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0322 FALMOUTH ROAD/RTE 28 - HAZMAT
:>�. � y Number Fee 1081 THE COMMONWEALTH OF MASSACHUSETTS, $150.00 Town of Barnstable Board of Health This is to Certify that Balise Nissan of Cape Cod 322 FALMOUTH ROAD, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. ---------------------------------- -------------------------...----------- ----.----------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2020 unless sooner suspended or revoked. --------------------------------------- PAUL J.CANNIFF, D.M.D,CHAIRMAN D_ONALD A.GUADAGNOLI, M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A. MCKEAN, R.S.,CHO Director of Public Health i Town of Barnstable Inspectional Services BAMSTABLE .THE T[L. MTGX4 IUS O A.W :,n•�Y.Nve Public Health Division W���u`y5=° ��<"'"�a" E BARNgrABLE, ` Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS DULY 1 st—JUNE 3 Oth). 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 X M7 *A late charge of$10.00 will be assessed if payment is not received by July 1st. fo C;w-=W- 801,q 1. ASSESSOR'S MAP AND PARCEL NO. �/ i�► , I 7, �� 1•jr? 2. IS THIS A PERMIT RENEWAL? ✓ YES_NO. IF YES, SKIP QUESTION 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: -rhjM,P_5 9 , I?yjI j"o. e-- 5. NAME OF ESTABLISHMENT: je.��� m�6Ca.►') AA.)b&yz )WiSSE A1/�tn 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 15� r lrv�(g 9. EMAIL ADDRESS:-1Uk pA c ', 10. SOLEOWNER: YES_.�XO IF NO,NAME OF PARTNER:, 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME I PRESIDENT TREASURER % 1Y1 i CLERK Eftpr) 12. IF PREPARED BY OUTSIDE PARTY: NAMEkjr)d& r& TELEPHONE • COMPANY ADDRESS Z rrhngdAEMAILI f .aO7 ah h 1 S ln'iGi f1 r'�l�® SIGNATURE OF APPLICAN DATE bh J g Q:\Application Forms\Haz Mat App Revised 09-10-18.docx Number Fee 1081 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Balise Nissan of Cape Cod 322 FALMOUTH ROAD, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2019 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 4` TRowr of ftnggble eg atory ervies Richard V. Scali, Director Public Health Division BARNSTABLE ` BA NWAMX. Thomas McKean, Director 1639-2014 « ww510N5 M105.OS1ErtYSlE•wlil EfSJ1AM:F MA83. �O --------mow - — -2001VIairi-Street Hyannis;MA 02G01-- - - ------ -----.--- - -��� +� 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 3 Oth). 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: $150.00 X V.$ . *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 81M V,01l :3 1?"V'? 4 2 8 I `A-1 2. IS THIS A PERMIT RENEWAL? ✓ YES_NO. IF YES,SKIP QUESTION q 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: �O.i`(�� E t)o��iSst. �S-C 5. NAME OF ESTABLISHMENT: -SSOX-L - �a��S;\f��5Su,,r 6. ADDRESS OF ESTABLISHMENT: 2)aa �cY•a., r�� •�c c�c�c C�� Od�o \ 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE:10)A,ahS 5o\ Q& G{ B�-ic c� AN oakDu S. TELEPHONE NUMBER OF ESTABLISHMENT: 525 9. EMAIL ADDRESS: J�► S`kC't C.xo Q &R Qz,&z t (YN 10. SOLEOWNER: YES �(-NO IF NO,NAME OF PARTNER: ZIQ . n1yo S 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: �{ -73b- CORPORATION NAME s5 1. o y�„ &L sn. 1 11 b PRESIDENT la - Via, ► Kalov, TREASURER �! �-kj � CLERK t $�5 NJ 12. IF PREPARED BY OUTSIDE PAR Y: NAME: 6C2CLa�.��5t 1 cz 'GN��� TELEPHONE it: COMPANY ADDRESS 3 a, EMAIL:brzi\syl-uE) Z a 'se. R�13vz> c3�v- 11 SIGNATURE OF APPLICAN ti w DATE (A ap\1 Q:W,pplication Forms\HAZMAT APP 2017 REVISE D.docx Number Fee 1081 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Balise Nissan of Cape Cod 322 FALMOUTH ROAD, Hyannis, MA Is Hereby Granted a License �q For: Storing or Handling 500 gallons or more of Hazardous Materials. --------------------------------------------------------------------------------------------------------------------- ------------------------------ ---------------------------------------------------------------------------------------------------------- - This license is granted in conformity with the Statutes and ordinances relating there to, and 4 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 f� I aQ fi - i ss a v-,� Tjw1� of Unstable Kegulatoervices Richard V. Scali,Director Public Health Division BARNSTABLE 6.xnsrnele••�.ru,,iut•conrrt•xrurrs -' &&RNaz•ABL Thomas McKean Director """��'"°� MAS& �1 f 1639.2014 039. 200 Main Street, Hyannis,MA 02601 J Office: 508-862-4644 02O/-7— R,0100 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE cap HAZARDOUS MATERIALS IN 1 ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 �7 CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ,g( V.:S *A late charize of S10.00 will bne assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO.Ot 15 1 O 1 IT a:ZTDlN� qj 2. IS THIS A PERMIT RENEWAL? YES_NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS • ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: To,M2S E (3gAi Ste. :yr 5. NAME OF ESTABLISHMENT: R.yS 6. ADDRESS OF ESTABLISHMENT: 3 X�-FcArv\tN;bN ec� gtlrl i s M K Q ako 0 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 0J0H��� hvo4 R�, 1�.r,wnn,i s I` abpl S. TELEPHONE 1V'UNMER OF ESTABLISHMENT: �b nr�l -3b 3w 9. EMAIL ADDRESS: b'Clx l l C.p @ bc�-N 10. SOLEOWNER: YES X NO IF NO,NAME OF PARTNER: �N� i 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT c- l & W O l Q TREASURER tYl (Yl►tv z c�S2 P a 8 5 CLERK 12. IF PRE ABED BY OUTSIDE PARTY: NAME TELEP O�iE#:,��3-54 8-3$SO COMPANY ADDRESS I Y�� EMAIL rl s-�icA O,�iSQ G�{� .G�`✓� �'�an n'►s MA O �v o l SIGNATURE OF APPLICAN L DATE la�-I 1-7 QAApplication FormsIHAZMAT APP 2017 REVISED.docx it y°FINE*ok� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BABMASS. 200 Main Street• Hyannis, MA 02601 t639. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT e Business Name: �7a.� S /� S s a,v` e� C Cod Date: 4 2a /t. Location/Mailing Address: %1&V%V1J Contact Name/Phone:`o n.,r kh. o8-757-(6 '7o 1>01% Ak We im 7 r Inventory Total Amount: �` , MSDS: CoM th,-- 0A �b5k4-09- License#: Iy$ j CAfl; Tier II : t<,ei? Labelina: 0* Spill Plan: Oi[/Water Separator: Je-47 Floor Drains: e,� Emergency Numbers: Y�5 Storage Areas/Tanks: 1610 A11A)•V), 3001al fkt(v a.�r. ,w•y���-0�x.o 1 awl�awl� lac R-eB�,�eS{ 9�Sol � Emergency/Containment Equipment: rv� �11� � �"� 2°� �w,a���°b�ai".t`•> 'o44«y Waste Generator ID: �Dt 4$ l ob t `v aste Product: g 4QLt- � Date&Amount of Last Shipment/Frequency: o� �•�.x r,o arks �luw�r- vnr kt c tR Licensed Waste Hauler&Destination: (21w 191 1- o 1 a 1ml Clow . e"ek ctla, o✓ Other Waste Disposal Methods:�VA�j Come, - r�/w�aw o tO5 51�4�1)C IV e LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. J Antifreeze Dry cleaning fluids ���V-- Automatic transmission fluid �— Other cleaning solvents&spot removersq Engine and radiator flushes Bug and tar removersf� l � oo. �— Hydraulic fluid (including brake fluid) ✓ Windshield wash Gt� Motor oils ti Miscellaneous Corrosives Gasoline,jet fuel, aviation gas\O Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants V Miscellaneous petroleum products: Road salts grease, lubricants, gear oil qN\ Refrigerants J Degreasers for engines&garages P,14�,N Pesticides: Caulk/Grout t+< t x insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers A lt?o 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: ('M011W-65A CtGGLgh o e� , 5 �a �S �S � CJwI.� y ,Q, : w �. �'t5. v � ,� � N• S• S yrl�v�cl g l s o w a� mr� 0,11 fosk 0e, / Inspector: ►N6,0Z,i VJ A O��w • Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS �3 Number Fee � 1081 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable _ Board of Health This is to Certify that Balise Nissan of Cape Cod 322 FALMOUTH ROAD, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2017 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 f Town of Barnstable �WE Regulatory Services Richard V. Scali, Director ' B"R"6 Public Health Division F:5Tu#wu*A1:uLEb q. 0 •�rranna3 � 61gnSGBtFThomas McKean,Director N(� 200 Main Street, Hyannis,MA 02601 �N Office: 508-862-4644 Q /t Fax: 508-790-6304 APPLICATION FOR PERMIT TO STOREAND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE.WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ 'r CATEGORY 3 PERMIT 500 or more Gallons: $150.00 Y `o A late chame of$10.00 will be assessed if payment is not received by July 1st. ASSESSORS MAP AND PARCEL NO�� o?9314 , , DATE dtv FULL NAME OF APPLICANT: NAME OF ESTABLISHMENT: ADDRESS OF ESTABLISHMENT A''R �IrY1 `I�1 �(� , 14 4"Vi w5, ' 1 lA 0 --(oo l. MAILING ADDRESS(IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: EMAIL ADDRESS: m6r.-� 8Q 6.�a V-L. co SOLE OWNER: YES NO IF NO,NAME OF PARTNER: FULL NAME,HOME AD RESS,AND TELEPHONE# CORPORATION NAME -1 15 M A PRESIDENT C . S D Z$}• rd kQLI� TREASURE L rk5 CLERK IF PREPARED BY OUTSIDE PARTY: S ATURE O A LI T N me: Company Address : Telephone#: Email: Q:Wpplication Forms\HAZZAPP Rev I6.docx Page 1 of 2 THE T°� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 9 BARMASS. 9` 200 Main Street• Hyannis, MA 02601 �PrFD M p`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: bond I Sp- 4 S Sa w o cap— L' Date: � 247 / Location/Mailing Address: 3Z7Z VZ1 wNPJV.— Contact Name/Phone: o,n 2leu ('.Ace_ $tea S`7 37o W 1 y�' �owll�tCPat�,-;� Invento Total Amount: Saoo ��1 MSDS:C0.I� �K -YO►�I�tKl� Eiden a#: I t>9 I Tier II . Ip Labelina: ov Spill Plan: e , - ,4A CAI I K- Oil/WaterSeparator: -6A ��L�'L3 Floor Drains: Ow Emer enc Numbers: S Storage Areas/Tanks: - 0 'kkor� a I tiJ 0 15,00 JfVJ&J14efoc. S`T Emergency/Containment Equipment: I(gyp Vt�h�til�„eI�CQ v. ��v ;' ��� fsw"- Waste Generator ID: f 1��°I (�1. 1 Waste Product: 411 ,X,1+&5.,Uk<kS Cl eAu-�-d, Date&Amount of Last Shipment/Frequency: OtK.���c 1�2e, OV6 Iu� i Licensed Waste Hauler&Destination: aha eSks Jt btitj ✓S• �5 �o►ti ,,eS Other Waste Disposal Methods: kce -1- &V 84-11,� df -Al Q Lf Aof 061- I Htr,+A.�fC. Cry5ta l Gl 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. 1\/J Antifreeze Dry cleaning fluids Automatic transmission fluid T- Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers —� Hydraulic fluid (including brake fluid) �- Windshield wash ` Motor oils Miscellaneous Corrosives Gasol_ ae,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 25 insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteriesV Photochemicals(Fixers) Rustproofers ,�100 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: VV-Z z ®d CO aC P o.( C -�k ow gP X k,P-Yo r )0a4 fie C� fie--'-A If 5 Inspector: le, Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number Fee 1081 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Balise Nissan of Cape Cod 322 FALMOUTH ROAD, 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 fs� f Town of Barnstable Regulatory Services Richard V. Scab,Director � BA8N8TAgt„E, : f�;n , S Public Health Division 4; Thomas McKean,Director �a 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 F 508-790-6304 Application Fee: $100.00 ; , 10, l 1, 1 e2 ASSESSORS MAP AND PARCEL NO._o? 7,ad' y/j DATE /j APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERLA—LS FULL NAME OF APPLICANT ; A ' Mgr ; tYL NAME OF ESTABLISH3fENT 0 r ADDRESS OF ESTABLISHMENT QJR'� �� �,�'f�, �� , ��� I,S I'4,4 t TELEPHONE NLMER SOLE OWNER: YES vZNO IF APPLICANT IS A PARTNERSHIP,FULL NAMT AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION NA FULL NAME AND HOME ADDRESS OF: PRESIDENT MA d lok� CLERK TREASURE Ol O��r r SIGNATLRE/ OF APPLIC ANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# CAcachelTempomry Intemet Files\O M'MAZAPP ReQ015DOC r °F IKE Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARM E. AS& • 200 Main Street• Hyannis, MA 02601 Fo 06. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: &1,5e- a� C-S Date: 22 Y Location/Mailing Addres : .32'2- F'alw�o Q }} Quirt,s Contact Name/Phone: SD - 9S-7- 6370 '1 one `7ot9-vt 0 `Jeav,c-Q- S,r. Inventory Total Amount: ��- `Iq��°�` MSDS: License#: l 08 l Tier II : rJ° Labeling: Spill Plan: Ycs Oil/Water Separator: Ye-6 rccvca25 AVu AElpor Drains: Yes 7 ow S Emergency Numbers: t S Storage Areas/7anks: � -loon vao e o• 1So ,,oil , 30og�tAST-�754j ar*�g«� . ��ogal Asr wi..2sWeis Emergency/Containment E ui ment: SPA 5orbe� aya,la\ol�4tyt66e+ (xhs) Waste Generator ID: M \jqS I ©b!;'l -7 Waste Product:a,Ir�%IfeK{Sol,As Date&Amount of Last Shipment/Frequency: io e d x/+ip• ,xr}s e,.-Cawc r 2>c4X Licensed Waste Hauler&Destination: $2ce)cy Af<,le--,,.. -`— Other Waste Disposal Methods: rJJA LIST OF TOXIC AND HAZARDOUS MATERIALS �o WVt lose cA&AAAL1b tut,, AVvsj t�of SIVkf- kAl� 1k5 f1,1 NOTE: Under the provisions of Ch. 111, Section 31, of the General Lawsubf MA, hazardous material use, t 123 I' storage and disposal of 111 gallons or more requires a license from the Public Health Division. JAntifreeze Dry cleaning fluids Automatic transmission fluid v/ Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers —�� Hydraulic fluid (including brake fluid) --� Windshield wash �~ Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes �— Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil&stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS' NO t51t)\Xl� o! et} %4 w�-e- Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: /,13/ TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS RENNSTRAMIN FORM NAME OF BUSINESS: &13-e- BUSINESS LOCATION: �322 rah ,rvla,rE-Q� l� }�U4n,�, 5 INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: .So S- 95�7 (6'3'7o y 9z S CONTACT PERSON: Aid l / K-0-f l-e-k-e-r EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: eki,4 Y77ke I4Ml,,t-t,?e -ess INFORMATION / RECOMMENDATIONS: )A1101v relm-OWA caQ 9tira�e is c/ern y G Fire District: o n,L .Cwu- cvr;/lor anl� �A fox► },�l a e,I Iu -we5 g HV-torl,s AS+e 62 e,(r be elf V or IV(_ lte, 4-r eow-f-41 eu j- n. S,�c oev 64zK 3 0 e oc a s sh�1 nod'- o /K- r�vkr-'r&sk ✓mle55 C-o" c � y i a//�ovt-Fa�vt 10 na. -c �C 1e, k lu n ✓t o �+a. v� c°ar► ,ri. bc1 Waste ., ' :; MAt PQks o6 s1�7 L st shipment of hazardous waste: :Tan 2or� Name of Hauler: _ale--r,/ yt.- Destination: Waste Product: Oil, DQr4S Licensed?� No -. Tq I l�oBy�0Z8`f Z- T�� F C/ZaKzt 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 3$� A ntifreeze (for ga line or coolant systems) Miscellaneous Corrosive W Qo a USED 300 45'< Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) /0 Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides O NEW s°o (insecticides, herbicides, rodenticides) 106o 6o USED Z,00 Photochemicals (Fixers) Gasoline, Jet fuel,Aviation gas Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) /0 lubricants, gear oil ❑ NEW ❑ USED 3o Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine 7o 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) / D Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous(please list): Metal polishes 6 Laundry soil &stain removers (including bleach) { n �L�DC+�iv of c►�l�e� Yac Bc.C+/�G I-npl Spot removers &cleaning fluids n (dry cleaners) 0A,9JU VeA' _4 'r►�ct a' 1�iPi�'t,5 v��fewt o l 5 Other cleaning solvents (�/oolClc4 / Bug and tar removers is / a0"e/1 avG+- 1 ,Zooe ,wg o►�I Windshield wash 7 3'G�taNtbefe�cQ1e� WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signa ure Staff's Initials Number Fee 1030 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Ford of Hyannis 332 Falmouth 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. May 24, 2006 PAUL J. CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health l Town of Barnstable FINE ley, Regulatory Services v ti o� Thomas F. Geiler,Director f Q . &UMSTABLE. ` Public Health Division J MASS.9� 165 ,0�' ATED ena'�A Thomas McKean, Director are 200 Main Street, Hyannis, MA 02601 f Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. OJO DATE f /� 04,. APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN - 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT 71C#,4P-f) �. PeVIA4G:—IejAJ NAME OF ESTABLISHMENT !G(1 !FyArua[iS ADDRESS OF ESTABLISHMENTAi_nv,v;`ti TELEPHONE NUMBER 77,5"6 12- SOLE OWNER: YES ✓NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALLY PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. G'fJ I L7,3 STATE OF INCORPORATION FU �ME AND HOME AD PRESS OF: PRE RE /ate/sC JC l/6 SF&w'GF1,a6 /11/1 G'/c,�l TREASURER llcm, '- •CL/ itmvktti :�or� G= s3 �✓ GN �L SI 'N URE OF APPLICANT RESTRICTIONS: HOME ADDRESS „ z %3 L)C• � % �til e-h i10 HOME TELEPHONE# \5U8- 7,3-7-Z`V y Q:\Application Forms\HAZAPP.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 five to seven (7)working days for in-house processing. Our mailing address is: Town of Barnstable Publie 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 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) 86274644 Back to Main Public Health Division Page Q:\Application Forms\HAZAPP.DOC • t� f Number Fee 1030 THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that Ford of Hyannis 332 Falmouth Rd., MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------- - This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 31, 2008 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. 5/31/2007 PAUL J. CANNIFF,D.M.D. THOMAS A. MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable zHE. � Regulatory Services Thomas F. Geiler,Director P KAn Public Health Division 9$ iGg9. ,0�' '°JEa re�►'�" Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. , DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT �'ft�2%� Z �IlAjj5-Te,>a. NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT � v-r� .TELEPHONE NUMBER O "7 75 - %/L. w SOLE OWNER: /YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS+ ALL w PARTNERS: zn w N C"' {*1 IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 01- --0' ,3101J STATE OF INCORPORATION 1JA//z- FULL NAME AND HOME ADDRESS OF: PRESIDENT 7/6'fR/CO L �vi,�GT/l. ' lj 14)miAisr TREASURER �Am E ,6Au sF T/L //0 Z ,5ZALERK c:vsW Ah, 4) p/a g SIGNA F A//P,PLICANT C RESTRICTIONS: HOME ADDRESS �,3 A4"tQ a Jay. HOME TELEPHONE 9 �,99V-73 7—7 V91) 1 Number Fee 173 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Auto Zone 332 Rte. 28,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 31, 2008 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. 5/31/2007 PAULJ. CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable Regulatory Services �, 0 Thomas F. Geiler,Director " ` SS. Public Health Division 039. 1�� 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 Ur yen 131a;r NAME OF ESTABLISHMENT fluty Zow *51 V O ro ADDRESS OF ESTABLISHMENT 33 Ro%itc-a ir Can) TELEPHONE NUMBER $OS�- 771 ?373 M 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 d 0%�{ STATE OF INCORPORATION Ncws�rseu FULL NAME AND HOME ADDRESS OF: PRESIDENT Gill Rhodes I a 3 Soutl, Fc oc)-r S+. Memek-,(S 1 ki 39-103 TREASURER_13cie,r CojNpbe'U •� CLERK qc^,,l C-r1dst-,,t1n •i SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS l)epT S,190, /.2.3 S.FruarS-t 4e�r»� a 7N3 1e HOME TELEPHONE# %61- 7V1 7 AutoZone, Inc. Environmental Business Plan AutoZone's commitment to safety and the environment AutoZoners take personal pride in our commitment to safety and the environment. AutoZoners managers place primary importance on providing AutoZoners with a safe workplace and customers with a safe place to shop. All AutoZoners receive specific training on hazard communications, safety equipment, hazardous situations, first aid and emergency procedures. The training not only focuses on personal protection but also motivates each AutoZoner to use good safety practices throughout the entire store and parking lot. AutoZone's commitment to customer satisfaction includes taking care of the environment by responsibly handling chemicals. AutoZone Safety Dept. carefully evaluates the fire and health risks associated with each chemical product. We also make sure to comply with federal and local fire codes and environmental standards for the presentation, storage and distribution of chemical products. AutoZoners handle each chemical product as indicated by the MSDS or package instructions. AutoZone provides safety information sources like 3E and supplies safety and spill response equipment to each store so we can safely respond to chemical emergencies. The following Environmental Business Plan provides AutoZone's policies and guidelines for handling chemicals and responding to emergencies. Additional Information Comprehensive guides to our Used Oil Recycling Program, including orphan material issues, as well as our Used Battery Recycling Program are attached to this Environmental Business Plan. Environmental Business Plan ©2003 AutoZone, Inc. All Rights Reserved 1 Emergency response In the workplace, AutoZone employees could face two possible emergency scenarios. These potential dangers are from fire and chemical spills. Through proper training of AutoZone employees, AutoZone is committed to the prevention of emergency situations that may place the lives of AutoZoners and customers in danger. However, if an emergency should happen, an emergency action plan can be found in the store's office. This plan will have emergency phone numbers and instructions to be followed in the event of an emergency. Fire All fires, no matter how small should be treated as if the fire has the potential to grow and expand beyond control. The store will be evacuated until the fire is extinguished and the ALL CLEAR has been given. Small fires will be controlled, using ABC fire extinguishers, by shooting short bursts of the extinguishing agent at the base of the fire. All AutoZoners are trained on an annual basis on how to use the provided extinguishers in the store. In the event of a large fire, a member of management will evacuate the store and direct everyone to the assembly area if necessary. The manager, once the store has been evacuated, will notify local authorities, including the fire department and other emergency agencies, as . needed. The Safety Dept. will be contacted immediately after the store is evacuated and emergency agencies notified. Small chemical spills (Less than 2 gallons) Any chemical spill can be dangerous. Therefore using the appropriate PPE (Personnel Protection Equipment) and the correct response material is important. Small chemical spills will be cleaned up with absorbent materials (oil dry or soda ash) using proper protective clothing (rubber gloves, splash goggles, and acid- resistant apron). AutoZone management must attempt to prevent any material or waste from reaching drains or soil. Once completely absorbed, sweep the material into a trash bag (same day process). The Safety Dept. should be contacted immediately for disposal methods. (if after hours, contact 3E at 800- 360-3220.) They will provide information on how to dispose of the spill properly. NOTE: AutoZoners will evacuate the building if any vapors, strange odor, or any extreme medical condition is experienced Large spills (More than 2 gallons) In the event that a large amount of a chemical is released, management will ensure that the store is evacuated of all customers and all AutoZoners not trained or other wise engaged in the clean up process. All AutoZone employees will wear the proper PPE while cleaning up or containing the movement of the spill. AutoZone management will attempt to prevent any material or waste from Environmental Business Plan ©2003 AutoZone,Inc. All Rights Reserved 2 reaching drains or soil using absorbent to dike or contain the movement of the material. The Safety Dept. will be contacted immediately for the proper disposal methods or instructions. (If after hours, contact 3E at 800-360-3220.) They will provide information on how to dispose of the spill properly. The manager will notify local authorities, including the fire department and other emergency agencies, as needed. NOTE: Once again AutoZoners will evacuate the building if any vapors, strange odor, or any extreme medical condition is experienced Store evacuation In the event that the store needs to be evacuated due to a fire, chemical spill or other emergency situation, the manager will direct everyone out of the store and to the assembly area. The evacuation routes are on the Emergency Action Plan procedure diagram posted in the store's office. The manager will call the appropriate emergency agencies and account for all AutoZoners in the assembly area. ��as��iA�to�crage s e �lr t�e�e e s li As rc �z faun t� ® i �st- cr Cedaures ll a 'so laote�c ie � g ,tr o :� ' awls tc sst Alarm Central Station Alarm Central Station is AutoZoners in-house monitoring system that reports all emergencies after hours. Alarm Central Station is located in the SSC, and the emergency contact number is(800) 313-9693. AutoZoner training All AutoZoners participate in the AutoZone Safety Specialist Program. They're trained about AutoZone's commitment to safety policies and programs. Each AutoZoner receives training in hazard communication, safety equipment, recycling programs, hazardous situations, safe-lifting techniques, first aid and emergency procedures. AutoZoners are initially trained as new hires and participate in refresher training annually. The length of each training course varies from 30 to 40 minutes. Training is performed in the following areas: • Proper procedures for storing, handling and labeling hazardous waste • Proper use of 3E's services Environmental Business Plan ©2003 AutoZone, Inc. All Rights Reserved 3 • Proper procedures for keeping records using 3E • Instruction in the Written Hazard Communication Program, including reviewing MSDSs and safety procedures for materials • Review of the emergency action plans • Coordination of emergency action plans with your local fire department, paramedics and cleanup contractors through 3E • Monthly inspection and maintenance of safety equipment (including fire extinguishers and eyewash stations) • Training on the proper use of fire extinguishers • Review of the Emergency Action Plan and store management's responsibilities in an emergency Prevention AutoZone collects used oil as a service to our customers and as a commitment to the environment. AutoZone provides a 120-220 gallon portable tank wagon approved for this type of storage. The tank is generally kept in the back room of each store near the loading area. The tank is double-walled to prevent leaks or spills and provides 110% secondary containment. AutoZone uses Safety-Kleen Corp. or Asbury Environmental to remove and recycle the used oil when needed by each store. (Manifests are maintained in the store's office filing system for up to three (3) years. Each container of used oil collected from the customer should be inspected for contamination before pouring it into the tank. The tank should also be periodically inspected for damage, contamination, or leaks. AutoZone also collects core batteries as a service to customers. Proper disposal of core batteries also protects our environment from the release of harmful acid. The batteries contain dilute sulfuric acid that can cause serious harm if it comes in contact with the eyes or skin. When accepting the battery for recycling, the AutoZoners inspects the battery for leaks before handling it. If the battery is not leaking or damaged, the battery is then placed on the pallet in a specific battery storage area. If the battery is damaged or leaking, the battery is allowed to completely empty its leaking contents into a bucket before placing it on a pallet to be shipped to the distribution center. The acidic fluids in the bucket are then neutralized, using soda ash, and disposed of properly. (PPE must be worn during this process.) Mitigation and abatement (containment procedures) 410,A,a , o ild��q c l c e f e fie o f ©fr 5ne s Ito k e tcfi s a1 <The 3' - ��i/,,✓ �r-s r ' r y � v � � 6te, If an evacuation is necessary or if the spill is outside of the store, the manager will refer to the evacuation procedures posted in the manager's office and contact the following: Environmental Business Plan ©2003 AutoZone,Inc. All Rights Reserved 4 • District manager See telephone directory • Regional manager See telephone directory • Regional maintenance manager See telephone directory • Jim Davis, AutoZone Safety Manager 901-495-7240 • Environmental Specialist 901-495-7217 If further assistance is needed, contact the following: • Local fire department, police and ambulance 911 • Poison control See emergency telephone card Members of management should be prepared to provide the following information on the phone: • The store's name and address • His or her name and title • The,location of the spill • The product and amount that was spilled • The extent of any injuries • The current risks to people or the environment if known • The location of all AutoZoners and other people in the store at the time of the spill rlsi ,ess�s 4,,:` ate o elan If evacuation isn't necessary, the manager will: • Contact 3E at (800) 36063220, and follow their instructions. • If necessary, seal off all floor drains near the spill using plastic trash bags and oil absorbent. • Prevent access to the spill area except for those involved in the cleanup. Disposal of Recycled Wastes Safety Kleen (used oil) (800) 545-3520 Johnson Controls SSC Onsite equipment The following supplies for emergency response are available in all AutoZone stores: • Four 40-pound bags of oil absorbent • Splash goggles • One 25-pound bucket of soda ash • Acid-resistant apron • Mops and buckets • Acid resistant rubber gloves • Paper towels and shop towels • Fire extinguishers • First-aid kit Environmental Business Plan ©2003 A • 30-gallon plastic drum (trash can) • Plastic trash bags • Safety glasses Used Fluid Recycling 1. When a customer brings used motor oil to the store DIY customers may bring in up to 5 gallons of used fluid per visit. If a customer has slightly more than 5 gallons, accept the fluid, but register the quantity in the Used Oil Log in your computer. • Fluid is defined as motor oil, transmission fluid and gear oil. 2. Ask the customer if he or she added anything to the fluid. Explain you can't accept fluid that contains: carburetor cleaner bleach antifreeze gasoline/kerosine paint or varish solvent or thinner 3. Examine the fluid. If you can see into the container, look for water, paint chips, fluid that isn't black or dark brown or fluid that's separated into more than one layer. If the fluid is contaminated, return the container to the customer, and politely explain that the fluid can't be recycled because it's contaminated. Direct them to contact their local Fire Dept. or Public Works Dept. for disposal information. �Y���� ot��ee�; e�✓fie nta�rer, �s I e �flt�td evade �t'�t�71Tt�atl � pa '��b'e ;y�cle �Fb use t� ritar�rn ��I is o� ar�,ta ���ei%r„`.�cad 4. Enter the information on WITT JR. • Enter the customer's phone number, first name, last name, address and the quantity of fluid he or she is recycling. 5. Take the container to the recycling tank, and slowly pour the contents into the tank. • Only trained AutoZoners (NOT customers) can transfer fluids into the tank. • After transferring fluids, wash your hands with soap and water. Environmental Business Plan ©2003 AutoZone, Inc. All Rights Reserved 6 s °� tame ��f� �� y✓,�� � �' � uc � ,ate �� � ,�� p � � M e ;'117 Aer -' o pan RON Telephone: (800.) 545-3520 Monday— Friday 8 a.m. to 6 p.m. EST Remember—only Safety Kleen or its subsidiary can collect used fluid from your fluid storage container. • When Safety Kleen arrives, the driver may test the tank for unacceptable materials. If the driver thinks the tank is contaminated, he or she can refuse to pick up the oil. If this happens, call the AutoZone Environmental Specialist at ext. 7217. Used Battery Recycling When a customer brings an old battery into the store, follow these procedures: 1. Examine the battery for leaks or damages. 2. Log the battery on WITT-JR. as a core return. Environmental Business Plan ©2003 AutoZone, Inc. All Rights Reserved 7 3. Wear proper protective equipment (eye protection and battery gloves) when handling batteries. 4. Check again for leaks or damages before placing the battery posts are turned away from each other to avoid contact. 5. When you place the battery on the pallet, make sure the battery posts are turned away from each other to avoid contact. Battery Storage Procedures • Stack used batteries on a pallet, and keep it in the back room. • Load these batteries on the truck on delivery day to be returned to the DC. Follow these steps when returning batteries: - Stack batteries no more than two layers high on pallet. - Stack the batteries with all of the side posts facing in and not touching each other. Touching side posts can spark and create a fire. - Completely fill the first layer before starting the second layer. - When the first layer is full, count the batteries. Place a wafer board on the first layer. Write the first layer's quantity on the corner of the wafer board before starting the second layer. - After filling the second layer, count and record the total number of batteries. - Wrap the battery pallet securely. - Place a 4-inch "corrosive" label on the pallet. - Record the total number of batteries and the amount being returned in pounds (36 multiplied by the number of batteries) on the bill of lading. Never estimate the number of batteries. Battery Acid Spill When you have a battery spill, follow these procedures: • Wear proper protective equipment (eye protection and battery gloves) when handling batteries. Batteries contain diluted sulfuric acid. Avoid contact with the skin and especially the eyes. • Spread a layer of soda ash over the spill to neutralize the acid. • Contact 3E immediately at (800) 360-3220 for disposal procedures. Environmental Business Plan ©2003 AutoZone, Inc. All Rights Reserved 8 . i Procedures are posted at each battery charging station for how to clean up battery overflow and spilled battery contents. Orphan Oil As an AutoZone employee you might have to deal with the problem of containers that have been abandoned, that contain materials that AutoZone does not recycle. This material is referred to as Orphan Material. Orphan Material is defined as any fluid that a customer leaves without registering it. Upon discovery of Orphan Material • Check the fluid. • Do not touch or smell the material because you do not know what is in the container. • Determine, if possible, what the material inside the container is. • If it is oil, and it is not contaminated and five gallons or less then you can pour it into the tank. • If the material is contaminated, more then five gallons of oil or if you are unsure set it aside and call the District Manager assigned to your store. Then call the Environmental Specialist at Ext: 7217. • Ensure that the container is not leaking and the lid is on tight as to prevent any spilling of the material. • Place the material in a safe area out of the way of daily operations. Even though AutoZone does not accept material abandoned, the store will be liable for any accidents that happen with the material on its property. That is why it is important to arrange for the disposal of the material as soon as it is discovered. I I Environmental Business Plan ©2003 AutoZone, Inc. All Rights Reserved 9 First Aid Use these first-aid techniques if anyone in your store is exposed to used battery fluid: Eyes: Hold eyelids open, and immediately rinse with cool, running water for at least 15 minutes. Seek medical attention after rinsing. Skin: Thoroughly wash affected area with soap and water. If acid is splashed on clothing, remove and discard the clothing.,If acid is splashed on shoes, remove and discard shoes. If inhaled: If symptoms develop, immediately move the person away from the exposure and into fresh air.. Seek immediate medial attention. Keep the person warm and quiet. If ingested. Don't induce vomiting. See a doctor immediately. Environmental Business Plan ©2003 AutoZone, Inc. All Rights Reserved 10 Number Fee 1030 THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that Ford of Hyannis 332 Falmouth Rd., Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------- ---- ------ ------- -- ------- -- ------ --- - ------ ---- ------- ---- - --- ------ ------- b\� ----------------------------------------- ---------------------------------------------------------------------------- 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 r ,may Town of Barnstable Barnstable IKIE Aegulatory Services Department o ;eriea C-i • Public Health Division BARNSTABLE, ' 9cb , `0� 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. J�3 0/0 DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT Z NAME OF ESTABLISHMENT ODD kll'5 L 7 ADDRESS OF ESTABLISHMENT 7 TELEPHONE NUMBER U5a(I-775 SOLE OWNER: YES ENO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. �5/-QK3 ql) STATE OF INCORPORATION FULL NAME AND HOME ADD SS OF: PRESIDENT 71CI<&,0 /_ kll l6-iyj �J A)JAs,u 1 G%5 iLd--1 L`�Aii 42/GNPAA, TREASURER �Am�S. - MSC-16,F.. -2. Ile.? -/c7LegWALN-St. L5FI AjAr-lam /na• CLERK /h, T� J2 _ M e i,9,t57 a' L_ SIGNATLMEOCPPLICANT /) c RESTRICTIONS: HOME ADDRESS /n, `�'o /lCui U� its,m HOME TELEPHONE# Q:\Hazmat\Haz Mat Application2008.DOC Number Fee 1030 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Balise Ford . 322 Falmouth 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 6/30/2011 unless sooner suspended or revoked. WAYNE MILLER, M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2010 JUNICHI SAWAYANAGI A. MCKEAN, R.S.,CHO yDirector of Public Health —~-----------_-—-- e� • 4 Town of Barnstable �0F1ME Tp Regulatory Services P Thomas F. Geder, Director • ' BARNnABLE, MASS. a Public Health Division va° 1639 `gym ArEoM A' Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6 iO4 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. / 3 /Q DATE La/w m - APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT V A1ME'6 6,41-1,51C , NAME OF ESTABLISHMENT IlYk04J1,5 'liuG ADDRESS OF ESTABLISHMENT \�R3o� �i9�i►1 D uTlf /7�//���u�s ; O�U/ • TELEPHONE NUMBER SOLE OWNER: YES ✓<0 IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF'AI:L PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. ��I-� 3 STATE OF INCORPORATION ��qI AiLrs FULL NAME AND HOME ADDRESS OF: PRESIDENT /ri 5 c5ts v�L, 7 LvE i�L�O — rra,j _ TREASURER /YVj7V �u4 /OFf� CLERK • SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADD S [,� S`T. . S?,4— .�) HOME TELEPHONE # In4 Haz.dochcp/q /O� BALISE AUTO SALES • HAZARDOUS WASTE SPELL CONTAINMENT PLAN Fire and Police Department or Ambulance: 911 Hazardous-Waste Emergency Coordinators: Service Manager Alternative Hazardous Waste Coordinator Parts Manager If possible,Emergency Coordinator should first contact one of the personnel listed below and/or our Hazardous Waste Transporter before calling one of the numbers to report a release, spill or leak which may threaten human life or the environment: PERSONNEL TO BE NOTIFIED: Work Cell Home David White General Manager 508-568-3810 678-367-5905 Jim Demas Facility Director 413-735-1003 413-348-8689 413-781-1548 Stephen W. Fitts I Risk Manager 1 413-735-1047 1 413-374-1664 1 413-567-9534 Steven Mitus CFO 413-735-1001 413-530-4429 413-530-4429 • Hazardous Waste Consultant: Fred Ramos 508-245-4267 Smith&Lamountain Hazardous Waste Transporter Safety-Kleen Spill Contractor: 888-375-5336 EPA Transporter#CTD021816889 Hazardous Waste Spill Kits are maintained in the facilities Parts Department. Fire and Police Department or Ambulance 911 EPA New England 888-372-7341 EPA National Response Center 800-424-8802 EPA Hazardous Waste Super Fund Hot Line 800424-9346 VnD DA DrVY"TT ADC nU DT ANT DIVVI'D WA 1 V-1 Al\11v V Lrfl\IJ Vl' 1 • i\ 1\ 1-1:Jl\ 1 V. Hazardous Waste Contingency Plan on Balise Intranet under Risk Management • HAZARDOUS WASTE CONTINGENCY PLAN The following is our written contingency plan for each site, designed to prevent and minimize hazards to public health or to the environment from fires, explosions, spills or any other unplanned_release of hazardous waste to the air, soil,_surface or ground water. Plans have been prepared for each site and will be administered by the Emergency Coordinator. FIRE RESPONSE Use of Fire Extin iuhers. In the event that a fire does start, associates may respond with ABC-rated dry chemical fire extinguishers if the fire is small and they can approach it without endangering themselves. The location of the fire extinguishers is shown in the"Evacuation Plan". In such cases one associate should call the Fire Department (911) while others try to contain the fire. If associates are alone, they are instructed to call the Fire Department -- not to fight the fire. If associates determine that they can use the fire extinguishers without endangering themselves, they should remove the pin of the fire extinguisher, point the nozzle at the base of the flames, squeeze the handle and direct the output to sweep back and forth at the base of the flames. During this operation it is important to be alert so that the fire does not cut off the associates' escape route, and that their lives are not threatened by smoke inhalation. If either of these conditions seems possible, they are instructed to get out fast, and leave the fire fighting to the Fire Department. Generally, water is not effective in fighting flammable and combustible liquid fires. Gasoline and • oil float on water, so pouring water on this type of fire may actually spread the fire. Natural Gas Line. There is a gas line coming into a shut off and meter located in the outside of the building as shown in the"Evacuation Plan". In the event of fire or leaking gas the Emergency Coordinator should close this valve if it can be done without endangering themselves. Otherwise they should alert Fire Department and Gas Company workers. SPILL PREVENTION AND RESPONSE Initial response and reporting spills. If there is a leak, immediately stop the discharge if it can be done quickly and without risk. Notify the Hazardous Waste Emergency Coordinator at once (phone numbers for the Emergency Coordinator are under"Emergency Information"). Whenever the Emergency Coordinator determines that there is an imminent or actual emergency which could threaten public health, safety, welfare or the environment, they shall immediately: 1. Activate internal facility alarms or communications systems to notify all personnel. 2. Refer to section"Emergency Phone Numbers"-Hazardous Waste Contingency Plan 3. Notify local agencies with designated response roles if their help is needed. Gasoline, Solvent and Oil Spills. . If flammables are present, use only non-flammable tools and eliminate all sources of ignition. If the smell is very strong evacuate the area. Windows and doors may be opened to reduce odors, but do not turn on fans or other electrical equipment, unless they are explosion proof when flammables are involved. If there is a fire, don't open windows and doors, since the air will make the fire burn faster. For small spills pour ground clay(e.g. Speedi-Dri) around the spill, building a dike to prevent its spread. Pour additional ground clay on top of the spill. Remove or stop the source of the spill. Often this involves transferring material to an approved non-leaking container, such as DOT specification 17E closed head drum. In some cases it may be possible to tip a leaking drum on its side so that the hole is on the top. After the spill is stopped and absorbed, shovel the round clay into an approved container, such as DOT specification 17H open-head drum with a Hazardous Waste label filled out. Acid Spills. Electrical storage batteries are a potential source of sulfuric acid spills if dropped or otherwise damaged. Spilled acid from batteries is hazardous waste because it is corrosive, and also may contain toxic substances including lead and arsenic. WARNING: SULFURIC ACID CAN CAUSE SEVERE SKIN BURNS, AND BLINDNESS IN THE CASE OF EYE CONTACT! In case of contact with acids, first rinse skin for at least 5 minutes(15 minutes for eyes) with cold running water then go for medical help. There is an eye wash flushing station at each dealership. If someone else is present, then get medical help while rinsing continues. Large acid spills (more than a quart) can be confined by pouring a dike of ground clay around the spill. The subsequent clean up of a large spill should be left to professionals. Small acid spills can be neutralized with sodium bicarbonate (baking soda) or sodium carbonate (soda ash). Wear protective clothing including eye goggles since there will be bubbling and splashing. Apply soda by sprinkling the powder, or an aqueous soda solution, on the aid spill gradually. The neutralization process is exothermic(gives off heat). Diluting strong acid solutions with water also generates heat that can cause boiling and splashing. The bubbles of carbon dioxide gas evolved during neutralization are not flammable but acids coming in contact with some metals including zinc generate flammable hydrogen gas. Always make sure that there are no sources of ignition at any acid spill and that flammables are kept separate. When enough soda has been added to neutralize the acid, the bubbling will stop even if more soda is added. Neutralization should be checked by dipping a piece of pH paper in the liquid and comparing the color of the paper with the chart on the package of paper. A pH of 7 is completely neutral, but a reading of 6 or above is acceptable. Clean up the neutralized spill with a mop and place in approved labeled Hazardous Waste containers. A DOT specification 17H drum is acceptable if a heavy duty polyethylene liner is put in the drum first. Rinse the area with mop and water. The first rinse water should go into the drum also. If you are certain that the spill area has been fully neutralized (use pH paper as described above) subsequent rinses may be poured into the sewer. • • HAZARDOUS WASTE CONTINGENCY PLAN EQUIPMENT LIST Fire Extinguishers See"Evacuation Plan" Fire Blanket Service Area Eye Goggles Issue Baking Soda Parts Storage Rubber Gloves Tool Room Rubber/Plastic Apron Tool Room pH Paper . Service Manager Office First Aid Kit Service Area Hazardous Waste Labels Service Manager Office DOT 17E& 17H Drums Service Area Polyethylene drum liners Parts Storage Flash Light Service Manager Office Ground Clay Service Area Drum Wrench Tool Room Brooms Tool Room Non-Sparking Shovels Tool Room • Y f' Number Fee 1030 THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that Balise Ford 322 Falmouth Rd., Hyannis,JVA 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. 9/15/2009 JUNICHI SAWAYANAGI THOMAS A. MCKEAN,R.S.,CHO Director of Public Health r YOU WISH TO OPEN A BUSINESS? EYour Information: Business certificates[cost$30.00 for 4 years). A busin s certificate ONLY REGISTERS YOUR NAME in town(which must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk'sOffrce, V FL.,367 n Street,Kyannis, MA 02601 (Town Hall) DATE: / r/ Q Fill in please: APPLICANT'S YOUR NAME/S. BUSINESS YOUR HOME ADDRESS: ��D - TELEPHONE # Home Telephone Number 11/43 NAME OF CORPORATION: O _ / NAME OF NEW BUSINESS TYPE DF BU MESS- &2-17� IS THIS A HOME OCCUPATION? YES NO /Lp ADDRESS OF BUSINESS L32! FA A L NUMBER , Q��' / (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST 00 TO 200 Main St. -[corner of Yarmouth Rd.&Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM NER'S OFFICE This individu I h ff—info f ny rmit requirements that pertain to this type of business. uthorized Signat e COMMENTS. D / 2. WARD OF HEALTH This individual has be n informed of t permit re Ciirernents that pertain to this type of business. MUST COMPLY WITH ALL "Au zed Signature '� ' COMMENTS: HAZARDOUS MATERIALS REGULATIONS 3. CONSUMER AFFAIRS)LICENSING AUTHORITY) This individual has been informed of the fcensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: Number Fee 173 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Auto Zone 332 Rte. 28, 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 r Town of Barnstable '� H pFTME r� Regulatory Services P� •� Thomas F. Geiler, Director * BARNSTABLE, MASS. Public Health Division �p i639' �� ArFD 39. Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 /� Wayne Miller,M.D. Fax: 508 790 6304 / �(� Paul J. Canniff,D.M.D. Junichi Sawayanagi NOTICE TO ALL BUSINESS OPERATORS WITH HAZARDOUS MATERIALS IN BARNSTABLE The Town of Barnstable Town Council adopted, Chapter 108: Hazardous • Materials, a requirement for each business operator to obtain an annual permit and to renut a fee of$100.00 if one-hundred and eleven (111) gallons or more of hazardous materials are stored, transported, utilized, and/or 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. Submit the fee of$100.00 payable to the: Town of BarHstahle, MAIL all of the above to this office on or before June 30, 2009. A late charge of$10.00 will be assessed if payment is not received by July 1, 2009. Upon receipt of the fee and a completed application form, an inspection may be performed by the Hazardous Materials Specialist to complete the Hazardous Materials On-Site Inventory. A permit will be issued once the application, contingency plan and check are received. • Please feel free to view the above Code, Chapter 108: Hazardous Materials on the Town Website, www.town.barnstable.ma.us , which is located under the E-Code section if you should have any questions or concerns. Q:\Hazmat\14az Mat Permit Letter.DOC } ' Town of Barnstable Barnstable `"�I �Regulatory Services Department � ds"meicaCity Public Health Division RARNsrAHM MAS&• 9�A1639 ; * 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. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN I II GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENO!2 R- a �V Cl.'c1�11`S • TELE PHONE NUMBER SOLE OWNER: ?\YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: n IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. l Lt S L[ STATE OF INCORPORATION 1 FULL NAME AND HOME ADDRESS OF: -� PRESIDENT TREASURER CLERK SIVNATIJRE OF APPLICANT • RESTRICTIONS: HOME ADDRESS (Q0, l .3 C_ 7 St-. HOME TELEPHONE # 1�6('`(4'S Q:\Hazrriat\Haz Mat Application2008.DOC Number Fee 1030 THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that Ford of Hyannis 332 Falmouth Rd., Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------- ------------------------------------------ ----------------------- -------- ---------------- --------------------------------- ---------------------------------------------------------- ---------------------- ----------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2010 unless sooner suspended or revoked. -------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF;D.M.D. 6/30/2009 JUNICHI SAWAYANAGI THOMAS A. MCKEAN,R.S.,CHO Director of Public Health �w Town of Barnstable Barnstable Regulatory Services Department ABftmicaCft • Public Health Division RMLNSTABLE 9 ' 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application pp Fee: a $100.00 ASSESSORS MAP AND PARCEL NO. d �3 0/0 DATE U�`/A 4 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT 1,/44& L OV-'n —14, NAME OF ESTABLISHMENT C1 / ADDRESS OF ESTABLISHMENT 5,32 �M UUY� �L . /7 /-4,4 OZ 0 TELEPHONE NUMBER O(� 775-may/Z_ SOLE OWNER: YES A O r_ 4 IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALLY PARTNERS: -o ry •� IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. . O 3 �'073 STATE OF INCORPORATION )AA, FULL NAM D HOME 'V C,SS OF: PRESIDENT ,C� In D TREASURER n S�G CLERK Wee- 1A Yqipz M46/D 8,T- • SIGNATURE�OFAPPLICAN�T RESTRICTIONS: HOME ADDRESS 5� r HOME TELEPHONE # Q:\Hazmat\Haz Mat Application2008.DOC r BALISE AUTO SALES • HAZARDOUS WASTE SPILL CONTAINMENT PLAN Fire and Police Department or Ambulance: 911 Hazardous Waste Emergency Coordinators: Service Manager Alternative Hazardous Waste Coordinator .Parts Manager If possible,Emergency Coordinator should first contact one of the personnel listed below and/or our Hazardous Waste Transporter before calling one of the numbers to report a release,spill or leak which may threaten human life or the environment: PERSONNEL TO BE NOTIFIED: Work Cell Home Richard Covington Ford of Hyannis 800-561-5835 508-737-2980 Edward Kardon Nissan/Hyundai 508-771-3636 267-784-2555 Jim Demas Facility Director 413-735-1003 413-348-8689 413-781-1548 Stephen Fitts Risk Manager 413-735-1047 413-374-1664 413-567-9534 • Steven Mitus CFO 413-735-1001 413-530-4429 413-5304429 MS Hazardous Waste Consultant: Kristen Perkins Ct`iS 508-8244939 �� John Furrh Associates pcF�C'R. f►� YL: Hazardous Waste Transporter Safety-Kleenp Spill Contractor: 888-375-5336 EPA Transporter#CTD021816889 Hazardous Waste Spill Kits are maintained in the facilities Parts Department. Fire and Police Department.or Ambulance 911 EPA New England 888-372-7341 EPA National Response Center 800-424-8802 EPA Hazardous Waste Super Fund Hot Line 800424-9346 FOR PARTICULARS OF PLAN REFER TO: Hazardous Waste Contingency Plan r HAZARDOUS WASTE CONTINGENCY PLAN The following is our written contingency plan for each site, designed to prevent and minimize hazards to public health or to the environment from fires, explosions, spills or any other unplanned release of hazardous waste to the air, soil, surface or ground water. Plans have been prepared for each site and will be administered by the Emergency Coordinator. FIRE RESPONSE Use of Fire Extinguishers. In the event that a fire does start, associates may respond with ABC-rated dry chemical fire extinguishers if the fire is small and they can approach it without endangering themselves. The location of the fire extinguishers is shown in the "Evacuation Plan". In such cases one associate should call the Fire Department(911)while others try to contain the fire. If associates are alone, they are instructed to call the Fire Department--not to fight the fire. If associates determine that they can use the fire extinguishers without endangering themselves, they should remove the pin of the fire extinguisher,point the nozzle at the base of the flames, squeeze the handle and direct the output to sweep back and forth at the base of the flames. During this operation it is important to be alert so that the fire does not cut off the associates' escape route, and that their lives are not threatened by smoke inhalation. If either of these conditions seems possible,they are instructed to get out fast, and leave the fire fighting to the Fire Department. Generally, water is not effective in fighting flammable and combustible liquid fires. Gasoline and • oil float on water, so pouring water on this type of fire may actually spread the fire. Natural Gas Line. There is a gas line coming into a shut off and meter located in the outside of the building as shown in the"Evacuation Plan". In the event of fire or leaking gas the Emergency Coordinator should close this valve if it can be done without endangering themselves. Otherwise they should alert Fire Department and Gas.Company workers. SPILL PREVENTION AND RESPONSE Initial response and reporting_spills. If there is a leak, immediately stop the discharge if it can be done quickly and without risk. Notify the Hazardous Waste Emergency Coordinator at once (phone numbers for the Emergency Coordinator are under"Emergency Information"). Whenever the Emergency Coordinator determines that there is an imminent or actual emergency which could threaten public health, safety,welfare or the environment,they shall immediately: 1. Activate internal facility alarms or communications systems to notify all personnel. 2. Refer to section"Emergency Phone Numbers"-Hazardous Waste Contingency Plan 3. Notify local agencies with designated response roles if their help is needed. Gasoline, Solvent and Oil Spills. • If flammables are present,use only non-flammable tools and eliminate all sources of ignition. If the smell is very strong evacuate the area. Windows and doors may be opened to reduce odors, but do not turn on fans or other electrical equipment,unless they are explosion proof when flammables are involved..If there is a fire, don't open windows and doors, since the air will make the fire burn faster. For small spills pour ground clay(e.g. Speedi-Dri) around the spill, building a dike to prevent its spread. Pour additional ground clay on top of the spill. Remove or stop the source of the spill. Often this involves transferring material to an approved non-leaking container, such as DOT specification 17E closed head drum. In some cases it may be possible to tip a leaking drum on its side so that the hole is on the top. After the spill is stopped and absorbed, shovel the ground clay into an approved container, such as DOT specification 17H open-head drum with a Hazardous Waste label filled out. Acid Spills. Electrical storage batteries are a potential source of sulfuric acid spills if dropped or otherwise damaged. Spilled acid from batteries is hazardous waste because it is corrosive, and also may contain toxic substances including lead and arsenic. WARNING: SULFURIC ACID CAN CAUSE SEVERE SKIN BURNS,AND BLINDNESS IN THE CASE OF EYE CONTACT! In case of contact with acids, first rinse skin for at least 5 minutes (15 minutes for eyes)with cold running water then go for medical help. There is an eye wash flushing station at each dealership. If someone else is present,then get medical help while rinsing continues. Large acid spills (more than a quart) can be confined by pouring a dike of ground clay around the spill. The subsequent clean up of a large spill should be left to professionals. Small acid spills can be neutralized with sodium bicarbonate (baking soda) or sodium carbonate • (soda ash). Wear protective clothing including eye goggles since there will be bubbling and splashing. Apply soda by sprinkling the powder, or an aqueous soda solution, on the aid spill gradually. The neutralization process is exothermic (gives off heat). Diluting strong acid solutions with water also generates heat that can cause boiling and splashing. The bubbles of carbon dioxide gas evolved during neutralization are not flammable but acids coming in contact with some metals including zinc generate flammable hydrogen gas. Always make sure that there are no sources of ignition at any acid spill and that flammables are kept separate. When enough soda has been added to neutralize the acid,the bubbling will stop even if more soda is added. Neutralization should be checked by dipping a piece of pH paper in the liquid and comparing the color of the paper with the chart on the package of paper. A pH of 7 is completely neutral,but a reading of 6 or above is acceptable. Clean up the neutralized spill with a mop and place in approved labeled Hazardous Waste containers. A DOT specification 17H drum is acceptable if a heavy duty polyethylene liner is put in the drum first. Rinse the area with mop and water. The first rinse water should go into the drum also. If you are certain that the spill area has been fully neutralized (use pH paper as described above) subsequent rinses may be poured into the sewer. • • HAZARDOUS WASTE CONTINGENCY PLAN EQUIPMENT LIST Item Description Location Fire Extinguishers See"Evacuation Plan" Fire Blanket Over Parts Tech Window Eye Goggles Issue Baking Soda Parts Storage Rubber Gloves Tool Room Rubber/Plastic Apron Tool Room pH Paper Service Manager Office First Aid Kit Service Area Hazardous Waste Labels. Service Manager Office DOT 17E & 17H Drums Service Area Polyethylene drum liners Parts Storage Flash Light Service Manager Office Ground Clay Service Area Drum Wrench Tool Room Brooms Tool Room Non-Sparking Shovels Tool Room l Town of Barnstable \ °Ft rq,tti Regulatory Services Thomas F. Geiler, Director ' MASS. ' Public Health Division 9 MASS. 1639• ♦0 '°lFc nor•+°' 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 O NAME OF ESTABLISHMENT O Xb o tj ,S p G- ADDRESS OF ESTABLISHMENT O rqL h Oab 0I TELEPHONE NUMBER ��g S- 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 — 3 3 STATE OF INCORPORATION D eL AW A k C FULL NAME AP HOMI� RESS OF;^ PRESIDENT 0 1-� l� J 3� ' CR. AL 6 'P.o- -IRF.ASURE—RA OJc W9 E�. /11• 6r I. Noepo ko o o -w r3 0 to A A OPS37 SIGNLATURE OFF -PP CANT RESTRICTIONS: HOME ADDRESS �f w e 5/SAS r � HOME TELEPHONE# D Haz.doc/wp/q Number Fee 173 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Auto Zone #5160 .-------------------------------------------------------------------------------------------------------------------------------- 332 Falmouth Rd/Route 28, Hyannis, MA .----------------------------------------------------------------------------------------------------------------------------------------------------------------------- Is Hereby Granted a License For: Storing or Handling 500 gallons or more 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 r...' . • ''' Town of Barnstable Inspectional Services BARNS], BLE �TNE Tq� Lures 6 MW3enOe WL_—.'OnM a W Public Health Division"""_�°39-201 "��°�"�`F p 1639-2014� 1 BAM MT/', Thomas McKean, DirectorhUm 1639 200 Main Street Hyannis,MA 02601 � r*� Office: 508-862-4644 Fax: 508, 0-6304 oi. 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 El Gh *A late charge of$10 00 will be assessed if payment is not received by July 1st. DO`.- 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 Q1VANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT:. _J\���-tJ r ja �hlo 5. NAME OF ESTABLISHMENT: Zolge /l�1 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE:` • �` `� IJ 8. TELEPHONE NUMBE OF ESTABLISHMENT: 1-jUU� 7i— 757� �`� 9. EMAIL ADDRESS: 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADD SS, TELEPHONE#OF: CORPORATION NAME PRESIDEN tf TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: �— TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANTkQ 411&4j2hl 10AfiJE Q;\Application Forms\Haz Mat Appli Draft Jan2019.docx Number Fee 173 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Auto Zone #5160 332 Route 28, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2020 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.,CH() Director of Public Health �� 1 / 1 �• i Town of Barnstable BMW Inspectional Services BARNSTABLE MRNSfNB!E-CEYTEfI":lE•CO'UR•riYANxI_ WPSTC.454NS•t]S`EF' •v:iT 6WNSTtkE Public Health Division :E,�- 1�4 9BARNMBLE, Thomas McKean, Director 039 ♦0 200 Main Street, Hyannis, MA 02601 r—a Office: 508-862-4644 Fax: 508-790-6304 z:. �e �a4 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZEh HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 XV 1 f Ch4 *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 STORAGEIUSE OF • GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: cab 5. NAME OF ESTABLISHMENT: ®®fi G �{(!� 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: fi i S Tip !o 8. TELEPHONE NUMBER OF ESTABLISHMENT: 7 9. EMAIL ADDRESS:—dtfhotah, ,,, U)/,///?Ify7s doln 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADD S, TELEI E#OF: CORPORATION N M PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: • COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE Q\Application Forms�Haz Mat App Revised 09-10-18.docx Number Fee 173 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Auto Zone #5160 332 Route 28, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2019 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 s l� t lo wr of BVnsxable U 0� SNE a f eg atoty ervices Richard V. Scah, Director ' Public Health Division BARNSTABLE • ,•j j. BAftNSTACIF.CFffi9lYlLtE.mIVR•NYMRi15 ��� BAMMBM • Thomas McKean, Director ""�°V5M1S'° ""1•"� ^�� C KAM 1639�--772014 `� ----2001Vfain Street Hyariiis;MA-02G01------ - 1XI Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS r� 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 g V,5, *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: 5. NAME OF ESTABLISHMENT: &40zofe J-"4wo o 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: ww. Q/ 8. TELEPHONE NUMBER OF ESTABLISHMENT: c568_ /?/ — 9. EMAIL ADDRESS: S°' a^es,Wo7&7e. Cafne- 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADD S,AND TELEPHONE#OF:r� CORPORATION NAME a�o Zone T / 3 -f'/Ong. i ° AJ q0/145:6,oa PRESIDENT i TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: `— • COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT GATE 1� Q:Wpplication FormSWAZMAT APP 2017 REVISED.docx I Number Fee 173 THE COMMONWEALTH OF MASSACHUSETTS $160.00 Town of Barnstable Board of Health This is to Certify that Auto Zone #5160 332 Route 28, Hyannis, MA Y Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. ---------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2018 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 0710112017' JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Tow of Unstable 50/I l!e.2!�Regu�latoervices RECEIVE Richard V. Scali,Director j KWE Public Health DivisionUN 5 2017 BSTALE 6nRN5fAWEi[R tLLE.COAIL iSPABLE, XY«I:IS ` x,xsnr.•s F••us-esi:cwue•wsye<ansreo: Thomas McKean,Director 1639-2014r' 200 Main Street, Hyannis,MA 02601 - Office: 508-862-4644 �� Fax: 508-72-6304 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 3 Oth). 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 X V•S - *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: Deb d fail) L ,..l 1 i A rns 5. NAME OF ESTABLISHMENT: &h 7a p e, C©V 6. ADDRESS OF ESTABLISHMENT: 3 t�ri(, 1•��.�InI S, // '� ��`��� 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 9. )Gfil-911 // I&�6 /S TA, 8. TELEPHONE NUMBER OF ESTABLISHMENT: 1�.� 79 / ' 7393 I 9. EMAIL ADDRESS: 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME �- )7—one- , n o_, �/�l �9S�5�� PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL:O �7 A /J904 SIGNATURE OF APPLICANT ATE & Q:Applicaticn FormsOAZMAT APP 2017 REVIS D. ocx Number Fee 1081 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Balise Nissan of Cape Cod 322 FALMOUTH ROAD, 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 N Town of Barnstable P4°FrnETq�� Regulatory Services Richard V. Scali, Director B"R" EX," Public Health Division 94j i639• � pTFp3.ys Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 �G3 ASSESSORS MAP AND PARCEL NO. /OZ 1 z 7 DATE A114 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT U/�/i r-5 6ALim , Jx, NAME OF ESTABLISHMENT —7)�L "kC� . ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER O '! 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. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT /J y M I TREASURER / V. CLERK SIGNATURE OF APPLICANT L RESTRICTIONS: HOME ADD AL � HOME TELEPHONE# Q\Application FormsUiAZAPP.DOC Falmouth Rd.Hyanni,. ``✓/off1?6 A b E f TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS NAME t^cl '� C I�D VE- % ARC 'IN C ADDRESS, F44\yip Z�- VILLAGE LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE: OR CHEMICAL (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: TESTING CERTIFICATION SUBMITTED: 5zaa, PASSED DID NOT PASS SENDER: Complete items 1,2;3 and 4. 'n o Put your address n the"RETURN TO"space on the 3 reverse side. Failure to do this will prevent this card from W being retyrned to you.The return receipt fee will provid00 you the name of the person delivered to and the date of —� delivery. For additional fees the following services are C available. Consult postmaster for fees and check box(es) fo}}r��,,seervice(s) requested. 01 9' Show to whom,date and address of delivery; 00 2. ❑ Restricted Delivery. _ 3. Article Addressed to: Manager Mid-Cape Ford 332 Falmouth Rd. Hyannis, Ma. 02601 4. Type of Service: Article_Number I Registered ❑ Insured Certified ❑ COD ❑ Express Mall Always obtain signature of addressee or agent an DATE DELIVERED. O .5. Signature — A ressee O X m 6.Ai cwt A ent I N n c 77 aiefdf Delivery y D M S. Addressee's Address Y f d a fe paid) �SPO t UNITED STATES POSTAL SERVICE OFFICIAL BUSINESS SENDER INSTRUCTIONS u® Print your name,address,and ZIP Code in the ®p space below. e Complete kern$ 1,2,3,and 4 on the reverse. e Attach to front of article if space permits, PENALTY FOR PRIVATE ''otherwise affix to back of article. USE,$300 . • Endorse article"Return Receipt Requested" ad acent to number. h RETURN TOWN OF BARNSTABLE . TO BOARD OF HEALTH j (Name of Sender) I I I - o.end treet,Apt.,Suite,P.O.Box or R.D.No.) Hyannis, Ma, 02601 - 0534 (City,State,and ZIP Code) P 522 444 226 RECEIPT FOR CERTIFIED MAIL NO INSURANCE COVERAGE PROVIDED NOT FOR INTERNATIONAL MAIL (See Reverse) Manager sent to Mid-Cape Motor, Inc . s Street and No. 332 Falmouth Rd. o P.O.,State Ma. 02601 a . d Postage $ vi Certified Fee 1 . 50 Special Delivery Fee Restricted Delivery Fee Return Receipt Showing to whom and Date Delivered N Return receipt showing to whom, Date,and Address of Delivery m TOTAL Postage and Fees $ 1 . 50 U. g Postmark or Date is 2/7/85 E 0 ILL STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES.(see front) 1. If yop want this receipt postmarked,stick the gummed stub on the left portion of the address side of the article leaving-the receipt attached and present the article at a post office service window or hand it to your rural carrier. (no extra charge) 21zIf yoUdo not want this receipt postmarked,stick the gummed stub on the left portion of the address side of the article, date,detach and retain the receipt,and mail the article. 3. If you want a return receipt,write the certified mail number and your name and address on a return receipt card, Form 3811,and attach it to the front of the article by means of the gummed ends if space permits.Otherwise,affix to back of article. Endorse front of artile RETURN RECEIPT REQUESTED adjacent to the number. 4. If you want delivery restricted to the addressee, or to an authorized agent of the addressee, endorse RESTRICTED DELIVERY on the front of the article. 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If return receipt is re- quested,check the applicable blocks in item 1 of Form 3811. 6. Save this receipt and present it if you make inquiry. S. C -r i- t T •t 7 t t L",�'IJ Ct �'FR '��'a a�,` .k t.:` �.' I s •1r F'�.'a° r � r �r �, � r `' ` t'N r s "rf r '; �? ' .:. �• t rsk t i � ,a '.,t,:";� 'd' •. ��. { •�'T A +'". { 3 ,j✓ � .'�a +•-' 5y '�-' t '•«. p rr tq r il,. � � .' , •Fs.. » `fit - + y .rd. '� >�R s,' •," �' �'r s+ �S4 `` g'"t, �.+et s M•, r i •� ai•, r7xr .j. � � s� � � 1 '' �i•,, eS f ✓ '4� r'E :- A tial '•r M!-'r' �1� • �9 i Z''1,.,�,ti`t i 6 •r ,y,� d Y_i : ,S•'` .� � �y r��`'.y A t` 1 r S y,� `-r, ,'A, 4 S. .,a,4 „'%�R Z ,; ;l- �:r �'�.. �.. w {. y .ti,- -.•...:,l.' .. ip .3,; x.f ,.dt ',y�1 } -..a. � t� s`yr* t4,. •ci,' +°d'a' 7t ar ;•} 5" 4 • r I y «y S Y'' t s , .r :i' a 4 .. �e nr , i? y . .y- „tr ,•e �'', �� S �"!'4 _�,%', i _'�. Je ", sS •{: 3• <R S'i x r., a .S• t L- ta" ,?� ° t \3.45 '♦:k '} t .•�' ��• r ! M ;, s" � r. G �ty rSr�� � i•p �,. r �t :4��4"� a 3` ,*s.;y�r.r ��+ ,c-., £ r �' Y 4 � �r fi . a } Y t a5^ r r 1 "C eb tidi.y Va.� 98 W F }e", t - 4'. ur'.�,- • � a �" r�-, 41 .. t fk'' 4. ! 7^ a �'r tea' �i �, '�l'S 'k a,:'4 k ^ r t7k •.' ,.,14.fF . .t. '•,.;,:�.f J cJ T �" ,.� .:,�.. - ",dr. r a? °r'+ % .a E �� - s.,`i Manager r f �. � A-+.t, sy �• 't - i' Mid-Gape` M&tbts n�• G 5..1i .•5' i YR r ,332 :1F" mt iiuth Rd.��.i ,. " t {,t- to Y• r� �' t s`fa.� i ! ''a 14 .'� - • ?``Hyannis; Ma.a "t, 'T '• ;., 1r ,a`4 }{:1'»ri• "� i" , i r r `,r c- i;; { � - - - .a •;;, � Y .� � w t � { Y r ,,,;, ti' ��. r�: T r7..at i � � ,G, ?.J t,.4 fY � y, f k r • i a i.r}, ,,.> $...' ,a.1' a N `'� a "',.- ' �,ry,{• ,,r C i t :.. ♦a.F4. r,Uhddi(jiounc fuel^ 'tanks atr'33 al ou h. .*y^.• ' .r M '.r ! h a e M '� �•• r -'Ca a •^k < ...,& n•Yl'"' ,� J.ark �k '."7, ' 'f. t• ,,,,t :,',k un s ;'.' ;Ar.#1.� �S k .� rY.. �`� r w - . q f {,r ` ...s r�3 . ,}7 n * '-Dear Sirff t .a , \ t.. �• � i. }Cr' a,1.. ti 'tl Yr`. } ,". 't,x.y � ,.,� 4i a{t y'x:,f d � ' {' '"i 'r. t , T Mt�`�i wt ` .1 'Swy t s '�'•T�,+ry` rt"'� 9 � t�a 4;%' y G�,4`r .� " � t��t-� �i' "�`, +ls,.Y• '��t L . t,at s ;r",� +4..: }>F r ta.;, ` r Tf ar�card; 1camp :etecl 'by`'y+ " shox4s )(ouk--40Q4` 41,lb' . dna"l6 000 ,4- w rx ,-0yc aX3.bn tanks,' .' :ocated At% 332 Fal h 1kd; , :�t�'�nri s; :t6 b { v W f {.tweet ;fyears f 3.. a T ' egu a ion ; ,a e Q Q ` oc too, r"eire all t nks ,twenty `. `yews o .age•;tc b teaec annuali �ua `3it :.' th ' Kent�ko.are.{ 'tessiare s� f =`' w F'�r'' Test'caar . tearlIk ais,.em +ty; a� 5 'S Aid'' pessue `' estSy b, •y ''!� r +' 4'.• ; ri - t r .- �, »a ; r used. , t ' s r f r t .+tiyW s. � « 5 � ,"',r '�...kl �.,y r t .�_;�,. r .! r+� ,s4 r Y � 't'p • � t ,"t i" „x�h •+ aY, ''+s. -+. -C. 4 °Z. a `a.,l. s"' - i%•SEs "i.r tfis, 'iy +s'',ak,?.7};:,,:f # - �" r• ,�€ou �re,�trect'edtc .;hayre yourtanls�test '` y �. { •� Please. 'suk �t'testing r esu s',and they r :'ih d �retetic rci to,",this ` office: pfior ,to' une R 1,y419,85'. �y t ,x i.4 < , ,� ��: r r .,' r , tsS" ..I" .F `` . 'c•� �..+'e4 r 3 4 k S C.t.,,. ,r_.- ..[;� x�r 'a'. T +z a,. a = c F .a t ,,- M1. +•,.: r ' „,. r k •:.,;. Fii1ure t6 dQ�`sQ com, "reAutt in I� a7. 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You 7may 'als6r.•utx a any�othe co - ,�' •' ` 6• t f t hp terns `qual:iffed tag perform `this 'ftesti�ng C a y. �; as a.•tR- x `!'�`-• �', ,t S,Sr i.fit �: � rr�3" ��Sr 4t ,GN�.i w �', r" °' �a r •^. � ,re.F at..F�'3 S-^ a, t+' 4 '."yr`�t rt { r •,_,. ...Y -0 -q- It� Y'A :e ' sp'S` :J'Ks ` a. ': Y '�: ,. h 'ti�'..Y+,�.'.,GrrS'{�"t-`�•`:_,t^ry"',fay at.4{tt,�:•.,�t`r5^�+ar_r-'.Tr-�J� cVt tCU+ br l.f yryhai ,y�rr it- '�_.s<;,,.`t!r e r*.;s�5»i:-'.+.y-....,rr.`"E'r`�rr.:a-}Rv.'�a:.'�^'tlt srr}rY*.";�y•i''"�:�'.,a Lt'�.�`�,,.t{{L•u,9.!4+,1.•k.+-.2.�{7,��i�"•a dGyt t7 YSri,`Yr..t.._,i'jyrS..,�j.+�..,-�,�Yxir�k,`#".'�,�a}`�Y a<J w�„yro'35-t;'�,i,.t>i��r a+,'r♦¢t F?r y,ti•�}l�C'``r.4�,.-,ap r;:•,..r d{aG•x'qasf�'xrt yVr rk".�,rn,.-�v.^.tS.fl,';.'.,;a'•y`yt.lw r:N��rhir Ctr'f,S't:"r?�.;�4 r j!r trak A r�,«."w"y�:v,,�..j'.'.,d:�aih�^7*.,a r °ey'c1t*r`.•`:';a�.}r,4a".•t .*a♦_.'.�ia;,..�r,-4r, Rrc.,rA �t f.•$ rery- p Ld Gm 7`/ 4C, F7 i A11 4 '4 M•D_F rr shcver° BOCRb .6plr A. ?- , :'I3Cl`�7�.r,Gp i3 s' f- �. t 7 s�• i,i '+, r rr ; 1..,`r" �,..r -�.� ,s .',� .,,, �'Y } '•s ,•+- fir s yr Y� r i_ � T , .: �r i. i,_!. � 4 1•s r'}f� e..Z' � >:f 6'J 2 "G„ Y r .�r.,,, r a .F '.�• _; ,,[ �.. , ;6.' Fs ti r ,-y� •. . a. r .{. 1 C" t y' t N 4.r• +.. yr } _,ti F i�,�t„�s , r`•` ! _ � .•' -1 R. •� .{ �t' LS :. � dt: t � 1 'l � 4 # " t";; �yl:1J.Yi4• .��r y •3 r.,� u a ",r i^t J 'r v r.r j�.� -x � :-�a ♦� "l}' * {, 'n afy,I 4j ly ,. � _ r�. ��, { �' �t ri. �•• � c. r � trt-"f4 .l •� t".y +�{�t r �'` 6�sj ; ° 4 �; r'^ s s M1 'w . 4' r rr, {,. + ` t," + _ };h. +.�� t S c r•4 +"i "� � f C ,i' r k'1e« r ° 'V r • . -. .._ . S • ' 4 y Y`!7 ." � 1' h,J` y a .g r1 '�" i� R '.t. � a � 'l r r Y � w .. �w✓ 3 xa lti 'r .d i y+ w r_�..4 '+�' rr TOWN OF BA%NSTABLE UNDERGROU'I`TD FUEL AND CHEMICAL STORAGE SYSTEMS ---I�AlViE - �"-MID""CAPE FORD SALES -- (ORO) ADDRESS Falmouth Rd VILLAGE Hyannis LOCATION OF TANKS: NO. OF CAPACITY: TYPE OF FUEL AGE: TYPE: TANKS: OR CHEMICAL Within the 1 4000 gals gasoline 1965 steel �EJ property lines described above (Give same information for anv additional tanks on reverse side of card) DATE OF PURCHASE OF EACH: 1. 2. 3. 4.. _ DATE OF FIRE DEPARTMENT PE%'YIIT: TESTING CERTIFICATION SUBiVITITED: PASSED DID NOT PASS pM/mp 71580 • Z Form 77-1U0u Data Chart for Tank System Tightness Tester 21a03.364) USING KENT-MOORE CORPORATION TANK TIGHTNESS TESTER MODEL 1000 Copyright©Kent-Moore Corporation 1977 PLEASE PRINT 1. OWNER Property !D C. P �t> / i'�c v r// /Zv 91v ris XAI s Name ddress .r-.Representative Teleonone . Tank(s) 1L- Name Address Reoresentative Teleonone 2. OPERATOR 1�11 o Ci9 P r F,�,w i) "L7L.� (>Ct�l'i: C? F` n'd r Fc;,1 Name Address Teleonone 3. REASON FOR TEST r L) t5 (Explain Fully) 4. WHO REQUESTED TEST AND WHEN Name Title Comoanv of Affiliation Oat. Address Teleonone 5. WHO IS PAYING Company.Agency or Individual Person Authorizing Title Teleonone FOR THIS TEST? Billing Atltlress /T /1nj City .State Zio Attention of: ( (/Z' Order No. Other Instructions ' Identify by Direction Capacity Brand/Supplier Grade Approx.Age Steel/Fiberglass 6. TANK(S) INVOLVED tin r��Eyl �L'P�I2 3HI IXVx '-(0 0 0 Cy L)(_- 0.;c r C e cs: r i s -e L ' I I Location Cover Fills I Vents I Siphones I Pumps ' 1. INSTALLATION 'Tc' /40 G KXIA—DATA �- I BA� /Z North inside driveway. Concrete.Black Too. Size,Tirefill make.Oroo i ! Suction.Remote. Rear of station.etc. Earth.etc. woes.Remote Fills i Size.Manitolded Which tanks? I Make if known 8• UNDERGROUND Is the water over the tank 7 WATER Depth to the Water table I Yes i No Tanks to,be filled �, V-11 hr. /� �L� Date Arranged by - 9. FILL-UP Name Teleonone ARRANGEMENTS Extra product to"top off"and run TSTT. How and who to provide 7 Consider NO Lead. Terminal or other contact for notice or inouiry Comoanv Name Teleonone 10. CONTRACTOR, MECHANICS, any other contractor involved _ 11. OTHERG1 C��� 'TC"�"% /�' oS INFORMATION OR REMARKS I Additional information on any items above.Officials or others to be advised when testing is in progress or completed.Visitors or observers present during test etc. r Tests were made on the above tank systems in accordance with test procedures prescribed for Kent-Moore Tank Systems Tightness Tester Model 12. TEST RESULTS 1000 as detailed on attached test charts with results as follows: Tank Identification Tight I Leakage Indicated Date Test! /CLS � O I ( I i t I I I I This is to certify that these tank systems were tested on the date(s)shown.Those Indicated as'7ighY'mee IyF criteria established by the National t3. CER IFIC TION Fire Protection Association Pamphlet 29. rl' ICK ELECTPIC, INC. a S 0 '. j' ,e c ClC is ... �-y� ('i �+^ fiesunq Conaae:or or Comoanr. By: Signature I J77`�i(��7� �111,R`H fi:L_., . .,.::�. _ E- I Suual No.of Tester Technicians - ' Address r ti • h ' G #1 14. G'1Z AGc AL1vcc�Tf 3 t� Name of Supplier, caner or Dealer Address No.and Street(s) city V State Ded of Test r 15. TANK TO TEST 16. CAPACITY From ❑ Station Chart Q By most accurate �/ ✓/,0� F ✓ v C r (� Nominal Capacity L/rt. �� capacity chart available yC��� ❑ Tank Manufacturer's Chart Identify by position Gallons Gallons ❑ - Company Engineering Data —1 ;K ` C� z 0` Is there doubt as to True Capacity? ❑ ❑ Charts supplied with TSTT O^ CDC` Brand and Grad. See Section"DETERMINING TANK CAPACITY" ❑ Other 14 C19S-/i('19 _ /. r4 r 3' 17. FILL UP 60R TEST Stick readings . to G in. Gallons Total in Tank f � N Stick Water Bottom . before Fill-up / Inventory Q to%in. Gallons Z Fill up. STICK BEFORE AND AFTER EACH COMPARTMENT DROP OR EACH METERED DELIVERY QUANTITY — m O Product in full tank(up to fill pipe) Tank Diameter v o = 18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK v C_ D See manual sections applicable.Check below and record procedure in log(26). A �L'(91GU2v g r) a Water in tank ❑ High water table in tank excavation v0 Line(s)being tested ❑ Vapor recovery systems ❑ Stage I ❑ Stage ll tr Z O) c M 19. TANK MEASUREMENTS FOR 21. TEMPERATURENOLUME FACTOR (a)TO TEST THIS TANK TSTT ASSEMBLY Inventory Top_'F Center_ 'F Bottom_'F On Truck_'F Expected Change =6 y5Bottom of tank to Grade'............. D 22. Thermal-Sensor reading after circulation � -F n Assemble tubing +30-for 4'L........... digits Nearest 7z. + 24-for 3-L............. .. 23. Digits per'F in range of expected change � Total tubing to assemble (Approximate) ........ digits ) 24. `1'OG'O X •eln h/9 gallons 2 20 total quantity coefficient of expansion for volume change in this tank rn Tank top to grade'........ full tank(17) for involved product per'F Z Extend hose on Test Elbow 6'or more 25. / ?- 7,)— — This is O volume change per'F(24) Digits per'F in test Volume change per digit. test Nbelow tank top................................ Range(25) Compute to 3 decimal places. factor(a) 0 t't 'If Fill pipe extends above grade,use top of fill. y" i q /�.� /ems �AC���c vc�� �/i tii s ll�� 30 HYDROSTATIC 31. 34. 38.NET VOLUME 39• . 26, VOLUME MEASUREMENTS TEMPERATURE COMPENSATION ACCUMULATED LOG OF TEST PROCEDURES PRESSURE CHANGES � CONTROL IV) RECORD TO .001 GAL. USE FACTOR (a) .. ,:. _�t t L G Q S EACH READING CHANGE , G'o T _ 27 28 29. Standpipe level 32. Product In 33. Product 35. 36. 37. Temperature At High Level record In Inches Change Computation Adjustment total and deflection Date flecord details of setting up Read- Graduate Replaced(—) Thermal Higher+ (c) x (a)— Volume Minus Time and running lest.(Use full ing Beginning Lavelle Sensor Lower— Expansion+ Expansion(+)or A y 3t low level compute (24 r.) length of line if needed.) No. of which Before Alter Product Reading (c) Contraction— Contraction(—) change per hoar Reading Restored Reading Reading Recovered(+) (v)—It) (NFPA criteria) ' l�1» ���7/Li[ ��G�i �:✓ T/� %/�i rG l/l Uc-� �wty' > 3 c /'J/ r<" / ('(Icr� r� a -- / .� GGG/�S - 6'�CGjy// �� ` LGc�c /aLCrL G✓i T 7�� �/zS / uc 11 .- 7o �•`�`7r '//G%] s/L/�7 / G� U"�Ulf `�� / t�C /-��, ��/7-t Y 3 qq z'.;2 .7 �� , i F r -33`�3 19 e�,C, , /'`/S (°L fZ ' �O ��ve L +c� , 3ol � ,,� � 7c Y it T� ,eve �- S y . ©o rod o8 -aC-39 i8 37 /2/�/�Z �/ (� �I Vl. (� l.�l?C�� r00 r �J �13Q I �� �'�� �y�7 /. .F��S3 � TJ� 3 3;42 &iY�, To z } ev�L 317 2- c�0 33 • 3 9 ,33� ,0nc, .3 1 , o 9 3J7 ,9 C,J 12 9 z _ y / 12 33 .33 t 3 )� w ev�� L 5 /�_ I Z_ ,C) 3 G el r3?S93 _0067 - TOWN OF BARNSTABLE [ �� UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS NAME C." ADDRESS 3 °1 ��[1h 014k kdP, RVIL k VILLAGE LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE: OR CHEMICAL / S4AJI 33 a �a�?rn0 tdA /oceu tr ti P (�K� 66 (Give same information for any additional tanks on reverse side of card) A A 19R a. AFlew(• DATE OF PURCHASE OF EACH: 1. -� i L T 2. 3. 396 "6j 4. DATE OF FIRE DEPARTMENT PERMIT: — y TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS .Mk1t.�tlF��pTnr�'•r �, .. . �, " w„P}` ! •T•,` ,.> l �s'%'(YGt$•.¢r• �';, � _` ,k + ' !. .tip .: t• -r - :, , r August'.13, 1980� y 1 x « :Manager ,A5g1" �zeAlty :Corp. ¢� Box 578� = 3324 Falmouth Rd r.• *� Hyannis, Ma. beldr' Sir: The'! information .you.• returned -to---us. indicated 'the ,age of your ;.underground,fuel. tanks as being fift le years"oia': `-You must have these`' tanks'•tested, 'use ng`theT,Kent-Moore Pressure R T Test,,rby November 2t}, :198Q� Please �'s'ubm .t testing results and their .interpretation",to' this. office'F`prior to"',November 240 1�980. For your convi enience, we.',have µenclosed a listing 'of companies who w r 'perform this ,testing. •`, You' al so ,,utilize any other . concerns. - cualified', to 'perform this :testing, 'Very. truly yours, John M. Kelly Director of�-Publi Health _ .F. • _ 4jr'�w .�. � ns tjt. .s � . enlic�l+,i... l• .F, F_ ... ti s r. . o A. S. -A. Realty Corp. Box 578 Hyannis, Mass.,,, 026.01 August 18, 1980 Mr. John J Barrows 87 .0ak Street Hyannis, Mass. 02601 Dear John;. Attached .please find copies of John M. Kelly' s letter dated August ,13, 1980. '* .. Mr. Kelly has suggested I= forward a copy of this ietter to you as Gulf Oil Company is the owner of the gasoline tank located on our premises. Yours,jtruly, James S McGonagle President enc. cc: John M• Kelly JSMcG:rs /ate)+ •, - _ j `I r1ET�, TOWN OF BARNSTABLE it y OFFICE OF 0 BAH39TABLE, a 1, 90 arras. BOARD OF HEALTH } p 1639. �EQ Mp'{ e 367 MAIN STREET ° I HYANNIS, MASS. 026ot August 13, 1980 Manager �y } ASA Realty Corp. Box 578 - 332 Falmouth Rd. Hyannis , Ma. - i Dear.• Sir: The information you returned to us indicated the age of your underground fuel tanks as being fifteen years old. You must have these tanks tested, using the Kent-Moore Pressure Test, by November 20, 1980. Please submit testing results and their interpretation to this office prior to November 20 , . 1980. For your convenience, we have enclosed a listing of companies who perform this testing. You may also utilize any other concerns qualified to perform this testing. Very truly yours , JP n M. "Kelly 1Sirect6r 'of Public Health JMK%mm encl..! ,� r y � _ !.1rich Electric Co. , l;arshfield, !•t4 S 3 4-9 4 3 3 � $300.00 average price for one t ;ink- test x:4 $750. 00 - charge for a good day; 4 tanks in 12- 15 hours u- - charges by hour $35.00/hour, other misc. s-, - 0ve1-nig11t , I i 1(•age , fittings -- A test for ;a 550 gNI tank is Ocarly iNTOSSUALP' rMOKres s]Iccial fittings, in ;hint cases the t�nak needs to be uncovered t -- Many towns are requiring new residential tanks to be of fiberglass construction. ai•• -- 'Fhe tester doesn 't like to do heavy oils , it clogs the equipment t� -- Coordination of project is essential for efficient use of the tester's time. OPIER comnani es th�.t do Kent-;Moore Hallaurg Electric - 256-5397 o-t: 729-2320 ecco - 3 -2537 =; oil Zo rco - 245-7250 I ..,. G �k r � K `f S r NAME LOCATION A. S. A. Realty Corp. 332 Falmouth Rd. , Mid-Cape Motors., Inc. Hyannis 332 Falmouth Rd. Hyannis, Mass. BOOK & PAGE - DATE LICENSE GRANTED AMOUNT OF STORAGE 77/153 September 20, 1965 15,000 gals.Gallons : 0,000 gals.Gasoline) (.101000 gals. Fuel Oil) DATE PAID 1973 - March 26 MAR - 3 1976 1979 - 4-26-79 MAP _ 1g74 MAR 1977 F" ` ? 198 MAID 2 ': 1978 MAR 2 1975 TOWN OF BARNSTABLE OFFICE OF i BAR STA MM& ft BOARD OF HEALTH °A %639 �0® 367 MAIN STREET - HY-ANNIS,-MASS-02601_... _ December 21, 1980 Manager Mid Cape Ford Sales i Falmouth Rd. _ Hyannis, Ma. Dear Sir: On August 148 1980, you were notified to have your under- ground fuel storage tanks tested using the Kent' Moore Pressure Test, by November 20, 1980. To date, we have-.not received-'the -results of any .testing performed. If this- testing is not .done immediately, the Town. Clerk' s office will be notified by this office to withhold your` registration for storage of fuel underground. In addition, .you are subject to a fine of twenty (20) dollars for ' each days failure to comply with a Board of . ., Health order. Very truly-.-yours, John M. Kelly Director of Public Health JMK/mm A.S.A. REALTY CORP. Box 578 Hyannis, Mass. 02601 December 3, 1980 Peggie McKeen Town of Barnstable Office of Board of Health 367 Main Street Hyannis, Mass. 02601 Dear Ms. McKeen; This will confirm our phone conversation of this date. As stated the Gulf Oil Corporation is having the tank in question tested today. It is my understanding that they will submit a result of this test within an appropriate time. With the above information we feel it is in order for us to close our file on this matter. ours truly, James S. McGonagle JSM/rs y el 5 TANK TO TEST CAPACITY '1 ;� swam own AV Araw..wa.... N.."Cape" � � ■tOaww/Man wMr a� ;_ Tw M«wlww�'w GrT Cw«owwt EwPrwvr D.r Is www r InT.tweet/ ❑. C Grew■mow.m Tm w E..Eww■m-DETERMINING TANK CAPAcn r Ll Dtw« FILL-UP FOR TEST iwx RwwAY`aw TOW GaMrw Ia M r OwRaNw r Rrawy tMlea ww Eraasw Is tw tR G■llow .. A y,SnCK 9EFORE AND APTER EACH COMPARTMENT DROP OK EACH METERED DELIVEITY.DYAWWY To*OlwrwwweP 4 Pm"lot nr bob jy r a pv.) O Oc> SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK %MR RECOVERY SYSTEM Oft.rwwr w.etiw.w wppbe.L Gres W"w Maw waewwu.in ra(2e). t4iiew in w* Hip No too in Tam w■op■IWI � w*%)w■ry flow"a LVLLT O Ettwyw E t..Y TEMPERATURE/VOLUME FACTOR Is)TO TEST THIS TANK b Twat wmw■A C cowv o7_E ft■m o Dy_P "Pwawt,a TmW_•E Emomd Dow(•w- (f i7)i21d aYorwKw■� ^ � JIM'S PUMP A TANK SERVICE' °"'0''~'w'oa°f a4'e'w� 3 PEAWN4 UWAINOORE n$T=EQUM. . aw" M ae.mtww of a+Pmrlew w vaaMw olwnyw r•atr to* to am*(w U 17) YwwwFwN faoWO Pw P 1 /,�• AIM 04M HAR+Mc►l MA clan Tmm wr.e am w A'►04 maw r?IN am volt w Orwow Par disk No — m-W EE7E C■mPvaw psw t.ow to r�ro�af �fwaOiTAM am Elm• iE�t cupffl E wMAW wtT�� rw�laATa in w noPiE�E BEEE A JO t< <tE i�d Ism MaAmill omm amodpw•• T..wrww. moo wEu'm fww■a �� ttwtar wr 1-1 Tyy Ow' E"w'� a+� tar aria tt E aw ro mq oa(Use km w► so"" Iwd• Ew• taw_ Er�w• # ■w rr..ON bwp of go i made&) r .rr wrtw ata► fw" Erw ra r Me T+.ws- D.rs I-I r.■• , a, O.awe &Now brawl law"r a�■rl•1 yam—wsrfr rRww■m Oa 4 w. ti ,Q�ea o 0 a EO' S(000 or. eel 60 pw 4 0 4D 4 0d0 0 told 0,301 �' 660 4o o v p oa ov 6 y 640 D .0 2 311 ti ao o S " O •y :6�U — Da a o b �lD ; d d -- o 00 • 00 4 p . a.. 04 `f — .O If o I. { ..._tea:.. �.. .•._ . . . .'.t• :.: - �'ti-.�.rtiti`:r. ..�_. X _.,.�'. . . . . . . : . . . . . Wr M .0....�Oaw AM.a. W.'w•P.ar.l CM. Rmm twr M i.r TANK TO TEST WACTTY F'O'" d cC/t oft law..own C.o+F • v �r uW: V o TMa Mwf eri.CAM /►W..ft w o..m.. a.a+v orWa Li c000uw Ew�...w Daft b rra buM a is TN Coo F 0 cmm WFPYd+m TSTT Ew bwrti-DETErtMwN6 TANK CAPACIW'.: ❑ 011w Rpl•UP FOR TEST riot Hemp Tow amrpm a M a. Otlaa r a"woof boom dll"� motor�y to•oi+r► IP%im A up,STICR SEFOR AND AREA UCH COMPARTMENT 01IW 00 EACH YITMED DiLMXV OUANhW ' Tear oa.Wr pro"ill fun WAimp a n MvN V . SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK VAPOR RECOVERY SYSTEM S•. W w Tatar•oof.obiL C1.4 OM..WA naa.re.owoo w I.S In). .��' wp I y�xmw a art O Np wv era in wr*ow P..re.l O umoso Ow*wom."m utt1T ❑aw E . TEMPEAATURE/VCUME FACTOR I+)TO TEST THIS TANK ({V{;t22 21e •Uft woom I G CdW F Noso■T" F ASW Fmwa a Tma_•F Ever Ctrop 1•v-1 }} T1t..r•s.r.r t..arto Mearat.r., / �t G q JIM'S PUMP&TANK SERVICE' "a. FEATUM4 KEIrt4400K nSTING EQIN. /� 6 ad*MW11EF an .oACMr so vWw. M we a& Id Wa(/14 r 171 a.a)MAgMawa! Fr F JIM CHASE HArlrci i aaw /.. 6, .. . 3 A L ° 00 ooh—ariip/r'p 04 OWN pt IF In am t/atrr.trip PW dlvL No now p7) c4opum to•Arar.r Paa.a ten III, to r taF FrCEEiKi �M EtIJ>s■IwIBEi!w tEwfltSE ottPetIw �•—rat m IEGw■al wl s!�YI t4a� erne plmP� Fal.rr lraP Dow column Mom+ belYWr trw wed dot of(IY!1�+ a� sorer &~1-) T.na Ky..• p.HI. w�am. Yr toot• it tw- to an• 4.�LI a r la I��� o d i tuNLL) of r @do* Her ow" rdq a a•d r ur . O=iFJ Sar! �d NNW" God" Saar.14•1 IKIIM-.mFq na r.r Ob -t - N Z, iR itz -770 . a FF •7 0 ;8 D .d3o 40 60 H O •5�r0 .D o od 00 r' �, -� o S70 0 14 0 Q $ xij ufie •6 D osa . O D #3 ! .4 /24- 2 o 4 cl � " • SD . o0 0�•o a Dl D I i Jimts Pump &. Tank Service P.O. Box 224` Harwich, Mass, 02645 May 15,1985 Mid Cape Motors P.O. Box 578 332 Falmouth Rdo Hyannis, Mass. 02601 Gentlemen; The 4,000 gallon underground storage tank in front of Mid Cape Motors, was air tested for a period of 24 hours and during this time 5 lbs. of air was held. Sine erel Yours; games Chase cF THE Tod TOWN OF BARNSTABLE y o OFFICE OF DAfl7MA . L BOARD OF HEALTH MASS. i639' 367 MAIN STREET �0 MAY k. HYANNIS, MASS. 02601 February 24, 1987 Mid Cape Ford 232 Falmouth Road Hyannis, MA. 02601 Dear Sir: Our records show your undergound fuel tanks to be twenty years of age, or older. Town regulations require all tanks twenty years of age, or older, to be tested using the Kent-Moore Pressure Test. You are directed to have your tanks tested by April 1, 1987. Please submit results and their interpretation to this office and Fire Chief Farrenkopf, Hyannis Fire Department, 95 High School Road, Hyannis, prior to April 15, 1987.1' Failure to do so could result in legal action and the penalty of a fine. Each separate day's failure to comply with an order shall constitute a separate violation. You may request a hearing before the Board of Health if written petition requesting same is received within seven (7) day's of receipt of this order. Very truly yours, 4 tirEALTH n M. Kelly ector of Public Health h DEPARTMENT / TOWN OF BARNSTABLE JMK/ka TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: Board of Health MAILING ADDRESS: Town of Barnstable TELEPHONE NUMBER: P.O.P.O. Box 534 CONTACT PERSON: Hyannis, MA 02601 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in qu tities 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 ' - Please put a check beside each product that you store: Antifreeze (for gasoline or coolant systems) Drain cleaners V Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants l� Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal 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 l/ 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 ^ems (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 DIRECTOR OF SERVICE MID CAPE FORD r 332 Falmouth Road 508 775 5912 Hyannis,MA 02601 TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 2.Printers satisfactory sfacto • BOARD F HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY �/ (see"Orders") 5.Retail Stores ,e, 6.Fuel SuppliersF ADDRESS �7 4 Class: /� 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel(A) Diesel, Kerosene, #2 (B) Heavy Oils: G/ waste motor oil (C) new motor oil (C) tra mission/hydraulic - eir Synthetic Organics: deereasers ,z, Miscellaneous: v DISPOSALlRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O Town Sewer Public _ On-site OPrivate r 3. Indoor Floor Drains YES-j/NO Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES N0—Z ORDERS: O Holding tank: MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 2. 71 Q er n (s) Interviewed Inspector Date TOWN OF BARNSTAB E co I,rANCE CLASS: 1.Marine,Gas Stations,Repair nters BOARD OF HEALTH satisfactory 3.2.Auto Body Shops O unsatisfactory 4.Manufacturers COMPANY 4,2 (see"Orders") 5.Retail Stores �` , 6.Fuel Suppliers ADDRESS or--Qlass: 7.Miscellaneous QUAIqTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel(A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil(C) transmission/hydraulic. Synthetic Organics: degreasers Miscellaneous: u paid 5 c e vea DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply "f4- O Town Sewer OPublic O On-site OPrivate 3. Indoor Floor Drains YES NO t O Holding tank:MDC O Catch basin/Dry well aeA n O On-site system 4. Outdoor Surface drains:YES NO OR ERS: O Holding tank:MDC ::Y O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 1. 2. rson (s) nterviewed InspectoZ Date MATERIAL SAFETY DATA SHEET o AND SAFE HANDLING AND DISPOSAL INFORMATION ZEP MANUFACTURING COMPANY PAGE 1 OF 3 FIRST IN MAINTENANCE PRODUCTS SUPERSEDES: 02/20/87 PRODUCT NUMBER: 0452 CTION I - E rl E R G E N C Y C O N T A C T S P MANUFACTURING COMPANY NON-OFFICE HOURS, WEEKENDS, AND HOLIDAYS: AREA CODE 404 0. BOX 2015 435-2973, 996-0899, 252-1587, 351-2952, 445-9226 LANTA, GEORGIA 30301 LOCAL POISON CONTROL CENTER . . . . . . . . . . . . . . . . . . . . . . . . . . LEPHONE (404)352-1680 TRANSPORTATION EMERGENCY TWEEN 8: OOA. M. -5: OOP. M. CHEMTREC: TOLL FREE 1-800-424-9300 ALL CALLS RECORDED ASTERN TIME ZONE) DISTRICT OF COLUMBIA (202)483-7616 ALL CALLS RECORDED :CTION II - H A Z A R D O U S I N G R E D I E N T S TLV EFFECTS % IN -SIGNATIONS (PPM) (SEE REVERSE) PROD. * HEXYLENE GLYCOL ## 2-methyl-2, 4-pentanediol; 2, 4- 25 IRR 10-20 hydroxy-2-methylpentane; 1, 2-hexanediol; CAS# 107- -5; RTECS# SA0810000 ETHYLENE GLYCOL MONOBUTYL ETHER ## 2-butoxyethan- 25 TOX IRR CBL 5 butyl cellosolve; CAS# 111-76-2; RTECS# 5575000; OSHA PEL (SKIN)-50 ppm. � t I IDENTIFIES CHEMICALS LISTED UNDER SARA-SECTION 313 FOR RELEASE REPORTING. ='ECIAL NOTE: ADVERSE HEALTH EFFECTS WOULD NOT BE EXPECTED UNDER RECOMMENDED 3NDITIONS OF USE SO LONG AS PRESCRIBED SAFETY PRECAUTIONS ARE PRACTICED. ------------------- --------------- --------- -------------------------------------- CTION III - I-i E A L T H H A Z A R D D A T A UTE EFFECTS OF OVEREXPOSURE: IS PRODUCT MAY IRRITATE EYES AND SKIN UPON CONTACT. INFLAMMATION OF :E EYE IS CHARACTERIZED BY REDNESS, WATERING, AND ITCHING. SKIN INFLAMMATION IS AP.ACTERIZED BY ITCHING, SCALING, REDDENING, OR, OCCASSIONALLY, BLISTERING. ER-EXPOSURE BY INHALATION MAY CAUSE RESPIRATORY IRRITATION. !STING RESPIRATORY DISORDERS OR SKIN DISEASES MAY BE AGGRAVATED BY EXPOSURE. MATERIAL SAFETY DATA SKEET o AND SAFE HANDLING AND DISPOSAL INFORMATION ZEP MANUFACTURING COMPANY PAGE 2 OF 3 FIRST IN MAINTENANCE PRODUCTS SUPERSEDES: 02/20/87 PRODUCT NUMBER: 0452 TION III — 1-1 E A L T H H A Z A R D D A T A (CONTINUED) ONIC EFFECTS OF OVEREXPOSURE: MAL STUDIES INDICATE A POTENTIAL FOR LIVER, KIDNEY, OR RED BLOOD CELL DAMAGE. EVANCE OF THESE STUDIES OR EXPOSURE LEVELS WHICH MIGHT PRODUCE THESE EFFECTS HUMANS HAS . NOT BEEN ESTABLISHED. E OF THE HAZARDOUS INGREDIENTS ARE LISTED AS CARCINOGENS BY IARC, NTP, & OSHA 'D PEL/TLV: NOT ESTABLISHED PRIMARY ROUTES OF ENTRY: INH, SKIN. ------------- ----------------- --------- ----------------------------------------- S CODES: HEALTH 2; FLAM. 0; REACT. 0; PERS. PROTECT. B ; CHRONIC HAZ. YES ST AID PROCEDURES: N IMMEDIATELY FLUSH CONTAMINATED SKIN WITH PLENTY OF WATER FOR "AT LEAST 15 MINUTES. GET MEDICAL ATTENTION IF IRRITATION DEVELOPS. S IMMEDIATELY FLUSH EYES WITH PLENTY OF WATER FOR AT LEAST 15 MINUTES, OC— CASIONALLY LIFTING UPPER AND LOWER LIDS. GET MEDICAL ATTENTION AT ONCE. ALE_: MOVE EXPOSED PERSON TO FRESH AIR. IF IRRITATION PERSISTS, GET MEDICAL ATTENTION PROMPTLY. EST: IF THIS PRODUCT IS SWALLOWED, DO NOT INDUCE VOMITING. IF VICTIM IS CONSCIOUS GIVE PLENTY OF WATER TO DRINK. GET MEDICAL ATTENTION AT ONCE. TION IV — S P E C I A L P R O T E C T I O N I N F O R M A T I O N TECTIVE CLOTHING WEAR NITRILE GLOVES OR USE GLOVES WITH DEMONSTRATED RESISTANCE TO THE INGREDIENTS IN THIS PRODUCT. PROTECTION WEAR TIGHT—FITTING SPLASH—PROOF SAFETY GLASSES ESPECIALLY IF CONTACT LENSES ARE WORN. PIRATORY PROTECTION: NO SPECIAL MEASURES ARE REQUIRED. TILATION : NO SPECIAL MEASURES ARE REQUIRED. ------------------------- --------------- --------------- ---------------------- .TION V — P H Y S I C A L D A T A .LING POINT (F) 215F SPECIFIC GRAVITY 0. 98. 'OR PRESSURE(MMLiG) : N/D PERCENT VOLATILE BY VOLUME (%) : ' 70% 'OR DENSITY(AIR=1 ) : N/D EVAPORATION RATE(WATER =1 ) : 1. 0 UBILITY IN WATER : COMPLETE PH(CONCENTRATE) : 10. 0-10. 5 P H(USE DILUTION OF 1% SOLUTION ) : 9. 2-9. 7 -EARANCE AND ODOR : CLEAR, ORANGE/AMBER LIQUID WITYH STRONG, PLEASANT MINT ODOR :TION VI — F I R E A N D E X P L O S I O N D A T A SH POINT(F) (METHOD USED) : N/A ( ) s,MABLE LIMIT; LEL N/A UEL N/A 'INGUISHING MEDIA NOT COMBUSTIBLE CIAL FIRE FIGHTING: NONE_ iSUAL FIRE HAZARDS : FIRE EXPOSED DRUMS SHOULD BE COOLED WITH STREAM OF WATER. MATERIAL SAFETY DATA SHEET o ANDSAFE HANDLING AND DISPOSAL INFORMATION ZEP MANUFACTURING COMPANY PAGE 3 OF 3 FIRST IN MAINTENANCE PRODUCTS DATE 2 SUPERSEDES: 02/20/87 PRODUCT NUMBER: 0452 TION VII — R E A C T I V I T Y D A T A BILITY : STABLE' OMPATIBILITY(AVOID) STRONG ACIDS OR ALKALIES. YMERIZATION WILL NOT OCCUR. ARDOUS DECOMPOSITION: CARBON DIOXIDE AND CARBON MONOXIDE TION VIII — S P I L L A N D D I S P O S A L P R O C E D U R E S PS TO BE TAKEN IN CASE MATERIAL IS RELEASED OR SPILLED: ERVE SAFETY PROCEDURES IN SECTION 4 & 9 DURING CLEAN—UP. ABSORB SPILL ON RT ABSORBENT MATERIAL (eg ZEP—O—ZORB ) . PICK UP AND PLACE RESIDUE IN A TABLE WASTE CONTAINER OR, IF PERMITTED, FLUSH TO SEWER. THOROUGHLY RINSE LL AREA WITH WATER. TE DISPOSAL METHOD: UID WASTES ARE NOT PERMITTED IN LANDFILLS. THIS PRODUCT IS NOT CONSIDERED A ARDOUS WASTE UNDER RCRA. UNUSABLE LIQUID MAY BE ABSORBED ON AN INERT ABSORB— ( eg ZEP—O—ZORB ) , DRUMMED, AND TAKEN TO A CHEMICAL OR INDUSTRIAL LANDFILL. IN E AREAS DISPOSAL BY FLUSHING INTO A SANITARY SEWER WITH PLENTY OF WATER MAY PERMISSIBLE. CONSULT LOCAL, STATE, AND FEDERAL AGENCIES. FOR PROPER DISPOSAL HOD IN YOUR AREA. A HAZ. WASTE NOS. : N/A TION IX — S P E C I A L P R E C A U T I O N S CAUTIONS TO BE TAKEN WHEN HANDLING AND STORING: RE TIGHTLY CLOSED CONTAINER- IN A DRY AREA AT TEMPS. BETWEEN 40-120 DEGREES F. P PRODUCT AWAY FROM SKIN AND EYES. NOT BREATHE SPRAY MISTS OR VAPORS. THING OR SHOES WHICH BECOME CONTAMINATED WITH SUBSTANCE SHOULD BE REMOVED MPTLY AND, NOT REWORN UNTIL THOROUGHLY CLEANED. P OUT OF THE REACH OF CHILDREN. TION X — T R A N S P O R T A T I O N D A T A PROPER SHIPPING NAME )NE F HAZARD CLASS: N/A I. D. NUMBERR : N/A DOT LABEL/PLACARD: NONE TSCA CHEMICAL INVENTORY — ALL INGREDIENTS ARE LISTED CWA 40CFR PART 117 SUBSTANCE(RG IN A SINGLE CONTAINER ) : NONE MID-CAPE FORD BODY SHOP 771-1044 ROUTE 28 AT CORPORATION RD.,HYANNIS OPEN MONDAY-FRIDAY 8:00-5:00 PAULRYLL MANAGER MA. LIC. APPRAISER #11141 I YOUR SERVICE APPOINTMENT IS SCHEDULED FOR TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: 9Board of Health FAw�na�R� �� �tt��S �j Town of Barnstable MAILING ADDRESS: TELEPHONE NUMBER: _11i tc �4A P.O. Box 534 CONTACT PERSON: tV^VL- sob? �MGQ Hyannis, MA 02601 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, 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 Please put a check beside each product that you store: ✓ Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel T Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, 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 V 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 • • • ' Stations, •. 3.Auto Body Shops unsatisfactory- 4.Manufacturers • • Stores Miscellaneous I6 Fuel Suppliers IN 9 V 0 1 ONZILAIIN pla • ' A 1 Case lots Drums Above Tanks Underground Tanks Emmons 94i ffi- 0 INESIONOME MENNESOM 011011001M 11011011 0011011M / . . , , , off top a • • 1 �!.%�� s�I s'fd _j ter/ Inl,�i i.�>� �imma • •. 1 i ! f v Name of Hauler Destination Waste Product Licensed? i TOWN O 13ARNSTA13LE � ,,COHPLIANCE: CLASS: 1. Printers Stations,REpair Q satisfactory 2. Printers L IAR D' . OF HEALTH '' � 3. nanu Body Shops a O unsatisfactory- 4. Manufacturers COMPANY /11C (see"Orders") S. Retail Stores. 6. Fuel Suppliers J i V 'i• Y�• -� T 7. Miscellaneous ADDRESS �'A.� /1U , rill 0� Class t QUANTITIES AND STORAGE (IN=lndoars; OUT=outdoor. MAJOR MATERIALS * case - lots Drums AboveTanks UndetgroGnd Tanks IHL it 4 _IN N lZ.�a l lons A Fuels: • Gasoline, Jet Fuel (A) Diesel, Kerosene, 12 (B) . Heavy Oil!!. _ -H ,haste orator oil.-(C) "new motor oil (C) transmission/hydraulic '-Synthetic Organics: degreasers Miscellaneous: DISPOSAL RECL MAT ON RBV.RKS: 1. Sanitary Sewage 2. Water Supply ^/ /�^ Q Town Sewer Public �.� 1 � �C 0�[.j �J;WV on-site (-) Private Ak �' rL�111 iCA L '`, 0V)`('0 -H : il)M_. , e- 3. Indoor Floor Drains: YES\ NO _ �®° 1 t1 V r _ -�=�oN �1� l Holding tank: MDC ;pu _ t -�/ , t� C a,y U A6 60eflc,�� O Catch basin/Dry well —ORDER V ���L M�_•y� ..�j �' _ 0 On-site system P6 (I - AU, (nAt_iM1A1 t I-n 4. Outdoor Surface drains:YES NO v Q ffoldinL tank: MDC - _ O Catch basin/Dry wall �y OOn-site system jdDYA �•�n ___��__ S. Waste Transporter �`� " �'° fG �N Licensed? .,besting ion .Waste Product. r ,, YE,S ESL V I 1 n D b'JN4.01, C erson s Infery ewe Inspector 'Date' u2Jet � - _ �VVN OF BARNSTABLE COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repai.r a isfactory 2• Printers A R L OF HEALTH 3. Auto Body Shops ®unsatisfactory- 4. Manufacturers V Y '1� C'-{-w �=,��� ' (see"Orders") S. Retail Stores COMPANY 6. Fuel Suppliers ADDRESS �1J —Z` Class: 7. Miscellaneous QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums AboveTanks Undetgtouad Tanks !IN OUT IIN IOUT IN 1OUT # m7allons L7e est? Fuels: N; vz�"r7 Gasoline, Jet Fuel (A) � Diesel, Kerosene, #2 (B) ' � J Heavy Oils: ld�s � waste motor oil (C) new motor oil (C) transmission/hydraulic 2 - Synthetic Organics: degreasers ; i Miscellaneous: y . DISPOSAL RECLAMATION REMARKS: 1. ASanitary S age 2. Water S ly ® wn Sewer ublic 0 On-site P vate 3. Indoor Floor Drains: YES NO Holding tank: MDC •--____.____.._�..�_ --- - ® Catch basin/Dry well 0 On-sit system 4. Outdo o Surface drains:YES NO Holding tank: MDC ® Catch basin/Dry well ® On-site system S. Waste Transporter Licensed? Name of Hauler. _ Destination , ILI r 2 23 81 Persons t.I rviewed Inspector Date MID-CAPE MOTORS, Inc. Box 578 - 332 Falmouth Rd. \� HYANNIS, MASS. 02601 Area Code 617 Telephone 775-5912 — Parts Dept. 771-1661 July 28, 1981 Board of Health Town of Barnstable P.O. Box 534 Hyannis, Mass. 02601 The writer wishes to apologize for the tardiness and late reply to your inquiry to Mid-Cape Motors,Inc. and A.S.A. Realty Corp. regarding toxic materials. As I personally inadvertently filed your letter with previous correspondence from your offices. For you information A.S.A. Realty Corp. is the owner of the facilities occupied by Mid-Cape Motors,Inc. Also for your information we do not have a body shop. All work of this nature is sublet. All materials mentioned on your check sheet are stored in the con- tainers shipped by the manufacturer with the exception of our heating oil. The paints we have in inventory are the air tight spray cans of the typical touch-up paint cans. Motor. Oils and other fluids- are shipped by case in one quart containers. Other chemicals mentioned are also stored in similar small con- tainers and only opened upon use. We have on the premises two five hundred gallon underground waste liquid storage tanks. These are pumped out periodically by the Cynn Oil Company. Our degreasing equipment is leased from the Safety-Kleen Corp. which shpplies the degreasing material and removes the waste for reprocessing. All materials such as used anti-freeze, lubricants, gasolinoe are dumped into the above mentioned waste tanks. Please contact the writer if there are any further questions. Y rs truly, James S. McGonagle Pre si dent JSM:jf mom— — =:r.�.. �..-_� _ � "'-• - ---�•� ---•----.----.. Y Y N for BARNS ABLE COMPLIANCE: CLASS: 1 *Marine,Gas Stationsi Repair 0 satisfactory" •. 2• printers 3OAH D- O HCAUH � .4,•ttae,ufactttre'rsps unsatisfactory- Retail Stores VAN, 'f.1tCi� � (see Orders ) S. TAM � Z �. ' �-tv �. PP ve fuel Suppliers., Class . R 7. Miscel,ianeous • QUANTITIES AND S10RAUS (INSindoors; UUT=outdoors) 'Oa FMERIALS Case lots-a ( Drums ' Aboy anks Y Underground Tanks _ 1�1 1� - It 6 gallons a �s t 1_ Gasoline,', Jet Fuel (A) Diesel, Kerosene; 12' (0) y�=`' j � eavy Oils: taste motor oil (C) new motor.eil (C) transmission/hydraulic , 4 •nthetic ,Organics: degreasers ,�•� ry :cellsneouss 1 , lJ..�f A ! A _� _ r� 1 �� i"ALF.UUT WMIut , Sani ary Sevige. 2. Water Supply Town Sewer public On-site private - . .indoor floor Drains: YES 140_,r` • ,�---•fit*„. ;, Holding tank: MUC OCatch basin/Dry well 0 .UWsits system W_tt Y I!\N.6J �� GIi 'r. •....writ ...�.0�. . 71 )utdo6r Surface drains:Yl;5 N7_ (a Ilulding• tanks MUC - aLa 4 0 Catch basin/Dry well O Un-site System ---- aste TransporterMz 42m M "Vr� ,� tsedT ICE - .4 t t .�.. TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF FIRM: Uoce a Gifu a MAILING ADDRESS: 3 n +c-(►� TELEPHONE NUMBER: _7 p-8LIZ3 CONTACT PERSON: fah4 , Does your firm-store any: of -the=toxi:c--or._haz-ar-.dous nat xials -Jist.ed-below, 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. i If you answered YES above, please indicate if the materials are stored at a i 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 j 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: / I i/ Antifreeze (for gasline or coolant systems) Refrigerants Automatic transmission fluid w Pesticides (insecticides, Engine and Radiator flushes herbicides,rodenticides) Hydraulic fluid (including brake fluid) Photochemicals V/ Motor oils/waste oils Printing Ink Gasoline, Jet fuel Wood preservatives Diesel fuel, Kerosene, #2 heating oil (creosote) Other petroleum products: grease, 'I Swimming Pool chlorine lubricants 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 PCB' s 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 Other products not listed (including bleach) which you feel may be' Spot removers & cleaning fluids (dry cleaners) � toxic or hazardous (please Other cleaningsolvents ' `' H E list. :: HEALTH DEFT. Bug and tar removers TOWN OF BARNSTABLE Household cleansers, oven cleaners Drain cleaners Toilet cleaners Cesspool cleaners Disinfectants , 2 0 1981. Road Salt (Halite) " I TOWN OF BARNSTABLE BAR_W 40. 3383 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager �° ;rs6�,, 4-� ���, , ' (y Address of Offender_ r' { ;)t.aIL*--f drjo irl MV/MB Reg.# Village/State/Zip - t�.etc.i �. x ); c . = �'c'( Business Name rl 6&UA4",4: :ou am/pm; on Business Address �rT+�++. ." Signature of Enforcing Officer Village/State/Zip 4--f Location of Offense t t�►t,'<�eti ,a# _ - i i r��,ee�. k; ,, f-�'Pc` .,,�►r rj t zc Enforcing Dept/Division Offense —I' ,:)e t--e-4,z e&A t. ��t'.y��. if:t� Facts r L44(11aA4 sje -#a*Aty A F'+ CA = '• �` 1/t Jca.1 . 64...R i.ka 04,.-, r 4 uO-4:A iWo > 1 c`•c_s -L;ili J This will se a 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. j