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0149 NORTH STREET - Health (2)
,' y 9 ��oa_� )^ 5 ire e�' TOWN OF BAR S i L. L Q satisfactory 2• Printers BOARD . OF HEALTH ; 3. Auio Body Shops nsatisfactory- 4. Manufacturers COMPANY i - (see"Orders") 5. Retail Stores _ 6. Fuel Suppliers ADDRES ` 67Z Class: 7. Miscellaneous j� QUANTII`I'E'S AND.STORAGE (IN=indoors; OUT=outdoors Cave lotis Drums AbnveTanks Underground Tanks MAJOR MATERIALS IN 7UT IN IOUT IN IOUT q & LYLllonse rest Fuels: Gasoline, Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic 6<� Synthetic Organics: !� degreasers i � Misce laneous: NCIV 1 j DISPOSAL RECLAMATION REW,RKS: 1. Sanitary Sewage 2. 'Water Supply /� CA Town SewerPublic `� OOn-site '�• © Private = ' 3. Indoor Floor Drains: YES NO O Holding tank: MDC O Catch basin/Dry well fURULKS: / _ � OOn-site system 4. Outdoor Surface drains:YES INC, O Holding, tank: MDC__ 4 O Catch basin/Dry well OOn-site system S. Waste Transporter Licensed? Name of Hauler_ _Dggti nazi on Waste ProdUct NO 1. .,.. 2. 12 e a "Int.en - nspec or ate �3 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF FIRM: l`7X)W/0,0I Z' ��,PX MAILING ADDRESS: TELEPHONE NUMBER: CONTACT PERSON: `_#I/WT Does your-firm--.store=-any=.f the toxic or hazardous---material-s- -listed -below;- either for sale or for your own use, in quantities totalling, Batt any time, more/�, than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a YES or NO answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address : ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put a check beside each product that you store: Antifreeze (for gasline or coolant systems)w Refrigerants Automatic transmission fluid Pesticides (insecticides, Engine and Radiator flushes herbicides,rodenticides) j Hydraulic fluid (including brake fluid) Photochemicals Motor oils/waste oils Printing Ink Gasoline, Jet fuel Wood preservatives Diesel fuel, Kerosene, #2 heating oil (creosote) Other petroleum products: grease, Swimming Pool chlorine lubricants Lye or caustic soda Degreasers for engines and metal Jewelry cleaners j Degreasers for driveways & garages Leather dyes Battery acid (electrolyte) Fertilizers (if stored ' Rustproofers outdoors) Car wash detergents PCB' s Car waxes and polishes Other chlorinated hydro- Asphalt & roofing tar carbons, (inc.carbon Paints, varnishes, stains, dyes tetrachloride) Paint and lacquer thinners Any other products with Paint & Varnish removers, deglossers "Poison" labels (including Paint brush cleaners chloroform, formaldehyde, Floor & Furniture strippers hydrochloric acid, other _ Metal polishes acids) �- Laundry soil & stain removers Other products not listed (including bleach) which you feel may be Spot removers & cleaning fluidR E C toxic or hazardous (please (dry cleaners) HEALTH DEPT list)': Other cleaning solvents TOWN Of BARNSTABLE Bug and tar removers Household cleansers, oven cleaners Drain cleaners Toilet cleaners Cesspool cleaners MAY 1 5 1981 Disinfectants Road Salt (Halite) 1 TOWN OF BARNSTABLE BOARD OF HEALTH CONTROL OF TOXIC AND HAZARDOUS MATERIALS - INSPECTION SHEET FIRM •3 LA.V64 ADDRESS llicS Ma or types of materials: �d ± 3 J YP ) 6A.t'WV TES Q 50 " yh:.__ .Sour'- QG K" v gMvJ C*rh•n �7e) d�)� 4) a 6MS �J SS)t$ 5) 3 � 6) �etf.J'ier -- Z I. Description of materia�s) use: II. Storage (denote product by number listed above) A. Containers metal glass paper plastic cans,bottles;jars drums,barrels aboveground tanks underground tanks bags,boxes open, loose,uncovered inadequate labelling. B. Storage Facility V/or # Remarks/Recommendations 1. Indoor a) separate, contained room b) stored in general work area ✓ 2 00 SatS i) inadequate ventilation ii) floor drains iii) inadequate fire protection 2. Outdoor a) uncovered, exposed to weather b) pervious surface/catch basins III. Disposal A. Reclamation/Recycling unit B. On-site disposal 1. Town sewer 2. Regular septic system 1� 3. Separate holding tank C. Off-site disposal 1. hauled by own firm 2. hired hauler a) name of hauler b) address or disposal site Person(s) Interviewed Inspector - - — — — — — — — — — — — — Date �-�- - -