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UPC 129M
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IKE�°� Town of Barnstable Office:508-862-4644
Public Health Division Fax:508-790-6304
• BARM SSBLE.$ 200 Main Street• Hyannis, MA 02601
" ,6M TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT
CFO MA'S f
Business Name: a coot/ 7 Date: J1101
Location/Mailing Address: 67
Contact Name/Phone:
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Inventory Total Amount: MSDS: License#:
Tier II : Labeling: / Spill Plan:
Oil/WaterSeparator: Floor Drains: Emerge6y Numbers:
Storage Areas/Tanks: P V Ifid C9
Emergency/Containment Equipm ntnt:
Waste Generator ID: Waste Product:
Date&Amount of Last Shipment/Frequency:
1 [Licensed Waste Hauler&Destination:
4Other Waste Disposal Methods:
LIST OF TOXIC AND HAZARDOUS MATERIALS
NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use,
storage and disposal of 111 gallons or more requires a license from the Public Health Division.
Antifreeze Dry cleaning fluids
Automatic transmission fluid Other cleaning solvents&spot removers
Engine and radiator flushes Bug and tar removers
Hydraulic fluid (including brake fluid) Windshield wash
Motor oils Miscellaneous Corrosives
Gasoline,jet fuel, aviation gas Cesspool cleaners
Diesel fuel, kerosene, #2 heating oil Disinfectants
Miscellaneous petroleum products: Road salts
grease, lubricants, gear oil Refrigerants
Degreasers for engines&garages Pesticides:
Caulk/Grout insecticides, herbicides, rodenticides
Battery acid (electrolyte)/batteries Photochemicals(Fixers)
Rustproofers Photochemicals(Developer)
Car wash detergents Printing ink
Car waxes and polishes Wood preservatives(creosote)
Asphalt&roofing tar Swimming pool chlorine
Paints, varnishes, stains, dyes Lye or caustic soda
Lacquer thinners Miscellaneous Combustible
Paint&varnish removers, deglossers 'Leather dyes
Miscellaneous Flammables Fertilizers
Floor&furniture strippers PCB's
Metal polishes Other chlorinated hydrocarbons
Laundry soil &stain removers (including carbon tetrachloride)
(including bleach) Any other products with "poison labels"
(including chloroform, formaldehyde,
hydrochloric acid, other acids)
VIOLATIONS:
ORDERS:
INFORMATION/RECOMMENDATIONS: 6 b a C.
Insp- �r: -
Facility Representative:
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS