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0276 FALMOUTH ROAD/RTE 28 - HAZMAT
x t71 J SMEAD UPC UM ..yd.o. • �r l�ui1► �� Number Fee 1080 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that West Marine Products 276 Falmouth Road, Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. --------------------------------------------------------------------------------------------- ---------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2010 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2009 JUNICHI SAWAYANAGI THOMAS A. MCKEAN,R.S.,CHO Director of Public Health � r' Qun 23 2009 5: 32PM HP LASERJET FAX p. 1 Town of Barnstable stable i.. Regulatory, Services Departmen •, A1-1irin�fC4! WW Public Health Division ee 02601 . a 200 Main Str t,Hyannis MA �" 2007 Otce: SD8-B61.46 ► Thomas R Qailer,Director FAX: 503-790.6304 T wmas A.McKean.CFO i Application ae: $160.00 ASSESSORS mAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF RAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT l � ADDRESS OF ESTABLISB11'IENI' t:P 74 TELEPHONE NUMBER SOLE OWNER: YES �NO IF APPLICANT IS A PARTNERSHIP,PULL NAME AND HOME ADDRES OF AIW PARTNERS; c IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. co,� rn. STATE OF INCORPORATION FULL NAME AND ROM1E ADDRES OF: 131 PRESIDENT C ►` -GLfflLRKJ%Le P S%GNATURE F,PFLICANT RESTRICTIONS: HOME ADDRESS 5S ` H ONIE TELEPHONE# $3-I Q;VjumatUHoz Me Applieatioa2008-00C _ 06/23/2009 10 :35AM • • Number Fee 1058 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Sherwin-Williams Co. .-------------------------------------------------------------------------------------------------------------------------------- 276 Falmouth Road, STE A, 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 Inspectional Services E*: BLE Public Health Division nm•rvr nMls''1FSi BPRNSt4B!E BAMSr"M Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 �u Office: 508-862-4644 Fax: 508-790-6304; e0 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 &YV81— *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 ZONINGBUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF • GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 51Ae f LOLO V �1 `l[0101 2 Cc 5. NAME OF ESTABLISHMENT: 51AC�V,/"'y W` ( 1Cl`i C' (V 6. ADDRESS OF ESTABLISHMENT: Z'1 G l �lu�'�� i`l/� ✓`� ` �� , 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: J J - Z 9 1 9. EMAIL ADDRESS: 5w 51 b6 5Li er1,Vi yV. Cep ivl 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME 1A -t in04 S CD PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATLtRE OF APPLICANT DATE v �Application Forms\Haz Mat Appli Draft Jan20 Q: 9.docx Number Fee 1058 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Sherwin-Williams Co. 276 Falmouth Road, STE A, 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 Town of Barnstable Inspectional Services BARNSTABLE F THE T-�, w>s"*cts uE�.s c n i`0 i e%u.""isvZE Y Public Health Division C.9-2Ui F" w CAB . ` Thomas McKean, Director ArEc Nw+n`0 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-796-6304 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 .9,� 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. P 3--03 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)? S NO. 4. FULL NAME OF APPLICANT: 11 5. NAME OF ESTABLISHMENT: 2 LteWftW l((c t,4j S CU 6. ADDRESS OF ESTABLISHMENT: 276 PC4140..1�0O 1 vi vt 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE:8. TELEPHONE NUMBER OF ESTABLISHMENT: 0 b -77 5`2 (S Z 9. EMAIL ADDRESS: 5 w .57'�-S 5tq e/w 1 k)• 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME 5'ieiwti, I,✓� ��(�=� S l� PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: ` NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: T SIGNATL RE OF APPLICAN DATE & Q:\Application Forms\Haz Mat App Revised 09-1 -18. bcx Number Fee 1080 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that West Marine Products 276 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 Town of Barnstable Inspectional Services BARNSTABLE "I ME 1p� wvsic�s uius`•u-`.4'ru_� ��aia'"a",—"va;e Public Health Division -2014 ^ BABNHABLE. Thomas McKean Director 1639. 4',ren �a`0 200 Main Street, Hyannis,MA 02601 0 �4 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 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 JS1V5--T` *A late charge of$10.00 will be assessed if payment is not received by Jules �A ( � a 08 1. ASSESSOR'S MAP AND PARCEL NO. Q-93 r83 2. IS THIS A PERMIT RENEWAL?,2C YES_NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF • GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: V3t�` 'A 4,CN V t., 6. ADDRESS OF ESTABLISHMENT: 7- 4AD S�e C- ,^A o z e 0 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: .SO® e S QC VJ-h3 o,"i Ive C'A 9.Sa�b 8. TELEPHONE NUMBER OF ESTABLISHMENT: SU 5 - gb 2-2:-o o 9. EMAIL ADDRESS: we to r� 10. SOLEOWNER:AC YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME W PRESIDENT Y.P� TREASURER-;z-.,e 95\ral CLERK @a V' 06�-'A=ICE 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: . COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANTq7j(2 DATE Z� r Q:\Application Fonns\Haz Mat App Revised 09-10-18.docx Number Fee 1080 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that West Marine Products 276 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 :e ell, Veg,o of B�rnstable atory emices Richard V. Scali,Director AA "o Public Health Division BABSTABL x w BARN LE = Thomas McKean,DirectorMAS& ib-2 ;" pre1 �. 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE tl 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 9 V.S k7 So? *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. z'(3 03 I -96- 2+6 2. IS THIS A PERMIT RENEWAL?X_YES_NO. IF YES,SHIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD Q`U^A�NTITIES (225 AGALLONS)? YES NO. 4. FULL NAME OF APPLICANT: y-S �'\C,�-Cx -�- 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 0-e-�('I' 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: ".0vC% 1� ay� Ccam 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE OF: CORPORATION NAME PRESIDENT TREASURE GYM S� CLERK 5-O Vr 12. IF PREPARED BY OUTSIDE PARTY: • NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICAN DATE Q:\Application FormsUiAZMAT APP 2017 REVISED.docx Number Fee 1058 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Sherwin-Williams Co. 276 Falmouth Road, STE A, 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 i� pGQ Pro Cy/*S;�tge — ` Voengatory%Me of Bsxabler�ces Richard V. Scali,Director oyTr+e r Public Health Division ��ARMNSTABLE • anxNsraa[E � ' Mass Thomas McKean,Director 1639-2014 200 Main Street, Hyannis,MA 02601 575 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 O 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 %. YES 2. IS THIS A PERMIT RENEWAL? _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 T• Q—UAN ITIES(!25 GALLONS). AYES NO. 4. FULL NAME OF APPLICANT: �J v "k"fir 5. NAME OF ESTABLISHMENT: 10,/ 6. ADDRESS OF ESTABLISHMENT: ti 1'LR ' t�3�,iz kA U 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: �t✓� '_ 8. TELEPHONE NUMBER OF ESTABLISHMENT: �- 9. EMAIL ADDRESS: 5(A-) 621- Cc 10. SOLEOWNER: ;YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME _54e/mob 0 wk lco" 5 Co PRESIDENT TREASURER CLERK—. 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE Q:\Application Forms\I-IAZMAT APP 2017 REVISED. c U s� I Number Fee 1058 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Sherwin-Williams Co. 276 Falmouth Road, STEA, 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 fu:T0Hd LT0Z 61 Nnf TRow of B stable �, g oryrvices / �-- Richard V. Scali,Director IME ram, i o Public Health Division BARNST31D—S— BARNSTABLE, E y • enuvsrvsre••rvrwtue.Thomas McKean Director `"� MASS. ) 1639-2014 �f039. .�s� 200 Main Street,Hyannis,MA 02601 �g 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-NNE 30th). _a 08 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 C V- . *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? YES_NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS • ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: Cu 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: S. TELEPHONE NUMBER OF ESTABLISHMENT: 5(Aif" 9. EMAIL ADDRESS: 5W 5�U Q �kie(m ru. ( o Lti 19. SOLEOWNER: YES-/kNO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME -54 W v Itict t cj PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT �� DATE Q:\Application Forms\HAZMAT APP 2017 REVIS D.d `°pTME TOk� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 a"M�`E.� 200 Main Street• Hyannis, MA 02601 �p s639.p�0 �FOMA+ TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: rJ Q.Cto 1 K-- 0.111 a V s Date: Location/Mailing Address: �"►� F'a.twe,r�� �, l yaAV% t5 Contact Name/Phone: -0.- t(„ti4 50A --f"7S- Z92- Inventory Total Amount: Q Ga,SDS:Y' 00 ti� • wze ltk-e- License#: 10,58 W3 Tier II : Labeling: c c-Oa i< Spill Plan: es Oil/WaterSeparator: Floor Drains: Mo Emergency Numbers: leS Storage Areas/Tanks: o , 1 r.. Emergency/Containment Equipment: 5 a, oV,S,T,Qi Waste Generator ID: Waste Pr duct: Date&Amount of Last Shipment/Frequency: 1,o lckws WAS Mov 16 I Licensed Waste Hauler&Destination: Other Waste Disposal Methods: -e. I5 5o IX AS(-t:a I- Tv4 ,eC�w — t kVDtc eS QV4i 4 1-e— LIST OF TOXIC AND HAZARDOUS MATERIALS vk�,as Gkawy� �,ixce_ (C.,S{' I Ksf4 1 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 �e,CaSaIS 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),, too g k I Any other products with "poison labels" / (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: D t55\At4 Inspect r: Facility Representativ . WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS Number Fee 1080 THE COMMONWEALTH OF MASSACHUSETTS $15o.00 Town of Barnstable Board of Health This is to Certify that West Marine Products 276 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 suspender) or revolkcd. -- - ----------- - = 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 �Q�iK-�# 3 a(�►►3 i Town of Barnstable egulatory ervices Richard V. Scali Director P�.►�, BLECD Public Health Division BARN TA 00 �BABh3TABLE. = Thomas McKean Director �A 1639• �0 , MASS. 4 rEo��y a 200 Main Street,Hyannis,MA 02601 Office: 308-862-4644 }gas: 5I_18-790-6304 `:ak 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 ❑ a CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 )v% i ySa CATEGORY 3 PERMIT 500 or more Gallons: $150.00 <T.Q *A late charge of$1.0.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. -4 7-f'b 2. IS THIS A PERMIT RENEWAL?4 YES_NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS • ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD `Q,UANTIITIES(25 GALLONS)? \ YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: Z-�\o S4,- C-- 14p,.t ISM t--\-A- 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 500 mj-cq Z.` (9/ 8. TELEPHONE NUMBER OF ESTABLISHM11ENT: 9. EMAIL ADDRESS: tie S7- rj,.Q,_c on 10. SOLEOWNER: YES—NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE OF: CORPORATION NAME 4T\J es�- Mc,,,` ,7J PRESIDENT 1+ e- TREASURER r CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE #: COMPANY ADDRESS EMAIL: • SIGNATURE OF APPLICANT✓ DATE 7`31 - l C:\Users\Dccollik\AppData\Local\Microsoft\Windows\Temporary Internet Piles\Content.outlook\B\4QD49112\IIAZMAT APP 2017 REVISEDAoex r' K �FTHE TOk Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMA�,q 200 Main Street• Hyannis, MA 02601 p t67 q.p�0 M TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rF0 P'� Business Name: uJt+K- - I)I l)I a'vk S Date:AM/1 Location/Mailing Address: 2-1 b 5LA A VV A 16 Contact Name/Phone: ;•, o e. K wti a o$-7-7 S- Z9 Z.g Inventory Total Amount: ti Dl7 1 SDS: C 0 &kel License#: I O S$ Tier II : o Labeling: C a t\ Spill Plan: 25 Oil/Water Separator: NSA Floor Drains: AA b. Emergency Numbers: es Storage Area e)N Emer enc /Containment E ui ment: Il kt s �� r on efe. .re. tx� �►5 r� ✓ "fop�4�. aste Generator ID: o�l' + •C� - �. �ot�l5�afe5Vllas a Product: Date&Amount of Last Shipme t/Frequency: Qom"C�'�`L�''�` '^'e��°l Licensed Waste Hauler&Destination: Other Waste Disposal Methods: y r'2+v1rx 5 4f�e, c'ecwej yes-I iMVpieaS ate. k!W&3 RZGor s, A,C" gay 4�eP �osa.l"—. •c ►tell loos�� &a�txsfe LIST OF TOXIC AND HAZARDOUS MATERIALS O ,tea i•ov' Lkt4",, I V- r&f��yt�ory S i✓lam /45� NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, i rt y�ecf oK,. 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/wo -s e ,vf-,5 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: Lov<, Ai c v o v 44 e A-A INFORMATION/RECOMMENDATIONS: ov5 .Z !ltc--k,ow. - tetVtS.9e� afl 17—i��O,QI�j OP��Ga,�'�avt.-+ +tiGC,►v� Inspector: Facility Representative I WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS - -;f Number Fee 1058 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Sherwin-Williams Co. 276 Falmouth Road, STE A, 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 y 14 Town of Barnstable 'THE Regulatory Services Richard V. Scah, Director ` MANSTABM Public Health Division �� BARNSTJ E 8ARX5*ABIL•@l1C9.NLLL•COMT 1639. nnsraxsrws•osnwue.wsri rse� Thomas McKean, Director ,\ "5�" 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Qj'0 Fax: 508-79=304 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 �1-- ' • A late charge of$10.00 will be assessed if payment is not received by Jules ASSESSORS MAP AND PARCEL NO. DATE Me FULL NAME OF APPLICANT: NAME OF ESTABLISHMENT: S�e� w �� "�« Co ADDRESS OF ESTABLISHMENT: Z1 �'l��`'ld�� 44 c -� V U'1 taV l MAILING ADDRESS(IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: EMAIL ADDRESS: 5W 51%% E5tig(wi Kj , Co v%l SOLE OWNER: YES NO IF NO,NAME OF PARTNER: 5�et wov-kA`k tr4,,i FULL NAME,HOME ADDRESS,AND TELE ONE# OF: CORPORATION NAME -5tA0- W y"1 c G\VAI G PRESIDENT TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: SI F A PLICANT Name: Company Address Telephone#: Email: Q:WpplicatioKr.ms\H )APPRev16.docx Page I oft `oF'"e rows Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMASS. 200 Main Street• Hyannis, MA 02601 039. 0 39 s� 'DrFDMn� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: %ey�,w - 0 vA-s Date: L 28 1(, Location/Mailing Address: -710 sA VL I Contact Name/Phone: -0� k<� ,Sa$-'7 7S�- 292y In a to Total Amount: n' OD a,) MSDS: 0��``� License#: 10 5�R> Tier II : o Labelina: ] Spill Plan: -/e5.- � - Oil/WaterSeparator: tJ A Floor Drains: o Erfiergency Numbers: Yas Storage Areas/Tanks: AoA4-,� Emergency/Containment Equip ent: Waste Generator ID:17? cl,��} r�� Waste Product: 7 5 Date&Amount of Last Shipment/Frequency: M t& ,)v,c. ✓aS A- . eQ<e �e- Licensed Waste Hauler&De—stination: Other Waste Disposal Methods: W 4 It,t,a\ LIST OF TOXIC AND HAZARDOUS MATERIA S / �V�` �� ew y Q / NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous mate{'ial use storage and disposal of 111 gallons or more requires a license from the Public Health Division. *,e �-- Antifreeze Dry cleaning fluids `a5{- H'tQ�teVl Automatic transmission fluid Other cleaning solvents&spot removers Y Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout 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: INFORMATIO /RECOMMENDATIONS: %A (!,)e- 41ti G+- S 5L.> a. 1 1Z 1 vim. Inspecto \� Facility Representative: WHITE COPY- HEALTHDEPARTMENT/CANARY COPY-BUSINESS INE Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMAS,1;- ! 200 Main Street• Hyannis, MA 02601 i639 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rFD MPS Business Name: St g-,rvJ i►.,- 0. wt :s Date: Z2 Location/Mailing Address: 2"76 Vi-lv", a•✓1n1'5 Contact Name/Phone: woe,_#C��.�, ,508 - 7'1S-2Q29 C�3 Inventory Total Amount: X` Sb 00 [4 1 MSDS: PA—) License#: (b,5-S -ek f Tier II : .N A Labelina: 16&iAi I ldjbdivASpill Plan:4 a vw r-J Oil/WaterSeparatcr: Floor Drains: 0 LmergencXNumbers: QK Storage Areas/Tanks: 1i PA ( oC v e� Emergency/Containment Eq ipment: &A- 9 t x-r- Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: e,+ve vlga OQ I v%A� o u Ca,� t"q-T 'c. s vP ^-�2.�C �( 120-1b0ya,l5 LIST OF TOXIC AND HAZARDOUS MATERIALS - /`Al -9 u`1q I V < 41-4-N&ert- i NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material us 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: _ kT&< JS ORDERS: C.Q.VLy— Aeo 11 y 5, INFORMATION/RECOMMENDATIONS: m lS5vt5 o� (C.Co+^Mn+e..n •19IA-5 Inspector: ��- Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS �i Number Fee S�- 1058 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Sherwin-Williams Co. 276 Falmouth Road, STE A, 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 r,:�17818``183199 09:14:39 a.m, 01-23-2015 1 11 LV 130 Uf L( I I.WW JIMJf UUI rtn of UI.f IfU 1Ur-U-J 177 F 1/ 1 Town of Barnstable o�, r Regulatory Services • Richard V.Scali,Director _ H/1 Public Health Division 163 Thomas McKean,Director C7 200 Main Street, Hyannis,MA 02601a Office: 508-8624644 FaXG 508-790-6304 Application Fee:$100.00 K3 ASSESSORS MAP AND PARCEL NO.o�%'0' 1 -0L5 _ DATE �3 APPLICATION FOR PERMIT TO STORE ANWOR UTILIZE MORE THAN 111 GALLONS OF-HAZARDOUS MATERIALS FULL NAME OF APPLICANT at s r-r'aC9� r r;k,4 % AI*Aao r 9 r NAME OF ESTABLISHMENT J c Vl e.`vJ i"V C.o ADDRESS OF ESTABLISHMENT 2, � t��l t11'Gi� �; NMA 5. W • TELEPHONE NUMBER SOLE OWNER YESNO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION 4nA FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK rV SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS J01 LJt.,1' P� r-c �vc.�1t�.c� Ok o HOME TELEPHONE# 21 L-��L-1-7) 0 IMAZAPPDOC I Town of Barnstable Office: 508-862-4644 � Fax: 508-790-6304 o Regulatory Services Department ` Public Health Division BA�tx�STl'ABLE' � MASS. Thomas A.McKean, CHO . 200 Main Street, Hyannis, MA 02601 Payment Receipt Hazardous Materials Payment received: $100.00 (Check) on 8/13/2015 CCheck number: 5788-1273-7 Check amount: $100.00 Name on check: The Sherwin-Williams Co. I 1 ;Business: Sherwin Williams Co. Owner: BORNSTU LP j Address: 276 FALMOUTH ROAD/RTE 28, Hyannis 40 i I • } `oFIKE•Wrti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • RARMAgS .. D• 200 Main Street• Hyannis, MA 02601 ,b,q. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT QED MPS a Business Name: `.�'lticrc��.� - W,11,0,-5 Date: Location/Mailing Address: 2'llo cz\w.o Q..9 1.inV%. Contact Name/Phone: , oJ- TO$-1 2. 19 Inventory Total Amount: "�5 boo��'-\ MSDS: 407- License#: lD S$ Tier II : Labelina: OK- Spill Plan: Oil/WaterSeparator: JIJ Nk Floor Drains: 00 Emergency Numbers:25 -� Storage Areas/Tanks: Emergency/Containment Equipment: S 11,% J, A-4 ee kV.A0Q tw# 1 reJ fW-6C Waste Generator ID: N R Waste Product: Date&Amount of Last Shipm nt/Frepuency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: 4 1Q1Q&0 iC< \5L•O -to \0Ca-N G-r.kyy LIST OF TOXIC AND HAZARDOA MATERIALS Mo VA 1-( cAkAq-5 6k �u��ec�;e,n • NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardou 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 VDegreasers 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: -U C-o%A*4 wJ-(5 a� Iv, 0X• L G£ Q-W---0 olotA Inspecto : La�11-0_ Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS TOWN OF BARNSTABL Date: `� / / 7 /3 TOXIC AND HAZARDOUS MATERIALS FORM NAME OF BUSINESS: !j ►n1Q,tVJlr1 - h�►�� aw�,S BUSINESS LOCATION: 2.-7(o l,nno 1�� . JA A I s INVENTORY MAILING ADDRESS: S4LA . TOTAL AMOUNT: TELEPHONE NUMBER: ��� 77� 2�2.q /\-- S6aQ q� CONTACT PERSON: o ► 6f Ore M l hr,s m4 r 33R-23-%' 7081 EMERGENCY CONTACT TELEPHZYNE NUMBER: Gcy 5-oF, 3Z6 25 6 MSDS ON SITE? TYPE OF BUSINESS: ( e+av a '-2. Gs- Comppoik r �c�cees S INFORMATION / RECOMMENDATIONS: H&5 jo letm- Qn Fire District: IAUM s 114 &qqir1Qo e-e.s ra r y� h>'!►5 I vim- S ► 1 ) re Do VAk Ajo &'a r C a vk K -C.vv d Waste Transportation: _ p AA ' 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) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene,#2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints; varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous(please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's 7s7i�i, `°ptME rokti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 a • BARn SSBLE.g` 200 Main Street• Hyannis, MA 02601 i639 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT ff0 MP'� -Business Name: Date 06 qlgo�8 Location/Mailing Address: d9kSjp.'Raf Dr. fflei CA 445-W Contact Name/Phone: .54!B�- 970n Inventory Total Amount: SDS: II g License#: dck�b Tier II : 'f 0 Labeling: i Spill Plan: �PS Oil/Water Separator:_ No Floor Drains: O Emergency Numbers: pa iStorage Areas/Tanks: ,11 mergency/Containment Equipment: Waste Generator ID: Waste Product: MIA Date&Amount of Last Shipment/Frequency: �( ( Licensed Waste Hauler&Destination: �V I Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze ry cleaning fluids Automatic transmission fluid ther cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) ����iiV 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 r, V Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) W ash detergents renting ink Sd� axes 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:�1),DAn4ina Cq n m nD CAfY`P 1 tS Inspector:Ahva�u Af Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS `°Ft rokti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 M RM- 200 Main Street• Hyannis, MA 02601 '6 39 M TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT ' rfD P'� Business Name: \40 r1od'(lf ' ero&C}S Date: Location/Mailing Address: 7� Qlrnpl)Aft qA :1 m41111Q., 06 kv 2 a-- Or\v' eL Contact Name/Phone: d0�F 1- -X700 Inventory Total Amount: <50o SDS: 1E CM11 ;A License#: v 3 0 Tier II : Labeling: r Spill Plan: Oil/WaterSeparator: N n Floor Drains: ArO Emergency Numbers: Storage Areas/Tanks: J Emergency/Containment E ment: , !S� `I C, Waste Generator ID: My iS ; b- Waste Product: U2 1 (►1 Date&Amount of Last Shipment/FrequencX- Licensed Waste Hauler&Destination: t d pa DtJfV 1+ MX. Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS No M C� i� (A NOTE: Under the provisions of Ch. 111, Section 31, of the General L`�ws of MA, haza dous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Ewy cleaning fluids — Automatic transmission fluid ,Other cleaning solvents&spot removers2o ,Engine and radiator flushes Bug and tar removers 20 ydraulic fluid (including brake fluid)20 Windshield wash Motor oils CO ? y 0 p Miscellaneous Corrosives ,/Gasoline,jet fuel, aviation gas Cesspool cleaners iesel fuel, kerosene, #2 heating oil Disinfectants y Misce Igneous pgtroleurn products:36 Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: aulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries yo Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine aints, varnishes, stains, dyes Lye or caustic soda L cquer thinners q d r (o Miscellaneous Combustible aint&varnish removers, deglossersgW Leather dyes Miscellaneous Flammables 16 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: f ` Inspector: Facility Representative: 1W:::::_ WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS `oFT"E TOirti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARNSTABLE. MASS g 200 Main Street• Hyannis, MA 02601 �A ,639.a�0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT at, yl-o 'w Business Name: Je-4+ af',Ke , Date: 7`�J�SO Location/Mailing Address- 2-716 aJwLov & ,n i Contact Name/Phone: h f-, 1 - 2- o t' D �� 700 Wot-�fo m - o SYc r,vtg 2X cad GoP./ 4 �i een5.c, (wvs p 6 20� I vent/ Tota Am unt: '�- (0<1 e" M DS: ►^ �� as Vie c � License#. I DAD Tier II : Labelino: �5 -a� bI oc- Sill Plan: yc S Oil/WaterSeparator: QS Floor Drains: Emergency Numbers: VE S Storage Areas/Tanks: a�� 'S� jy St°`°` Gtrr c,� .1 a1AA ,R 6L(,)4 -A W%4A,, AAA c„t� ACcest,, Emergency/Containment Equipment: k QQ L Waste Generator ID: 100 Waste Product: Al,s - 6-/4,,c%or-e KtixkAZ Date&Amount of Last Shi ment/Fre uenc -1 12S ,F I Io el-al R AA, Licensed Waste Hauler&Destination: 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 frpm,he ybli Health Division. Antifreeze 2,<-F bD 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 7 Motor oils °o5 a-t5'DX'�o k ISO Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants 10 Miscellaneous petroleum products: Road salts grease, lubricants, gear oil S.r Refrigerants Degreasers for engines&garages Pesticides: l 1 5 CaulWGrout/4ot"-5--<} i3 1'%o kq0 insecticides, herbicides, rodenticides Battery acid (electro eries Photochemicals(Fixers) _ Rustproofers boa. GteAv.L<s/ 1%O h Photochemicals(Developer) ,5 e is b\ �1\ Printing ink Car waxes and polishes k`,\D Wood preservatives(creosote) Asphalt&roofing tar fib, 0T )e Swimming pool chlorine �2. Paints, varnishes, stains, dyes XSd .r90 Lye or caustic soda 'I Lacquer thinners 2t 63 k10 x t$�A,/ Miscellaneous Combustible <' Paint&varnish removers, deglossers x Leather dyes 105 Miscellaneous Flammables Oi l)gS � Fertilizers Floor&furniture strippers Va,ev\k5k& k 50 PCB's Metal polishes IVY y t� ),yD Other chlorinated hydrocarbons Laundry soil&stain removers a\(Awk -+)2 (including carbon tetrachloride) D (including bleach) Any other products with "poison labels" - egIxc.s'f�-,Avcer-srJZgm.#,c � 't (including chloroform, formaldehyde, t (" 66< I hydrochloric acid, other acids) VIOLATIONS: �rct:tas ou5 k- k c. td1+t\ v\0 O�cceS'S . w , vyv► , S+o�L OV 6 t-S w ae 4, hs.e- . ORDER ¢ ar 5 ('2wW1�e m1 4 osa --AeIR I -Toro L I n INFORMA ION/RECOMMENDATIONS: C� R C oV of !V eo yl e r L-\Jaske,�vvn S W�d� ®Cu.�.�e '�,20/I(o Inspector: V,6 I Ie-� 0 N b� `-r was+4.- S0J)K., OA 4r f e .Facility Representat' �4 WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number Fee 1080 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that West Marine Products 276 Falmouth Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- --- --------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2017 unless sooner suspended or revoked. ------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health 2016-06-114 13:19 store1269fax 5087753753 >> P 1!1 ._. Town of Barnstable Regulatory Services Richard V, Scah,Director 6 9. Public Health Division BARNSTABL 'Thomas McKean,Director �, i639-2D16 200 Main Street, Hyannis,MA 02601 n�� Officc: 508-862-4644 0� Fax; 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE-WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 1081 HAZARDOUS MATERIALS,ALL BUSINESSES TFIAT HANDLE OF,STORE HAZAR-D0i7S MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN 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: $150.00il Y A late charge of$10.00 will be assessed if pgyment is not received by Ist. ASSESSORS MAkP AND PARCEL No. 2130 31 DATE F 07 L NAME OF APPLICANT: NAME OF ESTABLISIItii TENT: V V k"5 V ADDRESS OF ESTABLISHMENT: IF,k*-�o ji'L, (U- s).-r- L c��ri�5� HA MAT.LING ADDRESS(IF DIFFERENT): 5-00 W-e slc\�r= Q-r. 0 2 0o CD TELEPHONE NUMBER OF ESTABLISHMENT: n (o EMAIL ADDRESS: ('�'( cn r-�r1 to r1 SOLE O'A FR: YES—NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONFAOF. � �e CORPORATION NAME �4cY PRESIDENT l-A a V a-- H-v a e- TREASCIRER -5� �-P \—c,,3 • CLERK Va, Pre.l _ IF PREPARED BY OUTSIDE PARTY: SIG � ' APPLICANT Name: Company Address : Telephone#: Email: Q:1Applicption Forrn.AHAZZAPP ReY16.docx Pap 1 of 2 Robert Sminkey - Hub Manager 276 Falmouth Road Hyannis,MA 02601 Port Supply Tel. 508.778.0894 Fax 831.768.5301 BobS@portsupply.com portsupply.com Toll Free Ordering Tel. 800.621.6885 Fax 800.825.7678 0 PO 4safiPPEY i l 0K%E 1 Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 9 BARMASS_ 200 Main Street• Hyannis, MA 02601 1619-MP TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT �FDy Business Name: 062 Y�►�n� A!, " Date: Location/Mailing Address: 2'7(, 'Fc,tw,-o-K ., PUT 0,pv%Y_ I S - M 4 8 rel _, .)AJ5 +o cc� 4 � Contact Name/Phone: X70D - yh�wl.Ge CXAe,', ��ICA .\S Inventory Total Amount: MSDS: VAJ110-,,c5 r99a License#: Tier II : o Labeling: h',q Ndae t c Vtk&%W_C5 Spill Plan: C-�P. h�k.a.-y" Oil/WaterSeparator: NIA Floor Drains: Emergency Numbers: *5 StorageAreas/Tanks: b Ae °{old W 2 t2 ql� WAS r2— Emergency/Containment E ui ment: ��� k�k w Soy s dv \gble� Waste Generator ID: M A 6 Waste Product: VAl G M\Xe wa — (etacKS Date&Amount of Last Shipment/Frequency: ,Mork( Licensed Waste Hauler&Destination: EQ AJovAQvtk latco,k- Vyl 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. JAntifreeze 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) VRustproofers 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 V 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: IN ORMATION/RECOMME DATIONS: kUu-s \k W2. J«- bk `--e_ VNka 40 o "2, a�6���«fit. kb`2f1� OJk�oo�s ©�. Qa,1�e�5 Inspector: �l cw�. V qc 1,Aq y YJ.f® ti%Ar IV, ct,�- Facility Representative:/ MIT �y OPY- HEALTH DEPARTMENT /CANARY COPY- BUSINESS I °F IME ro Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARM % .A • 200 Main Street• Hyannis, MA 02601 t6j9 �0s TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT CEO MAC e Business Name: We,,,f MvriKA, Date: Location/Mailing Address: 2? J a h,n s — ✓"A lg �o cor orate Contact Name/Phone: A,gh ?&S 812 -2'76D . Im I 11l - La.V3«�� a r4<ati Invento Total Amount: r' moo qC0 MSDS: C1M1'J-1 �h License#: (05D Tier II : b Labeling: UIQ Spill Plan:CKI?0 Oil/WaterSeparator: 1JA Floor Drains: t6c> Emergency Numbers: Yew Storage Areas/Tanks: k4' t' k c ,w altq, 1orAh \\ .2V-Q Emergency/Containment E ui ment: 1( v s,4.f- ZVM f r-4 Vka r n /Ire 45-r- Waste Generator ID: 1097tb lo`U-I o Waste Product: Esc 1 ate. Date&Amount of Last Shipment/Frequency: q 1161�{ _ X Licensed Waste Hauler&Destination: 1�Q 1J S'C o,4k . A-� AA \200 LA Sf!13o -7 Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS IVD ,. tr1 a��� �.-, "�, 1v.J / �1�c�\k64r NOTE: Under the provisions of Ch. 111, Section 31, of the Uneral Laws df MA, hazardous materiel use, "^'7! storage and disposal of 111 gallons or more requires a license from th�+PP bli Health Division. �v.w-��Cotyva-c,2S SA -k-p 4�c-Sour- o(� 6,,V�I's' OW Ivl Ga W a4k %� Move- ) 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) 9 R tp ofers Photochemicals(Developer) G R sh 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 V 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/REC MMENDATIONS: Oct o s of w"aa' Inspector: I Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS MATERIAL SAFETY DATA SHEET Manufacturer: Star brite Distributing, Inc Emergency Number: 800-424-9300 or 703-527-3887 Chemtrec 4041 S. W.47 Avenue Information Number: 954-587-6280 Ft. Lauderdale, FL 33314 Product Code: 31400, 314G55 Date Printed: September 12, 2005 Product: Star brite-500 RV Anti-Freeze 1. INGREDIENTS: (%w/w, unless otherwise noted) Propylene glycol CAS# 000057-55-6 <30% Dipotassium phosphate CAS# 007758-11-4 <2% Deionized water CAS# 007732-18-5 Balance This document is prepared pursuant to the OSHA Hazard Communication Standard (29 CFR 1910.1200). In addition,other substances not'Hazardous'per this OSHA Standard may be listed. Where proprietary ingredient shows, the identity may be made available as provided in this standard. 2. PHYSICAL DATA: BOILING POINT: 3700 F, 188°C VAPOR PRESSURE: 0.22 mmHg @ 220 C, 680 F VAPOR DENSITY: 2.62 SOLUBILITY IN WATER: Complete SPECIFIC GRAVITY: 1.020- 1.030 @ 600 F, 160 C APPEARANCE: Scarlet. ODOR: Odorless liquid. 3. FIRE AND EXPLOSION HAZARD DATA: FLASH POINT: 2150 F, 1020 C METHOD USED: TOC (Tag Open Cup) FLAMMABLE LIMITS LEL: 2.6%@ 100*C UEL: 12.5%@ 130' C EXTINGUISHING MEDIA: Water, fog, carbon dioxide, dry chemical,foam. For large scale fires, alcohol resistant foams are preferred if available. General purpose synthetic foams or protein foams may function, but much less effectively. Water may be used to flush spills away from fire exposures and to dilute spills to non-flammable mixtures. If possible, contain fire run-off water. For large scale fires, direct water stream may cause violent frothing, but fine water spray may help control situation. FIRE&EXPLOSION HAZARDS: Keep unnecessary people away; isolate hazard area and deny unnecessary entry. When using water spray, boil-over may occur when the product temperature reaches the boiling point of water(tank-type scenarios, not spills). FIRE-FIGHTING EQUIPMENT: Wear positive pressure, self-contained breathing apparatus and full protective equipment. 1 I } t Product: Star brite-500 RV Anti-Freeze Product Code: 31400, 314G55 4. REACTIVITY DATA: STABILITY: (CONDITIONS TO AVOID) Stable over normal operating temperature range of -30' F to 2500 F. INCOMPATIBILITY: (SPECIFIC MATERIALS TO AVOID) Oxidizing material. HAZARDOUS DECOMPOSITION PRODUCTS: Combustion may produce carbon dioxide, carbon monoxide and water. Unidentified organic compounds may be formed during combustion. HAZARDOUS POLYMERIZATION: Will not occur. 5. ENVIRONMENTAL AND DISPOSAL INFORMATION: ACTION TO TAKE FOR SPILLS/LEAKS: Keep out of sewers, storm drains, surface waters and soil. Cover with absorbent material, soak up and sweep into bag. DISPOSAL METHOD: DO NOT DUMP INTO STORM SEWERS, ON THE GROUND, OR INTO ANY BODY OF WATER. FOR DISPOSAL, DISCHARGE INTO SANITARY SEWERS IS ONLY ALLOWABLE WITH THE EXPLICIT PRE-APPROVAL OF THE LOCAL BIOLOGICAL WASTEWATER TREATMENT FACILITY. For unused or uncontaminated material,the preferred disposal options are to send to a licensed recycler, reclaimer, or incinerator. The same disposal options are recommended for used or contaminated material, although additional evaluation is required (see,for example,40 CFR, Part 261, 'Identification and Listing of Hazardous Waste"). Any disposal practice must be in compliance with federal, state, provincial, and local laws and regulations. Check with the appropriate agencies for your location. For additional information, see Section 4 (REACTIVITY DATA)and'REGULATORY INFORMATION". 6. HEALTH HAZARD DATA: EYE: May cause slight transient eye irritation. Corneal injury is unlikely. SKIN CONTACT: Essentially nonirritating to skin on prolonged contact. SKIN ABSORPTION: A single prolonged skin exposure is not likely to result in the material being absorbed through skin in harmful amounts. The LD50 for skin absorption in rabbits is greater than 10,000 mg/kg. Repeated exposures may cause slight flaking,tenderness and softening of skin. INGESTION: Single dose oral toxicity is low. The oral LD50 for female rats is about 20.3/kg. No hazards anticipated from swallowing small amounts incidental to normal handling operations. INHALATION: A single prolonged (hours) inhalation exposure is not likely to cause adverse effects. Mists are not likely to be hazardous. SYSTEMIC (OTHER TARGET ORGAN) EFFECTS: Repeated excessive ingestion may cause central nervous system effects. CANCER INFORMATION: Did not cause cancer in long-term animal studies. TERATOLOGY(BIRTH DEFECTS): Birth defects are unlikely. Exposures having no adverse effects on the mother should have no effect on the fetus. REPRODUCTIVE EFFECTS: In animal studies, has been shown not to interfere with reproduction. 2 Product: Star brite-50 RV Anti-Freeze Product Code: 31400, 314G55 6. HEALTH HAZARD DATA CONT'D: MUTAGENICITY(EFFECTS ON GENETIC MATERIAL): Results of in vitro(test tube) mutagenicity tests have been negative. Results of mutagenicity tests in animals have been negative. 7. FIRST AID: EYES: Flush with plenty of water. SKIN: Wash off in flowing water or shower. INGESTION: Induce vomiting if large amounts are ingested. Consult medical personnel. INHALATION: Remove to fresh air if effects occur. Consult a physician. NOTE TO PHYSICIAN: No specific antidote. Supportive care. Treatment based on judgment of the physician in response to reactions of the patient. 8. HANDLING PRECAUTIONS: EXPOSURE GUIDELINE(S): Propylene glycol: AIHA WEEL is 50 ppm total, 10 mg/m3 aerosol only. VENTILATION: Good general ventilation should be sufficient for most conditions. RESPIRATORY PROTECTION: No respiratory protection should be needed. SKIN PROTECTION: For brief contact, no precautions other than clean body-covering clothing should be needed. Use impervious gloves when prolonged or frequently repeated contact could occur. EYE PROTECTION: Use safety glasses. 9. ADDITIONAL INFORMATION: SPECIFIC PRECAUTIONS TO BE TAKEN IN HANDLING AND STORAGE: Exercise reasonable care and caution. Spills of these organic liquids on hot fibrous insulations may lead to lowering of the autoignition temperature possibly resulting in spontaneous combustion. 10. TRANSPORTATION INFORMATION: Call for information. 3 REGULATORY INFORMATION: (Not meant to be all-inclusive--selected regulations represented). NOTICE: The information herein is presented in good faith and believed to be accurate as of the effective date shown above. However, no warranty, express or implied, is given. Regulatory requirements are subject to change and may differ from one location to another; it is the buyer's responsibility in ensure that its activities comply with federal, state or provincial and local laws. The following specific information is made for the purpose of complying with numerous federal, state or provincial, and local laws and regulations. See MSD Sheet for health and safety information. U. S. REGULATIONS SARA 313 INFORMATION: To the best of our knowledge,this product contains no chemical subject to SARA Title III section 313 supplier notification requirements. ------------------------------------------------------------------ SARA HAZARD CATEGORY: This product has been reviewed according to the EPA"Hazard Categories" promulgated under Sections 311 and 312 of the Superfund Amendment and Reauthorization Act of 1986 (SARA Title 111)and is considered, under applicable definitions,to meet the following categories: Not to have met any hazard category. ------------------------------------------------------------------ TOXIC SUBSTANCES CONTROL ACT(TSCA): All ingredients are on the TSCA inventory or are not required to be listed on the TSCA inventory. CANADIAN REGULATIONS WHMIS INFORMATION: The Canadian Workplace Hazardous Materials Information System(WHMIS) Classification for this product is: I This product is not a"Controlled Product"under WHMIS. 4 Date. I,2 13 TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS FORM NAME OF BUSINESS: G es-I' m4v-, BUSINESS LOCATION: 27L INVENTORY MAILING ADDRESS: .5,tK--e- TOTAL AMOUNT- TELEPHONE NUMBER: 5�0-9 - $62-;�-7D0 1260 I Q CONTACT PERSON: �rska ��rk�JksSel EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: anW— re,+ar (z,r' Vas- on.l►r,,e._ INFORMATION / RECOMMENDATIONS: a //r v'eYl or-% • Fire District: rrt. � -C JS ✓►1A4u,.� S rCe4i • e,r4 od k a Q N �Kn►S y4e4e�i&I--, ou+Locs w.46,.+,5eco #tr C.0A±41AoL-cg4- beve,Ioa S rlL0.P�( io-4eyv_V ,�lavt. -5d,1 .�k1+ ►S 4v'4► ablea��Srfe• /�o Imoc,��a�KSabgerve�. Waste Transportation: YOSZ-�6Z2.-7oo Last shipment of hazardous waste: Name of Hauler: of ea `r--' t, Destination: y,,A Waste Product: �,� a ar �' /awtrKa}i es ors Licensed s No Akb o c3` 131 q 138 Ye 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 re uires 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. ,5tar'e ►.avevLf-ry 4o"f'�/arlable- �'Sfirwc�f� �•tiF �- c s bead w a rye., I,�k,I1�arT2 �',�,v�c Observed / Maximum ObseSrved / Maximum �Sp Antifreeze (for gasoline or coolant systems) 0 Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene,#2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) /D lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine 10 p Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers fop Miscellaneous Combustible sp rst wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's s p0 Paints, varnishes, stains,,dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes `�I ral�e� rat, rOc�c���i �o�'o.�-r�"S►� Laundry soil &stain removers (including bleach) p 4gS 4iK,1 �oa+ Spot removers&cleaning fluids / (dry cleaners) far j A,vt d— ,SphU— d a�v�-�- o e4-(-6 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 �_BAR ` -W t, LF t Ordinance or Regulation - � - WARNING NOTICE Name of Offender/Manager M 15 6i -�'t,,+nwa . / Address of Offender MV/MB Reg.# Village/State/Zip """""'"/'y"� " " .� Business Name► /"pm� on Business Address Signature "of' Enforcing Officer Village/State/Zip 44AVIIAfz Ali 02.b01 Location of Offense a-4!5,/. 1 eo r ;$� b,441y4O4r, Po[ bkleiHL Enforcing Dept/Division Offense A(o 44,lr �p� a k� 4, ���".� , �;14,( ar,)5 Mwet"A tS -%,rlkJAs. COt4+r, IS Facts ty-,.7<40k w► 0,rN Geyc�r y �o � cIAIr ���1 This-will serve only as a warning. At this time Ino legakl action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. J, WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. Number Fee 1080 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that West Marine Products 276 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 4 y.t. 20 � - b-04 07:42 WESTMARINE 5087753753 >> P 2/2 Town of Barnstable a- .Regulatory Services Richard V. Semi,Director MAK Public Healtb Division Ec r Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862.4644 Fax: 508-790-6304 Apphcation-Fee:$100:D0 ASSESSORS MAP AND PARCEL NO,2930 31 -* 2+6 DATE 6 q)S APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN Ill GALLONS OF HAZARDOUS MATERYA.LS FULL NAME OF APPLICANT v`� e 1 ` °L-''I NAME OF ESTABLISHMENT V y -e.Y� °t,{I "--e . ADDRESS OF ESTABLISHMENT Z-+L -F I Lj t, C G I^iS, n'I 1� 0 2 W) TELEPHONE N U MEER 50 — &to 2-- 2 7 0 SOLE OWNER: r'YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALI, PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. I q— 236Z3 STATE OF INCORPORATION C A4 L��U 12 N FULL NAME AND HOME ADDRESS OF: PRESIDENT cl .50 0 UkieA6 O- Q4 J>0VtA CO95-U�� TREASURER 10 ork k k5— 0 P A- �SU CLERK a c- C iT SIGNATURE OF APPLICXNT RESTRICTIONS: MQ� ME ADDRESS 500 L�t ��f, - L( 1 �3Gn.�1k HOME tFLEPHONE# $3 I_Vv 12K 4 -6 C:lcache\Tcmporary Intcmct FiIcs10LKD3V AZAPf Rev2015.DOC 06/05/2015 11 : 22AM I - 2MI55-`fib-04 07:41 WESTMARINE 5087753753 >> P 1/2 Town of Barnstable Regulatory Services Richard V. Scali,Director Public Health Division eb�cc" Thomas McKean,Director 200 Main Street;Hyannis,MA 02601 Office: 508-862-4644 Wayne Miller,M.D. Pax: 508-790-6304 Paul J.Canniff,D_M_D. Junichi Sawayanagi NOTICE TO ALL BUSINESS OPERATORS 01 WITH HAZARDOUS MATERIALS IN BARNSTABLE The Town of Barnstable Town Council adopted, Chapter 108: Hazardous Materials, a requirement for each business operator to obtain an annual permit and • to remit a fee of$100.00 if one-hundred and eleven(11.1) gallons or more of hazardous materials are stored,transported, utilized, and/or disposed of at a particular site. STEPS 1 — 2: 1. Please-complete-t. e attached application form 2. S mit the fee of$100.00 payable to the: Town of Barnstable. MAIL all o efore Jae- 0—, 2 A late charge of$10.00 will be assessed if payment is not received by July 10, 2015, Please feel free to view the above Code, Chapter 108: Hazardous Materials on the Town Website, www.town.barnstable.ma.us , which.is located under the E-Code section if you should have any questions or concerns. • QAHuzmaffl uz k4a1 Permit LelLer.UOC 06/05/2015 11 : 22AM o Town of Barnstable Office: 508-862-4644 Fax: 508-790-6304 �.� Regulatory Services Department sntnt.� Public Health Division MASS; Thomas A. McKean, CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt Hazardous Materials Payment received: $100.00 (Check) on 6/15/2015 Permit number: 1080 CCheck number: 1251809 Check amount: $100.00 Name on check: West Marine Products Inc. Business: West Marine Products {Address: 276 FALMOUTH ROAD/RTE 28, Hyannis f Number Fee 1058 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Sherwin-Williams Co. 276 Falmouth Road, Hyannis, MA Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 6/30/2015 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health r� •17858283199 11:19:31 a.m, 06-16-2014 2/3 Town of Barnstable Q SINE Regulatory Services Richard V. Scali,Director Public Health Division. • 6J9 Mai Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862A644 Fax: 508-790-6304 Application Fee:$100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN I11 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT t, ` NAME OF ESTABLISHMENT 5 V`et W( rd r p�V��i 0 q" ,S 60 ADDRESS OF ESTABLISHMENT 206 i �� (�✓rr1 ,`, l/yV��- I TELEPHONE NUMBER Z Zcl SOLE OWNER: YES VNO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IV IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO.✓ 7 O 'J 26 i✓0 STATE OF INCORPORATION 4�-`6JeV-10V(A) O H FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER. CLERK IGNA E APPLICANT RESTRICTIONS: """ _ HOME ADD HOME TE HONE# 9 Q:IApplicagon FoimsUiAZMPDOC 1781U283199 11;20:00a.m. 06-16-2014 3I3 MAIL-IN REQUESTS Please mail the completed application form to the address below. Also include a copy of your contingency plan(to handle hazardous waste spills, etc). In addition,please include the required fee of$100. Make check payable to: Town of Barnstable. Allow five to seven(7)working days for in- house processing. Our mailing address is: Town.of Barnstable 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$100.00. Please make the check payable to:Town of Barnstable. The check must be mailed to the address listed above. Allow up to four days for in-house processing. For further assistance on any item above,call(508) 862-4644 Back to Main Public Health Division Page Q*plication Forms\ AZAPP.DOC 4 ;�- Number Fee 1080 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that West Marine Products 276 Falmouth Road, Hyannis, MA Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ----------------------------------------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2015 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 6/30/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health r —'4f-r vv r_r, ice. r wwrrrnr�ai�� dvvr r 4.rr rrd �f r r,/ o � i,own ai lsarin sta me Barnstable Regulatory Services Department � �d y( -� JJ Public Health Division /'m' � 8A$iYBlA!!LB 1 0 "= J ."00 Main Stmet Hyannis MA 02601 Offrac: 509-862-4644 Thomws P.Guiler,Director rAX; 50&790-630a Thomas�l tcKeact CHO fApplication Fee: $100.00 ASSESSORS MAP AND PAIRCEL NO.Zq3 p31 0 2T6 DATE (012-5/1 q APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPI.,ICANT -�^-�- NAME OF ESTABLI<5YEWNT W 1ST �ar>L�c ADDRESS OF ESTABLISHMENT .2 V. J,,Q 04. S� C_. Flu A �s r ftA 0 2-6 O 1 TELEPHONE NU -BER 5-O2Sv $b 2 - Z-7 Q f J SOLE OWNER ;�YES�NO •� .9 -may IF APPLICANT IS A PARTNERSHIP,FULL,NAME AND HOME ADDRESS OF ALL PARTNERS: f`lam. IF APPLICANT IS n CORPORATION. FEDERAL IDENTIFICATION NO, 94-2314S23 STATE OF INCORPORATION Cct\l�w FULL NAME AND ROME ADDRESS OF: PRF,STDENT Mai 1} �e 500 CA- l. TRIE,AS R o o { .1 Cft CLERIC e l S U O W crtAso /4w SIGNATL! r,r?F AfPLICAN'1 RESTRICTIONS:. AIDTqf ADDRESS 50 D We,SW Dr• VA H. W-Asq-%1 lk- i HOME TELEPHONE# 8* 1- It I-N9LS- (A IS016 !•',inspection handoumHv,Mat App1ieatio,12008.DfX- I LV i'T VV LT IT• r 7 wLV Ir'rnl\L11L. Ivor r IJr IF Id "'' r Town of Barnstable 'aFQ. '_ Regulatory Services Richard V. Scan,Director MAM ),O�� Public Health Division Thomas McKean, Director 200 Maims Stnxs t, Hyannis;IYLA 02601 Cfi6ce, 568-M2-4644 Wayne Mills,M.D. Fax- 508-790-6304 Paul J, Canni£,D.M.D. Junichi Sawayanag NOTICE TO ALL BUSINESS OPERATORS WITH HA �A OUS MATERIALS 1 -IN BARNST'A.BLE The Town of Banzstal?le Town. Council adopted, Chapter 108: Hazardous Materials, a requireii;)eT)t for. caCb basLiDccss opl_,rator to obtai.D an. amaal pe.mi.it and to remit a fee of$1.00.00 it one-hundrod and cdeven (111) gallons or raore. of hazardous materials are`stored, transported, utilized, and/or disposed of at a particular.,sitc. STEPS 1 - 2 ` 3; =t Please complete the attached application form Gz• ` Include a copy cif your Qontzza.geixcy p}an (tc, :►aaPdle hazar oas waste Spills, ete,) 3 Subriit the fee of$100.00 parable to the: Town of Barnstable, V ' f 1lI k_7 all�ofthe above to this I office on or be,fo e June 36, 2014. A e charge; o!'$1.0.00 will be assesscd if pa n,f,-nt is not receive v Jut.)r 30, 2014, Pleased feel free to view the above Code, Chapte 108, Hazardous Matez a.ls on the Tcvwn Websiie, vcrww.town.ba .stable'.,Tria.ias`, which zs located under the E-Code section if~,:you should have any questions or concenas. QARE RAHaz Mat P ermn Letter.DoC Number Fee 1058 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Sherwin-Williams Co. 276 Falmouth Road, Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------- --------------------------------------------- ---------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2014 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 6/30/2013 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health h! Jun, 29 2011 07:47AM P 1 To c .:f Barnstable Barnstable Regui.11 Services Department c" ,'Heaitb Division tmeeica 200.LAaui Street,Hyannis MA 02601 -ttOffice; 508-862-464q i1('K(0 Qr, f Thomas F.Ceilcr,DirccCor FAX 508-79t-6304 c� Thomas A,McKcan,c:HO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE 1 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN II.I GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT i NAME OF ESTABLISH �lL MENT r%,. e\ U t kk, ADDRESS OF ESTAI LISHMENT TELEPHONE NIJMMER `"1 -- SOLE OWNER: YESA, NO N IF APPLICANT IS A PART RtSHIP,FULL NAME AND HOME ADDRESaF ALL �. PARTNERS: to 0 w sue- ,. tip g IF APPLICANT IS A CORPORATION: FElltEIRA1 ENTIFICAT NO. _ _ �. S'V STATE OF INCORPORATION `' '�`�� `C� FULL NAME AND HOAff ADDRESS OF: PRESIDENT TREASURER CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS ROAM TELEPHONE# JAU ispcction himdouisUL2 Mat Application2008.DCC: FROM FAX NO. Jun. 29 2011 07:47AM P 2 MAIL,-IN REQUESTS Please mail the completed application form to the address below. Also include a copy of your contingency plan(to handle hazardous waste spills, etc.) In addition, please include the required fee of$100. Make check payable to: "1 own of Barnstable. Allow time Por in-house processing. Our mailing address is: Town of Barnstable Public Health 1!.livision 200 Main Street Hyannis,MA 02601 FOR FAXBD 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 bandle hazardous waste spills,etc.) In addition,please mail the required fee of$100. Please make the check payable to: Town of Barnstable. The check mast be mailed to the address listed above. Allow time for in- house processing. For further assistance on any item above, call (508) 862-4644 Back.to Main Public Health Division Pane JAinspection NindoutslHnx Mat Appliaaiion2008LOC k `._ _LO �% VNovic r. c t�Rtay v' k =:; The Sherwin-Williams Company f Emergency Response Contingency Plan L-VO S Store # 07/23/2012 - Pagel i A-on' Work K�P� TABLE OF CONTENTS EmergencyResponse Policy ...............................................................................................................3 Emergency Coordinator Responsibilities .........................................................................................3 EmergencyEvacuation ........................................................................................................................ 5 Evacuation Notification Exitways Exitway Maintenance Evacuation Accountability Evacuation FireResponse ........................................................................................................................................6 Fire Safety Preparedness Evacuation Route Fire Extinguishing Equipment Fire Evacuation NaturalDisasters .................................................................................................................................. 8 Natural Disaster Preparedness Natural Disaster Response Natural Disaster Follow-Up Hazardous Material and Waste Spill Response ...............................................................................9 Spill Preparedness Spill Discovery Spill Clean-Up Procedures Spill Response Rules Spill Decontamination Spill Waste Disposal Spill Clean-Up Follow-Up MedicalEmergency ............................................................................................................................ 13 EmergencyResponse Contacts ......................................................................................................... 13 Evacuations Fires Spills Medical Emergencies Government Inspections Regulatory Assistance Public Relations Issues Inspections, Investigations,and Notices SpillQ&A ............................................................................................................................................ 16 EmergencyEquipment...................................................................................................................... 17 EmergencyResponse Appendix....................................................................................................... 18 Bloodbourne Pathogens Emergency Exits Fire Extinguisher Use Fire Extinguisher Use Part 2 First Aid First Aid Kit State Specific Requirements For Spill Reporting Figure1 - Evacuation Route ............................................................................................... 19 Figure 2 -Spill Notification Contact Numbers ................................................................. 20 Pal, 07 23 2012 J / / c 2 Nor Sherwin-Williams Store # Street Address �'1(0 F41_1t' Allt V�✓L�' i city-. State Y`I Zip THE SHERWIN-WILLIAMS COMPANY EMERGENCY RESPONSE POLICY 1. It is the policy of the Sherwin-Williams Company to provide a work environment free of recognized safety and health hazards. This includes ensuring that employees are fully trained in how to react in potential emergency situations. 2. Sherwin-Williams will conduct emergency operations without endangering the safety and health of employees,customers,or the public. 3. The Paint Stores Group Health & Safety Program commits the necessary resources to respond to workplace emergencies and to employee concerns over safety or health related issues. 4. All employees are required to adhere to these requirements stated in this Chapter. S. The key to the success of this Emergency Response Plan is preparedness: * having the right emergency equipment and supplies, ready for use, and stored in a i designated,readily accessible spot;and * having every employee trained to react in a proper manner in each particular emergency situation. In any emergency situation, the priorities of concerns are to protect the people first, the environment second,and material assets last. This Plan covers five types of emergencies: * Emergency Evacuation(29 CFR 1910.38): * Fire Response (29 CFR 1910.38&Subpart 1) * Tornado,Earthquake and Other Natural Disasters (29 CFR 1910.38); * Hazardous Material & Waste Spill Response (29 CFR 1910,38, 120 & 40 CFR 26S); and * Medical Emergency(29 CFR 1910.38&Subpart K). All blank lines in the Emergency Response Plan must be completely filled out with the information requested.. EMERGENCY COORDINATOR RESPONSIBILITIES The Emergency Coordinator is the Store Manager. The Assistant Manager or Operations Manager is the Alternate Emergency Coordinator. At least one of the employees below is available at all times [either at the store or on-call] to coordinate emergency response measures in the event of a fire,hazardous materials spill,a hazardous waste incident,or other emergency. NAME TITLE CELL NUMBER HOME NUMBER HOME ADDRESS �oie tLe K,-'UC;- EC STORE MGR 50 V 3"L -59'6 Cdac AC AST MGR 5()W``95�-`iSs v raS�a ,rot DM -1'31-IN'6-L716 53 72'2 N/A 07/23/2012 Page 3 il .. ... .. .......: 1. The Emergency Coordinator shall report any discharge of hazardous waste or discharge of any material which, when discharged, becomes a hazardous waste that poses a threat to human health or the environment, for example,into storm or sanitary sewers,onto the land or into the air,groundwater or surface waters. a. Each state has its own spill reporting standards which may, or may not, be more stringent than the federal standards. Please check with your state for State S)e('ifi Re, uii-eme.nts for Spill Reporting and who MUST be contacted in the event of a Hazardous Materials Spill. 2. The Emergency Coordinator is responsible for controlling the activities at the emergency scene until professional help arrives, consulting with fire and police personnel regarding the emergency,contacting the family of any injured person,and notifying the appropriate company management personnel regarding the incident. 3. The Emergency Coordinator is also responsible for the completion of appropriate safety and emergency training, the proper maintenance of fire control and prevention equipment, the control of safe hazardous materials operating procedures, and good housekeeping, including the removal of flammable and combustible waste materials. 4. Emergency Coordinator will also provide assistance during an emergency to familiarize police, fire departments, medical emergency response teams, and environmental emergency response teams, with the layout of the facility, properties of hazardous materials and wastes handled at the store, places where employees would normally be working, entrances into the store, and possible evacuation routes. 5. The Emergency Coordinator must,in the event of a spill, fire or explosion, be able to identify the product, source, amount,and an estimate of the extent of any hazardous material released into the air,soil,or surface and ground water as follows: a. Name and telephone number of reporter: b. Name and address of facility: c. Time,date,and type of incident: d. Name and quantity of material(s) involved (if known): e. Extent of injuries: f. Possible hazards to human health or the environment outside the facility: g. Cause of the spill: 6. The Emergency Coordinator may need to submit a written report, usually within 15 days of the reported incident,that address all details of the incident,including: a. Name,address,and telephone number of the owner or operator: THE SHERWIN-WILLIAMS COMPANY 1101 PROSPECT AVE,NW;333 REPUBLIC;CLEVELAND,OH 44115/216-515-7E50 b. Name,address,and telephone number of the facility: c. Date,time,and type of incident: d. Name and quantity of material(s) involved: e. Extent of injuries: 07/23/2012 Page 4 a f. An assessment of actual or potential hazards to human health and/or the environment: g. Estimated quantity and disposition of recovered material that resulted from the incident: h. Please check with your state to determine the appropriate steps that must be taken after the spill clean-up is complete. A more detailed written report may be needed. Employees will retain from making any comments to the news media. The Emergency Coordinator will courteously explain that a public news release will be made only after there has been the opportunity to evaluate what occurred. Any further release will be made by the District Manager, or a Division, Group or Corporate management person. EMERGENCY EVACUATION Evacuation Notification Each location must have a method by which employees and visitors are notified of an evacuation. Most stores do not have an emergency alarm or paging system. The default notification to evacuation is a verbal notice. For this store,the method to emergency notification is: O-A)V CC- 4k__4111(eJ 4(Ao r_ (By Default Verbal) Exitways 1. In the unlikely event it should become necessary to evacuate the store, the following measures must be taken to facilitate a safe evacuation,even in the event of a power outage. 2. There must be a minimum of two means of exiting the store. The pathway to, through and out of these exit ways must be maintained free of obstructions--a clear pathway is required at all times. For this store the locations for emergency exit are: (By Default Front Sales Door Facing Parking Lot) (By default the back warehouse door facing the parking lot with open access to the street) Exitway Maintenance 1. Storage locations of merchandise, inventory, equipment and other items including flammable and combustible liquids, must be chosen carefully to avoid being placed along the normal path of travel to and through the exit door. 2. Flammable or combustible liquids must not be stored immediately adjacent to an exit door. 3. Each exit door must be identified with an illuminated "EXIT" sign;either a lighted sign or an exit sign,which is illuminated by an emergency light. 4. Emergency lighting must be installed in such a manner to facilitate safe travel to the nearest exit. At minimum, there will be one emergency light in the warehouse and one emergency light in the sales area. Emergency lighting and flashlights must be checked for readiness on a periodic basis. 07/23/2012 Page 5 "- ...'..... --., N1►t�ric�3-csssac=PEayBr:�v:�3 REIM] S. Exit doors that are normally kept locked during working hours, must be either equipped with a "panic bar", allowing the door to be opened from the inside at all times, or the security bar removed,or the door unlocked during working hours. 6. An exit door must never be locked or blocked while persons are in the store. Overhead roll up doors do NOT count as an emergency exit. Adequate aisle space must be maintained to allow a safe evacuation. Evacuation Accountability 1. Once outside the building, there must be a designated location at a safe distance from the store (recommended 500 feet) where employees will congregate until it has been determined everyone is safely out of the building. The Emergency Coordinator or the Alternate Coordinator must conduct a head count of all employees and persons after the emergency to insure that the store is completely evacuated. 2. For this store that meeting location is: R t,&M 0— cry , nj.ern sir 1 v 't/k (By Default Front Sales Door Facing Parking Lot) (By default the back warehouse door facing the parking lot with open access to the street) 3. Every employee must understand the evacuation procedure. New employees and transferred employees will be trained in the procedure within one week of the first day of work. Whenever the emergency response procedures change, retraining of the procedures is required. At a minimum, there will be annual training with all employees. All training shall be documented on a safety training record. Evacuation 1, When an evacuation notice has been given, without hesitation, every employee will quickly leave the building through the closest exit door, taking with him/her any customers or visitors who might be in the store. 2. Once outside, employees will congregate at the designated site until a head count has been taken to assure that everyone has evacuated. 3. Do NOT re-enter the store after evacuation. FIRE RESPONSE Although the nature of the coatings industry involves the use and sale of flammable and combustible liquids, the incidents of fire in our stores have been minimized through proper training. 1. Fire may result from the improper storage of flammable liquids near potential ignition sources, improper handling procedures with flammable material, improper maintenance of equipment,and smoking near flammable materials. 2. The risk of fire incidences may be minimized through the proper handling and storage of containers of flammable and combustible materials,good housekeeping,and through taking care when working with open containers of these products. 3. Deflagration or explosions may occur when hazardous materials are subjected to extreme temperatures and pressures resulting in a sudden uncontrolled release of energy. 07/23/2012 Page 6 Alai:IV,, WeVkt;ct 4ic P6ayug«a'VAEA Performance oriented packaging and pressure relief devices on containers prevent such ordinary risks of explosion. Explosion occurrences are likely in the event of a fire and therefore,emergency procedures for explosions are the same as a fire. 4. Explosions are the result of flammable or combustible materials being subjected to extreme temperature and pressure within a container. Emergency responses to explosions are similar to those of a fire. S. Strict standards regarding smoking, housekeeping, and the storage and handling of flammable and combustible liquids must have been established and communicated to all employees. These standards are presented in Chapter 3 -- Basic Store Safety,and Chapter 6 -- Hazardous Materials Handling. Store training materials have been developed to educate employees regarding the dangers of working with flammable and combustibles, and to make employees knowledgeable regarding the proper way to safely handle these products. 6. In those stores where intermixing of products occurs, a specially designed product service room (PSR) is used. In some facilities a special flammable liquid storage room is used to store flammables and combustibles. Proper bonding and grounding equipment is required for transferring flammable and combustible liquids from one container to another. Fire Safety Preparedness 1. Assure that fire protection equipment is in a state of readiness. Fire extinguishers must be fully charged, visually inspected monthly, serviced annually, mounted in a designated area with a fire extinguisher sign posted over the extinguisher,and not blocked by clutter,inventory,or merchandise. Sprinkler systems must be tested and inspected annually. Equipment must be maintained in a good operable condition, maintained as required in Chapter 3 --Basic Safety,and inspected monthly. 2. All employees must know the evacuation procedure. 3. Fire Drills must be conducted at least once per year. 4. Only employees trained and familiar with the general principles of fire extinguisher use and the hazards involved with incipient stage fire fighting that is the initial or beginning stages of a fire, as presented in the Store Learning System (START) Safety And Loss Prevention Learner's Guide,may respond to an incipient fire. Evacuation Route Use the template from Figure 1, located on page 18, to draw a diagram of your store's evacuation route. Fire Extinguishing Equipment The following provides a description of fire protection provided at this location: 1. Fire Extinguishers: Number of 2A: 20 BC,dry chemical 10 lb.Extinguishers Number of 4A: 40 BC,dry chemical 20 lb. Extinguishers Other Fire Extinguishers: 2. Fire Sprinkler System (describe the area of the building that is protected by an automatic fire sprinkler system. 3. Fire Alarm System (describe the area of the building that is protected by an automatic fire alarm system. 4. In Rack Sprinkler system S. Product Service room 6. Liquid Storage room 07/23/2012 Page 7 i 7. Outside Storage area Fire Evacuation I If the fire involves flammable or combustible liquids and is beyond its initial or beginning stages,and is beyond controlling or extinguishing with portable fire extinguishers,then: 1. Call out,"FIRE-- EVACUATE!" 2. Pull fire alarm,if available. 3. Assist customers and any injured employees in the evacuation. 4. Once outside, congregate at the designated location, and perform a head count to assure all have evacuated. 5. If not already done,call the fire department. 6. If necessary,dispatch an employee to adjoining businesses to warn of the fire. 7. Until professional help arrives,keep people at a safe distance from the store. If the fire is small and is in the incipient stage, that is the initial or beginning stages, and can be controlled or extinguished with portable fire extinguishers,then: 1. Call out,"FIRE-- HELP!" 2. A second employee will evacuate customers from the store. 3. The employee who discovered the fire, if properly trained, may, with the assistance of any other available properly trained employee,attempt to extinguish the fire. 4. If the fire spreads beyond the "incipient", that is the early, initial or beginning stages, or otherwise becomes too dangerous or life threatening or "too hot" to handle, give up the effort,evacuate,being sure to aid any injured employee in the evacuation. If the fire results in an explosion or any sudden releases into the air of hazardous materials or wastes,then immediately evacuate the store. NATURAL DISASTERS I. Most injuries and deaths resulting from a tornado or earthquake are not due to the high winds or shifting earth,but are instead caused by falling objects. 2. Although there is no absolute safe place to be during a natural disaster, there are some precautions,which can be taken to minimize the possibility of a serious injury. Natural Disaster Preparedness 1. Identify a location in this store where employees will congregate which provides the greatest protection from falling objects. The location should be an interior wall, away from windows,racks and other heavy objects that might fall. 2. During a tornado the safest place is the basement. If no basement is available, restrooms, closets,or office areas generally provide less ceiling area,which is likely to collapse. 3. You should check locally for the location of a tornado or hurricane shelter in the event time will permit moving to such a location. 4. In the event of an earthquake,the safest place to be is under a heavy piece of furniture,or in the same area identified for a tornado (except a basement). S. In this store,the safest location is: Tornado or Hurricane 07/23/2012 Page 8 Fk 111110 i Earthquake * Be sure emergency lighting is available and in working condition. Check emergency lighting monthly. Have a battery-operated radio available for emergency and weather information. * Just prior to the peak tornado season,review this plan with all employees. Natural Disaster Response 1. If time permits,shutdown all electrical and disconnect all gas mains. 2. Do not go outside! Move quickly to the location identified in #1 above. 3. Assume a sitting or crouching position with arms protecting the head. Natural Disaster Follow-Up 1. Check for injured persons. If injuries exist, have a second person call for medical help. Do not move seriously injured persons unless they are in immediate danger of further injury. Trained personnel may administer reasonable first aid -- stop 'bleeding by applying direct pressure, cover injured person with a blanket or coat. Trained personnel may provide artificial respiration,CPR,or other life saving techniques as necessary. 2. Do not use telephone unless there is a severe injury. 3. Do not use electrical switches. If there are no explosive gases, use a flashlight to check water and electrical lines. The use of the fire department's combustible gas detector may be necessary if gas leaks are possible. 4. If possible,put out small fires;if not possible,evacuate the store. 5. If there is a spill of material,refer to the responses to a hazardous material or waste spill. 6. Do not use a vehicle unless there is an emergency. 7. When conditions are all clear, call the District Manager and the Division Loss Prevention Director to report the incident,discuss damage,etc. HAZARDOUS MATERIAL AND WASTE SPILL RESPONSE 1. The spill of a hazardous material may involve the release of hazardous chemicals into the environment and may expose employees or customers to these chemicals. 2. The spill response procedures outlined in this Chapter are procedures in which all employees should be trained. 3. The procedures for cleanup may be followed by trained employees if a spill occurs in the store or during a delivery of material by store employees. 4. The priority actions to be taken when a hazardous liquid spill occurs is to protect personal health; protect against ignition of fire; protect against the liquid contaminating the environment by containing the spread of the liquid; and notification and reporting to company management personnel. At this point there is sufficient time to clean up the spill. Spill Preparedness 1. Every store must have a spill containment and clean-up kit which is readily available and stored in a designated area centrally located in the warehouse, or in a commercial store adjacent to the product service room or mixing area. Stores that have been identified as generators of hazardous waste (primarily commercial stores and blending stations) have been furnished with a spill kit packaged in a 95-gallon overpack drum. 07/23/2012 Page 9 µ r ' i A"INF For this Store: Spill Kit Locationc1� 2. Every store must have the Emergency Telephone Numbers list posted near a telephone which all employees have access. The Emergency Response Contractor is identified on the emergency telephone list as PSC 1.877.577.2669. 3. Every employee who responds to a hazardous liquid spill must be trained on the proper hazardous spill containment and clean-up procedure. Spill Discovery 1. Protect the PERSONAL HEALTH of all employees and customers. Avoid inhaling fumes and skin contact with the spilled material. 2. ASSESS the spill situation. Determine if the spill can be responded to by trained store employees. If the spill is too large or dangerous to perform cleanup, then the spill must be responded to by the Emergency Response Contractor, and the store evacuated (See Emergency Coordinator Responsibilities above). If the spill is small and safe, then employees may respond to the spill. Spill Clean-Up Procedures 1. GET HELP to clean up the spill. 2. The store manager should be notified of the spill. 3. Turn off and remove all potential SOURCES OF IGNITION. Shut off powered industrial lifts,and shut off or remove electrical equipment. 4. ISOLATE the spill area from customers and other employees. 5. Bring the SPILL KIT, AN EMPTY CONTAINER, AND A FIRE EXTINGUISHER to the spill area. 6. The spill kit container may be used in an emergency as a container. 7. Wear the EYE PROTECTION to protect against eye contact with spilled material. 8. Wear PROTECTIVE CLOTHING including gloves, coveralls, and shoe covers to avoid skin contact. 9. STOP THE LEAK. Turn the damaged or open end of the container up or if possible put the leaking container into a larger container. As required,turn off valves or close openings. 10. CONTAIN THE SPILL. Use absorbent socks, if needed, to contain the spill and to prevent leakage into drain systems, or onto exposed soils. Place the absorbent socks or other barriers between the spill material and potential receptacles. 11. RECLAIM as much of the spilled material in a liquid form as possible. Use the scoop, squeegee or straight edge to recover the spilled material and to place into containers. 12. When as much free liquid as possible has been recovered, use the absorbent sock and loose sorbent material,if needed,to clean up residual spilled material. Remember waste liquids should be segregated from waste solids. 13. Place absorbent socks which may be reused or still have some value in separate containers from recovered material or waste. 14. Place recovered contaminated loose sorbent, non-reusable absorbent socks, and other contaminated solid material into a separate container for subsequent disposal. 07/23/2012 Page10 I i NEU :. ...- gNOPL( �+w:.mac.;P{fig x'sx'-.1ej Spill Response Rules 1. Responses to releases of hazardous materials and waste where there is a potential for employee over-exposure to uncontrollable safety and health hazards should be performed by the Emergency Response Contractor. 2. Store employees may only respond to releases of known.hazardous materials. If the hazardous material or its hazards are not known or cannot be determined, then the Emergency Response Contractor should be contacted. 3. Incidental releases of hazardous materials where materials may be readily absorbed, neutralized, or otherwise controlled at the time of the release may be responded to by trained employees working in the store at the time of discovery of the release. If additional help is required,then the Emergency Response Contractor should be contacted. 4. Nuisance spills, minor spills, and spills of non-hazardous materials which do not require immediate attention due to minimal employee or customer exposure to safety or health hazards are not considered emergencies and may be responded to by employees. 5. The Emergency Response Contractor must be contacted to respond to a release if the spill poses an uncontrollable emergency under the following conditions: * It may cause high levels of exposure to toxic substances, * It is life or injury threatening, or it poses conditions which are immediately dangerous to life or health, * It poses a fire or explosion level, * It presents an oxygen deficient condition,typically in confined spaces, * It has entered surface waters,sewer or drainage systems, * It poses significant endangerment to public health or welfare,or * It poses significant endangerment to the wildlife or the environment. 6. Employees should not assist the Emergency Response Contractor in handling the emergency cleanup. 7. Assess the potential safety and health hazards of the spilled material. Consult the materials Material Safety Data Sheet(MSDS) to determine the risks associated with the material. 8. Potential safety and health hazards should both be assessed for flammable,combustible and corrosive materials to determine if the spill is too large or dangerous to be responded to by store employees. 9. Safety hazards to be assessed include: the size of the spill area; the quantity of material spilled; slippery, uneven and unstable surface conditions; unstable overhead conditions; confined spaces; and, the number of employees trained to respond which are available for the response. 10. Health hazards to be assessed include potential over-exposure to the spilled material by inhalation,ingestion,absorption,or skin contact. 11. Special hazards associated with flammable and combustible materials include the potential for explosion, ignition and fire. Explosions and fires, which may occur during response actions, most commonly include actions such as moving containers or introducing an ignition source. Sources of ignition typically found include powered industrial lifts, powered tools,electrical and lighting systems,static electricity, heat and high temperatures, and smoking. 12. Remember,a spill of flammable liquids emits flammable vapors into the air. If the spill area is not well ventilated or is near or may come into contact with an ignition source, a fire or explosion hazard is possible. The greater the surface area of a spilled flammable liquid,then the greater the volume of vapors emitting into the air and the greater the risk for fire and explosion. 07/23/2012 Page 11 Spill Decontamination Employees and spill response equipment also require, to some extent, some type of cleanup, wash down,or decontamination. Employee hygiene 1. Employees should remove their personal protective equipment for subsequent cleaning. 2. Employees should wash with soap and water, or as recommended by the spilled material's MSDS, at a minimum their hands and any areas of their skin, which may have come into contact with the spilled material. 3. If contact with the spilled material has caused a medical emergency,then the responses to a medical emergency,as presented in this Chapter,should be followed. Equipment cleanup 1. Equipment used to assist in the spill response and which has come into contact with the spilled material,should be wiped clean with as much of the spilled material being removed. 2. The equipment should be allowed to air-dry in a well-ventilated area prior to returning the equipment to storage. Personal.protective equipment 1. Personal protective equipment,which came into contact with the spilled material,should be cleaned or disposed as hazardous waste. 2. All personal protective equipment should be inspected after its use to determine if the equipment is in a good operable and sanitary condition. If equipment is no longer usable then it must be discarded. Discarded equipment must be restocked immediately. Spill Waste Disposal 1. Spilled material that is recovered and can be reused or still has some value is not considered a waste,and therefore should be separated from waste material. 2. if the liquid can be used, it should be moved to the appropriate raw material area and labeled as to the contents and its associated hazards. 3. Waste liquids should be segregated from waste solids. 4. If the container of liquid is determined_to be unusable, put a Hazardous Waste label on the container. S. Recovered liquids from a spill of a hazardous material, which are considered to be of no further value or use,should be considered hazardous waste. 6. If there is a release of hazardous waste,all recovered liquids and solids are considered to be hazardous waste. 7. Review Chapter 7- "Hazardous Waste Disposal"in LiveSafe to assist in the proper handling and storage of hazardous waste. Contact the Division Director of Loss Prevention for assistance with incident reporting and disposal of waste material. Spill Clean-Up Follow-Up 1. Return the spill kit to the permanent storage location. 2. Determine and order supplies necessary to restock the spill kit. 3. The Emergency Coordinator will take the following actions: Write written report to be submitted to the state (see Emergency Coordinator Responsibilities above) 07/23/2012 Page12 f i k, - im Ad Determine immediately why the spill occurred and ;hold a brief safety meeting within the week to discuss how it might have been prevented. The Coordinator should also discuss any details of the clean-up procedures,which are warranted. Complete a Loss Offense and Incident Report and distribute the report as required. Include in the report the identity of the spilled material,the quantity spilled and recovered,and a description how the spill occurred. MEDICAL EMERGENCY 1. Quick response to a medical emergency could mean the difference between life and death. Persons who are not trained in proper first aid procedures should not attempt to give medical treatment. 2. Telephone for trained, professional help, i.e. emergency medical service. (Remember to dial "911" if the universal emergency number is available in your area.) 3. While waiting for professional help,take whatever reasonable action is necessary to make the victim comfortable. 4. Do not move seriously injured persons unless they are in danger of further injury. 5. Trained personnel may administer reasonable first aid -- stop bleeding by applying direct pressure, cover injured person with a blanket or coat. Trained personnel may provide artificial respiration,CPR,or other life saving techniques as necessary. 6. If the victim is an employee,determine the person to contact in case of emergency. 7. Call that person, advising them that the employee has been taken to a particular medical facility. 8. It is acceptable to say the person was injured, was having chest pain, etc.; but do not say the person had a heart attack,stroke,was not breathing,etc. 9. If the victim is a customer,let the emergency response team determine whom to contact. 10. If the illness or injury is work-related, call the Workers' Compensation Coordinator at the ACCIDENT/INJURY PHONE in Cleveland at 1-800-543-1463. Refer to Chapter-4 Reporting Work-Related Accidents,Injuries&Illnesses for further instructions. 11. If the incident involves a customer, report the incident to:, the District Office and the Division Director of Loss Prevention. Complete a Loss Offense and Incident Report and distribute the report to the Division Director of Loss Prevention. If the medical emergency involves exposure to hazardous materials or wastes, familiarize hospitals or medical personnel with the products MSDS. EMERGENCY RESPONSE CONTACTS Evacuations The Emergency Coordinator or the alternate will contact the appropriate emergency agencies, the District Manager,and the Division Director of Loss Prevention. Fires 1. The Emergency Coordinator will IMMEDIATELY call the FIRE DEPARTMENT if not already performed. 2. Contact the Division Director of Loss Prevention, the District Manager and Division Management. 3. If paint or paint related material was directly involved in the fire,then immediately contact; 07/23/2012 Page13 r SRI'Md Wo�Oafin�c,.,�TQ*6aY r ..A' a. Stores Safety & Environmental at (216) 515-7850 or (216) 566-1710 or the Sherwin-Williams 24 Hour Emergency Phone 1-877=SWC-EMER, b. Immediately, not to exceed one hour from discharge discovery, Contact your local 911 responder or fire department, c. It may be helpful to write down all of the numbers you'll need beforehand so that you are prepared in the event of a spill (see Figure 2, located on page 19). Each state has its own spill reporting standards which may,o'r may not,be more stringent than the federal standards. Please check with your state for S� -,e Srjec�l),.: Ric tiircnier}ts for Siii Re �or,:inz; and who MUST be contacted in the event of a Hazardous Materials Spill 4. Air Ignition/Fire Incident Report should be completed andj submitted to the Division Director of Loss Prevention and Corporate Safety I Spills 1. If there is a spill which requires the use of the Emergency Response Contractor,or if there is a spill of material: into the drainage or sewer system, surface or ground water, or onto exposed soil, whether on or off the Store's premises, immediately call those numbers specified under Emergency Coordinator Responsibilities above 2. If there is a spill or release of hazardous waste equal to or in excess of "10 gallons (100 pounds), immediately contact the Stores Safety & Environmental Department at (216) 566-1710 or (216) 515-7850 or call Sherwin-Williams 24 Hour Phone Number 1-877- SWC-EMER for assistance in federal reporting requirements. 3. If there is a spill or release of hazardous material equal to or in excess of 100 gallons, immediately contact the Stores Safety&Environmental Department at 216-566-1710. 4. See Fire Notification Procedures above Medical Emergencies 1. If the illness or injury is work-related, call the Workers' Compensation Coordinator at the ACCIDENT/INJURY PHONE in Cleveland at 1-800-543-1463 Refer to Unit-4 Reporting Work-Related Accidents, Injuries&Illnesses for further instructions. 2. if the incident involves a customer, report the incident to the Division Director of Loss Prevention,the District Manager and Division Management. 3. If the medical emergency involves exposure to hazardous materials or wastes, contact the Stores Safety and Environmental Department at (21.6) 566-1710 or (216) 515-7850 or for help during non business hours, contact the Sherwin-Williams 24 Hour Emergency Phone 1-877-SWC-EMER. Government Inspection 1. Contact Division Loss Prevention, the District Manager and Division Management at the time of the inspection. 2. Contact the Stores Safety and Environmental Department at (216) 566-1710 or (216) 515- 7850 or for help during non business hours, contact the Sherwin-Williams 24 Hour Emergency Phone 1-877-SWC-EMER. Regulatory Assistance 1. Assistance with Federal/State/Local Environmental (EPA), Safety or Health (OSHA), o►- Transportation(DOT) may be obtained from: • Division Loss Prevention • Stores Safety and Environmental Department at(216) 566-1710 or(216) 515-7850. • Corporate Health at 216-566-3096 07/23/2012 Page14 f } Alp s 8c ' Work[:.r. sae'gPQayT=+'tie>r Corporate Safety at 216-566-2161 Corporate Environmental at 216-566-2182 2. Assistance with local Fire and Building Codes may be obtained from the Division Engineer. Public Relations Issues Any of the above issues may become involved with public relations issues involving local; or national media's including newspapers, radio or television. Store Employees are directed to refer all questions, statements or communications to the District Office. Assistance may be obtained by directing such issues to: 1. Division Loss Prevention,the District Manager and Division Management or 2. The Corporate Spokesperson--Conway Ivy at 216-566-2102. Inspections,Investigations,and Notices Any of the above correspondences by Federal,State, Local Agencies, Consultants or Investigators,or landlords regarding Safety/Health or Environmental COMPLIANCE OR LIABILITY. 1. Contact Division Loss Prevention,the District Manager and Division Management. 2. Contact the Stores Safety and Environmental Department at (2,16) 566-1710 or (216) 515- 7850 or for help during non business hours, contact the Sherwin-Williams 24 Hour Emergency Phone 1-877-SWC-EMER. i I I 07/23/2012 Page 15 INAMm SPILL Q&A Q1. In the event that my Store requires evacuation,do I need to report to anyone outside of the Company? Unless otherwise directed in this Chapter,no outside reporting is required. Only Company Management needs to be notified.If notification is required to outside parties, Division Management will direct the Store Manager. Q2. When am I supposed to fight a fire? You do not need to fight any fires.You should evacuate the Store and notify the local fire department. Q3. When is a spill too large or dangerous to clean up with Store employees, and when should the emergency contractor be called? * For latex paints, if the spill enters the storm or city water system in excess of 1 gallon call Division Loss Prevention;the emergency contractor may be contacted by Division Management as appropriate. * For latex paints,if the spill requires assistance from employees not normally working in the Store or the Company,the emergency contractor may be contacted. * For oil-based and solvent-based coatings, or pure solvents; if the spill enters the storm or city water system in excess 1 gallon call Division Loss Prevention, the emergency contractor may be contacted by Division Management as appropriate. * If vapors become severe where overexposure to a volatile coating is a problem and natural ventilation is not sufficient to vent vapors to; the outdoors, contact the emergency contractor at 1.877.577.2669. * Call Stores Safety & Environmental at (216) 515-7850 or (216) 566-1710 and for emergencies during non business hours, contact the Sherwin Williams Emergency Line at 1-877-SWC-EMER. Q4. If my Store has a new manager or assistant manager, does;the Emergency Telephone Number Page need to be changed? YES.The OSHA and EPA regulations require that a current listing;of local management be posted near a central telephone at each Store. Q5. In the event of an emergency requiring outside assistance, whether contractor or governmental,who in the Store has the authority to commit those resources? The Manager,Assistant Manager, Operations Manager,or any other employee acting in the best interest of the Company has the authority to call for assistance in responding to an emergency. Q6. Who is in charge of emergency response actions when multiple agencies arrive at the emergency? Sherwin-Williams employees will grant authority to the local agency having jurisdiction or the first responder until higher governmental or Company authority dictates otherwise. Q7. Who is in responsible if a spill occurs while shipments are being unloaded at the Warehouse area? Sherwin-Williams is responsible to ensure that the spill is properly cleaned up. Financial responsibility is the transporter.Contact Division Loss Prevention for further cost recovery procedures. i i 07/23 '2012 Page16 f I a, ISO I NO"N--V� EMERGENCY EQUIPMENT A listing of all emergency equipment typically located at Paint Stores locations,which could be used in the event of a hazardous material or hazardous waste release, is provided be low. Each piece of equipment is individually listed, along with a physical description of the item and a brief description of its capabilities. The designated Emergency Coordinator, should note the location of each applicable piece of emergency equipment. Inventories and location notations should be reviewed regularly and updated as needed. Use blank rows in the table to fill in location-specific emergency equipment that is not otherwise covered in the provided listing. EMERGENCY EQUIPMENT EQUIPMENT DESCRIPTION CAPABILITIES LOCATION Emergency Shower Shower Decontamination Near the lunch room. In the front area. To the right of front door of Emergency Eyewash One plumed One portabl unit Decontamination the PSR. 2nd one is near the e forklift charger Spill Kit White poly drum Control/containment At the end of first aisle 141,11 Boom Sorbant sock Control/containment 'Near the rear exit Oil Dry(or equiv.) Powdered sorbant Control/containment 'In the spill kit Coveralls Tyvek coveralls PPE In the spill kit Boot Covers Tyvek boot covers PPE 'In the spill kit Nitrile Gloves Chemical-resistant PPE In the spill kit Safety Safety PPE In the spill kit Glasses/Goggles glasses/goggles _ Respirator Air-purifying w/or anic cartridges PPE In the spill kit _ Broom Broom Control/containment Near the spill kit. End of aisle Straight Edge Straight edge Control/containment_ !Near the spill kit Sorbant Pads Chemical absorbant Control/containment !in the spill kit Fire Protection End of each aisle. Class d is Fire Extinguishers Fire extinguishers Equipment/we have ;located at the end of aisle 1 class a/b/c/and d Fire Protection Sprinklers Sprinklers Equipment In the lab and PSR Fire Hoses Fire hoses Fire Protection !N/A Equipment First Aid Kits First aid kits PPE !Near the lab Cell Phone, Walkie- Emergency Communicate !Near"Hazardous Waste Talkie, or air-horn communication Emergency Accumulation Area", PSR, or Evacuation other material transfer areas. i Page17 07/23/2012 f ._ ._ i '�fpr$t ti;-icra e'•p6tfiy ro.=aae&i EMERGENCY RESPONSE APPENDIX The following documents will supplement the retail store emergency response information and can be used for supplemental employee training. Bloodbome l'atl of -,ens C lirt itlt.i3lac.l.but =Red Cross Disaster : upport tk>r Children I_i!`ia_S,tel-Stli)j-D()rt `trLlievies Disaster 11):-, for lVl£inaL:yers ;Cti?ijEs 41C� l rf tiaredU.ess F,L,th.cLu,<e 4df Cross llfit <1,-I12'1!,or1 `Jhe(t`c:i �_71GY Tt iC\ Exits Ian-ier`4(;rx.v F'.xits and Life Safety E'tile.rLe!1c: .l?c '�i=rise: 't>licv Q-ta .ter2 .E,'.I,-LA-'1`ii{.)17.Hatined r�. i dllTtiy 1_)'Isastei- 111an Fire l:xtin<g1ti her C se I i:rhi :did First Aid K it. cal' l'o:_fc1 �. tety 1Zel (:r+. s �k--nert for Safc-f 1-1estt V.`ayc.- R.C-1 t:`riiss Hle:lp DLUJI12 I1;lni_a:1 llun icanie Ciea111-1,2 1 cL"F1 le an, o t lood` 1eaIltli) i 1-1, .icon S.-a t� Red (:r>ss , d.anl s ide Safety Resnot.-,er �rllchij-,�ai1 11 i :Er�lt)lIS �� t51 1_'T1,r '<Tc'i1C(' 1nt01'Irlal:l{).n 1'<IIIdc.ntic Hu Preixtrednes-s l m4fisii P,atF1dc.r(!'(,, Flu.Preparedness Spani1:=1] j if+"ewer 0. itafre Sa et'y --,Red C_r:ss> Svi!i t'Z.t:;soon.s and Cleanups Respwi c,Dcl.i�Y�s:.'r�- - St1i:e Sr-)ee.ific lZeguiremenits trill Rept11'tin St )rc .I:)isa tier 'lai-.i Red Cross Torn,-:,,do Saktti --Rcd Cross UlM ate Y('(,i111'1=;1YLergenL b Plan I 07/23/2012 Page18 FIGURE 1 — EVACUATION ROUTE TEMPLATE i I J I V I I 07/23/2012 Page 19 •� LflSb•GYP 7CFa?� P9 Y g• FIGURE 2 —SPILL NOTIFICATION CONTACT NUMBERS NAME OR ORGANIZATION NUMBER IN CASE OF EMERGENCY'. 911 OR LOCAL EQUIVALENT STORE MANAGER ASSISTANT MANAGERCr DISTRICT MANAGER LOCAL FIRE DEPARTMENT. � LOCAL POLICE DEPARTMENT 6,0-'71 -111'L NEARESTHOSPITAI° Lw EMERGENCY RESPONSE CONTRACTOR--PSC 1.877.577.2669 ACCIDENT/INJURY;HOTLINE 1800:543:1463 DIVISION DIRECTOR OF LOSS PREVENTION 611 -C y 1 C'I (it S STORES SAFETY&EN,VIRONMENTAL . : 216..515.7850 OR 216.566A710 ; S-W 24 HR EMERGENCY HOTLINE 1.877.SWC.EMER CORPORATE HEALTH, 216.566.3096 CORPORATE SAFETY 216.566.2161 CORPORATE ENVIRONMENTAL _ f; 216:566.2182, 1 - DIVISION ENGINEER CORPORATE SPOKESPERSON `. 216.566.2102 4e r LOCAL EMERGENCY MANAGEMENT AGENCY NATIONAL RESPONSE CENTER " 1.800 424.8$02 4. i i Due to thefact that each state has different s Aiil re orrini5 remli ments, lease click;-on the link and scroll down to your ac � � P state to determine what your reporting requirements are. This link also contains the numbers you will need(it will help to write these numbers down on the contact list above) in the event of a spill. Your local EMA should be able to tell you whom ease you need to contact,if you are unsure. 07/23/2012 Page 20 Number Fee 1080 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that West Marine Products 276 Falmouth Road, Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ----------------------------------------------------------------------------------------------------------------- -------- __________________________________________________________________________________________________________________________________________________________________ This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2014 unless sooner suspended or revoked. --------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2013 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health o A Town of Barnstable RegulA#pry Sen ices ham�-w kF Gu ar,D -e ' xaar W. *I bye e t D of �k� Tbr�mas 3�1•�a�,73'isr��'nr' 2D0 Mau StEe� R7=:s,MIA 02601 C'Fca: 5OP4624644Fay SD2-190630d A�pricaton Fee- $100.JO0 ASSESSOPS MAP ADD PARCZL NO. 2 013 03 I DAB 2- AP.'PLICA710- FOR PERI T-TO STORE AND/Q��j'c UT=...Y, .MORE THAN "p 1' 1JL.,L NjIL 7.[ 07 Y��.li�`.-t161 1� 1C.i�J� • \Q��`C, �O4� :i`LA ME OF 71s'.tABLL9Wyw _ �-ettbV _LDD ' +SS OF ESTA13L RN= 2 1 ., 'FvA t,OJY\r,- 0-4, � K1+;�'Ti ��Il� S7��� �o Z— 2 �'A 0 2 IIO TQ O 50LE 07TNTa:),YES No 1T AY- .LZC.A --IS A P.�R IP,1`0- NAME rk�HO!!0,' A-D.LREM OF ALL IRTN7j S: T-rT A,�'FL.TCANT I4 A cUR1110RATION: YEDERAL ID N'I'CATION NO,�01 S'L ,Tl OF MORPORAnOP C a�j L �\ 7711 MkM 02D EOM ADD SS OF: T-REsmRNNT M ak-� e- SOo Wts3''AIAf} SrSUTb , �,570Q �jjqNCA 40 vJ � - \�-rsc M � < <•- TITAL 0�'�P�id�,A.�'1' .— f1�)o dl1�cG'�'G�/ RI=C70ys. DRESS 0- V4e.&�-A MS-f LAUO��HoNZ �31 - b`� � a 2 � C, hay da�,hvp/q f Number Fee loco THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that West Marine Products ` 276 Falmouth Road, Hyannis,MA 02601 M Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. J -------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------- ------------------------------------------------------------------------------------_ This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 6/30/2013 unless sooner suspended or revoked. WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 5/6/2013 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health - Barnstable N; Regulatory Services Department i;axnscnpr�. � . Public Health Division r KAS& .200 Main Street, Hyannis MA 02601 2007 Office: 508.852.*4544 Thomas K Uoilcr,Virmtor .FAX: 508.790.6304 Thomas A,McKcan,(.H(.) Application Fes: $100.00 ASSESSORS MAP AND PARCEL NO. DATE 5/2/13 APPLICA'YTION FOR PERMIT TO STORE ANDIOR UTILIZE MORE THAN 111. GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT West Marine Products Inc NAME OF ESTABLISHMENT West Marine ADDRESS OF ESTABLISHMENT 276 Falmouth Rd, Ste C, Hyannis, MA. 02601 TELEPHONE NUMBER 508-862-2700 SOLE OWNEROYESiDNO IF APPLICANT IS A PARTNERSHIP,FULL NAIYiF;AND HOME ADDItESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL.IDENTIFICATION NO. 94-2374523 STATE OF INCORPORATION California FULL NAME AND HOME ADDRESS OF: PRESIDENT Bruce Edwards,EVP of Stores 500 Westridge Dr.,Watsonville,CA 95076 TREASURER Tom Moran,CFO 500 Westridge Dr.,Watsonville,CA 95076 CLERIC Mark Hadley,Central Price Auditor 500 Westridge Dr.,Wat ill A 076 �/............ SIG E OF APPLICAPdT RESTRICTIONS: HOME ADDRESS 500 Westridge Dr.,Watsonville,CA 9507 HOME TELEPHONE# 831-761-4211 J.'vnspoodon handouts\Haz Mat Apgiicaiion2008.DOC r SPILL CONTINGENCY PLAN Emergency. Coordinator, Name: John Dauley-District Manager Address: 137 Popes Island ,Daytime Phone: 508-997-5888 Evening Phone: 508-685-7187 "ire Department: 911 or 508-362-3312 Barnstable Public Health Division: 508-8624644 DEP 24 hour Spill Hot Line: 888-304-1133 Waste Hauler: Name: The Enviromental Quality Company-Amy Kasa Phone: 1-734-413-5677 Building diagram indicating hazardous material/waste storage area, tocation of absorbent scavenger materials, fire extinguishers, fire alarms (if present), .and evacuation route (if applicable). Actions to be taken to control a spill or release, and preventing it from reaching a catch basin, sewer system or the ground. e 1 CONDITIONS WIN.ROLLUP DOOR -7T D CAI EXISTING EXISTING IPAR ® ELECT PPNEL9 C ELECT RE TG REMN HASH PANE15 m ' EELEft J ME B I7 eXONE 'I � REC I _ . F77� FFIC I n I FORK sTRaornE LIFT sTacKFR ���� 1�7 (�'1 U. VB' 333 COLUUNT- PORT SUPPL HUB R STR W gg m SUPPLIES FlXNRES E,H, aH T K I TOFY I OVER LOCI P RU /1 2 S GROU D 2 e K 2 HOOKS TACKLE -K CCP,R TS 1 ��N T I 2 I 84 8484 84 B4 B4 J 84 x _ � a u, U I_ F 13 °O - `-' New^ S ESS OARS T A Y K I I - _ > I - U 84 5 84 c PROMO/ T27 T03 a - �- - -0 2 T = a I I � ENGINE i r, wls�i 1 2 3 4 6 7 H 8 9 -� 10 11 a I -,.�i - PROMO/9 Hu �)MO/B ❑ PROMO/I ROMO/2 ROMO� _ PROMO/ PROMO/ I 6 n P S T19 .~ T06 7722 T07 T04 T21 T02 - T34 — u r----------1 I m I m I Di 1 L � m I xr I I I 1 I 3p I. � _ I N a I I IL�yT1'yT 1yT'y11yT 11�I�I I I S L9 L 60____ J _ I 'cM4Y1"I 1� I o I fff77S7YDD---i i I I i L______LL1_____l___J 1 3 2 S 1 o ff cNaaT -ENsr«. sooMrin __ NIQ U� TaSIE UI� R I T o r--, N to i I o w SC SC SC SC SS 60 I .� I 72 -C- -l; m R� L� 4 U I -� V KS Nk "w,rs 'c 1 Villl s0 mm w S �'� �mMDx & RIGGERS T 130 Now N«wlu. .ENTERTAIN �L ««R Hill Will 111111 60. I——I O60 i!--I--I 12 BI T a I I x NI I I 4 w,Fu�m-D"Rr-t' FISMNG 9 DIUNE 60 J L__ _l c I m NI¢ FS1 I I FS2 i l � I I--FJI i i F-Fi « �J w rL $ J . A L__ J L__ JI A N o --- I,Hl I I I Jm. __ I L__ I I may 1 H I DISPaYEID � L__ J, L__ J r A MAGAZINE i ma I - H R%R1RE I � , FT-n I �r-ry ---rtR tYR' L T CTR � ',!`-h�I 3 L__ J L__ J A A —PKR X LOCKDOORS N YaKRa(:K RS WALL EXISTING SUP LCN ENTRANCE 32a8S°" 11269 BLE SLOT UPR R� E%SMG YANNIS # t269 02/14/13 EXIT 1NT TD DEIIING MERCHANDISING PLAN G AAutoCad\AII_Stores\1269-WM Hyannis Vis Merc 01269\01269 k�' Spill Clean u 1 . Ensure the mandated PPE is Proper S ill Containment worn .(such as goggles, gloves, p p � etc.). 2. Stop and contain the spill. 3. Barricade the area. 4. Absorb spill with kitty litter or spill pads. 5. Sweep or collect absorbent and place in a chemical bag along with the product container. Use of Absorbent Pads 6. Write the date and product name on the bag with a marker. 7. Place the bag in the proper bin designated by the instructional =5 poster. Number Fee 1030 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable `v Board of Health This is to Certify that West Marine Products (a/o Mar 2008) 276 Falmouth Road, Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------------------------------------------------------------------------------------------------- =------- ------------------------------------------ --------------------------------------------------------------------------------------------I----------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 30, 2009 unless sooner suspended or revoked. --------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/08 JUNICHI SAWAYANAGI t THOMAS A.MCKEAN,R.S.,CHO _ Director of Public Health G r s. WH+h 6 : 6 800Z/2 L/80 RECEIVED AUG'13 2008 Town of Barnstable Barnstable Regulatory Services Department AHankaft • Public Health Division 05 awvsseet.s. L 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 _ Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A McKean,CHO Application F ASSESSORS MAP AND PARCEL NO. DATE i3 g APPLICATION C TION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN Ill GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT Ll�e S 1'" y'A NAME OF ESTABLISHMENT e o— `"L rl �Q ADDRESS OF ESTABLISHMENT F c'lr--'6 y -- 94; C)ro— TELEPHONENUMBER 5-00 ��Giv�Vt1S� 0 2 f00 i 4�. cart SOLE OWNER: YES NO CP & —r3 IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF L PARTNERS: `-n r-, IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. q y-2 Y44 S Z STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT G C I'0 el se'tti - C o w2s�C" P r= Gi4 �—� C res�cie� Se rY �� V 0 des r. Sti IPS ' h's SIGNAPJW OF APPLICANT RESTRICTIONS: HOME ADDRESS 5®0 Wes)ri Aij 0r_ �}�dhvt llP,C1� HOME TELEPHONE# $-S 1- 7 2u- LTO 0 Q:Mmnat\Haz Mat Application20WDOC 2 -d Xdd 13rN21SUI dH Wd2T :t, BOOZ ET 2nd VENDOR TOWN OF_BARNSTABLE west Marine Products Inc., (831) 728-2700 No. 10 0 15 5 2 fir.:—��•,_: f, i' is DESCRIPTION INVOICE NUMBER INVOICE DATE GROSS AMOUNT PAID DISCOUNT NET HM89NEW1269 8/13/08 100.00 100.00 .00 100.00 HM89NEW1269 HAZ PERMIT *** TOTAL 100.00 100.00 .00 100.00 0 Town of Barnstable Inspectional Services BAM TABLE THE P —SW:c•<a:r.;yu:otu*•e n.:: o Public Health Division � :r,aan:a BARN 6APMBLE, - Thomas McKean, Director 0 Ore1659. � 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 Ist—JUNE 30th). APPLICATION FEES _ CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 / / Q �26 CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 ®' P �P D 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. ��. &OU 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 ZONINGIBUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: W0.1s " 5. NAME OF ESTABLISHMENT: )&/LSf lea.n n e, r YVJ U, 5 Tn c, 6. ADDRESS OF ESTABLISHMENT: ,-Z (2- 14ya 1) 3 S M74a e '01 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 5C7O We,&frjGe_, hr. MyC'I221AUI 0—A 9 s_V:,1 1, t A 8. TELEPHONE NUMBER OF ESTABLISHMENT: ) 9. EMAIL ADDRESS: eS`�u.rC.b1/PMctir��, Ca/Yl 10. SOLEOWNER: YES AO IF NO,NAME OF PARTNER:_&4-j2oy-a_. ,c2✓U 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATIONNAME �0�8- �O17 X 6 PRESIDENT TREASURER f2kalle o e r D CLERK / 1 6 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANIOLv►•,u"0—A-7—JDATE baa a3 a0ao Q:\Application Fomis\Haz Mat App Revised 09-10-18.docr TOWN OF BARNSTABLE BAR_w 4244 Ordinance or Regulation .�- WARNING NOTICE Name of Offender/Manager Address of Offender MV/MB Reg.# Village/State/Zip Business Name 11,5o ;am/pm, on Q15' 2017, Business Address — Signature."of Enforcing Officer Village/State/Zip MIA O '© t P I Li Location of Offense 14 A771 Enforcing Dept/Division Offense r}►U(41_ r✓64-1+'01_ 7Atk)'J , e�r�. Facts � ��s-k�� t. �,a x t.� 3t cd' �l� -fib XA4 (10VA0INO i1014Lvt- '7 4 k)_ . This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. TOWN OF BARNSTABLE BAR-w 4214,4 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager Address of Offender MV/MB Reg.# Village/State/Zip .S Business Name -� „•} �.' !_".�°+yt am/pm, on 20 Business Address Signature`of Enforcing Officer Village/State/Zip ` / �� y"�1, '� n 7-t r" t Location of Offense '• �` Enforcing Dept/Division Offense e Facts J F 3 .'•'✓�J This}will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT.