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HomeMy WebLinkAbout0151 IYANNOUGH ROAD - HAZMAT 329- Isl - Nla-� Number Fee 55 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Cape Cod Auto Body ------------------------- ..................................------------------------------------------------------------------ 151 Iyannough Rd., Hyannis, MA .-------------------------------------------------------------------------------------------------------------------- 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 CYARREMLE Inspectional Services ARRE EPublic Health Division 4 rt•%.YFiT B14 t B►nrMBM = Thomas McKean, Director ,4, ��39. 200 Main Street, Hyannis,MA 02601 P a P� Office: 508-862-4644 Fax: 508-79OZ04 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE 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 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 V(V5-r 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. °��l _ 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. '--b11 1 , ' � 4. FULL NAME OF APPLICANT- ►ra W 5. NAME OF ESTABLISHMENT: d ��'� V W 'C- 6. ADDRESS OF ESTABLISHMENT: ICJ o 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE. �• Box , 4(O M 8. TELEPHONE NUMBER OF ESTABLISHMENT: - 1 S 9. EMAIL ADDRESS:_ i O►^'� 10. SOLEOWNER: YES -✓1VO IF NO,N ME OF PARTNER 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME V1) 'n,-e t boC PRESIDENT—&" TREASURER l91 Ct r CLERK r •. 12. IF PREP BY OUTSID ARTY: NAME: TELEPHONE#: • COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICAN DATE Q:Wpplication FormsU3az Mat Appli Draft Jan 9.docx Number Fee 55 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Cape Cod Auto Body 151 Iyannough Rd., Hyannis, HA 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.,CH() Director of Public Health r 6 Town of Barnstable • Inspectional Sc vices BARNS ' BLE �1KF)p csre• c,u•cu mvaq• o* Public Health Division :J9.7G16 9a�s LF..Q Thomas McKean,Director �0reo 3.y p�0 200 Main Sueet, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERAIIT 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 MY 1st-JUNE 30th). APPLICATION FEES CATEGORY I PERMIT 26-- 110 Gallons: $ 50.00 CO CATEGORY 2 PERMIT 111 -499 Gallons: $125,00 �g �b����l�;it� CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ElP "A late charge of$10.00 will be assessed if payment is not received bY,1ul1Ist. `3 � -t� 1, ASSESSOR'S MAP AND PARCEL NO. 302 6- 2. IS TI-118 AP ERM IT RENEWAL? � YES—NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS • ZONING/BUILDING APPROVAL FOR 1AZARDOUS MATERIALS STORAGEMSE OF GREATER THAN HOUSEHOLD QUANTITIES (2S GALLONS)? YES NO, 4. FULL NAME OF APPLICANT; 5. NAME OF ESTABLISHA'LENT: o"A P",t, 6. ADDRESS OF ESTABLISHMENT: �x vtYIDcX��� L� t"�UC��1411 4r C��l Qd 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: •L VI S "A' 0,:;�601 8, TELEPIIOh'E NUMBER 01<l:S I'ABLISIIMENT; b �')�y --X1 L � "° .gip Y 9, EMAIL ADDRESS; J its Y7 10. SOLEON'i'NER: YESINO M NO,NAME OF PARTNER; �y L% 11, FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: 1 CORPORATION NAME- fir, kou PRESIDENT r: TREASURER CLERK b 1 ` �- -- 12. IF PREPARED BY OUTS11 t'PARTY: NAME: TELEPHONE Ih COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT ' DATE Q:1Applicnlian Vormsl}laz Mat App Revised 09.1 -18.doex NUMBER FEE 18 THE COMMONWEALTH OF MASSACHUSETTS $150.00 TOWN OF BARNSTABLE AGENT'S OR SELLER'S LICENSE - CLASS I FOR THE SALE OF SECOND-HAND MOTOR VEHICLES In accordance with the provisions of Chapter 140 of e e a in o Tracy Volk p-e Co - - -- - --- --- - whose principal business is the sale of new mot r as a e Volkswa a, Inc. -.-. - ----- - -- --- -------- -- ---- - --- ----- -- -- -------- - ------ or who has a signed contract as required by Se n)58, Class 1, is nse#to urch sen ll, as incidental or secondary BAR thereto, second-hand motor vehicles at No. 686 ute 132 1 ugh Rd;f 81 Cedar St., 63 Cit Avenue, Hyannis w on premises described as follows: BU NS/STS F CRET FRAME CONSTRUCTION. TWO SHO O REAS & PREP FACILITIES. OFFICE SPAC W& USED CARS. PARKING FOR CUSTO T AT 63 CIT AVENUE, HYANNIS. RESTRICTIONS: Lot at Cit Avenue restricted to 44 vehicles as s own on plan approved by the ildW' C Innussioner on 1017113. f Issue Date: January 1, 2019 Signed .. ..... ................................. lb - ........................................................................ THIS LICENSE EXPIRES: December 31, 2019 THIS LICENSE MUST BE POSTED IN A CONSPICUOUS PLACE UPON THE PREMISES. • JD Number Fee 55 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Cape Cod Auto Body 151 Iyannough Rd., 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 Ala FC-1he.- ' ow of Brnsxable TROeg atory ervlces Richard V. Sc*Director S , ` j Ta`"� Public Health Division. BABSTABLE C ASTABLE. = Thomas McKean, Director i "7¢a;4� 9� i6 9 A 200 Main Sheet, Hyannis,MA 02601 �JO11�0� M Office: 508-862-4644 Fax: 508-790-6304 r APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 1085 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 3Oth). 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 payment.is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL?/YES_NO. IF YES, SHIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: rod�VrA W 5. NAME OF ESTABLISHMENT: p _ CJ 6. ADDRESS OF ESTABLISHMENT: I n A+ 4 VI VA I t4 VV oa(,cQ 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: VT S. TELEPHONE NUMBER OF ESTABLISHMENT: 56 -7-7 5 s oZ So S -3a 1 i 9. EMAII,ADDRESS: Cf C yu L , on VVA 10. SOLEOWNER: YES JNO IF NO,NAME OF PARTNER: r� raC i 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME 'I e Ya . PRESIDENT_'V�?r kbr W. 0- TREASURER V4,ojtq ro-rsA1 ( d S CLERK IC1014 J 5XIA1 12.- IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: r SIGNATURE OF APPLICANT DATE Q\Application FormsU-AZ141AT APP 2017 REVISED.docx Number Fee 55 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Tracy Volkswagon A Cape Cod Auto Body 151 Iyannough Rd., 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 Sv 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 TRowr of B anstable eg atory ervices Richard V. Scali, Director " dUA � Public Health Division BARNSTABLE enu:sra+ •axr�vi .connr.nra:ms Z • xutsw:snut5 csrengxsrrte:a i awaivsTwarE. Thomas McKean, Director 1639:639-20zo14 ND MAM �Fn 3 a 200 Main Street, Hyannis, MA 02601 573 `n Office: 508-862-4644 aa`� Fax: 508-790-6304 X APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE 0 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 ,� V19. CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? \,/YES_NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS • ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. d� 4. FULL NAME OF APPLICANT: Y-Oj 5. NAME OF ESTABLISHMENT: C 6. ADDRESS OF ESTABLISHMENT: S -1 Cc V 10 U!4 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE.12�OX- 14 CaQ kqcLnw 3 FAA- CD-6ol 8. TELEPHONE NUMBER OF ESTABLISHMENT:5—OR ---1-75— a� 9. EMAIL ADDRESS: 10. SOLEOWNER: YES 'VINO IF NO,NAME OF PARTNER: �J 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION N �r iJ) oad L40 Re PRESIDENT TREASURER a, I , CLERK ' 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANAr TE &kb Q:Application Forms\HAZMAT APP 2017 RD V1I,E °p IKE*oHti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 7 BARMST�BLE.g` 200 Main Street• Hyannis, MA 02601 �'D'FOMP�a`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: CQ Coe� A- - 66 r&z Y Vo Date: Location/Mailing Address: S o 4xy7 Contact Name/Phone: A A-fke vL- I,�u,,00vrAo---- Sog - 7-75-2-12-Z Iry � 1/�2v Inventory Total Amount: #SDS: S License#: 2— Tier II : 1� c Labeling: AV^k &ti tQ Spill Plan: o Oil/WaterSeparator: tJlpt Floor Drains: 0 Emergency Numbers: Off• Storage Areas/Tanks: --S5,61 o < 5 & Emergency/Containment E ui ment: .,-\ " o 1 e, Waste Generator ID: D I o10� Waste Product: 'VA01"Agl-1 PA"Vtl o, Date&Amount of Last hipment/Frequ nc I IQO*Alnc s4' �o K .L Vg� Licensed Waste Hauler&Destination: If 0 Other Waste Disposal Methods: !!L 1 ' +CAkig&w--t y" Or Eb �atd-, m Swglc4 or �g�D�• LIST OF TOXIC AND HAZARDOUS MATERIALS (� V&w) 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) _ Z 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 c, s insecticides, herbicides, rodenticides Battery acid (electrolyte]/batteries 7-�" �,/ 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: ©(Lcw \0VG\AA O� olkli VJ OR ERS: V .L khV- V •t 5 L 1 b �Cti -fA b`ICe,a S, INFORMATION/RECOMMENDATIONS: 944, L% \ s ov2{ 0 4 vti 1 2 C� w '� Gt � 017G� ,,�-� nspector: -�- h, A,f nwL•— VK��J'-o a kVL� 4'o ow. 4 14� -1, Facilityke resentative- 1 46 WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS / I IKETo Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMT-R- .A g' 200 Main Street• Hyannis, MA 02601 �'DTEO MP'�p`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Ca Apr, Ca/ 4,4e, 6,1y �( racy 'VD&l sw���-� Date: Location/Mailing Address: I S'f/ Ty•e h 4 ov f iL 1Q,,-e d q o h,S Contact Name/Phone: �' -,A ' 0 87 � -7-7 ��- ;7--722 ATO D-rt vd&"� Inventory Total Amount: ^-?l 7 c J MSDS: S License#: Tier II : K3D Labelina: wa,StL o•11® Spill Plan:M Oil/WaterSeparator: A Floor Drains: EmeWency Numbers: StorageAreas/Tanks: - 5 -C.7wlggo-1 k� tn,..1,�e�Covt a 2-�5 Emergency/Containment Equipm nt: S � � o� Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: �2 `� �o c.1Au S%v.c e_ a. k + - Licensed Waste Hauler&Destination: ,t, s row 1 ytA•( o-r less Other Waste Disposal Methods: bx>c e <rUL- QA�.w4 S 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) `Ji Windshield wash Z. 1-1 Motor oils—00,5A.#, 151k\t Z Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants V Miscellaneous petroleum products: Road salts grease, lubricants, gear oil 2 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 g Wood preservatives(creosote) _ Asphalt&roofing tar ,�o��,�<S; Swimming pool chlorine s, stains, dyes caustic soda Lacquer thinners 15k\%.O � @('ckdA — M s erllaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables 41 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" `Lo V1,�15 L �,a J(4-- (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: o S Jill � Ayk. aVJo-' b\'p— ORDERS: oy Co�D�I 3� 11 Cove k�9,� �I �►�- 1��` „ 2�ur �.���/ mac. INFORMATION/RECOMMENDATION Ci o1 c.o atwcc o v� O c < .� I.JI WS. v ikvke,�,t< `Fc�c 1 Its/ �-o Oell I 6 InC� wtR NO ow�,C.�'v5,Leo � nspector: Facility Representative:�(JAJ WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS I i oF�►�ro Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 B"RM SS. 200 Main Street• Hyannis, MA 02601 or'w'o+ TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: C4 jpg-Co AoL r C V Volks Date: G 11 1 Location/Mailing Ad ress: ISI ✓ qv,- � �.- l 4riy%I s Contact Name/Phone: : !!91D$ - -775-- a-.-t7-2 �h+ti C9-,bbS Inventory Total Amount: MSDS: e S License#: SS Tier II : NO Labelino: ,� Spill Plan: AJp Oil/WaterSeparator: Floor Drains: A�y Emergency Numbers: 2 Storage Areas/Tanks: 2-SSgwl jQatvt`I-Shoo ow oer,A Aa1164 on Emergency/Containment Equipment: Waste Generator ID: D Waste Product: wa8te Qa�► -� nvLGf Date&Amount of Last Shipment/Frequency: 2 ILI O a I ,( Licensed Waste Hauler&Destination: bo v)4e p1av <-bors Other Waste Disposal Methods: P'ai� MR11 LIST OF TOXIC AND HAZARDOUS MATERIALS ►�� v�il 01- 6In4 5 1vt fv,*Vcv�O f 610 -e- le s j- 1A loK NOTE: Under the provisions of Ch. 111, Section 31, of the General La Gvs of MA, hazardof s 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 V Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants %7— 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 49 Wood preservatives(creosote) Asphalt&roofing tar 09 Swimming pool chlorine Paints, varnishes, stains, dyes W Lye or caustic soda Lacquer thinnersi 1 0 vim- � �'"w Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes 7— 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: 'kAz)v),o1•e.. d AJ2&ocs L, o+6o+ Cole-+,o.�. . ORDERS: /yo_y6A,40- v-4SA, •-4AD6-rs 06,!1 saa,ps. INFORMATION/RECOMMENDATIONS: �j- �l Cori „�Ie�S C4 52Cl,�t bU vt �►ti. Inspector: j L't1�0 l-e.- Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS TOWN OF BARNSTABLE Date:B /26 /13 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: a a v o Ifac Vol swa n 10 BUSINESS LOCATION: ► ahrtoo 4vl Y1 16 INVENTORY MAILING ADDRESS: Sa yK,c, TOTAL AMOUNT- TELEPHONE NUMBER: -77.5-- X-Ml- /t. CONTACT PERSON: o Iylyleq.-�, EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: &v 0 AS INFORMATION / RECOMMENDATI NS: L'1e-ZW-ejf Fire District: 4 b5o w s q ✓a i oA S )� • Co�ce c. ,�� A c},o s : ', e-� a 1 ���u Nt�. ,r►.�.I Gor1. ►tic.rs o�l�•Ce� 2) 15 100 ` axC o or a10 J2� c)2_ ,kSH I V1 w I - lei �-}� ppeer a ac+o�?�ble� _ a co,o s c-ov�.�. haste T _MA�TB►oS�pS9 Last shipment of hazardd�s wast�: 8 zo ►3 ss 4 r Name oiauler: �,,+ob o�y col�e►�' 2coye Destination: al�o(S - y Waste Product: l,�zs-F� „�.-� �l�.r,,.�� Licensed' es No MAC®S3�,S2 6�7 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 (o Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners 1 Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils ZU Pesticides O(NEW SED—t�w�s�ecre� (insecticides, herbicides, rodenticides) A (Y�OT�"`, Photochemicals (Fixers) Gasoline, Jet fuel,Aviation gas Diesel Fuel, kerosene,#2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil, d0M,9M6$o<0% 1 ❑ 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 p Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt&roofing tar PCB's 46 Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, 8oc' Lacquer thinners (including carbon tetrachloride) L� NEW30 0"USEDSS 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 I CANARY COPY-BUSINESS Applicant's Signature Staff 5 Initials LEI 1 I BRUCE P. GILMORE ATTORNEY AT LAW 99 WILLOW STREET YARMOUTHPORT, MA 02675 (508) 362-8833 FAX: (508) 362-5344 E-MAIL: capecodlawyer@comcast.net September 10, 2014 Thomas McKean, Director Public Health Division Town of Barnstable 367 Main St. Hyannis, MA 02601 Re: Cape Cod Auto Body Dear Mr: McKean: I represent Cape Cod Auto Body, Inc., 151 Iyanough Road, Hyannis, MA. My client has requested that 1'r`espond to your letter of September 3, 2014. Please be advised that Cape Cod Auto Body does not dispute the findings or the compliance order nor does it request a hearing before the Board of Health. My client is discontinuing its prior practice of washing vehicles with soap. Cars will now be washed with water only or if soap is required, the vehicle will be washed at a compliant facility. Finally, Cape Cod Auto Body will explore an alternative arrangement which fully complies with the Hazardous Material Ordinance if it chooses to wash vehicles with soap in the future. If you have any questions, please don't hesitate to contact me. Very truly yours, Bruce:P. Gi-more' . /gg enclosures SEN D ER: COM PLETE T H IS SECTIO N .'COMPLETE THIS SECTION ON DELI VERY� ■ Complete items 1,2,and 3.Also complete A. Sign re item 4 if Restricted Delivery Is desired. ❑Agent A Print your name and address on the reverse X ❑Addressee If so that we Can return the Card to you. a eivedrinted Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. I P I i '11'"ff I 1. Article Addressed to: D. Is delivery address different from item 1? ❑ es If YES,enter delivery address below: ❑No ��h �►�6s f�� �I C� 3. Service Type K Y)n 6 A Certified Mail® ❑Priority Mail ExpresC � eR iegistered etum Receipt for Merchandise V)yj I S O' _6 Q I ❑Insured Mail ❑Collect on Delivery 4. Restricted Delivery?(Extra Fee) ❑Yes t✓ 2. Article Number • . . • (transfer from service►abeq 7 012 1010 0 0 0 0 �:2 8 51`.;4 4 3 3 M I PS Form 3811,July 2013 Domestic Return Receipt I UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4®in this box" ti �m L -Pµd(, , 11 v►s:�, o wY) 6T 8aAnS+n� e Zo 0 M&1V1 ST 1 S M4 02 O i ts III," f ' I III 1p # 't 17Jt1 is1!i I m OFFICIAL CO Postage $ ru I Certified Fee �x'l S Ala p ReturnReceipt Fee Postmark t3 (Endorsement Required) V ere O A E3 Restricted Delivery Fee 1. 20�4 0 (Endorsement Required) v pTotal Postage&Fees t ,a L'SPSf fU Sent To 'j 4 /+', 1 (S - ------•------- - - --------------- IM Street Apt.No.; r � or PO Box No. �.J � 11 ±1 ►'f'Oi/ N ------------------------ ------- —Ciry,State,ZIP+4 ,r S 4 O��O l� "41 Certified Mail Provides: a A mailing receipt* ■ A unique identifier for your mailpiece ® A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Maile or Priority Mail®. o Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. e For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". a If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking: If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. i PS Forrn 3800,August 2006(Reverse)PSN 7530-02-000-9047 Town of Barnstable oFIME T Regulatory Services Richard V. Scali,Director Public Health Division BARNSTABLE, Thomas McKean,Director 9� 163 S. � 200 Main Street, Hyannis, MA 02601 Phone: 508-862-4644 Email: health@town.bamstable.ma.us Fax: 508-790-6304 . Office Hours: M-F 8:00—4:30 September 3,2014 Mr.John Gibbs RE: Vehicle Washing Wastewater Discharge Cape Cod Auto Body 151 Iyannough Road Hyannis,MA 02601 Dear Mr. Gibbs, On June 11,2014,Timothy Lavelle, Hazardous Materials Specialist for the Town of Barnstable,visited your facility at 151 Iyarmough Road for an annual hazardous'materials compliance inspection. He discovered evidence that vehicle washing with the use of soap is being performed outdoors in the back of your facility without an approved waste water collection system. You were provided with a copy of the Town of Barnstable Vehicle Washing Policy for your reference during the site visit. Your facility lies within the Town of Barnstable Wellhead Protection Overlay District. Please note that the Town of Barnstable Vehicle Washing Policy prohibits the use of any cleaning agents including but not,limited to: "chemicals,soaps, degreasers or detergents" in the use of vehicle washing without an approved waste water collection system. Also,Town Ordinance Chapter 108,Hazardous Materials, Section 9, Prohibitions,states in relevant part that,"The release of any hazardous materials and/or acutely hazardous materials upon the ground,or into any surface or ground waters or into any sewage disposal system,sewer system, catch basin or dry well within the Town of Barnstable is prohibited." This Ordinance was adopted to protect the public health and welfare, especially as it pertains to the public drinking water supply. As requested during the compliance inspection,please develop an alternative method/arrangement for cleaning your vehicles, which I understand is a vital component of your business. Please submit your alternative plan in writing to the Public Health Division for review within the next 30 days. If you wish to dispute this finding and compliance order,you may request a hearing before the Town of Barnstable Board of Health. Please submit your request in writing within the next 30 days. The Public Health Division appreciates your cooperation and acknowledges your intent to maintain compliance with the Hazardous Materials Ordinance. Please contact Timothy Lavelle at 508-862-4644 should you have any questions. Sincerely, 1�57 as . McKean, RS, CHO Public Health Division,Director . j Number Fee 55 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Tracy Volkswagon DBA Cape Cod Auto Body 151 Iyannough Rd., 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 06/30/2017 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 Q C,7 Town of Barnstable Cifs►M� Re ulatory Services lip gi, ti g °� Richard V. Scali, Director (� '" MAS& Public Health Division I BAMSTA 1639. nx"s°,u:sos�e'�inuemrw'siao`""' e� 165754 'O Thomas McKean,Director � 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790204 W 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 30th). APPLICATION FEES CATEGORY I PERMIT 26— 110 Gallons: $ 50.00 ❑ c CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 l � 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 Ist. ASSESSORS MAP AND PARCEL NO. DATE lQ U FULL NAME OF APPLICANT: M cQ f ct (o . 77ac NAME OF ESTABLISHMENT: W - k(- b 6 ADDRESS OF ESTABLISHMENT: ' E Q ✓1 S A, Ua(o 0, MAILING ADDRESS DIFFERENT : t O 1 M' A-CD TELEPHONE NUMBER OFESTABLISHMENT: 50 d q EMAIL ADDRESS: i CL VU_ Ykl SOLE OWNER: YES-NO IF NO,NAME OF PARTNER: �YQ FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME t cC VO 5W -en A C�� PRESIDENT ra ' LN , ,(O--Q- TREASURER (c(C CLERK e 1 IV4'-ry-aC k I (� „• IF PREPARED BY OUTSIDE PARTY: SI - N-AyTURE-OF APP--L--ICANT—) Name: Company Address Telephone#: Email: Q:\Application Forms\HAZZAPP Rev I6.docx Page 1 of 2 Number Fee 55 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Tracy Volkswagon DBA Cape Cod Auto Body 151 Iyannough Rd., 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 to - ,i o Town of Barnstable Regulatory Services Richard V. Scali,Director s r BAR ' 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./ DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN Ill GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT 4 ►'Lt NAME OF ESTABLISHMENT • ADDRESS OF ESTABLISHMENT 176 '"Cawlnojo, os TELEPHONE NUMBER. SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. (I)q' c� STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT , ' 4. ;1 TREASURER s d CLERK SI ATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS ( -recyf )4( V- )r U), HOME TELEPHONE# -C�� C:\cache\Temporary Intemet Fi1es\0LKD3\IiAZAPP Rev20IS DOC l IHE rod Town of Barnstable Office: 508-862-4644 Fax: 508-790-6364 a. Regulatory Services Department • BA8M Public Health Division v Mom. Thomas A. McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt Hazardous Materials Payment received: $100.00 (Check) on 6/15/2015 j Check number: 22734 Check amount: $100.00 Name on check: Tracy Volkswagen, Inc. 'Business: Cape Cod Auto Body Owner: 153 REALTY LLC Address: 151 IYANNOUGH ROAD/RTE 28, Hyannis I r� L �j Number Fee 55 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Tracy Volkswagon DBA Cape Cod Auto Body 151 Iyannough Rd., Hyannis, MA Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------------------------- ---------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2015 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health r Town of Barnstable °F1HE rqk, Regulatory Services ti Richard V. Scali, Director MAABLF. Public Health Division prED 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 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT 0& i UY d NAME OF ESTABLISHMENT cod LI-D 1O ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER SW 2!3- SOLE OWNER: YES 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 M(4- FULL NAME AND HOME ADDRESS OF: PRESIDENT &WW W,naM Cyeoq it I I Dr, w. 1'JI.Q, m8 oz( (� TREASURER ( 1 trCj Q u CLERK II W 1�GL� ,re 14-0 j Dr In s �SIGNATURE'_OF AP_P_L-ICAN RESTRICTIONS: HOME ADDRESS lgGf "[�hti pr, w, rnbl.���o2 `b HOME TELEPHONE# Q\Application Fonns\HAZAPRDOC Number Fee 55 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Tracy Volkswagon DBA Cape Cod Auto Body 151 lyannough Rd., 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 PA_U_L J.CANNIFF, D.M_.D. _ 6/30/2010 JUNICHI SAWAYANAGI — THOMAS A. MCKEAN,R.S.,CHO Director of Public Health re. Town of Barnstable OFIHE ra Regulatory Services • �`` °° LE. ° Thomas F. Geiler, Director BA ASS.MASS. : Public Health Division 9 M4 �0 1639. pTFDMA�A 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 (-R (D APPLICATION FOR PERMIT TO STOKE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT 60Cj hLY-Cl NAME OF ESTABLISHMENT CM Co(I aA rYMiJ ADDRESS OF ESTABLISHMENT 151 1Cjc0/)a-re d. 17LlCi,),1� 5 /'l� b�(�Q1 TELEPHONE NUMBER �(��" 7ZS" a 7 SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. (4/aw3�2tz 7 STATE OF INCORPORATION !n'I FULL NAME AND HOME ADDRESS OF: PRESIDENT fi cJ U1° /C) A TREASURER H. T 1 , t1dis tlQ CLERK • SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE # n'*-CjQt), 'o D 3C— hlaz.docA%u'y 04 Number Fee I 55 THE COMMONWEALTH OF MASSACHUSETTS $100.00 do Town of Barnstable Board of Health This is to Certify that Tracy Volkswagon DBA Cape Cod Auto Body 151 Iyannough Rd., 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. July 1, 2008 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable Barnstable Regulatory Services Department AtAffmiltaCky BARNBTABLE, Public Health Division • � 11. "& ' 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 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT r l LA -a V G�w�2�j4c •d`b c OF ESTABLISHMENT CJ ADDRESS OF ESTABLISHMENT 1 J I - 4'CAnO h . 0 HA. UZ(o Ol TELEPHONE NUMBER 1.3 SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS QF ALL PARTNERS: c_ ' IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. Di-/_cqL/3 j9 STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT ArbO 6Yzj P1,4 /9 6 TREASURER �G� l (c J D", fqn ;i CLERK / W' ;Qn1TA-TU1M OF APPLICANT RESTRICTIONS: HOME ADDRESS _IQ �iC'CLt- H1"ll ��. GU fkt HOME TELEPHONE# Q:\Hazmat\Haz Mat Application2008.DOC r i Number Fee 55 THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that Cape Cod Auto Collision - Tracy Volkswagon 151 Iyannough 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 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 f Town of Barnstable (� . Regulatory Services :.� g rY Thomas F. Geiler,Director • saxtvsxas�. + 9� sGg9, �' Public Health Division °Teas° Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT 6rCk(J 1 (( L NAME OF ESTABLISHMENT OC2,a- e- CT)d a jA fi) ADDRESS OF ESTABLISHMENT 151 T7k CAn n h - IA /)l 5 FV) pZ( 0 .TELEPHONE NUMBS-R SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: N ( Q ! C-1 :!r CA 7C� IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO: STATE OF INCORPORATION ,` S S C(-C h u S--� m FULL NAME AND HOME ADDRESS OF: PRESIDENT 6r(jd h:r-v w-%r�lCu TREASURER���� N l�Cgi 2 7q ri i j i-, Dc, Maus'vn S rl f is CLERK 2_d. SIGII(ATITRE OF APPLICA RESTRICTIONS: HOME ADDRESS /9 Gre4f- 07`11 )?H. W.&/M2 ubk-L- HOME TELEPHONE -NAO-aO$D Number Fee 55 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Cape Cod Auto Collision - Tracy Volkswagon 151 Iyannough 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 Town of Barnstable Regulatory Services Thomas F. Geiler,Director Public Health Division / ►/►��)— d .�._' Thomas McKean Director 200 Main Street, Hyannis,MA 02601 Office: 508-862A644 Fax:.508-790-6304 . Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT a;.X Ct (Ycj NAME OF ESTABLISHMENT Caot (,OCr al 11) 00 L[I -51 Qq, i- Res,by 6o ' • ADDRESS OF ESTABLISHMENT FJ - Manna , jn . n✓1 iS .02100( TELEPHONE NUMBER �-��S ` ra SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL ;.,., PARTNERS: CJZ IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. ON•Z(432 - STATE OF INCORPORATION 1`4CAS SCA(h�,cs-e 1+5 FULL NAME HO ADPRESS OF: PRESIDENT to d ,r k/'. TREASURER ;y N - i r� y 2� rl�.sh D� 1'f6/5rcy)5 njl1 s MA UZ(oL19 CLERK )o/AI t j- 7 rr4 M'q o710+{ SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS i P'' w- F V%, HOME TELEPHONE. MAIL,-IN REQUESTS Please mail the completed application form to the address below. Also include copies of your employees food sanitation training certificates. In addition, please include the required fee amount (see fees at bottom of this page). 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 copies of your employees food sanitation training certificates. In addition, you must mail the required fee amount (see fees at bottom of this page). 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, cail (508) 862-4644 Back to Main Public Health Division Page wf Number Fee 55 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Tracy Volkswagon DBA Cape Cod Auto Body 151 Iyannough Rd., Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. f -------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 6/30/2014 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 6/30/2013 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health r o ©f Baxnst2-ble r ' of1X ReguhtorY SenIces Thom Y Gamer,Di dar P-abhe Health Dmision 2DOijam Sta Rya=s, A 02501 ' F� SOS-790-b304 OE, cz: 5084 24644 A ,ppliczEcn Fee: V Oil C ASS SS�RS�i�P A P A�C� D NO. ATT, a� 3 ATPLICATION FOR PERMIT TO STORE 111 G_A T.T.n TS ®F If A- A MIUCTS 1�ATERLkLS /�1 ,,J (,mat IF=NAMZ OF APPLICANT Y-a �"O w N� OF EST H. L 0 u 0� ��DDI�ESs of EST-Ik H.��-' ' C� �-t!� oar a/ i -17 PHo_NT NUMB= 7 S P `7 a' o, o 0 SOLD owe: S NO L tt AND HON ADDRESS OF. I1 to T H PLICA�-T IS A PAI�T�`�, �J PART-NE,RS: j C6 Y'Yf t z APPLICANT IS A cORPIORATION: F=12AI IDrT=CATz-0N No. G y a y 3 9`7 ST,, I= of IN CORPORATION TDI L ETA AND H0N9,ADDRESS OF: Pi SID i I t,U sae Fq ti Ho DRESS a�STR7cTzoN�: w � � HONE TIIIUHo�g 4 =7�nctwp/q F 5'- y Date: �- 0 TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: C&gag. C&zg BUSINESS LOCATION: 4:rZ . INVENTORY .MAILING ADDRESS: •TELEPHONE NUMBER: .TO$ 7 7S— � . - 2 -7 Z TOTAL AMOUNT: CONTACTPERSON: � ,�� ar _T;e_zy /�f427ad, 0 . cvt' EMERGENCY CONTACT TELEPHONE NUMBER: TYPEOFBUSINESS: FIRE 0 r57-qlC7'+ OTHER INFORMATION: Afl s �z ✓ ea- Waste Transportation: ham P-d Name of Hauler: n*-04Ar Destinatio Waste Product: citave .N �� fl� Licensed?.�Y4eNo 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: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed (gallons): Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel 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) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners . Sara Car waxes and polishes Leather dyes Asphalt& roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's ✓ Lacquer thinners Other chlorinated hydrocarbons, 25-A04EW Z SED (inc, carbon tetrachloride)- Paint&varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners ` (including chloroform,formaldehyde, Floor &furniture strippers Metal polishes hydrochloric acid, other acids) Laundry soil &stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids Misc.: J�he (dry cleaners) Z Other cleaning solvents l Bug and tar removers a. . ,iocv f Town of Barnstable-Health Department Page 1 HAZARDOUS MATERIALS INVENTORY SITE VISITS DBA: Cape Cod Auto Collision&Restoration Fax: '7 75__ 9" Corp Name: Tracy Vol kswagon Mailing Address Location: 151 lyanough Road,Hyannis Street: 151 lyanough Road mappar: City: Hyannis Contact: Milve Weed;,Mqr� Verv-27 JKI?,c-" State: Ma Telephone: (508)775-2722 Zip: 02601, Emergency: Person Interviewed: Business Contact Letter Date: Category: Inventory Site Visit Date: Type: Follow Up/Inspection Date: S6 public water ❑ indoor floor drains ❑ outdoor surface drains ❑ license required ❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc ❑ currently licensed ❑ town sewage ❑ indoor catch basin/drywell ❑ outdoor catch basin/drywell expir --- - - on-site sewage ❑ indoor on-site syste ❑ outdoor onsite system date: _......_. Remarks: 5/16/97 Flamable liquid-stored in locker. Spray booth with compliance: fresh air system,3M charcoal masks,absorbant pads for spills,MSDS Satisfactory sheets on site. I I A t Page 2 Town of Barnstable-Health Department HAZARDOUS MATERIALS INVENTORY Chemicals: ❑ Zero Tc.ic Waste Materials gty's>25 Ibs dry or 50 gals liquid but less than 111 gals S�gty's 141 gals or more descriptiorU: qty:''' unit ofrneas'ure degreasers for drivewa........................... m... .. _.............. _ . _..__ ...__ __. _., ..��.�.... a_cquer thinners 1 55 gallons paint,varnishes,stains,dyes I 30 gallons other cleaning solvents 5 gallons _............................................_...........-.....-....-..................................... ...._..............__............................._............,.........................._..._.. ...........................................__.....__.....__............... paint,varnishes,stains,dyes 20gallons paint,varnishes,stains,dyes _ _125 liters waxes and polishes 10gallons Waste Transporter: varf�, Fire District: Last HW Shipment Date: Waste Hauler Licensed: PIN ryL. r Hazardous Materials On Site Inventory/Inspection For ALL Shops and Businesses: DBA: Location: Date: Physical Features to inspect: v p 1. Hazardous waste generation sites (production/manufacturing areas): 2. Waste storage areas: 3. Satellite accumulation points throughout: V 4. HazMat stored outdoors — CHECK OUTSIDE: 5. Shipping and receiving areas: 6. Run down of shop activities: 7. Housekeepin/g practices: r HazMat On-Site Inventory/Inspection: Records to Review for SQGs and CESQGs DBA: Location: Site visit date: • Hazardous Waste Manifests: 14 • Employee training documentation (if required): 14 f • Hazardous substance spill control and contingency plan: U 6-5- • MSDS on site? • HazMat Inventory records (if applicable): • HazMat Waste Shipping documentation: • Spill records (if applicable): /y/A. Number Fee 55 THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that Tracy Volkswagon DBA Cape Cod Auto Body 151 Iyannough Rd., 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 Town Of Barnstable Barnstable THE r Regulatory. Services Department o sl"maica Uy • # , ,5-� 8 Public Health Division 9 �� 200 Main Street, Hyannis NIA 02601 �A i b3 q. � m TFD hW�° 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 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT &dt7yet t-j , T NAME OF ESTABLISHMENT /-a c NI tia5 w C�3 &q �c, � . ADDRESS OF ESTABLISHMENT D� 775 TELEPHONE NUMBER 7 o^1 v� SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS F ALL,(— PARTNERS: _ CILI o � r N � - IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. -a STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: G PRESIDENT W AP 620 TREASURER A64LL4 /A-2q Altshic IDA G,d t1; 6 q CLERK . 6r(InSAtb te HI-) 0 aco e G\`ATURE OF APPLICf1`(T • RESTRICTIONS: HOME ADDRESS . ROME TELEP}TONE t5c,� �fao-aoSD QAHazmat!Haz Mat Application2003.DOC TOXIC AND HAZARDOUS MATERIALS REGI TRATION FORM Mail To: NAME OF BUSINESS: Board of Health MAILING ADDRESS: / Town of Barnstable TELEPHONE NUMBER: P.O. Box 534 CONTACT PERSON: Hyannis, MA 02601 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO V 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: MrxP TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored ' Please put a check beside each product that you store: Antifreeze (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 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 TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory 3.Printersdy Shops //�� O unsatisfactory- 4.Manufacturers COMPANY 1- (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Class: 7.Miscellaneous MAJOR MATER* QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATER S Drunis Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons 7,77 Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: 0 w��rW DISPOSALIRECLAMATION REMARKS: I:Sanitary Sewage 2. Water Supply O Town Sewer Public kOn-site O Private 3. Indoor Floor Drains YES--LNO Holding tank: MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: r O Holding tank:MDCt O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 2. erson (s) I 'terviewed Inspector Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM .—� Mail To: NAME OF BUSINESS: Board of Health MAILING ADDRESS: Town of Barnstable Lj TELEPHONE NUMBER: b-17 2 S'��Z,�� P.O. Box 53 4 � Hyannis, MAA 02601 CONTACT PERSON: ,,/if��AA.L-1.!5 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO /-`- This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered 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 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, T 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) 'RA� Lfbters.-- Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business �,•.� _ ,., f. ...,'�, -41°`A r...» en�+c '%i+- +..'+w'4t '"''tom '"w..,. '"•-... .`ra�'fiA"-',tf!i`l„d at�y -i#t", ivr�ii"'F•'""!,y""�,i,';i i. h� p.f.Y'T- •.� .E; '+t>• ^Sfie",`'E�+.'n.^qa,.+.i•.:�r:.+� C.,}�j13v,a,+,S'..s,t,;,,�•..+.. M TOWN VV N OF�BARNSTABLE COMPUANCE: CLASS: 1.Marine,Gas Stations,Repair . nters BOARD OF HEALTH QQ''`satisfactory 3.A2. uto Body Shops_ j ,+' O unsatisfactory- 4.Manufacturers COMPANY �^.f�� c/ (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Class: S 7.Miscellaneous f rQUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel(A) Diesel, Kerosene, #2(B) Heavy Oils: waste motor oil (C) . t new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Y Miscellaneous: ` J �a I .. 'DISP.OSAURECLAMATION REMARKS: �r p "1.'$anitary Sewage 2.Water Supply "'�� "` ,.�,�.�'1"rzi.406�<' a i O Town Sewer fO,Public s O On-site OPrivate x &A'4t�a_ & ' 7,4 � 3. Indoor Floor,Drains YES VNO O Holding tank:MDC �. .G' /b Catch basin/Dry well O On-site system 'Frl 'i,4. Outdoor Surface drains:YES NO � ORDERS: . O Holding tank:MDC •O Catch basin/Dry well O On-site system 5:v Waste Transporter Name of Hauler Destination Waste Product YES. N0 2. \,,Person (s) Interviewed "Inspector i Date h TOWN -OF BARNS +AB- LB ` Z"-. Prin- ters satis!actor' o Body shops B'OARD OF HEALTH C.- Manufacturers dovnsatisfactory- o (see"Orders") S. Retail Stores COMPANY , .- a 6. Fuel Suppliers ''� ` 7 Miscellaneous ADDRESS rotj , _ ` fFr Class: Or `""L ' ' 1` QU IES AND STORAGE (IN=indoors; OUT=outdoor Is i�' t, > ase lots Drums Above Tanks Undetgcoued Tanks MAJOR MAT `7�,Y. IN r IN lour_ R 8 Qt l lops a rest Fuels: Gasoline, Jet Fuel (A) Diesel; rosene, Z (B) Heavy Oils: 1 waste mom to"61 (C IlL ,- new motor oil (C) transmission/hydraulic l Synthetic Organics:.. degreasers - Miscellaneous: • i DJSPUSAL { GEWWMIUN 1. SanitarySewage 8 2. Water Supply 0 Town Sewer Public On-site Private V 3. ndoor Floor Drains: YES NO - 4 Holding tank: MIX l • O Catch basin/Dry wel z� On-site system p i s;3 q. outdoor Surface drains:YES N f1 ' ,Holding, tank: MUC -- Catch basin/Dry well 4LI -- °��- -- OOn-site system r t� ,__.• S. Waste Transporter , icensed? 1 .F.. XF.S NO it" Hauler- ,t A '12 23 ei erson s) -Interviewed Inspector. Uate TOWN OF BARNSTABLE BOAR ® OF HEALTH CONTROL OF TOXIC AND HAZARDOUS MATERIALS - INSPECTION SHEET FIRM crldcw Cos AL ADDRESS Major types of materials: 1) 2) 3)' 4) 5) 6) I. Description of material(s) use: 0V)dIi7Cj, 0� (PP`S DAI,0 ddn:f II. Storage (denote product by number'-listed abov ) a 0 C; A. Containers metal glass paper plastic cans,bottles,jars drums,barrels aboveground tanks underground tanks bags,boxes open,loose,uncovered inadequate labelling B. Storage Facility V/or # Remarks/Recommenc��.i_ons 1. Indoor a) separate, contained room b) stored in general work area i) inadequate ventilation ii) floor drains zlx iii) inadequate fire protection 2. Outdoor a) uncovered, exposed to weather b) pervious surface/catch basins III. Disposal A. Reclamation/Recycling unit B. On-site disposal 1. Town sewer 2. Regular septic system 3. Separate holding tank C. Off-site disposal 1. hauled by own firm 2. hired hauler a) name of hauler b) address or disposal sit i Person(s) Interviewe I — Inspector l/Q r1lS r - - - — Date - - - - `��� - - - 6 30 81 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 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 totaling, 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 stor 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 Qi'a"l, kero _#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 TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair BOARD OF HEALTH A satisfactory 2.Printers 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY � �/..X (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Class: 1 7.Miscellaneous g0k�UANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR M TIERIAL Case lots Drurhs Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) d Dial, Kerosene, #&+EF Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: iQ DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply 6ak 0i' —x O Town Sewer Public �fOn-site OPrivate 3. Indoor Floor Drains YES NO V O Holding tank:MDC O Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES NO ORDERS: 0 Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product 1. � YES NO 2. Person (srZterviewed Inspector Date