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Home My WebLink About0027 BETTY'S POND ROAD - HAZMAT off- �s ��-,oQ (.�; �-��,v►r��s c;-qv I i � o * RARNSTABLE, * _ 9 MASS. i639. At6D MA'S R Town of Barnstable Inspectional Services Public Health Division Thomas McKean, Director 200 Main Street Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 West End Auto Revival 3-5-20 Robert Cram/Owner Property Address: 2.7 Bettys' Pond Road Barnstable, MA. 02601 Mr. Cram, On 1-30-20 a site inspection was performed on your property in regards to any hazardous material stored/used/generated on your property. On 1-30-20 a letter was sent to you along with all appropriate forms needed to conform to the Town of Barnstable rules and regulations under Chapter 108 and 326 and Mass 310 C.M.R 30 Hazardous Waste regulations: An agreed upon date to remedy all of the minor violations was agreed upon with your daughter to be the first week of March 2020 for a re-inspection. I visited your shop on 3-2-2020 and found that nothing had been accomplished except for a marking on one of the waste containers. I again visited on 3-5-2020 for a final inspection (agreed on between us for the first week of March) and found nothing had changed. I am very concerned that no action has been taken to comply with the regulations spelled out in the 1-30-20 letter. Below are several violations that have to be taken care of within 72 hours from receipt of this letter. Also enclosed is a written warning notice that precedes any further action on this matter if all violations are corrected within the time frame. Citation # BAR-W 5870 if the violations are not corrected,. further action will be taken. This may include, but not limited to, criminal/civil violations, Barnstable Court action, and notification to the Mass D.E.P. All of the violations listed below are located at 27 Betty's Pond Road Barnstable, MA. VIOLATIONS: 1. A spill plan is not posted 2. A continizency plan is not posted 3. All waste products must be so marked hazardous waste and description of same 4. Spill kit not available 5. SDS sheets for products are not readily available to employees 6. A _ver_y small quantity generator of hazardous waste number assigned by the Mass D.E.P (VSQG) If your facility uses cleaning solvents, oils, inks,paints, acids or alkalines, it is probably generating hazardous waste with one or more of these characteristics: • Ignitable (catches fire easily, with a flash point lower than 140°F) ❑ • Corrosive (very acidic or basic,with a pH of less than 2.0 or more than 12.5) ❑ • Reactive (unstable,reacts violently with water,potentially explosive) ❑ • Toxic (leaches contaminants into the environment), or ❑ • Listed specifically as "hazardous" by the Massachusetts Department of Environmental Protection (MassDEP). MassDEP regulations (310 CMR 30.000: Massachusetts Hazardous Waste Regulations) require businesses that generate any of these wastes to properly identify and safely manage them, and to track them from where they are generated to their ultimate destination for recycling,treatment, or disposal. Facilities generating smaller quantities of hazardous waste are given more compliance flexibility than generators of larger quantities, but still need to safely manage wastes and prevent releases to the environment. You can take advantage of this regulatory flexibility by minimizing the amount of hazardous waste you generate. Use non-hazardous substitutes and reuse or recycle hazardous wastes wherever possible. Hazardous Waste Generator Status & Storage Limits Your status determines how much waste you may accumulate at your site at one time and how quickly you need to ship it off-site for recycling or disposal. • If you generate less than 220 pounds (approximately 27 gallons) of hazardous waste or waste oil per month and no acutely hazardous waste, you may register with (MassDEP) as a Very Small Quantity Generator(VSQG). As a VSQG, you may accumulate up to 2,200 pounds (about 270 gallons) for an indefinite period of time. • If you generate between 220 and 2,200 pounds per month (approximately 27 to 270 gallons), and/or up to 1 kilogram (2.2 pounds) of acutely hazardous waste per month, you are a Small Quantity Generator(SQG) and may accumulate up to 13,200 pounds (1,500 to 1,620 gallons) for no more than 180 days. • If you generate more than 2,200 pounds (approximately 270 gallons) and/or more than 1 kilogram (2.2 pounds) of acutely hazardous waste per month,you are a Large Quantity I Generator(LQG). You may accumulate any quantity on-site, but must ship it within 90 days. Please minimize your waste to the best of your ability. Note: The same numerical thresholds apply to both hazardous waste and waste oil. You may register separately and maintain different generator status for each, depending on the quantities you generate. Very Small Quantity Generator (VSQG) Requirements As a VSQG, you must: • Never accumulate more than 1,000 kilograms (approximately 2,200 pounds or 270 gallons) of hazardous waste or waste oil at any one time. • Store hazardous wastes on an outdoor impervious surface with a secondary containment area or an indoor impervious surface that is not adjacent to a floor drain or other point of discharge to the outdoor environment. • Secure the storage area against unauthorized access and post it with Hazardous Waste signs. • Keep each storage container in good condition and label it Hazardous Waste with the name of the waste (e.g.,toluene, acetone) and its associated hazard(s) (e.g., corrosive, ignitable,toxic). • Retain records of the type and quantity of waste you generate, and the date and method of treatment, recycling or disposal Obtain receipts when you self-transport waste and keep copies of manifests for shipments sent off- site.Use a licensed transporter and manifest(requires EPA ID)when sending your wastes to a MassDEP licensed or approved hazardous waste treatment, storage, disposal or recycling facility. Transport your own waste to another generator that will count your waste with its own, or to a licensed treatment, storage or disposal facility,permitted recycling facility, or community hazardous waste collection center with the operator's permission. Special Self-Transport Requirements As a registered VSQG, you may transport your own hazardous waste* if you: Transport no more than 55 gallons at one time and keep a copy of your VSQG registration in the vehicle. Do not transport incompatible wastes(e.g., alkaline cleaner and battery acid) simultaneously. • Keep waste containers tightly sealed,properly labeled (see above), and firmly secured to the vehicle. • Meet all applicable U.S. Department of Transportation(DOT) and Massachusetts Department of Public Safety(DPS) shipping restrictions and container, label,placard and permit requirements. Contact the federal Motor Carrier Safety Administration(617- 494-2770) and the State Fire Marshall's Office (978-567-3300) for details. Chapter 1081-Iazardous Materials § 108-1 Findings. § 108-2Authority. § 108-313efinitions. § 108-41nventory and registration. a controls. 108-5stora § g § 108-61-icense and contingency plan. § 108-7Appeals. § 108-8Handling or storage of additional hazardous materials. § 108-9Prohibitions. - § 108-101-icensure, registration, and inventory requirement exemptions. § 108-1121 E report information disclosure. § 108-12Enforcement. § 108-13Notice of violation. § 108-14Violations and penalties. § 108-15Severability. § 108-1 Findings. A. Exposure to hazardous substances can cause cancer, genetic mutation, birth defects, miscarriages, lung, liver, and kidney damage, and death. B. Environmental contamination can bankrupt site owners, lower or destroy land values, drive out residents and industry, depress local economies, and endanger public health. C. Most hazardous substances do not readily decompose into harmless components. They instead remain in highly dangerous forms and penetrate by movement through land and water into and throughout the environment. D. Some hazardous substances are considered explosive and/or extremely hazardous and toxic. These substances have caused death and serious injuries to Fire Department personnel. A comprehensive database containing the types and amounts of toxic or hazardous materials stored or handled within buildings within the Town should be formed in.order to provide essential information to Fire Department personnel. E. Barnstable's groundwater is the sole source of its existing and future drinking .water supply. When sufficient groundwater exists to saturate a permeable geologic formation so as to yield significant quantities of water through wells or springs, it is known as an aquifer. F. On Cape Cod, some aquifers may be integral with the surface waters, lakes, streams and coastal estuaries which constitute significant recreational and economic resources of the Town. These resources are used for swimming and other water-related recreation, shell fishing and fishing. G. Accidental spills and discharges of petroleum products and other toxic and hazardous materials onto the ground and surface waters have repeatedly threatened the quality of such groundwater supplies and related water resources on Cape Cod and other Massachusetts towns, posing substantial public health and safety hazards and threatening economic losses to the affected communities. H. Unless stricter preventive measures are adopted to manage the storage, use, and generation of toxic and hazardous materials and to prohibit the release of these materials within the Town, further releases of such materials to the aquifer will predictably occur, and with greater frequency and degree of hazard by reason of increasing construction, commercial and industrial development, population, and vehicular traffic in the Town of Barnstable and on Cape Cod. The foregoing conclusions are well known and have been confirmed by findings set forth by the Barnstable County Health and Environmental Department, the Cape Cod Commission, the Massachusetts Department of Environmental Protection, the Occupational Safety and Health Administration (OSHA), and the Environmental Protection Agency (EPA). J. Recent revisions to the Massachusetts Drinking Water Regulations, 310 CMR 22.00, created the need for this chapter to be amended in order to remove potential conflicts between this chapter.and 310 CMR 22.00. § 108-2Authority. The Town of Barnstable adopts the following measures under its home rule powers, its police powers to protect the public health and welfare, and its authorization under M.G.L. Chapter 40, § 21 . § 108-Mefinitions. A. Enforcement agencies. BOARD OF HEALTH A regulatory committee of the Town. It consists of three members, one of whom is a physician. The members are appointed by the Town Council of the Town of Barnstable. BUILDING COMMISSIONER The designated supervisor and administrator of the Town of Barnstable Building Department. The Building Commissioner is appointed by the Town Manager. FIRE DEPARTMENT The appropriate Town of Barnstable Fire District's Fire Chief and/or that Fire Chiefs designee(s). HEALTH DEPARTMENT The Director of Public Health, who is the designated agent of the Board of Health, and/or the Director of Public Health's designee(s). i The Health Department provides administrative support to the Board of Health. B. Other terms. ACUTELY HAZARDOUS MATERIAL A material which is extremely toxic or reactive. For the purposes of this chapter, any acutely hazardous waste listed within 310 CMR 30.136 of the . Massachusetts Department of Environmental Protection Hazardous Waste Regulations, and those wastes listed within 310 CMR 30.131 with EPA Hazardous Waste Nos. F020, F021 , F022, F023, F026, F027, and F028 are considered as acutely hazardous materials. HANDLE To use, to deal with, act on, or dispose of. HAZARDOUS MATERIAL One or more of the following: A product or waste or combination of substances which, because of quantity, concentration or physical or chemical or infectious characteristics, poses a present or potential hazard to human health, safety, or welfare or the environment when improperly treated, stored, transported, used, or disposed of or otherwise managed. (2) Any material regulated under Sections 310 CMR 30.122, 310 CMR 30.123, 310 CMR. 30.124, 310 CMR 30.125, 310 CMR 30.131 (except for those listed with EPA Hazardous Waste Nos. F020, F021 , F022, F023, F026, F027, F028 which are considered as acutely hazardous materials), 310 CMR 30.132, and 310 CMR 30.160 of the Massachusetts Department of Environmental Protection. Hazardous Waste Regulations, et seq., as these statutes may be amended. A general listing of these materials and quantities is available at the Health Department office. (3) is Any material, waste, product, or substance which has one or more of the following characteristics: (a) Ignitable: easily catches fire, flash point of less than 1400 F.; (b) Corrosive: easily corrodes certain materials, very .acidic or alkaline, the pH is less than or equal to 2.0 or greater than or equal to 12.5; (c) Reactive: explosive, produces toxic gases when mixed with water or acid; (d) Toxic: poisonous. MATERIAL SAFETY DATA SHEET (MSDS) The form containing data regarding physical characteristics, flammability, reactivity, toxicity, and the health and safety hazards of specific chemicals, as well as information relative to procedures recommended for spills and leaks of specific chemicals and special precautions to be taken during handling of specific chemicals. OPERATOR The person who has the effective control of a business operation, or governmental agency. OWNER The person who has legal ownership of a site. For the purpose of this regulation, the Health Department shall be entitled to rely on the most current list of owners in the records of the Town Board of Assessors as providing sufficient evidence of ownership under this chapter. RELEASE The accidental or intentional spilling, leaking, pumping, discharging, pouring, emitting, emptying or dumping of toxic or hazardous material upon or into any land, air, or waters of the Town of Barnstable. Release includes, without limitations, leakage of such materials from failed or discarded containers or storage systems, and disposal of such materials into any sewage disposal system, dry well, catch basin, unapproved hazardous waste landfill, or any other discharge of toxic or hazardous materials into the environment. The term "release" as used and applied in this chapter does not include the following: Proper disposal of any material in a sanitary or industrial landfill that has received and maintained all necessary legal approvals for that purpose; Application of fertilizers and pesticides in accordance with label recommendations and with regulations of the Massachusetts Pesticide Control Board; (3) Application of road salts in conformation with the Snow and Ice Control Program of the Massachusetts Highway Department and/or the Town of Barnstable Highway Division. (4) Disposal of sanitary sewage to subsurface sewage disposal systems as defined and permitted by Title 5 of the Massachusetts Environmental Code and the Board of Health regulations. (5) Disposal of sanitary sewage to the Town of Barnstable wastewater treatment plant and to other wastewater treatment facilities as defined and permitted by the Massachusetts Department of Environmental Protection. SITE Any real estate, personal property, facility, building, structure, installation, equipment, pipe or pipeline including any pipe into a storm drain, sewer or treatment works, well, pit, pond, lagoon, impoundment, ditch, tank, landfill, storage container, or any other I place or area to, from or at which toxic or hazardous materials have been stored or discharged. STORE The containment of substances or materials in such a manner as not to constitute disposal or use of such substances or materials. Notwithstanding the above, such terms shall not include the maintaining of hazardous materials which are in transit or which are maintained in a fixed facility for a period of less than 30 days during . the course of transportation. § 108-4 Inventory and registration. A. No owner of a business, home occupation, industry, or operator of a governmental agency shall handle or store acutely hazardous materials and/or hazardous materials in the Town of Barnstable unless he/she is the holder of a registration. Such registration shall include an inventory, the location of the site, the name of the operator, and the name of the owner. The inventory shall include the proposed and/or existing quantities of all acutely hazardous materials and hazardous materials handled or stored on site on the form provided by the Health Department. B. The owner shall describe the storage location of the material, safety data sheets on the registration form provided. The material safety data sheets shall be made available upon request of the Health Department and/or the Fire Department.C. There are no minimum quantities that exempt an owner from this section. D. New owners of businesses, home occupations, or industrial establishments. who have not previously obtained a registration in accordance with this section shall, if they handle or store acutely hazardous materials and/or hazardous materials, obtain a registration prior to handling or storage at a building or structure and prior to commencing business. E. The registration. shall be revised or renewed if there is a change in the inventory, the site, the operator, or the owner. § 108-5 Storage controls. A. All acutely hazardous materials and/or hazardous materials shall be stored indoors, unless in product-tight containers which are protected from the I elements, leakage, accidental damage, and vandalism. Liquid hazardous materials other than gasoline, which are stored outside, shall be stored above ground in a covered container within a containment area designed to contain a minimum of 110% of the volume of all materials to be stored. For the purposes of this subsection, fertilizer shall be considered as hazardous materials. B. Containers of acutely hazardous materials and/or hazardous materials shall be stored on an impervious, chemical-resistant surface compatible with the material being stored'. Provisions shall be made to contain the product in the case of an accidental release. C. Wastes containing acutely hazardous materials and/or hazardous materials shall be held on. the premises in product-tight containers and shall be removed and disposed of in accordance with the Massachusetts Hazardous Waste Management Act, Ch. 704 of the Acts of 1979.1,E [1l Editor's Note: See MGL C. 21 C, § 1 et seq. D. Road salts and other chemicals used for ice and snow removal shall be contained in a structure that protection rotection from the elements. The p structure shall be constructed in such a way to prevent a release and to prevent leachate from contaminating the groundwater and surface waters. E. Other containers/containment areas may be required as specified or as determined by the Director of Public Health. § 108-61-icense and contingency plan. A. The Board of Health shall adopt regulations from time to time specifying the hazardous materials and acutely hazardous materials which shall be regulated by licensure, specifying the quantities of such hazardous materials and acutely hazardous materials which shall be regulated by licensure, and specifying the fees for such licenses. The Board of Health may have reference to scientific literature, publications, recommendations and regulations of federal, state, and local regulatory agencies, the expertise and experience of public safety agencies, especially and including Fire Departments. Such a determination will be based upon the ignitability, corrosivity, reactivity, or toxicity of the hazardous materials handled or stored, the amounts of hazardous materials and acutely hazardous materials stored, and the. proposed storage location and handling location of the acutely hazardous materials and hazardous materials. B. The Health Department shall enforce such Board of Health regulations. The Health Department shall require, after reviewing the submitted registration information set forth in § 108-4, an owner to obtain an annual license. C. It shall be the responsibility of the owner and/or the operator to apply annually for such license. D. New owners of businesses, home occupations, industrial establishments or operators of governmental agencies who have not previously obtained a license in accordance with this section maybe required upon registration to obtain a license prior to handling and/or storage at a building or dwelling and prior to commencing business. E. The owner and/or operator shall submit a contingency plan prior to the issuance of a license by the Health Department. A contingency plan shall meet the requirements set forth below: (1) Submission of the names, addresses, and telephone numbers of the owner, operator, and all other persons responsible for implementation of the contingency plan in the absence of the owner and/or operator. (2) A plan showing where and how all regulated substances shall. be stored as described within § 108-5 of this chapter such that the method of containing any accidental release to ensure that all such releases will be totally contained and prevented from reaching any surface or ground waters or into any on-site sewage disposal system, sewer system, catch basin, or dry well. This plan shall also be posted in one of the following on-site locations: guard shack, fire alarm box, sprinkler riser, other location acceptable to the Fire Department. The location of the posting shall be specified. (3) The Health Department and/or the Fire Department may require the owner to provide vacuum suction devices or absorbent scavenger materials be present on site in sufficient magnitude so as to control and collect the total quantity of regulated substances present or may require such devices and materials to be readily available and easily accessible from off-site sources consistent with the contingency plan. Emergency containers shall be of such capacity as to hold the total quantity of regulated substances plus any absorbent material. A plan showing the location of all emergency collection devices shall be provided if the provisions of this section are required. (4) Proper and adequate maintenance of containment and emergency equipment shall be required. Procedures shall be established for inspections performed by the operator and/or the operator's designee(s) once every three months and for the verification . of maintenance of containment and emergency equipment. Such procedures shall be in writing, including a regular schedule of maintenance. A log documenting any accidental spills, describing how such spills were handled, describing inspection results and maintenance shall be kept at the site. Such logs and records shall be available for inspection by the Health Department and/or the Fire Department at all times. (5) The procedures which will be followed in the event of release so as to control and collect all released material in such . a manner as to prevent it from reaching any. surface or ground waters or into any sewage disposal system, municipal sewer system, catch basin or dry well. Every operator having knowledge of a release or other loss of acutely hazardous materials and/or hazardous materials shall report the release or loss of same to the Health Department and the Fire Department within one hour of detection. The operator shall ensure the telephone number of the appropriate Fire Department and of the Town of Barnstable Health Department office shall be posted on or adjacent to a telephone located at the site. F. Prior to submission of the contingency plan to the Health Department, approval of that plan must be obtained from the Fire Department. G. Upon receipt of the annual fee, completion of the annual application form designated by the Health Department, upon receipt of a complete inventory, and upon receipt of a satisfactory contingency plan, the Director of Public Health shall issue said license to the operator and the site. Said license shall expire on June 30 and shall be administratively renewed annually upon application and payment of the annual fee. H. The Director of Public Health may grant, suspend, modify, or revoke such license for due cause or failure to comply with any section of this chapter and/or failure to perform the conditions set forth in the contingency plan. § 108-7 Appeals. Any person or persons upon whom any order has been served pursuant to any section of this chapter may request a hearing before the Board of Health by filing a written petition, provided that such petition shall be filed within seven days after the day the order was served. Upon receipt of a petition, the Board of Health shall in writing inform the petitioner of the date, time, and place of the hearing and their right to inspect and copy the Board of Health's file concerning the matter. The hearing shall be commenced not later than 30 days after the date the order was .served. At the hearing, the petitioner and other affected parties shall be given an opportunity to be heard, to present witnesses or documentary evidence, and to show why an order should be modified or withdrawn, or why an action by an inspector or other personnel of the Health Department Should be reconsidered, rescinded, or ordered. Failure to hold a hearing within the time period specified herein shall not affect the validity of any order. The Board of Health shall sustain, modify, or withdraw the order and shall inform the petitioner in writing of its decision within not more than seven days after the conclusion of the hearing. § 108-8 Handling or storage of additional hazardous materials. A. No person shall handle or store any hazardous materials and/or acutely hazardous materials which were not listed on the submitted registration and inventory until after the owner and/or the operator has registered any additional hazardous materials as an amendment to the inventory. B. An operator shall first receive the approval of the owner prior to registering any additional hazardous materials with the Health Department. C. The Health Department may require, after reviewing the submitted amended inventory and other information, the operator and the owner of a business, home occupation or industry to obtain an annual license if such additional hazardous materials places the applicant under the current licensing regulations of the Board of Health. D. The Director of Public Health may grant, suspend, modify, or revoke such license. for due cause or failure to comply with any section of this chapter and/or failure to perform the conditions set forth in the contingency plan. § 108-9Prohibitions. The release of any hazardous materials and/or acutely hazardous materials upon the ground, or into any surface or ground waters or into any sewage disposal system, sewer system, catch basin, or dry well within the Town of Barnstable, is prohibited. § 108-10 Licensure, registration, and inventory requirement exemptions. Licensure, registration, and reconciliation of inventory requirements shall not apply to the following: A. Fuel oil stored in conformance with Massachusetts fire prevention regulations and regulations of the Barnstable Board of Health for the purpose of.heating buildings located on the site. B. Fuel stored in boats, airplanes, trucks, and other vehicles accessory to a residential use. C. Noncommercial buildings. The handling and storage of hazardous materials at a residential dwelling in quantities which are associated with reasonable household use. This exemption does not apply to a professional or home occupation use as defined by §§ 240-12C (1) and 240-18 of Chapter 240, Zoning. In addition, this exemption does not apply to hotels, motels, interval ownership facilities (time-shares), guesthouses. § 108-11 21 E report information disclosure. A. The Health Department shall be the repository of information relating to releases of hazardous materials. Any person possessing hazardous material release information has an obligation to submit such information to the Health Department. Every professional engineer and/or other person conducting a 21 E report analysis shall submit a copy of the final report to the Health Department within 21 days of completion of the report. Nothing shall contravene with § 12 of Chapter 21 E of the Massachusetts General Laws. B. If a person believes that the information required by this chapter involves the release of a trade secret, the person shall nevertheless make the disclosure to the Director of Public Health and shall notify the Director of Public Health in writing of that belief on the inventory document. C. The Director of Public Health and the Fire Chief shall protect from disclosure any trade secret designated as such by the operator. D. I Upon receipt of a request for the release of information to the public which includes information of which the operator has notified the Director of Public Health is a trade secret, the Director of Public Health shall notify the operator in writing of the request by certified mail, return receipt requested. The Director of Public Health shall release the information to the public within 10 days of receipt of a written request, but no earlier than three days after the date of mailing the notice of the request for information, unless, prior to the expiration of the ten-day period, the operator files an action in an appropriate court for a declaratory judgment that the information is subject to protection or for an injunction prohibiting disclosure of the information to the public and promptly notifies the Director of Public Health of that action. E. Any information which is confidential pursuant to this and/or § 108-4 shall not be disclosed to anyone except the following: (1) An officer or employee of the Town, county, state, or the United States, in connection with the official duties of that officer or employee under any law for the protection of health, or to a contractor with the Town and their employees if, in the opinion of the Director of Public Health, disclosure is necessary and required for the satisfactory performance of a contract, for performance of work, or to protect the health and safety of the employees of the contractor. Fire and emergency rescue personnel and Health Department personnel operating within the jurisdiction of the Town shall be considered employees of the Town, as the case may be. (2) Any licensed physician where the physician certifies in writing to the Health Department that the information is necessary to the medical treatment of the physician's patient. § 108-12 Enforcement. A. The provisions of this chapter shall be enforced by the Health Department. The Health Department may, according to law, enter upon any premises at any reasonable time to inspect for compliance. B. Upon request of the Health Department, the owner, individual identified on a registration or license application, or operator of any premises at which toxic or hazardous materials are used or stored shall furnish all information required to monitor compliance with this chapter. A sample of wastewater disposed to on-site septic systems, dry wells or sewage treatment systems may be required by the Health Department at the operator's expense. C. All records pertaining to storage, removal and disposal of toxic or hazardous. wastes shall be retained for no less than five years by the registration holder or license holder, and shall be made available for review by the Health Department upon request. D. The Building Commissioner of the Town of Barnstable shall condition issuance of building and occupancy permits upon conformity with the requirements of this chapter respecting any hazardous materials and/or acutely hazardous materials to be used in the course of such construction or occupancy. § 108-13 Notice of violation. Written notice of any violation of this chapter shall be given by the Health Department, specifying the nature of the violation; any, corrective measures that must be undertaken, including containment and cleanup of discharged materials; any preventive measures required for avoiding future violations; and a time for compliance. Requirements specified in such notice shall be reasonable in relation to the public health hazard involved and the difficulty of compliance. The cost of containment and cleanup shall be borne by the owner and operator of the premises. § 108-14 Violations and penalties. A. Any person who.shall violate any section of this chapter for which penalty is not otherwise provided in any of the General Laws shall upon conviction be fined $300. B. Any person who shall fail to comply with any order issued pursuant to the sections of this chapter shall, upon conviction, be fined $300. Each day's failure to comply with an order shall constitute a separate violation. C. In the alternative to criminal prosecution, the Health Department may elect to utilize the noncriminal disposition procedure set forth in MGL C. 40, § 21 d. Noncriminal ticket citation for any violation of any section of this chapter shall be in the amount of $75 for the first violation and $25 for each additional violation. Each day's failure to comply with an order shall constitute a separate violation. D. Further, the Health Department, after notice to and after a public hearing thereon, may suspend, revoke, or modify any license issued hereunder for cause shown. § 108-15 Severability. Each provision of this chapter shall be construed as separate, to the end that if any part of it shall be held invalid for any reason, the remainder shall continue in full force and effect. Again, if I can be of any assistance in this matter please feel free to contact me directly. 508-862-4645 Respectfully, C. Gus Johnson Hazardous Material Specialist, Cc FILE Barnstable Enforcement Office Thomas McKean Director Board of Health i 1-30-20 West End Auto Revival 27 Bettys Pond Road Hello, it was a pleasure to meet you guys today and I must say that your shop is very neat and clean As we discussed: 1. 1 left several blank sheets that need to be filled out and a DEP contact sheet for obtaining a generator of hazardous waste number. There is no cost for this, BUT you need one even if you use waste oil for heat at building. No company can pick up waste products without this number. 2. A spill plan and contingency plan need to be displayed in store 3. All waste products must be clearly marked as such 4. For your own protection, all floor drains should be documented by you, showing drain, date, etc. Especially if you do not own property. 5. All rules about safely storing and using any hazardous material are available on our web site and/or the Mass DEP. 6. MSDS Sheets need to be available 7. Spill kits/speedy dry available for any spills that me happen Just a few things that need to be addressed and I will check back with you for completion the first week of March Any questions or concerns, please feel free to contact me directly. C. Gus Johnson Hazardous Materials Inspector Town of Barnstable Board of Health 508-862-4645 chester.johnson@town.barnstable.ma.us F`oF� ►ok� Town of Barnstable Office:508-862-4644 c Public Health Division Fax:508-790-6304 +�BARNSTABLE. MASS. y, 200 Main Street• Hyannis, MA 02601 "rFOMP+ TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Date: Location/Mailing Address: vZ ` Contact Name/Phone: •7 7� Inventory Total Amount: MSDS:W-1l G(-T License#: Tier II : Labeling:0L 2eh 1 Spill Plan: UJ; )) 45Ls T Oil./WaterSeparator: WI Floor Drains: 0- Z Emergency Numbers: cv;11 nas y Storage Areas/7anks: / 0 Sy 1,V&.s+ao 0, 1 A s 6,_; )�j��S�r�I t.,r®,�e �}►,�;��-�S,�� Emergency/Containment Equipment: _-, Ill k-�b d - S afC!d 0CV —cu. Waste Generator ID: t,, )1 0", (V Waste'Product: �; �'rc'�zP— tom!� s�e a;f Date&Amount of Last Shipment/Frequency: M) W Licensed Waste Hauler&Destination: Other Waste Disposal Methods: Was+-e o ; 1 gu,rn A er 4 P q� 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 i "vk) 0 Dry cleaning Jam" 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) T` 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: Sr-[-- 1%40 +fe-t yyouj 8 AJ;C g C)to ORDERS: INFORMATION/RECOMMENDATIONS: )M AyZe }} I Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS I i �IKEroh Town of Barnstable . Office:508-862-4644 ~� Public Health Division Fax:508-790-6304 • BARNSTABLE. ` 200 Main Street• Hyannis, MA 02601 vTOXIC'AND HAZARDOUS MATERIALS INSPECTION REPORT , Business Name: I A .)&,—I'r tF;iA- r.0 Date: ! -5 d - y Location/Mailing Address:,- r � �,'c � Contact Name/Phone:: _ 's'..� �t .�> ._ '7 2q....Sr-?t �A14.2 {Q' C, Inventory Total Amount: MSDS:Li.1l (,�t i License#: Tier II : Labeling:t)f, Spill Plan: J Oil/WaterSeparator: ►VI in Floor Drains: (In. Emergency Numbers: Storage Areas/Tanks: l-.2 Su 11/Q*J,., 4: R..1.. pu` 1 t.�aa 4e !sue Emergency/Containment Equipment:: tl Ir 4 e ,�: .��.� y ��; On" -1—jA Waste Generator ID: t,,--. 1 1 6tg-mYa n/ Waste Product: tNw,a: 47rr.-> -- r_A r c, s�r-6 � Date&Amount of Last Shipment/Frequency: n/) 14 Licensed Waste Hauler&Destination: Other Waste Disposal Methods: (,o64 e o , 1 9, -Cc,— k o 6 It LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, J storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze .5'IV'x C) `'� I wa p}r� 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 L,,"- Motor oils µ 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: • 44,m,e- --- YVo,., V100gT } ao Y ii ORDERS: INFORMATION/RECOMMENDATIONS: vim` 1?4 e�►. h1V �1.( 1� N "?r Inspector: Facility.Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS .„ dF IJ OFFICIALILISE p Certified Mail Fee Ln $ rU Extra Services&Fees icheckbok add fee as ❑Return Receipt(hardcopy) $ a; �0 nj ❑Return Receipt(electronic) $ > Jostrnark rj�'a�lUI ,'�pp L7/ ❑Cert(fled Mail Restricted Delivery nr 1494 r3 []Adult Signature Required $ ❑Adult Signature Restricted Delivery$ .- a::'>. (A) O Postage n t $ Hb'iCE Total Postage and Fees C $ 11' Sent To We , � C3 Stieeip---dapr-riro.:-o--a -- - -- -o �� --- ------ ----- ----------- IFS r----z--- s - r, ,rr Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique Identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the ■A record of delivery(including the recipient's retail associate. signature)that is retained by the Postal Service- Restricted delivery service,which provides , for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent. Important Reminders. Adult signature service,which requires the - ■You may purchase Certified Mail service with signee to be at least 21 years of age(not i First-Class Mails,Rrst-Class Package Service®, available at retail). r1 or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is notavailable for requires the signee to be at least 21 years of age international mail. and provides delivery to the addressee specified, ■Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent 3 with Certified Mail service.However,the purchase (not available at retail). of Certified Ma:s dbes.4 _ ange the ■To ensure that your Certified Mail receipt is insurance cover'ege<$ "viatica y included with accepted as legal proof of malting,it should bear a certain Priority Mail items. USPS postmark.If you would like a postmark on— ■For an additional fee,and with a proper this Certified Mail receipt,please present your Q endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded porfion; of delivery(including the recipient's signature), of this label,affix It to the mallpiece,apply -.1 You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.`ai electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records. Ps Form 3800,April 2015(Reverse)PSN 7630.02-000-9047 • • COMPLETE THIS SECTIW,0NDELIVERY ■ Complete items 1,2,and 3. A. Signature ■ Print your name and address on the reverse -X O Agent so that we can return the card to you. Add ssee ■ Attach this card to the back of the mailpiece, eceived by(Printed Name) i or on the front if space permits. 1. Article Addressed to: D. Is delivery address different from item 1. as ��r y�� If YES,enter delivery address below: No W7 �M— ®use/ 111111111 Jill 111111111111111111111111111111111 3. Service Type ❑Priority Mail Expresso ❑Adult Signature ❑Registered MaiITM ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted -✓Cer�ertified Mail@ 4erchan, tified Mail Restricted Delivery etu9590 9402 5333 9154 1035 66 rnRcelpt for El Collect on Delivery ise ❑Collect on Delivery Restricted Delivery ❑Signature Confirmation �—article_Number_fTransfer_fCom_seruice/abeD red Mail ❑Signature Confirmation 7 019 16 4 :O O 2 5 0 O I{,9:I{Q di-d Mail Rgs(ricto Delivery Restricted Delivery _ r::Va�ar$500) PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt USPS TRACKING# First-Class Mail Postage&Fees Paid USPS Permit No.G-10 9590 9402 5333 9154 1035 66 United States •Sender:Please print your name,address,and ZIP+4®in this box* Postal Service a , C4 ►i��l,falf�„�,� ��I�frlflllli�..,riff►�>>�li.�,�jf�,>>,��,��f _. _.. ___•. - � .Irr✓�.� .r ti .... .. �r., .-Y:.:,.:y-• r.'-^..�...t,n y r3.,,,n.�.-..�r?..y -4fe--+ .- - .r ^. _- . .. .... ,. - _ TOWN OF BARNSTABLE BAR-W 5870 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager 0r01 xl,--N Address of Offender az JLI'il 01M MV/MB Reg.# Village/State/Zip - r,r Cis ,r)'�L at Business Name r,y# ,� A A y a ry 4 VOL I am/�� on 20;6 Business Address S-Mrv\ r Signature/'of)Enforcing Officer Village/State/Zip , Location of Offense ,,•,w Enforcing Dept/Division Offense'_a'A' Facts 11 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.? TOWN OF BARNSTABLE BAR-W 537 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager �, --s IV Address of Offender 4 7 v` 1-h"o A MV/MB Reg.# r Village/State/Zip )60r 1 0-gW r 0) l,c Business Name Wes ? 4,11 A �li ca i f`yt`Ja l am/gyp,� on � + � 20)6 Y Business Address 511 0 ft�-_} . Signature/of Enforcing Officer Village/State/Zip Location of Offense S r)rn ry Enforcing Dept/Division � 3 Offense rfa%Atet G yy�y,, 9 Facts Mrjs r 3 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. Number Fee 1351 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that West End Auto Revival Inc. ..------------------------------------------------------------------------------------------------------------------------------- 27 Betty's Pond Road, Hyannis, 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 4�!r Town of Barnstable Inspectional Services BARNSTABLE WN:TA LE-L4N1 MLI -CMU;,nYANMS Public Health Division ""`� ° °"-.fFn��E 1639-2Q34 D� .nn►vsTnsrc. Y Thomas McKean, Director �' �� 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 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ _CATFGOIR '2 PFRNI:I[T 1-1:1 —499 Gallons:__ $-125-.00 n __ 1 . 5�� _J . - CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ 0104g, *A late charge of$10.00 will be assessed if payment is not received by July 1st. ; t 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? YES_NO. IF YES,SKIP QUESTION 3. 3. FOR ALLNEW PERMIT A—PPLICA T IONS,INDICATE WHETHER BUSINESS HAS ZONINGBUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT:__ 0 is, v I 6. ADDRESS OF ESTABLISHMENT: 51-7 5T I I A,--,% pjmaA - IF DIFFERENT FROM ABOVE: F m 00 0 7. MAILING ADDRESS( q6 � p, 8. TELEPHONE NUMBER OF ESTABLISHMENT: 6 4 I `4. -9. "EMAIL ADDRESS:�`°��c,C' d 1 h C1 �_�.� c� 7- -C - 10. SOLEOWNER: ES_NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION A. PRESIDENT t7 TREASURER = "` CLERK V' . 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE Q:\Application Forms\Haz Mat Appli Draft Jan20l9.docx ;(")(,� ,��-u✓' t . . 0/ Number Fee 1351 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that West End Auto Revival Inc. 27 Betty's Pond Road, Hyannis,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. 12/16/2019 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable UK AA Inspectional Services BARNST LE Public Health Division Y 6 2C71 'q. y MASS Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6 304 CC) V 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 30th). APPLICATION FEES _ CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons:. $125.00 ;X — � CATEGORY 3 PERMIT 500 or more Gallons: $150.00 0pVSotch� *A late charge of$10.00 will be assessed if payment is not received by 1st. 4#, 2_048 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 QUANTITIES (25 GALLONS)?—X YES NO. 4. FULL NAME OF APPLICANT: '00ccram) 5. NAME OF ESTABLISHMENT: UULLt �A_to po,v i-U aj n Ca 6. ADDRESS OF ESTABLISHMENT: X7 Po)r� 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 7 9. EMAIL ADDRESS: 12- 2- 7 /17/9'/2- Cow 10. SOLEOWNER: S_NO IF NO, NAME OF PARTNER: 11. FULL NAME, HOME ADDRESS, AND TELEPHONE # OF: CORPORATION NAME W i✓✓( l�"✓ �e Vr�i/�L mil✓c PRESIDENT fie u TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS �E"MAIL: C *SIGNATURE OF APPLICANT Wl 4' / DATE Z Q:\Application Forms\Haz Mat App Revised 09-10-18.docx Number Fee 1028 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Independent Auto Repair 27 Betty's Pond Rd., Hyannis, 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 ' ow of B 4rnsxable eg atory Services Richard V. Scali,Director Public Health Division WNSTABLE Y ♦ BARNSTMIE•fRllfltVlLLE•NfU1T•HYM'NIS BABNSPABM Thomas McKean,Director i�"0 4WD S' 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 1st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 X VI 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. 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 STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: v5&- V rAz 6, L y&u 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: ` 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: f771- / il 9. EMAIL ADDRESS: u ea[,I )tA b)*6vaL1,oA n ca" 10. SOLEOWNER:_ZYE�S NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT e,D��pp u ATE -VA Q:\Application Forms\HAZMAT APP 2017 REVISED.docx Number Fee 1028 THE COMMONWEALTH OF MASSACHUSETTS $125.0o Town of Barnstable Board of Health This is to Certify that IndependentAuto Repair 27 Betty's Pond Rd., Hyannis, 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 ow of B nstable `h Kegulatorylervices �'WE r Richard V. Scali,Director Public Health Division BA NSTABLE PPRNST:.P 06iLL Mff-ITa.t:IS ~ ; lI.WSiJ'.S HILS•C51:.4VILLF+4lSf P<:NST<P:E BAIMSTABLE. ` Thomas McKean,Director +:839-2014 639. 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 D! Q`�/ Fax08-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZiE HAZARDOUS MATERIALS �i 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 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 - ❑ �-- CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 '� CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? YES_NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS • ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: STCti � LN�I� 5. NAME OF ESTABLISHMENT: CPS 6. ADDRESS OF ESTABLISHMENT: ° � Ly( (ZN� ' kriUAI �66� 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT:. 50$' '7 7/— 9. EMAIL ADDRESS: 10. SOLEOWNER: M.YES_NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE 6 --d,7 7 Q:\Ap,plication Forms\HAZMAT APP 2017 REVISED.docx Number Fee 1028 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Independent Auto Repair 27 Betty's Pond Rd., Hyannis, 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. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health I� • x� t� Town of Barnstable Regulatory Services ti Richard V. Scali, Director B4RMAM NSfABL6 ` Public Health Division BARNSTABLE 163q a""was"oa° Na eCDvrs"eNnme . �fD MA't A 1639-2014 Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-630 -U qp 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 DULY 1 st-NNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ,�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. ASSESSORS MAP AND PARCEL NO. DATE FULL NAME OF APPLICANT: NAME OF ESTABLISHMENT: ADDRESS OF ESTABLISHMENT: 021 Cv � •, , �Z'j IUY�fsr,/ /�, MAILING ADDRESS(IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: EMAIL ADDRESS: SOLE OWNER:.YES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: SIGNATURE OF APPLIC NT Name: Company Address Telephone#: Email: QAApplication Forms\HAZZAPP Rev16.docx Page 1 of 2 i �1 Number Fee 1028 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Independent Auto Repair 27 Betty's Pond Rd., Hyannis, 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 v Town of Barnstable Regulatory Services • °� Richard V. Scab,Director ` Public Health Division Eck` Thomas McKean;Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee:$100.00 ASSESSORS MAP AND PARCEL NO. DATE UNL . APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN . 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT S r4L v C lU CN LYticId NAME OF ESTABLISHMENT Nn CP �vO Cam+ I�Ul D 1ZP�31/� • ADDRESS OF ESTABLISHMENT J1 /0e77-VS P010D F-A, J�XfIvIm614 TELEPHONE NUMBER J 6�- P7 7) - y y SOLE OWNER:DYES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK SIGNATURE OF AP LICANT RESTRICTIONS: HOW ADDRESS LRA'6, HOME TELEPHONE# 5P$- yo C:mhe\Temporary Internet Files\01KD3IHAZAPP Rev2015.DOC w � 1 Town of Barnstable Office: 508-862-4644 Fax: 508-790-6304 .� Regulatory Services Department • ; BA"SrAOLK Public Health Division MASS. Thomas A.McKean,CHO n`$ 200 Main Street, Hyannis, MA 02601 Payment Receipt -Hazardous Materials Payment received: $100.00 (Check) on 6/24/2015 Permit number: 1028 I Check number: 3610 Check amount: $100.00 Name on check: Independent Auto Repair Business: Independent Auto Repair Owner: JACK EDWARD Address: 27 BETTY'S POND ROAD, Hyannis i • • f� Number Fee 1028 THE COMMONWEALTH OF MASSACHUSETTS 100.00 Town of Barnstable Board of Health This is to Certify that Independent Auto Repair 27 Betty's Pond Rd., Hyannis, 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. 6/30/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health Town of Barnstable Regulatory Services ti Richard V. Scali,Director s a BARNS t s 9 MASS. Public Health Division i639• ♦0 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. DATE -1 1 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT `TL` NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT ys TELEPHONE NUMBER 5��- 7�]� - 9 L'39 SOLE OWNER:_L,�QYES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: C> IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK SIGNATURE OF A LICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# SDI= L436-rI p'3) Q:Wpphcation Fonns\HAZAPP.DOC AA) LE aN L f- t4b5092 5'1) ,P LC C7s U/Yi �2S jr�R e Number Fee 400 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that JR Truck & Auto 27 D Bodick Road, Hyannis,MA 02601 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. 9/23/2013 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health 4 , Town of Barnstable - Barnstable Regulatory Services Department -� Public Health Division + BARNSUBLL 9MAM 200 Main Street, Hyannis MA 026011639. m� aru�" 2007 Office: 508-862-4644 Thomas F.Geiler,Director. FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 _ t 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 L p 0 V NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT D f G TELEPHONE NUMBER `� © P-5 -7-7 SOLE OWNER: YES NO t IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALLY" PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION, FULL NAME AND HOME ADDRESS OF: a PRESIDENT TREASURER CLERK J1' SIGNATURE OF A PLICANT RESTRICTIONS: HOME ADDRESS 'L`� /,L/ VL5' IZ4�' HOME TELEPHONE# JAinspection handouts\Haz Mat Application2008.DOC r SPILL CONTINGENCY PLAN .g Emergency Coordinator, Name: ,CO YA LP P,7 �l Address: AyYGs /LP Daytime Phone: -;G 0 --,7`76 -73 4 Evening Phone: Sy!! tA-L-r" Fire Department: /'/ Y1146-VA1 / � Barnstable Public Health Division: 508-862-4644 DEP 24 Hour Spill Hot Line: 888-304-1133 Waste Hauler: Name: Phone: Building diagram indicating hazardous material/waste storage area, location of absorbent scavenger materials, fire extinguishers, fire alarms (if present), and evacuation route (if applicable). F Actions to be taken to control a spill or release, and preventing it from reaching a catch basin, sewer system or the ground. Number Fee 1028 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Independent Auto Repair 27 Betty's Pond Rd., Hyannis,MA 02601 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. 6/30/2013 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health J r Town of Barnstable �fiHE RegulatorY Sery10ES Thomas F. Gefler,DiTudor Public Health Di i ion 16 513. a`� Thous McKean, D'inctor 200 Main Step#, HT=js,M-A 02601 Fes: 50&-790-6304 Ofica: 508462-4644 App1icaIjon Pee: $100-na ASSESSORS KAP AND PA�CML NO, DATE �.PPLI CA'I�O�T FOR PERj)UT TO STORE AND/OR UT + -MORE TF� 111 LIO-tq OF }LkZARDOUS MATERIALS F=NAAR OF APPLICANT .STCIICN C N;AAE OF ESTABT 7SEMKNT ADDRESS OF EST_A3LIS03IVIE21T �--.- TELEPHONE NUYSBER ,S©8' SOLE OwNYR:—X-YES No IF APPLIC ITT IS A PAATN ,y=NAyff AND HoNa ADDRESS OF ALL PARTNERS: Y IF APPIJC A.NT IS A C-ORPOAATI JDZq I�`ICATIO.N NO- STATE OF PI CORPORATION JTLL NANE AND H0Na ADDRESS OF: PRESIDENT E i CLIRR SI(34ATIIRE OF AYFLICA -1 P,ESTRICT10 s: HoAU ADDRESS How TILXPgoNE 9 SC>7 d F_azdc&wT/q I I I r PR C. ©l Day �wS . i Number Fee 1028 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Independent Auto Repair 27 Betty's Pond Rd., Hyannis,MA 02601 NIs 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 6/30/2012 unless sooner suspended or revoked. --------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2011 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health rev Town of Barnstable (,04 d C0IZg j ;c { j 0 °FINE Tq Regulatory Services Thomas F. Geiler,Director MAS& ' Public Health Division 1639.QED MAr A Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-8624644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE �t�l�' gb APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT _5 rg it A,) C, �xNCI� NAME OF ESTABLISHMENT T-/V,0ff 5JQrX1T /9-t/7"O IZEfi IJ ' ADDRESS OF ESTABLISHMENT '] ,�3L� �S �iy� PO,, Y�W TELEPHONE NUMBER S >Tf- r]2 t �l y39 SOLE OWNER:-YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: 9SR C? 0 s � W IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. t si STATE OF INCORPORATION NO FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK �t SIGNATURE OF AP ICANT RESTRICTIONS: HOME ADDRESS 3 Q7'657-VVl L"* C.1* 401 HOME TELEPHONE# ,SaB - 4,3D-1�3l 615 Haz.doc/wp/q I s �� N wA5� SPA t-L-.s, WE f�v� o� e�.EInl5CS -'o l�r� y f, Dl� any A6SLy - PCu rs' /qo 50�-OrNr 3 f Number Fee 1028 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Independent Auto Repair 27 Betty.'s Pond Rd., Hyannis,MA, 02601 Is rHbrdby'Grahted a. License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF,HAZARDOUS MATERIALS. This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2011 unless sooner suspended or revoked. WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2010 JUNICHI SAWAYANAGI „,., _. .. ...:..,.,.....THQMA$A,.MCKEAN,R.S.,CHO Director of Public Health - r Iw^•+ r i 7P N Town of Barnstable °F1HE rotti Regulatory Services Thomas F. Geiler, Director • BARNSTABLE, * - MASS. m Public Health Division 1639.'OTenMay°' Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT -5rL-VeIV Ca Ly,,)Cy NAME OF ESTABLISHMENT rffl)k . ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER ,S©� `7 q Ll V 3'q SOLE OWNER: X-YES NO IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF:ALL ++-r+' PARTNERS: _ C-3 . ... 477 M IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK C. • SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS_ Cl jvVT 1-19IU6 E, HOME TELEPHONE # �p$• y 3� - 183� Haz.doc%%%u'y TO 11191VOLC 8/vY Wi9SS -F -57 /BLS 1JF JgVC DN PR EI?71sES,' l DID ,CRY nL95n &EA;1- pEUcrs a, Re,Sog 13&t T Plus .36 Nt1merR5 FOR �/ Crvst-0 cLQ9,1-w1pZCmau,4L c��ws Number Fee 1028 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Independent Auto Repair 27 Betty's Pond Rd., Hyannis,MA 02601 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 6/30/2010 unless sooner suspended or revoked. ------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2009 JUNICHI SAWAYANAGI THOMAS A. MCKEAN, R.S.,CHO Director of Public Health w l 4 'own ®f Barnstable �I Barnstable Regulatory Services Department � • Public Health Division j i IMAB:E, 9�A 200 Main Street,Hyannis MA 02601 T�Jr1A�a 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT _TAjDEP&)0g 1T7 &W 1?rffig ADDRESS OF ESTABLISHMENT , f y� P&OD & • TELEPHONE NUMBER Sb _ 771 - q Y59 SOLE OYYNER:XYES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: toe"�.. 5..... c c.r Uj "a o ca y IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. a > STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK SIGNATURE OF APPLICANT. • RESTRICTIONS: HOME ADDRESS CkgaE44T 4R K /YN, O pOlf' HOME TELEPHONE# ,57pa- 43p• If 51 Q:\ElazmathHaz Mat Application2008.DOC • of �N`l �PI�S ' DIL, �q5, ��`✓'/�'E�z6, +� ADSaR dcN7' �l�S 1P a� xcE53- 7-5 )qur#oRi� • • Town of Barnstable oF'THE tom, Regulatory Services Barnstable yp� ti� Richard V. Scali,Director Public Health Division .(snFtxsras�, 9 MASS. g Thomas Mclean, Director�'OT 1639. A,� 200 Main Street 2007 fD MAC Hyannis, MA 02601 Office: 508-862-4644 Fax: 50.8-790-6304 CERTIFIED MAIL#7012 1010 0000 2847 8438 Jack Edward Greenslade January 23, 2017 49 Deerbrooke Circle Southington, CT 06489 IMPORTANT NOTICE RE: Map 290 & Parcel 084 According to our records, your property at 27 Betty's Pond Road, Hyannis has a septic system and is not connected to the public sewer system. The property owner was previously notified of the obligation to connect by 10/30/16 (see enclosed copy of letter) and to establish a sewer account with the town. This letter directs you to connect your building located at 27 Betty's Pond Road,Hyannis,MA 02601,to public sewer by July 15,2017. Please note the following permits also need to be in compliance: 1) Septic Abandonment Permits ($ 25) are issued at the Public Health Division, 200 Main Street, Hyannis. The old septic system must be either removed or filled in due to future safety concerns. This may be done by the same contractor who connects you to the sewer. 2) Contractors, approved to perform sewer connection work in the Town of Barnstable must obtain and file a Sewer Connection Permit with DPW-Water Pollution Control Division, 617 Bearse's Way, Hyannis—contractors,please call Dave Anderson at(508) 790-6244. You may request a show cause hearing before the Board of Health. If you would like a hearing, please send a written petition requesting a hearing within seven(7) days of receipt of this letter. If you should have any questions,please call 508-862-4644. Failure to comply with this order will result in a complaint against you, in a court of law, due to your failure to comply with a Board of Health Order. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., C.H.O. . Agent of the Board of Health h _ A IME►oh� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 enRMASS`E. ' 200 Main Street• Hyannis, MA 02601 1639. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: �� 0.� �.,/ Date: 2Z 1 Location/Mailing Address: 2-7 It, o in .1 V1✓l , Contact Name/Phone:�aey, L� _,Loa--7 7 1 - q 9 Cet� �S v8-q,3 Inventory Tot Amount: ^-q3D k J MSDS: b_A I0�t- a t-�SS License#: I o LS La g Tier II : J Labeling: laAI A14A Spill Plan: O-K, Oil/Water Separator: �J IVA Floor Drains: Wo _ Emergency Numbers: e5 Storage Areas/Tanks: 1s6 <, 44,1 W4LXA4V- L �I., �.G•�c„ SS4al �.� Emergency/Containment Equipment: aeV-V,)'w a- Waste Generator ID: JAV b SJ Wastepro6ct: o i 1 Date&Amount of Last Shipment/Frequency: e rWAKt g Licensed Waste Hauler&Destination: Other Waste Disposal Methods: VS to" a 'LZS !� �5 teA AwL<w 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 4 4-S� Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers f�l Hydraulic fluid (including brake fluid) x ' Windshield wash �.P 1L(bo Motor oils' 0 X?-So 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 Z Degreasers for engines&garages Z Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries 4- 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: 1,Ja l- 7<0VVt_- @A l .• , p .. Q oft , �na�Gl Cr�o�S 1JC.S'C �MaV��S fia r�x-ct� cQ�� Inspector: "J-4 el Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Aug^22.2016 02:22 PM independentauto 15087712279 PAGE. 2/ 2 \Jl� ��3y Pfeae6 pdnl tir type• Form dlnlgneAr uA on,ollle 12-pltoh wrfte' UNIFORM HAZARDOUS 1 1'15ondMV IO,Humbor 2,Pogo t of 3,EIt Imer Form Approved.fW No.2050.0030 WA$1t MIINIFES7 r•A a Ar I t I oom RAsporia PhonD 4.Manlfesk T0:15racking Number 6.Genera ors I�me and McUing M drees �. 'E;#4)••A IJ 1 r: V'4:fi',A If GanermiVa SIIeAddrese(a rmrere,d than Mailing address) f f 11 i,.1'li'ilf3 hd�t r.r�;�to) •o OAnaratOt'8 Prone: +' ." .y • ranspederl company a U.9.EPA ID umber Eirf>�('nrr�.�ir�Lr,�tr Fctwi :.,nnrp�tlr;, Ine. ' rdnaporter2 omparlyName I'', " :. ..1 0 0 0 fv4'ff'�r�> :iL:fqu}r_E_a Iidi: 9 U. T91D Numbof a Desl ated Fac '1'll.ulty Ngmd Ske Addroae F,1 r', •,. ;, C1 {i O (;I E3 `; f,j +:j l I'fF°I�t> a anE: U.S.EPA IDNumher i . W. ePhorro:`tilr ftf;ilt I?ftri 9a, Ob.U.S.DOT Dascriptfoa Iinclud)Ap P r S111 n Namo,Hazard Class,tD Number, I HM and Pads Gr p�g io.0ontehtors 11.Taw i2.Unit ng• auP(If ar'Y)) No, Type QM9ty WI.Nal. 13,Waste CodDs � O � Nl i yf]3,l•I,Sy�;::�f_C,+A„i��)l.ii'll fber'r;.i,�r'rr�i '' a— ��,.��`•:1tEI, y.. 1 � •r+.�, �'"'Y'� + uull rrt.r, i� � (h��t'J:titli)f.•C)+11fSJ➢ a aL/) ,y"�y� i 2• 3 � n 4. I 4.&p6da1flan n Inet ••._�_ _._ __ g nrctlonsandAddMonal tarmotion 4 18, GEN®tATOR'SIOFP¢ROR'8 CERTIflOATIDN: I hare by decliero that the tmrdendsaf Ihla conslgnmont are fully.and dowmely CMMM above UiD r shipping name,and are cfdsslaed marked and 1abaloYpit ilAd,and are 1Kall reapecls In Mar condldon for busport arxording to spp oft International and natlmrel govommantat rroula�tlans•ff Axport shlpmont and I am Ih0 Pdmaagryod, Exporigt I ca*that Ihs Contents of mia QonQnmorn cmform to the torma of tho a0ltchad EPA Ao<nod IAdgment of CAnsant I codify(hatthe waste mIMMIzetion statement menihled In 40 CFR 262.27(a)If I am a largo quMUty generator)or(b)(f I am a small quendty ganerator)is truo. Genaratot Iferod's P77,11viciv Name 4` H�lfSfgnaturA A9omh yon 1�e J�47 � .ntameUona menffi ❑ ❑Import to U.S. xfrom U.S. on ofenye s oneraigneture(foroxporfe only): ex:T Data leaving U.S., 17:T—mWorter Admowledgmer2 of%calpt of Malodals TraitRKWtv PrftdHyped 3 gr.eture �/ Mmth Da Year �� p me 9lgnaM Month Day Year 16,Discrepancy 2 1 V i6p,Olaerapancy Irldioallon Spars ❑Qua* ❑ ❑ TYAo ❑RaAldue Partial Re}ocalon ❑FWI RaJecllon iBb,Altemate Fodilly(orGonorelorl Mardfest Rofetenca Number: U,9,EPA ID Number W fadlt�e Phone: 18a natureoiAltemDto Aduty(orGonorator} onlh Day leer 'y 10,Hemrdous Wasto Rapmt Managomant Method Codas p.s,codas for hazardou ts W88tA t eaiment dlsposd,and retyding systems} � 11)•i l 2' 9, 4, 20.Destgnatod Fadllty Owner or Operator.coafttlon of roWpt of hazardous matelots cDwtrAd by N manifest except 68 notod In item too am 11 a'K✓ �" Igna uro Dnl EPA Forrtt aT-00.22(Rev,3-05) previous editions are obsolete. A r DESIGNATED FAMUTYTo GENERATOR Aug.22.2016 02:22 PM independentauto 15087712279 PAGE. 1J 2 7 lhoT YZ5�a ENVIRONMENTAL ENVIRONMENTAL, � s��EEZE WASTE OIL PICKUP ANTI rt.Exr;PIOKUR �� WRIGHT SLVENTER THINN UP SOLVENT•THINNER PICKUP TANKS CLEANEb TANK REMOVAL MDC VVATEk TRAP 781-293-4291 • Fax: 508-4�19-1669 ASOUNE&OIL urRAP CLEANOUr 24-Hr Emergency Service DOT DRUMSDELIVEkED 508-685-0871 DOT DRUMS CLEANED REMoveb SLJJDOt R[MoVED a°" W TER SEPARNroR Date r�MPso Name Address Bill of Lading/Pickup Receipt Telephon Cash O Check❑ BIII Ell Quantity DZ&A escription Total id �tl ROX Customer Signature Driver Signature *��dire U#on f ndtii na einr Ce :riles p�evgly°: r�ri4 :: y°F� towti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMABLE,$' 200 Main Street• Hyannis, MA 02601 p'EDMP�p`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: t (a Q 6C I{ Date: 1 ►z ►S' Location/Mailing Address: 2 � Pemt M klyaN j Contact Name/Phone: c. S" s 7-7 LN31 Callv -V3 -I 3 Inventory Total Amount: 1 MSDS: 0V',)�V-(,a4CZ1517 License#: 10 �atiti� Tier I[ : NJ o Labeling: 4K Spill Plan: ak4-vK4,A— Oil/Water Separator: FloorD rains: 1J o Emergency Numbers: °Yt I Storage Areas/Tanks: 2<0 01 A 07,1 �'[ avt�� Emergency/Containment Eq ipment: y+ 5 , o Waste Generator ID: J 5 71 Waste Product: dt av��.�C�e��s v►f,5��r1��S Date&Amount of Last Shipment/Frequency: D Ot 0,A S 61vtc4- vA �ri�4- 10 q C, ti I X V f Licensed Waste Hauler&Destination: Other Waste Disposal Methods: wot,4-- 01 k I01AI(AA-I. ova 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 1111 gallons or more requires a license from the Public Health Division. _ ti� Antifreeze-1( 5 Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers to Hydraulic fluid (including brake fluid)6 2� Windshield wash z.S Motor oils 2ft a-6o 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 It' 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 y Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes lie ol�"At`,e-k-) Miscellaneous Flammables Fertilizers �bsa�`l 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: V'�.t& o-e Lea S Ivt, v!il „- o Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS °Fn�rows Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARN `)M $ 200 Main Street• Hyannis, MA 02601 ,b„ e,0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT . rF0 MA'S Business Name: ,v,-AvA- PtQ�-o Re a,l Date: Location/Mailing Address: uz4e.VIA,S Contact Name/Phone: 6+2y2. Inventory Total Amount: MSDS: lf,5 License#: �y�g Tier II : Of) Labelina: oo Spill Plan: eK.�•k4- Oil/WaterSeparator: ►31A Floor Drains: 00 Emergency Numbers: e-S Storage Areas/Tanks: G-jtk luc,4& o�n 9 .l1 le -,as �a►.�.�c�e�� Emergency/Containment Equipment: a a,\ b\-t, Waste Generator ID: V Q 3 Waste roduct: kAr,Qce.e-ye-,i-AMx)(yQgj X6 Date&Amount of Last Shipment/Frequency: 2-5 I cal Licensed Waste Hauler&Destination: Av,\44 Wz k va v< '5 1 Q �N(�- Other Waste Disposal Methods: 0k�-P- o,\ )6\J v,. S -k&e— LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, 12(,I i3 storage and disposal of 111 gallons or more requires a license from the Public Health Division. ✓ Antifreeze-► sS,.x,eaL 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 -r zTo o4kskA, 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 Date: /.4/ // //3 TOWN OF BARNSTABLE � TOXIC AND HAZARDOUS -- MATERIALS R FORM NAME OF BUSINESS: :1::� vt� 4 A-,+D BUSINESS LOCATION: 2:7 ong 1 4vtvx,3 INVENTORY MAILING ADDRESS: _5,., TOTAL AMOUNT: TELEPHONE NUMBER: ,So 8 - 7-71 - t4q 3 9 o7 t//0 c s CONTACT PERSON: vtcG __ EMERGENCY CONTACT TELEPH NE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: -CC 41'r ffoykaz ✓L2.eX �'o c INFORMATION / RECOMMENDA IONS: ')::[ jAxh4z1 y/�dj rw t,v�o l u�� Fir Di trict: S �1 I5 (A- l oo ms 4 6 ae -,,-A� A.b5o rbe.K-5 ,I -Y a 1 ^ (� 4 Y1 I S a s 3) 11 6 "w 11 ovi- o,/V L4a OOA441VLV.Slsi, y) a kit s a l4 ,�. S),6e W(e_ a*46 �,ve to kW, �oor Vt., v Csevacor�D -t'® re �atvc�t',o,tid� rer}� Waste Tr on: 1 yy3� Last shipmbnt of hazardo s waste: la S I - / Name of Hauler: AAA.,& Destination: Waste Product: t i "czc w�1v s LicensedZge ot #1410610- 880a5— 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 a month requires 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. Observed / Maximum Observed / Maximum eeze (for ga line or coolant systems) Miscellaneous Corrosive Ant' 0 USED•S5' Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) �., Hydraulic fluid (including brake fluid) Refrigerants Z� Motor Oils Pesticides (insecticides, herbicides, rodenticides) 9NEW W C�USED ZSD j 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 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) 3 Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes kkly, L5 l sizce� ,,ti iQII ovL AS-r Laundry soil &stain removers (including bleach) 15 borvt J oyi-6 +P- ►yL;S�iGe �6i�e{— Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents _ Bug and tar removers W I'�, &A-Ai5 ti(e_ Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials TOWN OE BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRRATION a�� v OWNER AND INSTALLER INFORMATION � 7 ADDRESS: 4-4- �e`T'1'5 4© /J t7 t n� )AIZ MAP NO. 2 - 9 0 PARCEL NO.�� OWNER NAME: '7 '`-, �-! t �= i +:` i 1 UVILLAGE: � - !1 1 INSTALLATIO DATE: BY: ADDRESS: J ��'��0 -.) r� j CERT. NO. fir' q 1--- . W A-) �/ i ��" NTANIC~IyNFORMAT N Fl4v �: a ♦ % n LOCATION OF TANK: �I �i'.i'�1 . CAPACITY t ---�TyPE _f AGE j.k/f ,FUEL/CHEMICAL _ TESTING CERTIFICATION E I PASS E I FAIL DATE LEAK DETECTION E 7 IdECK IF /A TYPE/BRAND a � / >i /A ZONE OF CONTRIBUTION E ] YES E 7 NO DATE TO"BE REMOVED FIRE DEPT. PERMIT ISSUED E ] YES E 7 NO DATE ,i LUNSERVATION E ] CHECK IF N/A DATE BOARD OF HEALTH TAG NO. G 1 E 6 ]E5- ]E 7 J DATE 712 ?/9F PLEASE PROVIDE A SKETC WING THE TANK LOCATION ON THE BACK OF THIS CARD In CAN/J&rCT :k- - A 1z T® p y7FAC FIRE DEPT. STATE USE ONLY 111E icTTwa Copy to be certified by loca -bTent I.D.Number = O I q ZZ_ and; POSTED AT STORAGE Date Received 'r1Z9 . x Notification is required by Federal law for all underground tanks that have been 4. pipeline facilities (including gathering lines) regulated under the Natural Gas used to store regulated substances since January 1,1974,that are in the ground as of Pipeline Safety Act of 1968.or the Hazardous Liquid Pipeline Safety Act of 1979.or May 8,1986,or that are brought into use after May 8,1986.The information requested which is an inUastatc pipeline lacility regulated under State lass: is required by Section 9002 of the Resource Conservation and Recovery Act,(RCRA), 5.surface impoundments.pits,ponds,or lagoons: as amended. 6.storm,Rater or waste tinter collection systems; The primary purpose of this notification program is ut locate and evaluate under- 7.11oµ'-through process tanks; ground tanks that :store or have stored petroleum or hazardous substances. It is 8.liquid traps orassociated gathering linesdiicctl\related to oil orgas production and expected that the information you provide will be based on reasonably available gathering operations: records.or.in the absence of such records,your knouicdge,belief,or recollection. 9. storage tanks situated in an underground area (such as a basement. cellar. mmcwoiking.drill,shaft,or tunnel)it the storage tank is situated upon or aboyc the Who Must Notify? Section 9002 of RCRA, as amended, requires that, unless surface of the Iloor. exempted,owners of underground tanks that store regulated substances must notify designated State or local agencies of the existence of their tanks. Owner means-- What Substances Are Covered? l he notification requirements apply to under- (a) in the case of an underground storage tank in use on November 8. 1984,or ground storage tanks that contain regulated substances.1 his includes am substance brought into use after that date.any person who owns an underground storage tank defined as hazardous in section 101 114) of the Comprehensive Environmental used for the storage,use,or dispensing of regulated substances,and Response.Compensation and Liability Act of 1980(CERCLA).Aith theexccptionof (b) in the case of any underground storage tank in use before Notrmher 8, 1984. those substances regulated as hazardous Aasic under Subtitle C of RCRA. It also but no longer in use on that daie.any person who owned such tank immediately before includes petroleum.e.g.,crude oil or any fraction thereof which is liquid at standard the discontinuation of its use. conditions of'temperature and Pressure(60 degrees Fahrenheit and 14.7 pounds per What Tanks Are Included? Underground storage tank is defined as any one or square inch absolute). combination of tanks that(1)is used to contain an accumulation of"regulated sub- Where To.Notify? Completed notification forms should be sent to the address stances."and(2)whose volume(including connected underground piping)is IOCi or given at the top of this page. more beneath the ground.Some examplesare underground tanks storing:Lgasoline. used oil,or diesel fuel,and 2.industrial solycnts.pesticides.herbicides or fumigants. When To Notify? I. allCl J of underground storage tanks in use , that hate been What Tanks Are Excluded? Tanks remoscd Irom the ground are not subject to token out of o.0,Ane after.Ianuars 1. r974,but still in the ground,must notify b. notification.Other tanks excluded from noti6c:tion are: Mas 8. 1986.2.Owners tcho bring underground storage tanks into use after May 8, 1.farm or residential tanks of 1.100 gallons or less capacit\used forstoring rnotur fuel 1986,must motif\'u ithin 30 da)s o1 bringing the tanks into use. for noncommercial purposes: Penalties: Any owner who knowingly fails to notify or submits false information 2.tanks used lorsto.ing heating oil for consumptive use on the premises\+here stored: shall be subject to a civil penalty not to exceed $10,000 for each tank for which 1 septic tanks: notification is not given or for which false information is submitted. • Please type or print in ink all items except"signature"in Section V.This form must by completed for Indicate number of each location containing underground storage tanks.II'more than 5 tanks are owned at this location, continuation sheets photocopy the reverse side,and staple continuation sheets to this form. I ,_ _ _ attached Owner Name(Corporation,Individual,Public Agency,or Other Entity) (If same as Section 1,mark box here,) ,Jon SU I ueraip ir- Facility Name or Company Site Identifier,as applicable Street Address IN �et�u3 fond County Street Address or State Road,as applicable �r-r1�Iable M Its C „nl City State ZIP Code County HC4-_)nni5 Area Codd Phone Number City(nearest) State ZIP Code 50S -I-7 5- tZ3 Type of Owner (Mark all that apply®) ❑ Current ❑ State or Local Gov't ® Private or Indicate Mark box here if tank(s) Corporate number of are located on land within ❑ ❑ Former ❑ Federal Gov't Ownership tanks at this an Indian reservation or (GSA facility I.D.no. uncertain location on other Indian trust lands Ill • • • • Name(If same as Section I,mark box here 21) Job Title Area Code Phone Number IV;TYPE OF • • 64 ❑ Mark box here only if this is an amended or subsequent notification for this location. 44 • I certify under penalty of law that I have personally examined and am familiar with the information submitted in this and all attached documents,and that based on my inquiry of those individuals immediately responsible for obtaining the information, I believe that the submitted information is true,accurate,and complete. Name and official title of owner or owner's authorized representative Sign ure Date Sign d e 2/VERSE SIDE Form F.P. 290 Part 3 Pagel i4 Owner Name(from Section 1)_ Location(from Section II) Page No. - of. Pager, Tank Identification No.(e.g.,ABC-123),or Tank No. Tank No. Tank No. Tank No. Tank No. Arbitrarily Assigned Sequential Number(e.g.,1,2,3...) I 1.Status ofTank Currently in Use 0 (Mark allll that apply®) Temporarily Out of Use [_] Permanently Out of Use 0 0 Brought into Use after 5/8/86 0 2.Estimated Age(Years) UnEown 3.Estimated Total Capacity(Gallons) 4.Material of Construction Steel (Mark one®) Concrete [� 0 Fiberglass Reinforced Plastic Unknown 0 Q Other,Please Specify 5.Internal Protection Cathodic Protection (Mark all that apply m) Interior Lining(e.g.,epoxy resins) None Unknown Other,Please Specify 6.External Protection(Mark all that apply m) Cathodic Protection0 0 Painted(e.g.,asphaltic) Fiberglass Reinforced Plastic Coated 0 1 None Unknown 0 Other,Please Specify 7.Piping Bare Steel (Mark all that apply®) Galvanized Steel 0 Fiberglass Reinforced Plastic 0 0 0 Cathodically Protected C] 0 Unknown 0 0 0 Other,Please Specify 8.Substance Currently or Last Stored a. Empty 0 0 0 in Greatest Quantity by Volume b. Petroleum (Mark all that apply m) Diesel [� Kerosene �] Gasoline(including alcohol blends) 0 0 Used Oil 0 0 0 Other,Please Specify Utz�OI c. Hazardous Substance 0 Please Indicate Name of Principal CERCLA Substance OR Chemical Abstract Service(CAS) No. Mark box®if tank stores a mixture of substances 0 0 d. Unknown' �— 0 9.Additional Information(for tanks permanently taken out of service) a. Estimated date last used (mo/yr) b. Estimated quantity of substance remaining (gal.) c. Mark box M if tank was filled with inert material (e.g.,sand,concrete) Page 2 tME Tok� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARNMASS. ' 200 Main Street• Hyannis, MA 02601 1639.p'FD Ma+"�0� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT G� r3 f Business Name: of �� /a�/� Date: Location/Mailing Address: 6,'7 ovt Contact Name/Phone: �D� 7 (o82D =� t S s.�-, So8-360 --SoR Invento Tot A nt: SDS: License#: Tier II : Labeling: Spill Plan: Oil/WaterSeparator: Floor Drains: Emergency Numbers: Storage Areas/Tanks: Emergency/Containment Equipment: 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 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: L 1 v t VU W A-te q,-k kw S l w�" 4 ►ti, �� 0<` )�-A .e. m,r ORDE S: a, -t a v _v�, A e INFORMATION/RECOMMENDA ONS: l 1 ooI-t-oQ o w inspeLtoorr: �J ^I- �o r� ✓� �'e a� p W- ow► . ,<` t, Vxe v Lf- '00- . Facility RepYeserltative✓ -r WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS INE)°yam ;y Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 9 BARMASS. 200 Main Street• Hyannis, MA 02601 t639 M TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rFD AC Business Name:, `��",I f}f (-^�ti� ., Date: Location/Mailing Address: r -V Cont-act Name/Phone:. 7r Inventory Total Amount: SDS: License#: Tier II : Labeling: Spill Plan: Oil/WaterSeparator: Floor Drains: Emergency Numbers: Storage Areas/Tanks: Emergency/Containment Equipment: Waste Generator ID: %A Waste Product: Date&Amount of Last Shipment/Frequenc 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 licensWfrom the Public H ealthsDivisi%p. r' Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes I Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash ' Motor oils '-` Miscellaneous Corrosives . . i Gasolinejet 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, f hydrochloric acid, other acids) VIOLATIONS: .!l 5�vf�a C, f u 1.?a f c '�Lt S P�lee�Q t ►�"� '.�J�t� �wL-e_iti�' 0<,4)t^a1/ ale" r/•,c ORDERS: 1 KA- n, ` �t Ia ern l r, -{ C 6 V� yx— 19, h 1 ( . A s� LA D� I t� 0 TGi Vj� -6ae-.0_ t K- INFORMATION/RECOMMENDA+T_IO}NS: 5t? 1 a (, , .5 a 4-�1 wl,/r o��sv;-A r pV-e-ac - e> �L a ),C i .� 1�. I;\lr7 wne Ir)C. ) V1Dl Y, X c7 F t C'( �'0 K V 0 (i CJW( TI oe V V - �vLst� ©r Plu-6t'`! " -lei rlJUV d<< Yf.. V)a-+,e--',it Y\-f �� "tL� � �®Y �J ✓j0 ��G-f o� f Inspector: ©► ( - �tseuse. 0Cro �cj �}� ��J�s., c� li � coip. vt,`/,r. vi 9 w Facility Representative.:/ F WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS �a� �Q�o ao�- �� 90 - oR3 -ee� aD �d�� l POn��E � ConfDo ��NE�s co VIC C) Asf 290 C.)9 20E 19643 3 C,OL-BY, FRANCES G oo BE TYS POND FAD t.Jt-,I'[T' IE 1-1 Y HYANNIS MA o2,.':.ol. B BETTYS POND Rai HYON 0410 58-BOO 1008 1 00 UNIT :LE 00 J. ME • C 054 1 -,88 33A.0/196 COLBY, FRANCES G o J. A. 121 BETTY-'POND ROAD PAR C> 1T)A9-Xe1e 5 co vE co AI-00s 290 0 `01-1 -)646 0 RI( CIARDELL.1 , RAI-PH A 0C) 24 BETTYS POND RD FI y HYANNIS MA 12 0 1 8 241-1 BE-r*-rYS POND RD HYAN 0410 6200o I C) 4 0o UNIT 11-1 . 00 4:30J./ 1. 1 Oo 184 2 I ME c 1.087 0513,88 091 ls�::l 430 1 109 RICCIARDELLI , RALPH A 10:-.4 24 1 i BETTVPOND ROAD PAR 1.L VANCE, MARY JEAN oo .30 W MAIN EST #12 11 Y HYANNIS MA C-)2601 24 BETTYS POND RD HY BLDG 0100 00 UNIT 12 • 5:37 6 340 10 0 6 1 0 2 ML C J. 187 051388 07:2287 5-,'7 6, 4 C) VANCE, MARY JEAN 1086 24 121. BETTY"POND ROAD PAR I 251 i. r �. . `'�� r �� i i ., • • rV YY1V OI B/�1 1N.S`1'/�1L�L L3a 2. Printerstisfactory d ' 4 nuto Body Slops BOAR satisfQctory- 4. Manufacturers "Orders") S. Retail Stores • see Orders ) COMPANY _ ( 6. Fuel Suppliers 7 Miscellaneous ADDRESS �t Class: • �J QUANl'ITIES AND._STORAGE (IN=indoors; OUT=outdoor s , P`', ':` r� ' �� Case lots Drums AbdveTanks Undetground Tanks ' OR MATERIALS R fi gallons e MAJ IN r Fuels: ! Gasoline, Jet Fuel (A) Diesel, Kerdsene, fZ (B) Heavy Oils: waste motor oil (C) ' new motor oil transmission/hydraulic Synthetic Organics: ; •. degreasers t . t -- Miscellaneou k :. DISPUSA CEARMUN REM IKS: 1. Sanitary Sewage 2. Water Supply 10 Town Sewer Public - �� O On-site 0 Privy y °k 3. Indoor Floor Drains: YES i NO Holding tank: MDC - s Catch basin/Dry well RDE - y on-site system A. Outdoor Surface drains# ,NO,�,. � ' NuldinL• tank: MOC 1Z , ) t1 0 Catch basin/Dry well QOn-site system _._.. .• Licensed? S. Waste Transporter s t a yFrcrduct_ ' Name gf-flauler- 1 h `. e n ) Ant.ery ewe Inspector Date 12 't1 1