Loading...
HomeMy WebLinkAbout1620 FALMOUTH ROAD/RTE 28 - HAZMAT /�3g �c�lmac�i �., CRn�udl� �'--d" f TOWN OF BARNSTABLE BAR -W Ordinance or Regulation WARNING NOTICE Name of Offender/Manager "' % ` i Address of Offender MV/MB Reg. # Village/State/Zip j Business Name m`/pm;. on- 7/7'�' 20 Business Address pile ���\-4 Signaturelof/Enforcing Officer . Village/State/Zip � Location of Offense Enforcing Dept/Division Offense P&-,rA4-kZ-AJ VIA A+-,0-T c, 16-P-Vt k 101,-`}")0VL 0 Facts Lire l0?�-ko . 4EV'-c—J 1 �GL>Ul���c �t)rTV�IV. - J k Silt r This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result inappropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFER. GOLD - ENFORCING DEPT. TOWN OF BARNSTABL Ordinance or Regulation BAR -W 6024 WARNING NOTICE Name of Offender/Manager of Address of-Offender MV/MB.Reg. # Village/State/Zip J Business Name �- f "�-�--i ��7 -� i rl ' '' /am/pm; _on 2010 Business Address ,? �--- Signaturd of�Enforcing Officer Village/State/Zip ;f-Vt Location of Offense l Enforcing Dept/Division Offense Jcl � d -C—L {c ��-� c".+� 11 lit-e ,tt� se eV 1 ��Ir' r�..`�''0VL Facts . .. �f�i L' 1U�5-jc . 1 "V'Jo } ,l_ b� 1.ati` ty�. '} iy',�btC!a eo f This will serve only as a warning. At this time no legal action has,been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations; Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK- ENFORCING OFFER GOLD- ENFORCING DEPT. °p{ME TOk Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 �RAR.Sq E.�' 200 Main Street• Hyannis, MA 02601 �AfFOMA��`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Cefgfrjle. r Date: Location/Mailing Address: ,i-I Contact Name/Phone: 7N- S5L)-- i Inventory Total Amount: MSDS: License#: Tier II : d V Labeling: Spill Plan: Oil/WaterSeparator: t Floor Drains: IVOJ Emergency Numbers: Storage Areas/Tanks: VIM Emer enc /Containment E ui m t: o 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 n0 C ,, NOTE: Under the provisions of Ch. 111, Section 31, of th�Mal�Laws A, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: - Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS wvo Number Fee 1313 THE COMMONWEALTH OF MASSACHUSETTS $5o.00 Town of Barnstable Board of Health This is to Certify that Tedeschi Food Shops (7-Eleven) Store #37410 1638 Falmouth Road, Centerville, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. l�l --- ------------------ --------------- ------------------- - -------------------------------------------------------------- l� ------------------------------------------------`--------- ----------------------------------------------------------------- -.------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and v 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 �� 10 • Tow of Unstable egaatorvlces THE Richard V. Scali, Director m f o Public Health Division BARNSTABLE � 9n4N5i4tllF•i.ExfENVILLi•COiUii•HYnS'i:15 • ■ARNSTABLE, ' Thomas McKean Director HR5145 HW5ILLF•YIiSf PS?Nif592 � 9 MAgg q ) 1639-1639-2014 �OTp16 A 0 200 Main Street, Hyannis,MA 02601 575 � �.a T1 Office: 508-862-4 Fax: 508-790-6304 � APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE =� HAZARDOUS MATERIALS Cri 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). �' -31 � APPLICATION FEES CATEGORY 1 PERMIT 26— 11O Gallons: $ 50.00 �s CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ 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. R E C E I V E D' 1. ASSESSOR'S MAP AND PARCEL NO. ± i;. , - 2217 2. IS THIS A PERMIT RENEWAL? V YES_NO. IF YES,SKIP QUESTION 3. LICENSE DES T, 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: Tedeschi Food Shops (7-Eleven) " ��Q 1638 Falmouth Road i 6. ADDRESS OF ESTABLISHMENT: Centerville, MA 02632 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: ' Q V 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: ► ' ``� J2 � 1 L D ✓� 10. SOLEOWNER: YES N IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS, TELEPHONE# F: CORPORATION NAME, e -SU � vvA TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE l a (gyp t O Q:\Application Forms\HAZMAT APP 2017 REVISED cx 01 , Number Fee 1313 THE COMMONWEALTH OF MASSACHUSETTS �so.00 Town of Barnstable Board of Health This is to Certify that Tedeschi Food Shops (7-Eleven) Store #37410 1638 Falmouth Road, Centerville, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 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 i � f r yvIGI, Led S)ults b%3 ' owrl�of Unstable b 212. egu atory ervices Richard V. Scali, Director t KME t �, Public Health Division BABST ,BLE pp5 � CA»YS'�..5{tt3R_.0.1YiY Chi f4-n*A.A"5 �1� 'b4S"6'&4Lt'^tfi RRWJtE-jS3•6 ¢S1tSP BARNSTABLE. " Thomas McKean, Director MAS8. s639• �0 200 Main Street, Hyannis,MA 02601 i Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE f, 1 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 �c (Ji ANNUAL PERMIT(RUNS JULY 1 st—JUNE 30th). a APPLICATION FEES �, 40, CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 C CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 . ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL(NO. 2. IS THIS A PERMIT RENEWAL? - YES_NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTIT..IIErES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: :��W 5. NAME OF ESTABLISHMENT: —'� `wt� S�LH y� 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: A� Ids �3 8. TELEPHONE NUMBER OF.ESTABLISHMENT: 9. EMAIL ADDRESS: 01 ,(�'.�C:' 10. SOLEOWNER: YES 11V0 IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS, D TELEP ONE#OF: CORPORATIO,N,_NAME C PRESIDENT TREASURER 4 R svp 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICAN DATE '!" C:\Users\Decollik\AppData\Local\Microsoft\Windows\7'.Oc po a Internet Files\ ontent.0utlook\BMQD49H2\HAZMAT APP 2017 REVISED.docx °p IKE ro Town of Barnstable Office:508-862-4644 • °� Public Health Division Fax:508-790-6304 • BA MAC LE.$ 200 Main Street• Hyannis, MA 02601 �"IED MA'�p`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT J Business Name: ►eaQeSe-n.► 7FoeeQ S"° 5 Date: Location/Mailing Address: I Vb?7 Ga Z R- tit e} ,J,\ e Contact Name/Phone: 7 a G J&sU Inventory Total Amount: .� ��Dolb DS: License Tier II : o Llbelina: a Spill Plan: DK Oil/WaterSeparator: N Floor Drains: d Emergency Numbers: Storage Areas/Tanks: itVVV- \ n.\ Emergency/Containment Equipment: s ,(✓1�� Cow�q��u.r Waste Generator ID: P�I& Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. 1� Antifreeze 1� Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers kvl�jorer`1 Hydraulic fluid (including brake fluid) S- t Windshield wash i o 9-1 Gl 1V7 I- Motor oils 7- Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants y Miscellaneous petroleum products: po Road salts C-00 110 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 t Miscellaneous Flammables 1% Fertilizers Floor&furniture strippers 1 PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers 5 (including carbon tetrachloride) (including bleach)y Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: -L 1-r I A.0 006 e, Y•4- c.2x�K— I inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS r TOWN OF BARNSTABLE BAR-W Ordinance or Regulation WARNING NOTICE Name of Offender/Manager Address of Offender MV/MB Reg. # Village/State/Zip Business Name am/pm, on 20_ Business Address Signature of Enforcing Officer Village/State/Zip Location of Offense _ Enforcing Dept/Division Offense Facts This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD.IREG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT TOWN OF BARNSTABLE BAR-W ! Ordinance or Regulation WARNING NOTICE Name of Offender/Manager - ; Address of Offender MV/MB Reg.# Village/State/Zip Business Name r•-j r•- r am/pm, on 20 E-7 Business Address ,/ Signature of Enforcing Officer Village/State/Zip Location of Offense---!-'-., lE l Enforcing Dept/Division } 1 t Offense 1t , r - .{ Facts ' -� . ,r + 1 - t•i s� �. d This will serve only as a warning. At this time'no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. e; Number Fee 1313 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Tedeschi Food Shops (7-Eleven) Store #37410 1638 Falmouth Road, Centerville, MA Is Hereby Granted a License For: Storing or Handling 26 - 100 gallons of Hazardous Materials. ------------------------------------------------------------------------------------------------------------------------------------- ------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and 'and expires 06/30/2017 unless sooner suspended or revoked. --------------------------------------- PAUL J.CANNIFF, D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health � I . V ls� �O _C0 5*vr e 3 7'i 0 Town of Barnstable z Regulatory Services Richard V.Scali,Director ""R°S"B'$ Public Health Division BARNSTABL .s n {', Thomas McKean,Director. " 4 200 Main Street,Hyannis,MA.02601 O Rce. 50$-862-4644 ^ "05 rl� 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 1st—JUKE 30th). • APPLICATION FEES CATEGORY 1 PERMIT 26—110 Gallons: $50.00i�. CATEGORY 2 PERMIT 111—499 Gallons: $1 25.00 ❑ �6b 2-I'IC'4 l3� CATEGORY 3 PERMIT 500 or more Gallons:$150.00 ❑ A late charge of$10 00 will be assessed if payment is not received by Julyi Ist. ASSESSORS MAP AND PARCEL NO.� DATE FULL NAME OF APPLICANT: NAME OF ESTABLISHMENT: ( �1 n- � ADDRESS OF ESTABLISHMENT: J QV I fet A. MAILING ADDRESS(IF DIFFERENT): Rivtj TELEPHONE NUMBER OF ESTABLISHMENT: EMAIL ADDRESS: ® 1 It C SOLE OWNER:—YES—NO IF NO,NAME OF PARTNER: FULL NAME,HOMIE ADDRESS,AND TRI. P� ��_�� CORPORATIO M AE, IInP� ' TREASURER CLERK • IF PREPARED BY OUTSIDE PARTY: T QF• ICANT Name: Company Address: i1(,�pti(pGtV Telephone#: b Sw/64 SCE Email: QA1Applicaf on Fomis1HAZZAPPReY16.dorx Page 1 of2 y TOWN OF BARNSTABLE BAR--w 5195 Ordinance or Regulation ' WARNING NOTICE i Name of Offender/Manager_ 17�r Address of Offender MV/MB Reg.# Village/State/Zip /� S1� Business Name�J24esck r �'foo a q oa pm, on Z z3 20!7 Business Address �o 4:;_) i19,RA Signature o nforcing Officer village/State/Zip Cew1- ✓�l�e-- 2 32- Lgcation of,Offense cJ�[ `ell ,r �Enforcing Dept/Division Offense Vlo�a��oweir (U ora Vie Cr>✓ e� 7�kwo2� ri� OKS d AA Facts �/t�af M14a•T2-!'ram. S I A 1/ r� ! S D 4tit (i�•Lvt W,�'Vl.,x. 5� �5,�-t55 Goa 5. This wall serve only as a warning- At this a no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal, action by the Town. WHITE-OFFENDER CANARY-ORD./REG:PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. w • • THE fOk'� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMASS. 200 Main Street• Hyannis, MA 02601 1639. �ArFOMA'� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: 4nio&/TO,5 Wi Date: Location/Mailing Address: 1,b 91 FAM OUA TX1 Lvkc& 102 A 2 Contact Name/Phone: 77 Inventory Total Amount: MSDS: 0 License#: 13YI Tier II : ho Labeling: Spill Plan: 2 Oil/WaterSeparator: M/A Floor Drains: N Emergency Numbers: JJ Storage Areas/Tanks: gployq q Emergency/Containment Equip ent: b Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequengy: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: r LIST OF TOXIC AND HAZARDOUS MATERIALS fiO C)ILLI, Ih� NOTE: Under the provisions of Ch. 111, Section 31, of the G�heral Laws of , hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: 3 i ;Ve- Inspector: Facility Representative: U-L/V WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS �� �atrr 2.�9�or3 �¢.a..�P-tnAll4 — -�z � � ��. f /i IKE rokti �4-A ! ��2�> Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARN ABLE. MASS. �, 200 Main Street• Hyannis, MA 02601 —6`5 i6yq TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT RFD MP'� Business Name: vtvt ov G.T+o�S S 4� oYL- Date: 2 3 7 Location/Mailing Address: /& Sa f4./ o,.) Contact Name/Phone: °`+.e-v + 2 r'---V So 9 -?7 - C'- o<YKA 41ejK5oYl «-z.ol a Ss 0-%r sog- -z33q } I AInvento Total Amount: 41 a.l SDS: Pi II vxv�' F cw�l� }"ems License#: N� Tier I[ : o Labeling: OK c-vw� Spill Plan. Oil/WaterSeparator: t 1C Floor Drains: N o Emergency Numbers: Storage Areas/Tanks: Iq,, f,049o�5 atc mA,A 512� o� 5,*k� Emer enc /Containment ui ment: Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils I Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil I 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 1 �e�toSo1 S 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) 1 (including bleach) 1 Any other products with "poison labels" Aeeti\ 01 51,.. + re,,,,`Q,Q�,Cg (including chloroform, formaldehyde, t Col P�_ hydrochloric acid, other acids) VIOLATIONS: -►dam-ma's �21-t N2 -IS Slnc�,N.�bo^5� Coo+ .{,oti�a-5 S-i t O ORDERS: INFORMATION/RE-COMMENDATIONS: w J dovt. VA o,rs I yvt aLik re— D v5 va-esI , S AA- o-e 4 M- I _ 2.-12_ - ef-C - `Q �-eAspector: I ,,10 Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS U uy\!� f pFtME lay, Barnstable Town of Barnstable , Ar b MASS. �,�� Board of Health f� ►� 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi Public and Environmental Health Program Policies, Procedures, and Guidelines Tight Tanks at Beauty Salons and Barber Shops No. 2010-06 [The State Environmental Code, Title 5, 310 CMR 15.000, prohibits the discharge of beauty salon/barber shop industrial waste into an onsite sewage disposal system and requires that this waste be discharged into a holding tank. This policy only applies to beauty salons and barber shops which are connected to onsite sewage disposal systems.] On June 8, 2010 the Board of Health voted to issue the following policy relating to hair salons and barber shops: 1) Every owner of: • any new hair salon or barber shop,or • any existing hair salon or barber shop which is seeking approval to install additional seats, or • any salon or barber shop where the onsite sewage disposal system fails a sanitary inspection,or 7 0 any salon'or barber shop that has a change in ownership, or • any salon or barber shop operation that has a change in licensure. and which is connected to an onsite sewage disposal system shall submit plans for an industrial waste holding tank. The plans shall be submitted prior to opening for business, installing additional seats, or upon discovery of a failed onsite sewage disposal system, change in ownership, or change in licensure. The plans shall be prepared by a professional engineer, designed in accordance with 314 CMR 18.00, and shall be submitted to the Department of Environmental Protection and to the Public Health Division Office,at 200 Main Street Hyannis Massachusetts. .2) All hair salon and barber shop holding tanks shall be installed in accordance with the approved plans prior to opening for business, prior to installing any additional seats, or upon discovery of a failed onsite sewage disposal system, change in ownership or change in licensure. Q:Policies\TightTanksatBeautySalonsand Barbershops Revised 6/12/2010 3) Any sink, which is connected to the approved holding tank, shall be designated as a hazardous materials/chemical discharge sink. Clearly visible, permanent signs shall be posted at the designated sinks indicating that any and all potentially hazardous materials and chemicals shall be disposed of into this sink Signage at other sinks, at the same facility, shall also be posted clearly indicating that no employee(s) shall discharge any potentially hazardous materials or chemicals into these sinks. Each sink shall be posted separately. Wayne Miller,M.D. Junichi Sawayangi Paul Canniff,DMD Q:Policies\TightTanksatBeautySalonsand Barbershops Revised 6/12/2010 I1o58 Fci4�ma�4. Pam_ , (o,�ter��le, 44gZ�t�ce..4— °FIB►ors Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMS�LE.$` 200 Main Street• Hyannis, MA 02601 oMA+ TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Jam' SS 1 /�a, I Date: Va 7 Location/Mailing Address: 1 6 513 Contact Name/Phone: A&A SOS-$62 -023-7 ��o�v�g �n�wA_ Inventory Total Amount: < ) SDS: 40 o b�a�w License#: N lA Tier II : o Labelin : 'Y- 1C.e. Aa+e- Spill Plan: 0 Oil/WaterSeparator: Floor Drains: 1Jo Emergency Numbers: O3'C StorageAreas/Tanks: �4k&%nj \ fir.. a,\ f.ovJkA%% _-C$ Emergency/Containment Equipm nt: i'�s Ion s Waste Generator ID: �r Waste Product: X)I'a Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: ov,- 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) Z Windshield wash + w^„Ax 2. Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil -1 Disinfectants Z 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 ce cka%AA-4, Fertilizers Floor&furniture strippers \c,o;nP% PCB's Metal polishes \.Ck!lA C'C'`' Other chlorinated hydrocarbons Laundry soil &stain removers RV a\\ (including carbon tetrachloride) (including bleach) M`ho Any other products with "poison labels" k-ee o (including chloroform, formaldehyde, !9`5e hydrochloric acid, other acids) VIOLATIONS: ORDERS: 7 ca W ,Sv I-e-C e<- N-A t r V.4 INFOR ATION/RECOMMENDATIONS: A'`V._ 'mow Vk�.Jk.c� a, g La'�-� o -e c¢ g C. aa M_J k t,GeK fir,w,tom. T_-_ a I I Ce�w+a,ru.C 4 I'6-a )-• t`� �14w,fA"LW6-S iw yt dopi Cab.tie- Inspee 0%_ ag J..e: Cs l l,--e-+,ow qo./ �colv LA Facility Representative: O JITE CPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS