed to have your two underground fuel tanks (one gasoline tank 28 years old and one waste oil tank 28 years old) tested by Novem- ber 1, 1983 and a copy of the results sent to this office prior to November 1, 1983. Town .Regulations require .all underground fuel tanks, twenty years of age or older, that have a capacity of over 500 gallons must be tested each year for leaks. The Kent Moore Pressure Test is the preferred test; however, an empty tank can be tested by a 5 PSI Air Pressure Test held for a minimum of two hours. The air pressure test can only be done on an empty tank and is not the preferred test. Failure to have the tanks tested could result in a fine of not more than $200. Each separate day's failure to comply with an order shall constitute a separate violation. We would appreciate your cooperation in this matter so vital to public safety and the water quality of the town. Please call if you have any questions - 775-1120, extension 182. Very truly yours, jh M. Kelly ector of Publi' Health for Robert L. Childs, Chairman Ann Jane Eshbaugh \ e H. F. Inge, M. D. 1L BOARD OF HEALTH TOWN OF BARNSTABLE JMK/mm GENERAL CONTRACTORS WEAVER MANUFACTURING CO. SERVICE STATION Sales and Service INSTALLATIONS AND MAINTENANCE Cyr AFTS A ' ELECTRICAL CONTRACTING H6 CON TION COR ATION 24 White Street (P. O. Box 391) Winchester, Mass. 01890 Telephone 729-4197, 729.4198 May 31, 1980 Barnstable Fire Department Hyannis, Mass. , 02601 Attention: Chief Farrenkopt Re: Atlantic Richfield Service Station Junction Routes #6 & #132 Gentlemen: We on Friday May 30th corrected a leak at the subject service station in a submerged pump discharge line on the "regular" gasoline system. Mr. Charles Irvin, Operations and Division Engineer, Atlantic Richfield Company, Providence, R. I., District Office requested we investigate the sub- merged pumping system "regular" product at the site as a discrepancy had been reported in the subject locations records: Preliminary investigation revealed an abnormal pressure drop in the dis- - - charge line pressure .of the regular product, furthur checking disclosed a defective 2 inch union between a submerged pump and the main distribution line. The Service Station was out of operation on this particular product for a 24 hour period until the .condition was corrected; once corrected the line gauge indicated the system was ma?taining its proper operating pressures. Atlantic Richfield will be installing leak detectors on the product systems at this site which will automatically shut down any line that has a drop in pressure below the normal operating margin. In addition ter. Irwin is planning to have a permanent monitoring tube installed so as to be able to check this problem and any future suspects. Should there be any question regarding this problem please feel free to contact the writer at Winchester or Mr. Irvin at 1-401-278-4366, you will find us most cooperative. Yours truly, for Craftsmen st, Corp. Copies to: J Barnstable Board of Health Mr. C. Irvin, A/RCo., Prov. - NOTE: Above notices in lieu of unsuccessful attempt to report by phone on Sat. May 31, 1980 at 9:25AM and 1:30AM. CRAFTSMEN for 31 Years, 1949-1980 PROTAN1C PROFESSIONAL TANK INVESTIGATION` CORP. P.O. BOX,17591 a MILWAUKEE;WISCONSIN:53217 a PW)PE 'WISCONSIN (414)332-9422 332-0494 January- 15, 1981 . Mr. A.J. Sidles h►.Atlantic Richfield Company, Box A ;t , Providence, R.I. 02901 Rea . Tank System Test, January 8, .1981 Route 6 & 132 West Barnstable, MA. Dear -Mr. Sidla The tank .systems tested at this location are identified as follows:. " Tank System #'-1 South-East 5, 000 gallon Arco 'Unleaded "gasoline. Tank .System #. 2 North-East 5,000 gallon Arco Unleaded gasoline. - Tank System # 3 `South-West 5,000 gallon Arco 'Regular .gasoline Tank _System # 4 North-West 5,000 .gallon Arco Regular gasoline. (Tank Systems # 1 & 2 and systems # 3. & 4 are manifolded) . The National Fire. Protection Association's criteria for a tight tank system is a .system with a rate of leak less than .050 gal/hr. These are calculated, mathematical. tolerances only and are not meant to ,indicate the permission of any leak.. , : Manifolded Tank Systems # 1 & 2 showed .a rate of leak of -3. 040 gal/hr. :Of "�"'Manifolded Tank Systems # 1 & 2`:are. -.leaking. Manifolded Tank Systems # 3 & 4 showed a rate 'leak of. -1o482 gal/hr. Manifolded Tank Systems # 3 & 4 :are leaking. M E M B E R : o gfUM EQUIPMENT INS ' PROTANI.0 9 PRO'FESSLONAL TANK INVESTIGATION, .CORP. P.O. BOX 17591 a MILWAUKEE,WISCONSIN 53217 a PHONE WISCONSIN (414)332-9422 33270494 January 15, 1981. ". Mr. A.J. .Sidla : ... ,. .. ..Page . All product lines were -tested and found to be` tigh . Prior to and -after test ng., the tank -bottoms were checked for -water through the fill pipes, -the results are as. follows:; Tank System # 1 .= traces of water: were recorded. Tank ;System #. 2 Vinches of water were ,recorded. Tank System # 3 - inch of water was recorded. Tank .System # -4 - 0 inches of water were recorded. S'ncerely, William J. rpora WJP/lmw MEMBER gEUM EQUIPMENT INS\ ^ a FORM 77-1000A::.:. Data Chart for Tank S stem Ti h#ness Test. . '�21,03.36�) D3o Y 9 USING KENT-MOORE CORPORATION TANK TI G HTNESS_TESTER MODEL 1000 'For Packet Copyright p Kent-Moore Corporation.1977 of 50 Charts PLEASE PRINT ' Order J 23396-A 1.. OWNER Property r--t/ Name Address Representative Telephone Tank(s) s�0 Name - - Address' - Representative - Telephone L OPERATOR Name ,Address - ._ f Telephone - 3. REASON FOR- TEST : (Explain Fully) 4. WHO REQUESTED S TEST:AND WHEN Name Title. Company of Affitlat on Date .. Address. Telephone . 5. WHO IS. PAYING .FOR THIS .TEST? ompany,Agency or Individual - Person Authorizing Tide Telephone .. Billing.Address.. - - City -state- - Zip Attention of: Order No.. Other Instructions Identify by Direction .Capacity Brand/Supplier Grade Appros.Age Steel/Fiberglass 6.; TANK(S) INVOLVED O : Location Cover Fills Vents Siphones Pumps 7. INSTALLATION DATA North Inside driveway, Concrete,Black Top, Size,'ritetill make,Drop - - - Suction,Ramose, Rear of station,etc. Earth,etc.- tubes,Remote Fills Size,Menifolded Which tanks? Make It known 8. UNDERGROUND Is the water over the tank ; WATER Depth to the water table Yes No Tanks to be filled, hri Data Arranged by 9. FILL-UP Name Telephone ARRANGEMENTS Extra product to"top off and run TSTT. How and who to.provide 1 Consider NO Lead. Terminal or other contact _I for notice or inquiry - - - Company -Name - Telephone 1.0. CONTRACTOR, MECHANICS, any,other contractor involved 11,. OTHER INFORMATION . OR REMARKS I Additional information on any items above.Officials or others to be advised when testing is in progress or completed.Visitors or observers present during testetc. Tests were made on the above tank systems in accordance with test procedures prescribed for Kent-Moore Tank Systems Tightness 12. TEST RESULTS Tester Model 1000 as detailed on attached test charts with results as follows: Tank Identification Tight Leakage Indicated Date Tested G p , t This Is to certify that these tank systems were tested on the date(s)shown.Those Indicated as"Tight"meet the criteria established by 13. .CERTIFICATION the National Fire rProtection Asociation Pamphlet 329. Del. Testing Contractor of Company. By: Signaturs r ^� - - J, S1L11J� Serial No.of Thermal Technicians Address Sentwr FORM 71•luvurk. . �14 .30 Data t:oart for. Ta�l�t System`Tightness` Test tJ 21 toe 3Ba) USING KENT-MOORE`'CORPORATION':TANK TIGHTNESS TESTER-MODEL:t000 For Packet Copyright®Kent-Moore Corporation 1977:. Of 50 Charts PLEASE"PRINT Order;J 23396,-A 1.. OWNER Property Name Address Representative TelephoneTenk(s)' Name Addrass. . . Representative _ Telephone 2.. OPERATOR , Name - -Address _ .. .TehDhorie ::.. 3, REASON FOR TEST x (Explain Fully)' 4. WHO'REQUESTED —mac [ST AND WHEN Name • Title Company as Affiliation Date . x s at" Address - hone „ Telep 5, WHO IS PAYING „ Company.Agencyoa4 1, sy a PersonAuthonxlnD'• Tide Telephone` FOR THIS TEST? �< ,.'. -... Billing Address L....' .._a. '. Clry Sure Zip Attention of: Order No. - - Other Instructions Identify by Direction: 'Capacity- Brand/Supplier Grade ' Approx.Age Steel/Fiberglass TANK(S) INVOLVED — NV� ,r Location Cover Fills Vents Siphones Pumps 7. INSTALLATION DATA. 76 - - 'North inside driveway, Concrete,stack Top. Size,Tltalfll make,Drop .Suction,Remote, - Rest of station,eta Earth•etc. tubes,Remote Fills Size.Manifolded which tanks) Make if known 8. UNDERGROUND Is the water over tank). WATER Depth to the Water table „ Yes No Tanks to be filled hr. Date Arranged by 9. FILL-UP Name Telephone ARRANGEMENTS Extra product to"top off"and run TSTT. How and who to provide l Consider NO Lead. Terminal or other,contact for notice or inquiry ^ Company Name.. .. .Telephone . 10. CONTRACTOR. - MECHANICS, any other contfacter involved II • 11. OTHER INFORMATION ' ' OR REMARKS Additional.information on any items above.Officials or others to,be.advised when testing is improgress or completed.Visitors or observers present during test etc. Tests were:made on the above tank systems In accordance with test procedures prescribed for KenhMoore Tank Systems Tightness -12' TEST RESULTS. Tester Model 1000 as detailed on attached test charts with results as follows: v Tank Identification Tight Leakage Indicated Oats Tested l a.. V 11 ( i This Is to certify that these tank systems were tested on the date(s)shown.Those Indicated as"Tight"meet the criteria established by 13 CERTIFICATION the National Fire Protection Asociation Pamphlet 329. Date Testing Contractor or Company, By: .signature Technicians L Sepal No.01 fiennW Address Sensor 4 Y w.4, 31 is a.,,! k'T'� /3Z a/, —'' ' t.�s%,ZsL 1�A' b��/ 14. n 00 and Signal($) City state Test Dole of 15. TANK TO TEST 16. CAPACITY 7 F tation Chart C sy most accurate Tank Manufacturees;Chart If q 5.1 rl 54 Nominalapacity capacity chart available Ideninyouir Position GaUona Ilons Company Engineering Data 1, here doubt as to True Capacity, Cha its supplied with TSTT Brand and Grade See Section"DETERMINING TANK CAPACITY" El Other .17. FILL-UP FOR TEST Stick Residirius Total Gallons _4 ;K J to K In. Gallons ea.Reading M: Stick Water Bottom 'r* before Fill-up Ae e, z S Inventoy OL 2 to in. Gallons 0. ' JD 0` 1 Fill up.STICK BEFORE AND AFTER EACH COMPARTMENT DROP OR.EACH METERED DELIVERY QUANTITY% r_7 frr I Tank Diameter! fe , Product in full tank(up to z fill pipe) '411 -VAPOR RECOVERY SYSTEM 18. SPECIAL CONDITIONS AND PROCEDURES. TO TEST THIS.TANK!4 . Seemargual sections:applicable.Check below and record procedure in log(26). is el Water in tank O High water table In tank excavation Rllu ❑ Stne(s)being tested with LVLLT a &11 m .4> 21. TEMPERATUREIVOLUME FACTOR (a)TO TEST THIS TANK 19 TANK'MEASUREMENTS FOR -u V r Product on Truck F, Expected'Change +or—III Q.is Today Warmer?0 Colder?0 F Product in Tank F Fill-up TSTT ASSEMBLY 0 A., 83) Bottom of lank to Grade.'a...1.... ... Ae 3 ch D M d Thermal-Senscr rbidtg after circulatio n -F Ad30Jor 4. LL .. . AearA r Adcl'24",for 3"L or air seal ........ 2' 23 Digl of 2 is per.*F in,rp, expected change 9 4. digits .. fie Total tubing to assem ble Approximate, ........'M 24. 20. EXTENSION HOSE -SETTING. . X gal total quantity in j coefficient of expansion for.- volume change In this tan 0, ank top to grade! ...........a.......... ....... rr full tank(16 or 17) Involved product -per-F O Extend hose on suction tube 6"or more: below tank top ................... ......... 25. Thi F(24) Digits per*F in test volume change per- Volume change per digiL. test Is *If Fill x Use top of fill. pipe extends above a t' grade, Range(23) 1pompute to.4'decimsil places. factor(a) 38.NET VOLUME 30., HYDROSTATIC 31. 34' 39. PRESSURE VOLUME MEASURIMENTS M TEMPERATURE COMPENSATION. ACCUMULATED LOG DO TEST PROCEDURESL RECORD 10.001 CAL: CHANGES USE FACTOR EACH READING CHANGE ..27. 29' 29 Standpipe Level 32. 36.1 37. Temperature At High Level record in Inches product in Product Change Computation Adjustment of setting up Reading Graduate Replaced I—) Total End Deflection DATE Record details Thermal Higher+ (c) X (a)= Volume— and running test. (Use full NO. Beginning Level to Lower— . Minus At Low Level compute Senior Expansion+ At(+)or 7 length of line if needed.) �011 which Before After Product Reading Contraction.— Change per Hour Reading Restaged Reading Reading,. Recovered Contraction I IN I FPA criteria) 7 (4: • (24 bri33 V) #37(T) X L 7— 9 j a. .5 2Zbi r 70 IC 19 Aj Jr . IL � 7 ���` � .� � .. •; r#. r:' � - "�_ : „ .. - � �"� ._ ° _!mod - .. .. �r C9 Gi' � a a tit M xFfie, -W2 . 5,6 G �' 1,2 _ 2 Xca i9 2 -�aL�— .; ♦ t 16 t a ZY zo .. a , l+re 1. - o �t , r `` ' SX134------------- g e 1: -f,� ! Name of supplier.Owner or Dealer Address No.and Sueet(s) CHY - - State Date of Test r 5. TANK TO TEST 1.6. CAPACITY 1&rpm. - Station Chart By most accurate s �Y` Tank Manufacturer's Chart � Nominal Capacity eepaen chart available I .l, IdonlilY.DY p silion _Gallons r Company Engineering D Is there doubt as to Capacity 7 ❑ Data Charts supplied with TSTT �. Brand and rt;ade� See Section"DETERMINING TANK CAPACITY v _ Other ' w Stick Readin s .: 17. FILL UP FOR TEST to K In, ® Gallons TeataReading Q v: Stick Water Bottom _ 01 +0. before Fill-up © �� s ' Inventory f� r t to M in. Gallons o Q Q; Fill up.STICK BEFORE,AND AFTER EACH COMPARTMENT DROP OR EACH METERED DELIVERY QUANTITY © 'r Tank Diameter.. 1 7 Fr ,' Product.In full tank(up to fill pipit) 18 SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK `-�Va►�"�� d� S A VAPOR RECOVERY SYSTEM K 'See manual sections.applicable.Check below and record procedure in tog(26). '.ems+ • , Stage I ` o r t m oi'. Water in tank . High water table in tank excavation Line(s)being tested with LVLLT Stage 11 `1`11 C4 ly D ` 21.JEMPERATURE/VOLUME FACTOR (a) TO TEST THIS TANK x, .' 19. TANK MEASUREMENTS FOR ' 4" Is TodayWarmer?❑ . Colder?0_°F Product in Tank F fill-up Product on Truck F 'Expelled Change( +or—) �•: o a TSTT ASSEMBLY Bottom of tank to Grade* ��3 " �.-3c3Y tom 22.' Thermal-Sensor reading after circulation d _�°F to Add 30"for 4"L ..... _„ digs xN Barest .. Add 24"for 3"L or air seat ..,.... 23. Digits per°F in range of expected change 2 — 0. Total tubing to assemble. 'Approximate .. ' {� `20. EXTENSION HOSE SETTING 24. . �t7� x ° — - -�� �7 gallon ! o .' total quantity in coefficient of expansion for volume change in this tank L p ` Tank top to grade'.......... ..... '� full tank(16'or 17) involved product per°F O� Extend hose on suction tube 6 or more 1 _ belowtanktop rr 25 '" 3t!Wec3 Z -!- _ 72 C/ � q z - �—=c 2 �`—� , This is e volume change per°F(24) Digits per°F in test Volume change per digit, test • �p If Fill pipe extends above grade,use top of fill. Range(23) Compute to•4 decimal places. factor(a) ' 26 30. HYDROSTATIC 31: 34: 38.NET VOLUME 1139. f 106 OF TEST.PROCEDURES PRESSURE VOLUME MEASUREMENTS M TEMPERATURE COMPENSATION CHANGES ACCUMULATED A RECORD 10.001 GAL. USE FACTOR(a) CHANGE CONTROL EACH READING. • > 27 28 29. Slandpipe Level. 32, oduct 35.. 36. 37. Temperature it High Level record GATE• flecord details Of Settle U in Inches Product m Pi Change Computation AdjustmentTotal End Deflection 9 P. Reading. Graduate Replaced(-) Thermal Higher+ (c)x (e).= and running test. (Use full Mo. Beginning Leval to Sensor Lower- Fspansion+ Expalu oo nu or At Low,Level compute TIME length of line if needed.) of which Before After.' Product Reading (c) Contraction, Contraction(-) change per Hour (24hr.) Reading Restored Heading. Reading Recovered(+) #33(v)-N37(T) (NFPAcriteria) M, --eAP % 14. vA �,c ?; J✓�2 G✓. x-�JS ,C+-`SLR %✓J f� f�8/�� •.Name of Supplier.Owner or Dealer Address No.and Sueet(s) - -City State : Date of Test 15. TANK TO TEST16. CAPACITYFrom, L✓J s tao• on Chan By most accurate Fq Nominal Capacity capacity chart available ✓C"Q ❑ Tank Manufacturer's Chart Idonm b posit on Gallons Gallons ❑ CmmPony Engineering Data Is there doubt as to True Capacity 7 El f�l�iZ ❑ Charts supplied with TSTT Brand and Grade See Section"DETERMINING TANK CAPACITY ' Other 17. FILL-UP FOR TESTZ, stick Readings Total Gallons . 3 0 to%fit. Gallons ea.Reading Q Stick Water Bottom 0 before Fill-up inventory 8 1109%In. Gallons 0 Q _ .r•.� Y C O Fill up.STICK BEFORE AND AFTER EACHCOMPARTMENT DROP OR EACH METERED DELIVERY QUANTITY —� G in - zTank Diameter � .\�/ 1 �5 r! Product in full tank(up to fill pipe) 18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK _ rbF_ve; G $""� VAPOR RECOVERY SYSTEM " 1 N /�intJ� ASee manual sections applicable.Check below and record procedure in log(26). ❑ Stage t Eli Water In tank ❑ High water in tank excavation b�KLIne(s)being tested with LVLLT ❑ Stage li cam 7 Y w � 6,0 21. TEMPERATURE/VOLUME FACTOR (a)TO TEST THIS TANK .�L;r� 19. TANK MEASUREMENTS FOR, -. 0 F Product in Tank_ F Fill-up Product on Truck F Expected Change(+or $ is Today Warmer?Q Colder? P, TSTT ASSEMBLY u�i ig Bottom of tank to Grade*: i r m - 22 Thermal-Sensorreading after circulation °F V Add 30"for 4"L „ digits earest Qe -xr : g d Z to m Add 24"for 3"L or air seal .::... v it y 23. Digits per°F in range of expected.change -; r� digits Total tubing to assemble Approximate �J A 24.. aO / f m 20. EXTENSION HOSE SETTING --� X i C7DOt� _ _ 3, gallons' CD total quantity m coefficient of expansion for volume change in this tank , Tank top to,grade�.,::. r' full tank(16 or 17) involved product per"F Extend hose on suction tube B or more z. below tank to ....... ......... �yy rr� /Ay s�,ry r p rr 25. J a y l a9 2 P� -} _ A�J ter.+ s �Q`+7!� This iS s l 0 I` volume change per°F(24) Digits per"F in test Volume change per digit. test 1 Oki pipe extends above grade,use top of fiR. . Range(23). Compute to 4 decimal places. factor(a) U 26. 30. HYDROSTATIC 31. 34. 38:NET VOLUME 39• YM UME-MEASUREMENTS M TEMPERATURE COMPERSATIOR o LOG OF TEST PROCEDURES PRESSURE RECORD TO.001 GAL USE FACTOR(a) CHANGES ACCUMULATED CONTROL_ EACH READING CHANGE 27. 28. 29. standpipe Level 32, 35. 36. 37. Temperature At Hio Level record cat Product is Product Record details of setting u in Inches Change Computation Adjustment Tout End Deflection g P Needing Graduate Replaced(—). and'running test.(Use full, • No. Thermal Higher+ it) x to)• Volume Minus Beginning gavel to Sensor lower— Expansion+ , Expansion + At for lent compute TIME length of line if needled.) g c Contraction— l )or Chart* Now of vvhieA Before Alter Product Res 1) Contraction(� tiw It1 Ma Reading Restored Reading Reading Recovered(+) r33(1Q—N37 ) (krPA uiterial i n • s ® 4 i i ✓ i j I i II r , . MIMI MI. a"OVA inn ® mimm mimml i i,► ,. ` ( ` a -e I - . I mmi I mimmi EMI immElMli i m1mrAlI I .v 1 Iimm .... r Rim I r . .e � I iOM ! { I imimmi mimmlWiMli I I . • I Ie/Li11 / I I { - ®I® ! I 12 3 _ R. 2 .341 t +- W 2, - t j •r oov a• . a �"J Micu: �> > 14. Mw C►�.E � ._.._ g� j.�z. J. S,a,e�Ls�s��3�-�� i''�1-4 v8! a 5�8 C� �ea.J io n 1 �� % •... '. Name of SuPPlier.Owner or Dealer " Address No.and Streot(s) ` Cali Sots Date of Test TANK TO TEST 16. CAPACITY Fro station Chart " By most accurate I Tank Manufacturer's Chart Nominal Capacity capacity chart available Idenuty position Ga0one Gallons Q tompany Engineering Oats �p Is there doubt as to True Capacity 7 Q Charts supplied with T$TT . c: Biand and Grade See Section"DETERMINING TANK CAPACITY Other 11. FILL UP FOR TEST' Tota Gallons O X Stick Readingst . S in: Gallons ea.Reading O Stick Water Bottom tea, Q s .�► before Fill-up V ���� inventory r to to in Gallons d� 0 O Fill up.STICK BEFORE AND AFTER EACH COMPARTMENT DROP OR EACH METERED DEL.iVERY"QUANTITY v, �D C Z 'Tank Diameter._ !� �� Product in full tank(up to fill pipe) QZ 18. SPECIAL CONDITIONS,AND PROCEDURES TO TEST THIS TANK �'1.�'��1r.� .t/ g/°�/�,J� VAPOR RECOVERY SYSTEM to o m i See manual sections applicable.Check below and record procedure in log(26).. stage I .�'�+rN C. g w eN r \ Water in tank High water table in tank excavation �ine(s)being tested with LVLLT Stage It !" i-. W r— - 21. TEMPERATURENOLUME FACTOR (a)TO TEST THIS TANK ox 19. TANK MEASUREMENTS FOR e Is Today Warmer?17 Colder?❑_'F Product in Tank;•`F fill-up Product on Truck_°F Expected Change( +or —) o D TSTT ASSEMBLY Bottom of tank to Grade*. ` �L> � , m m 22. Thermal-Sons reading after circulation F Add 30"for 4"L ..... `,, digits areal x r•- .... - .. ro fn Add 24"for, L or air seal " 23. � Digits per.°F in range of expected change v n digits Total tubing to assemble Approximate ....-.... v Lam— _ 20: EXTENSION HOSE SETTING 24. x �-�' gallons o total quantitf in coefficient of expansion for volume change In this tank 4 := Tank top to grade'.. ... ......... �' full tank.(16 or 17) Involved product per°F 1 Extend hose on suction tube 6 or more ",.below tank top ...:. ........ ......... ........ .. -rr 25, This is volume change per°F(24) Digits per°F:in test Volume change per digit test *If Fill pipe extends above grade,use top of fill. Range(23) Compute to 4 decimal places. factor(a) E\ 26.130. HYDROSTATIC 311. 34. 38.NET VOLUME 39. VOLUME MEATUREMENTSIh TEMPERATURE COMPENSATION ACCUMULATED LOG OF TEST PROCEDURES PRESSURE RECORD TO.001 CAL. USE FACTOR(a) CHANGES CHANGE CONTROL EACH READING 27. 28, 29. Standpipe Level 32,. ud 35. 36. 37. Temperature A(High Lerel,record Pruct m Product g p I Total End Deflectionin inches Change Computation Adjustment DUE Record details of setting up Reading Graduate Replaced(—) Thermal Higher+' c x a and runningtest. Use full No. D 1 ) I ) Volume Minus ( Beginning level to Sensor lower— Expansion+ pExpansion(+)or �LlorrLevel compute length`of line if needed.) of which Before After. Product Reading Ic Contraction- Chan a Pei Hour TIME - - i Contraction(—) A p U/hcl Reading Restored Reading Reading Recovered(+) p33(V)—s37(T) (MFPA eriteria) t r J.}. "'Vt. �y i'"r,,°,w r a' •: r y _• ' r.`.'. r r• _ yv,.. •t. ta�^ d � e y ..y � M1 r ., 4 � I"'� t+ + � f r . as ai� <^.a., s .�_ +,;c',:. f° 'h'"r �,q A Y {a b'u' rt `Y A n l.• 7 q, r R '•. y kr4: V 6" r i � S •a ' Y � -f, �.' r��ut;k}•M1. x i K fi''?..�„� i W:�`� �°�'� �r �. ., � ,� N � � rx r.,, 1 �. }' .. C.{ 3 - � .y � :• ri �� . w}• 3 § z,rk �"'s •{r��.tt,a{,�d" .r* ¢ � `� .�. • �`sC r^ a�..,. 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'' •• h, r r •z 1 &," ♦ ,! "' 1��":1£' a ,.a[" r d s t.' L r{.; ,�� � f r t `. 1j, J' cttt r.• � r � �. Pt a 'tcs d 2.•t ,4, 4, a '�"� y,�,y A r �-[ �,! r �fd� �, ur3:+ >p � a�. �"t�,t�tT ,4•r f �.q* ;? ,�( Ev' r *'! ,{.; , ^j 3 ,..F.; `��.. ,u< ^.' ., �•�r +srg,_{' 4 iy tr 4 r r. {.;^.t o �{ ' t.s f s •eY•�i4 4". ° 'b s as'.r �,.} 4 ;' y{ eY}S d\,�X-i- a rr,x` - �. r.{.`• Y :':lk.i't? 4',~ ?,:..u.s V...i%_ ='Ms Roberta 7 k t,C• r tJ }�.9'w. x C'- ��r d 'r..f i y, dy. _„}«•r"aa{*� q;`}a, .f, d . Adminirative Assistant st ��•�` f (. .s.t r .. s*An cBnergy Diibtor , ,��rid♦ �. ! .:•L r �� d t $a. t 7"4 f` r ...a,�'� _-�-�y�'r� f a P O Box 405r , • f . ae ,- .• .: +S .F t t i J k Danbury,lConnecticut 068104405 ti � F; ,^ ..r Y. •�" _ e,., �,p .r.� ,rt 7 { r 'd V r K Y,.,•. .I�'C't r r -• f ° ? _ <- A . r z •�,rt .,. ., ' � � ` x x} ' ?. � 4.w P r•��,,�t ti ,� t i .. a `,���� r � a , e ,, �a f,; r. : Dear:'Ms."Smith . ; t A.; s ry$ :::r. y e °`may :,{.,v {.s ti , y� + " s S r ti i`•4 r .�• •i r•et � a * ,' : f�i} Lrt ti'�^ ��x. f i-.I r J .r '° " ' '. -4 v" r •. k r .. r d' F ?� sr''r,tii:a �' s leer y V7 .. ,r r Thank you:-for your recent letterr:�concerning•thevrelitiing�'of%t a four 5,000 allon� 1, . y, under round+fuel'�tanks in�i981i�lacateci t r '' ! f g at ,the Sunoco Station, Routes' 6,,and';132, r +.. xr �,C �.`i, , ♦ � Z +.. '+: r.r;.a 4 ski ..5£at rrY �• +wC l s Y •Hyannis ^ ' i l'. < 7, ,r.�y rrrR�,'�{� e .p 2F �J�r..,�=F�'.•��', s, •t �,. �t. gF,. t a y, iix rrw�,sf... •� � xr"�' `r " '.�; -• ,r a *.T ' `a •^' �"w':° ~< i s^ •'�`.y t: 'I, "t . +' •'{ Ck � •.� * `r a~<`°S+s ^r ,.�'.t �•C .kc�. Y" + '�4 You.stated' that the ocher tanks at�thts location �vere'replaced� n'I965 making them r K' �20 years-,ald, not•30.years'old'sas our reeoriisyshnw U � xy L• � �. s ,e� ,�3,• r ,.3. i ; .W r. a rry 1 a �•.rjl* � ` � ` ` C �`� AA�y Y -V .�* k��# i' e-,.i a{ �:� i � �,k'� n -%, s'- t r f �4. Y "� *r,,� $• 'r �'f S r ZY x.+- s"�yrI's,^ ,�.., Tnarit.regulations requite all,-underground•fac l tanks, twenty,•years of.:age`�o'r older, -W. +:that,have.a capacity .of over 500•gallons+°must be. tested'�eacti year,for leaks Using the' r y g De iti 4 authoriz�ecle b they r ent' lvloore.°Pressure 2es tiAir pressure testing Is -not y partme �t of#environmental Quality Ei'gineering ` t �^'e.' : r. ''"4 sw+t!• .� °�� ._.V } x.. •..r .. . „p ; t d�e a.r... ='s� �',)r� r 4'. `. f r, ^.. ►... ea '<t ,"' ` ..r .' i "hi ,..:, rt =-? <r'; r i ':. F� r ^�. X�;.' � "t��.•" + L Y., a '��, r} Youare directed to;have your''1000 gallon fuel oil,and°the .550 gallon. waste oil , s h r{ .. tiank 'tested Eby`C4ctober 1';a 1985,sand a;copy of the•results hsent-io this{office prior r` z M+, •to Octobe `l I985 :• .<. ,�: t . r _ s '�. • ';k � ,�� r e. 4a • 7, S s' t '' -1� r 1 < "S.:r �r ti r ,x I�;y. -♦ - a jr .�i� r p°,� .�'' ,�a ,ia,'=�.�„ S A"_ r' 'bA„ ' ,•Yr . ,k" 1#ailur'e to,have` these.'tanks Tested could.result in a fine of -not.:niiore" than $200.. Bach. separate day,s4ailure' 'to�,�comply5,wwith an 'or'dery ihall�constituter,a'separate, ,.;.' ',:-r{f ,� •Violation }, gr t �' a .+�'. May, #� i #' {y•-- � i .r 'i a. r"? " '�, i f M.," „r:. r l r � �' j '�S tp ' " .*•f 'rs''�.`yam' t, e k fi;.$)'t' •Mir `.c. ;We 'would'a y rec �, r: pp iategour cooperation in this matter so.vital eto public safety'and r ' it water qualityaof the town£ n.A �° r 4 ,Y+a•,r �' `" .V'�s } r `� � �,.•.'x ..k�'T'1 at> r .. R "�"i.. rear •1' d �'4i 'R� � rC-ty-- - t Please call'If,you have`anyrquesti�ns '775`"1120j.' extension"182 ' _, - �� ;f �F J A. � t J I'd tR �Tc,Y(^� •'rr'r.K?_..,c - �C l' :. � r { } ��w• �;r".; � y•. V' p s ku t "h` `y Ver :trul ours W ;°a ar y:C a, r sw a t fir. fit` ay •,.+ l' a� q. i t ' .;�" t•��,, •r ,a'r J� SAS. f y' r �+ir Ti'y -9x f r� �♦ a- •a ''h t E+'.F. a =ak m>L�j s-',h .«'S r ^�� t ,<; } �'. ,,.* �y �: y M`t = yR,� t •aa`3`H � r 4•a r , r k t e ^ �0..x•. r � i••yv .>f �'f' x � F•. ,h Y`',.� ,,.. � ti: 5� S 'S'^ +�,° � a#{ r, �ii „ 4y st,.� � 4:, r >> J. �t� '� '� L'F. John Ai ' •r n`y" ' r Mays n ,;° t ' r 't x f{ "`' { Director ofxPublteT Health' . ;� =h' �`. as y h ,f ` " ' J .for f ,y1' Robeit:L. Childs, . . •, •^y, �', . {' - . � �t, ' '� � ' z �_. � " `fir : , s, Chaiimant 4 'Ann ,1ane'Bshbaugh • .t • ;Grower` � + ., • y .�4 •a s .�" ' { ;� �,< ��, , C.M" F D BOA tD'OF'ii1 ALTH` .w r 'TOWN '< s OF .BARNSTABLE '' � �• �' # q s y� � �; �r ^3� S•; �' 4, ° � • ;, t r - ..rr 'r"fi: L � t. ,� 1 r mL� h,'�i1{+� �:h� C:v {•o- 1 ; � i�r; .. r" f J K/m f, i L �:� t . s� t .,. -. ,,;' - ^t 1'v $sF i'r2 ril•L< n 'r rr}' a. a, J Energy Distributors, Inc. April 4, 1985 Peg McKeen Town of Barnstable Board of Health 367 Main St. P.O. Box 534 Hyannis, MA 02601 Dear Ms. McKeen Re: Sunoco Station Rte. 6 and 132 Enclosed is a copy of a ten (10) .year guarantee for the relining of four (4) 5,000 gallon tanks done by Kessler Installation and Sales in Dedham, MA. We have also, been advised by Mr. Stanley K1'ocek of ARCO Petroleum Products Company (previously affiliated with the location with the former owner) that the tanks were replaced in 1965. This makes them 26 years old and not nearly 30 years as you stated your records show. Ve truly yours, Roberta Smith Administrative Assistant 40 Lake Avenue Extension - PO.Box 405 - Danbury,Ct. O6810-0405. (203)797-1004 ��,jr_. � r l^"a .. :� ;;«:'` ,_ -' . a• .: ..`;':. m.�..� �m •t•,,y�qy I6r„`��✓"�1, Ir xt �"4 I ,r.%."� P,{t Y��; ,gi '. r1 x.t��.�: y I •r� r �t�/�, r.. t /� I r � , , r�•:� r „a4t ,` r fL ,. 6 r J 1{r, cYi �I► •4ym t 5i T I( �°•• .^. cJGt '`i4t''> irk Jtrt try v +�.r 'v >, t` rtrt .. .. tt.... ... :! , + chased A limlor signed below• 9ridg¢port Chemical Corporation � pp ,t : ► t, x oertlRes .that the Glass.Armored steel stotsage.aa�uk at.described on the i+everse - feed or a: d of`ten:years' side) conWi?dng•petroleum fuels is hereby guamn f perio 1 YyL : 1 Y d ' O.>, t 1 � 1 L 1 f t+ .E.(.•'�„4�r r /.. 'p,r�YCy rY-'}d I J7 .. t £ . rg �lttteR/a1 'Pi X gpplicatiou to .said tank u:guaranteed a..... defective material and workmanship Any such defect:,will be, mpdmd without cost, by • R - flee installing FYanchised Applicator provided lliat the tank is made availablt and accessible ► 7Tie licblliry of:the Fignchised`Applicator is lindted to the sepair (C ' tank. Any Nobility, direct or indirect., resulti►rg from the.:use or application of •' Armor pnaducts is.not the.responsibiliry ofBt#dgeport Chemical,Corponatior� ( <rla�s te�- r the F,mnchised Applicator ` This guarantee is:hot valid unless ter d b y z x The, undersigned, Franchised Appliattor further cer[iJier that said steel stotgge tank has been Glass•Armored:tie accordance with the current Bridgeport Cgrenticel written specification including the following T A..Surface hepamteon aand blast to'white metal" ! k �� S 'Coating.Appleatton age thickness f r• .((JJ((r o,., M14 �-L�. �,��nQtl/�pect/Qn � 3trr'1�.4 G t _���A� �► •►_ �sV T x `a E:Oa[in$Test(eontinuit�►) ,Y r N 1 t', ,•;a 4'3 fY� /1�Y�i/� p� .� A �-+ r^K h +... �.,F rQ r Tf.Y��t�rkn��.P a i r t �h+.�, r •i at 5 , ' ` k '+ �' iJ. Permits as t+equu+ed• �t +iL+y� T tiU4 r d N t• � ► It j �. � Fr t •.r �'" t Fr�reAch/sed.APpltcator 4•�,�i�nt�N r.� .., ... 4 ',� 3 t + i.. > �' rr;► • .y l if' •'�'�ry�y�E�y'ed /�ature 3 • . j �(. .Sri. .r r r.c.r♦s F ^.�^� :• > t���.r?. �.j, �{yok� -� , c.'�yh�. >a •:. act.+a � \ ^.�t .e"fi t.r �+t 1.1 tr `-4 x t• �{i t ' / ram';{.t'•"fSr ci �''�tr K{W/c r-4C� a�'�'�`4S Y.lti�IiX+ �.h�W X+ w .0 P' . .:x�PC� .'t .f.�r."`.,y.P ti r tr•, .Z i,.- -•� ... f S s C,-'r (c .7ltj-bli$7t4t_'•'t.x,T .`1 ,•.r, c� } - ,• `.�t s ri � ;�i�'rtir.' 'S• �.r ,{"Fw t.+�`-+��F�'�S,a��t..'�..�i�'-•- t-c� t+• �C.,.,"` ,.3 3�rt c � r2 : .�, ? .. � y,,. c.;.: poratidfr/�/y) �✓�d °t`CY1 r'z't`�r�i t•- � a'`. • ¢ ;rtn fug p a5f•e[INOZs lror . -�iT g 'Z r �`4 Yl •P tt Y .` .c7rj��i P}gStk51��tF.��rw� mhaC r'�utrle/ltlCatlolfi g�e7 m.•° v�'ti � � ��' I^RJr.?1 'C'¢}Fh5 "l ..� M T AyTt�-, }� ,�dtte}-��fCK"� '"'^''�'�k �-n. M1 Y2 •l K. e C ♦ v'E 1c "� ♦ �+ r!.YfR1K,w�.srMfib 2M �t ..k- > � 2�'£�+ �L '� �.tt` 4c4• s.y � t rr t .yt 3G? y 1"'' s L'�.,! �r,?� F'r a s. 2rr , �5 � 'w:�'^Y��2L'��� -v t r�c�'crk'�t�@a•1�y ,�+(y '•k���'�PFc.?°�S'��Y,- r�"�^��v�3�,'�{�4' c�'C� Y ( �'"•'d M:'�'sl0t i�r"��'r t. •' ,• /' • •::" I"h. + �L, t i`�t\ xr'C t. r_:. ..,�S..F.; r!x F..�-4' -�}�7;+� P�i.• � t t4, �A • t. _ #, GLASS ARMOR INSTALLATION RECORD DATE COMPLETED ;A J08 ADDRESS * /y;Yr C .r Y a^� 'CITY AND STATE APPLICATING COMPANY: Mail Guarantee to: COMPANY "ADDRESS -. :', �d };,;S�t, �..`��..,. 'x3�"'* ? rtl e_ s �s - .� -Yf t x}3;#.,''' s,.,,,..„+-�� e>t .f.::r�+ a,..,—;�,•fi *•�i.� �i>�.,., r .'t��ti, ."'�:�". CITY ATTENTION `. SKETCH OF GA TANK LOCATION Fold TANK SIZE: '-4 ~a 'jw '.t Gallons PRODUCT: �' ✓p g j y,, v *'i y 6,61V d i1'[+.!�. '.,t � ,1,f t� $�7''e _�Y�^Vr i'yf�tf.:f!.f�9"k: his'?°x. %.fit < �a � s r':ik":` •r• Fold r r 1-7 S ' ' �> .. - �' s�• r t ,J•, en :t..: .. a. i„ylyµ. e t ` Bridgeport Chemical Corporation - Applicator ' 210 N::E..5'th=Avenue 71(al- M to Bridgeport for r. xP�mpano Beach; Florida 33064 _ authentication signature y-v , (use windmk envelope) Energy Distributors, Inc, a distributor of petroleum products February 11, 1985 Peg McKean Town of 'Barnstable Board of Health 367 Main St. P.O. Box 534 Hyannis, MA 02601 Dear Ms. McKeen: Re: Sunoco Gas Station Rte 6 and 132 Enclosed is a copy of the report on testing our tanks at the above-noted location in Barnstable by Zecco, Inc. We apologize for ;the_ ditlay.�c ,,-We had assumed that Zecco was to send you a copy. As for the other information you wanted on which tanks were relined two years ago, you will have to contact Thomas Venezia since this station was under his operation at that time. truly yours, Roberta Smith Administrative Assistant 40 Lake Ave. Extension P.O. Box 405 ° Danbury, Ct. 06810-0405 (203) 797-1004 e .__T _ __.r__., _ __.___ _ _ _._______ _. pFTHETO� TOWN OF BARNSTABLE OFFICE OF i BAHb9TdBLE, _ NAM BOARD OF HEALTH 7 p� 0�0 i639. � 367 MAIN STREET DMixa' HYANNIS, MASS. 02601 r June 30, 1983 Sunmark Industries Div. of Sun Oil of Pa. P. 0. Box 988 Framingham, Ma. 01701 Re: Your service station at Rtes. 6 and 132, West Barnstable Dear Sirs: You are directed to have your two underground fuel tanks (one gasoline tank 28 years old and one waste oil tank 28 years old) tested by Novem- ber 1, 1983 and a copy of the results sent to this office prior to November 1, 1983. Town Regulations require all underground fuel tanks, twenty years of age or older, that have a capacity of over 500 gallons must be tested each year for leaks. The Kent Moore Pressure Test is the preferred test; however, an empty tank can be tested by a 5 PSI Air Pressure Test held for a minimum of two hours. The air pressure test can only be done on an empty tank and is not the preferred test. Failure to have the tanks tested could result in- a fine -of not more than $200. Each separate day's failure to comply with an order shall constitute a separate violation. We would, appreciate your cooperation in this matter so vital to public safety and the water quality of the town. ; - Please call if you have any questions - 775-1120, extension 182. Very truly yours, % •X jh M. Kelly ector of Publi Health for Robert L. Childs, Chairman Ann Jane Eshbaugh H. F. Inge, M. D. BOARD OF HEALTH TOWN OF BARNSTABLE JMK/mm _e �OFTHEto TOWN OF BARNSTABLE Q wy OFFICE OF i BAH E, M"S. : BOARD OF HEALTH y n66. p� iD 11 p9 a.�� 367 MAIN STREET HYANNIS, MASS. 02601 July 5, 1983 Energy Services, Inc. of New England Lake Avenue Extension P. 0. Box 405 Danbury, Connecticut 06810 Re: Your service station at Rtes. 6 and 132, West Barnstable Dear Sirs: You are directed to have your two underground fuel tanks (one gasoline tank 28 years old and one waste oil tank 28 years old) tested by November 1, 1983, and a copy of the results sent to this office prior to November 1, 1983. Town Regulations require all underground fuel tanks, twenty years of age or older, that have a capacity of over 500 gallons must be tested each year for leaks. The Kent Moore Presssure Test is the preferred test; however, an empty tank can be tested by a 5 PSI Air Pressure Test held for a minimum of two hours. The air pressure test can only be done on an empty tank and is not the preferred test. Failure to have the tanks tested could result in a fine of not more than $200. Each separate day's failure to comply with an order shall constitute a separate violation. We would appreciate your cooperation in this matter so vital to public safety and the water quality of the town. Please call if you have any questions - 775-1120, extension 182. Very truly yours, n M. Kelly � irector of "Public Health for Robert L. Childs, Chairman Ann Jane Eshbaugh H. F. Inge, M. D. BOARD OF HEALTH TOWN OF BARNSTA4E JMK/mm ARCO Petroleum Products Company 155 South Main Street Providence, Rhode Island 02901 Telephone 401 278 4354 February 19, 1981 Town of Barnstable Board of Health 397 Main St. Hyannis, Mass. 02601 Attention: Mr. John M. Kelly Director of Public Health Dear Mr. Kelly: Attached are the tank inspection reports covering West Barnstable, Mass. Two of the four 5000 gal. tanks were found to be leakers. 'They were immediately emptied of -all product. We are planning to fiberglas line all four tanks. rt ! Very truly yours, C. A. Irvin, P.E. CAI:ajs Encl: ARCO Petroleum Products Company Is a Division of AtlanticRlchfieldCompany 8 P O3A IC laROFESStON'AL TANK INVESTIGATION CORP. PO. BOX 17591 MILWAUKEE,1NiSCONSiN 5321'7 PHONE WISCONSIN (414)332-9422 332-0494 February 4, .-1981 Mr. A.J. Sidla Atlantic ' Richfield''Company BOX A Providence, R.I. 02901. Re: Tank System Re-test, January 22, 1981 Mid-Cape. Highway (Rt. 6 & 1321 West. Barnstable, MA. Dear Mr. Sidl.a The tank system re-tested at this location is identified as follows: Tank System # 1 South-East 5,.000 :gallon Arco Unleaded gasoline. The National Fire Protection Association' s criteria for a tight tank System is a' system with a rate of. leak less than . 050 .gal/hr. These are calculated, mathematical tolerances only and are not meant to indicate the permission of any Teak. Tank System # 1 showed a rate flf leak of 1.603 gal/hr. Tank System # l is leaking. Prior to re-testing, the tank bottom was checked for' water .through the fill pipe, no measurable amount was recorded. Re-test, January 28 & 29 Tank System # 1 South.-East . 5, 000 gallon Arco -Unleaded .,gasoline. Tank System # 2 North:-East 5, 000 gallon Arco Unleaded gasoline. Tank System # 3 South-West 5,000 gallon'Arco. Regular gasoline. - Tank System # 4'North.-West 5,000 gallon Arco Regular gasoline. MEM [iER Ll ��EUM EQUIPMENT IN"). PROTA:N�C. ; 'PROFESSIONAL TANK :INVESTIGATION. :CORP., - P.O.BOX 17591~ a MILWAUKEE,,,WISCONSIN 53217 •l PHONE WISCONSIN (414)332-9422 ! 332-0494 1•ebruary- 4, 198.I , Mr. A.J. sidle . Tager .2 Tank System # 1 showed a rate .of. leak of -1e937 gal/hr. Tank. System # l is leaking.,,-- Tank : . System # 2 showed a rate of leak :of -.038 gal/hr. Tank System # 2 is tight. Tank _System,'# 3-showed is rate of Teak' of: 045 gal/hk. Tank System # 3. .is tight. Tank .System #. 4 showed a -rate =of ..leak, of .�.439 gal/hr. Tank Systz:r. # 4 is leaking. Prior to re-testing, the tank bottoms were checked for :water through the fill pipes, no .measurable amount was recorded. , . I� :S' erely, �j •William J. .P Ora WJP/lmw I P e. . li {yr MEMBER . gfUM EaUIF MLNI INS \ uis., ..hart for in at SYSICEMi 3 s �: 3 L'St atvs't Irs�t.o�:s,+1 USING.KENT-MOORE, CORPORATION TANK TIGHTNESS TESTER MODEL 1000 For'Picket, , 'Copyright-©Kent=Moore Corporation IS77 of 50 Charts i.., ., PLEASE PRINT J :. 33 Order) 2 964 r�_rt, L4� t OWNER Property �- • Name- A� A dress Representative Telephone r ` Tank(s) t -- Name:- - ;Address `Representative - - Telephone" Z. :OPERATOR' < f' ✓ :o. G�!/lrtb • Ne Address r ��— Telcpnonv. 3. REASON FOR. fti�-Z'1� TEST t (Explain Fully) 4. :WHO REQUESTED. ,c..1. �t4���c... .�c� ,`t .'TEST AND WHEN Na T�r�r Company or Affiliation Date Address ;-. ". -'Telephone 5. WHO IS PAYING FOR THIS TEST' CompanY..ABenev or Individual Person Authorizing Title Telephone ( - - Billing Address City 'Stab Zip. Attention of: - Older No." Other Instructions - - - Identify by Direction Capacity Brand/Supplier Grade Approx.Age Steel/Fiberglass 6. TANK(S) INVOLVED 41/ O I . Location Cover Fills Vents Siphons . Pumps 7. WS:TALLATION 1`i t�14 DATA C�l�COI/tk+iltt �8r. North fndde drlvewsV, Concrete,Black Too. Size,Titefiff make,Drop .Suction,Remote, Peat of station.etc. Earth,etc. tubes.Remote Fills Size.Manifottied 4Yticn tanks 7 Make if known 8 UNDEPGROUND .. Is the water over the.tank7 WATER Depth to the Water table ,• Yes No Tanks to be filled hr. Date`. .Arranged by 9. FILL=UP Nam. Telephone d run.TSTT. How and who to provide)"' Consider lead. ARRANGEMENTS Extra product to"top off-an Terminal or other contact - for notice or inquiry - Company .. Name - Telephone to. CONTRACTOR. MECHANICS, any other contractor involved e. 11. OTHER � ,��•-. INFORMATION OR REMARKS _ Additional information on any items above.Officials or others to be advised when testing is in progress or completed.Visitors or observers present during test etc. Tests were rode on.the above tank systems Imaccordance with test procedures prescribed for KenWoore Tank Systems Tightness Tester model 1000 as detailed on attached test charts with results as follows: ,,. 12. TEST RESULTS ..- ..: . , Tank Identification Tight Leakage Indicated Date Tested �S r %�t' 6.P.N w f This Is to certify that these tank systems were tested on the date(s)shown.Those'Iridicated'as"Tight"meet the criteria established by 13. CERTIFICATION the National Fire Protection Asociation Pamphlet 329 t p Date )+-�L�1��1f- i0 �U 1 75Ai cTesting ti9P! 4Wl .GQnrpinY• 5.4; srgnatute - _Senal No.of Thermal t t Tecnnivans .Address Sensor t le- do Name of Supplier.Owner or Dealer . Address No.and Sneel(s) Clry. `Slate Date of Test ` Z 15. TANK..TO TEST 16- CAPACITY Fro/ 1 (/Station Char; r 8y most accurate , . j/ Tank Manufacturer's Chart Nominal Capacity-" capacity chart available— Gallons IOenu y posrlion _ - Gallons _ Gallo El Company Engineering P Y g g Data �. Is there doubt as to True Capacity T A, Charts supplied with TSTT an and Glacial - See Saction-DETERMINING TANK CAPACITY" 0 Other - - 0 . 17. .FILL-UP FOR TEST Stick Pleadings Total Gallons to sh in. Gallons ea.Reading Stick Water Bottom"e' ^r* before Fill-up y t ,U� inventory 4 r to Vi In Gallons 0 0 Fill up:STICK BEFORE AND AFTER EAm CCOMPARTMENT DROP OR EACH METERED DELIVERY OUANTITY (_n Tank Plameter: r " ,! I P Z E/ Product In full,tank u to fill pipe) 18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK VAPOR RECOVERY SYSTEM See.manual sections applicable.Check below and record procedure in log(26). El Siege f o i- - gym Water in tank ElHigh water table in tank excavation Linc(s)being tested with LVLLT Stage II . A '�� 21 TEMPERATURE/VOLUME FACTOR (a) TO TEST THIS TANK i9 :TANK MEASUREMENTS FOR 100 r: + Is TodayWarmer? Colder?p—°F Product in Tank F Fill-up Product on Truck F Expected Change.(_ +or - 'm n = TSTT ASSEMBLY p g 1 ) 0 a` !• Bottom of tank to Grade!..;.... ,• . 2. I tiOr t 12 T d gds crest tam t.. � .. .. herrna-San ♦ead'ng char circulation - •F < V' 1� Add 30"for 4:'l ' ^a m w Add 24"for.3".L or air seat ... " 23: ca •, Digits per°F in range. expected !" un n ` Total tubing to assemble Approximate ....... m 20 EXTENSION HOSE SETTING24. t� total quantity in coefficient of expansion for volume ctiange in this.tank rn'1 Tank top to grade'... ••.••. ••••••••••••••• full tank(16 or 1 T) involved product per IF V` Extend-hose on suction tube 6 or more �p below tank top .....`.:...... T„ 25, t �.. L + X / _ ' �L/ This is volume change per'F(24) Digits per IF in test Volume change per digit., test •II Fill pipe extends above grade,.use top of fill. Range(23) Compute to 4'decimal places. factor(a) . 26. 30. HYDROSTATIC 31.. " 34. 38.NET VOLUME 39. n• VOLUME MEASUREMENTS(Y) TEMPERATURE TOR Is) TION CHANGES .� LOG OF TEST PROCEDURES PRESSURE RECORD TO.DOt GAI. USE FACTOR la) ACCUMULATED CONTROL EACH READING CHANGE 27. 28.. 29. Standpipe level 32. 35. 36. 37. Temperature At Hilh le.el record Productie Product but Record details of settin U in IncfiH Change Computation olumem int . Total End oatecGon gg- P Reading Graduate Replaced(-) thermal Higher c a and running test. 1.Use full *a. o I ) l ) Volume Minus Beginning level to Sensor lower- Expansion+ Ill lo.le.el compute length of line if needed.) At n or TIME - of which Before Alter Produc9 Reading (c) Contraction- Condadion(-) thanle per Noar 124 hr.) > Reading Restored Reading Reading Recovered(+) a33lh-037(T) IRFF%crilerial I . • _ a cr 10 3 ? QO Z36 _ Z76 _G _ 72 ^ Z U 1 30 �l ..oD 2 Q 217, 71 sue....r... . ..�,,:,...,. ..._......<.c�+...m...-.:�,...,.��s.,.tr..u._r....�.�r�.•.._..,.....:r.q:i_.. � ,.,�.. ._�.. .,-�- :..._-_ - U....,._, - ���. _� . . - - "^ �_-_ —�..,— 1. Data ' .hart f®C Tanlic System ,Tightness Test (J.21103-31ir1) ` USING, KENT-MOORE CORPORATION TANK TIGHTNESS TESTER MODEL 1000 For Packet o74,-J1 V. Copyright C Kent-Moore Corporation 1977 of 50 Charts. PLEASE. PRINT SA_EY 1 Order':J 23396-A 1, OWNER, Property.[ 01/. 2. t?ac)ut0 e Name Address Representative T.elephono .• Tanks) _ Name -Address - - Representative- Telephone. 2. OPERATOR ��� �,Jy_,f, MID-c.> hvJ` - t,J�S'r.3ARi�lsr� L� t1��S,.G,7 -3a?•2`3$'S ` Name. _ Address.. Telephone 3. REASON FOR> �`il-i oP_D,4A J t-, TEST (Explain.Fully) ' 4.' WHO REQUESTED _--L�3�Cr�- TEST AND WHEN Name Tine Company of Affiliation Date Address - Telephone. �. 5.. WHO IS PAYING FOR THIS TEST?` Company,Agency or Individual Person Authorizing Title Telephone Billing Address - -City State - .ZIP Attention of: Order No. Other Instructions Identity by Direction Capacity Brand/Supplier Grade Approx.Age Steel/Fiberglass 6. TANK(S) INVOLVED 15- 51 0°° 4 2G0 LAN t.r. Z p Location R<no•g Cover.r��� daps. Fills Vents Siphones. Pumps . - - 1.' INSTALLATION f �'itt~iti1GS 'y:` 3 if A11A DATA I o) o3ll. vNCvJ-2�a rr of Conuete,Black Top. Size,Titefill.make,Drop . Suction,Remote,. . 1.1;h,etc. tubes,Remote Fins Size,Manitoided Which tanks T - Make if known - 8. UNDERGROUND y:Nts Is the water overthetankl WATER Depth to the Water table Yes No ` Tanks to be filled hr. Date Arranged by 9. FILL-UP Name Telephone ARRANGEMENTS Extra product to"top off"and run TSTT. How and who to provider Consider NO Lead. Terminal or other contact for notice or inquiry, Company Name _ Telephone 10. CONTRACTOR. MECHANICS, any other contractor involved . 11. OTHER -%%xf. I !'2_ �SJ�LLy MAwIGo�o;O GoMP��rI_y ISaI-A'110 4ZoA �oc.it orHr2� INFORMATION' U_ It DI'..00IJ�T'L1.tJ=S N9'. nJrAGe-O .Fo2T �y. .T:=S"�' . pt.i_ t.irJs Pt.v��t 0 OR REMARKS Additional information on any items above.Officials or others to be advised when testing is in progress or completed.Visitors or observers present during test etc. Tests were made on the above tank systems 16 accordance with test procedures;prescribed for Kent-Moore Tank Systems.Tightness 12. TEST RESULTS Tester Model rl000 as detailed on attached test charts with resufts.as follows: Tank Identification Tight Leakage Indicated Date Tested �.Cconr�c�^� # l u�✓�-- No -i • 9 37 4.v,4- i 28 038 G.P't+-- Z 8 8t r - This Is to certify that these tank systems were tested on the date(s)shown.'Those Indicated as."Tight"meet the criteria established by 13. CERTIFICATION the National Fire Protection Asociation Pamphlet 329. +t„rY IAQR� /f1tCKr�5oA1 Data Testing Conus�tpr 1. ltYtce iuv:v.SIg luis - - Serial No.W Thermal Tnciwicians Address - swisa - - FORM !/ 1 ovj, " Data Chart far Tank S' stem Tightness Test 1J 21103 3u41 USING KENT-MOORE CORPO-RATJON TANK.TIGHTNESS TESTER.MODEL 1000 For Packet r Z ST5 Copyright©Kent-Moore Corporation 1977 of 50 Charts PLEASE PRINT _5A.EZ P�.2- Order JI 23396-A ,. 1. :OWNER Property ►P,6Vl D E.O'G.z- _ . Nema Address Telephone Repteeentetiva. T Tanks) e Name - Address. - Representative - - Telephone - Z. OPERATOR 5T_IJ.E 'D tay_2 MID-GAP'. _AWY . IAI. AiCn1 5'EAGLZ rotASS e (,t? � a�-":`i 3 Name- Address 3. -REASON FOR TEST (Explain Fully) 4. WHO,REQUESTED Y\ .5 c-�'�Ctc` TEST AND WHEN Name Title Company or Affiliation Data Address` Telephone 5. WHO IS PAYING' FOR.THIS TEST? Company.Agency m individual. Person Authorizing Title Telephone .. -Billing Address -• City - - State Zip . Attention of: - - Order No. Other instructions - Identity by Direction- .Capacity Brand/Supplier Grade Approx.Age Steel/Fiberglass 6. TANK(S) INVOLVED ' t�.°CI& AOV R 4()LAICa 20'` 5'rS t- ( 3 g-yJ 5;000. RGa �c"Guu�i�. v+ Location. Cover Fills a Vents Siphons. Pumps 7. INSTALLATION OA/-co%2 TA•r)rG'roPS 3 t' f R� o DATA uftl.Z"11'Fc C-.o « . Fe 7 y 3 Rc�0 Ps'S /t/ _ ,Noah inside driveway, -- l:ortcrete,-Black Too. Size.Titefid T_sT make;Drop - Suction,Remote, Rear of station,etc. Earth,etc.'- tubes,Remols Fills Size,Manifolded `- Which tanks 7 Make if.knawA 8. UNDERGROUND Is the water over tank WATER Depth to the Water table Yes ❑'No Tanks to be filled hr. Date Arranged by 9. FILL-UP Name . Telephone ARRANGEMENTS Extra product to"top off"and run TSTT. How and who to provide 7 Consider NO Lead Terminal or other contact -for notice or inquiry Company - Name - Telephone 10. CONTRACTOR, MECHANICS, . 7. any other contrartor involved 11. OTHER T # at=s-Y 15d"rF10 AfloA01 5�4cr3 INFORMATION �or2 __HE.5S. 'ra,cS'('s-.. �4LL. L!4 ,��iJaG. f�. sr r�uea�6 oc. .rLtic. OR REMARKS Additional information on any items above.Officials or others to be advised when testing is in progress or completed.Visitors or observers present during test etc: Tests were made on ttre above tank systems in accordance with test procedures prescribed for Kent-Moore Tank Systems Tightness 12. TEST RESULTS Tester Model 1000 as detailed on attached test charts with results as follows: Tank Identification Tight; Leakage Indicated Date Tested R-6,01-A Z Alo ` y3? G:a,04 .. 0 3 This.Is to certify that these tank systems were tested on the dates)shown.Those indicated as"Tight"meet the criteria established by t3. CERTIFICATION the National Fire Protection.Asoclation Pamphlet 329. �irur!rjr.ir; L,lf/Z✓ .1 All(— 52ea.j Dale _ - - - Tasling Co' sn{!•� Ignaturri Serial No.of Thermal 40mielans Address Sensor 14. «P 5 , AS) Name of supplier.Owner or Dealo - - Address No.and Street(s)' - - City State Date 15. TANK TO TEST 16. CAPACITY From Station Chart rj By most accurate �0) Tank Manufacturer's Chart ._ Nominal Capacity capacity chart.� available,-�—�—ldantity by posirion Gallons. Gallons El Company Engineering Data Is there doubt as to True Capacity 7 t��i QL 0 t)ot.ti . ti Charts supplied with TSTT grind and Grade.` See Section"DETERMINING TANK CAPACITY Other ' 17. FILL.-UP FOR TEST Stick Readings Total Gallons Oto 1h ita Gallons ea.Reading . Stick Water Bottom j0 0 e+ before Pill-up O 0. 6c Inventory r to Ne in. Gallons � O PeFro— -a IID O FIII up.STICK BEFORE AND AFTER EACH COMPARTMENT DROP OR EACH METERED DELIVERY QUANTITY . Cn Z Tank Diameter v�NX f., tl Product In full:tank(up to II0.pipe)• 5.62- 94 18. SPECIAL CONDITIONS AND 'PROCEDURES TO TEST THIS TANK, VAPOR.RECOVERY.SYSTEM' c a See manual sections applicable.Check below and record procedure in log(26). o ` Stage I Water in-tank N p❑ High water table in:tank excavation � Line(s)being tested with LVLLT. ,. .. _, - 1�Q0 Stage IF m 21. TEMPERATURENOLUME FACTOR (a)TO TEST THIS TANK J.0 19. TANK MEASUREMENTS FOR �1!, a Is Today Warmer?O Colder?O—"F Product in Tank_°F Fill-up Product on Truck F Expected Change( +or ); TSTT ASSEMBLY *.,Bottom of tank to Grade' 12 r3 So m m �, Thermal-Sensor reading after circulation ? 3 "F 22. 01 1 x d Add 30"for 4"L :.. digits Nearest ro m S t Add 24•'for 3"L or air seal ....... 23. Z � � Digits per°F in range of expected change (3 l �� - II digits - n f, i Total tubing to.assemble Approximate ........ tr 24. ���� X . 000 6 F� 3 a 4163Z gallon co 20. EXTENSION HOSE SETTING g o 2 q total quantity in coefficient of expansion for.:-= volume change in this tank cz Tank top to grade-............. ... ..... /t+' •, full tank(16 or 17) involved product per°F Extend hose on suction tube 6 or more N 2 below tank top ...... " -25. J•�/ '0 3 2. 2 9 2 ,._. .:0116 9 9 7 2.. . �D/l + This Is 1,kc:; volume change per°F(24) Digits per°F in test Volume change per digit. test •if Fill pipe extends above grade,use top of fill. Range(23) Compute to 4 decimal places. factor(a) . 26. 30. HYDROSTATIC 31. VOLUME MEASUREMENTS(yl 34' TEMPERATURE COMPENSATION 38•NET VOLUME 39. ACCUMULATED LOG OF TEST PROCEDURES PRESSURE RECORD TO.001 GAL '+ USE fACTOR(a) CHANGES, CHANGE CONTROL EACH READING 27. 28. 29. Standpipe level 32. - 35. :. 36. 37. - Temperalu's At High Level record _ Product in Product - I tots)End Bellec6oa in inches Change Computation Ad ustment SATE Record details of Setting Up' Reading Graduate Replaced(-J Thermal Higher+ .(c) -,(a)_ Volume Minus and running test. (Use full NO: Be innin level to Sensor ten th of line it needed. 0 g lower— Espansion+. Eapansion(.+)of At low le.al compute LIME _g - ) of which. Before After Product Reading (Cl__ Contractions- Corilradion(—) Change per Hour t7�N� - - Reading Restored Reading Reading flecovered(+) p33(y)—p37(T) :IrirPAcriterta) - ,. G z _ f ( -O � ,jfRJ 4130 r�r. NK, 4- / e z.Lf'� - - 15t L4T54 7r .J r, G L t x: y �J >•.!`�.(G(.z rutA sij L:pr - -- — �5 A S 5 M:r 1.L i' z'('2 C� 'F 1 `�t. "f 7 1' f Q�,� /_Ir_ _ f f►�f G._tr.,.�/�L f"t'I'i G,�. C e i11.1 C 'l'" � 'A S _ PLU4 ��.1-1oTw � Ip •?'i �i� <...t� r� j S — Z�- 1010 Poelp pl 1M D 1 e, 10'��0 �'f'r!�t�1�61. S�tl��2 I�iQDt1j Lf2 �7f ( 611 7�� :- 42._ ,9q5 . J20 $Z6' 7/ f4t - �--IS tr .? 32 g fiIZ . 98� 2 S o 735 13z { I� + � 29 796,1 �IZS Co►Ji)r1� Al" Al- � JS 31.7 a12 .�95 Z '1S ` 720 6 �S � 13 + ►S2_ .67Z 697 ��`�° GaJ!'rN J X r 9 i- �:-_4L-- 33.8 'Y 2- . 540 �� 7 I. 0 1 `� t 9 + 2 2 2 9 3 2 : l2t cz�,Jj a-' �o,til c..;J�c�.. `1. 2- 12... ' 805, . HSS 3Sa '�,33.. t13 + iS2. .`SOZ - So2 I�ZS C�,�Tt►1v .,�r �...0�1 t_�J �-» 8 �. I tZ y5S 10 �..350` �`� t0 . • 1 1,E � y�7 ; .9 4-9: ` IZ�10 Co�Jr1.JU_ A ! ovJ 1.=Jy �D : l�S ' ;'::3�5 7'lvd I " 52 1:4-9 .3 r 4.- 9 7 3 t 2 y t 7 }"'9 9 . to 7.3 �2- .9T5 G c) ..31,15 1 +II 129 " �fyy rj 9:37 IZ:�., '�sT. Gor;1C�J�cr7 CFfF lr., "f. 3`�0 4 5�� `/,937 �.PAt, 7 1.53 , f,n s,rtfl . b 3 — , --- ---— -- 14. G.PC_0 —GHQ t1 )4( '/�4`P t� sT 11^�.J.sri�.�L. �1hs5" Zit �l - - 'Name of.Sopptiel„QwoBr.of Dealer '.Address No.and Sueet(s) City State .Date of Test .df .. , 15. TANK TO TEST 16 from CAPACITY Station chart . C O�V By most accurate S O/a.f —'d S f Nominal Capacity J capacity chart available r Tank Manufacturer's Chart .. _i Identity b'y position Gallons.. ' Gallons Company Engineering Oats Is there.doubt as to True Capacity T/J�1 harts ti1L-AD t� � Ch is supplied with TSTT Oland and Grade See Section"DETERMINING TANK CAPACITY" ' Other 17. FILL UP FOR TEST Stick Readings Total Gallons 0 Stick Waler Bottom. ^h v.U, ea. n . -4 �' ::' to Gallons 'Reading, 0 I •� : before Fill- V Inventory t - �i 0l I r to L,in. Gallons 0 Fill up.STICK BEFORE, AND AFTER EACH COMPARTMENT DROP OR EACH METERED DELIVERY OUANTITY ZTank Diameter Y tt Product in full tank(up to fill pipe). `' • e 2 18.' SPECIAL CONDITIONS AND PROCEDURES TO TEST. THIS TANK . VAPOR RECOVERY SYSTEM -4 F10 a a See manual sections applicable.Check below and record procedure in log(26). J a Stage I r'a q tJ L9 Water in tank P.e High watec.tabie in tank'excavation Line(s),being tested with.LVLLT . N Q Stage II m t;> 21. TEMPERATURE/VOLUME FACTOR (a)TO TEST THIS TANK ' - ' 19. TANK MEASUREMENTS FOR r„ a •. • .� IS Today Warmer?0 :Colder?❑_ F Product in Tank F fill-up Product on Truck_°F Expected Change( 4 or - ) o r j: TSTT ASSEMBLY m a"••:a oNorn.of tank to Graded . .... 123 3►9 37' '< - ' e circulation d ns Nearest 22. Thermal Sensor reading after irculati °F Add 30'for 4"L 0 m ► i Add 24°for 3"L or air seat 2 N 73. Digits per°F in range of expected change 1 zr �_ tJ Total tubing to assemble A.PProzimate drgds 24. 0,2`{ X , 000(e$ 3.y/Co.3Z gallons rn p g full'tank 16 or 17) involved roduct per•F change m this tank; 20. EXTENSION HOSE SETTING Tank to to grade*:. total quantify in coetficienl of expansion for Volume ch Extend hose on'suction tube 6 or more py below tank top .......... ... 25. �. /(o .Z 3 �a. _ " . Ot�3r' -E- This is elect, volume chap er°F(24) Digits per'.F n test Volume change per digit lest atf Fill pipe extends above grade,use top of fill. Range(23) Compute to 4 decimal places. factor(a) 26. LOG OF TEST PROCEDURES 30. HYDROSTATIC 31. 34. 38.NET VOLUME 39. VOLUME MEASUREMENTS M TEMPERATURE LOyPENSAt(ON ACCUMULATED CEDURES PRESSURE. CHANGES RECORD 10.001 CAL USE FACTOR(a). CHANGE CONTROL EACH READING 27 26. 29. Standpipe carer 31. 35. 36. 37. Temperature At High Level record Product in Product Chan Cam Ad' Total End Deflection nin Inehef e Change Camp Adjustment DATE Record details of setting.up Reading Graduate Replaced(-) Thermal Higher+ (c):x Is)__ Volume Mnus and running test. (Use fUII No: Beginning level to - - - Sensor lower- Expansion+ Expansion(4)or At for Level compute - nul length of line if needed.) of which Before Alter . duct r Reading (c) Coniraction- ConIlraclion(-) 'Change per Nowt �s• ' Reading P.. Fed + (NFPA criteria) 11Ahr.) Reading Restored Reading 33 ♦37T v r J��S J� Q'r SiT� St'rG(c, TJ1�at S �Z. t�f 'fJsi ra� NZo_�A�IK. '!I'_ 'rt-I'k-S- ` Qom 1) - -- _ �:_r,►r ►.J fr S i��+��J Lary, ,� -ro ?,� f ,�_c cA P r.. o ` ._� -- e i�t►=I.L Tf L I /S o LL t o ro TN I _. __.. 16,�o -r'�GtJsf '-d'. � ac t' � 0M /-?. R U�J� F2�0 �d;3 -re �i�F z P� Ca/�lOc cT A SrN �L� P.L c� Ti 'f�:S 2 Q�.1 -r�i.l �r �-- G I-� zGl ALL !1T'/Qcs 1700 ' ,PtJhiP 2v,��J&Jc. - 6. c't� f4 Lt,� : vg �� 3 ; � � ::_ � u— DA BIZ.- {z.. ��o�D�2. f�a'cSc LEA,kS fZ Mov'c/, u L)tv ��MN' so A0Af'^f"�� ►�JI� usz GL� L�2 �fL (�z fZA F4=ic. T{� r.1 f3t.c! P 2. TYPz. 172o !°SS�MRj�. P T2-�-T� tL. T� tz G r_�K LL C.O MScr[ os �.t- 5 Y TAM C oi.JN c Gr 10 45 J73 PoMF P �r�z�: �' uN����, 3 z o ,� �. s g s4. Szr.JSoil �:r"1�rJin14 / �12. 319 R io StA r µi- c_u.� -r"Cs-rt�4 3�.7 Z 9So : 7io • Zya 321 . +2 + 023 - 2b3 37.? -12- . 110 SiS ; � 95 3Z:� 5 t.o57 "25 . r8�10 y 38.3 y2 , r, S . 355 too 330 � � +. oOS :zoS C? 185� 5 3�•7 y2 3 55 2 00 5 333 �, r43 a 9 19►o �, 39•$ 12 , �yo . yyQ- i o0 336 3 ©3y I .,y 39:�( �2 yyo 3zo' 20 l,� g 39 c� : •yz 71 �05 i 0 2 " oz3 • 1955 9 yo 2 ' yz �oS . .�Zo p� 20+0 1D. lb.� yz 520 L1(�0 : obi 3 �t8 +2 � oz3 . 483 1025 1'I- y.1.0 :�lZ ;H� o y20 oNo 3S.b 'Z t025 ;063 2o-to rZ �1.: 2 • �120 : 390 " 030 352 Zo55 , 3 ��.6 y : . UyS y2o :025 3S3 ti •� 011 03 Z1►o 1`I yz .1 y2 yZ:a . y3o +o10 3 3 - o 000 ono ono 2r2S .. �� /,g �lZ. ° • yZ 4l0 :0115 3SS �2 023 < o3g ` ozg y2.o q2 <10 ylo , 000 35'5 C) 000 = oco028 ZiS : �l�•8 `yz LJ10 yoo :'o I O 355 O =o_ o o • o i o o3a : 2157 wnP s of � r• TZsT co..j Vo a : o, 023 038 rJoT - T'Si Cnhj71nJiltO !�'t':.131 L�.� W�ltt_c �I 0 , V A S � c J P v''1 P- G J tJ pt b,1 :,tJ f Tb . � 92 0.P -t'o �.d•� t r.��� J►�:►T'►�. �- � •t- - �p �- n.JG, 4 P:; I- J A 2n Sc At 1 / _ _ I -Name Sunpiier.Owner or'Dealer - Address No.andSneet(s) City slate Date of Test 15. TANK TO TEST 16. CAPACITY From 13'Slation Chart j t 00 ` Ely most accurate D/ ' , T Tank Manufacturer's Chart Nnmina)Capacity --•.r capacity chart available ❑ Identity bw position Gallons Gallons Conrparry.Engirieering Dat a r=G U L4 fZ, Is there doubt as to True CapacitYT rJ� Charts supplied with TSTT grand and Grade See Section"DETERMINING TANK.CAPACITY" . Other ,_4 17. -FILL-UP FOR TEST Stick Readings Total Gallons to Gallons ea.Reading' 0 O f3 Stick Water Bottom: ems+ before Fill--pp O Or Inventory " Si 0/4 r to%in.. Gallons I O �Tr'fe • o 0 Fill up.STICK BEFORE.AND AFTER EACH COMPARTMENT DROP OR EACH METERED DELIVERY OUANTITY © Tank Diameter ^�w �( J JI product in full tank(up to fill pipe) Z 18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK VAPOR RECOVERY SYSTEM n -4 See manual sections applicable.Check below and record procedure in Ioa,126)• ro Stage I CID a ?' o c =r N Water in tank. (.) oo High water table in tank excavation . Line(s)beirg tested with CVLLT N o Stage It 21: TEMPERATURENOLUME FACTOR (a)TO TEST THIS TANK x 19....TANK MEASUREMENTS FOR )s Today watmer?p: Colder? _°F Product in Tank F Fill-up Product on Truck_°F Expected Change( +or — ) TSTT .ASSEMBLY O Bottom of tank to Grade" " thermal-SensorO'l8 p 1 3.ClY o to i "" "' / 22. reading after circulation °F xC - 2 + drgna Nearest sf m ,�.,��ti Add 30"for 4' ). .. L LO t Add 24"for 3"L or air seal ... 23. 'Digits per Fin iange_of expected change Z 9Z 3 ►. f p " — ..Total tubing to assemble Approximate �3 �_ 5 Al . o00 8 3.y/� 37- S. 24. / X G - gallons c 20. EXTENSION HOSE SETTING 38 total quantity in coefficient of expansion for volume change in this tank . Tank top to grade*:................ .. ..... ... full tank(16 or 17) involved product per IF - -� Extend hose on suction tube 6 or more below tank fop .... 25. . �. 4- 2 � v O// 6 9 9 This is d volume change per IF(24) Digits per*Fin test Volume change per digit. test 'If Fill pipe extends above grade,use top of fill. Range(23) Compute to 4 decimal places. factor(a) 26. 30. HYOROSTATIC 131. M A M 34. i R M SA11011 38.NET VOLUME 39.ACCUMULATED LOG OF TEST PROCEDURES PRESSURE VOLUMEE SURE.ENIS.IY1 EMPER LURE CO PEN CHANGES CONTROL AECDAD TO.001 GA{; USE FACTOR(a) EACH READING CHANGE 27: 28. J• Standpipe Level ; 32, 35. 36. 37. Temperature At High te.ei record in Inches Prodticl in Product Change computation Adjustment Total End Deflection DUE - Record details.of selling up ;Reading - Graduate tfeplaced(-) Thermal Higher+ (d'• (a)= Volume Minus .. and funning test. (Use dlsl) No. Beginning Level to Sensor Lower- Expansion+ Expansion(+)or At Lew Leret compute TIME length of line if needed.) of which Before Alter Product'. Reading (e) Contraction- Contraction(-) Change per Hour ReadingRestored Reading Reading Recovered + dtf Q 124 tint, D D ( ) F33(V)- r32(T) INiPA cr' a) l4k - 0ISA5S,--%5.: L ITN POLO 7f? V �nit L-�N� PCUC' tCLUG Ma a. i t s a a ., .. 4.. SS=M B L� P tea 'Ti r�. �' �,� of 'r11rJ # .. _ N:�C AL F,�L 320 PUMP P21 M ,2 V fJtJi n1 G, !3 p 7-H;.i;i-jQl. e.,5!o.roR l 42— tv\ I`{oo STae�f Ni - �.�Jz-� ��sa' 3� 9 `/7 99 .5 ?O y2 j 808 �`� �, p$3L.7 .960 275 �eS a08 o ¢ oao Gasyz .925 . 65D . 2 '�'S 813 5 .05 9 337.2 ti� .�14 . �13� ..210 8I3rZ�P3�a . 290 1515 1 4.0.2 yZ . 285 . 25 "0� 0 8iy + � }. oy� ' r r `] CSC8 /l.o yZ. Z "1532 OQoPP=o Tp LO VJ LG�. of 2_1Uoo ► 011:5 i2 89S ��S o30 788o 1z 5Soyo792 t`1 + o'47 - 09�3aA4o: I'M +2— } D�3 '01 /o.? 1Z- 7�S o . 085 78`f /� . �/7 : 03`Z3 8 r1Q _,O11700 I� 1.6.8 12 /0g0 . 6zp :0eo, �80 �y y`7 3 4 G, u , V 4... fl• y „ PO,07A,d e 14. .. R� rG..r ;,?u, /'AID �Ut✓� /_'fcC0 to- CAPS N'V�y.t_ h�i etJrT�gL Nam of supplier,Owner or Dealer Addl ass No.and Street(s). - City State Date or Test. y 3 15. TANK TO TEST 16. CAPACITY From h _. y ,` B pmo t accurate S 7Lf. 1 Station Chan ` most curate 'a4�� Nominal capacity, , � capacity chart available ❑ Tank Manufacturer's Chen `. _Idenuly by position Gallons Gallons ❑ Company Engineering Data LO G LG Is there doubt as to True Capacity T 0�� 2 ❑ Charts supplied with TSTT arand and Giotto see section"DETERMINING TANK CAPACITY" - .. ❑ Other." 17. FILL-UP FOR TEST Stick Leading$ Total Gallons 0 to%{n. Gallons ea.Reading Stick Water Bottom off a before Fill-up ` Inventory 8 SOS 1 to to in. Gallons v o P'C j% ,o O Fill up.STICK BEFORE AND AFTER EACH COMPARTMENT DROP OR EACH METERED DELIVERY QUANTITY Tank Diameter Product In full tank(up to fill pipe) 18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK - :VAPOR RECOVERY SYSTEM ra.on nu manual sections applicable:Check below and record procedure in log(26). NJE Stage 0 m, �Q Water in tank yJ Q High water table in tank excavation ❑ Line(s)being tested with LVLLT /J® Stage 11 A - m - - b 21. TEMPERA.TURENOLUME FACTOR (a).TO TEST THIS TANK o x P i 19. TANK MEASUREMENTS FOR ,, a ,� Is.Today Warmer?❑ Colder?o_°F Product in Tank_°F Fill-up Product on Truck_°F _Expected Change( +or — ) o:M . TSTT ASSEMBLY 3 f! - ! S * Bottom of tank to Grades ....... " Bt7 (p 0 m I -'� Y •••• 22. Thermal-Sensor reading after-circulation °F oy 3 .•;� Add 30 for 4"L .. _" digt3 - Nearest L-r r w m W s,. Add 24 for 3"L or air seal " 23. Digits per.°F in range of expected change digits _ ��s n Total tubing to assemble .Approximate ........ �3 A �. .Sow y'„ x ,'o o a 2.. anent; co 20, EXTENSION HOSE SETTING p g .0 3CJ total quantity in coefficient of expansion for` volume change in this tank 01 Tank top to grade*. ..... ............ y t� full tank(16 or 17j: involved product per°F Extend hose on suction tube 6 or more ,(,�`b - t below tank top I _ 25. 3..Leto 32.. } 2 9L C) I 1 (0.) 5 2. / volume change per°F(24) Digits per°F in test Volume change per digit test )s �► {)L 'If Fill pipe extends above.glade,use top of fill. Range(23) Compute IDA decimal places. factor(a) , 26. 30. HYDROSTATIC 31.. VOtUN.E MEASUREMENTS(V) . 34 TEMPERATURE COMPENSATION 38•NET yOIUME 39.ACCUMULATED LOG OF TEST.PROCEDURES' PRESSURE RECORD 10.001 CAI." USE FAC10R(a) CHANGES CHANGE CONTROL EACH READING 27. 28. 29. Standpipe level 32. 35. . 36. 37. Temperature At Ni level record Oat Record details of Sellingu Product in Product Nigh in Inches - _ Change' Computation Adjustment iaUl.End Deflection l AtNo. Graduate Replaced(-). Thermal Higher+ 1c1 " la) Volun-e Minus and funning test. (Use.full No. Beginning Level to Sensor lee th of line if needed. tower- Expansionontrao+ Expansion(+)or Al ha Level compute TIME.. g ) of which Before After Product Re (c) Contraction- ConUacion(-) Change pet Xow 171 kt.l Reading Restored Rradinp Reading Rrcovered(+) r33(V)- t37(T) c:.IMFPA erAeiia) s-r1cK., -Gr1k:S i�tt" y�l'�S=SJ I^srJ 02 � 1�oK V .,.h' S,ptl�J�� C )..) T �JKr II -- lC It r : TP -.*• . J F- �. PQ D� cam' ' T/.� .f 1510 T Rk�15F�t2, Cc, ALA r `Q f AJf ^M C14 A�� -rrinJuS iOnJ yac-< F -rt-,.J� 6L ALL Pt,�9�,s- P0r.4 ALL_ A, 1 Zd 'fop1+° Pee111Foe P,u1JN,,Jy O %7-0MMAL. 611.7_S� Jsc2 AA1►•}G► 1 — yZ :�5 8'Q �12.. . d Vic. 337 /yYS 42 I S 33 ;-/ 60 . NO -O2oaPsp --0 Lovi L4,)�L_ IZ. LOri L'c0zL- 2c1��� .1G ]Ioors Sao } : o?o ' o5s 15i5 ri I1: 8 . 3.5U 010 ( g - tA g 1S3o 8 /24 12 �{C► 'o © 879 ' 3 3 1n 1� 08� ,Sys o2 8 8 * 105 13.0 332 'o2S 89S ' + 082- ' 40 7 3 Ca cLvDa0 N,C.� 0.30 . 3q` ; 3,9 �yo� 3 a H _ . PROTA I.0 : PROFESSIONAL TANK INVESTIGATION CORP. P.O. BOX 17591 a MILWAUKEE, WISC'ONSIN 53217 • PHONE WIS.CONSIN (414)332-9422 332-0494 January 15, 1981 Mr. A.J. Sidla Engineer Atlantic Richfield Company Box A Providence, R.I. 02901 Re: Tank System Test, January. 6, 1981 Route 132 Hyannis, MA. Dear Mr. Sidla: The tank systems testes? at ,n,- ,+ x,n a r,, ._...__.......... �:�U1icws Tank System # 1 North, 6,000 gallon Arco Unleaded gasoline. Tank System .# 2 Middle 5,000 gallon Arco Regular gasoline. Tank System # 3 South 5, 000 gallon Arco Regular gasoline.. (Tank . Systems . # 2 & 3 are manifolded) a The National Fire Protection Association's criteria„ fora tight tank - system is a system with a rate of •leak less than 050 .gal/hr. These are calculated, mathematical tolerances only: and are not meant to indicate the permission of any leak. Tank System # 1 showed a mate of, leak. of -. 005 gal/hr. Tank System # I is tight. Manifolded Tank Systems # 2 & 3 showed. a rate of leak of _¢. 043 gal/hr. Manifolded Tank Systems # 2. & 3 are tight. - MEMBER g€UM EQUIPMENT INS1�1 pRQTANIC PRO.F;ESS`ION_AL TANK: ,iNVES:T`IGATION CO-RP.` r_ P:O BOX 17591' MILWAUKEE,WISCONSIN 53217 PHONE WISCONSIN _ j414►:332-9422 January' 15, 1981 Mr.I A.J. Sidla - - - - .page 2 All 'product lines were tested_ and found to be tight.Y Prior to testing, the tank bottoms were checked for water through_ the fill pipes, no measurable amount was recorded. S' cerely, x _ William J. pora WJP/lmw MEMBER gfUM EQUIPMENT e s / - lJ'21103464) t�ata l.t�art for Tangy `System Tightness hest USING.KENT-MOORE.CORPORATION TANK TIGHTNESS.TESTER'MODEL.t000 For Packet l Copyright0 Kent-Moore Coiporetion;1977 r Of 50 Charts PLEASE PRINT Order J 23396-A Y` I. OWNER-Property 0: 6✓F.,S /q O •/.��' ::e /I!/. P Name Address -Representative. Telephone i Tank(e)-. Name 'Address - Representative - - Telephone ( 2. OPERATOR .bt�,v/Sr' .t - - - Name pW. Address - . . . S Telephone - 3. REASON FOR �..._ l TEST (Explain Fully) 4. WHO REQUESTED • .S L� .. ._. rLG'O TEST AND WHEN Na a Title Company ofAl116etio0 Date . P,¢o mil ' R. a 2 r _ _ '.A dress . . Telephone 5.. WHO IS PAYING FOR THIS TEST? Company,Agency or Individual Person Authorizing Title Telephone. eilling Address -.City Sub Zip tit Attention or: Order No. Other Instructions Identity by Direction Capacity'.. Brand/Suuppiier Grade A prox.Ago Steel/Fiberglass p 9 6: TANK(S)dNVOLVED _ f-ll�oar �Gf ' A,l�a ,o.� . .t•lFA�Fl9 "?�o /1S. STEEL T- T- c'o --.-7" A9-5_- A174 pi cationW't3L Cover Fills Vents Siphones Pumps: 7. INSTALLATION +w ;c !< •�C— Sl/'- yE5 �Pro�' DATA 2. D P46Por "TtaBES ;F LEAK IDt''7�"T>7 . orth inside driveway. Concrete Black Too.. Size,Tifelflt meke,:Arop 5u !.,n -..6moto:.. . Aesr of starter••,etc. l - s.,th.01c. tubas,Fawnote Piiis Sue,rotando.dod•, Which tanks i''- ' .Make It known S. UNDERGROUND Is the water over the tank? WATER Depth to the Water,table 0-Yea E31,10 Tanks to be filled' hr. Date Arranged by ' 9. FILL-UP Name.:. Telephone. ARRANGEMENTS Extra product to"top off"aria run TSTT.. How and who to provide l'. Consider N0 Lead:: Terminal or other contact,1' r for notice or inquiry- .. Company - ;Name Telephone .. ;. 10. CONTRACTOR, � .SI= , MECHANICS, any other contractor - - involved 11. OTHER ' GE 7A "6. To T/o♦ W !./yiac/ f_mjP vV was INFORMATION F�d OR,REMARKS ditional information on any items.above:Officials or others to be advised'when testing is in progress or completed.Visitors or:observers.present during:test etc. Tests were made on the above tank systems In accordance with test procedures prescribed for Kent-Moore Tank Systems Tightness -12. TEST-RESULTS Tester Model 1000 as detailed on attached test charts with results as follows. Yank Identification Tight' Leakage Indicated Date Tested' d — a2T '. This is to certify that these tank systems were'tested on t te(s)shown.Those 1 Icat P_as 'Meet the criteria established by 13. CERTIFICATION the National Fire Protection Asoclation Pamphlet 329. r ^Oae � rk N"Tng o Ira t P.dr Co "th Y. Y• Slgn j S: P.pN�RLL Seiial No,of Thermal ... Technicians Adders Sensor r 9 - r VIES �,Qc'O OQT 3 / .�� t a br SuDDliet.Ow or Dealer Address No.and Sdeet(s) Clry State Dep o1 Tast 15. TANK TO.TEST 16. CAPACITY From Fill Station Chart �1 // By most accurate / y t �^ ✓�n2 Tff" Nominal Capacity-, capacity chart available 6O:/ : Tank Manufacturer's Chart _ Idenritr Dy position' - - - .Gallons : � ngrneenng Data n° r Company U t Gallons L t E �//� n Is there doubt as to True Capacity? de> u co 1►� • (. " na E Charts supplied with TSTT' Brand and Grade See Section"DETERMINING TANK.CAPACITY" - 0 Other O 17. 'FILL UP FOR TEST Stick Readings Total Gallons L to%In. Gallons ea.Reading O Stick Water Bottom 4' , r' before Fill-up .. �O�lE' btventdry to K in. Gallons . �To v (' 1 ' O Fill up.STICK'BEFORE AND AFTER EACH COMPARTMENT DROP^OR EACH METERED DELIVERY OLIANTITY A oI"I� r O Tank Diameter r� Product in full tank(up to fill pipe) 18. SPECIAL:CONDITIONS AND PROCEDURES TO,TE4T THIS WANK , i i VAPOR.RECOVERY SYSTEM i mW i '_.. See manual sections applicable.Cheek elow and record procedure in log(26) age( ' o r d , �ty Water In tank. High water table In tank excavation :.', Llne(s)being.,asted with LVLLT 'Stags w m s t, . :;D. 21. TEMPERATJRE%VOLUME FACTOR (a)TO TEST.THIS TANK br.z 19.."TANK MEASUREMENTS FOR ' $4 Ln e. -. Is Today Warmer?0 Colder?0_°F Product in Tank F fill-up Product on Truck F' Expected Change( +or-Jeyr TSTT ASSEMBLY .�, o" b i Bottom of tank to Glade• 12. Thermal-Sensor reading.after circulation �. ' F m i Add 30"for 4"L ,• digits Nearest N m Add 24"for 3"L or air seal " 23, . w •:' Digits per ,=in range of expected change digits .. n Total tubing to assemble Approximate, ....... - 4. �� x Oa 0fz�' 0 10. EXTENSION HOSE SETTING ,;- ;in gallons Tank cop to glide". n' • expansion for - volume change.in this tank Ill I per*°F total;qu coefficient of Extend hose on suction tube 6"or more �. o t 3.3 full tank(�/ or 17) involved product p F below tank top ...:_ .._......._... �?.::,_ _3,'jf `�1 �� This is 25. 2 or of33 5��� volume cha,tge per°F(24) Digits per°F In lest Volume change per digit. test If Fill pipe extends above grade,use top of fill Range(23) Compute t0 4 decline)places. factor(a) �. 16 30. HYDROSTATIC 31: 34. 38:NET YOLUME 39•ACCUMULATED VOLUME MEASUREMENTS M TEMPERATURE COMPENSATION LOG OF TEST PROCEDURES PRESSURE' . CHANGES CONTROL RECORD 10.001 GAL USE fACTOR(a) EACH READING CHANGE- 17:. 18. Standpipe Level 35. 36. 37. Temperature At High level record 19. 31 Precut m Product DATE Record details of settingu in Inches - Change Computation Adjustment Total[Ad Deflection P Reading Graduate Replaced(-) TAermal Higher+ c x a m and running test.Oise full ao. p O O lblume:Minus _ , Beginning Level to Sensor tower- Expansion+ Expansion J+ er At Low Level compute length of line.if needed.) of which Before After Product Readin Contraction- thane er Hour TIME R (cl Contraction(—) t D (24 tirl. ' ` Reading Restored Reading Reading Recovered(+)� 33(V)—N37(T) (NFPA criteria) ,- O �- - - '.7•v .ems' opff--V,�z S s e �z?b � �o Lv iv A GCS /.o �,ZZ E G : 20P 9 4,Qa` :. o .SiA ♦ ♦- LEYL-G %St` T , 'lily =' 6 �s. ,a133 • %os0 EST STa�PEd -. iinR cT J� Ye' �s- �R�� o � iGE- /N� c7 /b HTE .. !!�/ � :. lJlLL �E Er0 N o.V a Q 'qs �i9 o ro .�N NE ell �r� CltE 8�a' it u 3 D ? �7 4Z.: i7S`; 7`{ 3 S 3. t m 3 , 32q 2 Z i33 - 0�3 77 yo Ap g s • .33 r. 14 - � CYa /71�0 6 /rZ f�dr�it/.�//.T �.S.S° O/ : - Name of Supplier.Owner or Dealer - • Address No.and Su et(a) City ' state Data of Toot 15. TANK TO TEST 16. CAPACITY From Cation Chan IF I �' G hoo By most accurate .�� Nominal Capacity- capacity chart available w ❑ Tank Manufacturer's Chart Identity by position : Gallons Gallons O r Company Engineering Date Is there doubt as to True Capacity T J Ej. Charts supplied with TSTT stand and Grade. See Section"DETERMINING TANK CAPACITY_ ." - Q Other 17. FILL-UP FOR TEST Stick Readings. IG 0CDo to%in. Gallons otaReading s Stick Water Bottom ® . before Fill-up �6/✓E Inventory 6 r d to'ti in. Gallons Q .. w O Fill up:STICK BEFORE AND AFTER EACH COMPARTMENT. DROP OR EACH METERED DELIVERY QUANTITY n /op C*4 o Tank Diameter , ` p '�. roduct in full tank(up to fill pipe) ^' f+ Gc Y19��iQy Q� aS `�� 18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK VAPOR RECOVERY•SYSTEM ;. o a See manual sections applicable.Check below and record procedure in log(2B). S' c r s O Stags Water In tank LJ High water table In tank excavation � ln s being f 9 Line(s) g tested with LVLLT Stage II ^ M. D - s, l 21. TEMPERATJRE)VOLUME FACTOR'(a)TO TEST THIS TANK . .'� • 19. TANK MEASUREMENTS _ . � . . SUREMENTS FOR ° C, . Is Today Warmer?d Colder?❑ F Product In Tank_°F fill-Up Product on Truck F Expected Change(+or=.) o D TSTT ASSEMBLY cn Bottom of tank to Grade* m m 22. Thermal-Sensor reading after circulation c �J °p m Add30"for4' / D.�702� t7 ( ae .x r- - 'L ....... _ "� digits Nearest �•��` . Add 24"for. L or air seal rNa m �� � - 23. Digits per`; in range of expected change n Total tubing to assemble Approximate ......,r " F digits = r- 00—A 20. EXTENSION HOSE SETTING q 24• `� "`!L_ _ x D.ADd e tzl..cl cl Tank top to grade*.. ....... 3J expansion ;,.volume change In this tank ��. total quanr;v in �: f coefficient of gallons k full tank(Tr or 17) Involved product pe Extend hose on suction tube 6"or more ion for below tank top ... ..... f�)!. '! 25. �. !J r f r., .29� D. 6//ao C/ + _This is ° volume ct.a,ige per°F(24) Digits per°F in test volume change e If Fill pipe extends above grade;use top of fill.' K 9 p r digit : test e(Z Compute to 4 decimal places. "iaclor(a) 26. 30 . HYDROSTATIC .. 31 I Range 11A : 38.NET VOLUME 39. R TOG OF TEST PROCEDURES 'PRESSURE Yf LME MEASUREMENU m `" TEMPERATURE CDYPENSATION -,.a ' CONTROL RECORD 0.001 GAL USE FACTOR(11 U E ACCUMULATED CHANGES EACH READING CHANGE _ 27. 28. 29,. Standpipe Level ' 32. Prodoct in Product 35. 36. 37. Temperature At Nish Level record DATE Record details of settin u in Inches I Total End Deflection. 9 P Reading Gra�uata Replaced(-) � Change Computation Ad'usamant and running test. • M ^ lei Vol me Minus length of line if needed.)Use full N0• Beginning Level to Sensor ,Lower.her+ Expansion+ Expansion(+)or At Low Level compato - TIME r•. of which onto» I Alter Product Reading (c) Contraction— g n ChanQe per how (y)—N31 124 hr.) Reading Restored Reading Reading Recovered(+) ♦33 (m (N criteria) o traction FPA 111, !v' p?, . 40-h'1 iU SM�S e` 1JSTO!R1_6 Z/A)G / A P _"Ale 8* ?%�10aLo ✓ l. t�'� �c a4 4o:s S% ��D I/oG5" � -Paob Nam, c � 3 '.� Z ai; IS Cto'7 330 �� ', yo.7 y z SG e 3 yo 2 3 0 -f S f,to 3 yam:o2-- 5'0 . aq # y/.fl ,335' , 270 7'0b33 t3 t,o33 ?all - �,/ S y�. 33. ;V w a /y/� •� ��' 2 �/ y3.,o = 4z , 3�5' 30 lz W 663 L4 Lw ',a3ca 4 � ; Z �. z S ..5' -f-3 f 3 03 3.z 26 rR , w if•�o • r 0'3: • Srr OPM D6 T r k rote a , \ a1�IN iffy.. All i .. 1 7. 14. Awls- - vm< A2 C 0 Narne of Supplier.Owner as Dealer Address No.and Siteet(a) city State Doti of Test f 15. TANK TO TEST From 16. CAPACITY 94--gr-tion Chart By most accurate r Nominal Capacity capacity chart availab I. Tank Manufacturer's Chart Jr. Identity by position Gallons Gallons Company Engineering Data E] Charts Is there doubt as to True Capacity?, �&(54rzg B -_ :, , � : Supplied with Tsrr Brand and Grade "DETERMINING TANK See Section CA.PACITi� Other 0 17. FILL- FOR TEST Stick Readings' p Total Gallons t %In. Gallons ea.Reading M UP Stick Water Bottom before Fill-u nventorV 0 to Y.in. Gallons 0 0 Fill up.STICK BEFORE AND AFTER EACH COMPARTMENT,DROP OR EACH.METERED'DELIVERY CLIANTITY P0 Tank.Diameter Product In full tank(up to fill pi Z A 18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK VAPOR RECOVERY SYSTEM CD to .1 co 4 See manual sections applicable..Check below and record procedure in log(26). Stag e =7 L T I 0 Water In tank High water table In tank excavation Line(s)being tested with LVLLT En Pta 4 go 11 m > 0 21. TEMPERATURENOLUME FACTOR (a)TO TEST THIS TANK 19. TANK MEASUREMENTS FOR me 13 __�2 F Fill-up Product on Truck F Expected Change +or- Is Today Warmer? Colder?Q__:v F Product in Tank C) TSTT ASSEMBLY 0 Bottom of tank to Grade* ..... rr SIM 22.' Thermal-Sensor reading after circulation F CD < 18 Add 30"for 4"L ....... digits Nearest Add 24"for 3"L or air seal .... 23. 6,K Digits per'F In range of expected change Total tubing to assemble Approximate ...... • digits -4 3.24. 2 Co -:-. 20.. EXTENSION HOSE SETTING .._�! - . -.iw, I. 7� total qua:city inthis go ons !.i%i coefficient of expansion for volume change n this tank n a Tank top to grade*...... .................. full tank(Su or 17) involved product per*F E a on suction tube 6"or more Extend hose Tint S I 25 below tank top .. ............... 91 go per digit. test volume change . �. I ��.%1. *If Fill pipe extends aboveper*F(24) Digits per'F in lost Volume change grade use top of fill. Range(23) a Comput to 4.decimal places.'- factor(0 26. 38. 3 130. HYDROSTA71C 31 347 9. VO LOG OF TEST PROCEDURES VOLUME MEASUREMEIHS TEMPERATURE COMPENSATION ACCUMULATED CONTROL RECORD TO.001 CAL USE FAFOR(2) MANGE. CHANGE EACH 27. 28. 29. Standpipe Level 32. 35. 36. 37 Temperature .:, ' - Pit, uct in Product Adjustment At High Level record DATE chahilk liompulati in Inches Total End Deflection Record details of setting up leading Replaced on ?- Graduate -Thermal and running test. (Use full Higher+ (c) x (a) Volume Minus No. Bell Level to of Lower Expansion+ ExOansi At Low Level compute inning Sensor a Product -'eading (c) Contraction Contraction I-) Change per Hour 124 brj ailing Restored Reading Reading Recovered(+) 33(V)-#37(T) — length of line it needed.) After Cc on(+)or TIME of which Belot Re -7_`77=— 1 I I i hLL PEli i• `:' 345 WEST'MAIN STIIRET } r'•v / *ram+ C►IU6RTTS 016�? „ �,CO '1V11. N011T110110 MA61A ZF"' " 1 TEL: (6171 303•7637 r •( "j NpurT�v SERVIC[; INSTALLATIONS 1 EQIPMENT SALES % ' $PORT e 't TANK OR: pIPINC AIR TEST R NDrnrmoUNDU '';'�� -1{1,:,�•�;;•'�'�• ; I,OCATION: 1) DATE: / Z/2/�8� �'�U/��fC/P-L� resaure �D/?•v ah III' f eY'anc r Level 5tarC Finish' Start Fi'nY el • „�. C,lnk 0 Proms t �1—r�-`�i1c" 1 Wn to 00 `boo s• s� ¢ s• �• ------ 14 4AL------ 2f3 — . y �• — z 0 Z/f / lad . Jz 'S Q 00• ' si s l ' �? . O /0 ' 1/4 I L 3c� 13D c� S� .� st '� •� '© IL134 _ 40 3"r a . . . . . . . . . . . . Remark. : . . . •• a Ila, v-7 obf �lQ Q..k,�v�2e G l�.�t�.��o- -�-wr,deG- _ -32.� 5 � � C��