The URL can be used to link to this page

Home My WebLink About0035 IYANNOUGH ROAD - HAZMAT i i 48420 P4 www.pendaflex.com ` MADE IN USA 30% PCW GufLess® File Folder FEWER PAPER GUTS Number Fee 167 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that JT's Pool & Paito 35Iyanough Rd., MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111.GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 30, 2008 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. 7/1/2007 PAULJ. CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health i Town of Barnstable °F > Regulatory Services Thomas F. Geiler,Director `' "B Public Health Division 9 MA9S. 4y 10q,: ♦0 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 ki -01 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT MAIL kteM6 a( I NAME OF ESTABLISHMENT �T SpLSI �•-7Q [tC� _Lrl C ADDRESS OF ESTABLISHMEENT TELEPHONE-NUMBER OB $ -- �i4 `P SOLE OWNER: `�YES NO -- c CD -a IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: N co W r- ED rn IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO.045-505-3oZ STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: (�,�,� PRESIDENT doh n�eml�l c,u 530 Q_ck i k n� hoc400s hkl 5 Inq TREASURER dS abLu-e. CLERK -T A I I ILA%1 1%.I%_-./ L am M.Q. SIGNATURE 0- (A�PP ICANT RESTRICTIONS: HOME ADDRESS 530 Co�U�{ Rd 111\OT OttS �II1��5 �IN'a HOME TELEPHONE# .bl-4Q-9-y5 y 2 Number Fee 167 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that JT's Pool & Paito 35Iyannough Rd., Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. - ------ ---- ----- ---- - ---- -------- --- ------- - --- ------ ---- --------- --- ------ --- - eu®ro) --------------------------------------------------------------------------------------------------------------------------------------- ----- 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 is Town of Barnstable Barnstable ��zTa�ti Regulatory Services Department o ;erieaC-i DARIV ffPABLE, Public Health Division • I 'm 9� &MLAM 9. � 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. -DATE U! 131 C)� APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT nCk&4.M6�0 ( 1 NAME OF ESTABLISHMENT J 1 F5 �ool �- Pox� Co 'En C, ADDRESS OF ESTABLISHMENT 55 � l TELEPHONE NUMBER 5 O SOLE OWNER: " YES NO d p Q. pr1�,(a --�na IF APPLICANT IS A PARTNERSHIP,`FULL NAME AND HOME ADDRESS OF AI99 PARTNERS: . X S IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. O STATE OF INCORPORATION (� FULL NAME AND HOME ADDRESS OF: PRESIDENT 5 3>J � I N q TREASURER CLERK p—irumblaq 4 SIGNATURE OF APPLICA T RESTRICTIONS: HOME ADDRESS 550 R� l'-IG Mor4onshiliz �TJ HOME TELEPHONE# 5OB -433 ` 5 4 4 Q:\Hazmat\Haz Mat Application2008.DOC ;l Town of Barnstable Regulatory Services P °s Thomas F. Geiler,Director ' RARMNMASS.CAB . ' Public Health Division 039. ♦0 A�EDMA'�ah Thomas McKean,Director ®) ✓Sl'r CS'7i1 200 Main Street, Hyannis,MA 02601 t p ' 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 i I I GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT O Z 1 r eNAME OF ESTABLISHMENT "C Ila C. ^ ADDRESS OF ESTABLISHMENT 35 —Lu Q n rl n t►n[l Rd A u o n Tl l g TELEPHONE NUMBER 5 O 51 L!al " A H H i) � SOLE OWNER:—ZYES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. C)4 3-3 O J-S a STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: 11 PRESIDENT-7T'6%N-TLMbLfiy 53D !9T 1149 r(lars-tOns hX115 ft A TREASURER M K-T�A R T P EM flLMy CLERK IGNATUR OF APPLICANT RESTRI.CTIONS: HOME ADDRESS Jr'30 kt 14 q norz4o rl-'!. _ ..HOME TELEPHONE# ' SO1J=gt A-la 2 tin.dod-W q Town of Barnstable oFIME, Regulatory Services ('I Thomas F. Geiler, Director peg Public Health Division ArF1639. a Thomas McKean,Director 200 Main Street, Hyannis, MA`02601 Office: 508-8624644 Fa�: '5 08 746-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. 3 4 3-nO 3 DATE 5-1 C4-O Lt APPLICATION_FOR-PERMIT TO STORE AND/OR UTILIZE MORE THAN - III GLLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT Y C�.l('(�O�W 1 NAME OF ESTABLISHMENT -CS�O�� c -TO'Ato =nc, . Rd oaWsi ADDRESS OF ESTABLISHMENT 3 5 _l l!Q Yl n l�U I(� ']�Q 1( n YY1 TELEPHONE NUMBER `J D$ g l r,d•r� D SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: - ': 4 2> IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 044 -3. 5-c3AA STATE OF INCORPORATION rM V1 FULL NAME AND HOME ADDRESS OF: PRESIDENT 53 t TREASURER bk,3 abour— - CLERK SIGNATURE O APPLICANT - RESTRICTIONS: HOME ADDRESS 5W 0->C L)1► ill (1C tJrlS HOME TELEPHONE# c51�j4• s�l Q:\Application Forms\HAZAPP.DOC } Ar 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$100.00. Please make the check payable to: Town of Barnstable. The check must be mailed to the.address listed above. Allow up to four days for in-house processing. .�a:y��. '{"-, �t�r ,t..,,, 5 r '�.� e.r.: �•�':y+i°"r5( �'"!!. r „ � �}t ;'�"Dv�b v� ?��.$ �t�fi;a.t � ,�rs 17r'�'`�'4' s�":;�dw Y ,eS.y� .Y,:` ati. t�'�` >7.;.. i'. }.... s3J •"J i " -,.h ..;P .�1� r,?J+:rr. �'a y y,�t tt rti y7 „*�iv#"� �t r,?+�:y d ,�t��Mr^��"fy,", r n ,-i� ,sr,i' x ,H ,Y'.`F 1 ? �'`s'iyb `� ;-;y w ate....: r; r�l,,, ,��!'a �n �.4�'. -eta ;�t, �X- jra' "'" � Y m�, f'.nj. s �.xa :s�,LL '�i:rC' +�„t i.�+� '+ yy��'r::?1P/..t� Y -c""•o is•�'x'� .Z s.-;� �.;ti,. i f i � '�. 5 i.+. �,as i1..•-�> .xi A^�...� t:,v � � ?^ i�.t w �' �`'F^e 1. � }'.,,n.r K�x,: �f „, �'� ,.�'! -y,'..., it `s<_r�,. r A-lr s �! .� �.'^"s „`[�, . ! 4 s,� �* :�,:. ttr L .y P Ytq++.`2, . r �� i h or♦' ro „."� �.,a,�4C' °a !;=N � �.+xx rtsye=. s •r r,� i ^�:)� tsttT ':-:i r -� �+ rw:bpi&Cp1.•'-`'P,y'`-��"�*:..'ti�4 ?r�r�k.�° s.t••� ,Y,��,+R 4�;;�5 h ,;�;�, ra�.f„�r, �. �e,xo.�:._ +..«� -.,. �;.,:�.r. :s..'q r� «g: x i. t � r- 1 �,� 4 rz..R .1.. ;r"•:�'' ,7 r. ,x i� 4 x �r Y +t '4� }��f.•, For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page r . Q:\Application Forms\HAZAPP.DOC Number Fee 167 THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that JT's Pool & Paito 35 Iyanough Rd., MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 30, 2007 unless sooner suspended or revoked. --------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. May 24, 2006 PAUL J. CANNIFF,D.M.D. THOMAS A. MCKEAN,R.S.,CHO Director of Public Health In PD l�J Date. (oU-7 �/ � TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: �'1�,5 �oa�l F'Gt�4-c'a . BUSINESS LOCATION: Jh2efd'L�:5 �� `� MAILINGADDRESS: INVENTORY TOTAL AMOUNT' TELEPHONE NUMBER: ft CONTACT PERSON: �'To�fa.n ern e.Y.�Iyl u,H . , �n �c. I `70 .8 EMERGENCY CONTACT TELEPHONE NUMBER: TYPE OF BUSINESS: ado F 1 e Dt 57�ICT OTHE INFORMATION: '.S s e M 50S aP� azo4'r-xv 0.;L-- — .612ffe,4e_39'. es LA Waste Transportation- Name of Hauler: NkJ kaL _e v Destination. Waste Product: /V/A Licensed? Yes No LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. _ NOTE: UST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed ( a!I ons +000/ Antifreeze(for gasoline or coolant systems) Drain cleaners /(p 09NEW USED Cesspool cleaners Automatic transmission fluid `:;g 4a.� Disinfectants Engine and radiator flushes Road Salt(Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils !6.'7SPesticides , NEW USED e�"``. (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diese!fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink `` Degreasers for driveways&garages /. Wood preservatives (creosote) Battery acid (electrolyte) 9 Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt& roofing tar Fertilizers Paints, varnishes, stains, dyes PCBs Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon te'trachloride)- ------ Paint&varnish removers, deglossers as Any other products with 'poison' labels Paint brush cleaners -- Floor.&furniture strippers (including chloroform,formaldehyde,- Metal polishes hydrochloric acid, other acids Laundry soil &stain removers —� Other products not listed which you feel (including bleach) may be toxic or hazardous (plea a list): Spot removers&cleaning fluids Misc.: Sb.25" (dry cleaners) v e✓ /0 N. Bug Other cleaning solvents �X�cCc .4197. 3 awl and tar removers 3e157 lal�la�b-� Z 3. 2 e Town of Barnstable-Health Department Page HAZARDOUS MATERIALS INVENTORY SITE VISITS ®LA DBA: JT's Pool&Patio,Inc. Fax: ` Corp Name: Mailing Address Location: 35 lyanough Rd.,Hyannis Street: 35 lyanough Road mappar. City: Hyannis Contact: iJohn Tremblay State: Ma Telephone: (508)862-2440 Zip: 02601: �-- Emergency: (508)428-4548 Person Interviewed: Business Contact Letter Date: 6/2/2004 _......... _..... _... ....-.... r f \ Category: Miscellaneous Inventory Site Visit Date: 6/7/2004 p .... r Type: Follow U /Inspection Date: W ublic water ❑ indoor floor drains ❑ outdoor surface drains license required ❑ ivate water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc currently licensed ❑ to n sewage ❑ indoor catch basin/drywell ❑ outdoor catch basin/drywell expir - -- - date: 6/16/2004 ��❑ on site sewage ❑ indoor on-site syste El outdoor onsite system -- - - ---- Re rks: 6/5/96 BC Fire extingusiher&ABC. Chemtrec&Fire Dept.for compliance: e ergency response. Has MSDS Sheets. H2 02=24 gal. Remarks: Satisfactory Pool chemicals stored in one room. MSDS sheets on site.Chem.Tech for spills. Note: See 97 inspection report for current list of chem. REMARKS: 6/4/98-MSDS in file. Acids moved away from oxidizers/alkaline chemicals during indpection. No liquid chlorine. Back-up storage in sicond bay. 275 AST outside dumped on ground. ORDERS: Remove t AST,275 gal within 30 days.4'4'� ;lle S— a LA c/1 ems, -( f Page 2 Town of Barnstable-Health Department HAZARDOUS MATERIALS INVENTORY Chemicals: ❑ Zero Toxic Waste Materials W gty's>25 Ibs dry or 50 gals liquid but less than 111 gals ❑ gty's 111 gals or more description: :' , qty „unit ofymeasure, swimming pool chlorine 48 g Waste Transporter: Fire District: Last HW Shipment Date: Waste Hauler Licensed: No 5 owti,_� P 7 •jZ. ��(. v 'a , Lf 13 � Li % b �- -�-tv .�� 'a— � 5 � L � Or/Y�'�ZR-�'' StRh o 5 � � 5 2 iJ i ' l Hazardous Materials On-Site Inventory/Inspection For ALL Shops and Businesses: DBA: Location: Date: Physical Features to Inspect: 1. Hazardous waste generation sites (production/manufacturing areas): N 1A 2. Waste storage areas: /4 3. Satellite accumulation points throughout: 4. HazMat stored outdoorsy — CHECK OUTSIDE: 5. Shipping and receiving areas: a/ 6. Run down of shop activities: 7. Housekeeping practices: A/ a J HazMat On-Site Inventory/Inspection: Records to Review for SQGs and CESQGs DBA: Location: Site visit date: • Hazardous Waste Manifests: �� /vv c-vq MA-e-, • Employee training documentation (if required): L� • Hazardous substance spill control and contingence n: • MSDS on site? ✓ - � • HazMat Inventory records (if applicable): U-. • HazMat Waste Shipping documentation: • Spill records (if applicable): TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: Board of Health MAILING ADDRESS: Town of Barnstable TELEPHONE NUMBER: P.O. Box 534 Hyannis, MA 02601 CONTACT PERSON: Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalli g, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: iVdW__ TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when store Please put a check beside each product that you store: Antifreeze (for gasoline or coolant systems) Drain cleaners }� Automatic transmission fluid _� Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils _ Road Salt (Halite) Gasoline, Jet fuel Refrigerants Dteee*-# kerosene, #2-4eati9grff' _V"'Pesticides (insecticides, herbicides, _ Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes ,Paints, vamisfte-str%tair ,Ayev Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair nters BOARD OF HEALTH O satisfactory 3.2.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS v Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJORMATERfAL S Case lots Drurns Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: oline, ue Iairensj, Kerosene,. 2414 Heavy Oils: wa or oil C) new motor oil(C) V 1C v transmission/hydraulic ,9zza V Synthetic Organics: degreasers i ce apgp us: j - ae A* V DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply 004 &JV 0Af9-1-3 01 7 O Town Sewer ublic On-site OPrivate „u. 3. Indoor Floor Drains YES—J(' NO O Holding tank: MDC O Catch basin/Dry well XOn-site system 4. Outdoor Surface drains:YES NO ORDERS O Holding tank:MDC �C O Catch basin/Dry well c O On-site system - 5.Waste Transporter , Name of Hauler Destination Waste Product YES NO 1. 4&W 5�w all erson (s) Int rviewed Inspector Date