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0199 FALMOUTH ROAD/RTE 28 - HAZMAT
rya ��►���� � 2,��-�--�--- / '��, 1 GC v � S Ji �oy IA1/ 12543 No. 3LOR � . . ''�� HASTINGS, MN K TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM f` Mail To: NAME OF BUSINESS: es Board of Health MAILING ADDRESS: M Town of Barnstable TELEPHONE NUMBER: P.O. Box 534 CONTACT PERSON: arm 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 qua ies totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when store Please put a check beside each product that you store: ntifr z f gasoline ee a ( •r gas• ne or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners ngine and radiator flushes Cesspool cleaners ydraulic fluid (including brake fluid) Disinfectants --rotor oils/waste oils Road Salt (Halite) asoline, Jet fuel Refrigerants sel 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 Car waxes and polishes Jewelry cleaners Asphalt & roofing r p g to 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 TOWN OF BARNSTABLE MPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops ��yy O unsatisfactory- 4.Manufacturers COMPANY Dow �'�'..!> (see"Orders") 5.Retail Stores ��/ 6.Fuel Suppliers ADDRESS �'qA�iZ���d�t'�g$g; 7.Miscellaneous UANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATER S 1Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline, o Te L'�•� g Diesel, KW_4"e, #2 (B) 7 Heavy Oils: waste motor oil (C) W TIP-'- new motor oil ) lli�e transmission/hydraulic fi Synthetic Organics: degreasers Miscellaneous: am� DISPOSATIRECLAMATION REMARKS: F 1. S itar Sewage 2. Water Supply .1" Town Sewer �ublic On-site OPrivate _ 3. Indoor Floor Drains YES 1' NO O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO OR ERS: n O Holding tank:MDC •— [ /L4L O Catch basin/Dry well O On-site system 5. Waste Transporter Name of Hauler Destination Waste Product YES NO 2. R11, I ow Person' (s) Inte ewed Inspector Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: '= Board of Health MAILING ADDRESS: /1W Town of Barnstable TELEPHONE NUMBER: `�`� - - 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 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 wh Please put a check beside each product that you store: tentifreeze (for gasoline or coolant systems) Drain cleaners utomatic transmission fluid Toilet cleaners gine and radiator flushes Cesspool cleaners ;ytodraulic fluid (including brake fluid) Disinfectants r oils/waste oils Road Salt (Halite) asoline, Jet fuel Refrigerants D' el fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) greasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may pot 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 TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory 2.Printers 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY•zkzo. / (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS /% jg3S; 7.Miscellaneous 7 7/- QUADiTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJORMATERIALS Case lots Drums Above Tanks Under&n-ound IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Ut -�- Diesel,Ker.,ase #2 (B) • �fP Heavy Oils: / waste motor oil (C) IL �� new motor oil(C) transmion/hydraulic �(f Synthetic Organics: degreasers Misce la eous: mob �d C DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply -� � ��'�P' ` �'"�' 0 Town Sewer �ePublic ' Pe-,ek„v s-a,- ''On-site OPrivate 3. Indoor Floor Drains YES NO U /, O Holding tank:MDC .J�.• `� j.�ACatch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES NO ORDERS: 0 Holding tank:MDC ' �K O Catch basin/Dry well , A 0 On-site system l 5.Waste Transporter Name of Hauler Destination Waste Product •d YES NO � 2. Person (s) In erviewed Inspector Date r n \ : L J� .. •Did UG,Ui%. \71nL.1V1 I.,. .Yo,., [�'(C) °SIN OF BARNSTAI - . , sa'tisfactm r Printers BG,�RD OF HEALTH r'' \nuto Body Shops unsatisfactory- 4. Manufacturers f --r- ('see"Orders") S. Retail Stores COMPANY b,)I\5 [ Fkf:t` "6. Fuel Suppliers ADDRESS �' f�'� �1��1+u�_J Class:_ 7. Miscellaneous 104 QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums AbdveTanks Underground Tanks IN IOUT IN IOUT I IN OUT 1 6 gygljqq�_Agerest? Fue si,lin Jet Fuel (A) % G�- . iese Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil. C transmission/hydraulic rAl Synthetic Organics: } degreasers' Miscellaneous: CJSPOSAL RECLAN.ATION 4REW.RKS: . 1. Sanitary Sewage 2. Water Supply Town Sewer `Public ( On-site Q Private 3. Indoor Floor Drains: YES NO Q Holding tank: MDC _ () !Catch basin/Dry well ..___..�._..:_..._ ..--- - -- •._...-- ----- — On-site system 4. Outdoor Surface drains:YES NC_y Q,Hoiding, tank: MDC O Catch basin/Dry well OOn-site system 5. Waste Transporter r Licensed? J D ctination -PrInduct -Z7/ u 23 el Person(s) Interviewed Inspector Date L TOWN OF BA R N STA B L EL-Osatisfactory NCE: CLASS: 1. Marine,Gas Stations,Repair 2. Printers BOARD OF HEALTH3. Auto Body Shops j� sfactory- 4. Manufacturers COMPANY Dc��S "��� ee"Orders") S. Retail Stores UlY? �C` 6. Fuel Suppliers. ADDRESS= k Z 46 c n n L=� Class: 7. Miscellaneous . QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums AbdveTanks Underground Tanks IN OUT IIN IOU IN OUT izallons Aze rest? , Fue]s- C'`Gasol' Jet Fuel (A) -- �"�— s! ,- J i2� Diesel Kerosene, #2 (B) Heavy Oils: waste motor oil (C) 2 new motor oil (C) transmiss.i h draulic l Synthetic Organics: ! degreasers Miscellaneous: i DISPOSAL REC ION 2. Water S ply REM�tRKS� 1. Sanita Sewa e �t. o Sewer Public / -site Pri to 3. Indoor Floor Drains: YES NO O Holding tank: MDC O Catch basin/Dry well v On-site system r --- kA 4. Outdoor Surface drains:WYES NC 0 Holding, tank: MDC df ( - + OCatch basin/Dry well OOn-site system �c '�S �-�`+� C�` 5. Waste Transporter Licensed? Name of Hauler. Destination Waste Prod YN 2. -A) I A\r--YO 12 23 B1 Person(s) Interviewed Inspector Date TOWN ' OF BARNSTABLE COMPLIANCE: CLASS: Marine,Gas Stat tons,REpall QJ.1aatisfactory 2. Printers C1�R p • OF HEALTH 3. Auto P•ody Shops a 4. manufacturers Qunsatisfactory- COMPANY �/�� // .! � /Y/ �� f(.' �jJ (see'brders") S. Retail Stores �, {� 6. Fuel Suppliers ADDRESS/"`�yf ,')l /� I kill- L� Class 7. Miscellaneous QUANTITIES AND STORAGE (IN=indoors; OU1'=outc1oor. MAJOR MATERIALS- Case.lots Drums AboveTanks Undetgrohnd Tanks I d_ �t MT Jt� �sllQns_ 9�� EW Fue � • Gasoline;Jet Fuel (A) 11` Diesel, Kerosene, 12 (B) Heavy 'waste motor oil,• (C)' Heir motor (C) transmission/hydraulic 'Synthetlns ticc degreasers _ _ • •Miscellaneous: • ISPOSAL RECI. MAT ON RBV.RKS: 1. Sanitary Sewage 2. Water Supply / n O Town Sewer ! Public ��li t�1U\� 7' �) ' / ,� 1 7TV1 0 on-site Private 3. Indoor Floor Drains: YES NO Holding tank: MDC OCatch basin/Dry well ..____.. _.__�..___.._---•---..:._....--_- _I 0 On-site system 4. Outdoor Surface drains:YES NO Q huldinL tank: MDC O Catch basin/Dry well OOn-site system S. Waste Transporter Licensed? I��m�f_1iauL�� Destination_ blasta Produr.t:. 0 YES_ no MAI u 21 IR Person(s) Interviewed Inspector Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: L02P_LAN'06 sr C-T-N S Board of Health MAILING ADDRESS: PO BOk 12432- Town of Barnstable TELEPHONE NUMBER: S(F 5374 P.O. Box 534 Hyannis, MA 02601 CONTACT PERSON: LE(`I �c��._AWDc, 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 gasoline asoline or coolants systems)Y ) 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 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 Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes 9 ' Paints, ems;=stems,-dam- Fertilizers (if stored outdoors) _ Paint & lacquer thinners PCB's _ Paint & varnish removers,.deglessef-� 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 TOWN OF BARNSTABLE MPUANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops / unsatisfactory- 4.Manufacturers COMPANY O ") Z�C (see"Orders 5.Retail Stores 6.Fuel Suppliers ADDRESS /2 l lass: 1 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground IN OUT I IN I OUTI 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: .'10'-r f4e--9,41 2FA111,61A 3 4k Ix- DISPOSAUREGLAMATION REMARKS: r 1. Sanitary Sewage 2. Water Supply of / W/ O Town Sewer Public XOn-site OPrivate f� 3. Indoor Floor Drains YES NO O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO P-' 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. - Person (s) Interviewed Inspector Date IHE r Office: - - `oF owti Town of Barnstable O ce:508 862 4644 Public Health Division Fax:508-790-6304 RM ssg`E'g 200 Main Street• Hyannis, MA 02601 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rFD MA'S Business Name: on,, Date: 91-7I1 q Location/Mailing Address: PrklmbiA Contact Name/Phone: 77'1- " 7 OSQJ Inventory Total Amount: � SDS: License#: ��35 Tier II : Labeling: S` i� Spill Plan: Oil/Water Separator: N6 Floor Dr aims: Emergency Numbers: �. Storage Areas/7anks: JOL o&lion C"K It cu/I C) Emergency/Containment Equipm_e�nt-t:"� Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: IST 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 � 'biesel 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 wimming pool chlorine Paints, varnishes, stains, dyes eye 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: + a Inspector:, Facility Representative: N)Q uZULM . WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS °p ISE iokti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARM5f�BLE.g' 200 Main Street• Hyannis, MA 02601 Wm prEOMP�4 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: �tI &,0,g Date: 41 . Location/Mailing Address: I Q 5ul W.,D v l Contact Name/Phone: E i Inventory Total Amount: ti SDS: > OK, kw_ CLceS S License#: Z So Tier II : Kk Labeling: ZS Spill Plan: -led, Oil/WaterSeparator: MIA Floor Drains: Emergency Numbers: `ks Storage Areas/Tanks: -� I KV Emergency/Containment Equipment: n Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: -f Fs54 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 1, Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) t p Windshield wash to 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 I Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons 'L Laundry soil &stain removers (including carbon tetrachloride) (including bleach Any other products with "poison labels" Ssq I C4<Q 014d q< 61 ` (including chloroform, formaldehyde, iti b&eAZ_ i>Q 4 / hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMM N ATIONS:)� a P4\_/ eLO Inspector: -' nspector: Gt-10 bJ� QV`'u2- Yl L �D C2�V�2 5, - �- �J.¢ `\'Q- �►��.s - Sv b �Q A44 S�r -fe, �e0,.0VCFac1ity Representative. WHITE C - HEALTH D RTMENT/CANARY COPY-BUSINESS °F IKE r°k, Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 ' B"",„Qq ' 200 Main Street• Hyannis, MA 02601 "rfo TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: k 0ke CYaS Date: f sj Location/Mailing Address: a Contact Name/Phone: e ( S ors- - - Si t In a toTotal Amount: qA, MSDS: �0 License: Tier II : NIA Labeling: gF Spill Plan: a as-� Oil/WaterSeparator: Floor Drains: K\o Emergency Numbers: Storage Areas/Tanks: o t2armA4S-eo< a)i SY Emergency/Containment Equipment: ,l le,'4 s ;-c- Cc I +A- s 1 l 1 Waste Generator ID: 'Wastb Product: I e� > n 1- Date&Amount of Last Shipment/Frequency:-) -t''., 2 Licensed Waste Hauler&Destination: I Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. 12 Antifreeze 12 Dry cleaning fluids 2 Automatic transmission fluid Z Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) 3 Windshield wash 3 1 Motor oils 11 1 Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil t Disinfectants I 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 Z, Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons 2) Laundry soil&stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" �- (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: Vna ,o-s W eVw, . INFORMATION 4 ECOMMENDATIONS: S °�TD OS�eUc(,t:}-�ru er �I DC�, ��5ole&inspector: IDS �O o ^ 0 � eS XD r Q,S KJ2-J � "ex-�%IONg�n,�f J`�q��j{`�q,\ �k�fL �1 FacifityRepresentative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS Hazar ous Materials Inventory Sheet Checklist / —Date �-_ Physical Street Address-Check database to ensure it exists L.-- Working Phone Number f/.. Actual Amounts - ( ie. gas being used to fuel machines, thinner to clean brushes all count as hazardous materials-no blanks) %Storage Information - location of storage, how long is storage for? If none, note that. 1/ Disposal Information -where and who? If none, note that. Applicant Signature - understand what is listed and noted Staff Initial -any questions, know who to ask Vehicle Washing/Rinsing.? -give a vehicle washing policy and xplain it Attach the Business Certificate with your sign off and comments '*The inventory form should explain what the business consists of and the procedures they are doing. Notes need to be left to explain what you discussed with them. J A N 2141 ptj1 qqoj,E6 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it sloes not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1 FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) 'r. • DATE: \ `" Fill in please: Ili,a�It&rE.)lu T3�PI. di' i;I4 s { ' r 0 @� „srq �;lp�ry d"i q ' APPLICANT'S YOUR NAME/S: L fjr''-'�F''`��°��'i�('� "�'" �� •'''' +H'Y;FF- BUSINESS YOUR HOME ADDRESS: ;�4 5 14tJiial — � l°,_�•.: ILA j mxlm lii' ;ii: i�l S(' (,�CLAAA171� i 7 TELEPHONE # Home Tele�l�ione Number '7 4 ( � h C� 7 •r.l :YILi!Yv�'ll'��"rn{l rdlT s.^�S NAME OF CORPORATION: O ?� SS °���/v 54i o 1 NAME OF NEW BUSINESS e- c o TYPE OF BUSINESS G c 0 g 1 JL i!5)0 IS THIS A HOME OCCUPATION? YE NO ADDRESS OF BUSINESS I - MAP/PARCEL NUMBER — 0-7 GI (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 GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) to malce sure you have the.appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING CO ISSIO R'S OFF CE This individu I he n'infor e f a p mit requirements that pertain to,this type of business. Au horizeErSignatu COMMENTS / 2. BOARD OF HEALTH This individual he infor d f the p rmit aiFements that pertain to this type of business. Authorize nature** tAAEIST C�MII�ETH COMMENTS: HA?Af:DOA MATERIALS EQULA31016 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: cs - TOWN OF BARNSTABLE Date: TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: as9-71 v11 fP /4, BUSINESS LOCATION: INVENTORY MAILING ADDRESS: s A TOTAL AMOUNT: TELEPHONE NUMBER: 774 !� Y70 6 `7 CONTACT PERSON: i`� s� EMERGENCY CONTACT TELEPHONE UMBER: `7-24 r, A9'7 off D MSDS ON SITE? TYPE OF BUSINESS: /� � INFORMATION/RECO ATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) r Gasoline Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers ma be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials Town. of Barnstable ti Regulatory Services 12ECEIVED / Thomas F. Geiler,Director Maj." Public Health Division JUL 13 2004 ► : prEDgMp`La Thomas McKean Director TOWN OF BARNSTABLE HEALTH DEPT. 200-Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304. Application Fee: $100.00 �t ASSESSORS MAP AND PARCEL NO. DATE D 7 O/ O XJ'� �" APPLICATION.FOR PERMIT.TO. STORE.AND/OR UTILIZE MORE THAN 111 GALLONS OF.HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT T%�(��✓/f/j f CTG � ADDRESS OF ESTABLISHMENT / / 2 LtZ200;14h A , 7JiS �i� TELEPHONE NUMBERS SOLE OWNER:A-YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL ID/ENTIFICATION NO. ©2( 3 7 8 S S STATE OF INCORPORATION /'/�3•�S��ii ci.5 e14 — FULL NAME AND HOME ADDRESS OF: �� C PRESIDENT Ogg i.,ri 6• /D ! 6�i G'� C�� �/• /r4�j�0�v' TREASURER CLERK $mac SIIG`NATURE OF APPLICANTT / RESTRICTIONS: `HOME ADDRESS 021 21Pw HOME TELEPHONE# Haz.doc/wp/q r 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$160. Make check payable to: Town of Barnstable. Allow five to seven (7)working days for in- house processing. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax us a copy of your,contingency plan (to handle hazardous waste spills, etc). In addition, please mail the required fee amount of$100.00. Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed'above.,Allow up to four days for in-house processing. For further assistance on any item above, call(508) 862-4644 r -- Number Fee 1235 THE COMMONWEALTH OF MASSACHUSETTS $5o.00 Town of Barnstable Board of Health This is to Certify that United Gas .-------------------------------------------------------------------------------------------------------------------------------- 199 Falmouth Road, Hyannis, MA ....------------------------------------------------------------------------------------------------------------------------------------------------------------------•. Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. ------------- ------------------------------------------------------------------------------------------------------------------------------------------------------ Restrictions: .------------------------------------------------------------------------------------------------------------------------------------------------------------------. This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONAL-D A.GUADAANALI,M.D. _ 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN, R.S.,CHO Director of Public Health rf Town of BarnstableMA Inspectional Services BARNSTABLE Public Health Division VJN:TnB E•EN639W20 CNrt•FYANNIs MfitS101I5 N'll5.p;zpy�lL%•'t:Si8a N5iM19!E 1639-2014 f 1 1 Thomas McKean,DirectorMAM ., nITZ A 02601 .`'� 200 Main Street, Hyannis,M C> Office: 508-862-4644 Fax: 508-790-6304 r c. APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE i 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 ❑: C Z CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ 1 *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 I d 7�/ 2. IS THIS A PERMIT RENEWAL? tl 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: geAS \-N 0,-16-"S,Sv� C--- 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: Ilk 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: R Q 7 s e 9. EMAIL ADDRESS: \p C.l Seta L ga-\2 -, 10. SOLEOWNER: YES ji NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND T LEPH NE#OF: CORPORATION NAME � I CL4v PRESIDENT � r oe TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICAN DATE D I 1 Z Q\Application Forms\Haz Mat Appli Draft Jan2019.doc r Number Fee 1235 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that United Gas 199 Falmouth Road, Hyannis, AL4 Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. ----------------------------------------------------------------------------- ----------------------- - - - - - This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2020 unless sooner suspended or revoked. ------------------------------ PAUL J.CANNIFF, D.M.D,CHAIRMAN DONALD A.GUADAGNOLI, M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A. MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable Inspectional Services BARNSTABLETHE fp �a Public Health Division �B B •�` Thomas McKean, Director- a'61 �'preo Mp+1639. A 200 Main Street, Hyannis, MA 02601 a �t Office: 508-362 4644 Fax: 508-790-6304 1XII 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 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 ❑ *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 l/ D 7 oe 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 ST GE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: Cry 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: '\`I L� 0 9. EMAIL ADDRESS: 10. SOLEOWNER: YES�O IF NO,NAME OF PARTNER: YLesnd��rP 11. FULL NAME,HOME ADDRESS,AND TELEPHO #OF: CORPORATION NAME } /3elz� c `fie ' PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHO #: `I .� C 7"7 COMPANY ADDRESS EMAIL: 16CQSS ' !ti SIGNATURE OF APPLICANT DATE��f s Q:\Application Fonns\Haz Mat App Revised 09-10-18.docx l Number Fee 1235 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that United Gas 199 Falmouth Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. ------------------------------------------ ------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------- -------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06130/2019 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 pt� z Gh 10w of B ns able eg1aatoryYerv1ceS Richard V. Scah,Director Public Health Division BAMSTABLE o� BAFN SZAB . 1 Thomas McKean,Director `�1639-1639-01`.'��M MAM Ar1639. a`0� 200 Main Street, Hyannis,MA 02601 �Dg 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 El CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 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[, OF GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: 1�Cl 12CA 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: "I`"\ -I 9. EMAIL ADDRESS: �('1lS �( �ca ► � D�'ZpMe';_,-D , 10. SOLEOWNER: __(YE�_NO IF NO,NAME OF PARTNER: 11. FULL NAME,HO�//ADDRESS,AND TALEP119NE#OF: CORPORATION NAME ` PRESIDENT L. cL TREASURER -- CLERK 12. IF PREPARED BY OUTSIDE PARTY: • NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT Q:\Application FormsUTAZMAT APP 2017 REVISED.docx I 5, F Number Fee 1235 THE COMMONWEALTH OF MASSACHUSETTS $5o.00 Town of Barnstable Board of Health This is to Certify that United Gas 199 Falmouth Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. ----------------------------------------------------------------------------------------------------------- --------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2018 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2017 JUNICHI SAWAYANAGI , THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Tow of B stable RegiAatory erv1ces �VaEr Richard V. Scali, Director �� � o Public Health Division BARNSTABI • t BA BPNk5i4tlLF•iHIf .CtlNli•NY4r:t.' � , RN�ABr.L. � X/.g5:15 HWS•[51 E1VILLk•Yfc51 R¢.NitR9:E 9 $ Thomas McKean, Director :b39-2„_Zo,< 4'�fo ,cs`e 200 Main Street, Hyannis,MA 02601 575 J Office: 508-862-4644 �/ '�©y Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE n� HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTERF108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS DULY 1st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 U $ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL 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: @St-S ; n� 5. NAME OF ESTABLISHMENT: V 1 ![fa CAUD 6. ADDRESS OF ESTABLISHMENT: C� '� (t\ 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS:/ 10. SOLEOWNER: c/ YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS, AND-TELEPHONE#OF: CORPORATION NAME C PRESIDENT U TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: • SIGNATURE OF APPLICAN — DATE 16 �. �A lication Forms\HAZMAT APP 2017 REVISED. T— Q� PP `1 t e e - ,` r ti ,�,,<� r,�. ..�, y. Ll .. / �� • _ TOWN OF BARNSTABLE — UNDERGROUND FUEL AND CHEMICA/L STORAGE REGIST�R"'%ATIONN 03 MAP NO. 6 ! PARCEL NO. /1 l r ADDRESS OF TANK: Rt 28 - Falmouth Road 1 VILLAGE: Hyannis N u m b 4w r O t r wm t MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : 501 Park Ave. , V6cester. MA 01610 OWNER NAME: Marane Oil Corporation PHONE: E (508) 791-7161. INSTALLATION DATE: 03/31/66 BY.! Unknown INSTALLER ADDRESS: 'CERT.idO. *TANK LOCATION: Right of building 25op (DCOOra!mW TANK ILOQAT2ON W2TM AMOPQCT TO mUSLO2NO) CAPACITY 5000 TYPE OF TANK steel AGE 23 YRS. FUEL/CHEM I CAL # 2 NO Oil TESTING CERTIFICATION C ] PASS C ] FAIL DATE N/A LEAK- DETECTION [ Al CHECK IF N/A TYPE/BRAND } ZONE OF CONTRIBUTION [ ] YES C ] NO DATE TO BE REM VEDI./ f / '� 1'r FIRE DEPT. PERMIT ISSUED C ] YES C ] NO DATE CONSERVATION C ] CHECK IF N/A DATE a ,Ia / '� ,+ BOARD OF HEALTH TAG NO. C c — ] DATE q, rl� 1tl fis PLEASE PROVIDE A SKETCH SHOWING THE TANK. LOCATION ON THE BACK OF THIS. CARD ldod s00 / ,D iESE� No-,(eAd s Oo fooO S,000 TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. '\ � - PARCEL NO. f ADDRESS OF TANK: Rt 28 - Falmouth Road q VILLAGE: Hyannis Nu m b a r Y t r�i t MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : 501 Park Ave. . Worcester. MA 01610 OWNER NAME: Marane Oil Corporation PHONE: (508) 791-7161 INSTALLATION DATE: 03/31/66 BY: Unknown 1 I INSTALLER ADDRESS: w 'CERT.i40. *TANK LOCATION: Riqht of building (DQQOF4 Z aQ TANK LOOAT Z ON W Z TH 1lQOPQCT TO mlJ Z LD I NO) CAPAC I Ty 5000 TYPE OF TANK Steel AGE 23 YRS. FUEL/CHEMICAL Gasnl inP TESTING CERTIFICATION C X3 PASS C 3 FAIL DATE 10/23/87 J LEAK DETECTION C X3 CHECK IF N/A TYPE/BRAND ZONE OF CONTRIBUTION C ] YES C 3 NO DATE TO BE REMOVED - _ ( � FIRE DEPT. PERMIT ISSUED C 3 YES C 3 NO DATE CONSERVATION C 3 CHECK IF N/A DATE a BOARD OF HEALTH TAG NO. C 3 DATE PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD !'UE�C Q/.0 � SGO / / i ,(7i�sE,C No-�E'�Id � � s�'o soon �o-.�EAcY f S'ui°�/'/ SOoO ,el%-�C��CY 000 �,�U/.CO'//Iy 501 PARK AVENUE M A RAN E OIL WORCESTER,MASSACHUSETTS 01610 TELEPHONE 1617)791-7161 July 1, 1985 Board of Health Town of Barnstable Barnstable Town Hall Barnstable, MA Dear Mr. Kelly: We are the owner of the Texaco station located on Route 28 in Hyannis and have been notified by your department that we are mandated to Kent-Moor Test the four (4 ) 5, 000-gallon tanks , because they have exceeded the twenty-year limit. In lieu of Kent-Moor Testing, I respectfully request that we be permitted to re-line the tanks with fiberglass , which will eliminate the necessity of. Kent-Moor Testing for the ten years and will also insure against any environmental mis- hap that may occur. The fiberglass lining is to be done by John Hallberg and Sons, who is a Fire .-Marshall Approved Contractor and applies an approved product. The process has also been approved by Chief Farenkoff of the Hyannis Fire Department. I have also contacted the Conservation Commission, and they have advised me that it is outside of their interest . Please find enclosed a copy of the Warranty for your information. If you have any questions, please feel free to contact me. Very trul , T as W. Hannigan --� ice President msp enc . I � of ws DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION PERMITApril 19 86 (4 Dace Famr.o. 2W TO MAINTAIN AN EXISTING/NEW UNDERGROUND STORAGE FACILITY i Part 4 In accordance with the provisions of 527CMR9.24 this permit to maintain an existing/new underground storage facility is granted to: Location of property: Rt. 28 Falmouth Road, Hyannis, MA 02601 Street aaaress Owner of property: Marane Oil Corp Full name person. clr" Cr corporation Restrictions: Fee P a i J : S�LZ �C --- (M.:;.L .A. Chapt . 148 Sec . IOA) This permit wiil :.ire :.eta .e .•r w r: '' ` ,•• ant' + '�� (Nner' s Copy to be posted at the storage facility with F .P.290 Part 3) ` / •.�/,, ,/11• ' I,X' �1 IJ `'W / '0' i.'17' 1'/ •r✓ ,Q/,� ,1 r✓ �;/,•�1.�,�•11. - I t� r (Y ,1 •J•: r�j/ �,�rh,< ( r °✓. r +M /N, ,•�. Ml,,, .• r,l1/1 �/ 'y�Jv ,�..�,(/3 't. \ ,1'1�,1,'i4+ .`w�` d' :�,�1 ,'i 1k•:� /'.. IIP ,• .;.,h /. ► 1 �y s� h r .�l Ills ,�. .. ''�� `� rr ,;:�:� >�' � �• r 'R �f••. w;��r�11�4� -,1,. $,;;?'.•,+��r 1�IS .�. r! �1rrr ti .`+1,.'•`�` /,� ,:www r }r�,�r , �� a✓✓ti , r12� rf,,t }:�.�,�•'�'it'��' ,r �'� ''-,•�' iY ti� f''r. ` ;�� .c r :A;sue• ��:�!• ��i� L. �� i1F. v. 'Teri~�!'J 'f.•t�?� ,.. -i ' fir.:•. �. imi#eb Parmntg 7239 •�R+l/. " �+ The Armor Shield AuthorizedApplicator,certifiesthot the Armor Shield-lining system ^s{f'.r r•'": { as indicated on the reverse side is hereby warranted ors period of�� ears against ..,. Y I P Y g ,ie�;�•. defects in material and workmanship. mL�`�•._r;Q Said defects will be repaired by the installing Authorized Applicator provided the tank .. .�-:.v:•". is made available and accessible. There will be a charge for travel, labor, lodging, r{ excavation,fuel transfer, permits, and/or testing. Any and all incidences regarding . _t--c• . damage,structural failure,maintenance,or change of product,which alters the structural tr.,Tiftr support, or structure of the Armor Shields lining, releases the Authorized Applicator Y from any liability, direct or indirect and nullifies this Warranty. •.'_- • The liability of the Authorized Applicator is limited to the repair of the tank lining.In � .,r•:;:-•Q_> no event, including in the case of negligence, shall the Armor Shield. Authori=ed - p f Applicator be liable for incidental or conseyuenrial damages.This warranty is expressly in lieu of any other warranties expressed or implied including any implied warranty of f. �Allo., merchantability offirnessfora particular-purpose. -* This warranty'is molt-transferable without the expressed written approval of the Armor == },i =_. Shields Applicator,and is not valid unless authenticated by Armor Shields of Ohio,Inc. ,,; __;:--i licensed Applicator urther certifies that said lining system has.been done b the -- The lice seI8 > Y r,.• •. .Q= Armor Shield. lining process which includes: '`"' •'?'' 1. Surface Preparation-(white metal blast, 3//1 mil profile min.) I.rIfit 2. Lining Application -(125 mil) 3. Final Inspection - (Holiday /2,500 volts-Barcol 935 hardness, 80 Minimum') Relative humidity 85% less on surface to be lined. t.a Dated: August 16, 1985 r= ,I� ARMOR SHIELD OF MASSACHUSETTS •,r! Authorized Applicator: .fit __ •�''�-'� P.O. Box 24 S. Chelmsford, Ma. 01824 == Address: =? :�.; ',-.--•. . Authentication: f '• The above Applicator iscertifredasalicense Ap licator by rmor,Shi�/d•RofOhiu,/ne D / B ° . - _.Seal > - "' " Armor Shield.of Ohio. lnc. 2.1 '3 a •;I r' age I D 2 . 1 P e r .., - r ,,.dl,",14,�' .\, ��• �rr'rl�i�� •'::fr ,,y;7 al Y,�.,j r-�. .�'�:%r•,\'��,is ril 1+1•" (✓ \:'r. ''rill'1`�+il'.,, r, ,�ti � 4�(�r,'„tiff,; .: r'r,rlrr''Ir •' ?:7,•�Pr;. Ld�111++� q, 1 :•I;y,,;:,:'gill+III!y�i :•:/!yti; r!'�i r hY •4• '►11 ll�/+'yrr �';,Y,'t•.,�,''r+/•J,t!•,'�. ':;.�51'•.• .�Mrlll+,Ir :'.� 111 .yl, !''i• •'•• l' ,� •yyl !r ,` 1 1 1 h �''iy..., ,.[� ,.p� y .....�, ► y 1 ,�'iy r, , .. 1'1 �• i•• n 1 /�• r r,•!J / 1, � ...,. •�w ;�,, .� q. �_,.1, �. ,, f, � 1' 1�1 P r+ Nv'►IY/:1��1. . •1�.1./! ,;•�Q7 .�If�.1/ '.;y.;.• 1/ 1.1!:' 'Srr,'• 1• r'•;:�,' !� •1 .rtiif lyl'1��/r �.�.tiJ r�.1:11 t?t; THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) IM ^ACC DATA Installation N0 7239 4182 New Invoice No. __________ ARMOR SHIELD® INSTALLATION RECORD DATE COMPLETED Aucu�t 16, 1985 Job Name: THOMAS TEXACO STATION Address: Route p28 (Cape Code MaU)Hyann.vs, Station Manager. John Thomas APPLICATING COMPANY: Ma'J D HA11 BFRG TANK 1 TNTNG CORP- The Authorized Applicator certifies that said lining has been done with Armor Shields materials, recommended amount of Spray material was used referenced on back side and meets Armor Shields®lining specifications, which includes surface preparation, lining application and final inspection and further requests that the Armor Shield® Warranty number indicated above,be issued to the below named customer by Armor Shield of Ohio,Inc.,representing said certifications. CORPORATE OFFICER'S SIGNATURE: L!I'Z Q^~"`— Mail Warranty to: Madete.cne J. D6co.teaux, Conponate Ctenh MARANE OIL COMPANY COMPANY 501 PaAk Avenue ADDRESS WoAce,6teJt, Ma. 01610 CITY STATE and ZIP A4. Tom Hannigan ATTENTION Name TANK# SIZE NAME OF SPRAY GALLONS USED NAME OF TROWEL NAME OF BASE RESIN 1 Reg. 5M TL-300 35 AG-300 2.Su eA 5M TL-300 35AG-3 0 3.Reg.N/L 5M TL-300 35 AG-300 4. 20it 5M TL-300 35 AG-300 5. 6. SKETCH OF TANK LOCATIONS I E L P U MJP cr PUMP ISLAND I ^hi 7s2�t Applicator: Mail to Armor Shield of Ohio, Inc., for Authentication signature and seal. TOWN OF BARNSTABLE — UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRRATION hh , MAP NO. PARCEL NO. �/ 7q ADDRESS OF TANK: Rt 28 - Falmouth Road VILLAGE: Hyannis NIJmb�r, MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : 501 Park Ave. „ Worcester, MA 01610 OWNER NAME: Marane Oil Corporation i PHONE: ( (508) 791-7161 INSTALLATION DATE: 03/31/66 BY: Unknown INSTALLER ADDRESS: -CERT.140. *TANK LOCATION: Right of building (D C 0 O iQ Z U C TANK L O Q A T Z ON W I T H R W O P U C T T O m U Z L O Z N 0) CAPAC I TY: 5000 TYPE OF TANK Steel AGE 23 YRS. FUEL/CHEMICAL Diesel TESTING CERTIFICATION E X] PASS E ] FAIL DATE 10/27/87 ol LEAK DETECTION EX ] CHECK IF N/A TYPE/BRAND I 7� ZONE OF CONTRIBUTION E X] YES [ ] NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED E ] YES E ] NO DATE CONSERVATION E ] CHECK IF N/A DATE ffjj a BOARD OF HEALTH TAG NO. E ] DATE h'" � /PA�L Y PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD Eud O/z/ J010:02/ loco D�ss�' s000 No �EF�d t ( 'V000 f U00 NO / 3 it TOWN OF BARNSTABLE — UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION j 6 MAP NO. I/ PARCEL NO. ADDRESS OF TANK: Rt 28 - Falmouth Roa VILLAGE: Hyannis Numb.�r Ytr��t MAILING ADDRESS ( IF DIFFERENT FROM; ABOVE) : 501 Park Ave. , Worcester, MA 01610 OWNER NAME: Marane Oil Corporation ' PHONE: (508) 791-7161 INSTALLATION DATE: 03/31/66 BY -UnknownT INSTALLER ADDRESS: 'CERT.140. *TANK LOCATION: Right of building (a c m o Pt z nC TANK L O Q A T 2 ON W S T H w G O P Q C T T O m U x L D 2 N 0) CAPACITY 5000 TYPE OF TANK Steel AGE 23 YRS. FUEL/CHEMICAL Gasoline TESTING CERTIFICATION [X] PASS [ ] FAIL DATE 10/26/87 } LEAK DETECTION [ X3 CHECK IF N/A TYPE/BRAND " ZONE OF CONTRIBUTION [ ] YES [ ] NO DATE TO BE REMOVED l FIRE DEPT. PERMIT ISSUED [ ] YES [ ] NO DATE CONSERVATION [ ] CHECK IF N/A DATE l / BOARD OF HEALTH TAG NO. [ ] DATE �T77�✓ / 7 PLEASE PROVIDE A SKETCH- SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD Todo/< )/E'Sez S,000 S a o0 s000 /No l£�d S,000 i 1 TOWN OF BARNSTABLE — UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. __�_.-3// :PARCEL NO. _ o q� of I 1 i r ADDRESS OF TANK• Rt 28 w almouth Road VILLAGE: Hyannis NuTb�r YEr��t MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : 501 Park Ave. , Worcester, MA 01610 i OWNER NAME: Marane Oil Corporation PHONE:i (508) 791-71.61 ti INSTALLATION DATE: 03/31/66 By: Unknown INSTALLER ADDRESS: 'CERT.iJO. *TANK LOCATION: Right of building (mamon z as TANK LOOAT I ON w I TH nammoo-r TO al.J z LLD I NO) CAPACITY 5000 TYPE OF TANK Steel AGE 23 YRS. FUEL/CHEMICAL gasoline TESTING CERTIFICATION C A] PASS C I FAIL DATE 10/27/87, LEAK DETECTION CX3 CHECK IF N/A TYPE/BRAND. �� yllylef ZONE OF CONTRIBUTION & YES C ] NO DATE TO BE REMOVED— � 15t tz 11) FIRE DEPT. PERMIT ISSUED C I YES C ] NO DATE CONSERVATION C ] CHECK IF N/A DATE BOARD OF HEALTH TAG NO. C / ] DATE #445)7?( I * .PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON 'THE• HACK OF THIS CARD J-00 00 �;oao saoo 3pGG No-.(£mac/ �° ; , rl� ,• ! ` 1. R 'r i•'Y! � 41 {�`'L♦}t � � � } r. `� `9. � - - '� qr 1 � ) � q s rr•rr '� ;y 1 ° i .1<� "y 'P S. 3d Z R H* �"�i y J r * .e' 'r ,•'vr• ' t .. f .`� t¢ e: +, L f�f f �,��{{.' Icy��d rl} a: � � it ,•A � - Yr .. r. �.-,. F t ar .i ,� .f t3n �ra,.�r'tv.« i � S 'f._.• r , "Ea? So ♦ +^} ,{a„ +3�::y* �. Y'Is fx -s." C t,.Nr 3 ` � � '� y' ? t + � .. r a 1 'a r r� „i �r,+ r ry T. •:•r - Y � ,a�♦` s{t �,?: ; s Y _ , t .•� 1 t.� R '� " R J r51 �. ,,. y •x,t � �r +• f. t l,..., ''� ^} "' r - t 3�*x a)r ,? ,f .'� f 6 .♦J', � + S i .ri � pL , •+5., 4 ` ' ,:,TiJ `� s>: t ;it J• e 1 3 • ;' .^ � �+ "� 3 .+ � a f' 1 K >°� 1t,i. r J -, 4 } .. ..: t,.' i••. J� tt��i }tx �• :: � c -Z L ,° }` it ` '� f.rs s' _ vf. s r �- ya, �," �i t `.'< w f� °r 9`+ �,.- ,� .:1y ra.! '.•N �� i Wry . r t,, i"•'v F a }`+ 1 �5�' t,4. _°� � ��y,��4 a tS..t � .a 1 Ec �.IW v t e•t•, a d� .,,."• � �•'�±7r.i '+t,# y .v:"'� ^.' ':� -•° ,°' .,c ?" y a,+ lip sa,t *- .isr,, n +s Q r-,4 q�t N 'tr S,+y. t .+ � „� t t •�' � 'w�,� '�r y 'r�, i -_�tt '1 t� .il ^`y r A' � i•} s. - , t , t r.t<t .•.} y 1� _ !.: a t4.:. A it�,e r r J a� 'July•3,a1985 Y a^ s t ,� .. r� � ,`, 3 t�r; i °�; ,•,. tr ,. 4 >.ti. r Y yr' '�'�tLr c.9 �` '�•, ,. + ;� t q,� S i „f��r.,+r�,��s.a .,• 'S �L .a.. ice,, t t� . _,, �..�- ��C 1 4.RY, � 't ' !' Fd..,. '.� � �;.. �t�� 41<..^., �i., r .r Y y �4 r � � r .r {���{.x�.�'r �_� r rut.aJ. _ ,'._t �•, ? to - .}} x, y .k � J ty y1,, ?��.;:.5 r '. :� d L '•.�.r r .t rF x 1 r'} 3� ' 6 a5 x +'.i rt n 9 .r.{ i. a Sr ,'•r f{r 1 4 „f .tr 4 d . 1 r�y� �r1 ;�, ,1 T S . , .,��f � '+ .x:'d ♦ r 4� ,�. �e �.�r. Sr'a •y'T y, *..- t „:y�tx v e. y :,r' .+ .t f rtiiY f 1 «:Y F�=l•" a ' .•.- ,jR " *� t_+''1 S �r "- E y S .t :'� r.x #' ..•{ ,d tt>...� r� f• Y �" 'r � kti .,• ,t ..1. r': Mr.•Thomas v1. . Hannigan,",,- Vice:`President�f u r ' r Marane'Oi1 '501 Park Avenue, ` ♦ `�, r t• ,x.++ wry- Sa., ,y. ,•, b . y,f *+. r M R ;a94 '� r -pi d " r +r •Worcester •`MA-. 0161U + art r'.'_ _ ar �..t t� 'V♦ s + •it. k., i'j` _ t�l t 'AR3 �"r f.''� a Dear Mr Hanni 1an °t ,•, ' �. ` t 6 V.6 t,+. 'l. I x}' r , l �.k•a,y h. �#;',- a T 7.,alf r,' r x nr - �`2 rF'r 3 *� L :'t••.yrr"! " 4' + ,��� .� Y•++ t # r '" 7 ry.� r`F Jr'}!,r ±. d' i++r, r+ a . L i'� t •y n, S•.x•. ':,1: ". .t,' ♦ r.`,.� K+^ 1 zr,, .r r ,_t Ky rf r tJ �.,r t .,.,ty '�y'�, Y :trti Y� • You,,are granted . variances from our ,regulation,governing+underground°'fuel and d t { rr ' Oc2 oinical. sfo'rage 'tanks.',"Y'ou will .be-f"allowed io: reline four (4) 5,040 gallon r`T ` underground gasciline tanks at Don's Texaco Station, Route a Hyannis,,w Ch the following"conditions. ` ,` Lr, '' > F �, c - _ ,.,' ti' t nw s ;w� s .'! jz. s '• , to rxp_ ?••,t ti t. ° _R J6 S,2 •A 1 v . •.{ relining must be'-°done'°tby qa contractor approved" by the State 1 Fire c x biar`shall t ..r rot .s' x�'!�•. `" r, x �` �. \ ♦ r x Y-,+rr� t4--�' ,F 3 t F ,� � ,° . �, �i ''r r - .�' � -t # '� .:4t '.�`.,, to kc'f'; '•-1rEi,,� ' -qrt •°i �♦ t ;. t" -r J;A�R ' 'r •�, ri .,at z j (2) '_The -tanks-must;be relined.under the supervision of the Hyannis Fire Chief. in accordance:,Wth tfie API Publication 1631,RFirst EdiCion, 1983.4w .: tr •'-� y p s• ,,• ; <. } •.c rt' � •�`~ r t r Ft„ f r (3) .Aft"of the relined tanks r shall+be �tigl tness' tested .before 'back`fillln �,and' writ yten�certification, of the testing 5received'by the Board{of :Health prior a" 3 to their use. r !. tit . ..+: x x T•`., r , �' ' ° ,,.• t F' r ,t d . `,+ t �< •♦ � )r .rr 't ° ;.t. - Ik' �urj °t + � +i°� -r±.�i} s•e ,ty � r�! � _ ttt•..� 'rY4 � s _ y ~t f*• G�. r i 'r ". }•!.' rilr d . a ! x •�,". ,+lZ,x t t.The armor` .shield reli�riing Kwarranty 'expires` aftef',ten y ars:''3�The`relinedrrk k r ftanlis must ,be replaced:_upon expirationWof the-warranty. " S t x §, , •:.r �. ., „:,x r x. .a.. �� fx � a V nt'.Kb^r f t t • 'Yti+v ,�.fry Ver truly`yours, • i 1. , ✓S l„ ,a\ , y �.1 ''•i \ Y' j M k `:. r ` q 1.' .._i '�„r 'r� � j tn.. ' ♦,.*;-pq *. 'r - a- Y� K eJ t � {+: 'S„':' x � i .x :. rh t' t beet . :. Chairman' •rt fi t , ,` s: r x , . 'c'?f`y•fr + . BOARD•OF s , •t� f HIIALTHt '"' , • �. '� , ;. R. , '� 'r r9' $` : �€ ` �, Rr . ;�. TOWN CAP B_ARNSTABLE `r • i <� 4 ,,' t ,, z ,� 1 r. • F : w ,. ,y� }" v+�• , }t ` rSt ,� }, � di K ,}+' x JMtc mm. , d ,. .L:a s f r x• tr_.e x..- �ws Tt' f .7 ;5 �� r 'fit •> u♦k,i i`t:•.'• r cc: F ire Chief Board of,Selectmen V • r 'r 3�g i•�t,i � •t�. � � y „ �, P r`Y ; '�••ar• R .'s:. �' r :a., r }W�<,r # •+Fay.. rT�.7 -*V•. .L k r'�'1r r a ,C. -I t t k. *' �. t ,.,� Its ♦..•y,,s. y .,A * .` * :i`xe f 3:.} if ^• r L •� j,�• ;' '• 'w q".t * Y Y f 6.• ° ± 7�+ .* S. .w'I.t;:.Y i it OkA T. i< 1 . - I • - x r h, ,p{1 a ''� �i aai'S Y ;..°kt r '+,t r- �t'r^r ,n st"t } } �••i 3:' / ..,! .r y.; a�4r - Q R l � '�: � �., , c , , � �. i yr = s•:$ �. SET. r y' :i •"` * ' { � r. °s. 'R t. t;° , ..n �t t . . �°.,�x i4: '<<�, r ,�,� .•� 'd ';+�i it '� � ♦ ` '` ♦,ice- - °r o � .s •.• �- � � \1tt i* � ," tt _* Sk ��a p °r�,r� 3 .. + ` S� � �',,5: "tt ';,' k' - ` :"ai�e s.i .*�. i'•' i '� T%a �ci .ti rM,4y .�t ,,` ! r. 4 r Gr.: • '� ° 1 ''¢'' r '°` .1Pt,t•"`r•� Wit': S 'L 501 PARK AVENUE UVl!q ML/ M L5 Op as WORCESTER, MASSACHUSETTS 01610 TELEPHONE (617)791-7161 July 1, 1985 Board of Health Town of Barnstable Barnstable Town Hall Barnstable, MA Dear Mr. Kelly: We are the owner of the Texaco station located on Route 28 in Hyannis and have been notified by your department .that we are mandated to Kent-Moor Test the four (4 ) 5,000-gallon tanks, because they have exceeded the twenty-year limit. In lieu of Kent-Moor Testing, I respectfully request that we be permitted to re-line the tanks with fiberglass, which will eliminate the necessity of Kent-Moor Testing for the ten years and will also insure against any environmental mis- hap that may occur. . The fiberglass lining is to be done by John Hallberg and Sons, who is a Fire,_Marshall Approved Contractor and applies an approved product. The process has also been approved by _ Chief Farenkoff of the Hyannis Fire Department. I have also contacted the Conservation Commission, and they have advised me that it is outside of their interest. Please find enclosed a copy of the Warranty for your information. If you hav ny questions, please feel free to contact me. Very your , omas W. Hannigan ice President msp enc. f • No, A 1516 4 Jt •,•'a" /!/HIj F•:v��N�� �su:�.' ��1 '�:i1` �; I/ 1 JlHiy t A in ..t• to �, 1' ,/ ' .-/t!4 �. 'ram\7••�•V -:i- �\ 11 is '. - , , _ Vli' y,4 �� •+.. �l 1, .. (....... .1.1 1. 1. -� •� rwor t m ,ttrrttnt� The Armor Shield© Authorized Applicator, certifies that the Armor Shield, lining system as indicated on the reverse side for Gasoline is hereby �!" ' warranted for a period of 10 years against defects in material and workmanship. Said defects will be repaired by the installing Authorized Applicator provided the tank is made available and accessible. There will be a charge for travel, excavation, fuel transfer, permits, and/or testing. Any and all incidences regarding damage or maintenance to an Armor Shield, lined tank, which alters the structure of the ". Armor Shield, lining or any change of product releases the Authorized Applicator ' - from any liability, direct or indirect, and nullifies this warranty. The liability of the Authorized Applicator is limited to the repair of the tank lining. In no event, including in the case of negligence, shall the Armor Shield,i Authorized Applicator be liable for incidental or consequential damages. This _ n warranty is expressly in lieu of any other warranties expressed or implied including any implied warranty of merchantability of fitness for a particular purpose. _ J This warranty is non-transferable without the expressed written approval of the _ Arinor Shield, Applicator, and is not valid unless authenticated by Armor Shield, + of Ohio, Inc. The licensed Applicator further certifies that said lining system has been done by the Armor Shield, lining process which includes: r 1. Surface Preparation �* 2. Lining Application .,l�. fir;,• 3. Final Inspection .t Dated: November 14, 1980 �. Authorized Applicator: J. D. Hallberg Tank Lining Corp " I P.O. Box 24 Address: r S. .Chelmsford, MA 01824 Authentication: .. The above Applicator is certified as o li�ensed Applicator by Armor Shield, of � Ohio, Inc. (•` '� w B� ���1, 1 /yj/h Seal `f' Armor Shielde of Ohio, Inc. - 579 ST Page 1 of 2 o I✓� � �srit�{. ,i ,�!`\,r•.; �' , � .+''' � �:i. r ��• ,t a t j j�,;..1,t "� .j jJ` Ju 31 n';.14♦°�y�rr� j{ •,,, a � ti�1�V//t/!�1.^'•'a. /� RRI - .y`'a�7lr, :`.. + \''"7I'r„ :i• r _:r,,, .+, � .'M•;�%• :M ti i l 4'. yl:: .4t,:: - :i'- ?.. ;i.'. rrr ,,, ,•+,�,�/p ,,�_ � a1�'1�Yr::ti�. t �r€•:, �'t� A - I 4. V y OFFICE OF THE STATE FIRE MARSHAL JOSEPH A. O'KEEFE, PE 1010 Commonwealth Avenue ' State Fire Marshal, Boston, Massachusetts 02215 (617) 566-4500 June 25, 1985 Chief Richard R. Farrenkopf Hyannis Fire Department 95 High School Road Extension Hyannis, MA 02601 Dear Chief: This letter is in -response to your letter dated May 20, 1985, concerning approved methods for relining of underground steel storage tanks. The following are approved methods: (1) New England Tank Relining, Inc. 333 North Ave. , Bridgeport, Conn. 06606 (2) Armor Shield (Hallberg Co. , Chelmsford, Mass.) 3141 Reading Road, Cincinnati, Ohio 45229 (3) Anchor Tank Lining, Inc. 13 Brookdale Rd. , Stoughton, MA 02072 (4) Stone Lining (James DeWolfe, Inc.) 155 Walnut St. , Reading, Ma. 01867 15) Glass Armor Relining by Kessler 244 Prospect Ave. , Hartford, Conn. 06106 A permit is necessary from the head of the fire department for relining. We consider this procedure of relining a hazardous undertaking and recommend Fire Chiefs assign a fire. watch when this work is done. If you have any further questions regarding our approval procedures or methods of approval please call at your convenience. Very truly yours, J ep A. O'Keefe, E shal JAO:gpd Fi)Le Pneventi.on pay.a the gneatUt div.iden6--the .6aving o� ti6e and pupenty I rn 0 SENDER: Complete items 1,2,3 and 4. n o Put your addressfn the"RETURN TO"space on the 3 reverse side-.-Failure to do this will prevent this card from � being returned to you.The return receipt fee will provide T 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) for}}s��errvice(s) requested. 1. �Lq Show to whom,date and address of.delivery. Go 2. ❑ Restricted Delivery. 3. Article Addressed to: �. Mr. T. W. Hannigan Marane Oil Corp. 501 Park Ave. Worcester, Ma. 01610 4. Type of Service: Article Number Registered ❑ Insured Certified ❑ COD ❑ Express Mail Always obtain signature of addressee or agent and DATE DELIVERED. 0 5. Si a re— Addressee 0 X my 6. Signature— gent i X 7. Date of Delivery a (� � J<i p INS C Z 8. Addressee's Address(ONLY if requested and fee pat .m n m M i UNITED STATES POSTAL SERVICE OFFICIAL BUSINESS SENDER INSTRUCTIONS Print your name,address,and ZIP Code in the u® Ant below. . • Complate items 1;2,8,and 4 on the reverse. ' • Attach to front Of article if space permits, PENALTY FOR PRIVATE otherwise affix to back of article. USE,Wo • Endorse article"Return Receipt Requested" i adjacent to number. RETURN TOWN OF BARNSTABLE TO -_BOARD OF HEALTH (Name of Sender) 8r�y (No..end Street,Apt,Suite,P.O.Box or R.D.No.) Hyannis, °Ma. 02601 9534 (City,State,and ZIP Code) , P 522 444 228 RECEIPT FOR CERTIFIED MAIL NO INSURANCE CgERAGE PROVIDED NOT FOR.INTERNATIONAL MAIL (See Reverse) � Sent to W. Hannigan Marane Oil Corp v Street and No. 501 Park Ave. w C P.O.,State and ZIP Code d Worcester . Ma. 01610 6 Postage $ Cd 6 * Certified Fee 1. 50 Special Delivery Fee Restricted Delivery Fee Return Receipt Showing to whom and Date Delivered c4 Return receipt showing to whom, vi Date,and Address of Delivery d TOTAL Postage and Fees $1. 5 0 LL Postmark or Date E 2/7/85 0 U. H a I F STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES.(see front) 1. If)ou want this receipt postmarked,stick the gummed stub on the left portion of the address side of the article leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier. (no extra charge) ?. If you do not want this receipt postmarked,stick the gummed stub on the left portion of the address side of the article, date,detach and retain the receipt,and mail the article. 3. If you wank return receipt,write the certified mail number and your name and address on a return receipt card, Form 3811,and attach it to the front of the article by means of the gummed ends if space permits.Otherwise,affix to back of article. Endorse front of artile RETURN RECEIPT REQUESTED adjacent to the number. 4. It you want delivery restricted to the addressee, or to an authorized agent of the addressee, endorse RESTRICTED DELIVERY on the front of the article. 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If return receipt is re- quested,check the applicable blocks in item 1 of Form 3811. 6. Save this receipt and present it if you make inquiry. f -+ +, r, A 1tit. r i v a\.,r F� S .•b r • .+.+ ,�- \`%,fit ...rf •, 'tiTV+I !`4' ; ." a ' 'tit ' {, '1 • .` ••{� ZLr r-L ' � �y ♦R•�F �r� 'r$ yr t" .'r ._:•"' t.I -•+r dl�J �. r ,C `'✓n t. � y, .. t T °b ++;y. �+' rr,� f' r"' �, �,• a r•. f # y. es� �A,. � r�.g, ' .. ^+Y, r r .4 .,.- fti r t �� c • a `', R"�': -. - J '. - . •a. r a •f•• \!r,'Q'u''!4 f � 4 �A'. r,.•# 3 "' f f .`{ f t _ r�r. Y �� .' rI r • R^ T �h - a+ .ir "F .+ f ,ta c ��:` A ,rA t. •- y r �. �`a q �..w '� S: ,} ?i,a ✓ T a 7 a r s 4 f,,, + 11J ,• r .. 4r.°' .rAL 3+ �i. •C4ryl� r'tiTrl947�+ { r{}f .� �R •[. r it #.r^ 4.' r �.� '." ",�{••'i ! MF, �r�Ys,a�r,. M ;.• r r ~ L � `Rw < •AGr e- i!e 5�,,� �Je`'H'\ .y L• a[�* E� � 4',` � + h' 4,r a "� ..r'i.� A a��T` \. f M1 r •y$"�5�� r�.� ��,:`." ' 1 s5• '�S�'r r fir` •' T�✓ _ - , x.1�a1".,�:'^ 4' t '"' ,f,Jf 'i'a•f� t' , � '` .. - f '� e ,.� � � e. 2^ r•�, g4 r i'.•3r" ♦ � �''"7*�r t ' � l'' s� • �, .a e?i.• r jill '`' �: l fit. 74fc,. � ;:a� v �..:, ,F+, ! :ti a c ` ; � h n,t.a t �l'.� s r•]f iS a �'a �`'�."�£r � .� r.,*1'-•�M1rt.` -- .. y� b"', ,• t^,� • tir. .r _. T r 4.' rf -,. �C�.: � t r x • � t �'�� r a 'i M1 [ } Y •.r \rats!• ti." ' .[ z..T*3r ri" J- 1' '�'i t -m . #homns,W.-Hap an 'tvi6i_ Pry_ r{ . 501, Park 'Avenue Worcest .`Ma0161 er ' • � `�'a '* ' ` t * `'� '. ' ` =J r +r�_ a ry `rr Red;` n! `rGlobe TeacQ.' Service .Statxdrl, mJ `Q-` T.�. a..4 e •s r .,"t yc ,..�: ` ;+-�w ;�?f+k ! "\1xi 'tr e• :.� 4'if' (� •. 4}s. n{. - '.+. r •`. -r F. •Hannigan: t "fit 3 Y p , t 4" } b T.�'• # t.. • 1 r �� 'he cardsotpleted bar you `shows ,your i OOQ�ga1:�.on{ tanks; it , locat d orn 'Rowe 28,, Hy" n z to`�be -twenty yeara. o€, ache. . f Town r regii�.at`iohs pequire a3•' ..+tanks :twenty years o€ ale 4to x � e• t s't c *''artnua .ly usii ig -the 'Xezzt WorOi Pi!;-Ng sums"Test=o :the.:ttarik is empty, .a .5PSI,`Air pressure Nest may,'pe: user,, 4 You arp c r`ecte:j,-to hive;yourtahk`.tested _by[j1drie l; 1985 tsting ,resin:ts=-anet'heir=,i1.nte "prd ativn to ti .this bfff ce,,Vr,or to Jtti�e �' 1985 � Tr 3• .�'^ �1,� t f• L r ,. t !.n rX c + ."' a •a - h ilur.e ,toy- do "so j " .d ,x asu .t *in-,�leg.al\`'.action '-anil dtha pen- ° "A, tW of !a: €in ., Pach .: epaxate: day', €ad,lure' to comply-.with- an order sha31 coat trite Aa{separate violation. r �i rJ%a �.} •� •y ? � v +Pr { •__1 / I a,j� 3 - "4 '.4,+ t - "'3•1`, � '• .r - r � !T P + You �ztiay' request a ,hear nc b[e€ore§the 5oard of Health 'i€ - `r written pe:ttan 'recuesCS.ng'' same is`.'receved:tiwitnzn seven \h E 7) claysY`gf ceYpt of th i ryd oe�. '' % �' ,• �'E ` ++' k [ •, -.." f r-fCr, t" f� v 1i�T• 4.. ��. �.""�...' i r+.• •f�. ,f _ �. s+- For,,yours converiienCe, we°fit ive enclosed',a listing of,'companies ''- 1aho:'per€orm thisestang, ".You";may ?also,: uta,lze any "other concerns 4ual Pied, to ,pdiform this;;lest ng a F• , •, • 1.4 Very truly: yours • � .{ s - h, 3 T�4, t � � � J Zs'+. a .`t Va • - r. r .. F�aa 4 . a iL�I � ...1• � Y:s / ,�•:}+>• 4 T`� .�l.,- !I•;.� 'Y • ' y r r .• � ,`l� _; a eX t Ir.' Childs Chairman`s ! a •r. a F \1r. ' > R ' \ ♦ a •s S rye f r _ yr r ,,i,..-f r°r __ �'ar •}L, r.. e.-,4 r` ^� ,r Y� 1 - * - ' ,Ann' Vane' b u h- t,�'p_ L? T t .1•ar r" t f V r ' •, �� •yi ;\�` rs;+ � �.. r• "� Tfx. s rf� � f 4 r'}tr T.* .�.� _ i �~,r _ \. •�. i 'a,v .� + �' .. 5 1. }•�M ` y'1 • -f r t r " iiJ.Y�iF �•`a'! .l iit ish,i 1.�y[' „' —r � 1 L' w f eltL .� • - 3�. J-.K. ♦ ,M. �r - E30ARD�'.Qk�• H��,TH S ,.' f, �. K ,•r#.. ' r ;��` • :y [ r r : Eri I �f yob•„�gTo� TOWN of BARNSTABLE OFFICE OF i BABH9TABLE, i MAAS. BOARD OF. HEALTH.. . 0o i639. \gym 367 MAIN STREET MAX A`S A" HYANNIS, MASS. 02601 August 11, 1980 Mr. Thomas W. Hannigan, Vice President Marane Oil Corp. 501 Park Avenue Worcester, Ma. 01610 Re: Hyannis Globe Texaco Service Station Dear Mr. Hannigan: 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 201 1980. For your convenience, we have enclosed a listing of companies who perform this testing. You may also utilize any .othe,r con- cerns qualified to perform this testing. Very truly yours, off- g�ln M. Kelly irector of. Pub is Health JMK/mm encl. 1 Form 77-1000 ' Data Chart for Tank System Tightness Tester (J 21103-3E41, USING KENT-MOORE CORPORATION TANK TiGHTNESS TESTER MODEL 1000 Copyright®Kent-Moore Corporation 1977 PLEASE PRINT 1. OWNER Property [) . /�r/jrC �� yL ��/t../1,'jS' �`?/S.� 7,/ 019�✓ Name , Address Representanvs ` Ca Telephone Tanks) /; � /1 S t= T/t co Name Address Reoresentahve Telephone 2. OPERATOR Name Addtess Telephone 3. REASON FOR TEST w /Ito (Explain Fully) 4. WHO REQUESTED 1 �EGG e - CAA�'o le 3 g0 TEST AND HE�I " T' ,•nine ��O 5C Comoanv of Affiliation Oats .. Address 5. WHO 1S %titiNG 1. Co roanv.Agency or Individual Verson Authorizing Title Teteonons FOR THIS TEST? Billing Address City State zip I Attention of: Order No. Other Instructions Identity by Direction Capacity Brand/Supplier, Grade Approx.Age Steel/Fiberglass 6. TANK(Sj iNVOLVEJ TiFSf I �Teec :T'i 7C 1C ! - C►t�v I I vr�l-�R h ! S7e v C e L:aeon Cover Fills e� Vents I Siphon s Pumps7. 1INSTALLATION 4 P 79�� pit sec DATA D. it.$ s�A7fe~ North inside driveway. Cdnctete,Black Top. Sire.Titefill make.Otop I I ,� G I Suction,Remote. Rear of station.etc. Earth.etc. I tuoes.Remote Fills I Size.Mamfolded I which tanks? ! Make if known 8. UNDERGROUND Is the water over the lank WATER Depth to the Water table Yes No Tanks to ce fixed�hr. ate Arranged by n)olt pIA) 9. FILL-UP Name Teleohone ARRANGEMENTS Extra product to"top off'and run TSTT. How and who to provide t Consider NO Lead. 'erminal or other contact for nctice or inquiry Comoanv Name Teteonons 10. CONTRACTOR.. MECHANICS. — — any other contractor involved 11. OTHER Foe I TZT ►i,' .1 2) 52510c. INFORMATION OR REMARKS 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 eta Tests were made on the above tank systems in accordance with test procedures prescribed for Kent-Moore Tank Systems Tightness Tester Model ?. TExT RESULTS 1000 as detailed on attached test charts with results as follows: C'd- Tank Identification ( Tight Leakage Indicated ; Date Tested :71i 11 I' J �� y 4 'JtY I — I r w ; ,j This is to certify that these tank systems were tested on the date(s)shown.Those indicate Tight' eet the erttena a bashed the National „ 13. CE TI CATION Fire Protection Association Pamphlet 29. / - --_ /' G C:�C_ c ata !•t';, t... ,Jesting Cpnuac:or rC moan . By: rgnature . T;V9cksary rj - Signal No.of Tastes Technicians Address 14.(y ) Ex)A, C Zg �/ `�i lufu�S 1,0 3C T. Name of Suppler.Owner or Dealer Address No.and Sliest(s) City State Date of Test 15. TANK TO TEST 16. CAPACITY s�Z From 57,00 SD z O U—Station Chart By most accurate ❑ i V L ��✓L ;- Nominal Capacity r7,00 0 capacity chart available Tank Manufacturer's Chart - Identity by position r /O 000 Gallons Gallons ❑ Company Engineering Data " 7C �(G U C;+h S'��'i�OP !II '] ! Is there doubt as to True Capacity t ❑ ��� O yo Charts supplied with TSTT Q ' Brand and Grade j See Section"DETERMINING TANK CAPACITY" Other Xf 0 3 11.. FILL-UP FOR TEST Stick readings i to%in. Gallons Total in Tank Stick Water Bottom before Fill-up _ ' Inventory 0 to X in. Gallons Z Fill up. STICK BEFORE AND AFTER EACH COMPARTMENT DROP OR EACH METERED DELIVERY OLIANTITY � Ir o g U (C,C c,• Product in full tank(up to fill pipe) ! Tank Diameter 18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK .r vn See manual sections applicable.Check below and record procedure in tog(26). 0 d o t�0 �ewr o Ott P ❑ Water in tank ElHi h water table in tan excavation ion Line(s)being tested Vapor recovery systems ❑ Stage I El StageII LJ tb O to Z Ol - 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 x Bottom of tank to Grade'... ...... F{ 8� G 7S3D D 22. Thermal-Sensor reading after circulation __�_ "F 0 y Assemble tubing a 30'for 4'L................ r- digits Nearest .: .• ,, '.. ' a24"fora"L...... ....... ' n range c c l - 23 Digits per'F I t nge of expected change Z c Total tubing to assemble (Approximate) digits g 24. J 0, 040 x •00 0 CO _ / t ! gallons _ J 20 i t._ + Z y�c x* ,n}ws +3 k total quantity coefficient of expansion for volume change in this tank Tank top to grade'. .....c.. ..... fuli tank(17) for involved product per'F / 'Extend hose on Test Elbow 8'or more I <r a u t 25. 077 + — • �D This is m r below tank to s .t a volume change per'F(24) Digits per 'F in test ^ Volume change per digit test .:.c ,p •.�w -r' p•'••••••••••••••°'•••••••••••••' - - - Range(25) Compute to 3 decimal places. factor(a) - rs'T^ Fill pipe extends above grade•use top of fill. :. l L - u S xa�s.'�i�' 4 ,.�r.a � ,r.,r^t a� -,� t'§�,,,_.. n _ i•°1,,,_- .a: a "t' - .�, ,.s. - .. `� '�. "� - - A. y ;. 3 �,s� �. *( M;_ �}��A'r„f Y��K�ate•c� ,� ...G "'J' .w+vk.„.�.tC� s f +k, "n-- n s _ r_ ���RE "I.rEX�c,^ T• 7� '� N�.°n;iS IM�s S "r �° '�. 1t1...///� �_ 26. 30. HYDROSTATIC 31• VOLUME MEASUREMENTS 34. .TEMPERATURE COMPENSATION 38.NET VOLUME 39. ACCUMULATED LOG OF TEST PROCEDURES N PRESSURE (V) RECORD TO .001 GAL USE FACTOR (a) .:. CHANGES �- �fnn �'�r�uL�3n 'YI/LeS ' $� Q�►� CONTROL �!0-1:9� EACH READING CHANGE 27. 28. 29. Standpipe Level 32. Product in 33. Product 35. 36. 37. Temperature At High level retard In Inches Change Computation Adjustment total and deflection Date Record details of setting up peed. . Graduate Replaced(—) Thermal Higher+ (c) x (a)a Volume Minus Time and running test. (Use full fall Beginning Level to Sensor Lower— Expansion+ Expansion(+)or At low level compute (I�htI length of line if needed.) No. of whichFReading After Product Reading (c) Contraction— Contraction(—) change per hour IC b 1 Reeding Restored Reading Recovered(+) t1 (r)—(t) (NF//PA criteria) 3'00 Fj29IOco l.>✓C.WTrC,r1 —�i� � -J�:%t/ SIf L %f)/�/ c.1/ c` . S r/L. L- -, p _ ,--r n l q �3 3a/z ; -Z _ Z .� t IC Iror 41-1K �jo C/2 1 z3 � r o O •P00 Z o a x L 1/Z 770 - /.v� . g o/z — / •/�8 c '?- y a �,• z t� ,.a " t c b k w ''a z ww ' � 9 Y fi k _2- 91 n1 S 30.. HYDROSTATIC 31. 34. 38.NET VOLUME 39. 26 4N VOLUME MEASUREMENTS TEMPERATURE COMPENSATION ACCUMULATED -n '' LOG OF TEST PROCEDURES " PRESSURE CHANGES 5 CONTROL µ (V) RECORD TO GAL. USE FACTOR (e) . CHANGE EACH READING ` C r 27. 28. 29. Standpipe feral 32. Product In 33. Product 35. 36: 37. Temperature At High Level record In Inches Chenpe Computation Adjustment total and detlxtian Graduate Replaced Date Record details of setting up Read- (—) Thermal Higher+ (c) ■ (e)- Volume Minus Time and running test.(Use full ing Beginning Level to Sensor Lower— Expansion+ Expansion(4-)or At low level compute (24 hr.) length of line if needed.) No. et which Belpre Alter Product Reading (c) Contraction— Contraction(—) change per hour Heading Restored fluding Reading Recovered(+) (r)—(t) (NFPA criteria) -, 2111 �- o 70, r -o o / 3 � / �i/y 01 a� [3)-11/3h_ 90 . �� zjr VT. FIB tl 5:. �'3 11 7 ( / o �, CO C z 5_ e, , a r l 14. �T 1$ /2���' ri Name of of Supplier.Owner or Dealer - Address No.and Sneet(s) City State Date of Test 15. TANK TO TEST 16« CAPACITY From , -- -- - - - ❑'Station Chart , �G ZJ By most accurate Nominal Capacity capacity chart available ❑ Tank Manufacturer's Chart nut by position C �� Gallons Gallons ❑ Company Engineering Data X 17 Is there doubt as to True Capacity? ❑ ❑ Charts supplied with TSTT 0 7 " et nd end Glade See Section"DETERMINING TANK CAPACITY ❑ Other r s 3 17. FILL-UP FOR TEST v Stick readings CQ to S in. Gallons Total in Tank Stick Water Bottom before Fill-up Inventory 0 to%in Gallons ZJ. Fill up. STICK BEFORE AND AFTER EACH!COMPARTMENT DROP OR EACH METERED DELIVERY OUANTITY Product in full tank(up to fill pipe) . Tank Diameter v7 .. i 18. SPECIAL CONDITIONS AND,PROCEDURES TO TEST THIS TANK v See manual sections applicable.Check below and record procedure in log(28). - a. Water in tank High water table in tank excavation v Line(s)being tested Vapor recovery systems ❑ Stage I .❑ Stage 11 g ❑ ❑ tr Z - - MP RATURE VOLUME FACTOR a TO TEST THIS TANK m .:19. .TANK MEASUREMENTS FOR 21. TE E / ( ) .�:�. ASSEMBLY TSTT ASS _ ' . m 'F On Truck_'F Expected Chan e Inventory Top_'F Center 'F Botto P 9 • i m 1 tank t Grade l - «Bono o to o _ . r r1 ;� D _ 22• Thermal-Sensor reading alter eirculation 1 � �F � s_r, A Assemble tubing 30'for 4'L. ...... • di gits its Neatest .. ,- 24"for 3"L... i it `per'F in range of expected 23. D g s P 9 change Z t.. dlplta Total tubing to assemble (Approximate)......... � 0 O0C 24. Z t x gallons / � _ � II n_ � as n e. 3 k s a. nsion for volume change in this tan _ 20. _ �q. ''e ,ie � , yXy �total quantity - s eoeltieient of expa g . .. � Involved product er.'F vo ed P �x t full tank o P l yG)y r"Tank top to grade ................... ..y - ' r _ �O?� - Z >r< :n< ��?C: -F 1C _ This is Extend hose on Test Elbow 8 or m r 25 ��oe r� he► volume change per F(24) Digits Per'F in test Vommute h 3 e V-. lgitlaces. /actoi a N below tank top.................. a Range(25) Compute P ( ) i Ca *11 Fill pipe extends above grade,use top of fill. K� a' ;Y„ :..-.1.. ^::i.. .. wi, J .:?` a. r +gS< y f�.,„.3';.. r,:�: {• 4.,>:.�� r1_ "' k rT �, 'u. 'Fp,n ;,y. "...;:"t.:r-F.S / ? .'.s, :1 '� •a".Yt _ r _r m a ':« -r'c3N��'„;Y.� .,.,a.�., ...- to ..,,,r K:...:r s «SY �...':: a r^'a r;?ti;`--. #� •€"� �' .i. ,'•W.'..: �u,y�,,. '.N: .,..s ce d..,•'-:.,, r.:S �[ „'iY - § `Y- .? •r,::%:+7, r .n, •h.4. .• a «r=� .2' ''9 ,dk :«... s r .a � �.,yam-<•.,. .^r... g :}�y z,r�$•- � s:. .�':� .+ _ .i. }XT. f k lo�k 7tx,��� ��a J ti,t;,s 30. HYDROSTATIC 31. 34• 38•NET VOLUME 39• ACCUMULATED 26. .'r :` VOLUME MEASUREMENTS TEMPERATURE COMPENSATION CHANGES l0G OF TEST PROCEDURES CONTROL IV) RECORD TO .001 GAL. USE FACTOR (a) ..... . EACH READING CHANGE 21. 28. 29• Standpipe level 32. Product in 33. Product 35. 36. 37. - Temperature At High Level record Record details of setting Up in Inches Change Computation Adjustment total and deflection Oate Read. Graduate Replaced(—) Thermal Higher+ (c) . (e)= Volume Minus Time and running test.(Use full ing Beginning Level to Sensor - Lower— Expansion+ Expansion(+)or At-low level compute (24 hr.)� length of line if needed.) No. of which Belore Alter Product, Reading (c) Contraction— Contraction(—) change per hour lO {� �. Reading ' Restored Reading Reading Recovered(+) �� (v)—(t) (NFPA criteria( tYa ��/�l•v�� %� G��t� j �t�S n(Js/ /��U' - ve rt, �)C6 if �i� Tr. zlro, ell / t P �� 1"t 2U , eve' �- L/o , ,.n ; �/3 .l 708 ;. z ke,; r%-' y Z 13 ,o?� / io .Z 7o�nG �o��� �/.3/ C� 17 i y LE�ti� - 5' z 7 06 _ // 71 f. - , c.�o'" z- o / 1 , o �i yy vc y ? . // l 70 � l� L - -7 ?? 21,2 it 74/ , 4,3n �v �- �/f `% Z 7 % �c' +c' / 7l t/ "'.->�y 4 12. ` a /Wl- 0.5 Off'0 V G� C• C.� G�t z o A otv 12 ' 3 /9 JZ . /:3 79 / 5 ���ri??� i� ' co f2�eC l2`� 7 ?yz r ' l /7 - n `/ �� ~ l r�:�„y C t: ..- • 4,:. .. _ v+t..+4:' . }k ,S.Kj •fir+ .... -123 • x ...4`w.a:"t ,.f. s .. _ ... ... ,.fen..._ a� .. ✓.:zu:'z.^. _ - 1'-.. �F.rp y, w r�.. •,k* k"Y ➢.:f y''`5' T w -t � .x.•. `"' } � i. :,"-� i4��" �. t�s+,�u•���s"d� ��". ,�^!y� ale ��e:4„�, ,� ":ot. :3, .. t c... .. t .,,•;v ,^L.;...-.r. ... ..:._, ...;,,:s • �' �`r.rr"�0-. z +.;,• Y. 3 rc i }# `a P- t 41 4 > r .:":; $,i" _r,st + .'".•. } ! r.{ '.t-"'cmxy L•+"r;.`•,y �. f, !>..j'-�. tY«y rc i;: r - .r s:::s�mk, "J`�,��` .. _. .;.. '':,. ,. '.. ,.•a' 'y°�bx�a•.. -.�,�.r.�„c,^r,��' .�.Mtwx ; .. �:�$s., T 't'p^�::s":: � 'a' 1 s ,�7•.q „L4 �Y.,cr ,» .. . . � ... y.,..�'. � .. _- . ef J•� �'F 5 +-arc+y,n, r ,'Y4s2,}•.�:rr°yt „ram }„g�,v� `N7 }.,s'7 a 4a •- - - 10, ,.. ?° +, t �y,+ jL�' TM r t "`#+sgA is�i ri a;•t k,f, gt,^rah•<.. vd`)+f ^ .. ``:t.•c ,� "; .,.f S> ,.:-s" } a• yam. n 14. �L G O 0 ` `r Name of Supoller,Owner or Dealer Address No.and Streets) city State 1241.va T t 15. TANK TO TEST 16. CAPACITY From ' Station Chart .y►Q /� /l�/t/ By most accurate <—U L) Tank Manufacturer's Chart h / 1. /\ Nominal Capacity y capacity chart available J O ldentiiy by position - Gallons Gallons Company Engineering Data -1 7 0� Is there doubt as to True Capacity? Charts supplied with:aSTT 'v Island and Grade See Section"DETERMINING TANK CAPACITY• .r - .. `C 3 17. FILL-UP FOR TEST stick readings M to X in, Gallons Total in Tank N (D Stick Water Bottom /3__ � n ' before Fill up ACT r Inventory to%m Gallons , Fill up. STICK BEFORE AND AFTER EACH COMPARTMENT DROP 4p " -`OR EACH METERED DELIVERY QUANTITY • �, Product in full tank(up to fill pipe) 'n t / Q ox's � - Tank Diameter C li v 18 SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK r y See manual sections applicable.Check below end record procedure in log(26). w ���� IvV dv� l N Water in tank Hi h water table in tank excavation Lines)being tested Vapor recovery systems Stage I Stage It Z TANK MEASUREMENTS FOR 21.. TEMPERATURE/VOLUME FACTOR (a)TO TEST THIS TANK �.<. . x .f. m + h 'F On Truck_•F Expected Change t ':TSTT ASSEMBLY f ' . . •F cancer •r: cot o '< :e .r. '.Ina ry P— .. •"�'.�:�i^... ..a;�rt v 'l,,r ray-.• _ Bottom of tank to Grade'.:.. 2 y; w^ 2. Thermal-Sensor reading after circulation 0 �Assemble tubing+30 for 4'L .: R� digits Nearest .... • 24'for 3'L ,.:. .. � 23.« Digits Per F m range of expected change Z , digits .1 Total tubing to assemble (Approximate) •• _ 3 24 X ✓)00D v 1 TT gallons n , w •"�� � k`s a i $ total quantity coefficient of expansion for volume change in this tank. T:�e _. p n'20w�� •.� .. -, .l rs' , 'w4'`ar.7 .'.t.-�. 's{ '�''f' fi"'""�' rka,,� ;. full tank(17) r for involved product Per•F + .TanktoP to grade'. 3, u ( 36 4 Extend hose on Test Elbow B'or more �r r�yy jr i r 45. ,y + = This is I -`m below lank to ` ' volume change per'F(24) Digits per 'F in test Volume change per digit.oes test p..................:............. 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HYDROSTATIC 31. 34. 38.NET VOLUME 39. 5: .r, 26., y-; n VOLUME MEASUREMENTS TEMPERATURE COMPENSATION ACCUMULATED rn LOG OF TEST PROCEDURES PRESSURE (V) RECORD TO .001 GAL. USE FACTOR (a) ....... y CHANGES CHANGE Q vgp P CONTROL / EACH READING 27, Y8• • 29. Standpipe Level 32. Product in 33• Product 35. 36. 37. Temperature At High Level record Date Record details of selling up Read• in Inches Gredaate Replaced Change Computation Adjustment total and deflection P (—) Thermal Higher+ (c).x (a)= Volume Minus Time - and running test.(Use full Ing Beginning Level to Sensor Lower— Expansion+ Expansion(+)or At low level compute (24 hr.) length of line if needed.) No• of which Betora Alter Product Reading (c) Contraction— Contraction(—) change per hour s Reading -Restored Reading Reading Recovered(+) (v)—(t) (NFPA criteria) &?") �J Q L) e L 1 .3 y� �1 Z. ev 2 Lf2' e u et_ • q 4 2- o .z 6 :35 , eq i� q kooe(•-- 3 q � .o ,/ 620 43 . /575 32-5 7zo� p 1(l�� 10 �(a`� 1`e� eL_ N o3 . ` o ./O Z3 f 3 . l zYS1 ��,53 �i2'' Qv o L 5 y l /2 `l Z o 0 3 l✓ G -1 3 /5�/ . 17 i SaY io;zo 0-Fi, To ct 2`' l,�v�� � 7 Z- Z - 7 ;07 .00 621 •7-3 55-/ , ( 5,5 / b9 ij,''X 7D c�2i' 't2/z 1. 97 `'0 0 3 .6 3 f -+- Z v3(/ 30� 2 O 2-- Jo 7 Q :pS j 1r,4 � To L12;' �.c��L�L `/ ly ,� ' Oo ,0� { , p �03� i'Z l03 y o l 3`( f :`i �-7y h i4'���; i—o /.S I Z6 ./ (03 +3 ./551 oo4t COL4 Cl `--o \OW { eQ Z- j3 `L 6 LJ _� n. 10 �o( 1, eo 3 / L % 2 - .37 � 10 ,qZ - Z . o3�I off . _ 1 o I-,,a0 Jtf?0 z 1 i 3' %Z `l 7 1 10 1 6 `I 4 z 1e3q0 3� tW1Ki '� o ���,► i3 iZ rf7 . 57 D2 1 V•f/ r111 ' ,n+c w.,Ys,r� •*.la Rt.. � ""� nt Hr„`'4�d.�y'S�,i• "�'�'"�,7s�r..w�'�';" s y' ,N'-. _ � ' t _ TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS NAME MARANE OIL CORPORATION ADDRESS 501 PARK AVENUE VILLAGE WORCESTER, MA 01610 LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE: OR CHEMICAL RTE. 28 (Opp. CAPE COD MALL) 5000 GASOLINE 15 yrs. STEEL 5000 " 5000 " " t° 50 0 DIESEL Is (Give same information for any additional tanks on reverse sid ar y --4 DATE OF PURCHASE OF EACH: 1. 1964 2. 1964 3. 1964 4. 1964 DATE OF FIRE DEPARTMENT PERMIT: Dec. 31, 19 6 3 TESTING CERTIFICATION SUBMITTED: 10,12a��° PASSED IO_y...�° DID NOT PASS a fI ` r U � O , DISTRIBUTORS — PETROLEUM PRODUCTS_ 1� 501 PARK AVENUE WORCESTER, MASS.'01610 1\1 TEL'791-7161 s A , `� April 22 , 1980 - \ Town of Barnstable Office of Board of Health 397 Main Street Hyannis, MA 02601 Gentlemen. Please find enclosed the Underground Fuel and Chemical • Storage Systems card for our Hyannis Globe Texaco Service Station. I do hereby certify that' I have reviewed the records maintained at our office at 501 Park Avenue, Worcester, MA, and that there is no inventory variation at this time. If you have any further questions, please do not hesitate to call me. Very tr yours, Th as W. Hanniga e-President TWH/msp Enclosure f L oft Eros TOWN OF BARNSTABLE OFFICE OF i -BA fl MAS&STABLE, : BOARD OF HEALTH � A6& pj 1639. 367 MAIN STREET HYANNIS, MASS. 02601 August 11, 1980 Mr. Thomas W. Hannigan, Vice President Marane Oil Corp. 501 Park Avenue Worcester, Ma. 01610 Re: Hyannis Globe Texaco Service Station Dear Mr. Hannigan: 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 con- cerns qualified to perform this testing. Very truly yours, t�ln M. Kelly irector of Pub is Health JMK/mm encl. 1 RME LOCATION 1 Harare 0i.]. CnmparV�r Rte, 28 Hyannis I233 Main a Nalmar Rd. & Walnut St.) Worcester, mass, (Globe. Texaco) BOOK & PAGE DATE GRANTED A_MUtJPTP STORED 77/123 December 31, 1963 Under - 20,000 gala. (tanks 4 . 1,000 fuel oil 77/151 500 waste oil DATE PAID txi K ;; 1,11 i 0 `.. 1977 March. 23 MAR 8 1974 MAP ' q75 t S` �G I A�141977 ��., ,.� �� � '��� � t G �\ �' �.� y �� �. .�; ,, . : �{ J 7 '_ � Y ,. 'q/. � - 4 `:�'^ 4 ' � � � •�` tVR n•w1I '� �.'` yy,, ',t'. 'M ..�" V 1 3 �. �►� �. �`� �gr�,, � 3�19t�