The URL can be used to link to this page

Home My WebLink About0075 IYANNOUGH ROAD - HAZMAT "75 ��a�li9oWd ) ' f a,A2 Y✓l AT — 1 S M E A WEEPING VOU ORGANIZED No.10334 2-153L MADE IN USA GET ORGANIZED AT SMEAD.COM TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS:f�,rM Board of Health MAILING ADDRESS: G n Town of Barnstable TELEPHONE NUMBER: 33 P.O. Box 534 CONTACT PERSON: _�u� Hyannis, MA 02601 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities t tal 'ng, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored id 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/0q§Vj00s Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine _X Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, X_ 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 `�"^^':h+J�t �e7-T.,-,.i'�^'"�*••��`�""'.�.�ry+�(4n"f'�:t�..+„`.+..+�3."'F`y'r�y..,i ��:;. '�" �a•pPeF`.. -71y.�a�'7'!m,A�'f`^7 i-�.._:erE..�.,.,.. _ :4�},'..,,,, fe{;.�.a,�K.w x;:, TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH Q satisfactory 2.Printers „� - 3.Auto Body Shops_ i _ O unsatisfactory- 4.Manufacturers JF CO MPANY'7"�/,�1,.�/� �1 4 e4,A.L9f— (see Orders ) 5.Retail Stores 6.Fuel Suppliers ADDRESS "�- �� r Class': 7•Miscellaneous #�'�*MfQUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) -MAJOR MATERIALS Case lots Drums Above Tanks Undergi-ound IN OUT IN OUT IN OUT #&gallons Age Test Fuels: - Gasoline,Jet Fuel(A) Diesel, Kerosene, #2 (B) F' Heavy Oils: waste motor oil (C) new motor oil (C) x transmission/hydraulic Synthetic Organics: degreasers,�wK 1�/,.�'.ld e .'+� %may` ` !!! A 144 4?e,e i 44R - Miscellaneous: eerl DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply zre1 " °� ,� �G Town Sewer Public �O On-site OPrivate ; / 3. Indoor Floor Drains YES N0 O Holding tank:MDC. O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERSs ' O Holding tank:MDC O Catch basin/Dry well ' O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product •d 2. Person s"Interviewed Ins• ector ` Date L TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM 'NAME OF FIRM: CROWELUS LAWN MOWER SERV110E MAILING ADDRESS: 75 1YANOUGH ROAD HYANNIS, MA. 02501 TELEPHONE NUMBER: 'j °l 5 - o o 3 L CONTACT PERSON: 7FstK -bF-0- Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any, time, more than 50 gallons liquid volume o7 25 pounds dry weight? yES ;/ NO This form must be returned to the Board of.Health regardless of a YES or NO answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS i The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put ! a check beside each product that you store: Antifreeze (for gasline or coolant systems ) Refrigerants Automatic transmission fluid Pesticides (insecticides, Engine and Radiator flushes herbicides,rodenticides) Hydraulic fluid (including brake fluid) j Motor oils/waste oils Photochemicals Gasoline, Jet fuel Printing Ink I Diesel fuel, Kerosene, #2 heating oil Wood preservatives(creosote) Other petroleum products: grease, f Swimming Pool chlorine i ! lubricants g ; _ 1 Degreasers for engines and metal Lye or caustic soda Degreasers for driveways & garages Jewelry cleaners I r, Battery acid (electrolyte) Leather dyes Rustproofers Fertilizers (if stored Car wash detergents outdoors) j Car waxes and polishes PCB' s Asphalt & roofing tar Other chlorinated hydro- f. Paints, tetrachloride)varnishes, stains, dyes carbons, (inc.carbon Paint and lacquer thinners Any other products with Paint &. Varnish removers, deglossers Paint brush cleaners "Poison" labels (including � Floor & Furniture strippers chloroform, formaldehyde, Metal polishes hydrochloric acid, other Laundry soil & stain removers acids) (including bleach) Other products not listed Spot removers & cleaning fluids which you feel may be (dry cleaners) RECEIVED toxic or hazardous (please i _ Other cleaning solvents HEALTH DEPT. list) : z Bug and tar removers TOWN OF BARNSTABLE Household cleansers, oven cleaners Drain cleaners Toilet cleaners Cesspool cleaners MAY 2 9 1981 Disinfectants Road Salt (Halite) f t TOWN OF BARNSTABLE BOARD OF HEALTH n /CONTROL OF TOXIC AND HAZARDOUS MATERIALS .- INSPECTION SHEET�e FIRM b�✓ � ' life kyh7 ADDRESS Major types of materials: 1) 2) t . . 3) 4) 5) 6) I. Description of material(s) use: II. Storage (denote product by number listed above) A. Containers metal glass paper plastic cans,bottles,jars 3r® J JOAI$ 0 drums,barrels120 ' aboveground tanks •� / f underground tanks *� .w 13�a Oft bags,boxes open,loose,uncovered inadequate labelling B. Storage Facility v/or # Remarks/Recommenui;!Aons 1. Indoor a) separate, contained room b) stored in general work area i) inadequate ventilation ii) floor drains iii) inadequate fire protection 2. Outdoor a) uncovered, exposed to weather b) pervious surface/catch basins III. Disposal z A. Reclamation/Recycling unit B. On-site disposal 1. Town sewer 2. Regular septic system '':S , 3. Separate holding tank C. Off-site disposal 1. hauled by own firm 2. hired hauler i a) name of hauler ^ ' b) address or disposal site Perso.n(s) Interviewed , Ins ector Date ? 6 30 el SOWN OF BARNSTABLE COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repai.r (,J satisfactory 2. Printers ROAR D OF.- HEALTH 3. Auto Body Shops ®unsatisfactory- 4. Manufacturers `" (see"Orders" -S. Retail Stores COMPANY�Ct�€,t�ti : �-tZGU?� '��rL/ ) 6. Fuel Suppliers ADDRESS � 0 7-�} f��-�z�r � Class: 7. Miscellaneous fr . QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums AbdveTanks Undetground Tanks IN UT IN IOUT IN IOUT # & gallonserest? Fuels: Gasoline, Jet Fuel (A) Z Diesel, Kerosene, #2 (B) 4 Y , e Heavy Oils: waste motor oil C new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers. Miscel-Vaneous: f r / DISPOSAL RECLAN.ATION REWLRKS: 1. Sanitary Sewage 2. Water .apply jTown Sewer Public On-site O Private 3. Indoor Floor Drains: YES NO 4 Holding tank: MDC �— OCatch basin/Dry well On-site system r^" �+��.. fiV',�..�.^�M'.. ,fit',! C'� �'••a, 4. Outdoor Surface drains:YES NO QHolding L tank: MDC O Catch basin/Dry well On-site system S. Waste Transporter Licensed? yams of�Hauler- Destination WaSte ProductYESI-NO 12 9-1 81 Person(s) Interviewed / Inspector Date ' COMPLJANCE: CLASS //I_-, Marine.Gas Stations.Repai.r i"OWN OF BARNSTABLE-• :2. Printers satisfactory 3• Auto Body Shops BOA D OF HEALTH 4• Manufacturers , Rr unsatisfactory- 5 Retail Stores (see"Orders' COMPANY , . 6. Fuel Suppliers ' 7 Miscellaneous ADDRESS ` ! (. ;�.ij ; rrc- ,�11.:-=- Class: ' !T—~ QUANT (1N=indoors; OUT=outdoors) TIES AND STORAGE MAJOR MATERIALS Case lots Drums ' AboveTanks Undetground Tanks s IN Ur p6 rellonse fest? Fuel s: Gasoline, Jet Fuel (A) Diese .�Kero-senep� 2 (B) Heavy'0ils: r waste motor oil (C) �� r new motor oil. . .. (C) 13 transmission/hydraulic Synthetic Organics: degreasers l Miscellaneous: r 'a DISPOSAL RECLAM�A'fIUN REM US: -_� j j 1. _Sanitary Sewage 2. Water Supply °� QTown Sewer public On-site 4 Private -t 'u oor Floor Drains: YES NO Q Holdi ng tank. MD C ._._ 0 Catch'`basin/Dry well ._..__ •..._: Q On-site system ; - t- ;7 4. Outdoor Surface drains:YES N0: i Q Hulding• tank: MDC ' Q Catch basin/Dry well -�°c-- J I OOn-site system S. Waste Transporter Licensed? npqt i nat i on, ` ,ru 23, eilnspe&t'dc Date t '� .,G m i d,.., s ' •�o TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: Board of Health MAILING ADDRESS: 7� -� 2-S Town of Barnstable TELEPHONE NUMBER: 17,5123 ' P.O. Box 534 CONTACT PERSON: ,� �' Hyannis, MA 02601 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totall' , at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES - NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities totalling more than 50 gallons liquid volume or 25 pounds dry weight. 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 9 p Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy Business ti`�'-.a».-�--r^--�:..�..,,Y,r.,;T^I•--•:".,_^�.,;r„r.;�,,,--w,.n,;`"7�{'*...r-."ti,."''�....w,.,..<..,a.1-T:•�S^,,y,,...,.».:a,-ram,•.'.-'''!�''"-,..f^-f--.�,.s,...,,�,:..,,,yr. '..,5,�,� ,1->. p,,.J''�""..,.--•.,',`..- TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME F BUSINESS: ' � � Q Board of Health MAILING ADDRESS: '� Town of Barnstable TELEPHONE NUMBER: 175 -3,3 48 P.O. Box 534 CONTACT PERSON: Hyannis, MA 02601 Does your firm store any of the toxic or hazardous materials listed"'below, either for sale or for your own use, in quantities totalli,ng', at any time, more than 50 gallons liquid volume or 25 pounds dry weight? .'YES - NO This'form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: y LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit Toxic or hazardous t characteristics and must be registered when stored in quantities totalling more than 50 galloris liquid " volume or 25`0ounds dry weight. Please put a check beside each product that you store: Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners r Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) - Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers .Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners r' . Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes. i Fertilizers (if stored outdoors) Paint & lacquer.thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners r (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 i Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business