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Home My WebLink About1080 FALMOUTH ROAD/RTE 28 - HAZMAT � �� - � �� 7 �� f `°F�►�rotiti Town of Barnstable Office:508-862-4644 • °� Public Health Division Fax:508-790-6304 • BARMA.B% E • 200 Main Street• Hyannis, MA 02601 �ArfOMP+a`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: 1 g Date: /3 c6 a Location/Mailing Address: Contact Name/Phone: - O Inventory Total Amount: MSDS: License#: ►I Tier II : N 0 Labelina: Spill Plan: Oil/WaterSeparator: Floor Drains: 0 Emergency Numbers: Storage AreaslTanks: J Emergency/Containment-E ui ment: ` f Waste Generator ID: Waste Product: W� 000 Date&Amount of Last Shipment/Frequency: ge, C efiV S VM$ Al `ffl % o;o Licensed Waste Hauler&Destination: a00111c 10M M Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: VCaulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives (creosote) Asphalt&roofing tar Swimming pool chlorine 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: '•y :INFORMATION/RECOMMENDATIONS: nO hUfJ iS `j'11t° Inspector: h: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS THE rokti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 e"MAsssLe.$ 200 Main Street• Hyannis, MA 02601 p'FOMP+ TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: C✓S S�(Xe -R wq Date: Location/Mailing Address: Iyg0 T-alftt � oxv' G(D wooftcyA4,9 VAgigb Contact Name/Phone: SUS y0 6u Inventory Total Amount:".-A SDS: do Noe License#: Tier II Labelino: Spill Plan: QS'C)f1�t�V]2 Oil/WaterSeparator: 0 Floor Drains: N O Emergency Numbers: Storage Areas/Tanks: Emergency/Containment Equipment: a Mste Generator ID: C3 60 O _ Waste Product: - Date&Amount of Last Shipment/Frequency: /`J Licensed Waste Hauler&Destination: (fie fr}�tiu�i(d�f1V Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil V 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 ap V 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 etal polishes Other chlorinated hydrocarbons Laundry soil &stain removers3 ()43,) (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: U ( S Inspector. 1W 'IV Facility Representati _ WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS J °FIB►ors Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARM..% 200 Main Street• Hyannis, MA 02601 �ArEO MA'�p`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: C S Date: A� ►8 Location/Mailing Address: 0 a. wna� - 4►gvt l 'S Contact Name/Phone: SO -7 -G Z 1 4-V Inventory Total Amount: I�V C�GIU� SDS: Call 1K 00�1" �do�(,�- License#: < <Li sA Tier II : o Labeling: (7 '� Q PL% Spill Plan: ` S v ow Oil/Water Separator: Nil A Floor Drains: _ Emer enc Numbers: o -7 Storage Areas/Tanks: 2 -to 103e, c.I-QA ,ti&L o:!C 1AX OC 5 er enc /ContainmentEquipment: atb &wlZ 4 Waste Generator ID: G 0000(70 Waste Product: Date&Amount of Last Shipment/Frequency: ti l to e% a v Licensed Waste Hauler&Destination: -�KJ• Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS oC�1o►► t-5 Iv` NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous ma erial use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: '{" Wtta44.,6 yoc,5k�. A&Av�,Ce,--k5 %A," �\4G\e o r v� ORDER : � 2 S SV1 CGS vl & -AvL INFORMATION/RECOMMENDATUONS: u 0 &\A, C -mev, t-e G - I I I Inspecto� \Jf tt9— Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS I �pf 1►IE►ok� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMA-SBLE.g` 200 Main Street• Hyannis, MA 02601 Fo�'�'n+°�0T1OXIC AND HAZARDOUS MATERIALS INSPECTION REPORT C V Business Name: S Date: 8 /2 /b Location/Mailing Address: 1C'eVA"✓1-V1/1e. Contact Name/Phone: 08--7-7 2 5' 1 c ,4 44k ,n 'F1�..��v Inventory Total Amount:�C�� d� MSDS: 0or� wjQlo' A� License#: ( I L)4 Tier II : N o o�y Labeling:Q tk , 1 k w40t-f-"OK Spill Plan: e 5 Oil/WaterSeparator: Floor Drains: N D Emergency Numbers: �LS Storage Areas/Tanks: 13 tv-) wk5k,& S--or. - 'Vf a- i C,tl VA&A.a<,u.l,s ko fie. lolccl�e� Emergency/Containment Equipment: Waste Generator ID: MALIoopo -1 aste Product: & 4- !e v�rt IoC4fie� Date&Amount of Last Shi ment/Fre uenc : -7 1 t U 1 c ovum t+�WK,\n.c< ve Licensed Waste Hauler&Destination: \ vlv. Other Waste Disposal Methods: e C-A 9 - LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: , L- a.%, Ve-ep y 01-5-t-Z. �� Inspectors ` • Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS Number Fee 1144 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that CVS PHARMACYINC. #1869 1080 FALMOUTHROAD, 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 � - �,,� Regulatory Services Richard V. Scali, Director B" MAla E ` Public Health Division iARNSTABLE 1639. CEO MP'� Thomas McKean, Director 16��° 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE.WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1st—JUNE 30th). APPLICATION FEES CATEGORY I'PERMIT 26- 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00l V.�• • A late charge of$10.00 will be assessed if pgMent is not received/b, JUIV 1st. ASSESSORS MAP AND PARCEL NO. DATE FULL NAME OF APPLICANT: . --- - - - -- - - , NAME OF ESTABLISHMENT: _ _ _ CVS Store # 1869 ADDRESS OF ESTABLISHMENT �a , yn� 4a) _ MAILING ADDRESS DIFFERENT TELEPHONE NUMBER OF ESTABLISHMENT: TV— tLnQ L EMAIL ADDRESS• C W P SOLE OWNER: YES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME C PRESIDENT 7 SEE TREASURER ATTACHED CLERK • IF PREPARED BY OUTSIDE PARTY: n ATURE OF �PPLIC T Name: Company Address Telephone#: Email: QApplication Forms\HAZZAPP Revl6.docx Page 1 of 2 Number Fee 1144 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that CVSPHARMACYINC. #1869 1080 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 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M A�C(, I DATA -Wr - �y•�., '.*. ¢z a` ,� ,u'`Y."`;a. �. 'fi%1 Arws 'F��^�"", �2�'� _yp .ram AiL�+� r z� 1 p35 cvs m s ,-a AO 1i ON Al Lm 77 5 4 IME►ok Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARNSTABLE. MASS, g, 200 Main Street• Hyannis, MA 02601 �A�FDMAra`� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Date: 7 2v 1S Location/Mailing Address: I Oft T::kl . 4nnts Contact Name/Phone: o - 77 - BLS`k &-ik Wea InventoryTotal Amount: 5W /vt�, vtfO�y(14-/f MSDS: .3r f J/►'' ✓ ?License#: Tier II : o Labeling:\Ak7-wmsA�00bxe5 I&)Dd;- Spill Plan: gS Oil/WaterSeparator: MIA Floor Drains: K Emergency Numbers: 2 Storage Areas/Tanks: lna �Ar,�e„��. " �w 10 as 4AV Wvtr . "A Emer enc /Containment E ui ment: y�n°� �o<bc�n S �o-c 1d�1�5 ►-4 Waste Generator ID: 0. } &,- 0, a�U\61-e-� Waste Product: ,MtX as 140,lox. tic`; Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: o o 6\&zAnx(AA5f)A\\1 mA, Wit, 4 J+6 DOIX off! a1 A& ?. LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil&stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, /� hydrochloric acid, other acids) VIOLA�TIO S: 1 0 UCA00S �C.�� I�ce� A019teg. L'v<ce-N4 \Ak,F2a.c&v5 V4994-- �b ORDERS: o of GJCt ?A ate+ v�dt e vl %w C ki fAav� 2 g Pie 0vl i' o< P��5 INFORMA ION/ COMMENDATION : i4ktA- Rk C14 VM mot, <o e I eco l -6 -e- , eca/Nr`U J�y�e-45 �cz 4,( arPoo5 4-( f Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS / TOWN OF BARNSTABLE Date: 3 17�g e�ha„`, , TOXIC AND HAZARDOUS MATERIALS REraffiTFJkTM FORM NAME OF BUSINESS: CV BUSINESS LOCATION: 1080 CeVt&(-j%&1 INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: -1�> CONTACT PERSON: yeviv,LqjC0Ve, tM6x.� 'l wg , o `svuvoo� EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: .MRc C�e�Q•l �{'oc /..�'b s, � INFORMATION / RECOMMENDATIONS: ► -tto wko4tMA01 646 ovt S►46' Fire District: Zr AA ')-eA54 5 •lfA<"5 MJ64'ab ,44YLn VW.2-'f o✓5 ,,v► f- c15 �1t,cl►�.�- w,�'�, �O- ►/h/✓/ l ram: rwve.w c s e>re�i oh0kod4vx%CAI 4- �w .�' Waste Transportation: AA6 J�00001- 10 S Last shipment of hazardous waste: a�� Name of Hauler: al U2!q, ;rNd. MAC': Destination: A1<4 4 v14�i'"/�fo►t �, W ste Product- I�asfZ ol�oko /�x�t��w ae l Licensed . Yes No o. C°% �'` `i7 D ja q ,*, dz>i NOTE: Under the provisions of Ch. ?11, SectZn 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. m6pt4,,e ; Observed / Maximum Observed / Maximum +)bt%)d0rr/RgjAA16wL , Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners� ab,(� ct�v►�r�Q)�.►tl ' Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite)`1�b1e ��P14-v% 1m fJA Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides 0 l i vk6-Ga^A ,�� ❑ NEW ❑ USED (insecticides, herbicides, rodenticides),p� Gasoline, Jet fuel,Aviation gas 7NE; micals (Fixers) -�)PW.--l�r Diesel Fuel, kerosene, #2 heating oil ASED rtf er iokA.r Miscellaneous petroleum products: grease, Photochemicals (D veloper) 0;3 lubricants, gear oil KNEW 0"USED �0�"'�' Degreasers for engines and metal Printing ink '4 7 ce4. Degreasers for driveways&garages Wood preservatives(creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform,formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous(please list): Is' Metal polishes d 0K �p A) WvVLyi)AeX' Laundry soil &stain removers (including bleach) �a"�-�yb},A,��/ v� �o �t�3�yn� . S,�G B✓1 S►f� Spot removers&cleaning fluids (dry cleaners) f1t►�r `fD ►SPO,5a0 +rxn4DOf-k Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials qt 'F us- "• x "r?„ '� May 2, 2014 Town of Barnstable Regulatory Services Department 200 Main Street Hyannis, MA 02601 ATTN: Public Health Division SUBJECT: 2014 Hazardous Materials Registration CVS/pharmacy#1869—1080 Falmouth Road, Hyannis, MA 02601 CVS Pharmacy, Inc. authorizes 3E Company to act on its behalf in regard to regulatory reporting. The authorization includes the hazardous materials reporting requirements of the Town of Barnstable Regulatory Services Department. Based upon these requirements, please review the enclosed Hazardous Materials Registration and proof of previous payment(March 2014) for the facility listed above, Should you have any questions or concerns,please do not hesitate to contact me directly at(760) 602-8616. Sincerely, 3E COMPANY Eric Ensminger Regulatory Compliance Supervisor Enclosure BE.I HESD A,MD KINGSPoRI',TN CANTON,01-1 COPENHAGEN,DENNIARK, MONTREAL,QC;CANADA CVS Pharmacy#1869 1080 Falmouth Road Hyannis, MA 02601 Fire Code Hazard Class TotajcQuantity Unit of Measure' LEVEL 2 Aerosols 76.41 Ibs LEVEL 3 Aerosols 387.38 Ibs Carcinogenic Liquids 0.23 gal Carcinogenic Solids 0.90 Ibs Combustible Dust 1.24 Ibs Combustible Liquids-Class II 47.66 gal Combustible Liquids-Class IIIA 7.65 gal Combustible Liquids-Class IIIB 87.73 gal Corrosive Liquids 54.16 gal Corrosive Solids 6.31 Ibs Flammable Gases 0.81 gal Flammable Liquids-Class 1 B 58.70 gal Flammable Liquids-Class 1C 58.66 gal Irritant Liquids 241.30 gal Irritant Solids 29.13 Ibs Other Health Hazard Liquids 134.28 gal Other Health Hazard Solids 8.52 Ibs Oxidizing Liquids-Level 1 68.95 gal Oxidizing Solids-Level 1 16.23 Ibs Oxidizing Liquids-Level 2 0.18 gal Sensitizing Liquids 21.09 gal Sensitizing Solids 0.94 Ibs Toxic Liquids 3.44 gal Unstable-Reactive Liquids-Level 1 20.66 gal Water-Reactive Liquids- Level 1 I 0.57 gal Hazardous Materials Totals CVS Pharmacy#1869 QSD- O2-7- ) d nKE►oy� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMASS .. e` 200 Main Street• Hyannis, MA 02601 '" t639 M '�000 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT TFD A'S Business Name: CAS ,Date: Location/Mailing Address: ®�JO Contact Name/Phone: ® � Inventory Total AmouCWA 14 WMMSDS: Lies License#: 11qq _ Tier II : AV 0 Labelina: l Spill Plan: i -' Oil/WaterSeparator: Floor Drains: Emergency Numbers: Storage AreaslTanks: mer enc /Containment E ui ment: Waste Generator ID: Waste Product: ` S Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: "CA Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS n() C `� NOTE: Under the provisions of Ch. 111, Section 31, of the Merall Laws of MA, azardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION RECOMMENDATIONS: ® 0S dobRiM RMe T Inspect Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS • , C . Number Fee 1144 THE COMMONWEALTH OF MASSACHUSETTS $15o.00 Town of Barnstable Board of Health This is to Certify that CVS PHARMACYINC. #1869 -------------------------------------------------------------------------------------------------------------------------------- 1080 Falmouth Road, 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 Town of Barnstable of Inspectional Services Bt�F__ Public Health Division�� Thomas McKean, Director t; F639. c "` 200 Main Street, Hyannis,MA 02601 1 ' Office: 508-862-4644 Fax: 508-790-6304 r 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 *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. Stephanie Cadorette 4. FULL NAME OF APPLICANT: I ire\ncin3C oordin for 5. NAME OF ESTABLISHMENT: �v� 6. ADDRESS OF ESTABLISHMENT: M iCJ � �' ► ` 'I CVS/pharmacy 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: One CVS S Drive t�n (, UV onsocket,RI 02895 8. TELEPHONE NUMBER OF ESTABLISHMENT: �2/�' / ` `ZC1 �' 9. EMAIL ADDRESS: non pharmacypermits@cvshealth.com 10. SOLEOWNER: ' YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPH NE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICA A TE C U Q:Wpplication Forms\Haz Mat Appli Draft Jan2019.docx f / :NTITY NAME: CVS Pharmacy, Inc. S. arof A.DeNale President/Treasurer 75 Poplar St.,Watertown, MA 02472 One CVS Drive,Woonsocket, RI 0289S 401-765-IS00 -homas S.Moffatt Vice President/Secretary 29 Homestead Circle, Kingston, RI 02881 One CVS Drive,Woonsocket, RI 02895 401-765-IS00 .inda M.Cimbron Assistant Secretary 45 Bridge Street,Warren, RI 02885 One CVS Drive,Woonsocket, RI 02895 401-765-1500 vlelanie K. Luker Assistant Secretary 9 Coldbrook Drive, Cranston, RI 02920 One CVS Drive,Woonsocket, RI 02895 401-765-1500 effrey E.Clark Assistant Treasurer 2 Joy Lane, Hingham, MA 02043 One CVS Drive,Woonsocket, RI 02895 401-765-1500 ;heelagh M. Beaulieu Assistant Treasurer 50 Washington St. Fairhaven, MA 02719 One CVS Drive,Woonsocket, RI 02895 401-76S-1500 :imberley M. DeSousa Assistant Secretary 28 Larchwood Dr, Cumberland 02864 One CVS Drive,Woonsocket, RI 02895 401-765-1500 :arol A. DeNale Director 75 Poplar St.,Watertown, MA 02472 One CVS Drive,Woonsocket,TI 0289S 401-765-1500 'homas S. Moffatt Director 29 Homestead Circle, Kingston, RI 02881 One CVS Drive,Woonsocket RI 02895 401-765-1500 ASLAk w-CVSHealth RE: License Renewals Dear Sir/Madam: Enclosed please find completed application(s) and/or appropriate payment(s)for the License Renewal(s). Please note any changes made on the application(s). When/if new license(s) is/are issued,please send it to Mail Code 1160 at the address below. After making the necessary copies for my files I will forward the originals to the stores for posting. Thank you for your cooperation in this matter. If you require additional information or have any questions, please contact me at 401-770-2112 or email SLaScola@CVS.com. Sincerely, • Stefi"zaScd4 Stephanie LaScola Cadorette Licensing Coordinator One CVS Drive MC 1160 Woonsocket RI 02895 Enclosure(s) I Number Fee 1144 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health f This is to Certify that CVS PHARMACYINC. #1869 1080 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 DONALD A.GUADAGNOLI, M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A. MCKEAN, R.S.,CHO Director of Public Health f t; Town of Barnstable OA- Town &Inspectional Services ,Enxr-Public Health Division . `EARNsrrAHLE, • 9 MASS. $ Thomas McKean, Director 1659. o59 a`° 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 or, *A late charize of$10.00 will be assessed if payment is not received by July 1st.r 1. ASSESSOR'S MAP AND PARCEL NO. a 6D60'+X 01 2. IS THIS A PERMIT RENEWAL?�S—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: CVS PHARMACY#1869 5. NAME OF ESTABLISHMENT: 1080 FALMOUTH ROAD i HYANNIS, MA 02601 6. ADDRESS OF ESTABLISHMENT: Cy ' 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: Mail code 116�0! magS veEleei, 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: nonpharmacypermits(abcvshealth.com 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE# OF: CORPORATION NAME PRESIDENT TREASURER SEE ATTACHELF CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: • SIGNATURE OF APPLIC t TE Q:\Application Forms\Haz Mat App Revised 09-10118.docx w� Number Fee 1144 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that CYS PHARMACYINC. #1869 1080 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 f ' towtA of B rnsxable eg atory ervices Richard V. Scali, Director Public Health Division BARNSTABLE • i Thomas �ST�,- 1�,,,,E.�,T.„,.IM,1S WSTAB omas McKean Director ILLS- '�-� ^Mf MAE& � 7 1639-2014 �0 —— -- - s -- 200 IVlairi Street,-Hyaririis�MA 02601- - ---_------- - --- -- ---- -- Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st-JUNE 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: $150.00 A V,$ .� .'�tiE *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? S_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 h CVS PHARMACY#1869 - 5. NAME OF ESTABLISHMENT: 1080 FALMOUTH ROAD HYANNIS, MA 02601 CVS/pharmacy. 6. ADDRESS OF ESTABLISHME] one CVS Drive 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: Woonsocket, RI 02895 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: �j 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME 10,Q S n c- PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: A) 14- TELEPHONE#: • COMPANY ADDRESS / " EMAIL: SIGNATURE OF APPLICA4� — CLJ E� Q.\Application Forms\HAZMAT APP 2017 REVISED.docx a i Number Fee 1144 THE COMMONWEALTH OF MASSACHUSETTS $1s0.00 Town of Barnstable g�- Board of Health �? This is to Certify that — CVS PHARMACYINC. #1869 —_ 1080 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 06/30/2018 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 TRow�of Blrnsta � eg atory ervlce s , Richard V. Scah,Director Public Health Division BARNSTABIE r- Thomas McKean,Director 's n'�1639 24 4"'""°'"'`°e� 'rEc Meg s`� 200 Main Street, Hyannis,MA 02601 ��g Office: 508-862-4644 O�!// �`CJ Fax: 508-790-6304 X 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). I 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 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?IYES_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: -- -----�- CVS Store #1869 5. NAME OF ESTABLISHMENT: 1080 Falmouth Rd - -- - - Centerville, MA 2632 6. ADDRESS OF ESTABLISHMENT: i 7. MAILING ADDRESS (IF DIFFERENT> Kuivi-,pcsu-v E: - --- S. TELEPHONE NUMBER OF ESTABLISHMENT: SLA ` --v-W ` O U 14 9. EMAIL ADDRESS: Donna.Chevalier@CVShealth.Com 10. SOLEOWNER: YESN-NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME CJS Qf�ACa1 `_1J1(1C� PRESIDENT TREASURER SEE CLERK AMCHED 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF AP DATE Q: �Application FormsUTAZMAT A417AREV&Kdocx�-� TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS NAME C A(�1-1 �f1/n'% (!✓� ADDRESS / 1122- & VILLAGE 14 yXltlPb 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: PASSED DID NOT PASS