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Home My WebLink About0075 ENTERPRISE ROAD - HAZMAT if-N-M A Number Fee 36 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Bearse Auto Marine .-------------------------------------------------------------------------------------------------------------------------------- 77 Enterprise Rd., Hyannis, MA ------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. ------------- ------------------------------------------------------------------------------------------------------------------------------------------------------ Restrictions: -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF, D.M.D. THOMAS A.MCKEAN, R.S.,CHO Director of Public Health Town of Barnstable • Inspectional Services E*: BLE Public Health Division NR•YYRRRIS'FS B.�0.NSWBtE �.. 1 ■nMsfrnaM " Thomas McKean, Director F&639. 1. 200 Main Street, Hyannis,MA 02601 7 l�a Office: 508-862-4644 Fax: 508-790-6304 0 z> APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS �-1 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 Rar PA CATEGORY,3 PERMIT 500 or more Gallons: $150.00 ❑ WD *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO.. 2. IS THIS A PERMIT RENEWAL? YES_NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: RG b-e rl l`SCci r�e- 5. NAME OF ESTABLISHMENT: �C5�- A oo h 6. ADDRESS OF ESTABLISHMENT: 7-) En e—r ma /v/)/c nh)S ,06�2 Gee, 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: cot-1ccZ 10. SOLEOWNER: YES tAo IF NO,NAME OF PARTNER: /CQ ti or�L tr 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME gec%rLkc. ulo ,,• vrt✓LG /n<-\ PRESIDENT flg4er y 13a-.rf-e a' o Arrc,:.r yJr ,�Yc.�k of a26e) TREASURER Vr 0 ArlanlApod nr cod 04 0a6 0 CLERK Vc,^ .QyrJ-4 3o e- -7— . 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE 6� y_'2-b Q:VWpplication Forms\Haz Mat Appli Draft Jan20l9.docx Number Fee 36 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Bearse Auto Marine 77 Enterprise Rd., Hyannis, MA Is Hereby Granted a License For: Storing or Handling 111 -499 gallons of Hazardous Materials. --------------------------- - -- ----------------------------------------------------------------------- ------ ---------------------- ------------------------------------------ ------------- ------------------------------------------------------- --------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2020 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 i Town of BarnstableAAA pectional Services BARt�— Inspectional �Public Health Division °s� r«5 BAMMBLE, ' Thomas McKean Director 'S& : iOrEprb 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 50§ 90-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE "q 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: $125.00 -9 V$a at�;&r `add 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. og9X " O)7 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: 5. NAME OF ESTABLISHMENT: A! -ta Ilk 6. ADDRESS OF ESTABLISHMENT: 7hJ /j�- � P l7`SonRwPS A44 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: RA 7'7r commc-r- A*,-Y 10. SOLEOWNER: YES NO IF NO,NAME.OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME gyp` d g4ZE/l.1 a)/"= Y- PRESIDENT ��u �• 1'' <eu,rrx i ►^v -/ TREASURER CLERK ► 71P 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: • COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT VP DATE Q:Wpplication Fonns\Haz Mat App Revised 09-10-18.docx Number Fee 36 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Bearse Auto Marine 77 Enterprise Rd., Hyannis, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. --------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2019 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2018 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health d c r Vwofor Brnsxable eg atory erviceS �tKWE Richard V. Scali, Director MA Public Health Division BARNSTABLE BA NWABU, Thomas McKean Director Mu�tioas wlS•osiExv41E•We'f eAp -.f MARS, 8 1 1639-2014 C i639 ♦0 -- - - 200 M - in--— - �� --- — `-- — - ArEo�s a Street;Hpannis�MA 02G01.-- - -.--- Office: 508-862-4644 a0f Fax: 508-790-6304 N APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE -e1 HAZARDOUS MATERIALS r;'a 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: $125.00 N V.$ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 *A late charge of$10.00 will be assessed if paymentis not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. ` 017 2. IS THIS A PERMIT RENEWAL?J` YES_NO. IF YES,SHIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF • GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT:- 5. NAME OF ESTABLISHMENT: HAW-a- 4q�-d �� lnvc, 6. ADDRESS OF ESTABLISHMENT: -77 &5L1A-L,& 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: P� �'1~Z'7 /zz- 9 C6 X.e-i9-r, 10. SOLEOWNER: YES_NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME tW&&AC06 kA-&i � C PRESIDENT ,lly 4A-IiVIl A4 AA TREASURER Rea_jae ,Zy_ CLERK r" t-- HI A-V P r A,) (AJ 6g-�r cu C 1�u lh V, 42` 12. IF PREPARED BY OUTSIDE PARTY: • NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE S-'11 JR Q:\Application FormsUiAZNIAT APP 2017 REVISED.docx i °FINE ` Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMASS. ,$ 200 Main Street• Hyannis, MA 02601 t639. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: ,&ark A%AO IM Ar V%-. Date: Location/Mailing Add ress '7-7 Eve}er k Contact Name/Phone: ''(ab--.r* ^Q2e�c �Of� - -7-1 - Ll--�:I 1 e r Scvt 8;119 Inventory Total mount: ^-^-1-1'54A ` MSDS: Ott- License#: Tier II : 00 Labelina: Spill Plan: O Oil/WaterSeparator:_ Ilk Floor Drains: Emergency Numbers: Storage Areas/Tanks: t00 G k\ ek&j M,41 d&Vvnns ace Emergency/Containment Equipment: 54,11 u-+A- aw s At-,, p\v", V4" W Waste Generator ID: 0 1 Waste Product: �� 1 Date&Amount of Last Shi ment/Fre ue c : I I I's I I t. v oJ 1--X Licensed Waste Hauler&Destination: Other Waste Disposal Methods: 11 LIST OF TOXIC AND HAZARDOUS MATERIALS fV 0 VV6h tol �� ,N, NOTE: Under the provisions of Ch. 111, Section 31, of the Ge eral Laws of A, hazardous mater I use, \%A pe g storage and disposal of 111 gallons or more requires a license from the Public Health Division. 66 Antifreeze Dry cleaning fluids ,L 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 vl 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) VAsphalt&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. .Q. I o v`, =Et- d ta..,!A, 'A ,��t,�n�t4%4 4 64 Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS I IKE roy� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMASSSBLe.� 200 Main Street• Hyannis, MA 02601 1639 s�0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT 'Fo,An+ i 1%0 `I{p Business Name: D u l o av', Date: Location/Mailing Address- ! V1 Contact Name/Phone: o I c Off- 77 - ovl.� n Inventory Total Amount: MSDS: License#: 3(, Tier II : O Labelina: Spill Plan: J1 �eN� Oil/WaterSeparator: Floor Drains: o Emergency Numbers: dbC- Storage Areas Tanks: I11 -+O enw—. o 'A e- Emergency/Containment Equipment: NtL) N oo sa,l o&,A0V--WoJ1 A�°s�'vfu�a5k�o Waste Generator ID: PN 5A-1 Waste Product: oil, Date&Amount of Last Shipment/Frequency: I 4 ' Licensed Waste Hauler&Destination: t5 vl. ( � 7 l ( (� eovet ROE'4i�-- 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 (e Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers 3 Hydraulic fluid (including brake fluid)3 (o Windshield wash to 150 Motor oils fi2o�2�44 mc° W t-,jt., Miscellaneous Corrosives 7-0 Gasoline,jet fuel, aviation gas Cesspool cleaners ieeselTuel, kerosene, #2 heating oil Disinfectants 2,0 Miscellaneous petroleum products: Road salts grease, lubricants, gear oil 20 Refrigerants Z Degreasers for engines&garages 2 Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries k0 S Photochemicals(Fixers) Rustproofers '�°x Photochemicals(Developer) Car wash detergents 'F�° Printing ink Car waxes and polishes Wood preservatives(creosote) �— Asphalt&roofing tar Swimming pool chlorine 15 Paints, varnishes, stains, dyes 10 S 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: e v ?-a-r v5 ti•Ja f-e- 5 arm 2, WA i�e,S' a I buG 'S 1 Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS �\ Number Fee 36 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Bearse Auto Marine 77 Enterprise Rd., Hyannis, MA Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------------------------------------------- -------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2016 unless sooner suspended or revoked. --------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2015 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health 1/ , 7" j, Town of Barnstable Regulatory Services Richard V. Scan,Director ELMEMSUBM Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-190-6304 Application Fee: $100.0.0 ASSESSORS MAP AND PARCEL NO. Q 7 DATE -" ;ko(S— APPLICATION FOR PERNUT TO STORE AND/OR UTILIZE MORE THAN Ill GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT6 NAME OF ESTABLISHMENT AA AA1f Aj y,�- ")r • ADDRESS OF ESTABLISHMENT :7 l` d/,1A ' 4-C *f/r TELEPHONE-NUMBER '7 7s 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. d q aL G STATE OF INCORPORATION FULL NAME Alm O%DRESS OF: _ �(,� (j a6 PRESIDENT ('�� `�` rse TREASURER -[ t yl 1&arw CLERK • SIG NA APPL RESTRICTIONS: HOME ADDRESS 4r A,6w4e 4,c HOME TELEPHONE# Mcwhe\Temporary Intemet Files\OLMEAZ.APP Rev2015.DOC i .°F IME row Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARNSTABLE. MASS. g. 200 Main Street• Hyannis, MA 02601 �p t639• �e rFo►Ao+` TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: avS Av4o Max-, e - Date: 7/1-7/1!t Location/Mailing Address: 71 E e.r s2 4vl✓115 Contact Name/Phone: No 6g � rk .S08-7"T j�,- 4 S'7 I Inventory Total Amount: 0 MSDS: e-5 " Co`� a-UAs5 License#: 3�0 Tier II : o Labeling: -i(-ttz Spill Plan: Oil/WaterSeparator: Nb Floor Drains: Emergency Numbers: QI Storage Areas/Tanks: G �. AA e.d -Vv\so. r.,� ` 3 Rc. s1 Emergency/Containment Equipment: 11k. OJh, �oc,�Gs arm a.le�tic�b\� Waste Generator ID: M yJ "17S 6'- I Waste Product: WQ5+k o1 ( crasol iv-g- Date&Amount of Last Shipment/Frequency: 4 zb I L4 1 So a-1 J--Z t Licensed Waste Hauler&Destination: Avk">1ood-y c5o��.k (' OJ7 Other Waste Disposal Methods: I 1 1M�DOIfl��dB ,� LIST OF TOXIC AND HAZARDOUS MATERIALS Igo vp.)of ��na�,., IV- \y\:VtM-*� 5lwt-1 k- ��rxl., NOTE: Under the provisions of Ch. 111, Section 31, of the General La*s of MA, hazardo4 material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. V Antifreeze Dry cleaning fluids yAutomatic 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: VCaulk/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 Y— 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, 1 hydrochloric acid, other acids) II''11 VIOLATIONS: It5'� 01` tc-\)M,¢J &ok �P-W ek ORDE i�S: "0,(e- V22r k� �t INFORMATION/RECOMMEND TIONS: W too v ov ttn Ca e a Inspector: <Lyoi4e Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS Date: /1 122 3 TOWN OF BARNSTABLE ��+,�,� TOXIC AND HAZARDOUS MATERIALS RJEGtST4bk=N FORM NAME OF BUSINESS: 9mirse. ,r, At �,I-e— BUSINESS LOCATION: 1-1 INVENTORY MAILING ADDRESS: Ao,.t— TOTAL AMOUNT: TELEPHONE NUMBER: S'0$ -?-7S�- qS`7 „-, CONTACT PERSON: Igo lk -r-- EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE-?, n TYPE OF BUSINESS: Boa .r A !'e,�a Ie-A-t,.e �K�rr�ena.�cQ_ y""s - -Io � �� a INFORMATION / RECOMMENDATIONS: ')baste.o. I CAd,.Aes I bucl&-�s r44usi Fire District: 6-_Go*-<J CI-lcawva e11911 5o,/N.n3)CIe4H!�e R s aost OPAllco0Q114c.6 Ijy4r►✓i►s Gor�kco 15p,llg t�aQ��.as, �Labe klas+e.o►l Rrca_6�-��velo,e �n�2 Oyst SD,l1 Dla►a. Waste T spo a to M✓��y�Y�? I Last shipment of hazardous waste: r ►3 Name of Hauler: �ar'� � � 401 1-,lr�jWr Destination: A4,jrAv-5 Waste Product: I��st� m�I Licensed?� No MA-ba&r8800s' NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Z Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive 9NEW ❑ USED Cesspool cleaners 3 Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) 1� Hydraulic fluid (including brake fluid) Refrigerants 1 q Motor Oils Pesticides (insecticides, herbicides, rodenticides) C�NEW 30 USED I6� �Lo Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) 2a lubricants, gear oil ❑ NEW ❑ USED J Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine 37 Battery acid (electrolyte)/Batteries 71 37, 44 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, 3 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) 3 Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staffs Initials Number Fee 36 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Bearse Auto Marine 77 Enterprise Rd., Hyannis, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. --------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2018 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN - DONALD A.GUADAGNOLI,M.D. 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health CZ:Towd L TOZ 61 3ti fj> �o�a �,zs- TRowrZ of P gnstable eg atory Services �Cl Richard V. Scah, Director o Public Health Division BARNSTABLE + + esesraexaaaui.connvrn.p5 ` swuvsz'neis, : Thomas McKean,Director 16 9'2a 4wzie x use 9`b- %�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 ❑ *A late charge of$10.00 will be assessed if payment is not received by July lst. G. 1. ASSESSOR'S MAP AND PARCEL NO. l- 1617 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(255 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF EST ; IS T: � �3 4 kk 6. ADDRESS ? l J =4 PA.t S 4f s A Ali i¢ �LDr 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 64 � S. TELEPHONE NUMBER OF ESTABLISHMENT: S O& -2 (9- l 9. EMAIL ADDRESS: i�Pt " 7 7 z- G C 0 M C if S/. 4)f T 10. SOLEOWNER: YES �^NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION N 1�FAA F- #&46 AA AAA t-e 4�ut sb 7 n-qs"7/ PRESIDENT cz,V'Se . M 3 its ' 2-col roeSY�G TREASURER 6 2 Ct Vs r 0 P1i 7 CLERK .! 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE Q:\Application Forms1HAZMAT APP 2017 REVISED.docx i s Number Fee 36 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Bearse Auto Marine 77 Enterprise Rd., Hyannis, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. ------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2017 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable �VKVE Regulatory Services Richard V. Scali, Director { 34 RNSTABIE 1*- 100E MASK $ Public Health Division s6 q. 0 aI ♦ e�Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 1,.., Office: 508-862-4644 Fax: 508-79 6304 itS 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 ❑ A late charge of$10.00 will be assessed if payment is not received by July 1st. ASSESSORS MAP AND PARCEL NO. Q l DATE FULL NAME OF APPLICANT: j r ,& V'S 0- NAME OF ESTABLISHMENT: l b�P GZ►l e Avio V�6\1 A-)C � ADDRESS OF ESTABLISHMENT: :77 EA),7/e A PA-(S F /2 dVAA8)6 19 d, +&0` MAILING ADDRESS(IF DIFFERENT): TELEPHONE NUMBER OF° ESTABLISHMENT: —S-U 0 '7 7S 0,521 EMAIL ADDRESS: I, Wl 7 SOLE O`'VNER: YESJC NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION N F �114e_ A cm oQ, A)I-- . A)C. PRESIDENT rof3p--2r� /J &r ff- W lr _ / TREASURER e-z- 12 cv Q/ CLERK C: LE 44 W 43.S> . IF PREPARED BY OUTSIDE PARTY: SIGNATURE OF AP LICANT Name: Company Address Telephone#: Email: QAApphlcation Forms\HAZZAPP Rev16.docx Page 1 of 2 *++� Town of Barnstable Office: 508-862-4644 • Regulatory Services Department Fax: 508-790-6304 Public Health Division KAW, Thomas A.McKean,CHO a59. � 200 Main Street, Hyannis, MA 02601 Payment Receipt 'Hazardous Materials Payment received: 125.00 (Check) on 6/10/2016 Permit number: 36 ;Check number: 8920 Check amount: $125.00 Name on check: Bearse Auto Marina Inc. Business: Bearse Auto Marine Owner: ROBERT P 3111 TR ;Address: 73 ENTERPRISE ROAD, Hyannis I i I - . ........ ... ......... ........._.... _..-__ ---- • Number Fee 36 THE COMMONWEALTH OF MASSACHUSETTS 100.00 Town of Barnstable Board of Health This is to Certify that Bearse Auto Marine 77 Enterprise Rd., Hyannis, MA Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2015 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health n . Town of Barnstable �oF1HETti Regulatory Services Richard V. Scali, Director B"'MA `� ` Public Health Division 9 �,ss.SS. � 'Drfo 59. Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. g l 3 — 0 ! / DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT R66tyr P y1-a,at i T NAME OF ESTABLISHMENT G�m Al iP A-P-,)A, ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER Sb 6 - 7, y 1-7 SOLE OWNER: AYES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION ] FULL NAME HOME ADDRESS OF: PRESIDENT 06C.-f 1 r d4/9 TREASURER rT, 1�Y ,�,S CLERK 1 Uj >cxc W wy SIGNATURE F APPLICANT RESTRICTIONS: HOME ADDRESS /7 04d d0"-ew4 HOME TELEPHONE# �,A y (► C Q:Wpplication FOrmSUHAZAPP.DOC Bearse AM Marine,Ine. 77 Enterprise Rd. Hyannis,Massachusetts 02601 Phone 508-775-4571 -Fax 508-775-5957-Email Bam77e@comcast.net Have an OIL-DRI 5TR26 20 Gal. hazmat spill kit. L90894G. Consists of absorbent materials and a drum for holding clean up materials for disposal. Also have absorbent pads and socks throughout the shop area. t i Number Fee 36 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Bearse Auto Marine 77 Enterprise Rd., Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------ This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2014 unless sooner suspended or revoked. -------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2013 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health '} Town of Barnstable otIME Reguht'ory Services °* Thomas F. Geiier,Director -i AAANCTAAi.F._ Public Health DiVISIOn ? nnay Thomas McKean, Director 200 Main Streit, Hyannis, MA 02601 Office: 508462-4644 Fax 5U-790-6304 Appiication Fee: $100.00 ASSESSORS NlAP AND PARCEL,NO. Z 3 017 DATE APPLICATION FOR PERNUT TO STORE AND/OR U'T'TT= MORE THAN 111 GALLONS OF HAZARDOUS 1MATERIAI_,S FULL NANIE OF APPLICANT Rk-xw--r NANID OF ESTAB7 SIBfENT � � _. -J V r Z, :4) C- ADDRESS OF ESTABL=]Yi ENT d_ CC3 0 TELEPHONE NUMBER SOLE OWNER: YES NO v oO a IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: �`? < 00 M! IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 6 STATE OF ENCORPORATION 6c,4gIr- r/ FULL NAME.AND HOME ADDRESS OF: PRESIDENT r � 7" ?F 6z if S� v ivNrS Ae TREASURES 13P A-r F � &k r N f 6U/ Lee - SIGMA OF ZUCANT RESTRICTIONS: HONI ADDRESS HONff TELEPHONE# `C F-azdochvp/q _ i Number Fee 36 THE COMMONWEALTH OF MASSACHUSETTS $100.0o Town of Barnstable Board of Health This is to Certify that Bearse Auto Marine 77 Enterprise Rd., Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. o� -- ------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2012 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 6/30/2011 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health �K Town of Barnstable C 657 S 1W M �tHE rq�, Regulatory Services ti °s Thomas F. Geiler, Director MUMSUBLE. " Public Health Division ArEDMo'�a Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. -0 DATE I( APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT b � � t u"3.� �•- NAME OF ESTABLISHMENT , NSF tgAA1 C, ADDRESS OF ESTABLISHMENT �n F�Ju rim f b Sri TELEPHONE NUMBER t SOLE OWNER: YES e N0 IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALZ. PARTNERS: Y:. -n cr sv o E-- M IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. (3-q;j (,6;t A4,? STATE OF INCORPORATION FULL NAME ADDRESS OF: PRESIDENT VHOME es �t.R t 1 3`7 TREASURER eazapa -T<' CLERK kiq.! JI&f P A) 1AJ Aft iv c 90y SIGNATURE OF APPL ANT RESTRICTIONS: HOME ADDRESS 1? /7 M4 HOME TELEPHONE# � �� Haz.doc/wp/q Town of Barnstable °ptHElph Regulatory Services • y``P °� Thomas F. Geiler, Director BARNSfABLE, MASS. Public Health Division va° i639 ArEOMA�°i Thomas McKean, Director 200 Main. Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-004 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN I II GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT khfl l A-Wrb ki ab jF Z�� ADDRESS OF ESTABLISHMENT • 4 7/^ TELEPHONE NUMBER SOB � &- -�fX-7 SOLE OWNER: YES XNO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. O q ,2 L 7 STATE OF INCORPORATION FULL NAME HOME . DRESS OF: PRESIDENT17666-fl' . —t p, W tj VAAAq 4g 6,;t / TREASURER r-0-1 ?Np & g, a d, CLERK SI NATURE OF APPI ICA T • 0 RESTRICTIONS: HOME ADDRESS HOME TELEPHONE # y Haz.docm p,'q 5 Number Fee 1081 THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that Balise Nissan of Cape Cod 258 North Street, Hyannis,MA 02601 Is. Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. --------------------------------------------------------------------------------------------------------------------I------------------------------------------ ------------ ---------------------------------------------------------------------------- ---------------------- -------------- --------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2010 unless sooner suspended or revoked. WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2009 JUNICHI SAWAYANAGI THOMAS A. MCKEAN,R.S.,CHO Director of Public Health - � Town of Barnstable ' Barnstable oFtT Regulatory Services Department AB-Americacalp 0 A>g Public Health Division i • v "`'' , 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. 3, 0 -y�,'1 DATE —fib- 0A APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT k�ityU L g4g'�S'a- ni, Crlknc= C04,�- ADDRESS OF ESTABLISHMENT • TELEPHONE NUMBER U — 9s-2 SOLE OWNER: YES A--,NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: t e A (K)U ir 00b ra.1 E TJ L,_' - S Q[z.i, N 41 c:("b )'n"4 0 IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION M/P_,2)S FULL NAME AND HOME ADDRESS OF: PRESIDENT (ZucAN vz_tc a Vj-N& c)A 3 WC nn, r<0 iuttia? �ii wt e� Irn U2'S3� TREASURER 1��c� r{ _ f� uvr i rs �n . c s �v �nr c�, p CLERK S C-vt-N N \.� i tI auk ..n l GNATURE OF APPLICANT • RESTRICTIONS: HOME ADDRESS A76izsE yvuce6 !!7 O-Z HOME TELEPHONE# �e S- -7-7 Q:\Hazmat\Haz Mat Application2008.DOC MAIL-IN REQUESTS Please mail the completed application form 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 time 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 plan (to handle hazardous waste spills, etc.) In addition, please mail the required fee of$100. Please make the check payable to: Town • of Barnstable. The check must be mailed to the address listed above. Allow time for in- house processing. For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page a • Q:\Hazmat\Haz Mat Application2008.DOC Number Fee 36 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Bearse Auto Marine 77 Enterprise Rd., Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------ -------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2010 unless sooner suspended or revoked. ----------- ---------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2009 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health T . Town of Barnstable " Barnstable Regulatory Services DepartmentAD-kneficaCft • Public Health Division + IAMS`C'ASM + Q I., MASM 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. 6! DATE —/ ✓® 9 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT R4 6ev r 1 .S_@ NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENTN • TELEPHONE NUMBER �� S SOLE OWNER: bL YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS O ALL PARTNERS: `r' * cs �, co un IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME I ADDRESS OF: PRESIDENT TREASURERA4111 CLERK IEU SIGNATURE OF A PiLICANT • RESTRICTIONS: HOME ADDRESS HOME TELEPHONE # Q:\Hazmat\Haz Mat Application2008.DOC Number Fee 36 THE COMMONWEALTH OF MASSACHUSETTS $10o.00 Town of Barnstable Board of Health This is to Certify that Bearse Auto Marine 77 Enterprise Rd., Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 30, 2009 unless sooner suspended or revoked. --------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/08 JUNICHI SAWAYANAGI THOMAS A. MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable Barnstable INE Regulatory Services Department o ;edcaCftv Public Health Division ■ARNSPABLE. 'm 9$ 639 � 200 Main Street, Hyannis MA 02601 AjfO MPS a 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO., ~* DATE ,/n r.SU! dg APPLICATION iOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANTRAAZVx- NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT m a TELEPHONE NUMBER �� `�� 'ASV �- r- SOLE OWNER: KYES NO ca a IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADD S OF ALL s PARTNERS: r- m IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. Qq STATE OF INCORPORATION 6 FULL NAME AND O E ADD SS OF: PRESIDENT S-c t( 1 3� TREASURER i ,�, CLERK 3 SIGNATURE OF APPL ANT RESTRICTIONS: HOME ADDRESS f�&loJ HOME TELEPHONE# q Q:\Hazmat\Haz Mat Application2008.DOC Number Fee 36 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Bearse Auto Marine 77 Enterprise Rd., 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 June 30,.2008 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. 7/1/2007 PAULJ. CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health .T Town of Barnstable °F Regulatory Services Thomas F. Geiler,Director (� v v MR'AS& Public Health Division i6 9 1e� 39., °r Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Far: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE ! �� APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT Uto-t- Ir'SQ NAME OF ESTABLISHMENT �kAah _ ADDRESS OF ESTABLISHMENT .�,1Ticl S� l9Nai1S, , .TELEPHONE NUMBER SOLE OWNER:__SC_YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OFrLL PARTNERS: 2 r ra > IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. U C�> M M STATE OF INCORPORATION , FULL NAME AN ZE AWDRESS OF: PRESIDENT n/ts TREASURER v 1' CLERK 3 _ `F AN S NATURE OF APPLICANT RESTRICTIONS: .HOME ADDRESS HOME TELEPHONE#tJ n?$ 9! r/ C Beam Auto Marine,Inc. 77 Enterprise Rd. Hyannis,Massachusetts 02601 Phone 508-775-4571 -Fax 508-775-5957-Email Bam77e@comcast.net We have contract with Cintas Corporation to remove wiping rags used to clean small spills. All Needs Environmental Services collects any waste fluids periodically. We do not store large amounts of hazardous materials on the property. Number Fee 36 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of. Health This is to Certify that Bearse Auto Marine 77 Enterprise Rd., 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 June 30, 2007 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. June 19, 2006 PAUL J. CANNIFF,D.M.D. THOMAS A. MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable P� ✓ i p p Regulatory Services Thomas F. Geiler,Director Public Health Division //^l Thomas McKean,Director (( W 200 Main Street, Hyannis,MA 02601 Office: 508-8624644 Fax:.508-790-6304 . Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS NIATIERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT 13-a4 e'.Se Af4c) VAccy�>✓Le ..LAIC ADDRESS OF ESTABLISHMENT �/b �r✓Z�' 1 Sr A d dx_X�All S 'l �,d?6CI TELEPHONE NUMBER �(I `�`�S q&7/ -SOLE OWNER: YES NO ` IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PART I S: :_ 1 ;✓ c.= co IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 0&( 2f>6,X PV,7 STATE OF INCORPORATION FULL NAME HOME ADDRESS OF: PRESIDENT 4.-r P l arIQ v -y Cif. . owu S X44 d a6d TREASURER `"r `? ✓ cv�l�eec� h .v�S AM e m'l CLERK 3v C OF 2 �L —1-IJ SIGNATURE OF" LICANT RESTRICTIONS: HOME ADDRESS [2 Aelvwh e&l r 11yT�s � HOME TELEPHONE.# ap 79 g- HQz.doc'an(r MAIL- IN REQUESTS Please mail the completed application form to the address below. Also include copies of your employees food sanitation training certificates. In addition, please include the required fee amount (see fees at bottom of this page). 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 S Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax copies of your employees food sanitation training certificates. In addition, you must mail the required fee amount (see fees at bottom of this page). 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 Page Town of Barnstable °FIB n Regulatory Services Thomas F. Geiler,Director ` 5 Public Health Division TfoA Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax:.. 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS t �� FULL NAME OF APPLICANT �lt7' A NAME OF OF ESTABLISHMENT K(P'-"""' ADDRESS OF ESTABLISHMENT a3 G yfer^p rid g /. • an I^1A Z60 I TELEPHONE NUMBER 77 S - :3 2 r1.7 SOLE OWNER: �°'' YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: c. IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. i � ra STATE OF INCORPORATION `n n' FULL NAME AND HOME ADDRESS OF: PRESIDENT r-- TREASURER CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# Haz.doc/wp/q A I Town of Barnstable oFt Tow Regulatory Services ti Thomas F. Geiler,Director f `" MASS.' 639 Public Health Division to 9� i `0� �1 'Oleo" Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax:. 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. 2 9 3-017 DATE June 20 , 2005 ` T APPLICATIOl�, FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT Robert P . B e a r s e , J R . C+ NAME OF ESTABLISHMENT Bearse Auto Marine Inc . C ca z ' N cc, 71 ADDRESS OF ESTABLISHMENT 77 Enterprise Road, Hyannis , MAS 260,C0 Ln ( 508) . 775-4571 TELEPHONE NUMBER vc� N SOLE OWNER: YES X NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 0 4-2 6 6 2 2 6 7 STATE OF INCORPORATION MA 1979 FULL NAME AND HOME ADDRESS OF: PRESIDENT Robert P . Bearse., Jr - TREASURER Arrowhead Dr . Hyannis MA 02E�01 TREASURER _Robert P . Bearse . #30 Terry Ct_, Hyannis ,MA_ n26n1 CLERK-- Janette E. Bears , SIGNATURE OYAPPLICANT RESTRICTIONS: HOME ADDRESSI7 Arrowhead Dr . Hyannis , MA 02( HOME TELEPHONE# 5 0 8 7 7 5-8 9 51 Haz.doc/wp/q i Town. of Barnstable o� r Regulatory Services • 'y. Thomas F. Geiler,Director ~ nexsrasze. �E Public Health Division .� Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee:$100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO. STORE.AND/OR UTILIZE MORE THAN 111.GALLONS.OF.HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT > last ciN-e .niP ADDRESS OF ESTABLISHMENT F—, 9d A-'6t'.'U TELEPHONE NUMBER SOLE OWNER: YES GAO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION- j FULL NAME OM AJDDRESS OF: PRESIDENT TREASURER CLERK t GNATMVIATHMANT RESTRICTIONS: HOME ADDRESS `7Y A�a��"e�dC �`�yDi✓I`�`S "I/fi HOME TELEPHONE# Haz.doc/wp/q _ - -- -~ --- - --— z MAID,-IN REQUESTS Please mail 'the completed application form 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 plan (to handle hazardous waste spills, etc). In addition, please mail the required fee amount of$100.00. Please snake 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 Town of Barnstable l °FtME ro Regulatory Services Thomas F.,Geiler,Director '"�''AM.LF� ' Public Health Division 0:19. Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. �l .-j N 1`� DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT yr NA OF ESTLISHMENT T .l;✓4�` r A��'6 a {�c I iv, ME AB ADDRESS OF ESTABLISHMENT : Q, TELEPHONE NUMBER SOLE OWNER: YES ?C NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO.QY/ �0 147 STATE OF INCORPORATION I'I & FULL NAME AND HOME ADDRESS OF: f PRESIDENT P Q s �r j Yo NN, r,J� I A hh I TREASURER 67. CLERK O`.0 v -V SIGNATURE OF APPLICANT RESTRICTIONS:RESTRICTIONS: HOMEADDRESS l� dJL,d��,�,�eQ rf2 l OR j( HOME TELEPHONE# Haz.doc/wp/q TOWN OF BARNSTABLE-7 2 J UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS NAME BEARSE AUTO MARINE, INC. ADDRESS ENTERPRISE ROAD VILLAGE HYANN I S, Iv1A LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE: • OR CHEMICAL 16 77 ENTERPRISE ROAD, HYANNIS 4; 'a 7 6- 1 0 n: i i U IL. /4 (Give same information for any additional tanks on reverse side of card) DATE OF PURCHASE OF EACH: 1. �' (-' 2. 3. 4. DATE OF FIRE DEPARTMENT PERMIT: All 5'9 H�' /��- U r L 74.IJ TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS TOWN OF BARNSTABLE BAR-W Ordinance or Regulation WARNING NOTICE Name of Offender/Manager s . t c.,.x,,4a Address of Offender �" , , ; ,., + ,�# �,,,� MV/MB Reg.# Village/State/Zip Itr LA ),4,U i AQ1 Business Name „'t x '". "1 + r +, `, .._. : :00 am/N. on 20 1kj ';' Business Address '" 'awt ,. . ,t: .% t �xF.. l�,«•r. _ Signit .of' Enforcing Officer Village/State/Zip -�ta►rtat-tvs . . `� ` Location of Offense AP,^ �� t ��w�►� Enforc° ng Dept/D%vision off ense'"I o of, (,ram ,jnJ Qr$6& 3e ,%ye -4**4 A c "51 �' a 4ni Z 4 4 - .:7- 1 t, i Facts #.f.;.• ads f� 1� 1 fl .ta r¢"'"i s�e.f zr z :f. ^1l zaY�t �4MAde T ih s will serve only as' a wazdiing. At this,'tifne no legal action Chas 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. TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM �. NAME OF FIRM: PLAof 5; Z5 Pt17-b -A-? fc't & ,rNG MAILING ADDRESS: q t;� PP t 5E '�, f� �/ "� < S tn'lA 40G7 6 TELEPHONE NUMBER: 7 75'- CONTACT PERSON: 0 t3 i R•"7 � 13 e',O- R 3 E Does your.-.firm store.-any.-of the-:toxic or. hazardous: materials li.sted-=b:el.ow, . either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a YES or NO answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put a check beside each product that you store: _ Antifreeze (for gasline or coolant systems) Refrigerants Automatic transmission fluid Pesticides (insecticides, Engine and Radiator flushes herbicides,rodenticides) i Hydraulic fluid (including brake fluid) Photochemicals Motor oils/waste oils Printing Ink Gasoline, Jet fuel Wood preservatives Diesel fuel, Kerosene, #2 heating oil (creosote) Other petroleum products: grease, lubricants Swimming Pool chlorine Lye or caustic soda Degreasers for engines and metal Jewelry cleaners Degreasers for driveways & garages Leather dyes ' Battery acid (electrolyte) Fertilizers (if stored Rustproofers outdoors) Car wash detergents PCBs Car waxes and polishes Other chlorinated hydro- Asphalt & roofing tar carbons, (inc.carbon Paints, varnishes, stains , dyes tetrachloride) Paint and lacquer thinners Any other products with Paint & Varnish removers, deglossers "Poison" labels (including Paint brush cleaners chloroform, formaldehyde, Floor & Furniture strippers hydrochloric acid, other Metal polishes acids) Laundry soil & stain removers (including bleach) Other products not listed Spot removers & cleaning fluids which you feel may be � '��4 toxic or hazardous (please (dry cleaners) listY.;, Other cleaning solvents HEALTH DEFT. Bug and tar removers TOWN OF BARNSI HE Household cleansers, oven cleaners Drain cleaners Toilet cleaners Cesspool cleaners Disinfectants JUL J. 5 19�1 Road Salt (Halite) 6. A TOWN OF BARNSTABLE BOARD OF HEALTH CONTROL OF TOXIC AND HAZARDOUS MATERIALS - INSPECTION SHEET FIRM &'rf a, ADDRESS Major types of materials:. 1) AL20 `-t- 2) 3} Alf". 4) llf`r- ry 5) l 6) —r I. Description of material (s) use: II. Storage (denote product by number listed above) A. Containers metal glass paper plastic cans,bottles,jars drums,barrels aboveground tanks underground tanks ' Z 7 bags,boxes open,loose,uncovered inadequate labelling B. Storage Facility for # Remarks/Recommencoz_;� .ions 1. Indoor a) separate, contained room b) stored in general work area i) inadequate ventilation ii) floor drains iii) inadequate fire protection 2. Outdoor a) uncovered, exposed to weather b) pervious surface/catch basins III. Disposal A. Reclamation/Recycling unit B. On-site disposal k{ s0t -13 . 1. Town sewer A b 2. Regular septic system 3. Separate holding tank ,er C. Off-site disposal 1. hauled by own firm 2. hired hauler a) name of hauler IL61Ae b) address or disposal site co" Person(s) Interviewed _ _ — ,�� — Inspector _ — _ Date ✓ �� L 6 30 81 - - - - - - - - - - - - - - OWN OF • BARNSI% 26 Printers r Q satisfactory 3, Auto Body Shops (%BOARD OF HEALTHunsatisfactory- 4. Manufacturers . � (see"Orders") 5. Retail Stores COMPANY =- 6. Fuel Suppliers ADDRESS 1`t -- - Class:_ 7. Miscellaneous / QUANTITIES AND STORAGE (IN=indoors; OUT=outdoor MATERIALS Case lots Drums AboveTanks ndetground Tanks MAJOR I E e 1 IN UT Fuels: Gasoline, Jet Fuel (A) Dies,e (a) Heavy Oils: waste motor oil (C) z new motor oil (C) transmission/hydraulic t '. Synthetic Organics: y � degreasers ' • v n� 00 Miscellaneous: ' D l S POSTAL C ION ill REW%RKS: 1. Sanitary Sewage 2. Water Supply c} rrs OTown Sewer Public' On-site, Private -3. Indoor,Floor Drains: YES NO Holding tank: MDCI '® Catch basin/Dry well .___.-- -.---•-.._. . - ---•._...._....- -.-- ' On;site system 4. tdoor Surface drain N . r r•e Q Holding-tank: MDC w - Catch basin/Dry well On-site system Licensed? S. Waste Transporter XES -NDName of Hauler_ Dectinati nn -11,1ate Product . r 1 u z� ei erson '.) °t.erviewe fi, .—__Ins Uate THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) M 7� 'L� DATA TQ N OF BARNSTABLE COM AECLASS: 1. Marine,Gas Stations,Repai.r satis 2. Printers BOARq j j HEALTH 3. Auto Body Shops � , , ! unsat4. Manufacturers � �' 5. Retail Stores COMPANY �— - 6. Fuel Suppliers ADDRESS Cl7. Miscellaneous CM QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) Case lots Drums AboveTanks Undetgrouad Tanks MAJOR MATERIALS IN IDUT IIN IOUT IN tOUT # & gallons Age es ? Fuels: Gasoline, Jet. Fuel (A) Diesel, Kerosene #2 (u) Heavy Oils: waste motor oil (C) _ new motor oil (C) f �u transmission/hydraulic Synthetic Organics: degreasers ' Miscellaneous: Imam i DISPOSAL RECLAhATION _ REW,RKS: 1. Sanitary Sewage 2. Wate ply wn Sewer Pu 'z- ® On-site Private i 3. Indoor Floor Drains: YES NO _ ® Holding tank: MDC (_ �1�,Qr�i"`- ��--_..._..... �C2atch basin/Dry wellOR r .�� 0 On-site system 4. Outdoo Surface drains-.YES ZNC Holding tank: MDC Catch basin/Dry well -._-- ® On-site system S. Was e Trapporter Licensed? �/1Ya of,-Hauil �� : , , = -Waste�rod�uct , �z Persons InteinriqP7ed Inspector Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: ��iv✓� �i�i .v�.� Board of Health MAILING ADDRESS: 77 Town of Barnstable TELEPHONE NUMBER: L5-7 L P.O. Box 534 Hyannis, MA 02601 CONTACT PERSON: w -,E4— Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in qu�aptitles totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO , This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when store Please put a check beside each product that you store: V Antifreeze (for gasoline or coolant systems) Drain cleaners 1/ Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants _ " Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants t/ #2 heating oil Pesticides (insecticides, herbicides, i y Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing.ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business h - i TOWN OF BARNSTABLE �MPLIANCE: CLASS: 1.Marine,Gas Stations,Repair nters BOARD OF HEALTH satisfactory 3.2.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY .f�,11L7`1� Q,Z/ (see"Orders") 5.Retail Stores �- ` 6.Fuel Suppliers ADDRESS f :�- ,�''.l✓�� Class: / 7.Miscellaneous jr QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALSCase lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) .aie.s4e4—, 1@ -#2 (B) Heavy Oils: 29 waste motor oil (C) new motor oil (C) transmis h dr u is Synthetic Organics: degreasers Miscellaneous: a f � dr DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply O Town Sewer ublic s �On-site OPriivaate 3. Indoor Floor Drains YES /' NO O Holding tank:MDC O Catch basin/Dry well jV On-site system _514vnot 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC X Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product 1. �! _J` 4r4A1;W !' ell, YES NO 2. Person (s) Interviewed In pector Date