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HomeMy WebLinkAbout0020 CHARLES STREET - HAZMAT 20 C°Kc.cvieB oF�He row Town of Barnstable Office:508-862-4644 ~� Public Health Division Fax:508-790-6304 BARMSATQq 9` 200 Main Street• Hyannis, MA 02601 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: j. �u c�w Date: cp -a -� 0 Location/Mailing Address: f -Qo o Contact Name/Phone: 1 ONE, L&C-4- �3s7—e't a 9'I ._j�c� Inventory Total Amount: I b o&0 A MSDS: License#: 1 ) � l°Y T� Tier II : dill A Labelina: ac`n` Spill Plan: ✓c S Oil/WaterSeparator: Floor Drains: NYC) Emergency Numbers: Storage Areas/7anks: 40; Pz a ds ) S�CM low W1o4+C- i--,SM r:J Leak, Emergency/Containment Equipment: Waste Generator ID: M V S"S?-- 24r) Waste Product: &oo%;A -1 N-n;t,e r- Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: j V-q 1,6;& C-S n�eP A-A 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, deglossersg�9-96 Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers "�r� 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: ' taS e {��`�r YYI•/� �p a N�Q -2. W&aA-r P�t�—r i'1 q .me �Y1S �1,r-co s� �,c=Drp t a.- t• 10-e wc!.-rc ORDERS: . rw '\ _..� INFORMATION/RECOMMENDATIONS:SPr Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS I �ow� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARNSTABLE. MASS. g, 200 Main Street• Hyannis, MA 02601 �prE0�'AA+N TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT 'Business Name: 0 VJ � ( Date: 009 Location/Mailing Address: d S Contact Name/Phone: _q I O / Inventory Total Amount: �� SQS: s ✓ License#: 6*1 Tier II : Labelino: S Spill Plan: `�%at) Oil/WaterSeparator: Floor Drains: Emergency Numbers: __ - Storage Areas/Tanks: Emer enc /Containment E ui ment: Waste Generator ID: V�°I'rj 7 911-W] Waste Product: �� Date&Amount of Last Shi ment/Fre uenc Licensed Waste Hauler&Destination: Other Waste Disposal Methods: Si 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: Gaulk/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�q Leather dyes Miscellaneous Flammables +3a Fertilizers Floor&furniture strippers PCB's Metal polishes TIC Other chlorinated hydrocarbons Laundry soil &stain removers +cib (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: C 2-6' I 1 Inspector: 4&� Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS 3. IKE►oy� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BAHMARR �. 200 Main Street• Hyannis, MA 02601 ArEDMP+p`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: �" �e WDo�e.�C�,►•% Date: Location/Mailing Address: !3S a<-145+CA0 - 2 fl.e 4tint1S Contact Name/Phone: I nb„ Lea.N SDS �-� 7-2-Z91 LLvke EMI 4V r,A41, Inventory Total mount: SDS: VP,S- 0141%v-AU-e55 License#: W2- Tier II :AD I Labeling: Smell Plan: qes — Oil/Water Separator: Floor Drains: A 0 Emergency Numbers: `�eg Storage Areas/Tanks: Emer enc /Containment E ui ment: 01A41 6 *A*A*-<% A OK. SL k-c,. Waste Generator ID: Mv 1 Waste Product: 7 / Date&Amount of Last Shipment/Frequency: y ( 1 O ( ^- I Licensed Waste Hauler&Destination: taw b a r S •k . -I 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 1�tl &<,o/0,6t kt, t tes S� 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 �Z�3'ts Swimming pool chlorine Paints, varnishes, stains, dyes l Lye or caustic soda — Lacquer thinners t5*5S x6�d��Jw 4-o 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" "exl -r4AV-vv ''1 (including chloroform, formaldehyde, 1 ku kd VA, hydrochloric acid, other acids) VIOLATIONS: ORDERS k to, 5,*,AUZk A&r&kP;,r,%0 ^c 2V�jg Go IN ORMATION/RE MMENDATIONS: 0. t -2 a S {m+gL11e 11 Inspector: L k`L Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS °FIKE►o Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMASS. .$ 200 Main Street• Hyannis, MA 02601 ,b,q TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT QED MP'�A Business Name: I c 6 LeAry t1we. 1AJ,, -rUo-rk Date: Location/Mailing Addr ss: I ,lt `F b C Gg n Contact Name/Phone:���ea.,iU5-OA-9Sf7 -228 1 L, 5LOA 5�"p C- Inventory Total mount: "' I''�o I SDS: Yf,% " �"'�1 �e55 License#: Tier[I : N a Labelin : OK Spill Plan: /45 Oil/WaterSeparator: Floor Drains: 0 Emergency Numbers: StorageAreas/Tanks: T �c� - a� vJPAkc. Emergency/Containment Equipment: 0\0 atw -�ex, k Arm Waste Generator ID: \J�o q 15-1 2 =% i Waste Product: �� �Wt•tiv�e� Date&Amount of Last Shipment/Frequency: i-,49:e-CA \Sk 0t M\)b kw /- 1 Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS O v�A-k,0-1 L 5 \W t1n l 5 t I,fe 5� NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material/use, n 5 uJr,°w 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 f Pesticides: V Caulk/Grout f�dd� ',i1 s 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 1/ Miscellaneous Combustible VPaint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Rde-4-10 15 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" E f-'<7 J`e$I%A-- y A,I (including chloroform, formaldehyde, CIO vv-�vN hydrochloric acid, other acids) VIOLATIONS: ORDERS: Gk 504 V%< k, (mil.P, kD V- W,�� INFORMATION/RECOMMENDATIONS: Inspector: j Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Page 1 of 1 Lavelle, Timothy From: Siderwicz, John (DEP) Uohn.siderwicz@state.ma.us] y/z�. 4),t*_-5� pl,,,-„�,&} Sent: Thursday, April 06, 2017 11:31 AM m�ara2t,,>Y_ — hm VLSI/I,C. To: toby@tobyleary.com; luke@tobyleary.com V-S _ PAr5 Cc: Lavelle, Timothy ✓foiz �{-- f%�JD4 Subject: Inspection/Spray Boothwe— Good Morning Toby and Luke, Thank you for your time yesterday. As discussed during the inspection,there were multiple violations of our°Air Pollution Control Regulations concerning the spray booth at your Toby Leary facility. I have attached a copy of the plan approval (permit) exemption regulation for paint spray booths (310 CMR 7.03(16)). To avoid the requirement to obtain a plan approval for the operation of your spray booth,you must meet the performance requirements in 7.03(16). I made an observation yesterday prior to the start of the inspection of a cloud of overspray exiting a louvered horizontal exhaust on the west end of the building. That observation clearly identifies that the exhaust is not vertical as required and the filters are not working. During the inspection, it was revealed that the spray gun used was not HVLP. I have yet to finish my review of the coatings for compliance with the VOC limitation but I have attached for you a copy of the coating limitation regulation (310 CMR 7.18(23)). These observations constitute violations with the Massachusetts Air Pollution Control Regulations. This leads me to a quick overview of our enforcement program. MassDEP's environmental regulations have three (3) tiers: Class I (Hi-Level), Class II (Low-Level) and Class III (Low-level). Class I•violations are the more egregious and typically carry a penalty. These are carried out by an Administrative Consent Order(with Penalty) or"ACOP". The ACOP would identify the violation as well as a negotiated timeline for action to come back into compliance. Both parties agree and sign the document. Class II and Class III violations are minor in nature and are enforced through a Notice of Noncompliance or"NON". NON's carry no penalty but they work the same way as an ACOP whereas they identify a violation and a timeline for an action to come back into compliance. The spray booth violations identified above are Class II violations and would be handled through a NON. And Luke, as far as a NAICS number goes, I would use 238130 for Carpenter, Cabinets and 321918 for Wood Products, Millwork. I will have to get back to you on the record keeping form and Coating VOC calculation. If you have any questions or comments, please do not hesitate to call or email me. Regards,Jack n qJ11 Jack Siderwicz �--�.�.n/ �t� a� af� ,o-,- ��n�)y .Compliance & Enforcement Isu-< V14D� +�c5 Oxvi�.�vfv� �xho�� Mass-DEP Southeast RegionjJ Phone: (508) 946-2761 `jA .,J oe'r1/ Fax: (508) 946-2865 , -- Jer K- Iavt. i 5 �0 1to5��11 v�t..� v�.r--,cal J,P-w� 5 S+z•e`v_ �Az-S L VI J� ct,� S�e a,U�•y 4/6/2017 / 1 °r�►�*o,�� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARNST 200 Main Street• Hyannis, MA 02601 �prFpMA TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: —To- �'J --{dam r`fie- v ► Date: Location/Mailing Address: Contact Name/Phone: `col, 1Jvw,ry ,�0 8-���-22 S l S�,mo g L y 1 t-� C� r E► �cs x�o Inventory Total Amount: ^' I�Q` MSDS: Ye,-;, License#:—T3> Tier II : Mwk Labeling: 44,9f-to 14 -N Spill Plan: +o �S'r Oil/WaterSeparator: Floor Drains: No Emergency Numbers: Storage Areas/Tanks: 5 AaI d�� �� wa5i:e,AaiKA/-14%%-Awe.�� v4cW5 �P 6-*- I �)- I & J .y� S 5•�1 0(-(�5'� Emergency/Containment Equipment: SDC�/�9oa`� �l bus x, �, „ . oplut=-1 I S Waste Generator ID: 4-0 V?.S�'E' Waste Product: fin,VkVo4_,r 44,%-t- Date&Amount of Last Ship ment/Fre/c uencv: + h e--i tJ — Licensed Waste Hauler&Destination: w b ,D �I,Gv •/�-)- 'v 2'3 X/v r 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: 6 Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes ,S'��/ Wood preservatives(creosote) Asphalt&roofing tar + y �/-�Sx� Swimming pool chlorine '1`1 Paints, varnishes,wins, dyes�%,,p 0' 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: S,A0rn' ` e o 4- (�j s S 1 l ( �J�a w hJ S , Ste« Q p Inspector: I ��. � �Z g I � �'t r�v�— �4-5 V:tp, 4,+D f�D w,+L M,4 54 ��jp Facility Representative: M-O,S-v e-o lo.,/ o 5 I I I a�.�- a H 4 e va-1 VAey �o►�- =�5 I ►L `k, Sll WHITE COPY- HEALTH DE ATM NT/'PCANA Y COPY- BUSINESS / P TOWN OF BARNSTABLE BAR-W r' Ordinance or Regulation r WARNING NOTICE Name of Offender/Manager L v t.-,. Address of Offender MV/MB Reg.# Village/State/Zip Business Name 'rlb,/+ . • l-/' {'Ewr jj >F` t ,*�rvc•,- `i ` "� am/pm, on 20 Business Address 11 1_44 1, Signature of/Enforcing Officer !i 1 _ "L-1uet/� Village/State/Zip s/ t�v }� _k y1 kq 02 / 0 Location of Offense Ile 1A t Enforcing Dept/Division Offense .,;e- Facts �`t lu_- � ^mot 3(*� fJ► T: � � 7 � '�/ �; r This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate -lregal action' by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. TOWN OF BARNSTABLE BAR-W ` Ordinance or Regulation WARNING NOTICE Name of Off ender/Manager Address of Offender MV/MB Reg.# Village/State/Zip Business Nam J t•/ ,- A w '' am/pm, on 20 t Business Address4-- Signature of:/Enforcing Officer Village/State/Zips v"► :` r` ! I F Location of Offense / !t �' ' ' 'z "r ` 04 r' Enforcing Dept/Division Offense Facts _l•,. ` f This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. °F1MErow Town of Barnstable Office:508-862-4644 P ~°� Public Health Division Fax:508-790-6304 96ARMASSBLE.g` 200 Main Street• Hyannis, MA 02601 ,b,q e,0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT RFD MA'S Business Name r i� �oo c r Date: f S� Location/Mailing ocation/Mailin Addre s: e. 2 rl IS fl f 2 Contact Name/Phone: �_a b v L22ry So$-9 ,22$ 1 660 ,Ma{_VLJ 1 1. L.ale� InventoryTotal Amount: MAX \� O MSDS: License#: Tier II : v Labeling: LI-0 IA,o l Jr<10't;e Spill Plan: /J1A Oil/Water Separator: NIA Floor Drains: No Emergency Numbers: Storage Areas/Tanks: ,`- 4.1 21L5 « ov 0 avV 1-rA I Q. 1 Emergency/Containment E ui ent: Waste Generator ID: o &halm— Waste Product: )v� - Date&Amount of Last Shipment/Frequency: A— ar0 1-1 4 7 NQ,.,) K �c1DvcS Ca�.��r Licensed Waste Hauler&Destination: Other Waste Disposal Methods: Ck)t�CLN-Jv Qu�,V a01" o I (� O bb I 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/o-A%4 -Y,* 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-v1-° Lye or caustic soda Lacquer thinners 1Z 0 x <�Q�,�� 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/ ECOMMENDATIONS: v v�- \ �J o Wl �� e.aV� �\,k64a{S -{- C�55e5 5V t. gcom, Cl.�r1w- \�4C`D of7 0 � � Inspector: 0.���`�i k�A-vs� \k, Ao46ae,`%1� 1\\.kk Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CAN COPY-BUSINESS � f 4 TOWN OF BARNSTABLE Date:5 /,Z8 TOXIC AND HAZARDOUS MATERIALS FORM NAME OF BUSINESS: ok -?V BUSINESS LOCATION: INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: :�f7$ - `!'S��- 2.Z,� 1 -- I I a//ort6 CONTACT PERSON: '-�b L ca.r rto c ,� EMERGENCY CONTACT T LEPHO E NUMBER: MSDS ON SITE? TYPE OF BUSINESS: eo a<\A` k a.\AM wj--Fro INFORMATION / RECOMMENDATIO S: 9 w o %111� Y+ re District: of t J til� \SP o5.(. k� w 1 R v\VA\ SJ b V 0. k2. 0, ` i o 56-4 o w C° ���i '� �,ba o c' .a �� ate �?•¢-�o�7 WasteTransportation: IA - 014kM \&ew, Last shipment of hazardous waste: Name of Hauler: 4\Ava,d )1j&, *o hK.\OoAkt Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 1 11, 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 Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (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/aA6-s,vZ6 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 /o�,%r• A,tl 1 PCB's yam-I Paints, varnishes, stains, dyes"4<e05 Other chlorinated hydrocarbons, Ha Lauer thinners (including carbon tetrachloride) USED Any other products with "poison" labels 19 NEWIV � (including chloroform,formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes y An Laundry soil &stain removers (including bleach) VKVe e a� + Y ►o d��� Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials C �T T F ii�LD,OW�/�B ILL CRAFTSMEN IN PAINT AND PAPER SAFETY DATA SHEET ESTATE EMULSION 4 Page: 1/7 Compilation date: 17/09/2013 Revision No: 5 Section 1: Identification of the substance/mixture and of the company/undertaking 1.1.Product identifier Product name: ESTATE EMULSION Product code: USA 1.2.Relevant identified uses of the substance or mixture and uses advised against Use of substance/mixture: Indoor Application by Brush,Roller or Spraying. 1.3.Details of the supplier of the safety data sheet Company name: Farrow&Ball Unit 10 310 Judson St. Toronto Ontario M8Z 5T6 Canada Tel: (1)-877-363-1040 Email: customer.services@farrow-ball.com 1.4.Emergency telephone number Emergency tel: (1)-877-363-1040(Monday-Friday 09:00-17:00 EDT) (office hours only) Section 2: Hazards identification 2.1.Classification of the substance or mixture Classification under GHS: This product has no classification under GHS. 2.2.Label elements Label elements under GHS: Precautionary statements: P101: If medical advice is needed,have product container or label at hand. P102: Keep out of reach of children. P103: Read label before use. Safety advice: Hazard symbols: No significant hazard. Safety phrases: Keep out of the reach of children. Avoid contact with skin and eyes. In case of contact with eyes,rinse immediately with plenty of water and seek " medical advice. [cunt...] 1 � SAFETY DATA SHEET Compilation date: 17/09/2013 ESTATE EMULSION Revision No: 5 Page: 2/7 2.3.Other hazards Other hazards: This product does not contain any ingredients that are considered hazardous under the criteria of the OSHA Hazard Communication Standard(29 C.F.R.§1910.1200). PBT: This substance is not identified as a PBT substance. Section 3:Composition/information on ingredients 3.2.Mixtures The data quoted is for an untinted white base.Tinted colors may contain lower levels of Titanium Dioxide&Quartz. TITANIUM DIOXIDE EINECS CAS CHS Classification Percent 236-675-5 13463-67-7 - - 10-30% QUARTZ 215-684-8 1408-60-7 Contains: This product does not contain any ingredients that are considered hazardous under the criteria of the OSHA Hazard Communication Standard(29 C.F.R.§1910.1200). Section 4: First aid measures 4.1.Description of first aid measures Skin contact: Wash immediately with plenty of soap and water. Eye contact: Bathe the eye with running water for 15 minutes. Ingestion: Do not induce vomiting.Wash out mouth with water. Inhalation: Not applicable. 4.2.Most important symptoms and effects,both acute and delayed Skin contact: There may be mild irritation at the site of contact. Eye contact: There may be irritation and redness. Ingestion: There may be irritation of the throat. Inhalation: No symptoms. 4.3.Indication of any immediate medical attention and special treatment needed Section 5: Fire-fighting measures 5.1.Extinguishing media Extinguishing media: Suitable extinguishing media for the surrounding fire should be used. Use water spray to cool containers. 5.2.Special hazards arising from the substance or mixture Exposure hazards: In combustion emits toxic fumes. [cunt...] r ' SAFETY DATA SHEET Compilation date: 17/09/2013 ESTATE EMULSION Revision No: 5 Page: 3/7 5.3.Advice for fire-fighters Advice for fire-fighters: As in any fire,wear Self-Contained Breathing Apparatus(SCBA), MSHA/NIOSH(approved or equivalent)and full protective gear. Section 6:Accidental release measures 6.1.Personal precautions,protective equipment and emergency procedures Personal precautions: Refer to section 8 of SIDS for personal protection details.Turn leaking containers leak-side up to prevent the escape of liquid. 6.2.Environmental precautions Environmental precautions: Do not discharge into drains or rivers.Contain the spillage using bunding. 6.3.Method's and material for containment and cleaning up Clean-up procedures: Clear spillage by absorbing into a dry, inert,absorbent material. Transfer to a closable,labelled salvage container for disposal by an appropriate method. 6.4.Reference to other sections Reference to other sections: Refer to section 13 of SDS. Section 7: Handling and storage 7.1.Precautions for safe handling Handling requirements: Not applicable. 7.2.Conditions for safe storage,including any incompatibilities Storage conditions: Store in cool,well ventilated area. Keep container tightly closed.Avoid incompatible materials and conditions-see section 10 of SDS. Suitable packaging: Not applicable. 7.3.Specific end use(s) Specific end use(s): No special requirement. Section 8: Exposure controls/personal protection 8.1.Control parameters QUARTZ Workplace exposure limits: Respirable dust State 8 hour TWA 15 min.STEL 8 hour TWA 15 min.STEL USA 0.3 mg/m3 OSHA - 0.1 mg/m3 OSHA - [cunt...] SAFETY DATA SHEET Compilation date: 17/09/2013 ESTATE EMULSION Revision No: 5 Page: 4/7 TITANIUM DIOXIDE Workplace exposure limits: Respirable dust State 8 hour TWA 15 min.STEL 8 hour TWA 15 min.STEL USA 1 15 mg/m3 OSHA(PEL) - - 8.2.Exposure controls Engineering measures: Ensure all engineering measures mentioned in section 7 of SDS are in place. Respiratory protection: Respiratory protection not required. Hand protection: Protective gloves. Nitrile gloves. Eyeprotection:y Safety glasses as described by 29 CFR 1910.133,OSHA eye and face protection regulation. Ensure eye bath is to hand. Skin protection: Protective clothing. Environmental: No special requirement. Section 9: Physical and chemical properties 9.1.Information on basic physical and chemical properties State: Emulsion Odour: Barely perceptible odour Evaporation rate: Slow Oxidising: Non-oxidising Solubility in water: Miscible Viscosity: Viscous Boiling pointlrange°C: 100 Flash poinVC: >100 Relative density: 1.2-1.4 pH: 8.0-8.5 VOC g/l: Zero(EPA Method 24-Max.Limit 50 g/1) 9.2.Other information Other information: Not applicable. Section 10:Stability and reactivity 10.1.Reactivity Reactivity: Stable under recommended transport or storage conditions. 10.2.Chemical stability Chemical stability: Stable under normal conditions. 10.3.Possibility of hazardous reactions Hazardous reactions: Hazardous reactions will not occur under normal transport or storage conditions. 10.4.Conditions to avoid Conditions to avoid: Heat. [cunt...] SAFETY DATA SHEET Compilation date: 17/09/2013 ESTATE EMULSION Revision No: 5 Page: 5/7 10.5.Incompatible materials Materials to avoid: Strong oxidising agents.Strong acids. 10.6.Hazardous decomposition products Haz.decomp.products: In combustion emits toxic fumes. Section 11:Toxicological information 11.1.Information on toxicological effects Toxicity values: No data available. Symptoms/routes of exposure Skin contact: There may be mild irritation at the site of contact. Eye contact: There may be irritation and redness. Ingestion: There may be irritation of the throat. Inhalation: No symptoms. Other information: Contains Titanium dioxide: RTECS Number XR2275000.A proportion of Quartz may become available in the respirable fraction when in the dry state but when bound in a liquid matrix such as paint is non-respirable.Although the International Agency for Research on Cancer(IARC)has classified titanium dioxide as possibly carcinogenic to humans (213),their summary concludes:"it is considered that there is no significant exposure to titanium dioxide while using products in which titanium dioxide is bonded to other materials,such as paint." Section 12: Ecological information 12.1.Toxicity Ecotoxicity values: No data available. 12.2.Persistence and degradability Persistence and degradability: Not readily biodegradable. 12.3.Bioaccumulative potential Bioaccumulative potential: No bioaccumulation potential. 12.4.Mobility in soil Mobility: No data available. 12.5.Results of PBT and vPvB assessment PBT identification: This substance is not identified as a PBT substance. 12.6.Other adverse effects Other adverse effects: No data available. Section 13: Disposal considerations [cunt...] SAFETY DATA SHEET Compilation date: 17/09/2013 ESTATE EMULSION Revision No: 5 Page: 6/7 13.1.Waste treatment methods Disposal operations: Dispose of in accordance with federal,state,and local regulations. Dry,empty containers may be recycled in a can recycling program. Local requirements may vary, consult your sanitation department or state-designated environmental protection agency for more disposal options. Recovery operations: Recycling/reclamation of other inorganic materials. Waste code number: 0801 12 Disposal of packaging: Dispose of as normal industrial waste. NB: The user's attention is drawn to the possible existence of regional or national regulations regarding disposal. Section 14:Transport information Transport class: This product does not require a classification for transport. Section 15: Regulatory information 15.1.Safety,health and environmental regulations/legislation specific for the substance or mixture Specific regulations: This product has been classified according to the hazard criteria of the CPR and the SDS contains all the information required by the CPR. No ingredients in this product are subject to SARA 313(40 CFR 372.65C)Supplier Notification.Global Chemical Inventory Status:One or more components of this product are not included in the following inventories.These may be polymers(of which monomers are included)and as such are exempt from registration: USA TSCA-Toxic Substances Control Act.California OEHHA Proposition 65 Notice:This product does not contain any substances which are listed on the Californian Proposition 65 list as being toxic and causing cancer,birth defects or other reproductive harm. 15.2.Chemical Safety Assessment Chemical safety assessment: A chemical safety assessment has not been carried out for the substance or the mixture by the supplier. Section 16:Other information Other information Other information: In accordance with CPSC Regulations 16 CFR 1303 and 16 CFR 1500.121,this product contains<90 ppm of lead. WARNING!If you scrape,sand,or remove old paint,you may release lead dust. LEAD IS TOXIC. EXPOSURE TO LEAD DUST CAN CAUSE SERIOUS ILLNESS,SUCH AS BRAIN DAMAGE, ESPECIALLY IN CHILDREN. PREGNANT WOMEN SHOULD ALSO AVOID EXPOSURE. Wear a NIOSH approved respirator to control lead exposure.Clean up carefully with a HEPA vacuum and a wet mop. Before you start,find out how to protect yourself and your family by contacting the National Lead Information Hotline at 1-800-424-LEAD or log on to www.epa.gov/lead. [cunt...] SAFETY DATA SHEET Compilation date: 1 710 9/2 0 1 3 ESTATE EMULSION Revision No: 5 Page: 7/7 Legal disclaimer: The above information is believed to be correct but does not purport to be all inclusive and shall be used only as a guide. Farrow&Ball shall not be held liable for any damage resulting from handling or from contact with the above product. [final page] Notes to the File 3. Y ' June 30, 2011 Toby Leary Fine Woodworking 20 Charles St. (Other potential addresses: 135 Barnstable Rd., 60 Washington St. Ext., 6 Pine Ct.) Hyannis, MA Telephone: 508-957-2N 1 Cynthia Martin, PHD David Murphy, Facility Representative Jackson Moreau, Woodworker Judi Bricklin , The inspection was a result of an odor complaint noticed by Town employees driving by the address. A walk along the sidewalk adjacent to the shop did result in noticing a slight "thinner"type odor. The facility operates a fine woodworking shop and a paint spray booth. The booth exhausts through a flat, louvered, side wall vent that is approximately ten and a half feet above ground level. Spraying occurs approximately three hours per day. The inspection revealed that there are approximately thirty-one (31) gallons of various coatings stored/used in the operation. As there are less than one-hundred eleven gallons of hazardous materials, Toby Leary Fine Woodworking is not subject to the Hazardous Materials Licensing of the Town. In a telephone conversation with Toby Leary on June 30, 2011, he stated that he had spoke to Tom Perry and Paul Roma of the Building Department regarding the paint spray booth. A follow.up conversation with both Tom and Paul revealed that the paint spray booth was not discussed with either of them. Paul Roma will follow up for Building Department compliance. I THE 1 Town of Barnstable sA ASS.MASS' : Inspectional Services 9 M eg' , � 1639.ArFD N1 Public Health Division t Thomas McKean, DirectorCC C 200 Main Street Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Lumber Liquidators 2-27-20 0l o C'�Uvi'V-"D Hello, As discussed this is the letter that has all the information you need to comply with the regulations. Things that need to be fixed are as follows: 1. Spill kit and speedy dry needs to be on site 2. Contingency plan needs to be posted 3. Spill plan needs to be posted 4. 1 located the old inspection forms and the gallonage seems to be within the same guidelines. I marked you down for 350 gallons,this includes everything on site.This also is inside your current license which expires in July 2020. PLEASE HAVE THESE THINGS FIXED ASAP,AS I WILL BE BACK THE WEEK OF MARCH 23RD If you need anything at all please call me.Thanks for your cooperation I have enclosed my business card with contact information C. Gus Johnson Hazardous Materials Specialist I� `orIKE royti Town of Barnstable Office:508-862-46 S' Public Health Division Fax:508-790-6304 7 BARMA�BLE.9` 200 Main Street• Hyannis, MA 02601 EO MP�a`0 .TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: CWX 6,lnh�vaGGs/o- • Date: 4,Tfir- Location/Mailing Addres : _ Contact Name/Phone: _ n `�y Inventory Total Amount: MSDS: License#: Tier II : Labelinci: Spill Plan: Oil/WaterSeparator: Floor Drains: Emergency Numbers: Storage Areas/Tanks: Emergency/Containment Equipment: Waste Generator ID: 0( )9- Waste Product: dV) 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 C>' Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes 0 gt:L Bug and tar removers --w,i l lam. 4 Hydraulic fluid (including brake fluid) Windshield wash I o� 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 S Y �N^ Printing ink ' Car waxes and polishes 'r` Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners C i�� TM�; ��Z""`et4 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, M110 hydrochloric acid, other acids)- VIOLATIONS: ORDERS: e- ' INFORMATION/RECOMMENDATIONS: Vc;1A4,dC D'i•P 14c4SCeet Inspector: Facility Represent t ve: / WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS x ofaEZ printed On:913/2019 Complaint Call Report BARN9GBI�:,•` '*k" 'retw .^s14^ -nxFd e.z8^°°s'r¢a>v s "e': ttr. g'':: ,G.,., a{e .£',,: •wyµ+ .y... 9M MAIN-ST./RTE 6A(W.BARN ), WEST • �fDMp+° Case# C-19-704 BARNSTABLE . Case#: C-19-704 Address: 970 MAIN ST./RTE 6A Date: 9/3/2019 (W.BARN.),WEST BARNSTABLE Owner Info: Property Info: SUNDELIN, RICHARD MBL: 970 MAIN STREET 156-026 WEST MA 02668 BARNSTABLE Owner Notified?: Complaint Details: Type of Complaint Classification of Complaint Method of Complaint Zoning Medium Priority Phone Complaint Summary. Nonconforming use -auto body-RFS to investigate power washing of vehicles in front lot. This is a new development in the existing use. Abutter has an organic farm and is concerned about what is being absorbed into the ground water. Action History: Action Taken Date Description Fee Inspector Inspector Assigned to Complaint: bowerse Filed by: andersor Comments: Comment Date Commenter Comment 913/2019 andersor Also referring to Haz Mat/Health for determination regarding type of power washing and chemicals or soaps involved in process. r rN4.1 Date 9I3/2019` Town of Barnstable Johnson, Chester ( Gus ) From: Johnson, Chester (Gus) Sent: Wednesday,January 8, 2020 9:46 AM To: 'tg@capequalitycollision.com' Cc: Johnson, Chester(Gus) + Subject: Safety Data Sheets/contingency plan Good Morning, It was our pleasure to meet you and your crew and complete our required inspection of your business. I will forward the inspection form to our licensing agent(Vanessa Tripp) and she be in touch with you for the required license needed from the Town of Barnstable, Board of Health. I just want to remind you that the MSDS sheets should be easily readable and are very glad that you will post these for all your employees safety as required..There is also a contingency plan that needs to be posted ASAP. I have included in this e-mail the requirements. This is also available on the Town web site for your viewing. § 108-6License 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 may be 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: 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. 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. 1 I 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. u 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.. 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. Any questions or concerns; please do not hesitate to contact Board of Health for assistance. Again it was our pleasure to meet you and good luck with your continued success in business Respectfully, C. Gus Johnson Hazmat Specialist,Town of Barnstable Health Division z Number Fee 1151 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that LUMBER LIQUIDATORS, INC. 20 CHARLES STREET, 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. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A. MCKEAN,R.S.,CHO Director of Public Health r Town of Barnstable t Inspectional Services BABSTABLE FTME h'f.y L SN CFSNI:I.S;CS£FY`jlL��-R BfP�'�E .Public Health Division = ,4 BARNSTABLE, ' Thomas McKean, Director AIEc 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 1 l 1 -499 Gallons:; f$i25.00_rr 'N VGT CA VW- 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. 02 7�1 "o?4f4 r003 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: C.;��"�tt'�.. i,V 1 C �. 1 (5 5. NAME OF ESTABLISHMENT: � W 'Secs r�e �®Z 6. ADDRESS OF ESTABLISHMENT: Z L G ��' a�l�l(S /"'l'� C'21 lam/I 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: � ��p °-✓Z'd:VA Z3/6 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: G�)I b' ( .a� g)p U1/(e u,,`1C4d r5 . kp�q 10. SOLEOWNER: YESXC NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: �J _ CORPORATION NAME I.,. L-VI C PRESIDENT VI TREASURER i' , '( CLERK, l �� 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: �J SIGNATURE OF APPLICANTok DATE +L/ 19 Q:\Application Forms\Haz Mat App Revised 09-10-18.docx Number Fee 1151 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that LUMBER LIQUIDATORS, INC. 20 CHARLES STREET, 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 eVpatory%=ef Bsxable rviceS •• Richard V. Scali,Director Public Health Division BAMSTABLE RARNffrAgm WAM • Thomas McKean,Director ; ;; � &63 A�� 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 CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 CATEGORY 3 PERMIT 500 or more Gallons: $150.00 O *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 QUANTIITIIE,S�(/25�GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: tiLrM i w` Cl A2�� /►^� � � 5. NAME OF ESTABLISHMENT: b4 u LCI ( 5 �S_C n 2 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: �,7a0, VAZ3/Tob 8. TELEPHONE NUMBER OF ESTABLISHMENT:9. EMAIL ADDRESS: c-b}Vl cza4 v ( Q e}",Q M4�_ G-N,M 10. SOLEOWNER: YESXNO IF NO,NAME OF PARTNER: S L IW "T�I 11. FULL NAME,HOME ADDRESS,AND TELEP ONE#OF: Q CORPORATION NAME L u,04 �I` '�OCY�^�v4 bee�' r PRESIDENT o Q✓to eL TREASURER CLERK Le.2_ I 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS A EMAIL: SIGNATURE OF APPLIC DATE 9 Q:1Application FormsUiAZMAT APP 2017 REVIS . ocx 0 Number Fee 1151 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that LUMBER LIQUIDATORS, INC. 20 CHARLES STREET, 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 Ll Director of Public Health 1�tT f It JUN 022.017 owls of B nstable Regulatory ulato ervlces Richard V. Scali, Director oF'THE*pN. Public Health Division BARNSTABLE _ • ' LARK"T"LE-QNrlRll:1_.CO!Lil•HYAtlti15 f ?v.:'0'!HILiS•YKTCR'r9li.i^iEST PR"IP.DP '�: CAB Thomas McKean, Director iG39-201a ''Terri 81 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 �1 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE , HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 10& 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 N 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 QLUANTITIES(25(G,ALLO1�1 YES NO. 4. FULL NAME OF APPLICANT: C14UA � 5. NAME OF ESTABLISHMENT: Ck( 6. ADDRESS OF ESTABLISHMENT: Oc" J ' l d uW 5 , V`4V 0 7. MAH.ING ADDRESS (IF DIFFERENT FROM ABOVE: -,534vt k4-f , 7Ca40, V/(Z3fC�� t�r (� r 8. TELEPHONE NUMBER OF ESTABLISHMENT: �J" " ✓ t l 9. EMAIL ADDRESS:t kc��" l � (Ck �c u A 'C.0 A-'( 10. SOLEOWNER: YES_NO IF NO,NAME OF PARTNER: - o 11. FULL NAME,HOME ADDRESS,AND T LEPHONE#OF: I.c CORPORATION NAME Vk ' V(dW Sfi ��tr�Q2� I� -rd �6, PRESIDENT_QUn I S e TREASURXR CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: C:\Users\kaparks.LUMBERL\AppData\Local\Microsoft\Windows\Temporary Internet Fi1es\Content.0ut1ook\3X84Y HAZMAT APP \2017 REVISED.docx Number Fee 121a THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Toby Leary Fine Woodworking 20 Charles Street,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 rw of B�nstable / egulatorygi%atory Services DWI Richard V. Scah, Director Public Health Division BARNSTAB '_ « + munsrw •cc++ru;vi�.cmun•mnrems. sniwgrABM Thomas McKean, Director 39�20 4S p•%639. 575 6`0� 200 Main Hyannis,Street, MA 02601 Office: 508-862-4644 Fax: 508-790-63-74 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 3 Oth). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 US 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. S7-1 244 I Gt�� 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: I o LYS�C� -tOY�. �9�Y -1A70C�V�eD 11(�C� r-, 5. NAME OF ESTABLISHMENT:-TD10� Le���� ysL WC7 wo V ' I1'0 C, 6 v 6. ADDRESS OF ESTABLISHMENT: 135 f cs-yxskp-6t,?-/ PA. V51 'MA 07-60 � 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 4C�I/1 Uv' 8. TELEPHONE NUMBER OF ESTABLISHMENT: 50�- q5'1 2 Xt 9. EMAIL ADDRESS: �U �f��-l`'e���-t ° C,o-Y\A 10. SOLEOWNER: V YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME U)Q 319)C>[-y k PRESIDENT 46 TREASURE ( CLERK c 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANTW.doc DATE 612_ 1 1 QAApplication Forms\HAZMAT APP 2017 REVIS - � Number umb THE COMMONWEALTH OF MASSACHUSETTS Fee $1Fee 25.00 Town of Barnstable Board of Health This is to Certify that Toby Leary Fine Woodworking 20 Charles Street, 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 06/30/2016 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 04/04/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health r Town Of Barnstable �I ►ati Regulatory Services (.� Richard v. Scali, Director t BARNWAeLE. 1 9 MASS. Public Health Division INSTABLE �A 1639. �0 S OI1 BA ::..., rfDMA�a Thomas McKean, Director 200 Main Street, 11yannis, Nf'\ 02601 M Officc: 508-862-46.44 11g. 508 790-6304 W W APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH T111," TOWN OF BARNSTABLE GENL;RAL ORDINANCE, CHAI)TI?R 108_ HAZARDOUS MATERIALS, ALL BUSI.NI_�,SSf:S 1'I IAT I IANDLE OR S I'ORI: I IAZ,ARDOUS MA'1'L RIAI-S GREATE'R THAN I IOUSEFIOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT (RUNS JULY I st .-.TUNE 10th). APPLICATION FEES CATEGORY I PERMIT 26 110 Gallons: $ 50,00 F1 CATEGORY 2 PERMIT 111 499 ( allons: S125.00 x ,L CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ • A late charLx oI S10.00 Nvill be assessed ii'payment is not received by July Ist. ASSESSORS MAP AND PARCEL, NO. _DATE 6� l.;) FULL NAME OF APPLICAN'r:_� c.7�yt l._��?�( � � `tr-�. ���`� 1:�(' .�(' ,•_e� �. _ t1 O NAME OF ESTABLISHMENT: ADDRESS OF ESTAl3I.,ISH;rVIENT: j-a J— 1- _; )' Vx Y�k K',l ` d iA [i {:)� MAILING ADDRESS (IF DIFFERENT): 'TELEPHONE NUMBER OF ESTABLISHMENT: Jt EMAIL ADDRESS: i) � > SOLE OWNER: _YES^_NO IF NO, NAME OF I AIt`1'NGIZ: FULL NAME, HOME ADDRESS, AND TELEPHONE # OF: CORPORATION NAME: PRESIDENT T«l�i�I �k t;t( ;1 Ff : Lei •b° :j1",� +1 /{_tIL (`��,�f�� TREASURER ( j,ERN. 11 PREPARE:1) 13Y OUTSIDE PARTY: • SIQN UIZE Of APPLICANT Name: _ Company Address : Telephone #: _ Email: O:\npplieatwn Dorms\I IiVY.;1111)Rn P,dc:cx Pa!,,e I of i r r Town of Barnstable Office: 508-862-4644 / Regulatory Services Department Fax: 508-790-6304 trnBL& Public Health Division NAS& Thomas A.McKean,CHO 'b3� .b` 200 Main Street, Hyannis, MA 02601 Payment Receipt Hazardous Materials Payment received: $125.00 (Check) on 4/4/2016 i `Check number: 42900 Check amount: $125.00 Name on check: Toby Leary Fine Woodworking, Inc. Business: Toby Leary Fine Woodworking Owner: TL ACQUISITIONS LLC Address: 20 CHARLES STREET, Hyannis Note: Category II Permit _...._.. - .......... _.._...__.__ Number Fee 1218 THE COMMONWEALTH OF MASSACHUSETTS $125.00 9 Town of Barnstable Board of Health s This is to Certify that Toby Leary Fine Woodworking 20 Charles Street, 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 4 I Town of Barnstable - • Regulatory Services . ti � Richard V. Scah, Director ��� t& LTAAEB&LE MASS. $ Public Health Division 1639 4 Thomas McKean,Director Qy 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 A W 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 lsf—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 V 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 6 g l FULL NAME OF APPLICANT:_TD J NAME OF ESTABLISHMENT: ADDRESS OF ESTABLISHMENT: 01 j u l ` MAILING ADDRESS (IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: T ?Z4- EMAIL ADDRESS: S-2L -COYA SOLE OWNER: YES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHIONE#OF: '' CORPORATION NAME T'b � � �L�Wvd PRESIDENT .TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: SI AT RE OF APPLICANT Name: Company Address :- Telephone#: Email: Q\Application Forms\HAZZAPP Revl6.docx Page 1 of 2 L r Town of Barnstable Office: 508-862-4644 Fax: 508-790-6304 �. Regulatory Services Department • = Public Health Divi i0 n IAItIV3i'AClt:� � S Thomas A.McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt 'Hazardous Materials Payment received: $125.00 (Check) on 6/14/2016 Permit number: 1218 i 'Check rumber: 12767 Check amount: $125.00 Name on check: Toby Leary Fine Woodworking; Inc. ;Business: Toby Leary Fine Woodworking ,Address: 20 CHARLES STREET, Hyannis i ........ _ .. ....... _. ... .................... I i— Number Fee 1151 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that LUMBER LIQUIDATORS, INC. 20 CHARLES STREET, 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 JUN 2 0 2016 Town of Barnstable DIME Regulatory Services Richard V. Scali, Director C B"MASS. ' Public Health Division BARNSTABLE 7 A88. 039. 0� MNNSABLE—TER LLE•CORIR•im"Ms co NA0.5TON5 NRS•OSTE0.Y1lF•rii5i 9AJISTABIF. RFD 1/°rA Thomas McKean, Director 1639 -201 4 200 Main Street, Hyannis,MA 02601 ,1U1 �J 3> Office: 508-862-4644 1k 0 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 ❑l CATEGORY 2 PERMIT III —499 Gallons:C$125.00 J 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: ""` 1 q ,��C NAME OF ESTABLISHMENT: C ,(✓Lt C,( kv' {�(w f 0(-P, ADDRESS OF ESTABLISHMENT: 'Zo Cl�r(�5 dmf'-5 '6lk 026oI MAILING ADDRESS (IF DIFFERENT): co 6��yi>'re- loa✓/0 VA Z3166 TELEPHONE NUMBER OF ESTABLISHMENT: 5(D% » ✓ l 12 EMAIL ADDRESS: `Z `u Mom-` `�i (I SOLE OWNER: YES �NO IF NO,NAME OF PARTNER: �`— FULL NAME,HOME ADDRE S,AND TELEPHONE#OF: ` ,{ CORPORATION AME t"VV�er 1 r'A°Ft9l� Ivry . 'z 'lvl (e i� Tc t✓►d Vv 2��C�`� PRESIDENT TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: SIGN APPLICANT Name: Company Address Telephone#: C:\Users\choffman\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\TLBM4CCL\HAZZAPP Rev I6.docx Page I of2 (p J9 00oq to Number Fee 1151 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that LUMBER LIQUIDATORS, INC. 20 CHARLES STREET, 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 rf 3 ` Town of Barnstable. 1HE r Regulatory Services of o g Y °s Richard V. Scali, Director • snxxsrna�, 9Q Mom. $ Public Health Division 17" TFDMA'�A Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 598-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. --003 DATE 1J� APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS T Cat of L r u�(4Le FULL NAME OF APPLICANT � 2 NAME OF ESTABLISHMENT l,U VM p �� ADDRESS OF ESTABLISHMENT 20j4t 0'z6?o1 TELEPHONE NUMBER SOLE OWNER: YES✓ NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO.0(� �J`�/ STATE OF INCORPORATION `S�L� \ FULL NAME AND HOME ADDRESS OF: PRESIDENT ✓v1 �.1� . tjl�yt f .tt�tf�'� ►ZO, (lt� 2'`,�G2$� TREASURER �t " 7Ulvi. V 5?cr. CLERK tJt y SING OF APPLICANT RESTRICTIONS: HOME ADDRESS �� `' HOME TELEPHONE# Haz.doclwp/q OWN OF BARNSTABLE BAR-W P*4 Or finance or Regulation r WARNING NOTICE Name of Offender/Manager Dom- L evo Address of Offender MV/MB Reg.# Village/State/Zip Business Name f 1 :Oct p q lI 20 / m, on _ Business Address t i Signature o E orc.ing Of# Village/State/Zip f\l Vtvl )S , t/✓t }� D2�0 I Location of Offense Lv"� e� v 4Q4"cor S �ee�,I-� ,I Enforcing Dept/Division Offense �1 b'/.�`� 1 o•ti., a� ' "r�„t, Cp f(�gj -(o Facts ✓TDC V 5e. a'C 7 ��1 �� ortS o'c �/\cc �oL,Seti-�P� �.t5 ��Tv10J`f V I 1 Ge-yl�,,.�.� �j �o,nti ���i �K e-2_ a N l7" �t�G i'� 0 I7!vC 7A S , This will serve only a • warning. At this time no legal action has beein taken. It is the goal of Town agencies to achieve voluntary compliance of Town Or dinances, 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. III i r Town of Barnstable Office: 508-862-4644 Fax: 508-790-6304 Regulatory Services Department - Public Health Division *- aARNSTASM MASS. Thomas A.McKean,CHO xo9 a` 200 Main Street, Hyannis,MA 02601 Ffl N4A'� Payment Receipt Hazardous Materials Payment received: $110.00 (Check) on 10/5/2015 Permit number: 1151 .Check number: 873189 Check amount: $110.00 Name on check: Lumber Liquidators 'Business: LUMBER LIQUIDATORS, INC. ;Address: 20 CHARLES STREET, Hyannis E `Note: $100 + $10 Late Fee I ....._... I I Number Fee 1151 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that LUMBER LIQUIDATORS, INC. 20 CHARLES STREET, 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 r � �-= Town of Barnstable V',+- f6o3 b �Ve r. Regulatory Services Q, Richard V. Scab,Director NA Public Health Division Thomas McKean,Director 200 Main Street, HyFuuus,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE I�47 L APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZMWOUS MATERIALS FULL NAME OF APPLICANT u m 6 z,4' NAME OF ESTARLISHMMN'1" ADDRESS OF ESTABLXSIDVIENT o?0 G ✓ I-eS ,�- ;r /►�t�4 d o 1'ELEPUONE NUMBER S. 0S SOLE OWNER: V"YEs NO IF APPLICANT IS A PARTNERSB31',FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT 1S A CORPORATION: FEDERAL IDENTIFICATION NO. 1)(f— 3;Le9 19 9 STATE Or INCORPORATION ��°�� FULL NAME AND ROME ADDRESS OF: 4, Ave � �� a 3 � 3 0 PRESIDENT .t L _ J 23 3 o T'1tEASURER e r Iry l CLERK SIGNAT Ok APPLICANT RESTRICTIONS: DOME ADDRESS 1 Z G� d �'l� HOME TELEPHONE# Q:�Applicstiun Fonn3\14AZAPP.DOC CO:ST VTOUOT/90 Town ofBaT .stable IKE Regulatory Sendces Richard V. ScaU, Director d eV.UU, • Public Health WNTiSion �ED a Thomas McKca)a, Director 200 Main Street, Hyannis, MA 02601 office, 509-862-4644 Wayne-Miller,M.D. Fax' 509,790-6304 Paul J, Canaiff,D.M,D: Junichi 5awsyanagi NOTICE TO ALL BUSINESS OPERATORS WITH HAZARDOUS MATERIALS RIALS IN-BARN STAJBLE, , The Town ofBa.rnstable Town Council adopted, Chapter 108: Hazardous Materials, a'Irequireiuen.t for each business-operator to obtain an annual permit and to remit a fee of$100.00 if one-hundred and eleven (111) gallons or more of hazardous materials are stored, transported, utilized, an disposed of at a particular site. STEPS 1 - 2 - 3: 1. Please complete the attached application form 2. Include a copy of your contingency plan (to handle hazardous waste spills, etc.) 3. Subr it the fee of S100..00 payable to the: Town of Barnstable. a t thus office on or before June 30, Z014. .A late MAII., all of the above o charge of$10.00 will be assessed if payment is not received by July 30, 2014. Please :Feel free to Vie�q the above Code, 'Chapter 108' Hazardous Materials on the Town �,Nebsite, v;���Tv town.barnstable.riia.us , Which is located under thie �-Cade section if you should have auly questions or concerns. (1.\jjazmae1 jk 1l4al Pumil Laotr.DOC _ ti0 ST VTv/0T/90 Ali +. r' FL004.fa: SS Title: Spill Prevention and Response Doc.ID: SOP-ST-113 Process Owner: Manager,SH&E 6 Date Issued: 2/24/2013 Document Approver(s): VP,Store Operations i-800-NARDWOOD Revision No.: 0 Revision Hate: N/A 1.0 PURPOSE 1.1. This procedure establishes required protocols for to prevent spills and to respond to spills of hazardous materials sold or used at Lumber Liquidator's stores. 2.0 SCOPE 2.1.This policy applies to all Lumber Liquidators store associates and temporary employees. 3.0 RESPONSIBILITIES 3.1. Compliance with this safety policy is the responsibility of every associate and temporary employee. Disregarding or failing to comply with this policy could lead to disciplinary action, up to and including termination of employment. 4.0 PROCEDURES 4.1. Identify the character,exact source,amount,and extent of any released hazardous materials. 4.2. Assess possible hazards to human health or the environment(flammable material, noxious fumes,irritating gases,spills going to storm drains, etc.. 4.3. If a propane cylinder starts leaking or venting and cannot easily be stopped, promptly move the cylinder to an open area outside,away from ignition sources. 4.4. If a flammable liquid is spilled,turn off engines and nearby electrical equipment. 4.5. If a serious hazard is present leave the area and dial 9-1-1. When in doubt, consult the applicable MSDS for hazards. 4.6. Stop work activity in the area and notify the Store Manager. 4.7. Stop the source of the spill(plug hole, upright the container,shut off valve). 4.8. Keep the spill from entering any drain or sewer(use absorbent or other materials,close valve to drain,cover or plug drain). 4.9. Clean up the spilled material immediately, using absorbents when applicable (do not flush area with water), 4.10, Place materials/absorbents into a secure container for proper disposal. Contact corporate office(Safety . Manager,757-564-4843)for disposal guidance. 4.11. Make sure the cleaned area is not slippery. 5.0 REFERENCED DOCUMENTS 5.1. None. 6.0 REVISION HISTORY 0 Initial Release Manager,SH&E 2/24/2013 Page 1 of 1 MA:1L-DST REQUESTS Please mail the completed application forin to the address below. Also include a copy of your contingency plan (to handle'hazardous waste spills, etc). In addition, please include the required fee of$100. Make check payable to: Town of Barnstable. Allow five to seven(7) working days for in-- house processing. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 FOR FAXED REQUESTS. Our fax number is (508) 790-6304. Please fax a completed application.form. Also, please fax us a copy of your contingency p.an (to handle hazardous waste spills, etc). In addition, please mail the required fee amount of$10C.00. Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow up to four days for in-house processing. For further assistance on.any item above, call (508) 862-4644 Back to Main Public Health Division Pare Q;1ApplicAtion FormMAZAPp.DOC b0 ST VTOZ/0T/90 Number Fee 1151 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that LUMBER LIQUIDATORS, INC. 20 CHARLES STREET, 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. 4/28/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health 1. �M 04102/2014 07:59 TAX) - , P.0021004 Town of•Bar. astable Barnstable �TM Regulatory Services :Department fiHmelcaft Public Health Divisjoh I II 11.1 � 200 Main Street, Hyannis MA,02601 165 A� , �-t i 151 zoos 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 Ill GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT L-. rw 6.er L--t%y'i A. i r�t1±A ! NAME OF ESTABLISffigENT LV-0"-6 -,r �,MiLit t`dAkk�s ADDRESS OF ESTABLISHMENT Z 0 CINA&C Le S S n n i1f, MA 02,1001 TELEPHONE NUMBER S 0 g �'! S' Af'1 211 SOLE OWNER: /YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IS A CORPORATION: FEDERAL IDENTIFICATION NO. IF APPLICANT I STATE OF INCORPORATION D el FULL NAME AND IIOME ADDRESS OF: PRESIDENT >Z ,4- L•�.,n� .1�Oy rny Au4 ' a � TREASURER -fe'recd 440 3 W •6ma _54• Lhb�� Yet 7,3 Z3� CLERK S GrgATUP.E OF APPLICANT 23185 RESTRICTIONS: DOME ADDRESS I t Z C W 04 • lalfi'qnOym Yet HOME TELEPHONE# -7 7—L5A- J,\hupection handoutMaz Mat Application2008.DOC F FoQ LOSS Title: Spill Prevention and Response HA�w�c Doc.ID: SOP-ST-113 Process Owner: Manager,SH&E Date Issued: 2/24/2013 Document Approver(s): VP,Store Operations 1-800- ® Revision No.: 0 HARDWOOD Revision Date: N/A 1.0 PURPOSE 1.1. This procedure establishes required protocols for to prevent spills and to respond to spills of hazardous materials sold or used at Lumber Liquidator's stores. 2.0 SCOPE 2.1.This policy applies to all Lumber Liquidators store associates and temporary employees. 3.0 RESPONSIBILITIES 3.1. Compliance with this safety policy is the responsibility of every associate and temporary employee. Disregarding or failing to comply with this policy could lead to disciplinary action, up to and including termination of employment. 4.0 PROCEDURES 4.1. Identify the character,exact source,amount,and extent of any released hazardous materials. 4.2. Assess possible hazards to human health or the environment(flammable material, noxious fumes, irritating gases, spills going to storm drains, etc.. 4.3. If a propane cylinder starts leaking or venting and cannot easily be stopped, promptly move the cylinder to an open area outside, away from ignition sources. 4.4. If a flammable liquid is spilled,turn off engines and nearby electrical equipment. 4.5. If a serious hazard is present leave the area and dial 9-1-1. When in doubt, consult the applicable MSDS for hazards. 4.6. Stop work activity in the area and notify the Store Manager. 4.7. Stop the source of the spill (plug hole, upright the container, shut off valve). 4.8. Keep the spill from entering any drain or sewer(use absorbent or other materials, close valve to drain,cover or plug drain). 4.9. Clean up the spilled material immediately, using absorbents when applicable (do not flush area with water). 4.10. Place materials/absorbents into a secure container for proper disposal. Contact corporate office (Safety Manager,757-564-4843)for disposal guidance. 4.11. Make sure the cleaned area is not slippery. 5.0 REFERENCED DOCUMENTS 5.1. None. 6.0 REVISION HISTORY REVISION NUMBER CHANG E,SUM MARY _ EDITOR DAT6.PUBL#SHED.,! 0 Initial Release Manager,SH&E 2/24/2013 Page 1 of 1 0410212014 07:59 OAX) P.0041004 Date: 3 1.23 I 1 TOWN OF BARNSTABLE W-FRATION TOXIC AND HAZARDOUS MATERIALS RB FORM NAME OF BUSINESS: Luw,l, ��r�y �Ij BUSINESS LOCATION: 20 L/Ji,a.rk e- <-� u,/Kw d L ! INVENTORY MAILING ADDRESS: - - i' TOTALAMOUNT: TELEPHONE NUMBER: ,L - , I S- El I CONTACT PERSON:, l�,•r,�-�, „� �„5��.��.� J t,. M RGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: 6vo{, I S n0 '--INFORMATION 0 RECOMMEN ATIO S: 1)_'P0,4,M 4 , <. \cr Fire District: Waste Transportation: tJ LA 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.— 5ee The Board of Health and the Public Health Division have determined that the following pooducts exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed/ Maximum Observed / Maximum Antifreeze(for gasoline or coolant systems) Miscellaneous Corrosive, ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes p I( u Ifart Road salts(Halite) Hydraulic fluid (including brake fluid) U Refrigerants Motor Oils Pesticides ❑ NEW 0 USED (insecticides, herbicides,.rodenticides) Gasoline, Jet fuel,Aviation gas Photochernicals(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) daulk/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 PCs'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 SAP Other products not listed which you feel Floor&furniture strippers ° may be toxic or hazardous(please list): Metal polishes `f` , It u V11 lei Laundry soil & stain removers (including bleach) I I `t e.r, Spot removers&cleaning fluids ,. 12 3 (dry cleaners) 27. Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staffs Initlals _j L— TOWN OF BARNSTABLE - 056 Ordinance or Regulation BAR -W Go WARNING NOTICE C� Name of Offender/Manager �. !� C z O'l< Address of Offender MV/MB Reg. # Village/State/Zip Lume� � 11� {sl�UfS 1' 0 p �5127 20�4 Business Name am/, on iv Business Address Cc�r1S 5�(-e-k44 � f _ t /'8igriatbre of Enforcing Officer Village/State/Zip 4A(-XV)f)6 /AU`I/ C)I&)t Location of Offense LbAtt- J.'q J&Jors inc Enforcing Dept/Division Offense Wolallm 4 �rn W& 169-C (IrCer�S� c� Coll �fl �n�� I��uf�� Facts &60m r ner- is Gr6'o q <111 owlh-6 a 62raaw maier`,'1 1 rrJi�tc�� ixt1�� I,Ce61n. 5061- QPP)1'c6110nJfe + IA �6e iune ► w1111 �t su��ec+ +0 �fxs. This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK- ENFORCING OFFER GOLD- ENFORCING DEPT. TOWN OF BARNSTABLE Ordinance or Regulation. BAR -W 6056 WARNING NOTICE 7 Name of Offender/Manager I Address of Offender MV/MB Reg.# Village/State/Zip Business Name Lurat ( 11-4 uthAvis,ill �• 3a am/pm on 20A Business Address Vsigriat' re of Enforcing Officer Village/State/Zip RACM)()1S / U1 c� Location of Offense LU66,{ 1 ao t &Aa� inc 1r rat Enforcing Dept/Division, Offense VI'01atl(Al Of "n aO Ccolingfoc14 Am) Facts 9,60M rfW0fr i 4 1gos;nA. SArnli 1�� # � �#ee + 16 6Ue iunf �, w111 su�aftl f t1ncs. f .w This will serve only as a.warning:- At this time no legal action has been taken. .It is the goal of Town agencies to achieve .voluntary compliance of Town.Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance.. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK- ENFORCING OFFER GOLD-ENFORCING DEPT. THE T � Town of Barnstable BA_MSTABLE, : Inspectional Services MASS. 1 A 1 A'FD.19. Public Health Division Thomas McKean,Director 200 Main Street Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Lumber Liquidators 2-27-20 Hello, L L As discussed this is the letter that has all the information you need to comply with the regulations. Things that need to be fixed are as follows: 1. Spill kit and speedy dry needs to be on site 2. Contingency plan needs to be posted 3. Spill plan needs to be posted 4. 1 located the old inspection forms and the gallonage seems to be within the same guidelines. I marked you down for 350 gallons,this includes everything on site.This also is inside your current license which expires in July 2020. PLEASE HAVE THESE THINGS FIXED ASAP,AS I WILL BE BACK THE WEEK OF MARCH 23RD If you need anything at all please call me.Thanks for your cooperation I have enclosed my business card with contact information C. Gus Johnson Hazardous Materials Specialist F `°F�Me►ohti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARM SS. ' 200 Main Street• Hyannis, MA 02601 ArFOMP-I, TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: k UY-n �pf � P A Date: Location/Mailing Address: "'0' Q�ioy, &,, y-j Contact Name/Phone: -JaSrnn 4Q) Inventory Total Amount: 1646 1I* MSDS: 6h (—'.�"`P License#: Tier II : 060 Labeling: Qx Via--I ae� Spill Plan:°de-S Oil/Water Separator: YV© Floor Drains:dV/) Emergency Numbers: Y&f Storage Areas/Tanks: Emergency/Containment Equipment: N 5Qw i.n1 ' Waste Generator ID: Waste Product: t)Ore Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: IV.) l�l 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 ry cleaning fluids Automatic transmission fluid Other cleaning solvents 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 ec, .� Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda �LacquerthinnersOl„n Ciev-w-e- Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes ,Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons aundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: L 5--r 10 P ORDERS: INFORMATION/RECOMMENDATIONS: Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS c ~•• .. �oF 1nE roy� 6 Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 eARMASS .. g` 200 Main Street• Hyannis, MA 02601 %639. M TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT tED Ay Business Name: v' Date: �7` Location/Mailing Address: .9-6 C4\101 I ms 5"r* 14a.(7 V) ,q A 6`4266 Contact Name/Phone: JoscYN Inventory Total Amount: MSDS: 4,, License#: Tier II : -W-0 Labeling: a,- 'Ia. Spill Plan:Y&A Oil/Water Separator: Wo Floor Drains: AZO Emergency Numbers: Yt=t Storage Areas/Tanks: x Emergency!Containment Equipment: Saw h,,l Waste Generator ID: XV 1 A Waste Product: Y)qvi tla Date&Amcunt of Last Shipment/Frequency: Licensed Waste Hauler&Destination: IV 1 ) Other Waste Disposal Methods: V 1 tct r 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 � ,y,A1� v Automatic transmission fluid ✓Other cleaning solvents&spo#.removersPN' �r Engine and radiator flushes Bug and tar removers�R A* kl 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: .,aulk/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 Sko-i Swimming pool chlorine v' Paints, varnishes, stains, dyes Lye or caustic soda '- -Lacquer thinners\vr C\&~v- """r 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, E hydrochloric acid, other acids) VIOLATIONS: �3,"e-A )} ORDERS: , A INFORMATION/RECOMMENDATIONS: a t Inspector: 't Facility Representative: WHITE COPY- HEALTH DEPARTMENT/:CANARY COPY-BUSINESS � r °FI►+Er Town of Barnstable Office:508-862-4644 °� Public Health Division Fax:508-790-6304 BARNSTABLE. MASS. g 200 Main Street• Hyannis, MA 02601 �'DrFDMA+a`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Lu L_i 41y, 5 Date: Location/Mailing Address: 2 o 14 V-4 wr►i 5 Contact Name/Phone: c I - 2 i Inventory Total Amount: ^-, -19, 4AA MSDS: ow coeQ weAa,5,}%e.- License#: Tier II :_ D Labeling: to6n b Spill Plan: v Oil/WaterSeparator: Floor Drains: Emergency Numbers: y Storage Areas/7anks: oAAA. Emergency/containment Equipme t: Waste Generator ID: _N I IN Waste Product: A 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 y4 b k(,+ ID 41 .Automatic transmission fluid Other cleaning solvents&spot removers +�y 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 1 4,csi L;-R-s gD t %4 xti insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries 4 ti x Photochemicals(Fixers) Rustproofers 23!� 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: 0 Inspector Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS `°F�►��owti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMARS- $ 200 Main Street• Hyannis, MA 02601 1639. �'DrfOMP��`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: L,v- •V,,e G-� ��- �-rs Date: Location/Mailing Address: 2,o Cttil ems, 5-#-, yang, S Contact Name/Phone:�`�o e. �M e �yo v S'o8 -81 S-'412. 1 Inventory Total Amount: U0"300�a� t6-00,1" MSDS: Ge<•Q wf,b0-e- 34�5 License#: Tier II : JJ0 I Labeling: Spill Plan: QVAc 0\4+ Oil/WaterSeparator: Floor Drains: r�a Emergency Numbers: yes Storage Areas/Tanks: 5' w 1 v 4�-ks " e w eo l!&6 Emer enc /Containment ui ment: Waste Generator ID: Waste Product: Date&Amount of Last Shi ment/Fre uenc : 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/4-61t431 v25 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: N o `G5V-e-6 Ce c.v vV�v--- kor,ov-, Q. ,w-Q.. Inspector: a Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS UD T' T" :13 Certified Mail Fee $ H Yq Extra Services&Fees(check box,add fee as appropdate) Lr) ❑Return Receipt(hankopY) $ 0 ❑Return Receipt(electronic) $ Postmark ❑Certified Mail Restricted Delivery $ C Heerre+ -- 0 [:]Adult Signature Required $ ❑Adult Signature Restricted Delivery$ C ' O Postage $ 5 Total Postage and Fees � Sent To oL__ 1111P�DI�- ---------------------------- Smeet andAp£,(z o�, Box No. tti of( (jj� -- --- --- ---------------------------------------- City State,ZIP+4� A��/ 4�6v/ crr t rr rrr.rl UK/ Certified Mail service provides the following bendfits: ' ■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 First-Class Mail®,Rrst-Class Package Service®, available at retail. or Priority Mail®service. Adult signature restricted delivery service,which e Certified Mail service is notavailable for j 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 with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,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 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 portion of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version.For a hardcopy return receipt, complete PS Form 3811,Domesifc Return. Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT'.Save this receipt for your records. PS Form 3800,April 2015(Reverse)PSN 7530.02.000-9047 1 n I COMPLETE •N .COIWPLETE THIS SECTIONON DELIVERY ■ Complete items 1,2,and 3.Also complete A. S' nature item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse X Addressee so that we can return the card to you. B. Re eived by(Printe Na e)\ C. Date of Delivery ■ Attach this card to the back of the mailpiece, Pi �a_�,/ or on the front if space permits. P17 7 DD 1. Article Addressed to: IsEf ivery ad ress f{e nt'frip� em 1? ❑Yes If YES,enter1,0�larery a�`Helow: ❑No aU G�faR/ems s�-. 3. Service Type ya111113, A4 D2 &0/ )ZCertified Mail® O Priority Mail Express- J ❑Registered 0Return Receipt for Merchandise Q Insured Mail ❑Collect on Delivery 4. Restricted Delivery?(Extra Fee) ❑Yes 2' Art" 7015 0640 0005Y8489 7945 VS PS Form 3811,July 2013 Domestic Return Receipt UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS. Permit'No.G I %z/ N • Sender: Please print your name,address, and ZIP+4®in this baxrLl a Town of Barnstable Health Division 0. 200 Main Street Hyannis,MA 02601 a �. TOWN OF BARNSTABLE BAR-W r 0 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager 04- V,, ,/ / Address of Offender MV/MB Reg.# Village/State/Zip Business Name on �� 20 Business Address ;Z tr) !, �a �•'� - �`��' Signature of !Enforcing Officer Village/State/Zip 0-,13 rtrt +; , �A Location of Offense Enforcing Dept/Division Offense � C��itC�ri.ti. Facts , y)e ®Y f �tj ;�<<��nyt !s V1rt �t (> ceJS rt�� prr;.� , t�� t ► nJ`�` 1 �i1xC This will serve only ad 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-Wt- Ordinance or Regulation WARNING NOTICE Name of Of f ender/Manager * i '/ F Address of Offender MV/MB Reg.# Village/State/Zip Business Name v am/pm, on 'rt# 20 Business Address Signature of Enforcing Officer Village/State/Zip t:iVt t ; . Ito, Location of Offense ;ti . �- Enforcing Dept/Division c , Offense �11 , x V r . ~;, IPVL Facts , _A 't t1,.. �tr ; 7 ►1 Ili , >'" =' f ' � ,i1 ", r� � '_14i`'`' f 1, '7 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. i a °F IKE To�,b Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMASS .. • 200 Main Street• Hyannis, MA 02601 i639• �0 %639. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: L J%V% -e Date: Location/Mailing Address: 20 6t A 15 Contact Name/Phone: Inventory Total Amount: 5tl- <Nd,J - MSDS: OA C-odQ. w i�k� License#: (� Tier II : N o NLabelina: 60) &Aa-, Spill Plan: (W---Lqv�4t Oil/WaterSeparator: Floor Drains: No Emedgency Numbers:, IL Storage Areas/Tanks: Sq } C©A4.Ik-1 - 5lrv:5evlcas Emergency/Containment E ui ment: 1c.�v.s ctbSo� o�ar,Qc,� Waste Generator ID: NSA Waste roduct: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS tJa �"�0�1 a� ��a ,� (vl �v v mC 5�v�c2`� IYtS �Q� NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous ma erial use, [za I storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: %55Jf-5 0-C (fie a A\&Uv, ►ov0 Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: 3 I)S /1� TOWN OF BARNSTABLE Ks aw- TOXIC AND HAZARDOUS MATERIALS N FORM L� t NAME OF BUSINESS: ►+^ �qy� ,,, o r6, BUSINESS LOCATION: 20 61ai-kg6 Ny H i 1 15 INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: roo- CONTACT PERSON: EMERGENCY,CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: li-es Drl, tdfD, cks,+e— INFORMAj.TION / RECOMMEN ATIONS: q Vyt,n lL FiZ44 District: Q YK—UJ i AL �f T o s 'S�'o c�G 6vt, yl A ►S 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 — SCE a -aoQ �K�I¢.v�-�or ��oJb�/ rS The Board of Health and the Public Health Division have determined that the following �oducts exhibit toxlc�Or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive LJ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (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 Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous(please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers&cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's'Initia s 00 too 2 j� , 1 too 1202 T CTRG Bostik Best Adhesive 10oz Ctrg Z. _ 35.00 9 967.00 1202 TGA , 6 916z00'w,.._1202 0905-CTRG Mapei Urethane Adhesive 10 1 oz Ctrg Z28 00 419.00 Z824.00`"1202 15WE'3 CTRG. 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