HomeMy WebLinkAbout1676 FALMOUTH ROAD/RTE 28 - HAZMAT (2) /b �,(
�I
TOWN ' OF RARNSTAf3LELounsatl
ANCHI CLASS: 1. Marine,Gas Stations,RFpair
�-�•�-� factory 2. Printers
LTMR � * or- HEALTH 3. Auto Body Shops
sfactory- 4. fanufacturers
� see"Orders" S. Retail Stores
COMPANY 11't' ��.�.:'� �• Y ) 6. Fuel Suppliers
ADDRESS .� t �:, � ,� ��Cjf/LI-�� Class! �I 7. Miscellaneous--/)r'y 6W,.6-
QUANTITIES AND STORAGE (IN=indoors; OUT outdoor.
CaU lots Drums AbOveTanks Undetgr.otind Tanks
MAJOR MATERIALS f I_!L IN 4liZ
N gallons Ew
—
Fuels:
• Gasoline, Jet Fuel (A)
Diesel, Kerosene, 02 (B) ,
Heavy Oils: IT ,-
. 1
waste motor oil - (C)
new motor oil (C)
transmission/hydraulic
Synthet).c Organics:
degreasers •
Miscellaneous:
ISPOSAL RECL M T ON REM US: _
1. Sanitary Sewage 2. Water Supply _
QTown Sewer �;' Public
-; On-site Q Private r
3. Indoor Floor Drains: YES NO / /
Q [folding tank: MC
VCatch basin/Dry well .._.�...___._._....__ s___._........_....__.__...._.�_ _
On-site system
Q
4. Outdoor Surface drains:YES NO
Q 11oldinL tank: MDC
Q Catch basin/Dry well
0 On-site system
S. Waste Transporter Licensed?
Ndm�4f._llatll�� ,j)e ina ton ,Waste Product YES_ _EiL
u ae et
erson s Interviewed Inspector Date
, _
TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
BOARD OF HEALTH satisfactory 3. Body Shops
0 unsatisfactory- 4.Manufacturers
COMPANY � (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS J6 'T Lim, �, Class: 7.Miscellaneous
4CL-- QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors)
MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks
IN OUT IN OUT IN OUT #&gallons We Test
Fuels:
Gasoline,Jet Fuel (A)
Diesel, Kerosene, #2 (B)
Heavy Oils:
waste motor oil (C)
new motor oil (C)
transmission/hydraulic
Synthetic Organics:
degreasers
Miscellaneous:
DISPOSAL/RECLAMATION REMARKS:
1. Sanitary Sewage 2. Water Supply
O Town Sewer O'ublic
A On-site O Private
3. Indoor Floor Drains YES N0-)L—
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
4. Outdoor Surface drains:YES . N0,,V ORDERS:
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
5.Waste Transporter
Name of Hauler Destination Waste Product Licensed?
YES NO
1. lya_ 6i IVY,AJ, S 1'
2. �.
Person (s) ntervi ed Inspector Date
TOXIC A'ND HAZARDOUS MATERIALS REGISTRATION FORM
a PRINTERY Mail To:
NAME OF BUSINESS: 1678 FALMOUTH ROAD Board of Health
MAILING ADDRESS: Town of Barnstable
TELEPHONE NUMBER: �7 3�Q P.O. Box 534
CONTACT PERSON: /C I �/`�/��c� �S'J`G,�(,��'� Hyannis, MA 02601
Does your firm store any of the toxic or hazardous materials listed below, either for sale or for
your own use, in quantities totalling, t 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
vca i Please put a check beside each product that you store:
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)
Gasoline, Jet fuel Refrigerants
Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides,
Other petroleum products: grease, lubricants rodenticides)
Degreasers for engines and metal 1-----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
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