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IHE►o Town of Barnstable Office:508-862-4644
Public Health Division Fax:508-790-6304
C: BARMASSRLE.g` 200 Main Street• Hyannis, MA 02601
t639 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT
QED MA'S /
Business Name: W%11 ew`1 re.P-- MoL r�cc,± Date:
Location/Mailing Address: 1 S ka,r IZ ,cr
Contact Name/Phone: Sa..•ee-a2 CkA,,G , SD -7170 -11-7'7
Inventory Total Amount: MSDS: -,(A-,,\ only License#: ►J I�
Tier II : o Labeling: ct;ka,1 Spill Plan:
Oil/Water Separator: fJ Pk Floor Drains: f�n Emergency Numbers:
Storage Areas/Tanks: " �a� sw40-A„---�rs
Emergency/Containment E ui m nt:
Waste Generator ID: to Waste Product: lA
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 V Other cleaning solvents&spot removers
Engine and radiator flushes Bug and tar removers
Hydraulic fluid (including brake fluid) �— Windshield wash
Motor oils Miscellaneous Corrosives
Gasoline,jet fuel, aviation gas Cesspool cleaners
Diesel fuel, kerosene, #2 heating oil Disinfectants
Miscellaneous petroleum products: Road salts
grease, lubricants, gear oil Refrigerants
Degreasers for engines&garages Pesticides:
Caulk/Grout insecticides, herbicides, rodenticides
Battery acid (electrolyte)/batteries Photochemicals(Fixers)
Rustproofers Photochemicals(Developer)
Car wash detergents Printing ink
Car waxes and polishes Wood preservatives(creosote)
Asphalt&roofing tar Swimming pool chlorine
Paints, varnishes, stains, dyes Lye or caustic soda
Lacquer thinners Miscellaneous Combustible
Paint&varnish removers, deglossers Leather dyes
Miscellaneous Flammables Fertilizers
Floor&furniture strippers PCB's
Metal polishes Other chlorinated hydrocarbons
Laundry soil &stain removers (including carbon tetrachloride)
(including bleach) Any other products with "poison labels"
(including chloroform, formaldehyde,
hydrochloric acid, other acids)
VIOLATIONS:
ORDERS:
INFORMATION) RECOMMENDATIONS: 4o
Inspector: 'I •
Facility Representative:
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS
°Fig roh Town of Barnstable Office:508-862-4644
� ME, Public Health Division Fax:508-790-6304
• BARAq .g! 200 Main Street• Hyannis, MA 02601
s659. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT
RFD MAC s
Business Name: 011°�_� - IM,,�,}' Date: $ 22 t 6
Location/Mailing Address: 1 S C-LAAes S+ i t+y4V%h I S
Contact Name/Phone: �� c rtA ,Pr, .5—,pS '19 D t ►'n"7
Inventory Total Amount: 4 MSDS: 011L I - ace,,e`' License#:j
Tier II : 00 Labeling: Spill Plan: It
Oil/WaterSeDarator: Floor Drains: NJ o Emergency Numbers: o
Storage Areas/Tanks: VA-ax
Emergency/Containment Equipment.
Waste Generator ID: 01A Waste Product:
Date&Amount of Last Ship ent/FrequencX:
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 S
Engine and radiator flushes Bug and tar removers
Hydraulic fluid (including brake fluid) Windshield wash %o
eb Motor oils ''j 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 l lkq�kZV, Fertilizers
Floor&furniture strippers PCB's
Metal polishes Other chlorinated hydrocarbons
Laundry soil &stain removers 5 i-A (including carbon tetrachloride)
(including bleach)1. b� Any other products with "poison labels"
(including chloroform,formaldehyde,
hydrochloric acid, other acids)
VIOLATIONS:
ORDERS:
INFORMATION/RECOMMENDATIONS: a A.e k fie, �� �' �5 ►'k�-
Inspector: ' ` )_A t )e—
Facility Representative:
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
`{ /
TOWN OF BARNSTABLE , Date: 28/ I 4
NOV-
TOXIC AND HAZARDOUS MATERIALS FORM
NAME OF BUSINESS:
BUSINESS LOCATION: tS C-kyles Sa-� I�.lav`K�y INVENTORY
MAILING ADDRESS: TOTAL AMOUNT:
TELEPHONE NUMBER: I ly1
CONTACT PERSON: �aLe-A r�L, Jr;
EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE?
TYPE OF BUSINESS: c4.'rw.\
INFORMATION / RECOMMENDATIONS: t�o Fi[e District:
Waste Transportation: Last shipment of hazardous waste:
Name of Hauler: Destination:
Waste Product: Licensed? Yes No
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
freeze (for gasoline or coolant systems) I Miscellaneous Corrosive
An
EW ❑ USED Cesspool cleaners
Automatic transmission fluid S Disinfectants
Engine and radiator flushes Road salts (Halite)
Hydraulic fluid (including brake fluid) Refrigerants
Motor Oils Pesticides
Q NEW ❑ USED I (insecticides, herbicides, rodenticides)
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)
Miscellaneous. Flammables I Other products not listed which you feel
Floor&furniture strippers may be toxic or hazardous (please list):
Metal polishes
M Laundry soil &stain removers
(including bleach)
Spot removers&cleaning fluids
(dry cleaners)
Other cleaning solvents
Bug and tar removers
to Windshield wash t O 1
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials I