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HomeMy WebLinkAbout0065 INDEPENDENCE DRIVE - HAZMAT 65 ��� 7 _ _ � �� �� °FINE T°N Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-7s0-6304 7 BARMAq .9` 200 Main Street• Hyannis, MA 02601 1639. �PrEOMP ,�,T99OXIC AND HAZARDOUS MATERIALS INSPECTION REPORT l�Business Name: Date: 02/a 22 Location/Mailing Address: 5 ,S Contact Name/Phone: Inventory Total Amount: �' �u MSDS: 9 line License#: I Tier II : No Labelina: YR3 Spill Plan: LAES Oil/WaterSeparator: Floor Drains: . Emergency Numbers: ckk Storage Areas/Tanks: v', FD enContainment Equipment-': �° 30 rator ID: Waste Prod- . 0 unt of Last Shi ment/Fre ue c : rJ� �'- aste Hauler&Destination: ` O��j Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS ��QQ,, `�� i vx� a\� 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 40 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 7 yi1#1 Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) f3® Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: P09 &MA i✓ `n 0 Inspector: 5 to MQi`0 Facility Representative: ' e WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS °FIME roy Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 B"'MASSS.. 200 Main Street• Hyannis, MA 02601 "rFOMP+ TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: 1 O Date: O7 � Location/Mailing Address: ® • l Contact Name/Phone:- 1ol Inventory Total Amount: <111 MSDS: ao License#: -00 Tier II : AM Labeling: tkK Spill Plan: Oil/Water Separator: RA Floor Drains: Emergency Numbers: Storage Areas/Tanks: Emergency/Containment Equipment: C t Waste Generator ID: 1-111 Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid y/ Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform,formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFOR A ION/RECOMMENDATIONS: ` Inspecto . Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS °p\ME fOh� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMf,R. .A 200 Main Street• Hyannis, MA 02601 039. 'A�FO MP'�a`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: KO IBIS Date: Location/Mailing Address: �5.. ► kA Pifj R �NO: MI ,5 Contact Name/Phone: 501-77, — 7623 Inventory Total Amount: 7�o DS: (1' �� - h►�kidder License#: Rl Tier II : Labeling: )� �A`� v Spill Plan: Oil/WaterSeparator: Floor Drains: N 0 Emergency Numbers: Storage Areas/Tanks: mQ- b Emergency/Containment Equipment: C Waste Generator ID: �Jl� YS - 3 a1S Waste Product: �►�1d ` AA Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: 1, Other Waste Disposal Methods: IST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas esspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants 3 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 ye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossersa Leather dyes iscellaneous 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: " Cf� i C(jQny Inspector: ' Facility Representative- WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS t � of B411 stable TIfe atory JervicCS 'J a Richard V. Scali,Director ���►aid Public Health Division BARNSTABLE Ak,dBTA,li. , wu•rnwwE•.:.r w,.ut �� was. Thomas McKean,Director 200 Main Street,Hyannis;MA 02601 ' Offs= 508-862-4644 Fay 50B-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—JUKE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26—110 Gallons: $50.00 0 CATEGORY 2 PERMIT 111—499 Gallons: $125.00 tl 5 CATEGORY 3 PERMIT 500 or more Gallons: $150.00 11 *A late charge of S10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. a 4I — O is 2. IS THIS A PERMIT RENEWAL?_YES_NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGEIUSE OF GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 91'fLj 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: �Q`a lrv►,. �W.e ,xo 12occ " id4ut,/J MA 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 20 3 0, St 5'5- P4,���r, wy_I- Jv l S. TELEPHONE NUMBER OF ESTABLISHIW ENT: 2(o a • Dos- -76 l9 9. EMAIL ADDRESS:— C�:jc,v�, i Er,(d'r— L►L S. co �-- 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE QAApplication FOmsULAZ.MAT APP 2017 REVIS do f T :123456789 abcdefg 01:47:40 p.m. 06-30-2017 1 12 FAX TO: Town of Barnstable—Public Health Division FROM: Kohl's Department Stores—Store 1506 FAX 508-790-6304 FAX 262-703-6450 PHONE: 508-862-4644 PHONE: 262-703-7019 SUBJECT: Renewal — Hazardous Materials Permit DATE: June 3D,2017 COMMENTS: .To Whom It May Concern, Please find the attached renewal for the Hazardous Materials Pemit for Kohl's Department Stores—Store 1506 In Hyannis, MA. As mentioned In my conversation earlier today,we just received the application and have sent the payment request to our AP Team today. Should you have any questions, please let me know. Thanks, Ryan Piedot Manager of Environmental Compliance &Sustainability ryan.piedot@kohls.com Office: (262)703-7019 Cell:(262)349-5070 N56 W17000 Ridgewood Drive, Menomonee Falls,WI 53051 6o+ 00 P,'ALXWL<-Vl+ -�7 U"f s c oV-s( 0" 0) 0"X IPA a, 1 I r. - - ►`1 ya�l . P l e,10-4 k ok bs. Co wc- °F�►�*oq Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARN STABLE.`E' ` 200 Main Street• Hyannis, MA 02601 2659. �1DrEDMA'��`� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: LVS Date: Location/Mailing Address: ►� vt�e,h r•�e, ,n� Contact Name/Phone: Jp,rSU�X -50g--7-71 --7 �ioK- op5 Kaq,c.r CKV• Cov1p1,a�.Ge_'� �ScoM.z,k - 3oltivt.�odlu_� 2(02-703 - 7y O `- , Inventory Total Amount; a*Iru�&�MSDS: eof,P W�-bs.ker License#: � � L' Tier II : tJ c Labeling: tA< Spill Plan: eg Oil/WaterSeparator: Floor Drains: o Emergency Numbers: ��eS StorageAreas/Tanks: 2-S544,I �OvL1u�5�o��nk�waS�e-� n ��• cc.ka,� pwJ�c.a�,� ia,,.��S.,RAI• � Emergency/Containment Equipment: %k , } g 11 J (A-i- Waste Generator ID: Waste Product: ��G �'�-ws•� oQ� - Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination:_ 11'Z 2�bly Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, . storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cle ning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives✓ Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants✓ Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: J INFORMATION/RECO MENDATIONS: �r a �� •c.-� �{S s .�1��¢,` �.ti o! O a 0,<-�n , w -Cvan e LLS Gc S f 1 �p� 0�s �G?J�lr�bvS W�Sk.[,5�� ,v v�,�s O �2- Inspector:• !o&•c. kfL p,k G%kt,- adlity Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINHSS . �p�, Vfl�"I�tlfJ VVl C,A,'S L% ary"E'o Y}c�-�CNI t� lytutL Kohl's Department Stores - Store 1506 Hyannis Hazardous Materials Inventory , Hazard Class Class Name Maximum Daily Gal CA 2.1 Non-Flammable Gas 5 2.2 Flammable Gas 15 3 Flammable/Combustable 75 4.1 Flammable Solid 1 5.1 Oxidizer 1 6 Poison 1 8 Corrosive 5 9 Miscellaneous 15 C703 -70iq °F� ►ors Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • RAR MASS. E. • 200 Main Street• Hyannis, MA 02601 039.MASS �1. 0. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: o IS Date: S Location/Mailing Address: 6'� !��l�- tl ��••�s Contact Name/Phone: a< t 7'7 1 -'7491X':� ov m„A,, Inventory Total Amount: T$y - MSDS: C-tl e-" .-r 6AO 4"1 License#: Tier II : 0 Labelino: ©k� Spill Plan: x2..S Oil/Water Separator: N A. Floor Drains: t l o Emergency Numbers: Ye-5 Storage Areas/Tanks: Emergency/Containment Equipment: f.5 , 1cL 13 Waste Generator ID: Waste Product: M►xS9 g Date&Amount of Last Shipment/Frequency: tee ��� Licensed Waste Hauler&Destination: Other Waste Disposal Methods: 5 M4 u-94, 2 LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid _ Other cleaning solvents&spot removers 3 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 r 1, Disinfectants S t b -tZ 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 Z Miscellaneous Combustible Z 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: 5 DERS: � 8 dal b S J 61 e— �� ,o �' W4 �-e -6 C J 1611A) woo INFO MATION/RECOMMENDATIONS: it Inspector's � , L` vt I Facility Representative: APNMLe�7 WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS p`pf(ME fOk� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMASSBLE,9! 200 Main Street• Hyannis, MA 02601 �p a679• `000 rE1639. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: G Date: .Location/Mailing Address: r Contact Name/Phone: &a- ��'4o Inventory Total Amount: MSDS: L Coll License#: Tier II : Labelina Spill Plan: Oil/WaterSeparator: Floor Drains: Emergency Numbers: t1PC6R1 Storage AreaslTanks: iwimo, v Emer enc /Containment Equipment: 4, ' r L—OST aste Generator ID: Waste Product: N&41&0,Q,(2- ate&Amount of Last Shi ment/Fre uenc censed Waste Hauler&Destination: i ther Waste Disposal Methods: OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives (creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes ye 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 Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS THE rokti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 9 BARMAq ,9` 200 Main Street• Hyannis, MA 02601 �PrFDMOO" TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: 0A. Date: 6 Location/Mailing Address: 65 1 mUe 'n1 Contact Name/Phone: / SD — r O Inventory Total Amount: ` � �d e Ca i �. SDS: �l h License#: ��3 Tier II : Labelina: I�� Spill Plan: Oil/Water Separator: 6YA Floor Drains: N Q ncy Numbers: �. Storage Areas/Tanks: Emergency/Containment Equipment: 4;47",SO Vide, Waste Generator ID: M A-O " O l 6g3l Waite Product:P ' Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: 1✓ 9 l Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil y— Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives (creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: O ip Qf C. Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS OIE ro�y1 Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-7s0-6304 • BARMA.Aq E. • 200 Main Street• Hyannis, MA 02601 MASS. p y i6S9• ` TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: &et �a`r''� �cK� �� oK� �#6q ? Date: Location/Mailing Address: it, S Contact Name/Phone: a�Gv� 1�2.I 5 ovl SDS-9 S'7-�3°1D 1 Inventory Total Amount: MSDS: License#: Tier II : t3 O Labeling: t <Ltlu( Spill Plan: e.S Oil/WaterSeparator: Floor Drains: 0y.. " `}°�'at Kok S E�Sier enc Numbers:� Storage Areas/Tanks: W(fa \4\\&5 5&- 60k-E %J-1 - 1ab< -,- Emergency/Containment Equipment: �aS �fia 7 a� wkyte, t; Waste Generator ID: Mc ooC>11&93ate Product: Mtse Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: 2-0-r a 2�k Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS �1 ' ' wlV•hn�cctd`^ti- Gptpaca�� Con�ct��. NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform,formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: Nuts w a. S . 1 c,Q Co`J.I a 1�9 0� �&,X%arAov5 ok-Or-ex, 4kS Inspector: �eow�, w a,5k•e.- r�•�5c�,n,�.�,��ova,b od},C �.��Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number Fee 1253 THE COMMONWEALTH OF MASSACHUSETTS $15o.00 Town of Barnstable Board of Health This is to Certify that Bed Bath and Beyond 65 Independence Drive, 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 Town of Barnstable oF,►,E Tw,, Regulatory Services Pd o , Richard V. Scali, Director mmirABLE, • BARNSTABLE MAC r Public Health Division o �.w�NStW tf-7iRGR'=1!A:•�N!7•".R'.'.S p ►639' �� ''0.N5.ut5•aznN:uf.XSrtlra!Si:.!!E r rED D�a Thomas McKean, Director '°��`" , 200 Main Street,Hyannis,MA 02601 s 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 )�( • A late char a of$10.00 will be assessed if payment is not re( HIV 1st. ASSESSORS MAP AND PARCEL NO. DATE i FULL NAME OF APPLICANT: I NAME OF ESTABLISHMENT: 'a)e �� ADDRESS OF ESTABLISHMENT: (PS l nr 1,�Pend (J c 1 v� .�c� ,ten ►�►'LA MAILING ADDRESS(IF DIFFERENT): (60 Li b2.r4 A'yt • �C- (o ol y►LS'C TELEPHONE NUMBER OF ESTABLISHMENT: _'�Q 7 -9:S-7` g C76 t EMAIL ADDRESS: CMG r011 VAC( -C:��Lt Q.�C� ,,l2 bci4 a,)-, SOLE OWNER: YES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: SIG U OF APPLICANT Name: Company Address Telephone#: Email: Q:\Application Forms\HAZZAPP Rev16.docx Page 1 of 2 on `°FT ►°w� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARM��e.� 200 Main Street• Hyannis, MA 02601 �'pfEDORa,O TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT A Business Name: ' C 6noff A f�S ft mf+-S Date: Location/Mailing Address: C�S e 04110 Contact Name/Phone: l,Sp 6 - � 0A,31 Inventory Total Amount: jll 4qq SDS: License#: III y Tier II : Labelina: Spill Plan: Oil/WaterSeparato /A Floor Drains: N 0 Emergency Numbers: Storage AreaslTanks: Emergency/Containment Equipment: P11 � Waste Generator ID: Waste Product: ff*rnf Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: UU Other Waste Disposal Methods: h of DUSK INV LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants S 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 -1� Miscellaneous Combustible S t off. Paint&varnish removers, deglossers3 0 Leather dyes Miscellaneous Flammables -- kt 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: INFORMAT N/RECOMMENDATIONS: n 4( i "ilavy'shfa Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS IKEfo Y Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 ` &"`MAS& ` 200 Main Street• Hyannis, MA 02601 1639• .0� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT �f0 MPS a Business Name: A, (-. ,M.00•r<.. v k5 e, C<ft '�s Date: -7 24 i� Location/Mailing Address: bS- 4n wt4,J 4-o �3o C✓�loort ,� {iui�n,�1 Contact Name/Phone: S rx A-% C�^c�l�.�.. o - 7 t-'7& Inventory Total mount: I Mh"vq MSDS: �0.�� `� Cor� License#: Tier II : o /Labelina: -rE+ekk Spill Plan: Oil/WaterSeparator: Floor Drains: tJ Emergency Numbers: Storage Areas/Tanks: lrz -at a,(I\/-G %►, Emer enc /Containment ui me t: o r ,k _-J e `�— Waste Generator ID: A Waste Product: K4 4a T� yr Date&Amount of Last Shipment/Frequency: wo- 4AA aw . Licensed Waste Hauler&Destination: 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, 'k S storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/REC MENDATIONS: v ! t s v e kz (l c c*--, k s bo v`.. A \/\ cr- eS-, . 0 1 kl < oe, -L Inspectors � � (i( A,f GQ�� VW h'��. p Co GP,p�uC-25 . ` Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number Fee 1114 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that A.C. MOOREARTS & CRAFTS 65 INDEPENDENCE DRIVE, HYANNIS, 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 Town of Barnstable °f Regulatory Services • "Thomas F. Geiler, Director a BARNSTAB Public Health Division 9w 16.19 `0g `�iDIFD,aa<�' 'Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $1,00.00 ASSESSORS MAP AND PARCEL NO.J'o" L )(0,j DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT A C. w(e ow" i� / . ADDRESS OF ESTABLISHME f T 9I;ila�tnC_�P�Qi (�•S�ncl�� n�l�n� &'Iye l TEL PHONE NUMBER SOLE OWNER: V/YES NO IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF ALL PARTNERS: s IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO.6N91, 4&II I STATE OF INCORPORATION V i o n in FULL NAME ND HQXkADDRESS OF: PRESIDENT � , DC.YY 0 -30 At I aC 06 Y' Be-4,4,r7 rij q TREASURER CLERK , • SIGNATURE F APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# Date: 121 /31 13 TOWN OF BARNSTABLE s �OKI TOXIC AND HAZARDOUS nMATERIALS N FORM NAME OF BUSINESS: &4--4s BUSINESS LOCATION: (05`_��y�r �- e�rtL2. 1'�,I� , I'{��r►�15 INVENTORY MAILING ADDRESS: RomAv.- Rt6ovrc-es , i3o A.&.me!2ke , ev TOTAL AMOUNT: TELEPHONE NUMBER: O '7? 1 - -76(o I oBooY Ja. ors CONTACT PERSON: 54om * r. (-+, r,,) CWd Cvd%c�: Magic&All� 0 $Sb- 6a-�{F3©x163 EMERGENCY CONTACT TELEPHONE NUMBE MSDS ON SITE? TYPE OF BUSINESS: /1 Qr-�'S Cfa- -ys c�Aa.� 1 o d 10 5941 INFORMATION / RECOMMENDATIONS: �S.2e_ a. aGl,e�.ey►-ta► l P'IA a 6ktrict- e- Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) 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 Initials LOCO,- qc `�i1 ssage Page 1 of 2 Lavelle, Timothy From: Monica E. Milito [mMilito@ACMoore.com] Sent: Monday, December 30, 2013 4:12 PM To: Lavelle, Timothy Subject: RE: AC Moore Tim, I appreciate all of the assistance that you have provided to us as we work together to ensure our compliance with Barnstable regulations.The permit and application fee have been sent out. I have attached the list that you and Marti had compiled and the products coded "1" were those that had been determined to be hazardous materials. We are in the process of updating and finalizing our Spill Contingency Plan and will forward it to you upon completion. Thank you again and please contact me with any questions. Thank you, Monica E. Milito Benefits & Compensation Manager A.C. Moore 130 A.C. Moore Drive Berlin, NJ 08009 PH: (856) 768-4930 ext 163 FX: (856) 753-0593 From: Lavelle,Timothy [mailto:Timothy.Lavelle@town.barnstable.ma.us] Sent: Wednesday, December 18, 2013 10:01 AM To: Monica E. Milito Subject: RE: AC Moore Monica, Based on the hazardous materials inventory assessment conducted on Friday December 13, 2013, the Hyannis AC Moore store is required to obtain a hazardous materials license from the Barnstable Public Health Division. The total quantity of hazardous materials stored or used was estimated to be approximately 144 gallons, which exceeds the license threshold of 111 gallons. A license application is attached for your use. When submitting the application, include a spill contingency plan for the store. The requirements for the plan are detailed in Chapter 108-6 of the Town Code. During the assessment, I had asked Marti to provide me with MSDS for those materials counted in the inventory. At this time, I am no longer requesting to see the MSDS, but please include a list of the materials that were counted in the inventory when you submit the application and ensure that all MSDS are readily available when requested. Ideally, the list of materials would have been included in the Health Department's registration form required when the store opened (see Chapter 108-4). However, there is no registration on file. Detailed inventories during future inspections will not be required unless there is a major change in the materials stored/used on site. Please let me know if you have any questions. 12/31/2013 rMbssage Page 2 of 2 Timothy J. Lavelle Hazardous Materials Specialist Town of Barnstable Public Health Division 200 Main Street, Hyannis, MA 02601 508-862-4644 tim.lavelle@town.barn stable.ma.us -----Original Message----- From: Monica E. Milito [mailto:mMilito@ACMoore.com] Sent: Thursday, December 12, 2013 4:38 PM To: Lavelle, Timothy Subject: AC Moore Hello Tim, I spoke with you last week when you were out our Hyannis, MA location. I was hoping to get further clarification from you are to what the Township of Barnstable deems "Hazardous Materials", as well as get a few other questions answered. Are you available to discuss today? Thank you, Monica E. Milito Benefits& Compensation Manager A.C. Moore 130 A.C. Moore Drive Berlin, NJ 08009 PH: (856) 768-4930 ext 163 FX: (856) 753-0593 Notice:This message and any attachments may contain confidential or proprietary information and are only for the use of the intended recipient of this message.If you are not the intended recipient,please notify the sender by return email,and delete or destroy this and all copies of this message and all attachments.Any unauthorized disclosure,use,distribution or reproduction of this message or any attachments is prohibited and may be unlawful. Notice:This message and any attachments may contain confidential or proprietary information and are only for the use of the intended recipient of this message.If you are not the intended recipient,please notify the sender by return email,and delete or destroy this and all copies of this message and all attachments.Any unauthorized disclosure,use,distribution or reproduction of this message or any attachments is prohibited and may be unlawful. 12/31/2013 ,. 12/13/34i3 04:08:42 Pas Page 1 Physical inventory Printout 04-�e„,,n I_ Gar. ID: 100139 n Z� ITEM NUMBER - DESCRIPTION DEP QTY RETAIL EXT RETAIL ITEM BARCODE -------------- -------------------------- --- ------ -------- ---------- -------------I------ 1047381-43 2oz OIL BTL RED VLVT CAKE 001 1 2.99 2 99 IIII1111111111111111111�l11111111111111 Jill[11111111111111111111111 loeAiLe.I�Z lK- /04738145 2oz OIL BOTTLE HONEYSUCKLE 00i 1 2.99 2.11 If1if1111i1111l11lIJI111I!lIIIIIIIIIIIIIIIIIIII11111 pill Jill Jill Jill /04738197 2oz OIL BTL DRE'TWD SNDY SCHS 001 1 2.99 2.11 IJI111111111111JJ1IIII11111J1lIJBlllllllllllllllllllllllllllllll 104738149 2oz OIL BTL SGRD BERRIES 001 1 2.99 2 99 1111111 Hill III Hill111111111111111111111111111111111111Jllllil 104736153 2oz BTL LMN VERBENA 001 i 2.99 2 99 11111111111111111111 Jill[111111111111l11111111JJJJ11111111111 104738155 2oz OIL BOTTLE PATCHOULI 001 1 2.99 2.11 1111111111111111 Jill 111111Jil1111ll111111111111111111111111 Jill Jill 104738/57 2oz OIL BTL ECLYPTS NNT 001 1 2.99 2.91 1111111111111illl11111111111111111111111111111J1i11111111111111 104738159 2oz OIL BTL CRNBRY MNDRN 001 1 2.99 1.11 1111111 Hill 1111111III11111111111111111111111111111111111Jill 104736163 2oz OIL BTL APL CNMN, 001 1 2.99 2 99 1111111111111111111111ll1111111IllIIIIl1111111111111111111 Ell 1111 104738165 2oz OIL BOTTLE CLEAN LINEN 001 1 2.99 2.19 11U111111111 IIJII illl 1l 1111111111111111I1I1I1111111Jill 104738165 2oz OIL BOTTLE CLEAN LINEN 001 1 2.99 2 99 1111 ill Ill IlIIIJill[llll11111111111111 Ell 1011111111111111 104738i67 2oz OIL BOTTLE LAVENDER OOI 1 2•99 2.11 1�111J1111J1111111111111111J1111�1111I111111�1111IlJIJII 1111111 104738169 2oz OIL BOTTLE GARDENIA 001 1 2.99 2.19 IIIIIl111111I111llilllllllll111111111111111111111111111111 Jul 104738171 2oz OIL BOTTLE OCEAN BRZ 001 1 2.99 2.11 Ilili1111111111J1I1ilIllIIIIIl11111111�1IIIlIIII II111111Jn1 IIE 104738171 2oz OIL BOTTLE OCEAN BRZ 001 1 2.99 2.91 IIl1111111111111111111111111111111111 Jill 111111111111111111lillJill 104738173 2oz OIL BOTTLE SANDALWOOD 001 1 2.99 2.11 Illllllllllllillll�lllllll III II 11111111111 Jill 11111 Jill Jill 1-04738175 2oz OIL BOTTLE HANAIIAN MIST 001 1 2.99 2 99 111111111111111111111111111 JI1J1111J1JJ111J111JJJJ11111111111111 104738177 2oz OIL BTL WRM SGR CKS 001 i 2.99 2 99 llllllll J11111111 illl 11111111111111111�11111JJ11111111111Jill 104738179 2oz OIL BTL CINNAMON SWIRL 001 i 2•99 2'99 1111J11J1J1111J11J11JJ1111111111fl1111lllllllllllllllllllllll lil iF 11+ ;»�� S �,�,ar���eY/oCX.•n.Ce �Gr l /`t .k f'1.�►_'I► s _ r I O_i 1 a.l vck 5 — Z I se-v1 f 4i�ra- res�vLg���axYs e+t - 2- r Ibcal r��ti�s��Oal s lu gca.les - 3 I ii I I, �{ Qe�ylIe- arktgk�,����,. s_(�o� ►bly �a�i� �- viCD I IF I 3 � 4� )." ASV "J•i�.� 4�JS �.).: ,��i y. �1 4 Ji ?Y., f i "i4r .'t -., •7: � �` tiM } � - _.!,�. 1 `.-. r �_ 4r 1 .F :+ 14 . • -C3 .f 43 i�f Feb-11-201510:10 AM AC Moore Inc.1-856-753-7057 1/4 Town of Barnstable t r Regulatory Services Thomas F.Geiler,Director HAM $ Public Health Division �b Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 50&862-4644 Fay 508-790-6304 Application Fee:$100.00 ASSESSORS MAP AND PARCEL NO. ,;2?'0K'X0*-Z-DATE 6145 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT A •C . ���� � InCOrMrO.-�--CA NAME OF ESTABLISHMENT .C • 1"IQC,(' i`i`I(C1�(115, ADDRESS OF F TABLISHMENT SQAA VV1(\ [ 'P1C:2P (0s �ts t 3�. t��t\�s, m"c7ai=O I TELEPHONE NUMBER SOLE OWNER: J YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO.A35' •10tl STATE OF INCORPORATION V-1pw1n1CA FULL NAME AND HOME ADDRESS OF: PRESIDENT 0— 1302ACA= Of- <o DI CRY-29 TREASURER CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE It Feb-11-201510:10 AM AC Moore Inc.1-856-753-7057 2/4 . - ARTS & CRAFTS Create Moref,*hare More*save more- Spill Contingency Plan When a spill occurs,time is of the essence to make sure a quick and safe clean-up occurs. In the event of a spill;the Team Member(s)who is first made aware of the spill or who caused the spill is responsible for prompt and proper clean-up. It is also their responsibility to have spill control and personal protective equipment appropriate for the chemicals being handled readily available.The Spill Kit to be used is located in the Janitor's Closet. Steps that must be followed: 1. Unless doing so would cause a hazard to the Team Member, remain with the spill and call for assistance. • if a volatile,flammable material is spilled,immediately warn everyone. • if there is a fire or medical attention is needed,contact 911. , • Attend to any people who may be contaminated:Contaminated clothing must be removed immediately and the skin flushed with water for no less than fifteen minutes.Clothing must be laundered before reuse. 2. Unless doing so would cause a hazard to the Team Member,while one Team Member stands with the spill,the other Team Member will grab the necessary items and will notify the MOD: a. "Caution-Wet Floor"sign b. Spill Kit,which includes the following items: • Spill absorbent(pads and sorbent socks) • Gloves • Disposable Plastic bag c. Brush and pan i 3. Place the"Caution—Wet Floor"sign around the spill. I 4. Evaluate the spill and make sure the area is secure.Evaluate the source and type of material spilled. S. Using the chart below,determine the extent and type of spill. If the spill is large,if there has been a possible release to the environment or if you are not familiar with the liquid and its chemical properties,vacate the•area and contact the local authorities for direction and assistance with the problem. f 12.2014 Feb-11-201510:10 AM AC Moore Inc.1-856-753-7057 3/4 - Treatment Category Size I Response Materials , Small/Medium up to 5 a]isorp6ori and clean up Use Spill Kit liters ll Call the Fire Department more than (508)362-3312 and 1 Large I i outside help 5 liters The Health Department(617) i 665-3838 ' i 6. After determining the type of substance you will be cleaning up, put on the personal protective equipment,as necessary.Refer to the Material Safety Data Sheet or other references for information. 7. Absorb liquid with pads and sorbent socks.Work from the outside edges toward the middle. This reduces the chance of splash or spread of the spill. 8. Let it sit for a few seconds and carefully use brush and pan to scoop the absorbed material(s)in the disposable plastic bag. 9. Dispose of the plastic bag. • If necessary, contact Human Resources Support(856)768-4970 for additional information concerning disposal. 10; Decontaminate the surface where the spill occurred using a mild detergent and water,when appropriate. 11. Leave the"Caution—Wet Floor"sign out until the floor has had time to fully dry. 12. Ensure the floor is clean of any substance.Then remove the signage. 13. Replace absorbent materials and safety equipment,as needed by contacting HR Support at , 856 768-479OManagement will inspect the spill control products to ensure all equipment has been replenished and is in proper working order. 14. Any release of Hazardous Materials, into the group water or any sewage system, must immediately be reported to the following within 1 hour: 1. Barnstable Fire Department at 508 562-3312 2. Health Department at 617 665-3838 12.2014 Feb-11-201510:10 AM AC Moore Inc.1-856-753-7057 4/4 �y. r . o %.40 I"EToh� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMASS. 9` 200 Main Street• Hyannis, MA 02601 �'0'FOena+'�0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: mvo< r'15 ca 45 Date:A Location/Mailing Address: nRX . PVzl% ts mad , r Contact Name/Pho e:Cor eo --6 - o - -c I6 6 ,A, AS6-7E$-Vl-q si'o �e- ,J<: 4:*%Cs�v Inventory To al Amount: MSDS: License#: Tier II : Labeling: Spill Plan: Oil/WaterSeparator: Floor Drains: Emergency Numbers: Storage Areas/Tanks: Emergency/Containment Equipment: Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road.salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: 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: o{evx,, 1w ,eA<1JarGAA, A o-%T jioj fN.c ilt —7 D * I a v« Vo ir,. Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS f` `°Ft rok, Town of Barnstable "' Office:508-862-4644 Public Health Division Fax:508as0-6304 B"RMASS. r 200 Main Street• Hyannis, MA 02601 eoMn+N. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: �. Nooze 4 S i (�fa -�5 Date: A Location/Mailing Address: Contact Name/Phone: !�o Gz)„rt a e s M 14, s-yuo x 11.Z 4 ur t>o ra w. g3Sb-�f�-y'7S Inventory Tofal Amount: MSDS: License#: Tier II : Labelina: Spill Plan: Oil/WaterSeparator: Floor Drains: Emergency Numbers: Storage Areas/Tanks: Emergency/Containment Equipment: Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road.salts " grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticid e A. Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimrning.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, e hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS:: n(e uk.s )om- F.,.1, I, A,, L i o�,} i4)( ?iA4<G1-,.. M,, &c,j-,Ani.aV iv ,nn'k lo�t�ti P.� 1Qr�•e ![ nngr1,4 -,v ed,.. ara- )_Gvf r� c'or� Inspector: Facility Representative: . WHITE COPY HEALTH DEPARTMENT/CANARY COPY-,BUSINESS - " I ^� `4essage Page 1 of 2 Lavelle, Timothy From: Monica E. Milito [mMilito@ACMoore.com] Sent: Wednesday, December 24, 2014 12:52 PM To: Lavelle, Timothy Cc: Laura Doron Subject: FW: Follow Up: A.C. Moore Importance: High Hello Tim, I am trying to renew our Hazardous Materials license, however having trouble locating on the Township website. Are you able to provide me with the link so I can get this taken care of as soon as possible? My apologies, I was not aware that this was an annual fee. Going forward, we will know to renew in June. Thank you again & Happy Holidays! Monica E. Milito Benefits&Compensation Manager A.C. Moore 130 A.C. Moore Drive Berlin, NJ 08009 PH: (856) 768-4930 ext 163 FX: (856) 753-0593 From: Lavelle,Timothy f mailto:Timothy.Lavelle@town.barnstable.ma.us] Sent: Thursday, December 18, 2014 10:20 AM To: Laura Doron Subject: RE: Follow Up: A.C. Moore Hi Laura, Thanks for your response. I'll plan on conducting the hazardous materials inspection sometime in Jan. I can't give you a specific date. The inspection is based on the Town of Barnstable Hazardous Materials ordinance found in Chapter 108 of the Town Code. If any major changes in hazardous material inventory have occurred over the last year, a new registration should have been filed with Health Dept., therefore I'm assuming no major changes in inventory at the store and I will not require a full, detailed inventory as I did last year. I will verify this with a quick walk through the store. I will also be looking at where and how hazardous waste (basically just returned and/or damaged product) is stored. This area should be labeled as a hazardous waste storage area. Documentation that I'll be looking for include a valid Hazardous Materials license (my records indicate that it has not been renewed for the current year- renewals are due in June each year), a spill contingency plan posted for easy employee access, employee access to MSDS, and records related to hazardous waste transport and disposal. 1/8/2015 'Message Page 2 of 2 Hopefully this information will provide for a more receptive store staff during the inspection. I'm sure you'll have questions with all of this information. Please follow-up by email. Thanks. Timothy Lavelle Hazardous Materials Specialist Town of Barnstable Public Health Division 200 Main St, Hyannis, MA 02601 508-862-4645 tim.lavelle(aDtown.barn stable.ma.us -----Original Message----- From: Laura Doron f maiIto:ldoron@ACMoore.com] Sent: Wednesday, December 17, 2014 2:38 PM To: Lavelle, Timothy Cc: Laura Doron Subject: Follow Up: A.C. Moore Importance: High Good afternoon Tim, I am sorry it took me a few days to respond to your last phone message. I was traveling to a few of our stores at the beginning of this week and am still trying to catch up.You mentioned that you'd send me some information upon receipt of my email. My contact information is below. Thanks Tim. Laura Doron Executive Vice President, Human Resources A.C. Moore Inc/ Sbar's Inc 130 A.C. Moore Drive, Berlin, NJ 08009 Office: 856-768-4958/ Fax: 856-753-0593/ Email: Idoron0acmoore.com !""'IE. .PMAOORE ARTS & CRAFTS Create More*Share Morel save Morer• Notice:This message and any attachments may contain confidential or proprietary information and are only for the use of the intended recipient of this message.If you are not the intended recipient,please notify the sender by return email,and delete or destroy this and all copies of this message and all attachments.Any unauthorized disclosure,use,distribution or reproduction of this message or any attachments is prohibited and may be unlawful. Notice:This message and any attachments may contain confidential or proprietary information and are only for the use of the intended recipient of this message.If you are not the intended recipient,please notify the sender by return email,and delete or destroy this and all copies of this message and all attachments.Any unauthorized disclosure,use,distribution or reproduction of this message or any attachments is prohibited and may be unlawful. 1/8/2015 Y64644()� °F1HE►op Town of Barnstable Office.508 8 Public Health Division Fax:508-790-6304 98^RMASSB`E.�, _ 200 Main Street• Hyannis, MA 02601 1639.�i0'ED MP'�&`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Yw e Business Name: & X61 ��� Date" al b wa Location/Mailing Address: 6 5 WIC Contact Name/Phone: '501-77!K—A149 Inventory Total Amount: < MSDS: A � License#: 63 Tier II : Labelina: A Spill Plan: Oil/Water Separator: FI or Drains Emergency Numbers: Storage Areas/Tanks: Emergency/Containment Equipment: `'' v Waste Generator ID: Waste Product: Date&Amount of Last Shi ment/Fre uenc Licensed Waste Hauler&Destination: Other Waste Disposal Methods: NC4 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 nd disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids ,Automatic transmissiion fluid Other cleaning solvents&spot removers ngine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) � I indshield wash V Motor oils i/ Miscellaneous Corrosives Gasoline,jet fuel, aviation gas esspool cleaners VDiesel fuel, kerosene, #2 heating oil 1/ Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refri erants/ — F Degreasers for engines&garages Pesticides:d VCaulk/Grout & insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes916o ye or caustic soda acquer 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/ ECOMMENDATIONS: al, 44me -ov w b� Inspector: . Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number Fee 1290 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Kohls Department Store #1506 65 Independence Drive, Hyannis, WI ------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Is Hereby Granted a License For: Storing or Handling 111 -499 gallons of Hazardous Materials. ------------- ------------------------------------------------------------------------------------------------------------------------------------------------------ Restrictions: .------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable Inspectional Services BARNSTABLE .^ T 84RY.TABLE•LFNiEiV(lIE•[OTiIIf•FY4h#IS • MAiiT(NI-Y'1L5.639-2 L:.'tlEBT BABAIBtt3LE Public Health Division 1639_Zo=< 1 �srnBrE = Thomas McKean, Director 039. 200 Main Street, Hyannis,MA 02601 C . 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, rv; 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 _I11 —499 ('gallons: $125.00 Lk vST- i CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ ' - f *A late charge of$10 00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. JqS- o[s' 2. IS THIS A PERMIT RENEWAL? y 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 QUQANTITIIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT:. 5. NAME OF ESTABLISHMENT: �L1 6. ADDRESS OF ESTABLISHMENT: L S` T�/,.,��Oa►.P '��,'vY ti .� s !/YIf� 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: PC) Rd,, =: /C'1' , ��l ww� • �Z 5;J.)01 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER t CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE Q:\Application Fonns\Haz Mat Appli Draft Jan201 ocx I 2627036450 Kohls 10:02:33 a.m. 06-15-2020 1 /2 FAX TO: Town of Barnstable — Public Health Division FROM: Kohl's, Inc. — Store 1506 FAX: 508-790-6304 FAX: 262-703-6450 PHONE: 508-862-4644 PHONE: 262-703-7019 SUBJECT: Renewal — Hazardous Materials Permit DATE: June 15, 2020 COMMENTS: To Whom It May Concern, Please find the attached renewal for the Hazardous Materials Pemit for Kohl's Department Stores - Store 1506 in Hyannis, MA. A hard copy of the application and payment will be sent via USPS once the payment has been received from our AP Team. Should you have any questions, please let me know. Thanks, • Ryan Piedot Sr. Manager of Environmental Compliance & Sustainability ryan.piedot@kohis.com Office: (262)703-7019 Cell: (262)349.5070 N56 W17000 Ridgewood Drive, Menomonee Falls, WI 53051 • i 2627036450 Kohls 10:02:46 a.m. 06-15-2020 2/2 a Town of Barnstable m.Ja Inspectional Services BARNSTABLE Public Health Division n isuxt-cc.6.19-2014 nrcris Rat 73 1!S.6i?M:e•^Si 23SYSItltE �-` i619-201a - 575; 1 BARNSTABLE. = Thomas McKean,Director �'°�Fo •�� 200 Main Street, Hyannis,N A 02601 Office: 508-862-4644 Fax: 508-790-6304 �r APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE co 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 I st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ❑/ CATEGORY 2 PERMIT 11.1 -499 Gallons: $125.00 M vsr CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10 00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? y YES_NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUQANTITIIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: /`'1'ty l' 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: (�r r ,.�c��y �'���'v r� *7 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: f'T �� w . -JL S.f�v 8. TELEPHONE NUMBER OF ESTABLISHMENT: -)6a -703-701 9 9. EMAIL ADDRESS: T—f►�. F [� CI 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME &4 PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: • SIGNATURE OF APPLICANT DATE //j-/,,., Q:1Applicalion Fortns\Haz Mat Appli Draft Jan201 . ocx oi- Too `°F1NEroy� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 B"MARqB`E'$ 200 Main Street• Hyannis, MA 02601 i6'9 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT tE0 MA'S Business Name: Date: Location/Mailing Address: S Contact Name/Phone: - Inventory Total Amount: <5 00 SDS: 3k on 1,(1)•c. License#: 366 Tier II : N 0 Labelino: -re,4*; Spill Plan: a ) -3 Oil/WaterSeparator: NO Floor Drains: Aj (2) Emergency Numbers: Storage AreaslTanks: Qp cLErIfnij. bad(510rtd-td , . Ig Emergency/Containment E ui m t: X JP1 I O$ `r a Waste Generator ID: 060- -maniIAQ ste Product: hSCejhnrftS vV Date&Amount of Last Shipment/Frequency: w��ICS a / ep Un i Licensed Waste Hauler&Destination: S le- Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS N© m(t,� Eti-,n&� NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, stoyage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid ILI- Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) indshield 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 4 Lye or caustic soda Lacquer thinners I 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/RECOMMENDATIONS: nQ rP-Co m iQ S 4 A 1. i e Inspector- Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number Fee 1290 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Kohls Department Store #1506 65 Independence Drive, Hyannis, WI Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. -- -------------•---------------------------------------------- --------------------------------- ---- -- -- --------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2020 unless sooner suspended or revoked. - --------------------- PAUL J.CANNIFF, D.M.D,CHAIRMAN DONALD A.GUADAGNOLI, M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A. MCKEAN, R.S.,CHO Director of Public Health �` • 1111w?1111 ti 08:54:38 a.m. 06-20-2019 2/2 r' Town of Barnstable Inspectional Services BARNS ' oFiHErp� ll �®n1LLE�'S W9�5^�E E o„ Public Health Division ,. Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862.4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS AIATERLhiLS 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 PERAUT 111 -499 Gallons: $125.00 19 lj-ST-PdGhOF CATEGORY 3 PERNIIT 500 or more Gallons: $150.00 El *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. o?9S-- o/J_ 2. IS THIS A PERMIT RENEWAL? � YES_NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONINGBUMDING APPROVAL FOR HAZARDOUS MATERIALS STORAGEIUSE OF • GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: �- E / 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: Li-r.�r_Q,�,�ce A2',,,< 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: �!D. t :311-r-/yI.Iw•wlePo C✓1 $�p� 8. TELEPHONE NUMBER OF ESTABLISHMENT: `a.- 7.0 9. EMAIL ADDRESS: n/4CIL0 It. h �--- 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: • SIGNATURE OF APPLICANT (��KDATE Q:Wpplication Forms\Haz Mat App Revised 09-10-1 0.do 08:54:24 a.m. 06-20-2019 112 FAX TO: Town of Barnstable— Public Health Division FROM: Kohl's Department Stores—Store 1506 FAX: 508-790-6304 FAX: 262-703-6450 PHONE: 508-862-4644 PHONE: 262-703-7019 SUBJECT: Renewal— Hazardous Materials Permit DATE: June 20, 2019 COMMENTS: To Whom It May Concern, Please find the attached renewal for the Hazardous Materials Pemit for Kohl's Department Stores - Store 1506 in Hyannis, MA. A hard copy of the application and payment will be sent via USPS once the payment has been received from our AP Team. Should you have any questions, please let me know. Thanks, C, Ryan Piedot Sr. Manager of Environmental Compliance & Sustainability ryan.piedot®kohls.com Office: (262)703-7019 Cell: (262)349-5070 N56 W17000 Ridgewood Drive, Menomonee Falls, WI 53051 1 Number Fee 1290 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Kohls Department Store #1506 65 Independence Drive, Hyannis, WI Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. --------------------I 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 a - / l-qq1'e ' oWr of B nslable G�4r��U3 eg atoxy emces • Richard V. Scali,Director Public .Health Division iA�MSTABLEMRa ,,,SAWMAJ= Thomas McKean,Director 1e,9,,,. 163 ` 200 Main Street, Hyannis,MA 0260110 Zx Office: 508-862-4644- Fax:508-790-6304 01 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 PERN 1IT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 '&V''S . CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. a Rr - ar r 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: r 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: . 0 -Aga 04 �" 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: Z0. 8. TELEPHONE NUMBER OF ESTABLISHMENT: 4 _70;•7o (J 9. EMAIL ADDRESS:r1 4t.. .Qi� .�, k1 us. La ,,... 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME Ct t L PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: • NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATES Q XApplication Fomis\HAZMAT APP 2017 RE E ocx Sousa, Vanessa From: Ryan Piedot <ryan.piedot@kohls.com> •Sent: Ivdonday, June 11, 2018 9:11 AM To: Sousa, Vanessa Subject: Re:A scanned document from Kohl's Vanessa... thanks for the follow up. It was mailed Thursday or Friday. Rya Piedot I Sr. Manager of Environmental Compliance & Sustainability _-ryan.piedot0-)kohls.com Office: (262)703-7019 Cell: (262)349-5070 NN56 W17000 Ridgewood Drive Menomonee Falls, WI 53051 ***kNOw Before You Throw*** On Mon, Jun 11, 2018 at 8:08 AM, Sousa, Vanessa<Vanessa.Sousagtown.barnstable.ma.us> wrote: 9Hi Ryan, Thank you for submitting the application. I did not receive a payment yet for this specific store. We may just not have received it in the mail yet. If you have any questions, please contact Health Division at 508-862-4644.Thank you. Vanessa From: Ryan Piedot [mailto:ryan.piedotta>kohls.com] Sent: Monday, June 11, 2018 8:56 AM To: Sousa, Vanessa; Lavelle, Timothy Subject: Fwd: A scanned document from Kohl's Vanessa/Tim, i Number Fee 1290 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health Q This is to Certify that Kohls Department Store #1506 65 Independence Drive, Hyannis, WI Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. ----------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2018 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI;M.D. 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health 123456789 abcdefg 01:47:52 p.m. 06-30-2017 212 � of B2nstable 'k;lu atory Services a , rec I& k/�_ Richard V. Sca1i,Director / Public Health Division BARNSTABLE • KAMM= = ; • Thomas McKean,Director „�_Z,,, CA ° •` 200 Main Street,Hyannis,MA 02601 1 Office: 508-8624644 "6U� Fay 5DB-790-6304 X APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26—110 Gallons: $50.00 ❑ CATEGORY 2 PERMIT 111—499 Gallons: $125.00 0 CATEGORY 3 PERMIT 500 or more Gallons: $150.00 *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. a 4 f- o c 5 2. IS THIS A PERMIT RENEWAL?_YES NO. IF YES,SHIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONINGBUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QJUANTIT ES(25 GALLONS)? YES NO. • 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: 7. MAULING ADDRESS(IF DIFFERENT FROM ABOVE: PO 3 3l fY- AA, raS I-3)v t 8. TELEPHONE NUMBER OF ESTABLISHMENT: .2(va - Do s- -76 9. EMAIL ADDRESS: A,, p i ea(a't rw (to L, cc) �-- 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: _ • SIGNATURE OF APPLICANT DATE Q:1Applicatiaa FomsW AZ.MAT APP 2017 REVISE .do 123456789 abcdefg 01:47:40 p.m. 06-30-2017 1 Q • FAX TO: Town of Barnstable—Public Health Division FROM Kohl's Department Stores—Store 1506 FAX: 508-790-6304 FAX: 262-703-6450 PHONE: 508-862-4644 PHONE: 262-703-7019 SUBJECT: Renewal—Hazardous Materials Permit DATE: June 3D,2017 COMMENTS: To Whom It May Concern, Please find the attached renewal for the Hazardous Materials Pemit for Kohl's Department Stores—Store 1506 In Hyannis, MA. As mentioned In my conversation earlier today,we Just received the application and have sent the payment request to our AP Team today. Should you have any questions, please let me know. Thanks, Ryan Piedot Manager of Environmental Compliance 6 Sustainability ryan.piedot@kohis.com Office: (262)703-7019 Cell:(262)349-5070 N56 W17000 Ridgewood Drive, Menomonee Falls,WI 53051 e • Number Fee 1253 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Bed Bath and Beyond ..............................................................................................................................•-- 65 Independence Drive, 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 I Town of Barnstable • p Inspectional Services BARNSTABLE Q` F RSMIABIE•GERTEIYWLL:VNRV RA1iIS Public Health Division MiSN! YLLS1639-lL14 B?WVSTA&E 1639-2014 mmgmBm Thomas McKean, Director s63q ��� + ArF� 200 Main Street, Hyannis,MA 02601 r. sr Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 11 CATEGORY 3 PERMIT 500 or more Gallons: $150.00 LL��ii *A late charge of$10.00 will be assessed if payment is not received by Ju!Y 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? V/ 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: VJ ej &IL 6. ADDRESS OF ESTABLISHMENT: C 5 l ri e Oenolenc& bR. Hyann,5 M A Oho i 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 6$6 Lil1GcW A✓e. abin' %sk H[acvl�evrle/J� Uni©n, n37- 010$3 8. TELEPHONE NUMBER OF ESTABLISHMENT: 508^ 9,51 - 1I8 9 o i 9. EMAIL ADDRESS: LAURH• 67'G&R-TO �e� 3A7H GOH 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICAN C� DATE -6 1 1-2r,1/10 Q\Application Forms\Haz Mat Appli Draft Jan2019.docx Number Fee 1253 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Bed Bath and Beyond 65 Independence Drive, Hyannis, ALL 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 y ~lt Town of Barnstable Inspectional Services BARNSTABLE �ZFIE� enawsmB.=.•ce+rzn:: •cwrt•:.axnr • o Public Health Divisions,° "``S • sAURMN LE Thomas McKean, Director 1639. 200 Main Street, Hyannis,MA 02601 CC Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 A W-- *A late charize of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. -195-0/S,Xn 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: �IeCJ� r5k+h 6. ADDRESS OF ESTABLISHMENT: Vic) C P.CA 04 0 b r t c%Q.,, " g c n n t ,i ✓Yt A Ca (aD- � 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: , U r\, O r,\ N'� " oT''�s 8. TELEPHONE NUMBER OF ESTABLISHMENT:. o I e . 9. EMAIL ADDRESS: C-Ca0k',ryc,ratG,t �� .LJep�t -�-e-t Lp✓tom 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: I TELEPHONE#: COMPANY ADDRESS / EMAIL: SIGNATURE OF APPLICANT DATE Q: Application Forms\Haz Mat App Revised 09-10-18.do Number Fee 1114 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that A.C. MOORE ARTS& CRAFTS 65 INDEPENDENCE DRIVE, HYANNIS, MA Is Hereby Granted a License For: Storing or Handling 111 -499 gallons of Hazardous Materials. ---------------------------------------------------- --------------------------- -------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------- ----------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2020 unless sooner suspended or revoked. --------------------------------------- PAUL J.CANNIFF, D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A. MCKEAN, R.S.,CHO Director of Public Health `4 Town of Barnstable Inspectional Services *BARNSTABLIE Public Health Division BAmerABi^ ' Thomas McKean, Director a639 `0$ 1aJ Arfo �A 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 T �J 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"-1-11 ="499 Gallons:' - $125.00 CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ ��22 *A late charge of$10.00 will be assessed if payment is not received by July lst. 1. ASSESSOR'S MAP AND PARCEL NO. CMSO IS Q 2. IS THIS A PERMIT RENEWAL?X_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 (2(5�G�ALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: �i ,r C�C3� �'I Qr1Y1t S �! 6. ADDRESS OF ESTABLISHMENT: .LI'►tlQr V1C� T•, & )3c Yy;sz-W)A 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: A.C. MO®RE' Inr" 8. TELEPHONE NUMBER OF ESTABLISHMENT: �VFs�(n�3 _-LNJ 08009 9. EMAIL ADDRESS: 10. SOLEOWNER:)G YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME A.C. MOORE, INC. PRESIDENT 980 A. 0, g�fE'DORE DRWE TREASURER BERLIN, NJ 08009 CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE QAApplication Forms\Haz Mat App Revised 09-10-18.docx Number Fee 1114 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that A.C. MOORE ARTS& CRAFTS 65 INDEPENDENCE DRIVE, HYANNIS, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. ----------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2019 unless sooner suspended or revoked. -------------------------------------- PAUL J.CANNIFF, D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2018 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health r� • Vow11�� of B nsxable egulatory ervicer �t"e,� Richard V. Scali, Director Public Health Division *:SUAD MAK Thomas McKean Director MA63. $ 7 039 ♦0 . -- -- - - --200 Main Stireet;Hyannis,1\ -02601- - ------ — -- -.--.— Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 X V'S. CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if pUm�e/nt is not received by July 1st 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL?_YES_NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS.MATERIALS STORAGEIUSE OF GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: hlarTe_ mu Selz 5. NAME OF ESTABLISHMENT: AC nge-, -w*y1r1'15 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: A.c'• ®®RE,INC. 8. TELEPHONE NUMBER OF ESTABLISHMEN'�JJ &93-C)331 BERLIN, NJ 08009 9. EMAIL ADDRESS: d M Ser-0 10. SOLEOWNER: �, YES_NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME A.C. MOORE,INC. PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: 1 SIGNATURE OF APPLICAN V DATE "O 1)1 I I g Q:\Application Forms\HAZMAT APP 2017 REVI D.docx Number Fee 1253 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Bed Bath and Beyond 65 Independence Drive, 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— l 407 ' owl of B unstable cc t/ �-D 6A K* qa�'�1I eg atory Services THE Richard V. Scali, Director � Tp� Public Health Division BARNSTABLEM • s enaxsaeLE.[FmtnVluE.C7IUR.4VMTA5 �" Thomas McKean Director MARSONSM.'S•OSE0.Y E•NA 9AFM4NF MAS& 7 1639-2014 3 � -- - � --200 Main Street,-Hyaririis-1VMA 02601--- ---- -- ----- - -57g- ---- -----;�' Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZEa HAZARDOUS MATERIALS r IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st-JUNE 3 Oth). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 X V•S *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? ✓ YES_NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF • GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: ,P Gv Jt f,i-7(Q 6. ADDRESS OF ESTABLISHMENT: rNc�e ew-�C�z, f,%�w-t ye--) U4aryq.t-s, MCI 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: �� �'t�'�•�/ ��- - U� c�✓Z,, ��F3 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS:—0-rj--ro it Via,r G O bed Cn� 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: • COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE QAApplication Forms\I-IAZMAT APP 2017 REVISED.docx r' ti I • BED SATHi a Bevonci Y store Of it .S kincl. BED BATjg A BEYOND INC. CORPORATE OFFICERS AND DIRECTORS LISTING OF OFFICERS Warren Eisenberg Leonard Feinstein Co-chairman&Secretary Steven H. Temares aimam Eugene A.Ctaffin Chief Executive Oncer Arthur Stem Chief Operates Officer Matthew Morilli President&Chief Merchandising Steven Taplits * Senior Vim ident—Stores Officer Susan E.Lattmann � Vice-President—Tim Chief Fnancial Officer • L1S TING OF DOCTORS Warren Eisenberg 650 Liberty Ave.Ung®n,NJ 07083 Leonard Feinstein - Klaus Eppler * a Jeri�h0 P Jericho,NY 11753 650 Liberty Ave,Union,NJ 07093 Steven IL Temares Victoria A.Morrison _ * 69 Liberty Av&Union,NJ 07003 - Dean Se Adler 650 Liberty Ave,Uniem,NJ 07003 69 L Stanley F.Bar�ba * Liberty Ave.UnionQ NJ 07003 Jordan never y � Liberty Ave,Unio14 NJ 07083 Patrick IL Gaston * 650 Liberty Ave.Union,NJ 07003 650 Liberty Ave union,NJ 070a3 ' 650 Liberty Avenue,Union,RU 070>;3 " 2 Jericho Plaza,Jericho,NY 11753 A L Number Fee 1114 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that A.C. MOOREARTS & CRAFTS .�.� 65 INDEPENDENCE DRIVE, HYANNIS,MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. ------------------------------------------------------------------------------------------ This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2018 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health cP 4/dS r= i ow1� of B nstable P Regi%atory Services Richard V. Scali, Director �THE Tp� Public Health Division BARNST RE BnitN5h6lk•iExIFAVILLF•C0 MI:IS BARN3rABIX Thomas McKean) 1639-2024 Director "`"_'`"�"°�-39` 014 ,y 1639- ♦� � QED rat 200 Main Street, Hyannis,MA 02601 �g n Office: 508-862-4644 �^ / ®f Fax: 508-7 0-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS DULY 1 st—JUNE 3 Oth). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 E- Vs. CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed //iif payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. ( V`S 2. IS THIS A PERMIT RENEWAL?Y 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: bw2n)p— rou sum 5. NAME OF ESTABLISHMENT: �'Ce. 6. ADDRESS OF ESTABLISHMENT: 1Ip� Ylr_ Jp�1�Plr\Ce T(', ate 1 A6711�s r11A 7. MAILING ADDRESS OT DIFFERENT FROM ABOVE: A r+ wfinnar- INN 130 A.C. ROORE DRIVE 8. TELEPHONE NUMBER OF ESTABLISHMENT: BERLIN, NJ-N--- 9. EMAIL ADDRESS: d(�V�� � 10. SOLEOWNER:_XYES_NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATIO NAME PRESIDENT ,( & ntzl 130-A I E-DR- TREASURER 9ERI IN, U108009 CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT'DATE (0 Q:Application Forms\HAZMAT APP 2017 REVISED.docx ` rr„ a Ji. • } Page: 102 of 124 A. C. Moore, Inc. 130 AC Moore Drive Berlin NJ 08009 Yendor�iD��, ��� Ye ii r Name y ��A `C�ieck�iame �F ��� ayrnent Nu G ec�c Qat �;�� Cheek�Numbe �" 745668 Town of Barnstable — Town of Barnstable — 0000760856 6/13/2017 524745 � �� � Da>:e, ��O�Number �Store�t ' `Amount: � �mOklillr Paid D�sCoun�Net 6700547820 HAZMAT2017-54 6/9/2017 6000 $125.00 $125.00 $125.00 • "` as i¢'a i' ,v •�' - w }� r � '' ��x ':€ Number Fee 1253 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Bed Bath and Beyond 65 Independence Drive, 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 Elf 'k 0 of B nstable ��' / ,� t x w1� V Ke Mato �ervices � G'�' T`t°� g g rY a Richard V. Scali,Director �� T o„ Public Health Division BARNSTABLE • snansr:,¢tF..l,r sue.coiurt•xruri5 R�ARMN Thomas McKean Director MASS. ) 1639-2014 039..�s`� 200 Main Street, Hyannis,MA 02601 575 CIA Office: 508-862-4644 o � s Fax: 508-790-6304x�' APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE Ln HAZARDOUS MATERIALS ;w IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS DULY 1 st—JUNE 3 Oth). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 V-S *A late charge of$10.00 will be assessed if-payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? /YES_NO. IF YES,SKIP QUESTION 3.. 3. FOR ALL NEW PERMIT APPLICATIONS INDICATE WHETHER BUSINES S HAS • ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: q 5. NAME OF ESTABLISHMENT: C� Z l.�E'LZ. A- 2 c�✓>n(� 6. ADDRESS OF ESTABLISHMENT: �Q �'�� Qf1��Q rites ' , ���✓�ls ✓Y1 j 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: -(h 5 0 L.t�� �-Vt 02�o 8. TELEPHONE NUMBER OF ESTABLISHMENT: -7, 9. EMAIL ADDRESS: 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE Q\Application Forms\HAZMAT APP 2017 REVISEd Number Fee 1114 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health E This is to Certify that A.C. MOOREARTS& CRAFTS 65 INDEPENDENCE DRIVE, HYANNIS, Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. ------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------ This license is granted in conformity with the Statutes and ordinances relating thereto, 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 C Town of Barnstable • �tNME► Regulatory Services Richard V. Scali, DirectorAA s �ST"LE. BARNSTABLE MAE& Public Health Division �S 1639. `0� °Nines osx"s°nus�v��i�"'e.w'isoat v RFD Mo+� Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office:. 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE.WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 �S CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ • A late charge of$10.00 will be assessed if payment is not received by July 1st. ASSESSORS MAP AND PARCEL NO. �� COI5 X Q;LDATE l0- -) FULL NAME OF APPLICANT: CC -LI M 01C." NAME OF ESTABLISHMENT: Ce, tH n r11,S MA- ADDRESS OF ESTABLISHMENT: hC. 13a QnnD +m MAILING ADDRESS(IF DIFFERENT): c TELEPHONE NUMBER OF ESTABLISHMENT: b 3'" 0331 EMAIL ADDRESS: SOLE OWNER: "S—NO. IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAMFn A.C.MOORE, INC. PRESIDENT b 130 -': TREASURER CLERK „ IF PREPARED BY OUTSIDE PARTY: SIGNATUREEF APPLICANT Name: Company Address : Telephone#: Email: Q:\Application Forms\HAZZAPP Revl6.docx Page 1 of 2 Town of Barnstable Office: 508-862-4644 Regulatory Services Department Fax: 508-790-6304 • Public Health Division oAMIN ASS. Thomas A.McKean,CHO ra3q. 200 Main Street,Hyannis, MA 02601 Payment Receipt ;Hazardous Materials Payment received: $125.00 (Check) on 6/14/2016 'Check number: 503160 Check amount: $125.00 Name on check: A.C. Moore j I .Business: AC Moore Owner: OCW RETAIL HYANNIS LLC ±Address: 65 INDEPENDENCE DRIVE, Barnstable - -- . ........... _ _ • f Number Fee 363 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Home Depot#2612 .-------------------------------------------------------------------------------------------------------------------------------- 65 Independence Road, Hyannis, MA .----------------------------------------------------------------------------------------------------------------------------------------------------------------------- Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. ------------- ------------------------------------------------------------------------------------------------------------------------------------------------------ Restrictions: .................................................. ----------------------------------------------------------------------------------------------------------------. This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable �m�e��►� .���,nw>� THE Inspectional Services BARNSTABLE , nrxsrnai[ccnn,ni�.ccrurr•.ru.xr, Public Health Division t E39-201A BARNSTABLE. n Thomas McKean,Director 039. rear°� 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st=JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.0011 CATEGORY 3 PERMIT 500 or more Gallons: $150.00 Ll pd (�'►I�, *A late charge of$10.00 will be assessed if payment is not received by July 1st. r O 1. ASSESSOR'S MAP AND PARCEL NO. 295015X01 2. IS THIS A PERMIT RE,NEWAL? X 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: Merlando Contreras, Agent for The Home Depot USA, Inc. 5. NAME OF ESTABLISHMENT: The Home Depot USA#2612 6. ADDRESS OF ESTABLISHMENT: 65 Independence Drive Hyannis, MA 02601 Verisk 3E,Regulatory Dept/Home Depot 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 3207 Grey Hawk Court,Suite 200 Carlsbad.CA 92010 8. TELEPHONE NUMBER OF ESTABLISHMENT: (508)778-8948 9. EMAIL ADDRESS: regulatory@verisk3e.com 10. SOLEOWNER: X YES—NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME The Home Depot USA, Inc. PRESIDENTCraig Menear, 2455 Paces Ferry Road, Atlanta GA 30339 (770)433-8211 j TREASURERDwaine Kimmet, 2455 Paces Ferry Road, Atlanta, GA 30339; (770)433-8211 CLERKEVP Theresa Roseborough, 2455 Paces Ferry Road, Atlanta, GA 30339; (770)433-8211 ` 12. IF PREPARED BY OUTSIDE PARTY: NAME:Merlando Contreras, Agent for The Home Depot USA,Inc. TELEPHONE#:(760) 602-8700 COMPANY ADDRESS Verisk 3E,Regulatory Dept,3207 Grey EMAIL:requlatory(a-verisk3e.com aw ourt,SYRe 2 00 SIGNATURE OF APPLICANT DATE 06/25/2020 Q:\Application FormAHaz Mat Appli Draft Jan2019.docx 1 1 f Number Fee 363 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Home Depot#2612 65 Independence Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. ----------------------------- ------..------------------------------------------- --------------------- --------------------- ----------------------------- the Statutes and ordinances relating This license �s granted ►n conformity with g 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 Barnstablen� , Fz Inspectional Services BAMSTABLE w STC S MIS I.—TR'r 1 if 94nP* µ1S Public Health Division = -ot4 HARNMBLE, `` Thomas McKean, Director 1659. 0. � 200 Main Street, Hyannis,MA 02601 eta 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 ;K\j5,v � *A late charge of$10.00 will be assessed if payment is not received by July 1st. xagso 1. ASSESSOR'S MAP AND PARCEL NO. 2 9 S o 15 X p I 2. IS THIS A PERMIT RENEWAL? X YES_NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF • GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 6TEP9N Hogg► A&E#T FvR. THE HOME PEPPY VyA,ZNG. 5. NAME OF ESTABLISHMENT: 'THE Nmg DEPbT # 1412 6. ADDRESS OF ESTABLISHMENT: 65 ZAVENDPN66 'DRIVE )-1 rA VA 6y I MA 02601 VE'R16k BE , R6GVwo9Y D rP7. HpAf EWDT 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 3207 IrRl I RAW( GT: , 5TE 2D1�j�/1�9AU� G/j o12010 n 8. TELEPHONE NUMBER OF ESTABLISHMENT: UT69) —71$' 9. EMAIL ADDRESS: reAvIatorl C?W riyk 3E. Gott 10. SOLEOWNER: X YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME T o c 19 vP2f, D fp g V6A. IN- PRESIDENT L&4y, 6� )YfiAR 1 2%j* F&F,5 remy, Rywn , L.A rR, &A e33q ) /77V3 L133- 621) TREASURER 'DwA.pve kzmoiyT, 'NtA PAccs RAWRvf19, Amfft, L�1 3D550 j 1172P) 43 3-R U CLERKS-VO 11400A 9tAg Itoy&N) 2`ss PA146 FEWa'ROA . qit-/Vu'�k , GA 3�33�1 L7?fl7t�33- 2t� 12. IF PREPARED BY OUTSIDE PARTY: NAME: STEPw Norrv,AufNr FgL `(ldf MeMC D€Pvf_YA x1, TELEPHONE#: C76n�bdL '97P,9 COMPANY ADDRESS 5*7 &1& wAwif (yT. 1 59E. ?n0 EMAIL: re,,v I Aior�1&ev's 1c 3EJp1m . (,A?46OAa, 1/ Al 1 p SIGNATURE OF APPLICANT DATE OS l?1 p 2Lg) Q:Wpplication FonnsUiaz Mat App Revised 09-10-18.doc TL5 bD P✓ Number Fee 363 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Home Depot#2612 65 Independence Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2019 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2018 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health f RegulatoB Service le 0 3 g ry Services Richard V. Scali, Director • �, Public Health Division BARNSTABLE BAM = Thomas McKean, Director 16"5�7 o;" ^' ArFD MPy p 200 Main-Strdet;Hyannis;MA 02601--._- -. Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st—JUNE 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 0 U's *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 211 S of S X b I 2. IS THIS A PERMIT RENEWAL? X 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: C1SI 44yi D�ui�iS, ��� v TKI tfnY-t 2f�t1- vl.s,, Ift. 5. NAME OF ESTABLISHMENT: jAkt *r't Dk'p- # 2 w l 6. ADDRESS OF ESTABLISHMENT: Vqs jyl �4Va WvQ ,' �iavit04,MA OlLool 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 'bwi cow NAtty rt. cavlsl , d, M M 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: ynmIA}0ae yP.yl(k3F• a 10. SOLEOWNER: 7l YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME 14 l-IVvlr-0 1- USR Itit• PRESIDENT Cvtii4 Wnpiv, 2qw PAW L-tM f-J., KjAn+n,&.4 1�0" : (��D �Vh -`Tkl TREASURER DWAivu V4W -N Aad C 94. A19 A a,0 M '►�u 'th'�-�2q CLERK f►�VVP - wa4 Na�Ayi R-0002o n�V,, -N&s Paul Ft" ?f.,Mjio 4A, Oft 4" hi 9bfi-bzll 12. IF PREPARED BY OUTSIDE PARTY: NAME: kF,46y, �'s -rk rk Dp.OF Ush Inr. TELEPHONE#: (1yo) boZ- %�oD COMP ADD SS ;-wl G ttawy(f Jailt-i EMAIL: rpylA-ho P yv�40e,t*�, ud cIvlcl. , Pita `f2.Uio —� SIGNATURE OF APPLICANT DATE 0 Zl '2ols Q:\Application FormffiAZMAT APP 2017 REVISED.docx Imo_ Number Fee 363 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Home Depot#2612 65 Independence Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. ------------=---------------------------------------- --------------------- -------------------------------------------------------.---------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2018 unless sooner suspended or revoked. 4�0 -------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN t 1� DONALD A.GUADAGNOLI,M.D. 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health t_ pc� G�l�# 0 3339/ Ve"A' atoryof B nstablelervices Richard V.Scali,Director Public Health Division BARNSTABLE >jwalvsrwaie. = Thomas McKean,Director 1639. 39. 200 Main Sheet,Hyannis,MA 02601 -- Office: 508-862-4644 C IF—4x7g Fay 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE E6 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 *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 295015X01 2. IS THIS A PERMIT RENEWAL? x 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)? R YES NO. 4. FULL NAME OF APPLICANT: John Koning,Agent for the Home Depot USA, Inc. 5. NAME OF ESTABLISHMENT: The Home Depot#2612 6. ADDRESS OF ESTABLISHMENT: 65 Independence Dr. Hyannis,MA 02601 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 3E Company/Reg Dept/3207 Grey Hawk Ct Suite 200 Cadsbad,CA 92010 8. TELEPHONE-NUMBER OF ESTABLISHMENT: 508-778-8948 9. EMAIL ADDRESS: regulatory@3ecompany.com 10. SOLEOWNER: x YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME The Home Depot USA, Inc. PRESIDENT Craig Menear,2455 Paces Ferry Rd.Atlanta, GA 30339,770-433-8211 TREASURER Dwaine Kimmet,2455 Paces Ferry Rd.Atlanta, GA 30339, 770-433-8211 CLERK EVP Theresa Wynn Roseborough,2455 Paces Ferry Rd.Atlanta, GA 30339,770-433-8211 12. IF PREPARED BY OUTSIDE PARTY: NAME: John Koning,Agent for the Home Depot USA, Inc. TELEPHONE#: 760-602-8700 COMPANY ADDRESS 3207 Grey Hawk Ct Suite 200 EMAIL: regulatory@3ecompnay.com Carlsbad,CA 2010 SIGNATURE OF APPLICANT DATE — (o " C:\Users\Decol l\AppDataU=al\Microsoft\Wmdows emp&wy Files\Content.Oudook\BMQD49H2\HAZMAT APP 2017 REVISED.doai: L Number Fee 363 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Home Depot 65 Independence 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 Town of Barnstable 'IKE tom, Regulatory Services ti Thomas F. Geiler, Director « BARNM MASS.MASS. Public Health Division t63p. ,0�` 'O�Eo tips" Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. 9t7 "��� DATE 0 6l J 51 Zd 1 S' APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT The Oe g oJL U5 A 1, .Tri c. NAME OF ESTABLISHMENT The Ho Me Duo+ #2 6 l-2 • ADDRESS OF ESTABLISHMENT 65 Inde pen den ce Dr, HV a n n f cAA 026a i TELEPHONE NUMBER (5 b$ ) -7'7 9— 814-8 SOLE OWNER: X YES NO IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF ALL PARTNERS: NA IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 58_J 85- 3311 STATE OF INCORPORATION 6 ebrq i& FULL NAME AND HOME ADDRESS OF: PRESIDENT �rcco h neQr - 2455 ftt-es Rrr!j IRA, A4- 14,14a ,exA 330319 TREASURER QwA,ne. K;mcna-t•- z4-g5 puce5 F&r Aji A+Ian4 CzA 33031t CLERK—Ierf5awyao Rose bwouQb-2-45-5- Na5 J A4' A 35031 • �—� R u anda,&P-pl Forfie Home SIGNATURE OF APPLICANT ®e pvi-' V 5A1_TVjL. RESTRICTIONS: HOME ADDRESS -320`7 Cnrej 144w Ic Ca-. Svi 2®Do cgr( HOME TELEPHONE #(7bp)6D2-8700 3E Go,, GA g2fl a ■ June 23, 2015 Town of Barnstable 200 Main St. Hyannis, MA 02601 ATTENTION: Public Health Division SUBJECT: Contingency Plan and Haz. Mat. Storage Permit Application The Home Depot#2612 65 Independence Dr. Hyannis, MA 02601 The Home Depot U.S.A. Inc. authorizes 3E Company to act on its behalf in regard to p p Y g regulatory reporting. The authorization includes the Barnstable Fire Department emergency plan reporting requirements. Based upon these requirements, please find • enclosed the 2015 annual Contingency Plan and Hazardous Material Storage Permit Application for your reference and review. Should you have any questions or concerns, please do not hesitate to contact me directly at(760) 602-6676. Sincerely, 3E COMPANY Ryan Yanda Associate Regulatory Compliance Specialist Enclosure Cc: Store Manager BETHE SUA-mb KINGSI?om-,7 CANTON,OH COPE;NHAGEN„DENNIARK' Mmnr. 1,QC,CANADA i • i CERTIFIED MAIL RECEIPT STUB e ® . m 0♦ 9 ♦ r r � Fl fI LL Padaga pal ppReOelpt F19rB TotatPostageBFeas srPer APt ZOO O 1v1 n S+. orpp.8mtN0. _ `y,&&'� MA QZ(o0 ) . 91 7199 9991 7034 5570 8377 • • - w Town of Barnstable Office: 8-790-6304 4 Fax: 508-790-6304 e Regulatory Services Department • „ As Public Health Division HARv MASS, Thomas A.McKean,CHO ,i a`` 200 Main Street, Hyannis, MA 02601 Payment Receipt 11-lazardous Materials Payment received: $100.00 (Check) on 6/30/2015 ;Check number: 021881 Check amount: $100.00 Name on check: JPMorgan Chase Bank, N.A. Business: The Home Depot#2612 Owner: OCW RETAIL HYANNIS LLC Address: 65 INDEPENDENCE DRIVE, Hyannis • I Number Fee 363 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Home Depot 65 Independence 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 Yp I } ' f Town of Barnstable °FINE ram, Regulatory Services ti Thomas F. Geiler,Director + BA MASS,LE + Public Health Division 9� 1639. Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE 06/05/2014 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT The Home Depot USA, Inc NAME OF ESTABLISHMENT The Home Depot#2612 ADDRESS OF ESTABLISHMENT 65 Independence Drive, Hyannis, MA 02601 TELEPHONE NUMBER�(508)778-8948 SOLE OWNER: X YES NO IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF ALL PARTNERS: N/A IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 58-185-3319 STATE OF INCORPORATION Georgia FULL NAME AND HOME ADDRESS OF: PRESIDENT Frank Blake-2455 Paces Ferry Road, Atlanta, GA 33039 TREASURER Dwaine Kimmet-2455 Paces Ferry Road, Atlanta, GA 33039 CLERK.lack VanWoerkom -2455 Paces Ferry Road, Atlanta, GA 33039 Jan Kin Agent for The Home Depot USA,Inc. SIGNATURE OF APPLICANT 3E Company/Regulatory Department RESTRICTIONS: HOME ADDRESS 3207 Grey Hawk Court,Suite 200,Carlsbad,CA 92010 HOME TELEPHONE #(760) 602 - 8700 3E Company � r r Haz.doc/wp/q 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(tc. 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 P � L r e r " i T ,na �, June 5, 2014 Town of Barnstable Public Health Division 200 Main St. Hyannis, MA 02601 SUBJECT: Request for copy of Permit The Home Depot#2612 651ndeaendence Drive Hyannis, MA 02601 Home Depot U.S.A., Inc. authorizes 3E Company to act on its behalf in regard to regulatory reporting. T,-ie authorization includes applying for and maintaining regulatory permits. Enclosed is a check to .,over the associated fees. Please forward a copy of the permit to 3E Company. Our fax number is 760-918-4025. The permit may also be mailed to the following address: 3ECompany/Regulatory Department/The Home Depot#2612 3207 Grey Hawk Ct., Suite 200 Carlsbad, CA 92010 Should you have any questions or concerns, please do not hesitate to contact me directly at (760) 602-88,60. Sincerely, 3E COMPAN IVL Jan King Regulatory Compliance Coordinator Enclosure BEIHES DA,MD KmGvoPTjN CANTON,OH COPENHAGEN,DMNAARK MONI REAL,QC,CANADA - I ■ r: e e re 1 e ii e 1 1 :/ •1 i i :t .i 3 r June 11, 2014 Town of Barnstable Public Health Division Regulatory Services 200 Main St Hyannis, MA 02601 SUBJECT: Contingency Plan The Home Depot#2612 65 Independence Dr. Hyannis, MA 02601 The Home Depot U.S.A., Inc. authorizes 3E Company to act on its behalf in regard to regulatory reporting. T.ie authorization includes the Barnstable Public Health Division's emergency plan reporting requirements. Based upon these requirements, please find enclosed the 2014 annaal Contingency Plan for your reference and review. Should you have any questions or concerns, please do not hesitate to contact me directly at (760) 602-8621 or pnguyen@3ecompany.com. Sincerely, 3E COMPANY Phuong Nguy Regulatory Compliance Coordinator Enclosure d I'aNcisp,.)PTJN 'CANT 4 Ceti COPENr�AGM DENM RK �a ONTPeaL.QC,C„raADA �iETHES�t� , r r 1 4 11 6. r-i 0 0 June 11, 2014 ATTENTION: Store Manager SUBJECT: Contingency Plan The Home Depot U.S.A., Inc. authorizes 3E Company to act on its behalf in regard to regulatory reporting. The authorization includes applying for and maintaining regulatory permits. Please find enclosed your "Contingency Plan". If you have any questions or concerns, please feel free to contact me at (760) 602-8621. Sincerely, 3E COMPANY Phuong guyen Regulatory Compliance Coordinator BF' €�Fsun,MD. Kira VORT TN Cr.NV.#4.,GH DE.WAARK MCiNMEAL,QC,C,NADA i Contingency Plan J Y The Home Depot #2612 65 Independence Drive Hyannis, MA 02601 Contingency Plan 2014 1 Table of Contents Section 1) Plan Introducticn Elements Section 11)General Information A) Business Information B) Emergency Contacts Section III) Core Plan Elements A) Discovery and Initial Response B) Evacuation C) Sustained Actions D) Termination and Follow-Up Actions Section IV)Annexes A) Facility and Locality Information B) Notification C) Response Management System 1) Command 2) Information 3) Safety 4) Liaison, Staff Mobilization 5) Operations 6) Hazard Assessment Planning 7) Protection Planning 8) Coo9 dination with natural resource trustees 9) Hazardous Waste Minimization 10) Hazardous Waste Management 11) Logistics 12) Finance/procedure/administration D) Incident Documentation E) Training and Exercise Drills F) Response Critique and Plan Review Modification Process G) Prevention H) Emergency Equipment 1) Aid Agreemerts and Emergency Response Coordination Contingency Plan 2014 2 L Section I: Plan Introduction Elements Purpose and Scope of Plan Coverage The Home Depot is a retail home improvement center with prepackaged consumer products that are sold to the general public. The Home Depot also uses hazardous materials as fuel for forklifts, pallet jacks and other similar vehicles. The hazards associated with this facility are incidental releases. Hazardous materials are stored in various sizes, almost solely in consumer-packaged containers. This plan is being developed to comply with local, state, and federal regulations, including the Massachusetts Hazardous Waste Management Rules and 40 CFR 265 Subpart D. Section II: General Information A) Business Information Business Name: The Home Depot#2612 Business Address: 65 Independence Drive Hyannis, MA 02601 Phone Number: (508)778-8948 SIC Number: 5211 Business Description: Retail Home Improvement Center Owner/Operator: The Home Depot U.S.A., Inc. 2455 Paces Ferry Road Atlanta, GA 30339 B)Emergency Contacts: Facility Associates: Primary Emergency Coordinator: Jason Worrell, Store Manager Office Phone: (508)778-8948 Primary 24 Hour Phone: (508) 317-7896 cell Secondary Emergency Coordinator: Angie Cuevas, Operations Manager Office Phone: (508)778-8948 Secondary 24 Hour Phone: (561)703-4778 cell The Home Depot Corporate Personnel: Brandon Knox, Manager-Environmental Programs& Regulatory Compliance (770) 384-2298, Home Depot Office Number 3E Company, Hazardous Materials Assistance 24 Hour Hotline(800)451-8346 In case of emergency contact: Fire Department: 9111 Barnstable Fire District(508)362-3312 Police Department: 911/Barnstable Police Department(508)775-0387 Paramedic: 911 Poison Control: 911 or(800)451-8346 Spill Reporting (MA): (888)304-1133 Hospital: (508)771-1800 Cape Cod Hospital 27 Park St. Hyannis, MA 02601 Contingency Plan 2014 3 Section III: Core Plan Elements A) Discovery and Initial Response: Once a Home Depot associate discovers or is informed of a release, they shall take the following steps: 1) Immediately evacuate the affected area of all customers and non-essential associates 2) Notify a Store Manager, Operations Manager or Department Manager to coordinate the clean up and initiate emergency notification procedures, if needed 3) Contact 3E Company(hazardous materials consultants)for product specific clean-up instructions, 24 hours: (800)451-8346. 4) Obtain a spill clean-up kit from location closest to the spill (paint department, garden department, and receiving). The kit must contain rubber gloves, absorbent, broom, plastic shovel, durable bag and plastic container, and chemical splash goggles. 5) Only associates trained in these clean-up procedures can assist in the clean up of chemical spills. If the spill is greater than incidental or exceeds reportable quantities,the following procedures apply: 1) Immediately evacuate the affected area of all customers and non-essential associates 2) Notify a Store Manager, Operations Manager or Department Manager to coordinate the clean up and initiate emergency notification procedures 3) Notify 3E Company, 24 hours: (800)451-8346. 3E Company will complete telephonic and written notifications to National Response Center(NRC)and/or State Emergency Response Commission (SERC)as needed. 4) Immediately contain spill if possible without exposing associates to hazard (dependant on the materials involved„ location of spill etc.). 5) Notify corporate associates. Emergency Notification Procedures: The Home Depot corporate representatives, Store Manager on duty, or 3E Company will notify applicable federal, state, and local agencies. Massachusetts Department of Environmental Protection (DEP) regulations require that all releases of hazardous materials be reported. Massachusetts DEP: (888)304-1133 Fire Department: 911 Once a Home Depot associate discovers a fire, they shall take the following steps: 1) Immediately evacuate the affected area of all customers and non-essential associates. 2) Notify the Phone Operator or Manager on Duty. 3) Use the closest pull station available to alert associates and customers. 4) Immediate notification of 911 for fire department response. 5) If necessary, initiate store evacuation. If an unforeseen explosion occurs, Home Depot associates shall take the following steps: 1) Immediately evacuate the affected area of all customers and non-essential associates. 2) Notify the Phone Operator or Manager on Duty. 3) Use the closest pull station available to alert associates and customers. 4) Immediate notification of 911 for fire department response. 5) Initiate store evacuation. B) Evacuation: 1) Signals that will be used to initiate evacuation include announcements over the PA system, verbal means and via two-radios that management personnel utilize. 2) Evacuation will occur through the nearest emergency exits that are located throughout the perimeter of the building. Exits are clearly marked with self-illuminating signs. The evacuation staging area is in front of the building in the parking lot. C)Sustained Actions: In the unlikely event that a spill would require a prolonged clean-up procedure,The Home Depot would contact 3E Company to dispatch a licensed emergency response contractor. The following ER contractor may be used: PSC: (800)567-7455 Contingency Plan 2014 4 �I The emergency response contractors will utilize properly trained associates to clean up and remove hazardous wastes at the facility. D)Termination and Follow-Up Actions: The emergency response contractor utilized will be responsible for the demobilization of any resources they may have used to mitigate the spill. Any hazardous waste generated as a result of the clean-up process will be handled in accordance with local, state, and federal regulations. The Home Depot associates, in conjunction with 3E Company representatives,will conduct accident investigations, and submit all applicable written reports to federal, state and local agencies. Section IV: Annexes A) Facility and Locality Information This Home Depot facility is 79,878 square foot retail store with a garden center. This facility is equipped with an automatic sprinkler system that is maintained on a regular basis to ensure proper operation. B) Notification In the event that outside notification is required for an incident at The Home Depot, the manager on duty will make notification determinations and will appoint an assistant manager or applicable staff member to notify the people listed as emergency contacts in Section ll. 3E Company will be notified immediately to review appropriate spill response procedures prior to spill clean up. The Fire Department and the NRC and/or SERC will be contacted by 3E Company or Home Depot management, or a designated representative when appropriate. In addition,the fire department will be notified in the event of any evacuation of a significant area or the building in its entirety. 3E may instruct store personnel to contact the fire department if a spill exceeds the capability, training, and/or resources of The Home Depot associates. C) Response Management System As previously stated, in the event of an emergency incident at The Home Depot, a licensed emergency response contractor will be called to mitigate the incident. Home Depot store management will inform responders as to the location of the release, and assist all fire department and emergency response contractors during an incident at the facility. 1) Command: The command post will be determined according the location and type of incident that is occurring. The manager on duty will disseminate information at the facility. The designated Home Depot representative on site(manager on duty—see Section IV,C,4)will inform all responders of the specific products involved in the incident, as well as notify them as to the location of emergency response equipment located in the facility. Home Depot associates will adhere to the guidance of outside emergency responders and corporate associates. 2) Information: Local, state and federal officials will be contacted should a major release occur. A major release includes any release that exceeds the reportable quantity or is beyond the mitigation and abatement capabilities of Home Depot associates. If further notification is required,the fire department, in conjunction with the police department,will contact neighboring facilities. 3) Safety: Upon discovery of a release, customers and associates will be evacuated from the area. If the release is significant or immediate danger to life or health,the facility will be evacuated. Evacuation will be initiated via the public address,two-way radio transmission,verbal commands, and/or fire alarm when appropriate. Home Depot associates will assist customers in locating the closest emergency exits,which are illuminated. Once their department is clear of customers, The Home Depot associates will proceed to the pre-determined evacuation and staging area.for a head count and further instruction. Emergency responders and clean up contractors will then be summoned for assistance. Only licensed contractors utilizing HAZWOPER-trained personnel will be used. 4) Liaison and Staff Mobilization:The Home Depot does not have an internal emergency response team and will follow the guidance of responding officials and the emergency response contractors Contingency Plan 2014 5 dispatched to the incident. The manager on duty is responsible for informing the incident commander and local officials about the incident that has occurred. 5) Operations: Hazardous materials at The Home Depot consist primarily of prepackaged consumer merchandise. Home Depot associates also utilize propane and lead-acid batteries to fuel/power lift equipment. Materials that may be involved in an incident include, but are not limited to the following: flammable and combustible liquids,flammable gases, aerosol products, corrosive liquids, water reactive liquids, liquid and solid oxidizers, and liquids classified as irritating,toxic or as having other health hazards. The first step in responding to an incident is to determine which products were involved in the incident. Home Depot associates must then immediately call 3E Company's Hazmat Response Team personnel via the spill hotline(800)451-8346. 3E will assist Home Depot associates to access applicable Material Safety Data Sheets to determine product characteristics. After the characteristics are known, the proper response will be determined. 6) Hazard Assessment Planning: Potentially hazardous products located at the facility are identified above. The primary hazard to The Home Depot associates and customers in the facility is the inhalation of spilled volatile hazardous chemicals. Once a release has been recognized, all customers and non-essential associates shall evacuate the area. Spill clean up procedures deemed appropriate in consultation with 3E Company are to be followed, including the donning of PPE (i.e. gloves, eye protection, etc.). No person shall attempt to mitigate the release unless the appropriate PPE level is available and the person is adequately trained. 7) Protection Planning: All non-essential Home Depot associates will be isolated from the area of any release. All responding (properly trained) associates in the area will don the appropriate level of PPE. Environmental concerns may be mitigated by the use of absorbents to clean up chemicals involved. All hazardous wastes will be stored and labeled properly by the responders. Because The Home Depot stores primarily carry pre-packaged consumer products, planning consists of proper storage, handling and disposal, (if necessary)of hazardous materials. See Training and Exercise Drills Section for additional information. 8) Coordination with Regulatory Agencies: In the unlikely event that an incident at The Home Depot would affect the surrounding areas, Home Depot Corporate Associates, or a designated representative will provide information and cooperation with all appropriate agencies. 9) Hazardous Waste Minimization: If a hazardous product cannot be sold as a"standard"product for any reason, the following methods are used to utilize the product: a) Markdown if sellable(non-leaking, clearly labeled products only) b) Return to vendor-for defective products only 10) Hazardous Waste Management: The Home Depot may generate waste as a result of severely damaged products or accidental chemical spills. Waste stored on-site is properly packaged, labeled, secured, maintained and inspected by The Home Depot associates prior to disposal in accordance to federal, state, and local regulations. Hazardous waste manifests are maintained on file for verification of proper waste management and disposal. The licensed contractor selected by The Home Depot in conjunction with 3E Company will oversee hazardous waste operations and disposals. The contractor is responsible for providing and maintaining all required decontamination equipment. 11) Logistics: Because of the minimal chance of an incident,The Home Depot will utilize only licensed professional emergency response contractors. The logistics will be the responsibility of the contractor. 12) Finance/procurement/ad,ministration: The acquisition of resources and any incident related cost will be handled by The Home Depot corporate office and their representatives. D) Incident Documentation: In the unlikely event of a substantial release, all appropriate federal, local, and state requirements will be met. This includes OSHA incident reports, spill/generator reports, and risk assessments. Contingency Plan 2014 6 E) Training and Exercise Drills: In compliance with the OSHA Hazard Communication Standard and the Resource Conservation Recovery Act, the Store Manager and the Human Resource Manager provide Associates with the following training: • Federal Hazard Communication Standard"Right to Know' Law • Hazards associated with exposure to hazardous chemicals • Labeling System • How to read Materials Safety Data Sheets(MSDS) • Proper use and maintenance of Personal Protective Equipment(PPE) • Operations in which hazardous chemicals are used • Hazards involved with ncn-routine tasks • Emergency procedures • Protective measures against exposures • Proper waste handling, storage and disposal The Home Depot associates are also instructed in identification and handling of hazardous materials in the workplace. Additionally,Associates are trained in the containment and mitigation of incidental small chemical releases. The aforementioned training is provided in the following classes: 1) Hazard Communication training video, 2) Comprehensive Handling,Hazardous Materials (HHM)Training and quiz, 3) Annual Safety Training 4) And specific department instructions. There are also weekly inspections of personal protective equipment and weekly audits of work areas to ensure safe practices are being followed. Training shall be conducted upon initial assignment or reassignment to a new work area. Emergency communication systems, fire protection equipment and spill control equipment are tested and maintained on a regular basis to ensure proper operation. The Human Resource or Training Manager will document that all appropriate and required training has been completed. After attending training sessions, each Associate is to sign off to verify that he/she attended and understands the training. On-site contractors are also to be informed of chemical hazards their employees may be exposed to while performing work at this facility. On-site contracting employer(s) shall be given access to a copy of the Right- To-Know guidelines. Contracting employer(s) must read and sign the guidelines. A copy is to be kept on file. F) Response Critique and Plan Review Modification Process: If a change to the Contingency Plan is needed (i.e., updated emergency contacts), Home Depot associates should contact 3E Company's Regulatory Department at(760)602-8700. The plan will be updated within 30 days of any change notifications. G) Prevention: The Home Depot maintains hazardous chemicals primarily in prepackaged consumer products merchandised for retail sale. Products merchandised are stocked in such a manner as to preclude accidental damage, and to prevent spills or accidental mixtures. H) Emergency Equipment: The following communication devices are available throughout the store: • Telephone System—Internal and external communication system used to communicate between Store Associates and with Emergency Responders. • PA System—Internal communication system used to relay emergency notification announcements to Store Associates and customers. • Mobile Phones—Wireless handsets used in conjunction with the telephone system. These handsets allow Store Associates to use the telephone system anywhere throughout the store. Contingency Plan 2014 7 • Two-Way Radios—Internal communication system used to relay emergency information between Store Associates. • Call Boxes—Internal communication system used to relay emergency information between Store Associates. The following emergency response equipment is available on site: • Spill Kits—Spill kits are located at designated areas in Receiving (Central Storage Area), Outside Garden, and Paint. These kits include a spill collection container, single-use nitrile gloves, safety glasses, absorbent; trash bags, overshoe or disposable shoe covers, mild cleaner, a broom, a dust pan, a shovel, and a permanent marker. The materials are used together to contain and/or clean up spills. • Fire Extinguishers—ABC-rated fire extinguishers are located in Receiving (Central Storage Area), Outside Garden, and Paint as well as other positions throughout the store. The extinguishers can be used to control minor fires. • Eye Wash Stations—Eye wash stations are maintained in Lumber, Paint, Garden, Front End (Returns), and Receiving (Central Storage Area). The equipment can be used to flush eyes. • Waste Storage Buckets—In addition to the spill kit collection container, 2.5-and 5-gallon containers with plastic liners and lids are stored in the Central Storage Area. These containers are used to collect and store spilled materials. • Waste Labels—Waste labels are printed on 8.5"by 11°paper and are affixed to the waste buckets with a plastic sleeve to communicate container contents and hazards. These labels are generated through the computer system in Receiving (Central Storage Area). 1)Aid Agreements and Emergency Response Coordination: The Home Depot has formally notified local police departments,fire departments, hospitals and applicable State and local emergency response teams to assist with the coordination of emergency services, pursuant to 40 CFR 265.37. Contingency Plan 2014 8 i Home Depot Store # 2612 1 st Floor 65 Independence Drive Hyannis,MA 02601 FIRE FIRE FIRE EXIT EXIT EXIT FIRE EXIT RECEIVING 6\ con z Z z m � � M M = PAINTS v FIRE Z EXIT p PAINTS a � o�c w z cc PAINTS FIRE c z a EXIT W o a CO LEGEND FERTILIZERS z_ You Are Here Fire Extinguisher Hazmat Storage � � � � (�� � GARDEN CHEMICALS Eye Wash ® ❑ FERTILIZERS Spill Kit H First Aid Fire Alarm Pull ® FIRE FIRE FIRE Emergency Gen. BEN I EXIT EXIT EXIT Above Ground Stor. T EVACUATION MEETING AREA f Cy J Number Fee 1290 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health o� This is to Certify that Kohls Department Store #1506 65 Independence Drive, Hyannis, WI Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. ----------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2017 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07101/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health • Town of Barnstable Regulatory Services Richard V. Scali,Director 3� AA fil am ' Public Health Division BARNSTABLE .� 16I9.7o1a Thomas McKean,Director � V 200 Main Street, Hyannis,lVIA 02601 Office: 508-802.4644 Fax: 508-790-6304 � N 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- l 10 Gallons: $ 50.00 O �CAT�EGGOR�Y12PERZM�ITII 1 -499 Gallons: $125.00CATEGORY3PEIT 500 or more Gallons: 15 .00 11 A late charge of$10.00 will be assessed if payment is not received by July 1st. ASSESSORS MAP AND PARCEL NO. DATE FULL NAME OF APPLICANT: �x k S Deem- -M,,K+ S�bx c - Sire i sn(o t1 av�nr3 NAME OF ESTABLISHMENT: ok'-, t cr r -e ADDRESS OF ESTABLISHMENT: ;V C' c,vt+n i S M A 0 D(od MAILING ADDRESS(IF DIFFERENT): � D 31 S S TELEPHONE NUMBER OF ESTABLISHMENT: EMAIL ADDRESS: Go ."al:[aNCr E LUL SOLE OWNER: YES _ .NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: SitA � O APPLICANT Name: �� Company Address Telephone#: Email: ATemp%HAZZAPP Revl6,docx Page i of ,P... _ r Number Fee 1114 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that A.C. MOORE#54 65 INDEPENDENCE DRIVE, HYANNIS, 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 cr ' i Town of Barnstable oti T Regulatory Services °s Thomas F. Geiler,Director r �'"&L Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. c�9YCKX012-DATE 618-\m APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT •C jnCr rQLrQ-�--a NAME OF ESTABLISHMENT A . c , C SC 1—I�IG�f 1'(llS, M►"� ADDRESS OF ESTABLISHMENT S-tt)W1(\dl 'NG W (DS I Ctiebe (xC 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.o)c` 9541 toll I STATE OF INCORPORATION - lJ - - FULL NAME AND HOME ADDRESS OF:PRESIDENT P1- Q 3AA(,,L�= j Q I- � �n r) QXTJ? TREASURER - CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE # I cl �� y A. Al-` M- 1100RE {H S C _ 9S CHeqt. ft@e*Share Mare Save more, Spill Continigency Plan When a spill occurs,time is of the essence to make sure a quick and safe clean-up occurs. In the event of a spill,the Team Member(s)who is first made aware of the spill or who caused the spill is responsible for prompt and proper clean-up. It is also their responsibility to have spill control and personal protective equipment appropriate for the chemicals being handled readily available.The Spill Kit to be used is located in the Janitor's Closet. Steps that must be followed: 1. Unless doing so would cause a hazard to the Team Member, remain with the spill and call for assistance. • If a volatile,flammable material is spilled, immediately warn everyone. • . If there is a fire or medical attention is needed,contact 911. • Attend to any people who may be contaminated. Contaminated clothing must be removed immediately and the skin flushed with water for no less than fifteen minutes.Clothing must be laundered before reuse. 2. Unless doing so would cause a hazard to the Team Member,while one Team Member stands with the spill, the other Team Member will grab the necessary items and will notify the MOD: a. "Caution-Wet Floor" sign b. Spill Kit, which includes the following items: • Spill absorbent (pads and sorbent socks) • Gloves • Disposable Plastic bag c. Brush and pan 3. Place the "Caution—Wet Floor" sign around the spill. 4. Evaluate the spill and make sure the area is secure. Evaluate the source and type of material spilled. 5. Using the chart below, determine the extent and type of spill. If the spill is large, if there has been a possible release to the environment or if you are not familiar with the liquid and its chemical properties,vacate the area and contact the local authorities for direction and assistance with the problem. 12.2014 I A. l :Treatment Category Size Response f l Materials i Small/Medium t� o 5 1absorption and clean up Use Spill Kit 1 !'liters I I � 3 I i Call the Fire Department I more than I(508)362-3312 and Large 5 liters ` 1 outside help The Health Department(617) 4 665-3838 i 6. After determining the type of substance you will be cleaning up, put on the personal protective equipment, as necessary. Refer to the Material Safety Data Sheet or other references for information. 7. Absorb liquid with pads and sorbent socks.Work from the outside edges toward the middle. This reduces the chance of splash or spread of the spill. 8. Let it sit for a few seconds and carefully use brush and pan to scoop the absorbed material(s) in the disposable plastic bag. 9. Dispose of the plastic bag. • If necessary, contact Human Resources Support(856)768-4970 for additional information concerning disposal. 10. Decontaminate the surface where the spill occurred using a mild detergent and water,when appropriate. 11. Leave the "Caution—Wet Floor" sign out until the floor has had time to fully dry`. 12. Ensure the floor is clean of any substance.Then remove the signage. 13. Replace absorbent materials and safety equipment, as needed by contacting HR Support at 856 768-4790Management will inspect the spill control products to ensure all equipment has been replenished and is in proper working order. 14. Any release of Hazardous Materials, into the group water or any sewage system, must immediately be reported to the following within 1 hour: 1. Barnstable Fire Department at 508 562-3312 2. Health Department at 617 665-3838 12.2014 �l +f a 3. Human Resources at 856 768-4970 15. Document spill and clean up using the Spill Log.The ongoing spill log should be kept in a binder. The Binder shall be kept in the Cash Office. 16. This Spill Contingency Plan must be posted in the break room. Owner: Store Manager: Pepe Piperno Marti Gruhn 130 A.C. Moore Drive 65 Independence Drive, Rte 132 Berlin, Ni 08009 Hyannis, MA 02601 (856) 768-4930 (508) 771-7669 12.2014 Number Fee 1114 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that A.C. MOORE#54 65 INDEPENDENCE DRIVE, 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. 1/9/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable °ft r Regulatory Services ti Thomas F. Geiler,Director eA MASS. Public Health Division '°Tfn 39. Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT In C NAME OF ESTABLISHMENT /T•C A,40C )Ce) /0Q /J. A ADDRESS OF ESTABLISHMENTga:M NO -1 0 ,2�0, 6 ,S- I r�l� rr OL, TELEPHONE NUMBER (501) -T� " 1 U(OC1 SOLE OWNER: VYES NO IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION ,'ware-- JEULLg� AME AND HOME ADDRESS OF: jr-RESIDENT REASURER a LEIS JADRESS SIGNATURE OF APPLICANT 19STRNCTIONS: HOME HOME TELEPHONE # Fee Number THE COMMONWEALTH OF MASSACHUSETTS 363 $100.00 Town of Barnstable Board of Health This is to Certify that Home Depot 65 Independence 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 r f Town of Barnstable Regulatory Services ti Thomas F. Geiler,Director '"MASS. Public Health Division 9.ibg ,g� D p Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE 06/05/2013 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT The Home Depot USA, Inc NAME OF ESTABLISHMENT The Home Depot#2612 ADDRESS OF ESTABLISHMENT 65 Independence Drive, Hyannis, MA 02601 TELEPHONE NUMBER(508)778-8948 SOLE OWNER: X YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: N/A IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION No.58-185-3319 STATE-OF INCORPORATION Georgia FULL NAME AND HOME ADDRESS OF: PRESIDENT Frank Blake-2455 Paces Ferry Road,Atlanta, GA 33039 TREASURER Dwaine Kimmet-2455 Paces Ferry Road,Atlanta, GA 33039 CLERK Jack VanWoerkom-2455 Paces Ferry Road,Atlanta, GA 33039 c�r'.?L� Gulsinay Harris,Agent for The Home Depot USA,Inc. SIGNATURE OF APPLICANT 3E Company/Regulatory Department RESTRICTIONS• HOME ADDRESS 3207 Grey Hawk Court,suite 200,Carlsbad,CA 92010 HOME TELEPHONE#(760)602-8700 3E Company f Haz.doc/wp/q 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 working days for in-house $ p Y (� g Y 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 June 6, 2013 Town of Barnstable Regulatory Services 200 Main Street Hyannis, MA 02601 ATTENTION: Thomas Mckean, Public Health Division SUBJECT: Contingency Plan The Home Depot#2612 65 Independence Drive Hyannis,MA 02601 The Home Depot U.S.A., Inc. authorizes 3E Company to act on its behalf in regard to regulatory reporting. The authorization includes the Town of Barnstable office's emergency plan reporting requirements. Based upon these requirements, please find enclosed the 2013 annual Contingency Plan, Application for permit and associated fees for your reference and review. Should you have any questions or concerns,please do not hesitate to contact me directly at(760) 602-8847. Sincerely, 3E COMPANY Gulsinay Harris Regulatory Compliance Coordinator Enclosure BETHF5DA,MD KiN6Spom,TN C AN101J,OH CCRUWAGM,DENMAT;i MONTREAL,QC,CANADA: I L Contingency Plan The Home Depot #2612 65 Independence Drive Hyannis, MA 02601 I Table of Contents Section I) Plan Introduction Elements Section II)General Information A) Business Information B) Emergency Contacts Section III)Core Plan Elements A) Discovery and Initial Response B) Evacuation C) Sustained Actions D) Termination and Follow-Up Actions Section IV)Annexes A) Facility and Locality Information B) Notification C) Response Management System 1) Command 2) Information 3) Safety 4) Liaison,Staff Mobilization 5) Operations 6) Hazard Assessment Planning 7) Protection Planning 8) Coordination with natural resource trustees 9) Hazardous Waste Minimization 10) Hazardous Waste Management 11) Logistics 12) Finance/procedure/administration D) Incident Documentation E) Training and Exercise Drills F) Response Critique and Plan Review Modification Process G) Prevention H) Emergency Equipment I) Aid Agreements and Emergency Response Coordination 2 Section I: Plan Introduction Elements Purpose and Scope of Plan Coverage The Home Depot is a retail home improvement center with prepackaged consumer products that are sold to the general public. The Home Depot also uses hazardous materials as fuel for forklifts,pallet jacks and other similar vehicles. The hazards associated with this facility are incidental releases. Hazardous materials are stored in various sizes,almost solely in consumer-packaged containers. This plan is being developed to comply with local,state,and federal regulations, including the Massachusetts Hazardous Waste Management Rules and 40 CFR 265 Subpart D. Section II: General Information A)Business Information Business Name: The Home Depot#2612 Business Address: 65 Independence Drive Hyannis,MA 02601 Phone Number: (508)778-8948 SIC Number: 5211 Business Description: Retail Home Improvement Center Owner/Operator: The Home Depot U.S.A.,Inc. 2455 Paces Ferry Road Atlanta,GA 30339 B)Emergency Contacts: Facility Associates: Primary Emergency Coordinator: Jay Worrell, Store Manager Office Phone: (508)778-8948 Primary 24 Hour Phone: (508)317-7896 cell Secondary Emergency Coordinator: Angie Cuevas,Operations Manager Office Phone: (508)778-8948 Secondary 24 Hour Phone: (561)703-4778 cell The Home Depot Corporate Personnel: Brandon Knox,Manager-Environmental Programs&Regulatory Compliance (770)384-2298,Home Depot Office Number 3E Company,Hazardous Materials Assistance 24 Hour Hotline(800)451-8346 In case of emergency contact: Fire Department: 911/Barnstable Fire Department Police Department 911/Barnstable Police Station Paramedic: 911 Poison Control 911 or(800)451-8346 MA DEP(Spill reporting): (888)304-1133 Hospital: (508)771-1800 Cape Cod Hospital 27 Park Street Hyannis,MA 02601 f 3 f Section III: Core Plan Elements A)Discovery and Initial Response: Once a Home Depot associate discovers or is informed of a release,they shall take the following steps: 1) Immediately evacuate the affected area of all customers and non-essential associates 2) Notify a Store Manager,Operations Manager or Department Manager to coordinate the clean up and initiate emergency notification procedures, if needed 3) Contact 3E Company(hazardous materials consultants)for product specific clean-up instructions,24 hours: (800)451-8346. 4) Obtain a spill clean-up kit from location closest to the spill(paint department,garden department,and receiving. The kit must contain rubber gloves,absorbent,broom,plastic shovel,durable bag and plastic container,and chemical splash goggles. 5) Only associates trained in these clean-up procedures can assist in the clean up of chemical spills. If the spill is greater than incidental or exceeds reportable quantities,the following procedures apply: 1) Immediately evacuate the affected area of all customers and non-essential associates 2) Notify a Store Manager,Operations Manager or Department Manager to coordinate the clean up and initiate emergency notification procedures 3) Notify 3E Company,24 hours: (800)451-8346. 3E Company will complete telephonic and written notifications to National Response Center(NRC)and/or State Emergency Response Commission (SERC)as needed. 4) Immediately contain spill if possible without exposing associates to hazard(dependant on the materials involved,location of spill etc.). 5) Notify corporate associates. Emergency Notification Procedures: The Home Depot corporate representatives, Store Manager on duty,or 3E Company will notify applicable federal, state, and local agencies.Massachusetts Department of Environmental Protection regulations require that all releases of hazardous materials be reported. State of MA DEP: (888)304-1133 Fire Department: 911 Once a Home Depot associate discovers a fire,they shall take the following steps: 1) Immediately evacuate the affected area of all customers and non-essential associates. 2) Notify the Phone Operator or Manager on Duty. 3) Use the closest pull station available to alert associates and customers. 4) Immediate notification of 911 for fire department response. 5) If necessary,initiate store evacuation. If an unforeseen explosion occurs,Home Depot associates shall take the following steps: 1) Immediately evacuate the affected area of all customers and non-essential associates. 2) Notify the Phone Operator or Manager on Duty. 3) Use the closest pull station available to alert associates and customers. 4) Immediate notification of 911 for fire department response. 5) Initiate store evacuation. B)Evacuation: 1) Signals that will be used to initiate evacuation include announcements over the PA system,verbal means and via two-radios that management personnel utilize. 2) Evacuation will occur through the nearest emergency exits that are located throughout the perimeter of the building. Exits are clearly marked with self-illuminating signs. The evacuation staging area is in front of the building in the parking lot. 4 C)Sustained Actions: In the unlikely event that a spill would require a prolonged clean-up procedure,The Home Depot would contact 3E Company to dispatch a licensed emergency response contractor. The following ER contractor may be used: PSC : 800-567-7455 The emergency response contractors will utilize properly trained associates to clean up and remove hazardous wastes at the facility. D)Termination and Follow-Up Actions: The emergency response contractor utilized will be responsible for the demobilization of any resources they may have used to mitigate the spill. Any hazardous waste generated as a result of the clean-up process will be handled in accordance with local, state,and federal regulations. The Home Depot associates,in conjunction with 3E Company representatives,will conduct accident investigations,and submit all applicable written reports to federal,state and local agencies. Section IV: Annexes A)Facility and Locality Information This Home Depot facility is a 79,878 square foot retail store with a garden center.This facility is equipped with an automatic sprinkler system that is maintained on a regular basis to ensure proper operation. B)Notification In the event that outside notification is required for an incident at The Home Depot,the manager on duty will make notification determinations and will appoint an assistant manager or applicable staff member to notify the people listed as emergency contacts in Section II. 3E Company will be notified immediately to review appropriate spill response procedures prior to spill clean up. The Fire Department and the NRC and/or SERC will be contacted by 3E Company or Home Depot management,or a designated representative when appropriate. In addition,the fire department will be notified in the event of any evacuation of a significant area or the building in its entirety. 3E may instruct store personnel to contact the fire department if a spill exceeds the capability,training, and/or resources of The Home Depot associates. C)Response Management System As previously stated, in the event of an emergency incident at The Home Depot,a licensed emergency response contractor will be called to mitigate the incident. Home Depot store management will inform responders as to the location of the release,and assist all fire department and emergency response contractors during an incident at the facility. 1) Command: The command post will be determined according the location and type of incident that is occurring. The manager on duty will disseminate information at the facility. The designated Home Depot representative on site(manager on duty—see Section IV,C,4)will inform all responders of the specific products involved in the incident,as well as notify them as to the location of emergency response equipment located in the facility. Home Depot associates will adhere to the guidance of outside emergency responders and corporate associates. 2) Information: Local, state and federal officials will be contacted should a major release occur. A major release includes any release that exceeds the reportable quantity or is beyond the mitigation and abatement capabilities of Home Depot associates. If further notification is required,the fire department, in conjunction with the police department,will contact neighboring facilities. 3) Safety: Upon discovery of a release,customers and associates will be evacuated from the area. If the release is significant or immediate danger to life or health,the facility will be evacuated. Evacuation will be initiated via the public address,two-way radio transmission,verbal commands,and/or fire alarm when appropriate. Home Depot associates will assist customers in locating the closest 5 emergency exits,which are illuminated. Once their department is clear of customers,The Home Depot associates will proceed to the pre-determined evacuation and staging area for a head count and further instruction. Emergency responders and clean up contractors will then be summoned for assistance. Only licensed contractors utilizing HAZWOPER-trained personnel will be used. 4) Liaison and Staff Mobilization:The Home Depot does not have an internal emergency response team and will follow the guidance of responding officials and the emergency response contractors dispatched to the incident. The manager on duty is responsible for informing the incident commander and local officials about the incident that has occurred. 5) Operations:Hazardous materials at The Home Depot consist primarily of prepackaged consumer merchandise. Home Depot associates also utilize propane and lead-acid batteries to fuel/power lift equipment. Materials that may be involved in an incident include,but are not limited to the following: flammable and combustible liquids,flammable gases,aerosol products,corrosive liquids,water reactive liquids, liquid and solid oxidizers,and liquids classified as irritating,toxic or as having other health hazards. The first step in responding to an incident is to determine which products were involved in the incident. Home Depot associates must then immediately call 3E Company's Hazmat Response Team personnel via the spill hotline(800)451-8346. 3E will assist Home Depot associates to access applicable Material Safety Data Sheets to determine product characteristics. After the characteristics are known,the proper response will be determined. 6) Hazard Assessment Planning: Potentially hazardous products located at the facility are identified above. The primary hazard to The Home Depot associates and customers in the facility is the inhalation of spilled volatile hazardous chemicals. Once a release has been recognized,all customers and non-essential associates shall evacuate the area. Spill clean up procedures deemed appropriate in consultation with 3E Company are to be followed, including the donning of PPE(i.e.gloves,eye protection,etc.). No person shall attempt to mitigate the release unless the appropriate PPE level is available and the person is adequately trained. 7) Protection Planning: All non-essential Home Depot associates will be isolated from the area of any release. All responding(properly trained)associates in the area will don the appropriate level of PPE. Environmental concerns may be mitigated by the use of absorbents to clean up chemicals involved. All hazardous wastes will be stored and labeled properly by the responders. Because The Home Depot stores primarily carry pre-packaged consumer products,planning consists of proper storage,handling and disposal,(if necessary)of hazardous materials. See Training and Exercise Drills Section for additional information. 8) Coordination with Regulatory Agencies: In the unlikely event that an incident at The Home Depot would affect the surrounding areas,Home Depot Corporate Associates,or a designated representative will provide information and cooperation with all appropriate agencies. 9) Hazardous Waste Minimization: If a hazardous product cannot be sold as a"standard"product for any reason,the following methods are used to utilize the product: a) Markdown if sellable(non-leaking,clearly labeled products only) b) Return to vendor-for defective products only 10) Hazardous Waste Management: The Home Depot may generate waste as a result of severely damaged products or accidental chemical spills. Waste stored on-site is properly packaged,labeled,secured, maintained and inspected by The Home Depot associates prior to disposal in accordance to federal,state, and local regulations. Hazardous waste manifests are maintained on file for verification of proper waste management and disposal. 6 The licensed contractor selected by The Home Depot in conjunction with 3E Company will oversee hazardous waste operations and disposals. The contractor is responsible for providing and maintaining all required decontamination equipment. 11) Logistics: Because of the minimal chance of an incident,The Home Depot will utilize only licensed professional emergency response contractors. The logistics will be the responsibility of the contractor. 12) Finance/procurement/administration: The acquisition of resources and any incident related cost will be handled by The Home Depot corporate office and their representatives. D)Incident Documentation: In the unlikely event of a substantial release,all appropriate federal,local, and state requirements will be met. This includes OSHA incident reports,spill/generator reports,and risk assessments. E) Training and Exercise Drills: In compliance with the OSHA Hazard Communication Standard and the Resource Conservation Recovery Act,the Store Manager and the Human Resource Manager provide Associates with the following training: • Federal Hazard Communication Standard"Right to Know' Law • Hazards associated with exposure to hazardous chemicals • Labeling System • How to read Materials Safety Data Sheets(MSDS) • Proper use and maintenance of Personal Protective Equipment(PPE) • Operations in which hazardous chemicals are used • Hazards involved with non-routine tasks • Emergency procedures • Protective measures against exposures • Proper waste handling, storage and disposal The Home Depot associates are also instructed in identification and handling of hazardous materials in the workplace. Additionally,Associates are trained in the containment and mitigation of incidental small chemical releases. The aforementioned training is provided in the following classes: 1) Hazard Communication training video, 2) Comprehensive Handling Hazardous Materials(HHM)Training and quiz, 3) Annual Safety Training 4) And specific department instructions. There are also weekly inspections of personal protective equipment and weekly audits of work areas to ensure safe practices are being followed. Training shall be conducted upon initial assignment or reassignment to a new work area. Emergency communication systems,fire protection equipment and spill control equipment are tested and maintained on a regular basis to ensure proper operation. The Human Resource or Training Manager will document that all appropriate and required training has been completed. After attending training sessions,each Associate is to sign off to verify that he/she attended and understands the training. On-site contractors are also to be informed of chemical hazards their employees may be exposed to while performing work at this facility. On-site contracting employer(s)shall be given access to a copy of the Right-To- Know guidelines. Contracting employer(s)must read and sign the guidelines. A copy is to be kept on file. 7 F)Response Critique and Plan Review Modification Process: If a change to the Contingency Plan is needed(i.e.,updated emergency contacts),Home Depot associates should contact 3E Company's Regulatory Department at(760)602-8700. The plan will be updated within 30 days of any change notifications. G)Prevention: The Home Depot maintains hazardous chemicals primarily in prepackaged consumer products merchandised for retail sale. Products merchandised are stocked in such a manner as to preclude accidental damage,and to prevent spills or accidental mixtures. I)) Emergency Equipment: The following communication devices are available throughout the store: • Telephone System—Internal and external communication system used to communicate between Store Associates and with Emergency Responders. • PA System—Internal communication system used to relay emergency notification announcements to Store Associates and customers. • Mobile Phones—Wireless handsets used in conjunction with the telephone system. These handsets allow Store Associates to use the telephone system anywhere throughout the store. • Two-Way Radios—Internal communication system used to relay emergency information between Store Associates. • Call Boxes—Internal communication system used to relay emergency information between Store Associates. The following emergency response equipment is available on site: • Spill Kits—Spill kits are located at designated areas in Receiving(Central Storage Area),Outside Garden, and Paint. These kits include a spill collection container,single-use nitrile gloves,safety glasses, absorbent,trash bags,overshoe or disposable shoe covers,mild cleaner,a broom, a dust pan,a shovel,and a permanent marker. The materials are used together to contain and/or clean up spills. • Fire Extinguishers—ABC-rated fire extinguishers are located in Receiving(Central Storage Area),Outside Garden,Paint as well as other positions throughout the store. The extinguishers can be used to control minor fires. • Eye Wash Stations—Eye wash stations are maintained in Lumber,Paint,Garden,Front End(Returns), and Receiving(Central Storage Area).The equipment can be used to flush eyes. • Waste Storage Buckets—In addition to the spill kit collection container,2.5-and 5-gallon containers with plastic liners and lids are stored in the Central Storage Area. These containers are used to collect and store spilled materials. • Waste Labels—Waste labels are printed on 8.5"by I I"paper and are affixed to the waste buckets with a plastic sleeve to communicate container contents and hazards. These labels are generated through the computer system in Receiving(Central Storage Area). 1)Aid Agreements and Emergency Response Coordination: The Home Depot has formally notified local police departments,fire departments,hospitals and applicable State and local emergency response teams to assist with the coordination of emergency services,pursuant to 40 CFR 265.37. 8 l f Phil LeGnard Assistant Manager 65 Independence Dr 1 Hyannis,Massachusetts 02601 (508)778-8948 asm_2612@homedepot.com ' www.homedepot.com IKE To Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 B"RMLE ASS- 200 Main Street• Hyannis, MA 02601 Fo►, TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name:— TUP-,Jo 12— Date: P Q (o Location/Mailing Address: to 5�TK n r .xe_ a I rl+is Contact Name/Phone: m AIt, So -T7 - 8`T+-I 8 - �I $J 11 „a�, '-1 o� 83 $9ooC.o�K d� •K•�,�R.� � Inventory Total Amount: '�tZ "47-e- MSDS: lCS- 3E License#: x Labelino: °' Spill Plan: e7 Oil/WaterSeparator: b Floor Drains: b Emer enc Numbers: e StorageAreas/Tanks: S PQftta o< VAA av"La�j •r a ot��eSk� Emergency/Containment Equipment: 5 i I k �"'� 5� w 5�r ag��� 5 ge wwske.. Q C 5k .t Waste Generator ID: 000 5' Waste Product: r� a Date&Amount of Last Shi ment/Fre u c : I to �- 900 , b� �ed, v +� d►toKk I + � �, a�rQ.�• Licensed Waste Hauler&Destination: ov%0 'AV g --7V kti\aw G-vw. -1VVVV,r&VLce Other Waste Disposal Methods: b���.ru LIST OF TOXIC AND HAZARDOUS MATERIALS �` '� -tAc-v) LP&Awk � �`a��s-� C°(.�'v tK i�ve KA-. NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform,formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECO ENDATIONS:Nr\ o(i ` sS b k �� k `.an , 14�Q�i �° I.UWtiVK�.� ow Y�G 1vW21lleCy(. ;Spector: Vj_0,4,5 -�cG,va ti 1) Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS JAV146-ry reC-I!-'Va Aso wt, 7�oYV_,Je o-� q1)% --�o l hay ,� zo,6�70 ya l f Number Fee 363 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health s This is to Certify that Home Depot 65 Independence 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 • Town of Barnstable Regulatory Services z Richard V. Scali,Director pip Public Health Division BARI-STABLE a, 679.& in Oft.r.a:.�rlr.ou ro u N10s Thomas McKean,Director " 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 p�kb Fax: 508-790-6304 1 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(RUMS 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 0 A late charee of S10.00 will be assessed if payment is not received by July 1st. ASSESSORS MAP AND PARCEL NO. DATE 6/1/16 FULL NAME OF APPLICANT:Jan King,Agent for The Home Depot USA., Inc. NAME OF ESTABLISHMENT: The Home Depot#2612 ADDRESS OF ESTABLISHMENT: 65 Independence Dr. Hyannis, MA 02601 MAILING ADDRESS(IF DIFFERENT): 3ECompany/Reg Dept/3207 Grey Hawk Ct.Ste 200 Carlsbad,CA 92010 TELEPHONE NUMBER OF ESTABLISHMENT: (508)778-8948 EMAIL ADDRESS: regulatory@3ecompany.com SOLE OWNER: X YES—NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME The Home Depot USA., Inc. PRESIDENT Craig Menear, 2455 Paces Ferry Rd.Atlanta, GA 30339, 770-433-8211 TREASURER Dwaine Kimmet, 2455 Paces Ferry Rd.Atlanta, GA 30339, 770-433-8211 CLERK EVP Theresa Wynn Roseborough-2455 Paces Ferry Rd.Atlanta, GA 30339, 770-433-8211 IF PREPARED BY OUTSIDE PARTY: SIGN TURE OF APPLICANT Name: Jan King,Agent for The Home Depot USA., Inc. • t� ' � �� Company Address : 3207 Grey Hawk Ct.Ste 200,Cadsbad,CA 92010 Telephone#: 760-602-8700 Email: regulatory@3ecompany.com C:\Temp\HAZ.ZAPP Revl6.docx Page 1 of2 °FINE Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMASAS.RLE. ` 200 Main Street• Hyannis, MA 02601 �prFOMP ff IT,OXIC AND HAZARDOUS MATERIALS INSPECTION REPORT [� Business Name: 0"A f- b-e 7 fl+- s�bYe, a�12 Date: I I I q 1 Location/Mai ling Address: Va Hh 16 Contact Name/Phone: `'�Cvn-t2c-1 Sc-4+-1 t=f�„� ��or o vti�rl ��� ef- mfv' Fra,,t. 61ty •�w�� SGo-s-1-►- o,7 z0 So , o ,5 a.,ti, a,10 P Inventory Total Amount: �'�B D tl>"��,O) MSDS: 3 onbk---40 hOKP— License#: 3 63 Tier II : *1,- + ce+ m9c Labeling: &ooX Spill Plan: e s Oil/WaterSeparator: Ai a Floor Drains: No Emergency Numbers: e S Storage Areas/Tanks: 2, k w'5ls•te� 5+2c1 - mot'--s I,.l Emergency/Containment Equipment: S ,I I -k-s k $offbew:t6 Waste Generator ID: M A R IOO Waste Product: M 15e- lawf --�oX}aefo�o�s, f a r Date&Amount of Last Shipment/Frequency: io 370 1 bs , ►X o. ✓1°K- A steux e-r Licensed Waste Hauler&Destination: 21 vtrl�. vt./. �-•> a�-I�!� �c�orl✓ YL a Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS — Av,y,Ve-AIly Up�2l{ ��� CQ Co� Covkyw 5S�ow- NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material uses o �-oV storage and disposal of 111 gallons or more requires a license from the Public Health Division. v o��zdw-srr-. we ✓ Antifreeze Dry cleaning fluids �'�m,44-to , /"� � 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: —7 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: INFORMATI /RECOMMENDATIONS: swte►�k-r eat, c,rafS are s� �econn Svv ore. -e-✓ -,,r ooe— co�9 Y, o �Zy " La��l 0,A-+J a� nn,?A�ktk& VYL � �J�oyt�CS O��'21�y Inspector: S 11 S to M b'1' " %Ay . Met�+�SFacility Representative: C �� A-oL\ �"76 11 q-6rCANARY �5e. WHITE COPY- HEALTH DEPARTMENT COPY- BUSINESS cFIKErpk ' Town of Barnstable Office:508-862-4644 �p` tio Public Health.Division Fax:508-790-6304 BARNSTABLE. MAC 200 Main Street;• Hyannis, MA 02601 1639. 'TiOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT t Business Name: f 0V�A�e_ �,�o'�� 5+e> Date: ► l ? Location/Mailing Address: Contact Name/Phone: �4. i. rYl„ ��u-t . deg-��' ire rK c J�( 1��rf c?l fr5'� =798- f� t L n n c o44 h C .,�- s��''(ca �nGYf I'.s `~. .. y,?114 f'r.JT r4,V- ✓r�4 r-I k a.. c fn D-�� -r- 67;Z o ¢, o Iw SOS cave /�. , 1( a r Inventory Total Amount: �-'1'� � >�'����) MSDS: 3-ON/Ft IQ -+.,a e?K,4-- License#: 131,4'75 � Tier II : Labeling: 6-oh2 Spill Plan: ')N e Oil/WaterSeparator: tj 4 • Floor Drains: Emergency Numbers: Sto rag e Areas/Jan ks: 2. kaV44,-, yx,'- e-f:5 0<4 c-1 c S i � (^'4I40,-9-16rb.,. -k Emergency/Containment Equipment: =4P-I I � k% yocbe�•-t5 ;", ,.a Waste Generator ID: M;F1 AQ,-00O S-I nq 0 2-" Waste Product: + 5�.rr►�wt��"v x<<cry fv5©�s; t r , Date&Amount of Last Shipment/Frequency: �'o ` 2 /�4 'TO ��3 ✓��?-�'�' if w�steufe Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS ;: .`�!'1 )Uw�1�,�;v� + �� C4 -�d� �.��► t55v�t,,, , k NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use'"'j storage and disposal of 111 gallons or more requires a license from the Public Health"Division. o� Jay Vest , Antifreeze Dry.cleaning fluidsfP�2►�° , 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 7 Cesspool cleaners Diesel fuel, kerosene, #2 heating oil -" Disinfectants Miscellaneous petroleum products: A �— Road salts grease, lubricants, gear oil a Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout a, insecticides, herbicides, rodenticides' Battery acid (electrolyte)/batteries Photochemicals(Fixers) J— Rustproofers r Photochemicals(Developer) '' Car wash detergents ' Printing ink ; Car waxes and polishes Wood preservatives(creosote) Asphalt&roofingtar Swimming pool chlorine ` Paints, varnishes;stains, dyes Lye or caustic soda Lacquer thinners. Miscellaneous Combustible,r� / Paint&varnish"removers, deglossers Leather dyes 4 V Miscellaneous Flammables Fertilizers �— Floor&furniture strippers PCB's �- Metal polishes Other chlorinated hydrocarbons Laundry soil&stain removers (including carbon tetrachloride) 1 (including bleach) ✓ Any other products with "poison"labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS:" ORDERS: INFORMATION/RECOMMENDATIONS:,,L-�Ytto,4--r {E:��i. f E4U�/1wt-e,v�.cx Su1�t-� �r'lv��,,.; �-�.`ts w<. +Mt�C2,�vf0��}4t:1- , .� .:2.: .�'{�C��i � -tn ����('•P , o► v ��� ) in�Pet�i`��, �"l v�' b• c q'vt� oc`k vim Inspector: G1k 4< pilvm! Fa�icilit Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS' °FINE toq� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 RnRMASS. g• 200 Main Street• Hyannis, MA 02601 �'DrEO MA+a`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT f Business Name: Rome- b-e o'�- #a t,012 Date: 1 I 1 1 1 Location/Mailin( Address: %Lo Sq-7 20 Contact Name/Phone: �a� \�o c,L 1 Y'D$--1-7 1991 L4 Qj r'G0.w rr.1A iJ15Q. W/ Lo•k�- e-i d-I '7_.4d)nl L7 5fiorv,J./ _ Invento Total Amount: MSDS: 5 1� 0Vk 1"^R-t 1A%o L- License#: V3 Tier II : - 7ki ClhS t5�- Labeling: Cr&0 SSpilI Plan: '/Ve_5 Oil/Water Separator: oA Floor Drains: KS a 5 0 Emergency Numbers: `e-`5 Storage Areas/Tanks: cl ,k� z -C Wa -i. . o a Emergency/Containment E ui ment: 60M V,4 -k 5y<VAkti Waste Generator ID: nooblvqly Waste Product: w 5tL A4 A.ros015 Date&Amount of Last Shipment/Frequen a row- c w�yte_wc� Licensed Waste Hauler&Destination: 1g C�vt�r — N e N4J tlAl/ cove AtD_, Other Wast Disposal Me hods• L T OF TOXI�AND HAZARDOUS MATERIAL NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage a d disposal of 11 gallons or more requires a license from ZhePublic Hea h Di Vision Ant reeze cl�anin fluids rY 9 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) I Any other products with "poison labels" (including chloroform, formaldehyde;7 6 D V� hydrochloric acid, other acids) CA- VIOLATI N ORDERS: A. y, INFORMATION/RECOM NDATIONS: Kit, �e, W,ft 1ti / 6�tl �01 `kn� Inspector: OLVL�v� op 0 kop ���Qarvt.Lab `Facility Representative: WQi SQ1PARTM HIDE COPY-HEALTHENT/CANARY COPY- BUSINESS -> °FINE r°k Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-7s0-6304 BARMASS. .g` 200 Main Street• Hyannis, MA 02601 i639 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rFD MP'� Business'Name: pome b2eoo+ `l � Date:Ti t/fc7 r ti Location/Mailing Address: S' ���c a2�,� �n r e_ c - , ����,�vt s >t c a(r7 n-77_0 Contact Name/Phone: `�c��/ t o t r'_ I 4• � r3-"7"7 Q, - ,rf chv � �C1c ytR�t iJi5Q w/ `J o Re,V, A Jr 4<)A1 L-:�7S M1Vf Inventory Total Amount: MSDS: License#: Tier II : y��� - �� (�.©.��' _ t; Labeling: �9'�v(� Spill Plan: `/-5 Oi[/Water Separator: of �,/,r•J(11 Floor Drains: 3�'�i ;�; Emergency Numbers: `A�Z Storage Areas/Tanks: sA}�I I.���'� �,1, < r hweD ur, vaa _ . rat, G�� :�,,5 1:,.�� ;.,1 CIA-. e,4� Emergency/Containment Equipment: 6- 11 tiQ.}t, y <ncb�h�ti Waste Generator ID: MA9000, I D oti Waste Product: UJ8,4} �4V" -�F ��.01S Date&Amount of Last Shipment/Frequency: 10 1 M i N r ,,n Licensed Waste Hauler&Destination: 115'cev'� v,\, t4l,,k -- @<a\4J 11AIJ V'Z vOV4 vtru_ 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 1 Dry c�eaning fluids Automatic transmission fluid J. Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash f Motor oils Miscellaneous Corrosives' Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants .�` Miscellaneous petroleum products: yl Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides; rodenticides i� Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) J Car wash detergents Printing ink f f' f Car wax n es and polishes ,� Wood preservatives(creosote) ti roofing&Asphalt As tar .r p g a .. Swimming pool chlorine / Paints, varnishes, stains, dyes Lye or caustic soda { '. f Lacquer thinners `' Miscellaneous Combustible ' . Paint&varnish removers, deglossers Leather dyes ✓ Miscellaneous Flammables +" Fertilizers f 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 .�J I �) /. (including chloroform, formaldehyde, , ,,� -,c. hydrochloric acid, other acids) } VIOLATIONS. ti� r U % ,4�.,. . i ORDERS: v �• 4 t /7 i F \,: �L44 LPL ts'Yl` e INFORMATION RECOMMENDATIONS: I ;vA 1A; Q, ^frti� �,� I�"��� �' �� 1� �: ���} Inspector: Gaa.�✓ �'. �,`vt�/ �j , tit !:^+VL : lh - '� �V 1.'fi� y 1r r,,.t0 Facility Representative: _ } '. WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS 1 a Number Fee 363 THE COMMONWEALTH OF MASSACHUSETTS $10o.00 Town of Barnstable Board of Health This is to Certify that Home Depot 65 Independence Road, Hyannis,MA 02601 Q Is Hereby Granted a License w 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 6/30/2013 unless sooner suspended or revoked. ----------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2012 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable oF, t Regulatory Services Thomas F. Geiler,Director B► NSTABM 9Q 16 MASS 9, 1qi� . v�FDMA'ta Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE 06/14/2012 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT The Home Depot USA, Inc NAME OF ESTABLISHMENT The Home Depot#2612 ADDRESS OF ESTABLISHMENT65 Independence Drive, Hyannis, MA 02601 TELEPHONE NUMBER(508) 778-8948 SOLE OWNER: X YES NO IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF ALL PARTNERS: N/A IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 58-185-3319 STATE OF INCORPORATION Georgia FULL NAME AND HOME ADDRESS OF: PRESIDENT Frank Blake-2455 Paces Ferry Road, Atlanta, GA 33039 TREASURER Dwaine Kimmet-2455 Paces Ferry Road, Atlanta, GA 33039 CLERK Jack VanWoerkom -2455 Paces Ferry Road, Atlanta, GA 33039 Gulsinay Harris,Agent for The Home Depot USA,Inc. SIGNATURE OF APPLICANT 3E Company/Regulatory Department RESTRICTIONS: HOME ADDRESS 3207 Grey Hawk Court,Suite 200,Carlsbad,CA 92010 HOME TELEPHONE #(760)602 -8700 3E Company r, f Contingency Plan The Home Depot #2612 65 Independence Drive Hyannis, MA 02601 1 Table of Contents Section I) Plan Introduction Elements Section II)General Information A) Business Information B) Emergency Contacts Section III)Core Plan Elements A) Discovery and Initial Response B) Evacuation C) Sustained Actions D) Termination and Follow-Up Actions Section IV)Annexes A) Facility and Locality Information B) Notification C) Response Management System 1) Command 2) Information 3) Safety 4) Liaison, Staff Mobilization 5) Operations 6) Hazard Assessment Planning 7) Protection Planning 8) Coordination with natural resource trustees 9) Hazardous Waste Minimization 10) Hazardous Waste Management 11) Logistics 12) Finance/procedure/administration D) Incident Documentation E) Training and Exercise Drills F) Response Critique and Plan Review Modification Process G) Prevention H) Emergency Equipment I) Aid Agreements and Emergency Response Coordination 2 I Section I: Plan Introduction Elements Purpose and Scope of Plan Coverage The Home Depot is a retail home improvement center with prepackaged consumer products that are sold to the general public. The Home Depot also uses hazardous materials as fuel for forklifts,pallet jacks and other similar vehicles. The hazards associated with this facility are incidental releases. Hazardous materials are stored in various sizes,almost solely in consumer-packaged containers. This plan is being developed to comply with local, state, and federal regulations,including the Massachusetts Hazardous Waste Management Rules and 40 CFR 265 Subpart D. Section II: General Information A)Business Information Business Name: The Home Depot#2612 Business Address: 65 Independence Drive Hyannis,MA 02601 Phone Number: (508)778-8948 SIC Number: 5211 Business Description: Retail Home Improvement Center Owner/Operator: The Home Depot U.S.A.,Inc. 2455 Paces Ferry Road Atlanta,GA 30339 B) Emergency Contacts: Facility Associates: Primary Emergency Coordinator: Jay Worrell, Store Manager Office Phone: (508)778-8948 Primary 24 Hour Phone: (508)317-7896 cell Secondary Emergency Coordinator: Tara Comeau,Operations Manager Office Phone: (508)778-8948 Secondary 24 Hour Phone: (774)260-1098 cell The Home Depot Corporate Personnel: Tom Wroblewski,Manager—Environmental Programs&Regulatory Compliance (770)384-3314-Home Depot Office Number 3E Company,Hazardous Materials Assistance 24 Hour Hotline(800)451-8346 In case of emergency contact: Fire Department: 911/13arnstable Fire Department Police Department 911/Barnstable Police Station Paramedic: 911 Poison Control 911 or(800)451-8346 MA DEP(Spill reporting): (888)304-1133 Hospital: (508)771-1800 Cape Cod Hospital 27 Park Street Hyannis,MA 02601 3 Section III: Core Plan Elements A)Discovery and Initial Response: Once a Home Depot associate discovers or is informed of a release,they shall take the following steps: 1) Immediately evacuate the affected area of all customers and non-essential associates 2) Notify a Store Manager,Operations Manager or Department Manager to coordinate the clean up and initiate emergency notification procedures,if needed 3) Contact 3E Company(hazardous materials consultants)for product specific clean-up instructions,24 hours: (800)451-8346. 4) Obtain a spill clean-up kit from location closest to the spill(paint department,garden department,and receiving. The kit must contain rubber gloves,absorbent,broom,plastic shovel,durable bag and plastic container,and chemical splash goggles. 5) Only associates trained in these clean-up procedures can assist in the clean up of chemical spills. If the spill is greater than incidental or exceeds reportable quantities,the following procedures apply: 1) Immediately evacuate the affected area of all customers and non-essential associates 2) Notify a Store Manager,Operations Manager or Department Manager to coordinate the clean up and initiate emergency notification procedures 3) Notify 3E Company,24 hours: (800)451-8346. 3E Company will complete telephonic and written notifications to National Response Center(NRC)and/or State Emergency Response Commission (SERC)as needed. 4) Immediately contain spill if possible without exposing associates to hazard(dependant on the materials involved,location of spill etc.). 5) Notify corporate associates. Emergency Notification Procedures: The Home Depot corporate representatives, Store Manager on duty,or 3E Company will notify applicable federal, state,and local agencies.Massachusetts Department of Environmental Protection regulations require that all releases of hazardous materials be reported. State of MA DEP: (888)304-1133 Fire Department: 911 Once a Home Depot associate discovers a fire,they shall take the following steps: 1) Immediately evacuate the affected area of all customers and non-essential associates. 2) Notify the Phone Operator or Manager on Duty. 3) Use the closest pull station available to alert associates and customers. 4) Immediate notification of 911 for fire department response. 5) If necessary, initiate store evacuation. If an unforeseen explosion occurs,Home Depot associates shall take the following steps: 1) Immediately evacuate the affected area of all customers and non-essential associates. 2) Notify the Phone Operator or Manager on Duty. 3) Use the closest pull station available to alert associates and customers. 4) Immediate notification of 911 for fire department response. 5) Initiate store evacuation. B)Evacuation: 1) Signals that will be used to initiate evacuation include announcements over the PA system,verbal means and via two-radios that management personnel utilize. 2) Evacuation will occur through the nearest emergency exits that are located throughout the perimeter of the building. Exits are clearly marked with self-illuminating signs. The evacuation staging area is in front of the building in the parking lot. 4 i f C)Sustained Actions: In the unlikely event that a spill would require a prolonged clean-up procedure,The Home Depot would contact 3E Company to dispatch a licensed emergency response contractor. The following ER contractor may be used: PSC : 800-567-7455 The emergency response contractors will utilize properly trained associates to clean up and remove hazardous wastes at the facility. D)Termination and Follow-Up Actions: The emergency response contractor utilized will be responsible for the demobilization of any resources they may have used to mitigate the spill. Any hazardous waste generated as a result of the clean-up process will be handled in accordance with local,state, and federal regulations. The Home Depot associates, in conjunction with 3E Company representatives,will conduct accident investigations,and submit all applicable written reports to federal,state and local agencies. Section IV: Annexes A)Facility and Locality Information This Home Depot facility is a 79,878 square foot retail store with a garden center.This facility is equipped with an automatic sprinkler system that is maintained on a regular basis to ensure proper operation. B)Notification In the event that outside notification is required for an incident at The Home Depot,the manager on duty will make notification determinations and will appoint an assistant manager or applicable staff member to notify the people listed as emergency contacts in Section II. 3E Company will be notified immediately to review appropriate spill response procedures prior to spill clean up. The Fire Department and the NRC and/or SERC will be contacted by 3E Company or Home Depot management,or a designated representative when appropriate. In addition,the fire department will be notified in the event of any evacuation of a significant area or the building in its entirety. 3E may instruct store personnel to contact the fire department if a spill exceeds the capability,training, and/or resources of The Home Depot associates. C)Response Management System As previously stated, in the event of an emergency incident at The Home Depot,a licensed emergency response contractor will be called to mitigate the incident. Home Depot store management will inform responders as to the location of the release,and assist all fire department and emergency response contractors during an incident at the facility. 1) Command: The command post will be determined according the location and type of incident that is occurring. The manager on duty will disseminate information at the facility. The designated Home Depot representative on site(manager on duty—see Section IV,C,4)will inform all responders of the specific products involved in the incident,as well as notify them as to the location of emergency response equipment located in the facility. Home Depot associates will adhere to the guidance of outside emergency responders and corporate associates. 2) Information: Local, state and federal officials will be contacted should a major release occur. A major release includes any release that exceeds the reportable quantity or is beyond the mitigation and abatement capabilities of Home Depot associates. If further notification is required,the fire department,in conjunction with the police department,will contact neighboring facilities. 3) Safety: Upon discovery of a release,customers and associates will be evacuated from the area. If the release is significant or immediate danger to life or health,the facility will be evacuated. Evacuation will be initiated via the public address,two-way radio transmission,verbal commands,and/or fire alarm when appropriate. Home Depot associates will assist customers in locating the closest 5 emergency exits,which are illuminated. Once their department is clear of customers,The Home Depot associates will proceed to the pre-determined evacuation and staging area for a head count and further instruction. Emergency responders and clean up contractors will then be summoned for assistance. Only licensed contractors utilizing HAZWOPER-trained personnel will be used. 4) Liaison and Staff Mobilization: The Home Depot does not have an internal emergency response team and will follow the guidance of responding officials and the emergency response contractors dispatched to the incident. The manager on duty is responsible for informing the incident commander and local officials about the incident that has occurred. 5) Operations: Hazardous materials at The Home Depot consist primarily of prepackaged consumer merchandise. Home Depot associates also utilize propane and lead-acid batteries to f iel/power lift equipment. Materials that may be involved in an incident include,but are not limited to the following: flammable and combustible liquids,flammable gases,aerosol products,corrosive liquids,water reactive liquids, liquid and solid oxidizers,and liquids classified as irritating,toxic or as having other health hazards. The first step in responding to an incident is to determine which products were involved in the incident. Home Depot associates must then immediately call 3E Company's Hazmat Response Team personnel via the spill hotline(800)451-8346. 3E will assist Home Depot associates to access applicable Material Safety Data Sheets to determine product characteristics. After the characteristics are known,the proper response will be determined. 6) Hazard Assessment Planning: Potentially hazardous products located at the facility are identified above. The primary hazard to The Home Depot associates and customers in the facility is the inhalation of spilled volatile hazardous chemicals. Once a release has been recognized,all customers and non-essential associates shall evacuate the area. Spill clean up procedures deemed appropriate in consultation with 3E Company are to be followed, including the donning of PPE(i.e. gloves, eye protection,etc.). No person shall attempt to mitigate the release unless the appropriate PPE level is available and the person is adequately trained. 7) Protection Planning: All non-essential Home Depot associates will be isolated from the area of any release. All responding(properly trained)associates in the area will don the appropriate level of PPE. Environmental concerns may be mitigated by the use of absorbents to clean up chemicals involved. All hazardous wastes will be stored and labeled properly by the responders. Because The Home Depot stores primarily carry pre-packaged consumer products,planning consists of proper storage,handling and disposal,(if necessary)of hazardous materials. See Training and Exercise Drills Section for additional information. 8) Coordination with Regulatory Agencies: In the unlikely event that an incident at The Home Depot would affect the surrounding areas,Home Depot Corporate Associates,or a designated representative will provide information and cooperation with all appropriate agencies. 9) Hazardous Waste Minimization: If a hazardous product cannot be sold as a"standard"product for any reason,the following methods are used to utilize the product: a) Markdown if sellable(non-leaking,clearly labeled products only) b) Return to vendor-for defective products only 10) Hazardous Waste Management: The Home Depot may generate waste as a result of severely damaged products or accidental chemical spills. Waste stored on-site is properly packaged,labeled,secured, maintained and inspected by The Home Depot associates prior to disposal in accordance to federal,state, and local regulations. Hazardous waste manifests are maintained on file for verification of proper waste management and disposal. 6 F The licensed contractor selected by The Home Depot in conjunction with 3E Company will oversee hazardous waste operations and disposals. The contractor is responsible for providing and maintaining all required decontamination equipment. 11) Logistics: Because of the minimal chance of an incident,The Home Depot will utilize only licensed professional emergency response contractors. The logistics will be the responsibility of the contractor. 12) Finance/procurement/administration: The acquisition of resources and any incident related cost will be handled by The Home Depot corporate office and their representatives. D)Incident Documentation: In the unlikely event of a substantial release, all appropriate federal,local,and state requirements will be met. This includes OSHA incident reports,spill/generator reports,and risk assessments. E) Training and Exercise Drills: In compliance with the OSHA Hazard Communication Standard and the Resource Conservation Recovery Act,the Store Manager and the Human Resource Manager provide Associates with the following training: • Federal Hazard Communication Standard"Right to Know' Law • Hazards associated with exposure to hazardous chemicals • Labeling System • How to read Materials Safety Data Sheets(MSDS) • Proper use and maintenance of Personal Protective Equipment(PPE) • Operations in which hazardous chemicals are used • Hazards involved with non-routine tasks • Emergency procedures • Protective measures against exposures • Proper waste handling,storage and disposal The Home Depot associates are also instructed in identification and handling of hazardous materials in the workplace. Additionally,Associates are trained in the containment and mitigation of incidental small chemical releases. The aforementioned training is provided in the following classes: 1) Hazard Communication training video, 2) Comprehensive Handling Hazardous Materials(HHM)Training and quiz, 3) Annual Safety Training 4) And specific department instructions. There are also weekly inspections of personal protective equipment and weekly audits of work areas to ensure safe practices are being followed. Training shall be conducted upon initial assignment or reassignment to a new work area. Emergency communication systems, fire protection equipment and spill control equipment are tested and maintained on a regular basis to ensure proper operation. The Human Resource or Training Manager will document that all appropriate and required training has been completed. After attending training sessions,each Associate is to sign off to verify that he/she attended and understands the training. On-site contractors are also to be informed of chemical hazards their employees may be exposed to while performing work at this facility. On-site contracting employer(s)shall be given access to a copy of the Right-To- Know guidelines. Contracting employer(s)must read and sign the guidelines. A copy is to be kept on file. F)Response Critique and Plan Review Modification Process: If a change to the Contingency Plan is needed(i.e.,updated emergency contacts),Home Depot associates should contact 3E Company's Regulatory Department at(760)602-8700. The plan will be updated within 30 days of any change notifications. G)Prevention: The Home Depot maintains hazardous chemicals primarily in prepackaged consumer products merchandised for retail sale. Products merchandised are stocked in such a manner as to preclude accidental damage,and to prevent spills or accidental mixtures. H) Emergency Equipment: The following communication devices are available throughout the store: • Telephone System—Internal and external communication system used to communicate between Store Associates and with Emergency Responders. • PA System—Internal communication system used to relay emergency notification announcements to Store Associates and customers. • Mobile;Phones—Wireless handsets used in conjunction with the telephone system. These handsets allow Store Associates to use the telephone system anywhere throughout the store. • Two-Way Radios—Internal communication system used to relay emergency information between Store Associates. • Call Boxes—Internal communication system used to relay emergency information between Store Associates. The following emergency response equipment is available on site: • Spill Kits—Spill kits are located at designated areas in Receiving(Central Storage Area),Outside Garden, and Paint. These kits include a spill collection container,single-use nitrile gloves, safety glasses, absorbent,trash bags,overshoe or disposable shoe covers,mild cleaner,a broom,a dust pan,a shovel, and a permanent marker. The materials are used together to contain and/or clean up spills. • Fire Extinguishers—ABC-rated fire extinguishers are located in Receiving(Central Storage Area),Outside Garden,Paint as well as other positions throughout the store. The extinguishers can be used to control minor fires. • Eye Wash Stations—Eye wash stations are maintained in Lumber,Paint,Garden,Front End(Returns),and Receiving(Central Storage Area).The equipment can be used to flush eyes. • Waste Storage Buckets—In addition to the spill kit collection container,2.5-and 5-gallon containers with plastic liners and lids are stored in the Central Storage Area. These containers are used to collect and store spilled materials. • Waste Labels—Waste labels are printed on 8.5"by I I"paper and are affixed to the waste buckets with a plastic sleeve to communicate container contents and hazards. These labels are generated through the computer system in Receiving(Central Storage Area). I)Aid Agreements and Emergency Response Coordination: The Home Depot has formally notified local police departments,fire departments,hospitals and applicable State and local emergency response teams to assist with the coordination of emergency services,pursuant to 40 CFR 265.37. 8 June 15, 2012 Town of Barnstable Regulatory Services 200 Main Street Hyannis, MA 02601 ATTENTION: Thomas Mckean, Public Health Division SUBJECT: Contingency Plan The Home Depot#2612 65 Independence Drive Hyannis,MA 02601 The Home Depot U.S.A., Inc. authorizes 3E Company to act on its behalf in regard to regulatory reporting. The authorization includes the Town of Barnstable office's emergency plan reporting requirements. Based upon these requirements, please find enclosed the 2012 annual Contingency Plan, Application for permit and associated fees for your reference and review. Should you have any questions or concerns,please do not hesitate to contact me directly at (760) 602-8847. Sincerely, 3E COMPANY GulsinaY Harris Regulatory Compliance Coordinator Enclosure BETHESPA,MD KiNcseoar,TN CANTON,OH Crpeyi�a�oa,.[�eia fti�r,� MONTREAL,QC,CANADA w, Number Fee 363 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board'of Health This is to Certify that Home Depot 65Independence 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 6/30/2011 unless sooner suspended or revoked. WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. _ 6/30/2010 JUNICHI SAWAYANAGI THOMAS A. MCKEAN,R.S.,CHO Director of Public Health Y-a l t Town of Barnstable °FIRE pow Regulatory Services Thomas F. Geiler,Director BAR MASS. : Public Health Division y ASS. 039. �0 �1E0 MAIa Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE 06/21/2010 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT The Home Depot USA, Inc. NAME OF ESTABLISHMENT The Home Depot#2612 ADDRESS OF ESTABLISHMENT 65 Independence Drive, Hyanis, MA 02601 TELEPHONE NUMBER (508) 778-8948 SOLE OWNER: X YES NO IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF ALL PARTNERS: N/A IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION No.58-185-3319 STATE OF INCORPORATION Georgia FULL NAME AND HOME ADDRESS OF: PRESIDENT Frank Blake-2455 Paces Ferry Road, Atlanta, GA 33039 TREASURER Dwaine Kimmet- 2455 Paces Ferry Road,Atlanta, GA 30339 CLERK Jack VanWoerkom -2455 Paces Ferry Road;.A.tlanta, GA 33039 (Corporate Secretary) r S 6' Gulsinay Harris,Agent for the Home Depot USA,Inc. . / SIGNATURE OF APPLICANT "- RESTRICTIONS: 'f HOME ADDRESS :: j�HQ rtj f--tKEPyHONE # r I • Haz.doc/wp/q 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 • Contingency Plan The Home Depot 92612 65 Independence Drive Hyannis, MA 02601 • Table of Contents Section I) Plan Introduction Elements Section II)General Information A) Business Information B) Emergency Contacts Section III)Core Plan Elements A) Discovery and Initial Response B) Evacuation C) Sustained Actions D) Terminatior and Follow-Up Actions Section IV)Annexes A) Facility and Locality Information B) Notificatioe C) Response Management System 1) Command 2) Information 3) Safety 4) Liaison, Staff Mobilization 5) Operations 6) Hazard Assessment Planning 7) Protection Planning 8) Coordination with natural resource trustees 9) Hazardous Waste Minimization 10) Hazardous Waste Management a 11) Logistics 12) Finance/procedure/administration - D Incident Documentation E) Training and Exercise Drills - - — ---F) Response Critique and Plan Review Modification Process - G) Prevention _ _ - -� Amerg—= P enc q� uui merit_ — I) Aid Agreements and Emergency Response Coordination • 2 f , • Section I: Plan Introduction Elements Purpose and Scope of Plan Coverage The Home Depot is a retail home improvement center with prepackaged consumer products that are sold to the general public.The Home Depot also uses hazardous materials as fuel for forklifts,pallet jacks and other similar vehicles. The hazards associated with this facility are incidental releases.Hazardous materials are stored in various sizes,almost solely in consumer-packaged containers.This plan is being developed to comply with local,state,and federal regulations,including the Massachusetts Hazardous Waste Management Rules and 40 CFR 265 Subpart D. Section II: General Information A)Business'Information Business Name: The Home Depot#2612 Business Address: 65 Independence Drive Hyannis,MA 02601 Phone Number: (508)778-8948 SIC Number: 5211 Business Description: Retail Home Improvement Center Owner/Operator: The Home Depot U.S.A.,Inc. 2455 Paces Ferry Road Atlanta,GA 30339 B)Emergency Contacts: Facility Associates: Primary Emergency Coordinator: Tom Yaghoobian, Store Manager . Office Phone: (508)778-8948 Primary 24 Hour Phone: (617)653-1828 cell Secondary Emergency Coordinator: Tara Comeau,Operations Manager Office Phone: (508)778-8948 Secondary 24 Hour Phone: (508)207-0580 cell e Home Depot Corporate Personnel. - Ryan Williams,Manager—Environmental Programs (770)3844980 Home Depot Office Number 3E Company,Hazardous Materials Assistance 24 Hour Hotline(800)451-8346 In case of emergency contact: Fire Department: 911/Barnstable Fire Station Police Department: 911/Barnstable Police Station Paramedic: 911 Poison Control: 911 or(800)451-8346 MA DEP(spill reporting):(888)304-1133 Hospital: (508)771-1800 Cape Cod Hospital 27 Park Street Hyannis,MA 02601 • 3 r I i • Section III: Core Plan Elements A)Discovery and Initial Response: Once a Home Depot associate discovers or is informed of a release,they shall take the following steps: 1) Immediately evacuate the affected area of all customers and non-essential associates 2) Notify a Store Manager,Operations Manager or Department Manager to coordinate the clean up and initiate emergency notification procedures,if needed 3) Contact 3E Company(hazardous materials consultants)for product specific clean-up instructions,24 hours: (800)451-8346. 4) Obtain a spill clean-up kit from location closest to the spill(paint department,garden department,and receiving).The kit must contain rubber gloves,absorbent,broom,plastic shovel,durable bag and plastic container,and chemical splash goggles. 5) Only associates trained in these clean-up procedures can assist in the clean up of chemical spills. If the spill is greater than incidental or exceeds reportable quantities,the following procedures apply: 1) Immediately evacuate the affected area of all customers and non-essential associates 2) Notify a Store Manager,Operations Manager or Department Manager to coordinate the clean up and initiate emergency notification procedures 3) Notify 3E Company,24 hours:(800)451-8346.3E Company will complete telephonic and written notifications to National Response Center(NRC)and/or State Emergency Response Commission (SERC)as needed. 4) Immediately contain spill if possible without exposing associates to hazard(dependant on the materials involved,location of spill etc.). 5) Notify corporate associates. Emergency Notification Procedures: • The Home Depot corporate representatives,Store Manager on duty,or 3E Company will notify applicable federal, state,and local agencies.Massachusetts Department of Environmental Protection(DEP)regulations require that all releases of hazardous materials be reported. State of MA DEP: (888)304-1133 Fire Department: 911 Once a Home Depot associate discovers a fire,they shall take the following steps: 1) Immediately evacuate the affected area:of all customers and non-essential associates: ---- - - - _ 2) Notify the Phone Operator or Manager on Duty. 3) Use the closest pull station available to alert associates and customers. 4) Immediate notification of 911 for fire department response. 5) If necessary,initiate store evacuation. If an unforeseen explosion occurs,Home Depot associates shall take the following steps: 1) Immediately evacuate the affected area of all customers and non-essential associates. 2) Notify the Phone Operator or Manager on Duty. 3) Use the closest pull station available to alert associates and customers. 4) Immediate notification of 911 for fire department response. 5) Initiate store evacuation. B)Evacuation: 1) Signals that will be used to initiate evacuation include announcements over the PA system,verbal means and via two-radios that management personnel utilize. 2) Evacuation will occur through the nearest emergency exits that are located throughout the perimeter of the building. Exits are clearly marked with self-illuminating signs. The evacuation staging area is in front of the building in the parking lot. • 4 • C)Sustained Actions: In the unlikely event that a spill would require a prolonged clean-up procedure,The Home Depot would contact 3E Company to dispatch a licensed emergency response contractor. The following ER contractor may be used: PSC: 800-567-7455 The emergency response contractors will utilize properly trained associates to clean up and remove hazardous wastes at the facility. D)Termination and Follow-Up Actions: The emergency response contractor utilized will be responsible for the demobilization of any resources they may have used to mitigate the spill. Any hazardous waste generated as a result of the clean-up process will be handled in accordance with local,state,and federal regulations. The Home Depot associates,in conjunction with 3E Company representatives,will conduct accident investigations,and submit all applicable written reports to federal, state and local agencies. Section IV: Annexes A)Facility and Locality Information This Home Depot facility is 79,878 square foot retail store with a garden center. This facility is equipped with an automatic sprinkler system that is maintained on a regular basis to ensure proper operation. B)Notification In the event that outside notification is required for an incident at The Home Depot,the manager on duty will make notification determinations and will appoint an assistant manager or applicable staff member to notify the people • listed as emergency contacts in Section II. 3E Company will be notified immediately to review appropriate spill response procedures prior to spill clean up. The Fire Department and the NRC and/or SERC will be contacted by 3E Company or Home Depot management,or a designated representative when appropriate. In addition,the fire department will be notified in the event of any evacuation of a significant area or the building in its entirety. 3E may instruct store personnel to contact the fire department if a spill exceeds the capability,training,and/or resources of The Home Depot associates. C)Response Management System -- - -.As previously stated,in the even t.of an emergency incident at The Home Depot,a licensed emergency response -- contractor will be called to mitigate the incident. Home Depot store management will inform responders as to the location of the release,and assist all fire department and emergency response contractors during an incident at the facility. _ 1) Command: The command post will be determined according the location and type of incident that is occurring. The manager on duty will disseminate information at the facility. The designated Home Depot representative on site(manager on duty—see Section IV,C,4)will inform all responders of the specific products involved in the incident,as well as notify them as to the location of emergency response equipment located in the facility. Home Depot associates will adhere to the guidance of outside emergency responders and corporate associates. 2) Information: Local,state and federal officials will be contacted should a major release occur. A major release includes any release that exceeds the reportable quantity or is beyond the mitigation and abatement capabilities of Home Depot associates. If further notification is required,the fire department,in conjunction with the police department,will contact neighboring facilities. - 3) Safety: Upon discovery of a release,customers and associates will be evacuated from the area. If the release is significant or immediate danger to life or health,the facility will be evacuated. • Evacuation will be initiated via the public address,two-way radio transmission,verbal commands,and/or fire alarm when appropriate. Home Depot associates will assist customers in locating the closest 5 • emergency exits,which are illuminated. Once their department is clear of customers,The Home Depot associates will proceed to the pre-determined evacuation and staging area for a head count and further instruction. Emergency responders and clean up contractors will then be summoned for assistance. Only licensed contractors utilizing HAZWOPER-trained personnel will be used. 4) Liaison and Staff Mobilization: The Home Depot does not have an internal emergency response team and will follow the guidance of responding officials and the emergency response contractors dispatched to the incident. The manager on duty is responsible for informing the incident commander and local officials about the incident that has occurred_ 5) Operations:Hazardous materials at The Home Depot consist primarily of prepackaged consumer merchandise. Home Depot associates also utilize propane and lead-acid batteries to fuel/power lift equipment. Materials that may be involved in an incident include,but are not limited to the following: flammable and combustible liquids,flammable gases,aerosol products,corrosive liquids,water reactive liquids,liquid and solid oxidizers,and liquids classified as irritating,toxic or as having other health hazards. The first step in responding to an incident is to determine which products were involved in the incident. Home Depot associates must then immediately call 3E Company's Hazmat Response Team personnel via the spill hotline(800)451-8346. 3E will assist Home Depot associates to access applicable Material Safety Data Sheets to determine product characteristics. After the characteristics are known,the proper response will be determined. 6) Hazard Assessment Planning: Potentially hazardous products located at the facility are identified above. The primary hazard to The Home Depot associates and customers in the facility is the inhalation of spilled volatile hazardous chemicals. Once a release has been recognized,all customers and non-essential associates shall evacuate the area. Spill clean up procedures deemed appropriate in consultation with 3E • Company are to be followed,including the donning of PPE(i.e.gloves,eye protection,etc.). No person shall attempt to mitigate the release unless the appropriate PPE level is available and the person is adequately trained. 7) Protection Planning: All non-essential Home Depot associates will be isolated from the area of any release. All responding(properly trained)associates in the area will don the appropriate level of PPE. Environmental concerns may be mitigated by the use of absorbents to clean up chemicals involved. All —__�- -- hazardous.wastes.will be..stored and labeled properly.by.the responders._.,; Because The Home Depot stores primarily carry pre-packaged consumer products,planning consists of proper storage,handling and disposal,(if necessary)of hazardous materials. See Training and Exercise Drills Section for additional information. 8) Coordination with Regulatory Agencies: In the unlikely event that an incident at The Home Depot would affect the surrounding areas,Home Depot Corporate Associates,or a designated representative will provide information and cooperation with all appropriate agencies. 9) Hazardous Waste Minimization: If a hazardous product cannot be sold as a"standard"product for any reason,the following methods are used to utilize the product: a) Markdown if sellable(non-leaking,clearly labeled products only) b) Return to vendor-for defective products only 10) Hazardous Waste Management: The Home Depot may generate waste as a result of severely damaged products or accidental chemical spills. Waste stored on-site is properly packaged,labeled,secured, maintained and inspected by The Home Depot associates prior to disposal in accordance to federal,state, and local regulations. Hazardous waste manifests are maintained on file for verification of proper waste • management and disposal. 6 f • The licensed contractor selected by The Home Depot in conjunction with 3E Company will oversee hazardous waste operations and disposals. The contractor is responsible for providing and maintaining all required decontamination equipment. 11) Logistics: Because of the minimal chance of an incident,The Home Depot will utilize only licensed professional emergency response contractors. The logistics will be the responsibility of the contractor. 12) Finance/procuremen-Jadministration-- The acquisition of resources and any incident related cost will be handled by The Home Depot corporate office and their representatives. D)Incident Documentation: In the unlikely event of a substantial release,all appropriate federal,local,and state requirements will be met. This includes OSHA incident reports,spill/generator reports,and risk assessments. E) Training and Exercise Drills: In compliance with the OSHA Hazard Communication Standard and the Resource Conservation Recovery Act,the Store Manager and the Human Resource Manager provide Associates with the following training: • Federal Hazard Communimfon Standard"Right to Know'Law • Hazards associated with exposure to hazardous chemicals • Labeling System • How to read Materials Safety Data Sheets(MSDS) • Proper use and maintenance of Personal Protective Equipment(PPE) • Operations in which hazardous chemicals are used • Hazards involved with nor-routine tasks • Emergency procedures • Protective measures against exposures • • Proper waste handling,storage and disposal The Home Depot associates are also instructed in identification and handling of hazardous materials in the -- — workplace. Additionally,Associates are trained in the containment and mitigation of incidental small chemical releases. The aforementioned training is provided in the following classes: 1) Hazard Communication training video, - -- 2) Comprehensive Handling Hazardous Materials(HHM)Training and quiz, 3) Annual Safety Training 4) And specific department instructions. There are also weekly inspections of personal protective equipment and weekly audits of work areas to ensure safe practices are being followed. Training shall be conducted upon initial assignment or reassignment to a new work area. Emergency communication systems,fire protection equipment and spill control equipment are tested and maintained on a regular basis to ensure proper operation. The Human Resource or Training Manager will document that all appropriate and required training has been 'completed. After attending training sessions,each Associate is to sign off to verify that he/she attended and understands the training. On-site contractors are also to be informed of chemical hazards their employees may be exposed to while performing work at this facility. On-site contracting employer(s)shall be given access to a copy of the Right-To- Know guidelines. Contracting employer(s)must read and sign the guidelines. A copy is to be kept on file. i 7 4 • t • F)Response Critique and Plan Review Modification Process: If a change to the contingency plan is needed(i.e.,updated emergency contacts),Home Depot associates should contact 3E Company's Regulatory Department at(760)602-8700. The plan will be updated within 30 days of any change notifications. 1 G)Prevention: The Home Depot maintains hazardous chemicals primarily in prepackaged consumer products merchandised for retail sale. Products merchandised are stocked in such a manner as to preclude accidental damage,and to prevent spills or accidental mixtures. H) Emergency Equipment: The following communication devices are available throughout the store: • Telephone System—Internal and external communication system used to communicate between Store Associates and with Emergency Responders. • PA System—Internal communication system used to relay emergency notification announcements to Store Associates and customers. • Mobile Phones—Wireless handsets used in conjunction with the telephone system. These handsets allow Store Associates to use the telephone system anywhere throughout the store. • Two-Way Radios—Internal communication system used to relay emergency information between Store Associates. • Call Boxes—Internal communication system used to relay emergency information between Store Associates. The following emergency response equipment is available on site: • • Spill Kits—Spill kits are located at designated areas in Receiving(Central Storage Area),Outside Garden, Paint Center. These kits include a spill collection container, single-use nitrile gloves,safety glasses, absorbent,trash bags,overshoe or disposable shoe covers,mild cleaner,a broom,a dust pan,a shovel,and a permanent marker. The materials are used together to contain and/or clean up spills. • Fire Extinguishers—ABC-rated fire extinguishers are located in Receiving(Central Storage Area),Outside Garden,Paint Center as well as other positions throughout the store. The extinguishers can be used to control minor fires. • Eye Wash Stations—Eye wash stations are maintained in Lumber,Paint,Garden,Front End(Returns),and Receiving(Central Storage Area). The equipment can be used to flush eyes: _ • Waste Storage Buckets—In addition to the spill kit collection container,2.5-and 5-gallon containers with plastic liners and lids are stored in the Central Storage Area. These containers are used to collect and store spilled materials. • Waste Labels—Waste labels are printed on 8.5"by I I"paper and are affixed to the waste buckets with a plastic sleeve to communicate container contents and hazards. These labels are generated through the computer system in Receiving(Central Storage Area). 1)Aid Agreements and Emergency Response Coordination: The Home Depot has formally notified local police departments, fire departments,hospitals and applicable State and local emergency response teams to assist with the coordination of emergency services,pursuant to 40 CFR 265.37. • 8 1 - „„ EH&S INFURMA71ON&CCYRUANCC SERVICES li Y • & a, e n xi. a Yy A .f 1f v 1A : � .:1 i 1'1 .1 •1 r � .: k a c •c-. u -.'� ..:� ,p.S•,.na'.. .M :.:. m m..a.:.q E � .h�. *+a a aw.q? ..,x tP N:. ..,i.. f June 21, 2010 Town of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 ATTENTION: Regulatory Services SUBJECT: Contingency Plan The Home Depot#2612 65 Independence Drive Hyannis, MA 02601 The Home Depot U.S.A., Inc. authorizes 3E Company to act on its behalf in regard to regulatory reporting. The authorization includes the Town of Barnstable Public Health Division's emergency plan reporting requirements. Based upon these requirements, • please find enclosed the 2010 annual Contingency Plan, application for permit and a check to cover the associated fees for your reference and review. Should you have any questions or concerns, please do not hesitate to contact me directly at (760) 602-8847. Sincerely, 3E COMPANY Gulsinay Harris Regulatory Compliance Coordinator Enclosure RE NA KmrsP(-!P.r,TtqM ,OH Number Fee 363 THE COMMONWEALTH OF MASSACHUSETTS $100.0o Town of Barnstable Board of Health This is to Certify that Home Depot 0 65 Independence 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 �.! EH£t5 lkfGRHr11Ct+&C�dPL3ANC£5ER"<pEg. f June 9, 2009 Town of Barnstable 200 Main Street Hyannis, MA 02601 ATTENTION: Public Health Division SUBJECT: Contingency Plan and Hazardous Materials Permit The Home Depot#2612 65 Independence Drive Hyannis,MA 02601 The Home Depot U.S.A., Inc. authorizes 3E Company to act on its behalf in regard to regulatory reporting. The authorization includes the Town of Barnstable Public Health Division's emergency plan reporting requirements. Based upon these requirements, • please find enclosed the 2009 annual Contingency Plan, Hazardous Materials Permit Application, and payment for your reference and review. Should you have any questions or concerns,please do not hesitate to contact me directly at(760) 602-8890. Sincerely, 3E COMPANY Zli Maggie Metzler ': Regulatory Compliance Coordinator r ; Enclosure ca t • BETHEsSDA,MD KiNcs gat,Tip YIAWt,WN,OH CO3PEN;tA,,tL.DF„N>APK M011- EAL,QC,CrtldADA Town of Barnstable THE r, Regulatory Services • Thomas F. Geiler,Director BA MASS. ' Public Health Division y MASS. �w 1639• iDrFomo�° Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE 06/26/2009 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT The Home Depot USA, Inc. NAME OF ESTABLISHMENT The Home Depot#2612 ADDRESS OF ESTABLISHMENT 65 Independence Drive, Hyanis, MA 02601 • TELEPHONE NUMBER (508) 778-8948 SOLE OWNER: X YES NO IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF ALL PARTNERS: N/A IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION No.58-185-3319 STATE OF INCORPORATION Georgia FULL NAME AND HOME ADDRESS OF: PRESIDENT Frank Blake-2455 Paces Ferry Road, Atlanta, GA 33039 TREASURER Rebecca I. Flick-2455 Paces Ferry Road,Atlanta, GA 30339 CLERK Jack VanWoerkom-2455 Paces Ferry Road, Atlanat, GA 33039 (Corporate Secretary) fGulsinay Harris,Agent for the Home Depot USA,Inc. SIGNATURE OF APPLICANT • RESTRICTIONS: HOME ADDRESS HOME TELEPHONE # 1 • Haz.doc/wp/q 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 • Contingency Plan The Home Depot #2612 65 Independence Drive Hyannis, MA 02601 L • Section I) Plan Introduction Elements Table of Contents Section 11)General Information A) Business Information B) Emergency Contacts Section III)Core Plan Elements A) Discovery and Initial Response B) Evacuation C) Sustained Actions D) Termination and Follow-Up Actions Section IV)Annexes A) Facility and Locality Information B) Notification C) Response Management System 1) Command 2) Information 3) Safety 4) Liaison,Staff Mobilization 5) Operations 6) Hazard Assessment Planning 7) Protection Planning 8) Coordination with natural resource trustees 9) Hazardous Waste Minimization • 10) Hazardous Waste Management 11) Logistics 12) Finance/procedure/administration D) Incident Documentation E) Training and Exercise Drills F) Response Critique and Plan Review Modification Process G) Prevention H) Emergency Equipment I) Aid Agreements and Emergency Response Coordination • 2 f • Section I: Plan Introduction Elements Purpose and Scope of Plan Coverage The Home Depot is a retail home improvement center with prepackaged consumer products that are sold to the general public. The Home Depot also uses hazardous materials as fuel for forklifts,pallet jacks and other similar vehicles. The hazards associated with this facility are incidental releases. Hazardous materials are stored in various sizes,almost solely in consumer-packaged containers. This plan is being developed to comply with local,state,and federal regulations,including the Massachusetts Hazardous Waste Management Rules and 40 CFR 265 Subpart D. Section II: General Information A)Business Information Business Name: The Home Depot#2612 Business Address: 65 Independence Drive Hyannis,MA 02601 Phone Number: (508)778-8948 SIC Number: 5211 Business Description: Retail Home Improvement Center Owner/Operator: The Home Depot U.S.A.,Inc. 2455 Paces Ferry Road Atlanta,GA 30339 B)Emergency Contacts: Facility Associates: Primary Emergency Coordinator: Tom Yaghoobian,Store Manager Office Phone: (508)778-8948 • Primary 24 Hour Phone: (617)653-1828 cell Secondary Emergency Coordinator: Tara Comeau,Operations Manager Office Phone: (508)778-8948 Secondary 24 Hour Phone: (508)207-0580 cell The Home Depot Corporate Personnel: Ryan Williams,Manager—Environmental Programs (770)384-4980 Home Depot Office Number 3E Company,Hazardous Materials Assistance 24 Hour Hotline(800)451-8346 In case of emergency contact: Fire Department: 911/Barnstable Fire Station Police Department: 911/Barnstable Police Station Paramedic: 911 Poison Control: 911 or(800)451-8346 MA DEP(spill reporting):(888)304-1133 Hospital: (508)771-1800 Cape Cod Hospital 27 Park Street Hyannis,MA 02601 • 3 • Section III: Core Plan Elements A)Discovery and Initial Response: Once a Home Depot associate discovers or is informed of a release,they shall take the following steps: 1) Immediately evacuate the affected area of all customers and non-essential associates 2) Notify a Store Manager,Operations Manager or Department Manager to coordinate the clean up and initiate emergency notification procedures,if needed 3) Contact 3E Company(hazardous materials consultants)for product specific clean-up instructions,24 hours:(800)451-8346. 4) Obtain a spill clean-up kit from location closest to the spill(paint department,garden department,and receiving). The kit must contain rubber gloves,absorbent,broom,plastic shovel,durable bag and plastic container,and chemical splash goggles. 5) Only associates trained in these clean-up procedures can assist in the clean up of chemical spills. If the spill is greater than incidental or exceeds reportable quantities,the following procedures apply: 1) Immediately evacuate the affected area of all customers and non-essential associates 2) Notify a Store Manager,Operations Manager or Department Manager to coordinate the clean up and initiate emergency notification procedures 3) Notify 3E Company,24 hours:(800)451-8346. 3E Company will complete telephonic and written notifications to National Response Center(NRC)and/or State Emergency Response Commission (SERC)as needed. 4) Immediately contain spill if possible without exposing associates to hazard(dependant on the materials involved,location of spill etc.). 5) Notify corporate associates. Emergency Notification Procedures: The Home Depot corporate representatives, Store Manager on duty,or 3E Company will notify applicable federal, • state,and local agencies. Massachusetts Department of Environmental Protection(DEP)regulations require that all releases of hazardous materials be reported. MA DEP: (888)304-1133 Fire Department: 911 Once a Home Depot associate discovers a fire,they shall take the following steps: 1) Immediately evacuate the affected area of all customers and non-essential associates. 2) Notify the Phone Operator or Manager on Duty. 3) Use the closest pull station available to alert associates and customers. 4) Immediate notification of 911 for fire department response. 5) If necessary,initiate store evacuation. If an unforeseen explosion occurs,Home Depot associates shall take the following steps: 1) Immediately evacuate the affected area of all customers and non-essential associates. 2) Notify the Phone Operator or Manager on Duty. 3) Use the closest pull station available to alert associates and customers. 4) Immediate notification of 911 for fire department response. 5) Initiate store evacuation. B)Evacuation: 1) Signals that will be used to initiate evacuation include announcements over the PA system,verbal means and via two-radios that management personnel utilize. 2) Evacuation will occur through the nearest emergency exits that are located throughout the perimeter of the building. Exits are clearly marked with self-illuminating signs. The evacuation staging area is in front of the building in the parking lot. • 4 • C)Sustained Actions: In the unlikely event that a spill would require a prolonged clean-up procedure,The Home Depot would contact 3E Company to dispatch a licensed emergency response contractor. The following ER contractor may be used: PSC: 800-567-7455 The emergency response contractors will utilize properly trained associates to clean up and remove hazardous wastes at the facility. D)Termination and Follow-Up Actions: The emergency response contractor utilized will be responsible for the demobilization of any resources they may have used to mitigate the spill. Any hazardous waste generated as a result of the clean-up process will be handled in accordance with local,state,and federal regulations. The Home Depot associates,in conjunction with 3E Company representatives,will conduct accident investigations,and submit all applicable written reports to federal, state and local agencies. Section IV: Annexes A)Facility and Locality Information This Home Depot facility is 79,878 square foot retail store with a garden center. This facility is equipped with an automatic sprinkler system that is maintained on a regular basis to ensure proper operation. B)Notification In the event that outside notification is required for an incident at The Home Depot,the manager on duty will make notification determinations and will appoint an assistant manager or applicable staff member to notify the people listed as emergency contacts in Section II. 3E Company will be notified immediately to review appropriate spill • response procedures prior to spill clean up. The Fire Department and the NRC and/or SERC will be contacted by 3E Company or Home Depot management,or a designated representative when appropriate. In addition,the fire department will be notified in the event of any evacuation of a significant area or the building in its entirety. 3E may instruct store personnel to contact the fire department if a spill exceeds the capability,training,and/or resources of The Home Depot associates. C)Response Management System As previously stated,in the event of an emergency incident at The Home Depot,a licensed emergency response contractor will be called to mitigate the incident. Home Depot store management will inform responders as to the location of the release,and assist all fire department and emergency response contractors during an incident at the facility. 1) Command: The command post will be determined according the location and type of incident that is occurring. The manager on duty will disseminate information at the facility. The designated Home Depot representative on site(manager on duty—see Section IV,C,4)will inform all responders of the specific products involved in the incident,as well as notify them as to the location of emergency response equipment located in the facility. Home Depot associates will adhere to the guidance of outside emergency responders and corporate associates. 2) Information: Local, state and federal officials will be contacted should a major release occur. A major release includes any release that exceeds the reportable quantity or is beyond the mitigation and abatement capabilities of Home Depot associates. If further notification is required,the fire department,in conjunction with the police department,will contact neighboring facilities. 3) Safety: Upon discovery of a release,customers and associates will be evacuated from the area. If the release is significant or immediate danger to life or health,the facility will be evacuated. • Evacuation will be initiated via the public address,two-way radio transmission,verbal commands,and/or fire alarm when appropriate. Home Depot associates will assist customers in locating the closest 5 • emergency exits,which are illuminated. Once their department is clear of customers,The Home Depot associates will proceed to the pre-determined evacuation and staging area for a head count and further instruction. Emergency responders and clean up contractors will then be summoned for assistance. Only licensed contractors utilizing HAZWOPER-trained personnel will be used. 4) Liaison and Staff Mobilization:The Home Depot does not have an internal emergency response team and will follow the guidance of responding officials and the emergency response contractors dispatched to the incident. The manager on duty is responsible for informing the incident commander and local officials about the incident that has occurred. 5) Operations:Hazardous materials at The Home Depot consist primarily of prepackaged consumer merchandise. Home Depot associates also utilize propane and lead-acid batteries to fuel/power lift equipment. Materials that may be involved in an incident include,but are not limited to the following: flammable and combustible liquids,flammable gases,aerosol products,corrosive liquids,water reactive liquids,liquid and solid oxidizers,and liquids classified as irritating,toxic or as having other health hazards. The first step in responding to an incident is to determine which products were involved in the incident. Home Depot associates must then immediately call 3E Company's Hazmat Response Team personnel via the spill hotline(800)451-8346. 3E will assist Home Depot associates to access applicable Material Safety Data Sheets to determine product characteristics. After the characteristics are known,the proper response will be determined. 6) Hazard Assessment Planning: Potentially hazardous products located at the facility are identified above. The primary hazard to The Home Depot associates and customers in the facility is the inhalation of spilled volatile hazardous chemicals. Once a release has been recognized,all customers and non-essential associates shall evacuate the area. Spill clean up procedures deemed appropriate in consultation with 3E Company are to be followed,including the donning of PPE(i.e.gloves,eye protection,etc.). No person shall attempt to mitigate the release unless the appropriate PPE level is available and the person is adequately trained. 7) Protection Planning: All non-essential Home Depot associates will be isolated from the area of any release. All responding(properly trained)associates in the area will don the appropriate level of PPE. Environmental concerns may be mitigated by the use of absorbents to clean up chemicals involved. All hazardous wastes will be stored and labeled properly by the responders. Because The Home Depot stores primarily carry pre-packaged consumer products,planning consists of proper storage,handling and disposal,(if necessary)of hazardous materials. See Training and Exercise Drills Section for additional information. 8) Coordination with Regulatory Agencies: In the unlikely event that an incident at The Home Depot would affect the surrounding areas,Home Depot Corporate Associates,or a designated representative will provide information and cooperation with all appropriate agencies. 9) Hazardous Waste Minimization: If a hazardous product cannot be sold as a"standard"product for any reason,the following methods are used to utilize the product: a) Markdown if sellable(non-leaking,clearly labeled products only) b) Return to vendor-for defective products only 10) Hazardous Waste Management: The Home Depot may generate waste as a result of severely damaged products or accidental chemical spills. Waste stored on-site is properly packaged,labeled,secured, maintained and inspected by The Home Depot associates prior to disposal in accordance to federal,state, and local regulations. Hazardous waste manifests are maintained on file for verification of proper waste management and disposal. 6 . The licensed contractor selected by The Home Depot in conjunction with 3E Company will oversee hazardous waste operations and disposals. The contractor is responsible for providing and maintaining all required decontamination equipment. 11) Logistics: Because of the minimal chance of an incident,The Home Depot will utilize only licensed professional emergency response contractors. The logistics will be the responsibility of the contractor. 12) Finance/procurement/administration: The acquisition of resources and any incident related cost will be handled by The Home Depot corporate office and their representatives. D)Incident Documentation: In the unlikely event of a substantial release,all appropriate federal,local,and state requirements will be met. This includes OSHA incident reports,spill/generator reports,and risk assessments. E) Training and Exercise Drills: In compliance with the OSHA Hazard Communication Standard and the Resource Conservation Recovery Act,the Store Manager and the Human Resource Manager provide Associates with the following training: • Federal Hazard Communication Standard"Right to Know' Law • Hazards associated with exposure to hazardous chemicals • Labeling System • How to read Materials Safety Data Sheets(MSDS) • Proper use and maintenance of Personal Protective Equipment(PPE) • Operations in which hazardous chemicals are used • Hazards involved with non-routine tasks • Emergency procedures • Protective measures against exposures • • Proper waste handling,storage and disposal The Home Depot associates are also instructed in identification and handling of hazardous materials in the workplace. Additionally,Associates are trained in the containment and mitigation of incidental small chemical releases. The aforementioned training is provided in the following classes: 1) Hazard Communication training video, 2) Comprehensive Handling Hazardous Materials(HHM)Training and quiz, 3) Annual Safety Training 4) And specific department instructions. There are also weekly inspections of personal protective equipment and weekly audits of work areas to ensure safe practices are being followed. Training shall be conducted upon initial assignment or reassignment to a new work area. Emergency communication systems,fire protection equipment and spill control equipment are tested and maintained on a regular basis to ensure proper operation. The Human Resource or Training Manager will document that all appropriate and required training has been completed. After attending training sessions,each Associate is to sign off to verify that he/she attended and understands the training. On-site contractors are also to be informed of chemical hazards their employees may be exposed to while performing work at this facility. On-site contracting employer(s)shall be given access to a copy of the Right-To- Know guidelines. Contracting employer(s)must read and sign the guidelines. A copy is to be kept on file. 7 • F)Response Critique and Plan Review Modification Process: If a change to the contingency plan is needed(i.e.,updated emergency contacts),Home Depot associates should contact 3E Company's Regulatory Department at(760)602-8700. The plan will be updated within 30 days of any change notifications. G)Prevention: The Home Depot maintains hazardous chemicals primarily in prepackaged consumer products merchandised for retail sale. Products merchandised are stocked in such a manner as to preclude accidental damage,and to prevent spills or accidental mixtures. H) Emergency Equipment: The following communication devices are available throughout the store: • Telephone System—Internal and external communication system used to communicate between Store Associates and with Emergency Responders. • PA System—Internal communication system used to relay emergency notification announcements to Store Associates and customers. • Mobile Phones—Wireless handsets used in conjunction with the telephone system. These handsets allow Store Associates to use the telephone system anywhere throughout the store. • Two-Way Radios—Internal communication system used to relay emergency information between Store Associates. • Call Boxes—Internal communication system used to relay emergency information between Store Associates. The following emergency response equipment is available on site: • Spill Kits—Spill kits are located at designated areas in Receiving(Central Storage Area),Outside Garden, • Paint Center. These kits include a spill collection container, single-use nitrile gloves,safety glasses, absorbent,trash bags,overshoe or disposable shoe covers,mild cleaner,a broom,a dust pan,a shovel,and a permanent marker. The materials are used together to contain and/or clean up spills. • Fire Extinguishers—ABC-rated fire extinguishers are located in Receiving(Central Storage Area),Outside Garden,Paint Center as well as other positions throughout the store. The extinguishers can be used to control minor fires. • Eye Wash Stations—Eye wash stations are maintained in Lumber,Paint,Garden,Front End(Returns),and Receiving(Central Storage Area). The equipment can be used to flush eyes. • Waste Storage Buckets—In addition to the spill kit collection container,2.5-and 5-gallon containers with plastic liners and lids are stored in the Central Storage Area. These containers are used to collect and store spilled materials. • Waste Labels—Waste labels are printed on 8.5"by I I"paper and are affixed to the waste buckets with a plastic sleeve to communicate container contents and hazards. These labels are generated through the computer system in Receiving(Central Storage Area). n Aid Agreements and Emergency Response Coordination: The Home Depot has formally notified local police departments,fire departments,hospitals and applicable State and local emergency response teams to assist with the coordination of emergency services,pursuant to 40 CFR 265.37. . • 8 u Fee Number 363 THE COMMONWEALTH OF MASSACHUSETTS $Ioo.00 Town of Barnstable Board of Health This is to Certify that Home Depot 65 Independence 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 June 30, 2009 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/08 JUNICHI SAWAYANAGI THOMAS A. MCKEAN,R.S.,CHO Director of Public Health ,o off r t b e Regulatory Senices fl1 fill ti°},\ Thomas F.Cede.-, 3irector KOWSAi", � 1thS5 Pubfic .14ealth Division `rhomas JN1.r. v1n, Director ^ II''^^ 200 ,1%l in S1.3'�et. }-�}-anr6s..114A t 260I �} O i Icc: . �f.-862—t644 :f•A:i.. 1�7;%_t90„6�_)�.J. Application Fee: $900M ASSESSORS I+1.AP ANI7 PA:RCE L NON �,...._.,,_,...._.�„______.,._......���.:� 06/30/2008 A P PLICATION FOR PERMIT TO TORE, ANDIO L.TILIZE A-1011:E'; 11.1 GALLONS OF I.,. .AR )O*US M.ATER1, . .a Ft,1,Ia\:4MT OF pYLI °r1N The Home Depot USA, Inc. tiA +1E; (ll" 1S 1. :Eit 1t11:1 t 't' The Home Depot#2612 ADDRESS (lay':ESTA131;ISMIEN`C'65 Independence„Drive,__van nis,_._A..",_..._... TEI-E•T'aIONIF NIJ. I`BER (508) 778-8948 SOLEC)WNEIZ: X 1'li�+ NO IF APPLICANT IS A 1'ARTNERS1711' FUI.,L NA b7E .AND HE?1tFAJ)DRESS OF AI..t. N/A ........._....-_ _.._. _ _....._..__._._... _ ___..._.._...._...___ _ ._.........._.__ .....,__ T. ------- 11".AlYPLICANT IS A CC)RPORM1 TIO."N: Fa T3ER,AL WENTIEIC ATION NO.58-185-3319d�tv. Z STATE OF INC(>I2E'ORA lt_)h Georgia __...._....__._..__ _..._._.._- ._ -0 � FULL NAME ANT) 110M E ADDRESS CIF` Z a'IZI SI:I)l `I° Frank Blake 2455 Paces Ferry Road,Atlanta GA 30339,_,,,,,____........ _...,._.__�__ Lg� TREASURER Rebecca I.Flick 2455 Paces Fe�Road Atlanta, GA 30339_ ,........ _ C1 FRI Frank L. Fernandez-2455 Paces Ferry Road Atlanta GA 30, 39 _ , _,___ _....__._.._._.....__. „....__................M _ ,J .. ._ ...A,......._. -_._ Bryant Webster,Agent for The Home Depot USA, Inc. RESTRICTIONS: HC)'W.ADDRI SS 1IC)ME TELEI'1-t{:ONE r � # .: 21 sl �Ghl�!eRMATdLl $rL��4�'ll�tREF nW�iCE9 € -10 June 20, 2008 L 64 Town of Barnstable Public Health Division" 200 Main Street Hyannis, MA 02601 ATTENTION: Regulatory Services . SUBJECT: Contingency Plan I The Home Depot#2612r " M 65 Independence Dr.:. K Hyannis,MA 02601 - - 141 6A The Home Depot U.S.A., Inc. authorirzes 3ECompany to act on its behalf in regard to regulatory reporting. The authorization mclud�es the Town of Barnstable Public Health Division's emer ency Plan re ortin rements Basedu th � mt lease re ui on es uireens,p �..a find enclosed the 2008 annual Contmgericy Plan, Hazardous 1VlatenalsPerrriit, and check l your reference and, review. " ... 1 Should you have any questions or concerns,.please do not hesitate to contact me direct y at (760) 602-8723. f Sincerely, emu, 3E COMPANY 3 1 Sean Nix _ Associate Regulatory Specialist Enclosure CT a'1 l cv . — M 1: Carporatf H0041WOem, Drive,SvifttAGlnxn Pelf ar 3,T 1 8 ��`j�0, ' I<!dt> €#Pig"�uui P tLOwTr1,ifi�; a4� 1l Ew, stofie ,^ I� 3# f11'fl�t #a C i3li Ya6� f;Sflsl€�n,C ll� i i3 7:7U1 t;(i3e<# 3- Ki" pi3 1tJ�7t� 71`LM"ate T:7601[r 700 R T03.2.88 F s ,'la.E2 6A - +,.,,.s Contingency Plan The Home Depot #2612 65 Independence Drive Hyannis, MA 02601 Table of Contents Section I) Plan Introduction Elements Section II)General Information A) Business Information B) Emergency Contacts Section III)Core Plan Elements A) Discovery and Initial Response B) Evacuation C) Sustained Actions D) Termination and Follow-Up Actions Section IV) Annexes A) Facility and Locality Information B) Notification C) Response Management System 1) Command 2) Information 3) Safety 4) Liaison, Staff Mobilization 5) Operations 6) Haza-d Assessment Planning 7) Protection Planning 8) Coordination with natural resource trustees 9) Hazardous Waste Minimization 10) Hazardous Waste Management 11) Logis=ics 12) Finance/procedure/administration D) Incident Documentation E) Training and Exercise Drills F) Response Critique and Plan Review Modification Process G) Prevention H) Emergency Equipment I) Aid Agreements and Emergency Response Coordination 2 I Section I: Plan Introduction Elements Purpose and Scope of Plan Coverage The Home Depot is a retail home improvement center with prepackaged consumer products that are sold to the general public. The Home Depot also uses hazardous materials as fuel for forklifts,pallet jacks and other similar vehicles. The hazards associated with this facility are incidental releases. Hazardous materials are stored in various sizes,almost solely in consumer-packaged containers. This plan is being developed to comply with local,state,and federal regulations,including the Massachusetts hazardous Waste Management Rules and 40 CFR 265 Subpart D. Section II: General Information A)Business Information Business Name: The Home Depot#2612 Business Address: 65 Independence Drive Hyannis,MA 02601 Phone Number: (508)778-8948 SIC Number: 5211 Business Description: Retail Home Improvement Center Owner/Operator: The Home Depot U.S.A.,Inc. 2455 Paces Ferry Road Atlanta,GA 30339 B)Emergency Contacts: Facility Associates: Primary Emergency Coordinator: Marc Silve, Store Manager Office Phone: (508)778-8948 Primary 24 Hour Phone: (508)801-2522 Cell Secondary Emergency Coordinator: Mike Wichman,Assistant Manager Office Phone: (508)778-8948 Secondary 24 Hour Phone: (508)667-0808 Cell 3E Company,Hazardous Materials Assistance 24 Hour Hotline(800)451-8346 In case of emergency contact: Fire Department: 911/Barnstable Fire Station(508)362-3312 Police Department: 911/Barnstable Police Station(508)775-0387 Paramedic: 911 Poison Control: 911 or(800)451-8346 State(spill reporting): (888)-304-1133 Hospital: (508)771-1800 Cape Cod Hospital 27 Park St. Hyannis,MA 02601 Section III: Core Plan Elements A)Discovery and Initial Response: Once a Home Depot associate discovers or is informed of a release,they shall take the following steps: 1) Immediately evacuate the affected area of all customers and non-essential associates 3 2) Notify a Store Manager,Operations Manager or Department Manager to coordinate the clean up and initiate emergency notification procedures, if needed 3) Contact 3E Company(hazardous materials consultants)for product specific clean-up instructions,24 hours: (800)451-8346. 4) Obtain a spill clean-up kit from location closest to the spill(paint department,garden department,and receiving)The kit must contain rubber gloves,absorbent,broom,plastic shovel,durable bag and plastic container,and chemical splash goggles. 5) Only associates trained in these clean-up procedures can assist in the clean up of chemical spills. If the spill is greater than incidental or exceeds reportable quantities,the following procedures apply: 1) Immediately evacuate the affected area of all customers and non-essential associates 2) Notify a Store Manager,Operations Manager or Department Manager to coordinate the clean up and initiate emergency notification procedures 3) Notify 3E Company, 24 hours: (800)451-8346. 3E Company will complete telephonic and written notifications to National Response Center(NRC)and/or State Emergency Response Commission (SERC)as needed. 4) Immediately contain spill if possible without exposing associates to hazard(dependant on the materials involved, location of spill etc.). 5) Notify corporate associates. Emergency Notification Procedures: The Home Depot corporate representatives, Store Manager on duty, or 3E Company will notify applicable federal, state, and local agencies. Massachusetts Department of Environmental Protection(DEP)regulations require that all releases of hazardous materials be reported. Massachusetts DEP: (888)304-1133 Fire Department: 911 Once a Home Depot associate discovers a fire,they shall take the following steps: 1) Immediately evacuate the affected area of all customers and non-essential associates. 2) Immediate notification of 911 for fire department response. 3) If necessary,initiate store evacuation. B)Evacuation: 1) Signals that will be used to initiate evacuation include announcements over the PA system,verbal means and via two-radios that management personnel utilize. 2) Evacuation will occur through the nearest emergency exits that are located throughout the perimeter of the building. Exits are clearly marked with self-illuminating signs. The evacuation staging area is in front of the building in the parking lot. C)Sustained Actions: In the unlikely event that a spill would require a prolonged clean-up procedure,The Home Depot would contact 3E Company to dispatch a licensed emergency response contractor. The following ER contractor may be used: PSC: 800-567-7455 The emergency response contractors will utilize properly trained associates to clean up and remove hazardous wastes at the facility. 4 I D Termination and Follow-Up Actions: ) p The emergency response contractor utilized will be responsible for the demobilization of any resources they may have used to mitigate the spill. Any hazardous waste generated as a result of the clean-up process will be handled in accordance with local, state,and federal regulations. The Home Depot associates, in conjunction with 3E Company representatives,will conduct accident investigations, and submit all applicable written reports to federal, state and local agencies. Section IV: Annexes A)Facility and Locality Information This Home Depot facility is 79,878 square foot retail store with a garden center. This facility is equipped with an automatic sprinkler system that is maintained on a regular basis to ensure proper operation. B) Notification In the event that outside notification is required for an incident at The Home Depot, the manager on duty will make notification determinations and will appoint an assistant manager or applicable staff member to notify the people listed as emergency contacts in Section II. 3E Company will be notified immediately to review appropriate spill response procedures prior to spill clean up. The Fire Department and the NRC and/or SERC will be contacted by 3E Company or Home Depot management,or a designated representative when appropriate. In addition,the fire department will be notified in the event of any evacuation of a significant area or the building in its entirety. 3E may instruct store personnel to contact the fire department if a spill exceeds the capability,training, and/or resources of The Home Depot associates. C)Response Management System As previously stated, in the event of an emergency incident at The Home Depot,a licensed emergency response contractor will be called to mitigate the incident. Home Depot store management will inform responders as to the location of the release,and assist all fire department and emergency response contractors during an incident at the facility. 1) Command: The command post will be determined according the location and type of incident that is occurring. The manager on duty will disseminate information at the facility. The designated Home Depot representative on site(manager on duty—.see Section IV,C,4)will inform all responders of the specific products involved in the incident,as well as notify them as to the location of emergency response equipment located in the facility. Home Depot associates will adhere to the guidance of outside emergency responders and corporate associates. 2) Information: Local,state and federal officials will be contacted should a major release occur. A major release includes any release that exceeds the reportable quantity or is beyond the mitigation and abatement capabilities of Home Depot associates. If further notification is required, the fire department,in conjunction with the police department,will contact neighboring facilities. 3) Safety: Upon discovery of a release,customers and associates will be evacuated from the area. If the release is significant or immediate danger to life or health,the facility will be evacuated. Evacuation will be initiated via the public address, two-way radio transmission, verbal commands,and/or fire alarm when appropriate. Home Depot associates will assist customers in locating the closest emergency exits, which are illuminated. Once their department is clear of customers,The Home Depot associates will proceed to the pre-determined evacuation and staging area for a head count and further instruction. Emergency responders and clean up contractors will then be summoned for assistance. Only licensed contractors utilizing HAZWOPER-trained personnel will be used. 4) Liaison and Staff Mobilization:The Home Depot does not have an internal emergency response team and will follow the guidance of responding officials and the emergency response contractors dispatched to the 5 incident. The manager on duty is responsible for informing the incident commander and local officials about the incident that has occurred. 5) Operations: Hazardous materials at The Home Depot consist primarily of prepackaged consumer merchandise. Home Depot associates also utilize propane and lead-acid batteries to fuel/power lift equipment. Materials that may be involved in an incident include,but are not limited to the following: flammable and combustible liquids, flammable gases,aerosol products,corrosive liquids,water reactive liquids, liquid and solid oxidizers,and liquids classified as irritating,toxic or as having other health hazards. The first step in responding to an incident is to determine which products were involved in the incident. Home Depot associates must then immediately call 3E Company's Hazmat Response Team personnel via the spill hotline(800)451-8346. 3E will assist Home Depot associates to access applicable Material Safety Data Sheets to determine product characteristics. After the characteristics are known, the proper response will be determined. 6) Hazard Assessment Planning: Potentially hazardous products located at the facility are identified above. The primary hazard to The Home Depot associates and customers in the facility is the inhalation of spilled volatile hazardous chemicals. Once a release has been recognized,all customers and non-essential associates shall evacuate the area. Spill clean up procedures deemed appropriate in consultation with 3E Company are to be followed, including the donning of PPE(i.e. gloves,eye protection, etc.). No person shall attempt to mitigate the release unless the appropriate PPE level is available and the person is adequately trained. 7) Protection Planning: All non-essential Home Depot associates will be isolated from the area of any release. All responding(properly trained)associates in the area will don the appropriate level of PPE. Environmental concerns may be mitigated by the use of absorbents to clean up chemicals involved. All hazardous wastes will be stored and labeled properly by the responders. Because The Home Depot stores primarily carry pre-packaged consumer products,planning consists of proper storage,handling and disposal,(if necessary)of hazardous materials. See Training and Exercise Drills Section for additional information. 8) Coordination with Regulatory Agencies: In the unlikely event that an incident at The Home Depot would affect the surrounding areas,Home Depot Corporate Associates,or a designated representative will provide information and cooperation with all appropriate agencies. 9) Hazardous Waste Minimization: If a hazardous product cannot be sold as a"standard"product for any reason,the following methods are used to utilize the product: a) Markdown if sellable(non-leaking,clearly labeled products only) b) Return to vendor- for defective products only 10) Hazardous Waste Management: The Home Depot may generate waste as a result of severely damaged products or accidental chemical spills. Waste stored on-site is properly packaged, labeled, secured, maintained and inspected by The Home Depot associates prior to disposal in accordance to federal,state, and local regulations. Hazardous waste manifests are maintained on file for verification of proper waste management and disposal. The licensed contractor selected by The Home Depot in conjunction with 3E Company will oversee hazardous waste operations and disposals. The contractor is responsible for providing and maintaining all required decontamination equipment. 11) Logistics: Because of the minimal chance of an incident,The Home Depot will utilize only licensed professional emergency response contractors. The logistics will be the responsibility of the contractor. 12) Finance/procurement/administration: The acquisition of resources and any incident related cost will be handled by The Home Depot corporate office and their representatives. 6 l_ D) Incident Documentation: In the unlikely event of a substantial release,all appropriate federal, local,and state requirements will be met. This includes OSHA incident reports,spill/generator reports,and risk assessments. E) Training and Exercise Drills: In compliance with the OSHA Hazard Communication Standard and the Resource Conservation Recovery Act, the Store Manager and the Human Resource Manager provide Associates with the following training: • Federal Hazard Communication Standard"Right to Know' Law • Hazards associated with exposure to hazardous chemicals • Labeling System • How to read Materials Safety Data Sheets(MSDS) • Proper use and maintenance of Personal Protective Equipment(PPE) • Operations in which hazardous chemicals are used • Hazards involved with non-routine tasks • Emergency procedures • Protective measures against exposures • Proper waste handling,storage and disposal The Home Depot associates are also instructed in identification and handling of hazardous materials in the workplace. Additionally, Associates are trained in the containment and mitigation of incidental small chemical releases. The aforementioned training is provided in the following classes: 1) Hazard Communication training video, 2) Comprehensive Handling Hazardous Materials(HHM)Training and quiz, 3) Annual Safety Training 4) And specific department instructions. There are also weekly inspections of personal protective equipment and weekly audits of work areas to ensure safe practices are being followed. Training shall be conducted upon initial assignment or reassignment to a new work area. Emergency communication systems, fire protection equipment and spill control equipment are tested and maintained on a regular basis to ensure proper operation. The Human Resource or Training Manager will document that all appropriate and required training has been completed. After attending training sessions,each Associate is to sign off to verify that he/she attended and understands the training. On-site contractors are also to be informed of chemical hazards their employees may be exposed to while performing work at this facility. On-site contracting employer(s) shall be given access to a copy of the Right-To- Know guidelines. Contracting employer(s)must read and sign the guidelines. A copy is to be kept on file. F)Response Critique and Plan Review Modification Process: If a change to the contingency plan is needed (i.e.,updated emergency contacts),Home Depot associates should contact 3E Company's Regulatory Department at(760) 602-8700. The plan will be updated within 30 days of any change notifications. G) Prevention: The Home Depot maintains hazardous chemicals primarily in prepackaged consumer products merchandised for retail sale. Products merchandised are stocked in such a manner as to preclude accidental damage, and to prevent spills or accidental mixtures. H)Emergency Equipment: The following communication equipment is available on site: 7 • PA System • Telephones • Two-Way Radios The following emergency response equipment is available on site in the following departments—Receiving(Central Storage),Outside Garden,and Paint: • Spill Kits • Absorbent—used to absorb small hazardous materials spills(liquid) • Fire Extinguishers(ABC rated) • Eye Wash Station • Waste Storage Buckets(five gallon,plastic lined with lid) • Waste Labels I) Aid Agreements and Emergency Response Coordination: The Home Depot has formally notified local police departments, fire departments,hospitals and applicable State and local emergency response teams to assist with the coordination of emergency services,pursuant to 40 CFR 265.37. 8 Number Fee 363 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Home Depot 65Independence Road, MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 31, 2008 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. 5/31/2007 PAUL J. CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Regulatory Services Thomas P. Geiler,Nrector AAUNarABLB, r ►�. Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO.295,015-XO1 &X02 DATE May 30,2007 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT The Home Depot USA,Inc. NAME OF ESTABLISHMENT The Home Depot#2612 ADDRESS OF ESTABLISHMENT 65 Independence Drive Hyannis MA 02601 TELEPHONE NUMBER(508)778-8948 SOLE OWNER: X YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF d L PARTNERS: c� UO fu3 —4 cis ry r- 7 IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO,58-185-3 1.9 STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK SIGNATURE OF APPLICANT Derek Russell,Agent for The Home Depot USA,Inc. RESTRICTIONS: HOME ADDRESS 3E Company, 1905 Aston Ave, Carlsbad CA 92008 DOME TELEPHONE#(760)602-8663 Hnzdoc/wp/q !{bc !AnG14§00i4AN 5E&VYCE9 May 30, 2007 State of Massachusetts Department of Environmental Protection One Winter St. RM Boston, MA 02108 ri I ATTENTION: Department of Environmental Protection SUBJECT: Contingency Plan w The Hoine Depot*2612 F,x 65 IndeP endence Drive a- Hyannis,MA 02601 The Home Depot U.S.A., Inc. authorizes 3E Company to act on its behalf in regard to p _, p Y g regulatory reporting.The authorization includes the State,of Massachusetts Department of Environmental Protection's,emergency plan reporting requirements. Based upon these requirements, please,find enclosed the 2007 annual Contingency,Plan for your reference and review. Should you have any questions or concerns,please do not hesitate to contact me directly atx (760)602-8663. Sincerely, 3E COMPANY Derek Russell r Regulatory Compliance Coordinator Enclosure cc: Cape Cod Hospital, Barnstable Police, and Barnstable Fire Department -< corporate Headquarters =0 treertsi W Oft Sub 400 Ezvre F*ark 80091 L��gt ZO 3 f805 A+ nuCr MCLraan,VA 22102 1999 fast Steno Arty DK 2100 Cc onbagea►benmrk c,„• Garisoad,GA t 101. 63.1400 King cr%IN 37W T,+45 7022$t 70 760.602570t1 ; 03.20B 3S? T 423 5781219 P: 59'75 82 69 F 7E�.�2.85;55 � 42�578>123�a ��8 .,r �,.a.,✓;.� �'� i,��„s%��''s".`d.,.�,,�.fi:�i��ix....,f��..ue..�ir'lsP'� .:.����� $ f "� � " r� � �•n*=r .,. 't�3`r e _, Hazardous Materials Management and Contingency Plan The Home Depot #2612 65 Independence Drive. Hyannis, MA 02601 i 1 Table of Contents Section I) Plan Introduction Elements Section II)General Information A) Business Information B) Emergency Contacts Section III)Core Plan Elements A) Discovery and Initial Response B) Evacuation C) Sustained Actions D) Termination and Follow-Up Actions Section IV)Annexes A) Facility and Locality Information B) Notification. C) Response Management System 1) Command 2) Information 3) Safety 4) Liaison,Staff Mobilization 5) Operations 6) Hazard Assessment Planning 7) Protection Planning 8) Coordination with natural resource trustees 9) Hazardous Waste Minimization 10) Hazardous Waste Management 11) Logistics 12) Finance/procedure/administration D) Incident Documentation E) Training and exercise Drills F) Response Critique and Plan Review Modification Process G) Prevention H) Emergency Equipment 1) Aid Agreements and Emergency Response Coordination 2 f Section I: Plan Introduction Elements Purpose and Scope of Plan Coverage The Home Depot is a retail home improvement center with prepackaged consumer products that are sold to the general public. The Home Depot also uses hazardous materials as fuel for forklifts,pallet jacks and other similar vehicles. The hazards associated with this facility are incidental releases. Hazardous materials are stored in various sizes,almost solely in consumer-packaged containers. This plan is being developed to comply with local,state,and federal regulations,including the Massachusetts hazardous Waste Management Rules and 40 CFR 265 Subpart D. Section II: General Information A)Business Information Business Name: The Home Depot#2612 Business Address: 65 Independence Drive Hyannis,MA 02601 Phone Number: (508)778-8948 SIC Number: 5211 Business Description: Retail Home Improvement Center Owner/Operator: The Home Depot U.S.A.,Inc. 2455 Paces Ferry Road Atlanta,GA 30339 B)Emergency Contacts: Facility Associates: Primary Emergency Coordinator: Walter Varney, Store Manager Office Phone: (508)778-8948 Primary 24 Hour Phone: (508)775-8642 Home Secondary Emergency Coordinator: Mike Wichman,Assistant Manager Office Phone: (508)778-8948 Secondary 24 Hour Phone: (508)759-6227 Home The Home Depot Corporate Personnel: Ryan Williams,Regulatory Specialist (770)384-4980 Home Depot Office Number 3E Company,Hazardous Materials Assistance 24 Hour Hotline(800)451-8346 In case of emergency contact: Fire Department: 911/Barnstable Fire Station(508)362-3312 Police Department: 911/Barnstable Police Station(508)775-0387 Paramedic: 911 Poison Control: 911 or(800)451-8346 State(spill reporting): (888)-304-1133 Hospital: (508)771-1800 Cape Cod Hospital 27 Park St. Hyannis,MA 02601 3 Section III: Core Plan Elements A)Discovery and Initial Response: Once a Home Depot associate discovers or is informed of a release,they shall take the following steps: 1) Immediately evacuate the affected area of all customers and non-essential associates 2) Notify a Store Manager,Operations Manager or Department Manager to coordinate the clean up and initiate emergency notification procedures,if needed 3) Contact 3E Company(hazardous materials consultants)for product specific clean-up instructions,24 hours: (800)451-8346. 4) Obtain a spill clean-up kit from location closest to the spill(paint department,garden department,and receiving)The kit must contain rubber gloves,absorbent,broom,plastic shovel,durable bag and plastic container,and chemical splash goggles. 5) Only associates trained in these clean-up procedures can assist in the clean up of chemical spills. 41 If the spill is greater than incidental or exceeds reportable quantities,the following procedures apply: 1) Immediately evacuate the affected area of all customers and non-essential associates 2) Notify a Store Manager,Operations Manager or Department Manager to coordinate the clean up and initiate emergency notification procedures 3) Notify 3E Company,24 hours: (800)451-8346. 3E Company will complete telephonic and written notifications to National Response Center(NRC)and/or State Emergency Response Commission (SERC)as needed. 4) Immediately contain spill if possible without exposing associates to hazard(dependant on the materials involved,location of spill etc.). 5) Notify corporate associates. Emergency Notification Procedures: The Home Depot corporate representatives, Store Manager on duty,or 3E Company will notify applicable federal, state,and local agencies. Massachusetts Department of Environmental Protection(DEP)regulations require that all releases of hazardous materials be reported. Massachusetts DEP: (888)304-1133 Fire Department: 911 Once a Home Depot associate discovers a fire,they shall take the following steps: 1) Immediately evacuate the affected area of all customers and non-essential associates. 2) Immediate notification of 911 for fire department response. 3) If necessary,initiate store evacuation. B)Evacuation: 1) Signals that will be used to initiate evacuation include announcements over the PA system,verbal means and via two-radios that management personnel utilize. 2) Evacuation will occur through the nearest emergency exits that are located throughout the perimeter of the building. Exits are clearly marked with self-illuminating signs. The evacuation staging area is in front of the building in the parking lot. C)Sustained Actions: In the unlikely event that a spill would require a prolonged clean-up procedure,The Home Depot would contact 3E Company to dispatch a licensed emergency response contractor. The following ER contractor may be used: PSC: 800-567-7455 The emergency response contractors will utilize properly trained associates to clean up and remove hazardous wastes at the facility. 4 D)Termination and Follow-Up Actions: The emergency response contractor utilized will be responsible for the demobilization of any resources they may have used to mitigate the spill. Any hazardous waste generated as a result of the clean-up process will be handled in accordance with local,state,and federal regulations. The Home Depot associates,in conjunction with 3E Company representatives,will conduct accident investigations,and submit all applicable written reports to federal,state and local agencies. Section IV: Annexes A)Facility and Locality Information This Home Depot facility is 79,878 square foot retail store with a garden center. This facility is equipped with an automatic sprinkler system that is maintained on a regular basis to ensure proper operation. B)Notification In the event that outside notification is required for an incident at The Home Depot,the manager on duty will make notification determinations and will appoint an assistant manager or applicable staff member to notify the people listed as emergency contacts in Section II. 3E Company will be notified immediately to review appropriate spill response procedures prior to spill clean up. The Fire Department and the NRC and/or SERC will be contacted by 3E Company or Home Depot management,or a designated representative when appropriate. In addition,the fire department will be notified in the event of any evacuation of a significant area or the building in its entirety. 3E may instruct store personnel to contact the fire department if a spill exceeds the capability,training,and/or resources of The Home Depot associates. Q Response Management System As previously stated,in the event of an emergency incident at The Home Depot,a licensed emergency response contractor will be called to mitigate the incident. Home Depot store management will inform responders as to the location of the release,and assist all fire department and emergency response contractors during an incident at the facility. 1) Command: The command post will be determined according the location and type of incident that is occurring. The manager on duty will disseminate information at the facility. The designated Home Depot representative on site(manager on duty—see Section IV,C,4)will inform all responders of the specific products involved in the incident,as well as notify them as to the location of emergency response equipment located in the facility. Home Depot associates will adhere to the guidance of outside emergency responders and corporate associates. 2) Information: Local,state and federal officials will be contacted should a major release occur. A major release includes any release that exceeds the reportable quantity or is beyond the mitigation and abatement capabilities of Home Depot associates. If further notification is required,the fire department,in conjunction with the police department,will contact neighboring facilities. 3) Safety: Upon discovery of a release,customers and associates will be evacuated from the area. If the release is significant or immediate danger to life or health,the facility will be evacuated. Evacuation will be initiated via the public address,two-way radio transmission,verbal commands,and/or fire alarm when appropriate. Home Depot associates will assist customers in locating the closest emergency exits,which are illuminated. Once their department is clear of customers,The Home Depot associates will proceed to the pre-determined evacuation and staging area for a head count and further instruction. Emergency responders and clean up contractors will then be summoned for assistance. Only licensed contractors utilizing HAZWOPER-trained personnel will be used. 4) Liaison and Staff Mobilization:The Home Depot does not have an internal emergency response team and will follow the guidance of responding officials and the emergency response contractors dispatched to the 5 incident. The manager on duty is responsible for informing the incident commander and local officials about the incident that has occurred. 5) Operations: Hazardous materials at The Home Depot consist primarily of prepackaged consumer merchandise. Home Depot associates also utilize propane and lead-acid batteries to fuel/power lift equipment. Materials that may be involved in an incident include,but are not limited to the following: flammable and combustible liquids,flammable gases,aerosol products,corrosive liquids,water reactive liquids,liquid and solid oxidizers,and liquids classified as irritating,toxic or as having other health hazards. The first step in responding to an incident is'to determine which products were involved in the incident. Home Depot associates must then immediately call 3E Company's Hazmat Response Team personnel via the spill hotline(800)451-8346. '3E will assist Home Depot associates to access applicable Material Safety Data Sheets to determine product characteristics. After the characteristics are known,the proper response will be determined. 6) Hazard Assessment Planning: Potentially hazardous products located at the facility are identified above. The primary hazard to The Home Depot associates and customers in the facility is the inhalation of spilled' volatile hazardous chemicals. Once a release has been recognized,all customers and non-essential associates shall evacuate the area. Spill clean up procedures deemed appropriate in consultation with 3E Company are to be followed,including the donning of PPE(i.e. gloves,eye protection,etc.). No person shall attempt to mitigate the release unless the appropriate PPE level is available and the person is adequately trained. 7) Protection Planning: All non-essential Home Depot associates will be isolated from the area of any release. All responding(properly trained)associates in the area will don the appropriate level of PPE. Environmental concerns may be mitigated by the use of absorbents to clean up chemicals involved. All hazardous wastes will be stored and labeled properly by the responders. Because The Home Depot stores primarily carry pre-packaged consumer products,planning consists of proper storage,handling and disposal,(if necessary)of hazardous materials. See Training and Exercise Drills Section for additional information. 8) Coordination with Regulatory Agencies: In the unlikely event that an incident at The Home Depot would affect the surrounding areas,Home,Depot Corporate Associates,or a designated representative will provide information and cooperation with all appropriate agencies. 9) Hazardous Waste Minimization: If a hazardous product cannot be sold as a"standard"product for any reason,the following methods are used to utilize the product: a) Markdown if sellable(non-leaking,clearly labeled products only) b) Return to vendor-for defective products only 10) Hazardous Waste Management: The Home Depot may generate waste as a result of severely damaged products or accidental chemical spills. Waste stored on-site is properly packaged,labeled,secured, maintained and inspected by The Home Depot associates prior to disposal in accordance to federal,state, and local regulations. Hazardous waste manifests are maintained on file for verification of proper waste management and disposal. The licensed contractor selected by The Home Depot in conjunction with 3E Company will oversee hazardous waste operations and disposals. The contractor is responsible for providing and maintaining all required decontamination equipment. 11) Logistics: Because of the minimal chance of an incident,The Home Depot will utilize only licensed professional emergency response contractors. The logistics will be the responsibility of the contractor. 12) Finance/procurement/administration: The acquisition of resources and any incident related cost will be handled by The Home Depot corporate office and their representatives. 6 D)Incident Documentation: In the unlikely event of a substantial release,all appropriate federal,local,and state requirements will be met. This includes OSHA incident reports,spill/generator reports,and risk assessments. E) Training and Exercise Drills: In compliance with the OSHA Hazard Communication Standard and the Resource Conservation Recovery Act,the Store Manager and the Human Resource Manager provide Associates with the following training: • Federal Hazard Communication Standard"Right to Know' Law • Hazards associated with exposure to hazardous chemicals • Labeling System • How to read Materials Safety Data Sheets(MSDS) • Proper use and maintenance of Personal Protective Equipment(PPE) • Operations in which hazardous chemicals are used • Hazards involved with non-routine tasks • Emergency procedures • Protective measures against exposures • Proper waste handling,storage and disposal The Home Depot associates are also instructed in identification and handling of hazardous materials in the workplace. Additionally,Associates are trained in the containment and mitigation of incidental small chemical releases. The aforementioned training is provided in the following classes: 1) Hazard Communication training video, 2) Comprehensive Handling Hazardous Materials(HHM)Training and quiz, 3) Annual Safety Training 4) And specific department instructions. There are also weekly inspections of personal protective equipment and weekly audits of work areas to ensure safe practices are being followed. Training shall be conducted upon initial assignment or reassignment to a new work area. Emergency communication systems, fire protection equipment and spill control equipment are tested and maintained on a regular basis to ensure proper operation. The Human Resource or Training Manager will document that all appropriate and required training has been completed. After attending training sessions,each Associate is to sign off to verify that he/she attended and understands the training. On-site contractors are also to be informed of chemical hazards their employees may be exposed to while performing work at this facility. On-site contracting employer(s)shall be given access to a copy of the Right-To- Know guidelines. Contracting employer(s)must read and sign the guidelines. A copy is to be kept on file. F)Response Critique and Plan Review Modification Process: If a change to the contingency plan is needed(i.e.,updated emergency contacts),Home Depot associates should contact 3E Company's Regulatory Department at(760)602-8700. The plan will be updated within 30 days of any change notifications. G)Prevention: The Home Depot maintains hazardous chemicals primarily in prepackaged consumer products merchandised for retail sale. Products merchandised are stocked in such a manner as to preclude accidental damage,and to prevent spills or accidental mixtures. H)Emergency Equipment: The following communication equipment is available on site: 7 4 > , • PA System • Telephones • Two-Way Radios The following emergency response equipment is available on site in the following departments—Receiving(Central Storage),Outside Garden,and Paint: ". • Spill Kits • Absorbent—used to absorb small hazardous materials spills(liquid) • Fire Extinguishers(ABC rated) • Eye Wash Station • Waste Storage Buckets(five gallon,plastic lined with lid) • Waste Labels n Aid Agreements and Emergency Response Coordination: The Home Depot has formally notified local police departments,fire departments,hospitals and applicable State and local emergency response teams to assist with the coordination of emergency services,pursuant to 40 CFR 265.37. J. 8 Number Fee 363 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Home Depot 65 Independence Road, MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ---------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 30, 2007 unless sooner suspended or revoked. --------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. January 2, 2007 PAUL J. CANNIFF,D.M.D. THOMAS A. 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I ;X!, UFF5 ,"11-1 I December .I..-I. st,`I 20 0.6 :I 1.. 1 11 1 TII.I,oI 11wI��n,I o�IIfI I Barnstable -I� """---;I.:,,,"-�� , ReglatoySen4reSr ,1-I,.�,,I��", �% �,' II I ,- . 1,. ,.I, 11-­ 1I. - !O 200 Main Street -N�� gF- Hyannis, MA 0260 ? , ATTENTION Public Health Divisionsioi - 1I 1 1I I I . I A- VW SUBJECT U� B A. t�-1 T`,�.," CI., h!1�?�/e1.n-i1i-1,�-11 Ig11II 111,1I,�,6.�.->"f,.I,M-1 O12,1,M f-'1,I1-",1�,,i .-nN,�--1-;'1x� , d",; 1vT1-,1I , 1 " 7 Themee' mobepdt 4261 w M-� 0� ,�� - W " %,T" V v 4,1 ""�� " ,9 �5,1 n ence,Drive , r �. x6� ' Hyannk,,MA 02601 (Site) �v n I.I 1 1I� .*A"e0R,--gPI11 II 'H� o'I",-�-,I e Depot e 1�-I:�I`p o"t U, .1S,",.A,I".I -�,�"I1 n-o� "A--u`,, t;h o n."- .,,e§", -, -�3A1E C,"-�I�,,"�",,"m p,�;' I,a n-yact 1� o -I c " ,.- "1 -,o� n,'I ,i� s - h if i,-"1:"'I n �r;11�fe,- k Wg a -, � r to * 40 , ., :�I -: 1,I- :,I I. �� I .�. reguIatoy repor n& The aWth6 ,i& 6nInd includes applying T�,-f f-and, 14regulatory fung . ! 1..� I1, , l, I1, r j,A,,1i "0; permits. The ddr o 1Ji9tedi 616Wkft�e current mai I bilk W 4ffd Ws -f r the above ' ,- �i referenc d Site " I I' : AQ�:- A ��OWV,4" -" AA , 3E CompanyDepartment/RegulatoryI"- & Home Depot y � . 065,�stoa Avenue Suite 100 W� - � , Qk, � �W- ,,C � r,eX � � � � kiibid5'CA9008 � , _ s - , / " W, PIea§&-cnange�your` -SI 6 reflect this i formation Slould you"have any,questions-or„ 'conc6ins,please'do nothesitate 4o contact me dii6ctIy 70%602-88* " lq,i - � I - - , ' ISincerely, I i - I I , ;IyOW`"iI 3I1, E COMPANY ' 0 1 4 - " ,. I ,n'r � 1� "� ; ��� - I- : ': I I.- I I I ,--, , � -� I ,11 ��,-"� 'e -f I• I "I" � I 6 i .�rLeigh Huten rauck Jz, Regulatory OMDiince Coordinator .11 I,1I A-'iR�T-I1I4I iI -e­ A i��:,,�,�-���,,�-�-",:', . I I I , . , , I ���, �- �, , . "i 1,11- , �- , w.11.1 --' �� c ,6�- I-;,' � - �l ,2 J-- �-..1 �1-I- ��",�.��,.,.,,k,,.-P--.,-j",-.,1��, " ,�i 1"--� I1t'?z"1,1,�te,7,-,,, ,I,� ,- C*gate H WqUMeW !� 260 ; b601 1t0 ;'1,4' �" , ?� -"W xW6, rk fti�ldIMdl , 4 1 2 3l IMRW bTA lq - / 14t a0,A II gttik6r� DK '060hl4n iik ­ d�Oft= � J�J6 - 12- � , 6 , "',*- , , � ��-!- --�1- I- , .... �W­ "�""� ,- -, A IIM" 4 " ,- v - ..L ur-atr-[uu4 Ub:bd FROM— + T-838 P.002 F-498 Town of Barnstable Regulatory Services Thomas F.Geiler,nirector ` p MASS. Public Health Division i 16 9. ArED Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 �/ t Office- 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE December 1 st,2006 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OI''HAZARDOUS MATERIALS FULL NAME OF APPLICANT The Home Depot USA,Inc. NAME OF ESTABLISHMENT The Home Depot#2612 ADDRESS OF ESTABLISHMENT 65 Independence Drive Hyannis MA 02601 TELEPHONE NUMBER(508)778-8948 SOLE OWNER: X YES NO IF APPLICANT IS A PARTNERSHIP,PULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION; FEDERAL IDENTIFICATION No,58-185-3319 STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF. PRESIDENT TREASURER ®' CLERK t �r SIGNATURE OF APEii1CANT Leigh Huttenbrauck,Agent for The HorrieDepot USA,Ines; RESTRICTIONS: HOME ADDRESS `-' DOME TELEPHONE# co Hozdoc/wp/q W f Hazardous Materials Management and Contingency Plan The Home Depot #2612 65 Independence Drive Hyannis, MA 02601 i Table of Contents Section I) Plan Introduction Elements Section II)General Information A) Business Information B) Emergency Contacts Section III)Core Plan Elements A) Discovery and Initial Response B) Evacuation C) Sustained Actions D) Termination and Follow-Up Actions Section IV)Annexes A) Facility and Locality Information B) Notification C) Response Management System 1) Command 2) Information 3) Safety 4) Liaison, Staff Mobilization 5) Operations 6) Hazard Assessment Planning 7) Protection Planning 8) Coordination with natural resource trustees 9) Hazardous Waste Minimization 10) Hazardous Waste Management 11) Logistics 12) Finance/procedure/administration D) Incident Documentation E) Training and Exercise Drills F) Response Critique and Plan Review Modification Process G) Prevention H) Emergency Equipment I) Aid Agreements and Emergency Response Coordination 2 I Section I: Plan Introduction Elements Purpose and Scope of Plan Coverage The Home Depot is a retail home improvement center with prepackaged consumer products that are sold to the general public. The Home Depot also uses hazardous materials as fuel for forklifts,pallet jacks and other similar vehicles. The hazards associated with this facility are incidental releases. Hazardous materials are stored in various sizes,almost solely in consumer-packaged containers. This plan is being developed to comply with local,state,and federal regulations,including the Massachusetts Hazardous Waste Management Rules and 40 CFR 265 Subpart D. Section II: General Information A)Business Information Business Name: The Home Depot#2612 Business Address: 65 Independence Drive Hyannis, MA 02601 Phone Number: (508)778-8948 SIC Number: 5211 Business Description: Retail Home Improvement Center Owner/Operator: The Home Depot U.S.A.,Inc. 2455 Paces Ferry Road NW Atlanta, GA 30339 B)Emergency Contacts: Facility Associates: Primary Emergency Coordinator: Michael Wichman, Store Manager Office Phone: (508)778-8948 Primary 24 Hour Phone: (508)317-4711 Secondary Emergency Coordinator: Kevin Bacchiocci,Assistant Manager Office Phone: (508)778-8948 Secondary 24 Hour Phone: (508)667-0808 The Home Depot Corporate Personnel: Ryan Williams, Regulatory Specialist (770)384-4980 Home Depot Office Number 3E Company, Hazardous Materials Assistance 24 Hour Hotline(800)451-8346 In case of emergency contact: Fire Department: 911/Barnstable Fire Department(508)362-3312 Police Department: 911/Barnstable Police Department(508)775-0920 Paramedic: 911 Poison Control: 911 or(800)451-8346 SERC(spill reporting): (888)304-1133 Hospital: (508)771-1800 Cape Cod Hospital 27 Park Street Hyannis,MA 02601 Section III: Core Plan Elements A)Discovery and Initial Response: Once a Home Depot associate discovers or is informed of a release,they shall take the following steps: 1) Immediately evacuate the affected area of all customers and non-essential associates 3 2) Notify a Store Manager, Operations Manager or Department Manager to coordinate the clean up and initiate emergency notification procedures,if needed 3) Contact 3E Company(hazardous materials consultants)for product specific clean-up instructions, 24 hours:(800)451-8346. 4) Obtain a spill clean-up kit from location closest to the spill(paint department,garden department, receiving, special services desk)The kit must contain rubber gloves, absorbent,broom,plastic shovel, durable bag and plastic container, and chemical splash goggles. 5) Only associates trained in these clean-up procedures can assist in the clean up of chemical spills. If the spill is greater than incidental or exceeds reportable quantities,the following procedures apply: 1) Immediately evacuate the affected area of all customers and non-essential associates 2) Notify a Store Manager,Operations Manager or Department Manager to coordinate the clean up and initiate emergency notification procedures 3) Notify 3E Company, 24 hours:(800)451-8346. 3E Company will complete telephonic and written notifications to NRC and/or SERC as needed. 4) Immediately contain spill if possible without exposing associates to hazard(dependant on the materials involved,location of spill etc.). 5) Notify corporate associates. Emergency Notification Procedures: The Home Depot corporate representatives, Store Manager on duty, or 3E Company will notify applicable federal, state, and local agencies. Massachusetts DEP regulations require that all releases of hazardous materials be reported. Massachusetts DEP: (888)304-1133 Fire Department:911 Once a Home Depot associate discovers a fire,they shall take the following steps: 1) Immediately evacuate the affected area of all customers and non-essential associates. 2) Immediate notification of 911 for fire department response. 3) Initiate store evacuation process. B)Evacuation: 1) Signals that will be used to initiate evacuation include announcements over the PA system,verbal means and via two-radios that management personnel utilize. 2) Evacuation will occur through the nearest emergency exits that are located throughout the perimeter of the building. Exits are clearly marked with self-illuminating signs. The evacuation staging area is in front of the building in the parking lot. C)Sustained Actions: In the unlikely event that a spill would require a prolonged clean-up procedure,The Home Depot would contact 3E Company to dispatch a licensed emergency response contractor. The following ER contractor may be used: PSC : 800-567-7455 The emergency response contractors will utilize properly trained associates to clean up and remove hazardous wastes at the facility. �I 4 D)Termination and Follow-Up Actions: The emergency response contractor utilized will be responsible for the demobilization of any resources they may have used to mitigate the spill. Any hazardous waste generated as a result of the clean-up process will be handled in accordance with local,state, and federal regulations. The Home Depot associates, in conjunction with 3E Company representatives,will conduct accident investigations, and submit all applicable written reports to federal,state and local agencies. Section IV: Annexes A)Facility and Locality Information This Home Depot facility is an approximately 116,000 square foot retail store with a garden center This facility is equipped with an automatic sprinkler system that is maintained on a regular basis to ensure proper operation. B)Notification In the event that outside notification is required for an incident at The Home Depot,the manager on duty will make notification determinations and will appoint an assistant manager or applicable staff member to notify the people listed as emergency contacts in Section II. 3E Company will be notified immediately to review appropriate spill response procedures prior to spill clean up. The Fire Department and the NRC and/or SERC will be contacted by 3E Company or Home Depot management,or a designated representative when appropriate. In addition,the fire department will be notified in the event of any evacuation of a significant area or the building in its entirety. 3E may instruct store personnel to contact the fire department if a spill exceeds the capability,training, and/or resources of The Home Depot associates. C)Response Management System As previously stated,in the event of an emergency incident at The Home Depot, a licensed emergency response contractor will be called to mitigate the incident. Home Depot store management will inform responders as to the location of the release,and assist all fire department and emergency response contractors during an incident at the facility. 1) Command: The command post will be determined according the location and type of incident that is occurring. The manager on duty will disseminate information at the facility. The designated Home Depot representative on site(manager on duty—see Section IV,C,4)will inform all responders of the specific products involved in the incident,as well as notify them as to the location of emergency response equipment located in the facility. Home Depot associates will adhere to the guidance of outside emergency responders and corporate associates. 2) Information: Local, state and federal officials will be contacted should a major release occur. A major release includes any release that exceeds the reportable quantity or is beyond the mitigation and abatement capabilities of Home Depot associates. If further notification is required,the fire department,in conjunction with the police department,will contact neighboring facilities. Corporate Safety Associates will conduct any press conferences,press releases, or community relations. 3) Safety: Upon discovery of a release, customers and associates will be evacuated from the area. If the release is significant,such as unconfined volatile hazards or immediate danger to life or health,the facility will be evacuated. Evacuation will be initiated via the public address,two-way radio transmission, shouting,and/or fire alarm when appropriate. Home Depot associates will assist customers in locating the closest emergency exits, which are illuminated. Once their department is clear of customers,The Home Depot associates will proceed to the pre-determined evacuation and staging area for a head count and further instruction. Emergency responders and clean up contractors will then be summoned for assistance. Only licensed contractors utilizing HAZ`NOPER-trained personnel will be used. 5 4) Liaison and Staff Mobilization:The Home Depot does not have an internal emergency response team and will follow the guidance of responding officials and the emergency response contractors dispatched to the incident. The manager on duty is responsible for informing the incident commander and local officials about the incident that has occurred. 5) Operations: Hazardous materials at The Home Depot consist primarily of prepackaged consumer merchandise. Home Depot associates also utilize propane and lead-acid batteries to fuel/power lift equipment. Materials that may be involved in an incident include,but are not limited to the following: flammable and combustible liquids,flammable gases, aerosol products,corrosive liquids,water reactive liquids,liquid and solid oxidizers, and liquids classified as irritating,toxic or as having other health hazards. The first step in responding to an incident is to determine which products were involved in the incident. Home Depot associates must then immediately call 3E Company's Hazmat Response Team personnel via the spill hotline(800)451-8346. 3E will assist Home Depot associates to access applicable Material Safety Data Sheets to determine product characteristics. After the characteristics are known,the proper response will be determined. 6) Hazard Assessment Planning: Potentially hazardous products located at the facility are identified above. The primary hazard to The Home Depot associates and customers in the facility is the inhalation of spilled volatile hazardous chemicals. Once a release has been recognized, all customers and non-essential associates shall evacuate the area. Spill clean up procedures deemed appropriate in consultation with 3E Company are to be followed,including the donning of PPE(i.e. gloves, eye protection, etc.). No person shall attempt to mitigate the release unless the appropriate PPE level is available and the person is adequately trained. 7) Protection Planning: All non-essential Home Depot associates will be isolated from the area of any release. All responding(properly trained)associates in the area will don the appropriate level of PPE. Environmental concerns may be mitigated by the use of absorbents to clean up chemicals involved. All hazardous wastes will be stored and labeled properly by the responders. Because The Home Depot stores primarily carry pre-packaged consumer products,planning consists of proper storage,handling and disposal,(if necessary)of hazardous materials. See Training and Exercise Drills Section for additional information. 8) Coordination with Natural Resource Trustees: In the unlikely event that an incident at The Home Depot would affect the surrounding areas,Home Depot Corporate Associates, or a designated representative will provide information and cooperation to the Natural Resource Damage Assessment, administered by the Environmental Protection Agency(EPA). 9) Hazardous Waste Minimization: If a hazardous product cannot be sold as a"standard"product for any reason, efforts are made to disposition the product utilizing the following methods: a) Markdown if sellable(non-leaking,clearly labeled products only) b) Return to vendor-for defective products only 10) Hazardous Waste Management: The Home Depot may generate waste as a result of severely damaged products or accidental chemical spills. Waste stored on-site is properly packaged,labeled, secured, maintained and inspected by The Home Depot associates prior to disposal in accordance to federal, state, and local regulations. Hazardous waste manifests are maintained on file for verification of proper waste management and disposal. The licensed contractor selected by The Home Depot in conjunction with 3E Company will oversee hazardous waste operations and disposals. The contractor is responsible for providing and maintaining all required decontamination equipment. 11) Logistics: Because of the minimal chance of an incident,The Home Depot will utilize only licensed professional emergency response contractors. The logistics will be the responsibility of the contractor. 6 L r 12) Finance/procurement/administration: The acquisition of resources and any incident related cost will be handled by The Home Depot corporate office and their representatives. D)Incident Documentation: In the unlikely event of a substantial release,all appropriate federal,local, and state requirements will be met. This includes OSHA incident reports,spill/gmerator reports,and risk assessments. E) Training and Exercise Drills: In compliance with the OSHA Hazard Communication Standard and the Resource Conservation Recovery Act,the Store Manager and the Human Resource Manager provide Associates with the following training: • Federal Hazard Communication Standard"Right to Know' Law • Hazards associated with exposure to hazardous chemicals • Labeling System • How to read Materials Safety Data Sheets(MSDS) • Proper use and maintenance of Personal Protective Equipment(PPE) • Operations in which hazardous chemicals are used • Hazards involved with non-routine tasks • Emergency procedures • Protective measures against exposures • Proper waste handling,storage and disposal The Home Depot associates are also instructed in identification and handling of hazardous materials in the workplace. Additionally,Associates are trained in the containment and mitigation of incidental small chemical releases. The aforementioned training is provided in the following classes: 1) Hazard Communication training video, 2) Comprehensive Handling Hazardous Materials(HI"Training and quiz, 3) Annual Safety Training 4) And specific department instructions. There are also weekly inspections of personal protective equipment and weekly audits of work areasito ensure safe practices are being followed. Training shall be conducted upon initial assignment,reassignment to a new work area,and whenever a new type of hazard is introduced into the work area. Emergency communication systems,fire protection equipment and spill control equipment are tested and maintained on a regular basis to ensure proper operation. . The Human Resource or Training Manager will document that all appropriate and required training has been completed. After attending training sessions, each Associate is to sign off to verify that he/she attended and understands the training. On-site contractors are also to be informed of chemical hazards their employees may be exposed to while performing work at this facility. On-site contracting employer(s)shall be given access to a copy of the Right-To- Know guidelines. Contracting employer(s)must read and sign the guidelines. A copy is to be kept on file. F)Response Critique and Plan Review Modification Process: If a change to the contingency plan is needed(i.e.,updated emergency contacts), Home Depot associates should contact 3E Company's Regulatory Department at(760)602-8700. The plan will be updated within 30 days of any change notifications. G)Prevention: The Home Depot maintains hazardous chemicals primarily in prepackaged consumer products merchandised for retail sale. Products merchandised are stocked in such a manner as to preclude accidental damage,and to prevent spills or accidental mixtures. 7 L H)Emergency Equipment: The following communication equipment is available on site: • PA System • Telephones • Two-Way Radios The following emergency response equipment is available on site in the following departments—Receiving(Central Storage), Outside Garden, and Paint. • Spill Kits ' • Absorbent(Abzorb-it/Spill King)—used to absorb small hazardous materials spills(liquid) • Fire Extinguishers(ABC rated) • Eye Wash Station • Waste Storage Buckets(five gallon,plastic lined with lid) • Waste Labels n Aid Agreements and Emergency Response Coordination: The Home Depot has formally notified local police departments,fire departments,hospitals and applicable State and local emergency response teams to assist with the coordination of emergency services,pursuant to 40 CFR 265.37. 8 46re Unit D,W.Yarmouth, Massachusetts 02673, dated September 4,2020,and.last revised 1/15/21, Sheets 1 of 10 through 10 of 10, Sheet(Exhibit A); "The Home Depot Floor Plan and Elevations," prepared by Greenberg Farrow Architecture,Engineering, Planning,and dated 11/23/20, Sheets 1-3 (Exhibit B); and "DRI Analysis Calculation New Increase SF Area,",prepared by Greenberg Farrow Architecture,Engineering, Planning, Sheet I of I (Exhibit C)(collectively"Plans"), in and adjacent to a retail building,together with associated parking and access(collectively"Project")formerly occupied by Bradlees and adjacent retail tenants at 65 Independence Drive, Southwind Plaza, in the Town of Barnstable, MA(Premises);and'; 2. The Fourth Whereas Clause of the Amended and Restated Agreement for Judgment is hereby deleted in its entirety; 3. Paragraphs 2 through 9, inclusive of the Amended and Restated Agreement for Judgment, as previously amended,are hereby deleted in their entirety and replaced with the following: "2. The Parties agree that Home Depot shall not keep and maintain on the Premises at any time a total of more than 36,230 gallons of Hazardous Materials as that term is defined in Paragraph 3 below. Notwithstanding-the foregoing,Home Depot shall not keep,use or maintain any Hazardous Materials in the outside garden center or other outdoor spaces at any time,or in any store areas not provided with containment to handle potential spills or releases of Hazardous Materials." "3. For the purposes of this Amended Agreement,-,"Hazardous Materials" shall be defined per the definition set forth on page WR-33 of the Cape Cod Commission Water Resources Technical Bulletin`Bulletin", (effective 2/22/19)(See Exhibit D for Bulletin excerpt.)Also included in the definition are those consumer products that when released into the-environment may pose a significant threat to groundwater and drinking water supplies and Hazardous Waste as defined in the Massachusetts Hazardous Waste Regulations at 310 CMR 30.00).a "4. Home Depot,or its designee, has provided the Commission the name of the store manager and a memorandum describing Home Depot's standard operating procedures for assuring in-store compliance on a day-to-day operating basis with the limitations on Hazardous Materials set forth in this Amended Agreement(the"Hazmat SOP"). Home Depot shall also provide the Commission copies of any significant revisions of the Hazmat SOP within thirty (30) days of such revision." "5. Home Depot shall handle Hazardous Materials in accordance with the Standard Operating Procedures and shall report on the Iocations and quantities of Hazardous Materials in the store to the Commission three times per year, as set forth in the Arcadis Memorandum, "Hazardous Materials Classification and Accounting Procedures,"a copy of which is attached hereto as Exhibit E. The Commission retains the right to request that Horne Depot provide -SDSs for Commission review at any time,and Home Depot shall provide the same within fourteen(14) days of the Commission's request. The seasonal reports may be submitted to the Commission electronically." "6. The Commission or its agents may at any time enter upon the Premises during Home Depot's normal operating hours and undertake an inspection to determine Home Depot's compliance with the limitations set forth in this Amended Agreement. Immediately upon 2023625vl 2 I WATER RESOURCES TE..CHN.ICAL BULL�'IIN DEFINITIONS . Best Management Practice(BMP)-structural or:procedural Control 171eaSUre5 Implemented.to reduce the quantity and velocity.of stormwater I'idoffi and irnprove. water quality Fresh Water Recharge Area(FWRA)-Watershed area that contributes to a fresh water ` pond as defined by the topography of the water table, Hazardous:Material 4 Any chemical or'substance that when released into the erwironrYient will'pose a significant contaminant threat to groundwater and drinking water supplies. Hazardous Materials/Hazardous Wastes, Household.Quantity of-quantities-less than the following limits are considered Household Quantities: (a) 275.gallons of oil on site at any time to be used for heating of a structure,or to supply an emergency generator (b) 25 gallons or equivalent dry weight,total,of Hazardous material(s)on site at any time.(excluding oil as.classified in part(a)) (c) 55 gallons of'Hazardous Waste generated.at the Very Small.Quantity Generator level as defined in Massachusetts Hazardous Waste Regulations(310 CMR 30.000)and accumulated or stored on-site at any time. Hazardous Waste 'Any Hazardous Waste;Universal Waste,or.Waste as defined in the Massachusetts Hazardous Waste Regulations(310 CMR 30.010), not Including Hazardous Materials or biomedical wastes regulated under the Massachusetts State Sanitary Code(105 CMR 480.00). Impaired Area-impaired Areas are where groundwater may have been degraded by point and non-point sources of pollution,including but not limited to areas with unseweeed residential.developments with an average.lot size of less than 20,000. square feet; landfills,septage,and wastewater treatment plant discharge sites;and areas of high density commercial and Industrial development and those downgradient areas where groundwater may have been degraded by those sources. CAPE CUD COMMISSION WR-33 i �s ar MASSACHUSETTS FIRE INCIDENT REPORT l r 10 > .: ...... DEPARTMENT Revised Form :.::: 01922 Hyannis Fire Department Report l ; ?; ? If Ex Date Alarm Arrival In Service Iffi%&i 00622 Fire 006/18/94 Day ISaturday � 114:53 114:58 1 15:04 Sf WON FOUND ACTION TAKEN MUTUAL AID ill, Leak w/ No Ign `4 1 ;; Remove Hazard 4 .................... ill PROPERTY USE (OCCUPANCY) IGNITION FACTOR C Uncovered Parkin Area '9 6 5. I n Factor Undetermined 0 0 OCORRECT ADDRESS ZIP CODE CENSUS TRACT D SOUTHWIND PLAZA 02601 000020 O 11 OCCUPANT NAME (LAST, IRST, 7,) TELEPHONE ROOM or APT. PARKING LOT OWNER NAME (LAST, FIRST, MI) ADDRESS TELEPHONE F 12 FLATLEY BRAINTREE MA. G 13 METHOD OF ALARM CO. DIST. PERSONNEL AERIALS RESP. ENG RESP. 2 © RESP. El 0. 1 SHIFT HAZ MAT PRESENT? Y TANK. RESP 0OTHER RESP. C 0 Telephone (Direct) NO. ALARMS SUBSTANCE 12 0 3 1203 1 : SPEC. EQUIP. USED? 1/2 GAL JAN-SOLV O 20 FIRE TNJURIFS, F F SERVICE 0 0 ': > OTHER 0 < 0 O MOBILE PROPERTY TYPE VEHICLE STOLEN? ESTIMATED TOTAL INSURANCE CO. DOLLAR LOSS TOTAL INS. CLAIM PD 0 > >«< 0 0 •� 30 YEAR MAKE MODEL COLOR LICENSE NO. VIN# 40 1IF EQUIP INVOL. YEAR MAKE MODEL SERIAL NO. IN IGNITION O COMPLEX AREA OF EQUIP INVOLVED IN IGN. K ORIGIN FORM OF HEAT IGNITION ........:" MATERIAL FORM TYPE © . IGNITED ................. OMETHOD OF LEVEL OF ORIGIN Number of Stories CONSTRUCTION TYPE EXTINGUISHMENT EXTENT OF DAMAGE Flame ........ Smoke DETECTOR PERFORMANCE SPRINKLER PERFORMANCE op Material generating FORM ]TYPE ® most smoke AVENUE OF SMOKE TRAVEL R WEATHER CONDITIONS li Officer in Charge: Date ROBERT K.PICKERING LIEUTENANT 6/ 1 8/9 4 Comments for this incident have been printed on an additional comments page. - 3 Comments for Incident: 94 000622 Exposure: 00 Date: 6/18/94 THIS DEPI.RECEIVED A CALL FROM THE MGR.OF THE STOP&SHOP, HE REPORTED A GAS SPILL AT THE PARKING LOT. ENV. 826 WENT STILL ALARM, DN ARRIVAL WE FOUND A CAR THAT WAS LEAKING GAS ONLY WHEN THE ENG.WAS RUNNING, WE TREATED THE SPILL WITH JAN-SOLV.AND THE AUTOMOBILE WAS TOWED BY CAPE WAY TOWING. ENG.826 ALL SET TO QTRS. AT 15;04. OWNER,LUDIE WILLIAMS 40 STRAIGHTWAY HYANNIS. MA. TEL. 508 775 5677 1984 FORD,LTD SQUIRE VIN. 1 FABP4038EG108005 MA. REG. 437-APK R.K.PICKERING/LIEUT T 01922 A981030 0/24/9 Saturday ? 11 02 11 05 11 37 film", nce Drive annis 20 2 3��' f Type of Situation Found �� � Type of Action Taken Mutual Aide <a Fixed Property Use ��5 x Z P Y � � � ,E Ignition Factor � � 3 a � 'Stop & Sho 508 775 1774 ., x1� 3 tiaz rdau, M�teci�a�`t� � r�tisent� �t. Comment Page for • Incident No. A981030 Address 165 INDEPENDENCEDRIVE Date of Report 10/24/98- Commanding Officer Lt Kenney WE RESPONDED TO THE REPORT OF AN AUTOMOBILE LEAKING GASOLINE AT THE ABOVE ADDRESS.ENGINE 826 WITH FIREFIGHTER SCRIBI DRIVING AND FIREFIGHTER MEDEIROS IN THE JUMP SEAT.UPON ARRIVAL WE FOUND A 1984 FORD TEMPO,WHITE IN COLOR,PARKED UNATTENDED ON THE PAVED PARKING LOT.THE AUTO WAS FOUND TO BE LEAKING GASOLINE FROM AT OR ABOVE THE REAR SEAM OF THE TANK.THE STORE MANAGER PAGED OVERHEAD AND THE OWNER ARRIVED.HE WAS ADVISED OF THE SITUATION AND AGREED TO HAVE THE VEHICLE TOWED.OFFICER ROYCROFT CALLED FOR A DUTY WRECKER,A&F,WHO PROVIDED A FLATBED TO REMOVE THE CAR.WE APPLIED SPEEDY DRY TO MITIGATE THE ESTIMATED SPILL OF 1 TO 2 GALLONS. VEHICLE OWNER:MOHAMMAD CHAUDRY 123 WOODLAND AVENUE HYANNIS, MA. 02601 VIN 2FABP22R1EB265078 THOMAS F. KENNEY, LIEUTENANT 102498 • i 01922 A981002 0 of 0 0/17/9 Saturday �7 11 42 11 :48 12 23 � ��° 6 5 Inde endence Drive � H ann�s • 2 0 �`��' Type of Situation Found � � , Type of Action Taken � �£� . � "",Mutual Aids ` ..s x P n 9 '. t a� a 41 S �tl/teaks W/o 1 n�tron �i A 4 Remoue Hazard ��4r � ' t a r &�e I nition Factor 'Y Fixed Property User g k, +�- a a €� s a m roar „ 3aM- A eas9 6 5 00 'No F a 0� s> unc4vered� Parkin r sire F nd ,., jtE q . µpart ' iephp .. P vRON, x 7 StopAnd Shop Parking Lot Q1A!R J1T RMO I `n r,. t - � 3S ` �� 1AtrQTIe 9AldenP Way nnis,ma. 508 775g 501 8 Ter mina Das�lva Vieira �� � � � �raaia��da`us it 1,s 3 , 1iAateriats" ' MW ,� sent II fvto t( ee �C le` n1% Ct a a SEAa � IBM ffmm .z s �� r �� "� .gam" a �' �ra�'���"``�''���.` � • � ,.� r WRI a; pz yT t r Fig kF Ig�rrtrort�,�� "fs� r�'`vfiys�`' �`> ' Adz �r � � � � � ���s � �< ,�°a'�' •,��"�w ,��r�rs r� � -��� �, �-�* � m ��� �` r' Em � �� Deteo �erfoc �� r n r an )=lame R �. 3te�rrat �7eel�3tln ( o z s a e u x rs i t s Comment Page for • Incident No. A981002 Address NIDEPENDENCE DRI VE Date of Report 10/17/98 Commanding Officer Icapt E. Farrenkopf RECEIVED A CALL FROM THE STOP AND SHOP 65 INDEPENDENCE PARK FOR A VEHICLE LEAKING GASOLINE IN THE PARKING LOT. RESPONSE: ENGINE 826 F/Fs DARDIA, LANMAN CAR 812,BPD OFFICER BRIAN MORRISON UPON ARRIVAL HAD A 1984 OLDSMOBILE CUTLASS COLOR BROWN WITH A LEAK IN THE AREA ON TOP OF THE GAS TANK.PLACED A CATCH BUCKET UNDER THE LEAK AND COVERED THE AREA WITH JAN-SOL.I WENT INTO THE STOP AND SHOP AND HAD THE SERVICE.DESK PAGE THE OWNER. UPON ARRIVAL OF THE OWNER(TEREZINHA DASILVA VIEIRA)WHO DID NOT SPEAK ENGLISH I EXPLAINED THROUGH HER SON WHO DID SPEAK ENGLISH THE SITUATION.IT WAS DECIDED TO HAVE THE CAR TOWED BY THE DUTY TOWING COMPANY(BARNSTABLE COUNTY TOWING)TO A REPAIR SHOP ON THORNTON DRIVE. THE VEHICLE WAS REMOVED BY BARNSTABLE COUNTY TOWING AND THE SPILL AREA WAS WASHED DOWN. ENGINE 826 CAR 812 TO QTRS 12:23 ERIC FARRENKOPF CAPTAIN 10/17/98 1984 OLDSMOBILE CUTLASS MA REG #5723GR VIN # 1 G3AM47A4ER375214 OWNER TEREZINHA DASILVA VIEIRA #9 ALDEN WAY HYANNIS,MA 02601 508-775-5018 • I I 01922 A981002 0 of 0 0/17/9 Saturda 7 11 :42 11 :48 12:23 ��b 6 5 Inde endence Drive H ann,s 2 0 �M g'z$ T e of S,tuation Founder= a '� y YP h �� Type of Action Take n a � � Mutual Aid 41S 711/teak W/o I n�trorr� 4t 4 ¢ I t 3 emove.Hazard � 4 Fixed Property Used ; s f Ignition Factor - ��,� uncavered�; F'ark[n Area � 9tt6 5 � �00�� No F�r� Found` �� Oecu a,fxNI; � P Stop And Shop Parking Lot 5 0 8 7 7 5 9 6 3 0 ��� " „ `" }WEIeYl3a. = m �� e dsS •o e ft-M r d�A 4Yrlt Terezina Dasilva Vle,ra N 9 Alden Way Hyannis,ma 508 775 501 8 0 � " e'sent` I M;r.,5�w� 4 � �r erty 1rer � 1� oto I�gnsei RT �wYsr' °v�`a,._s���`z ��sn�'����' 'z�� �c. Sa �"�fr h '�m3 �`" `a a`zR re �t, � �a� - :far�°�E �fi` '- "• -�Y�%a�"z��v*. � "�`�z� � v..me. 9.��,��; ,..€ ,�,-.*�„'�r-,�. �✓1°�� "2,..w,.��°' .a��"..ata....,�,...�t '���3t.' .. .:�J.x=v��c"�.��a`�,.s�"���ss::���:� ...-: � ,. eth,d ofxm urs � euei f t1n n 411,4 C a� 3 b d�teoto� eroc �nca � � � r,rtKle'�I� � �'r�a�ic Ig f�rF 'r ar¢u - ,�,�� �' ater,aGer�e�a � N1os� rnoke s- ��, s RINK; r Comment Page for • Incident No. A981002 Address 165 1 INDEPENDENCE DRIVE Date of Report 10/17/98 Commanding Officer lCapt E. Farrenkopf RECEIVED A CALL FROM THE STOP AND SHOP 65 INDEPENDENCE PARK FOR A VEHICLE LEAKING GASOLINE IN THE PARKING LOT. RESPONSE: ENGINE 826 F/Fs DARDIA,LANMAN CAR 812, BPD OFFICER BRIAN MORRISON UPON ARRIVAL HAD A 1984 OLDSMOBILE CUTLASS COLOR BROWN WITH A LEAK IN THE AREA ON TOP OF THE GAS TANK.PLACED A CATCH BUCKET UNDER THE LEAK AND COVERED THE AREA WITH JAN-SOL.I WENT INTO THE STOP AND SHOP AND HAD THE SERVICE DESK PAGE THE OWNER. UPON ARRIVAL OF THE OWNER(TEREZINHA DASILVA VIEIRA)WHO DID NOT SPEAK ENGLISH 1 EXPLAINED THROUGH HER SON WHO DID SPEAK ENGLISH THE SITUATION.IT WAS DECIDED TO HAVE THE CAR TOWED BY THE DUTY TOWING COMPANY(BARNSTABLE COUNTY TOWING)TO A REPAIR SHOP ON THORNTON DRIVE. THE VEHICLE WAS REMOVED BY BARNSTABLE COUNTY TOWING AND THE SPILL AREA WAS WASHED DOWN. ENGINE 826 CAR 812 TO OTRS 12:23 ERIC FARRENKOPF CAPTAIN 10/17/98 1984 OLDSMOBILE CUTLASS MA REG # 5723GR VIN # 1 G3AM47A4ER375214 OWNER TEREZINHA DASILVA VIEIRA #9 ALDEN WAY HYANNIS,MA 02601 508-775-5018 • 1,rf MASSACHUSETTS FIRE INCIDENT REPORT �O 0- F DEPARTMENT Revised 9 2 2 Hyannis Fire Department Report Form If Ex Date Alarm Arrival In Service c ent•.# ..........::::.:.:.:. Day �00498 Fire 005/ 14/94 Saturday L—Ij 110 :45 10 :53 Ill :25 SITUATION FOUND ACTION TAKEN MUTUAL AID B ill, Leak w/ No Ign 4 1 '' Investigation Only FIXED PROPERTY USE (OCCUPANCY) IGNITION FACTOR C Market, Grocer Store 51 2 Part Failure, Leak, Break 5 .. OCORRECT ADDRESS ZIP CODE CENSUS TRACT D 65 INDEPENDENCE PARK 0 2 6 0 1 000020 O 11 OCCUPANT NAME (LAST, FIRST, MI) TELEPHONE ROOM or APT. STOP & SHOP 508 778-1774 OWNER NAME (LAST, FIRST, MI) ADDRESS TELEPHONE F 12 FLATLEY CO. BOSTON G 13 METHOD OF ALARM CO. DIST. © PERSONNEL ENG RESP. AERIALS RESP. >;2 RESP. 0. 1 SHIFT HAZ MAT PRESENT? TANK. RESP, OTHER RESP. B 0 1 : Telephone (Direct) N0. AL SUBSTANCE 0 0 1 SPEC. EQUIP. USED? O 20 FIRE F RESCUES SERVICE 0 i O ':> OTHER O L F O MOBILE PROPERTY TYPE VEHICLE STOLEN? ESTIMATED TOTAL INSURANCE CO. DOLLAR LOSS TOTAL INS. 0 CLAIM PD YEAR MAKE MODEL COLOR LICENSE NO. VIN# 30 40 IF EQUIP INVOL. YEAR MAKE MODEL SERIAL NO. IN IGNITION COMPLEX "'""' AREA OF .. EQUIP INVOLVED IN IGN. O K ORIGIN ................. FORM OF HEAT IGNITION MATERIAL FORM TYPE - 3: IGNITED METHOD OF ;:: LEVEL OF ORIGIN Number of Stories CONSTRUCTION TYPE OEXTINGUISHMENT EXTENT OF DAMAGE Flame ......... Smoke DETECTOR PERFORMANCE SPRINKLER PERFORMANCE OP O Material generating FORM TYPE no Material smoke AVENUE OF SMOKE TRAVEL R WEATHER CONDITIONS Officer in Charge: Date JOHN E. GRANT CAPTAIN 5/ 1 4/9 4 Comments for this incident have been printed on an additional comments page. I Co�n7inents for Incident: 94 000498 Exposure: 00 Date: 5/14/94 RECIEVED A CALL FOR OIL LEAK AT THE DUMPSTER TO THE REAR OF STOP&SHOP. UPON MY ARRIVAL I FOUND THE MAINTENANCE MAN FROM WASTE MANAGEMENT CO.CLEANING THE AREA. I WAS TOLD THERE WAS SOMEONE COMEING TO CHECK THE DRAIN. I TALKED WITH THE MANAGER OF STOP&SHOP.TOLD HIM THE SAME. CAPTAIN JOHN E. GRANT 5/14/94 M • MASSACHUSETTS FIRE INCIDENT REPORT :.;:.......... ::::>DEPARTMENT Revised Form :::. .. ......::..... >: 19 2 2 Hyannis Fire Department Report If Ex Date Alarm Arrival In Service den 0•.0.0..1...8 Fire 001 / 6/94 1 Day IThursday112:4 0 112:5 4 12:59 SI N FOUND ACTION TAKEN ;::;:: MUTUAL AID �aof, Leak W/ No Ign 4 1 Investigation Only FIXED PROPERTY USE (OCCUPANCY) IGNITION FACTOR C Food, Sales; Insuf Info 51 0 > Part Failure, Leak, Break OCORRECT ADDRESS ZIP CODE CENSUS TRACT D SOUTH WIND PLAZA 02601 000020 O 11 OCCUPANT NAME (LAST, IRST, MI) TELEPHONE ROOM or APT. SUPER STOP & SHOP OWNER NAME (LAST, FIRST, MI) ADDRESS TELEPHONE F 12 SAME G 13 METHOD OF ALARM CO. DIST. PERSONNEL ENG RESP. ........... AERIALS RESP. 2 RESP. E � 0 SHIFT HAZ MAT PRESENT? TANK. RESP. : OTHER RESP. B 0 1 Telephone (Direct) NO. AL SUBSTANCE 0 0 1 : SPEC. EQUIP. USED? O 20 FIRE O F 0 . . OTHER SERVICE 0 ::: »>> 0 L . z' O F O MOBILE PROPERTY TYPE VEFIICLE STOLEN? ESTIMATED TOTAL INSURANCE CO. DOLLAR LOSS TOTAL INS. CLAIM PD 30 YEAR MAKE MODEL COLOR LICENSE NO. VIN# 40 IF EQUIP INVOL. YEAR MAKE MODEL SERIAL NO. IN IGNITION O COMPLEX AREA OF >: EQUIP INVOLVED IN IGN. ORIGIN FORM OF HEAT IGNITION MATERIAL FORM .. TYPE •• © > IGNITED METHOD OF LEVEL OF ORIGIN Number of Stories CONSTRUCTION TYPE O EXTINGUISHMENT L] EXTENT OF DAMAGE Flame ......... Smoke DETECTOR PERFORMANCE SPRINKLER PERFORMANCE COop YPE Material generating FORM T ® most smoke WEATHER AVENUE OF SMOKE TRAVEL R CONDITIONS Officer in Charge: Date JOHN E, GRANT CAPTAIN 1 /6/9 4 Comments for this incident have been printed on an additional comments page. 1 C�Tr riehts for Incident: 94 000018 Exposure: 00 Date: 1/6/94 RECIEVED A CALL FOR A SMALL OIL SPILL AT THE STOP&SHOP AT THE REAR OF THE STORE. I RESPONDED IN 803 AND FOUND THERE HAD BEEN A LEAK AROUND THE COMPACTOR.SOMEONE HAD PUT SPEEDY-DRI OWN. I CHECKED WITH THE MANAGER AND SHE HAD CALLED SOMEONE TO PICK UP THE SPEEDY-DRI. CAPTAIN JOHN E. GRANT 1/6/94 ..� .. .. . > ti r- r .. �.--•-ter..-,...-..,. .,.�. ,--_-.: ... .� ... ....r .-_ ,� ... TOWN OF BARNSTABLE BAR-W Ordinance or Regulation WARNING. NOTICE Name of Offender/Manager Address of Offender MV/MB Reg.# Village/State/Zipf Business Name �K o 5 '4G� /pm, on Business Address r,VIP . Signature of/Enforcing Officer Village/State/Zip �)Vll 0 YI i r o;z1'n ! Location of Offense 4<10k I"-, 1 Enforcin`g� Dept/Division Offense t�'1 DI 14 1'Ink 0<)IdyL �tl� ����'S-t t�1-�<a� a 4��►�'� Ei�r'%��c!t �'l�+�r� e2 S� tt ✓' r tt ff_ � tt i Facts eler /100 r is !nr^, .!.r. cs , „tt ,Er,r. a ic�►'�' ta�.�T �d Alt It t►c�?of SE' 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 ' Ordinance or Regulation WARNING NOTICE Name of Offender/Manager A Address of Offender MV/MB Reg.# _ Village/State/Zip 4 , Business Name - i' ! ,� i,00 ram/pm, on 20 1- Business Address f cf x'._ , "-a 1rt , '>nV"- '''4 " Signature of/Enforcing Officer Village/State/Zip ` ` �4ffi ► -� , rtt` �` Location of Offense ' ,,k V Enforcing Dept/Division Offense + �� -tt Facts i ^t '} , 6� • �-'C�'.{J I'}✓! ii Cdi ��14%t t"' fir }i I r. IVI .►. 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.