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0230 IYANNOUGH ROAD - HAZMAT
C Number Fee 1198 THE COMMONWEALTH OF MASSACHUSETTS $so.00 Town of Barnstable Board of Health This is to Certify that Rapid Refill#129 230Iyannough Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 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 i i � r BOA r Vowr of B grnsxable / ��q a-1 eg atory emces TNE Richard V. Scali,Director � Public Health Division BAMSTABLE BMNSiMtE.flflIHMIIF.NNR•MYRI?IIS BARNSrABLE, Thomas McKeanXAS& ,Director MkUM'G""�i _014�"'� u 200 Main Street, Hyannis,MA 02601 575 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st—JUNE 3 Oth). APPLICATION FEES • CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 Ef CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 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: l OM-0 �i - 5. NAME OF ESTABLISHMENT: OV 6. ADDRESS OF ESTABLISHMENT: )CPA Riad 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: r�V 8. TELEPHONE NUMBER OF ESTABLISHMENT_ : cXJ 2�S — ve ,l L�I 9. EMAIL ADDRESS: �l 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADD TELEP ONE#OF: CORPORATIVMEA�f PRESIDENT TREASURE i� -eL� 12. IF PREPARED BY OUTSIDE PARTY: • NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: (� SIGNATURE OF APPLICANT 01 A DATE U r Q:\Application FormMAZMAT APP 2017 REVISED. ocx r Town of Barnstable Office: 508-862-4644 '+y Fax: 508-790-6304 ., Regulatory Services Department ;. enitwra�L '� Public Health Division MASS",9Thomas A.McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt ;Hazardous Materials Payment received: $50.00 (Check) on 5/25/2018 Permit number: 1198 .Check number: 150921 Check amount: $50.00 Name on check: M.P.G. Corporation ;Business: Rapid Refill #129 ;Address: 230 IYANNOUGH ROAD/RTE 28, Hyannis Note: 2018-2019 Category I Permit _.. _.._. - . ..._ _ _ -....... ----- • Number Fee 1198 THE COMMONWEALTH OF MASSACHUSETTS $so.00 Town of Barnstable Board "of Health This is to Certify that Rapid Refill.4129 230Iyannough Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- C� ------------------------------------------------------------------------------------------------ --------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and \ and expires 06/30/2018 unless sooner suspended or revoked. ------------------------------------ PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health T-own. of B nstable Regulatoryervices oF� r Richard V. Scali, Director Public Health Division BARNSTABLE r - ens;xsantF. rvreviue.co*uR•nra:nis � BARMASS. E, • nunsicers xNs•Ost9-201•arsl avnsrns Thomas McKean, Director 1639-20141639. �• y ninss. $. �prFD MA. 200 Main Street, Hyannis, MA 02601 J Office: 508-862-4644 - Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS DULY 1 st-JUNE 30th). APPLICATION FEES CATEGORY 1. PERMIT 26— 110 Gallons: $ 50.00 CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? YES_NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: ' 44A 8. TELEPHONE NUMBER OF ESTABLISIDMENT: 9. EMAIL ADDRESS: tJJVI 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TE EPHONE# OAF-� CORPORATI AME Y V PRESIDENT h TREASURER 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICAN DATE Q:\Application Forms\I-IAZMAT APP 2017 RE I .docx ��►�►ok Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 B"";�` 200 Main Street• Hyannis, MA 02601 �p f639 s, TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rED MAy Business Name: r�j. t lr "(4 5 co-;� 6-,q S Date: �2 1 Location/Mailing Address: 30 .J- 4 11? 2a a�r1/5 Contact Name/Phone: st�� c4 ✓1�a�,a Inventory Total Amount: MSDS: License#: Tier II : Labeling: Spill Plan: Oil/WaterSeparator: Floor Drains: Emergency Numbers: Storage Areas/Tanks: Emergency/Containment Equipment: Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: ,Q LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other r�acids) VIOLATIONS: (S�aS $ ,o K- i 5 - s Sa c,�vc.`1'c a� -CV6 rr&IIZOZ VQ 140L Oil 1Z 1, 41ej ORDERS: K- eo Ji S - u o INFORMATION/RECOMMENDATION a P JAQ TO (,9-p— ��o`"- �"� Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS r ,, °PIKE►op ! Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 ti..,' • BARMAQR NSTABL. �l1 � 200 Main Street!Hyannis, MA 02601 .639. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rFD MA'S s Business Name: 6�",7 s Date: 1!/Z 17 Location/Mailing Address: ? oy�H�.a�g .r ,,(l/IQ2$� I/Ahi��S Contact Name/Phone: s� Inventor)t Total Amount: MSDS: License#: Tier II : Labeling': Spill Plan: Oil/WaterSeparator: Floor.Drains: Emergency Numbers: Storage Areas/7anks: ' Emergency/Containment Equipment: Waste Generator ID: Waste Product: ' Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS � � NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot:emovers Engine and radiator flushes Bug and tar removers ` Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals_(Developer) Car wash detergents Printing ink ' Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes f Other chlorinated hydrocarbons Laundry soil &stain removers i (including carbon tetrachloride) (including bleach) `. ° Any other products with "poison labels" (including chloroform, formaldehyde, , . hydrochloric acid, other acids) VIOLATIONS: (ttn 4q4, ORDERS: U`2_ n j�K+,,,)fVtV,0 IW, a 1A_ nIn-10-�c_0 s —") mil, 4 lr,�,t,( 7 [t /ri _ INFORMATION/RECOMMENDATIONS: r 11 In,n1 e.f% ,JAA nVA T�-�r.�.--°,An Ig! ,11 Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS INE Tok� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARN SSB�e.$ 200 Main Street• Hyannis, MA 02601 ,a„ a,0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rEn iAoy Business Name: f er+ I S c.o�.ti`� a S -- +��Q2 rr. Date: 6 �� Location/Mailing Address: 2 o ah�o� Contact Name/Phone: /3y( Inventory Total Amount: _� �b MSDS: e h License#: N Tier II : KMA . . Labeling: `dal Spill Plan: e-5 Oil/WaterSeparator: Floor Drains: No Emergency Numbers: e- Storage Areas/Tanks: V — 172K VyVaAd 4^6 L ah 2 tr, I Emergency/Containment E ui ment: c k Waste Generator ID: Waste Product: todq 51J. — + by Date&Amount of Last Shipment/Frequency: 124e a. Po I e-o Licensed Waste Hauler&Destination: -- Ole, 1-"V+C Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) ID Windshield wash 30 I D Motor oils 10 Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMME DATIONS: t 11<WL% S f4AVt4 eQ,-5-P— Sv Inspector-1-1-1 CLVLJI-e� Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS pf IKE Tpy_ Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMASS . . • 200 Main Street• Hyannis, MA 02601 039. �PrFOMP'� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: e�` ��Scoa,��-(j-a — 12a ,�� Date: 060 /5--- Location/M ailing Addr ss: Ao Contact Name/Phone: VQaJ -495=t43 go ( ¢.��tible,�z�t��n+� Soo 3g-1 Inventory Tota9 Amount: 'G l \ q�� MSDS: Di4kA-4- License#: MIA Tier II : Labelin e5 _� Oki Sill Plan. Oil/Water Separator: Floor Drains: N o Emergency Numbers: VP.S Storage Areas/Tanks: Emergency/Containment Equipment: gRAW J CJ ©A 6 A& 4-k aLC,ln, Q.M� b aY Waste Generator ID: I I Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: \S -�necakot�lg�n��ot°f�l, h �50t�SaI 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. J Antifreeze Dry cleaning fluids �— Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform,formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMM DATIONS: o4 WAo-VA,ez, irt-Aro, i),Cosoa -ow 5rt� • o Inspector: l ` l-"t-ck`L Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS i q Massachusetts Department of Environmental Protection - NI Underground Storage Tank Program GO �cyy P.O. Box 120-0165-Boston, MA 02112-0165 Phone(617)556-1035 a o Facility Detail Report gSSACII GENERAL FACILITY AND REPORT •- • Facility Name: Facility ID: MPG#129 1098 Address: 230 IYANOUGH RD `' BARNSTABLE, MA 02601 G Region: Southeast Regional Office Type: -' Retail Motor Vehicle Fuel Dispensing ` Owner Type: Phone: q. ~ (508)778-0831. Owner Name: Contact Name: H & B PETROLEUM Owner Address: Contact Address: 33 BROOKS RD PO BOX 1238 BARNSTABLE, MA 02'601 Contact Phone: OPERATOR INFORMATION Operator Name: Contact Name: MPG CORPORATION Peter Garrett Operator Address: Contact Address: ONE ROBERTS RD One Roberts Road PLYMOUTH, MA 02360 Plymouth, MA 02360 Contact Phone: (508) 746-1341 r =, # _Installed Status Status Date Compartments Capacity„ Contents: � _ Use 5 10/13/1998 Tank 12/30/2016 1 12,000 Diesel Motor Vehicle Temporarily Out of Service 6 10/13/1998 Tank 12/30/2016 1 12,000 Gasoline. Motor Vehicle Temporarily Out of Service 7 10/13/1998 Tank 12/30/2016 1 6,000 Gasoline Motor Vehicle Temporarily Out of Service DUE DATES Type - Due Date - Compliance Certification 02/05/2018 Third Party Inspection Report(TPIR) 08/05/2019 ENFORCEMENT • -tea _ - - - Doc No Type _ r". .,Status g Date Issued Due Date Date Resolved Date Paid DISPENSERS Number Owner,Number Sump_ r T Sump Continuously Monitored 4 Yes No 5 Yes No 6 Yes No 7 Yes No 8 Yes No 9 Yes No DOCUMENTSSUBMITTED _. Submission ID Form ` Date Submitted 'Si 6t6ry _ _ 1118023 Tank Status Changes 01/23/2017 Peter Garrett 1107643 Third Party Inspection Report(TPIR) 10/12/2016 Peter Garrett 1107629 Update Tank/Piping/Components Registration 10/12/2016 Peter Garrett 1107627 Update Facility Registration 10/12/2016 Peter Garrett 1107626 Update Operator Registration 10/12/2016 Peter Garrett RESPONSIBILITYFINANCIAL yp_ Start Ehtl P_er-Occurrence A r`e ate T e Issuer , m>. �, __99 9 21J Program Facility History Owner Start End a H&B PETROLEUM 10/14/2004 B&A FOURNIER REALTY INC 03/01/1995 ReportTank Detail Status Tank Temporarily Out of Service Install Date 10/13/1998 Owner Tank ID Tank Construction Double-walled non-corrodible Financial Responsibility 21J (including "composite") material (cathodic protection not required) Total Capacity 12,000 Compartments Capacity Contents Use CAS Reg.# 12,000 Diesel Motor Vehicle Install Date 10/13/1998 Piping Description Pressurized piping system with mechanical automatic line leak detection Piping and Fittings Construction Material Double-walled non-corrodible material (No corrosion protection required) Turbine • Is the tank equipped with a submersible pump? Yes Submersible Pump Installation Date Is the tank equipped with a turbine sump? Yes If yes, is the turbine sump equipped with a sump sensor Yes continuously monitored for liquids? Intermediate • Is the piping system associated with this tank equipped with No one or more intermediate sumps? If yes, is this intermediate sump equipped with a sump No sensor continuously monitored for liquids? Spill Spill Bucket Installation Date Is the spill bucket equipped with sensors? No Overfill Overfill Prevention Device Installation Date Primary Overfill Prevention Device Type Automatic shut-off valve DetectionTank Leak Leak Detection System Installation'Date Primary Leak Detection System Type Continuous Interstitial Monitoring Piping Leak Detection Leak Detection System Installation Date Leak Detection System Type Continuous Interstitial Space Monitoring ,Automatic • Leak Detection System Installation Date Tank Corrosion Prevention System Type Pipe and Fitting Corrosion Prevention System Type , Tank Detail Report Status Tank Temporarily Out of Service Install Date 10/13/1998 Owner Tank ID Tank Construction Double-walled non-corrodible Financial Responsibility 21J (including "composite") material (cathodic protection not required) Total Capacity 12,000 Compartments Capacity Contents Use CAS Reg.# 12,000 Gasoline Motor Vehicle Piping Install Date 10/13/1998 Piping Description Pressurized piping system with mechanical automatic line leak detection Piping and Fittings Construction Material Double-walled non-corrodible material (No corrosion protection required)- Turbine Sumps Is the tank equipped with a submersible pump? Yes Submersible Pump Installation Date Is the tank equipped with a turbine sump? Yes If yes, is the turbine sump equipped with a sump sensor Yes continuously monitored for liquids? Intermediate Sumps Is the piping system associated with this tank equipped with No one or more intermediate sumps? If yes, is this intermediate sump equipped with a sump No sensor continuously monitored for liquids? Spill Spill Bucket Installation Date Is the spill bucket equipped with sensors? No PreventionOverfill Overfill Prevention Device Installation Date Primary Overfill Prevention Device Type Automatic shut-off valve DetectionTank Leak Leak Detection System Installation Date Primary Leak Detection System Type Continuous Interstitial Monitoring Piping Leak Detection Leak Detection System Installation Date Leak Detection System Type Continuous Interstitial Space Monitoring Automatic • Leak Detection System Installation Date Tank Corrosion Prevention System Type Pipe and Fitting Corrosion Prevention System Type Tank Detail Report Status Tank Temporarily Out of Service Install Date 10/1,3/1998 Owner Tank ID Tank Construction Double-walled non-corrodible Financial Responsibility 21J (including "composite") material (cathodic protection not required) Total Capacity 6,000 Compartments Capacity Contents Use CAS Reg.# 6,000 Gasoline Motor Vehicle Piping Install Date 10/13/1998 Piping Description Pressurized piping system with mechanical automatic line leak detection Piping and Fittings Construction Material Double-walled non-corrodible material (No corrosion protection required) Turbine Is the tank equipped with a submersible pump? Yes Submersible Pump Installation Date Is the tank equipped with a turbine sump? Yes If yes, is the turbine sump equipped with a sump sensor Yes continuously monitored for liquids? Intermediate • Is the piping system associated with this tank equipped with No one or more intermediate sumps? If yes, is this intermediate sump equipped with a sump No sensor continuously monitored for liquids? Spill Spill Bucket Installation Date Is the spill bucket equipped with sensors? No Overfill Prevention Overfill Prevention Device Installation Date Primary Overfill Prevention Device Type. Automatic shut-off valve DetectionTank Leak Leak Detection System Installation Date Primary Leak Detection System Type Continuous Interstitial Monitoring Piping Leak Detection Leak Detection System Installation Date Leak Detection System Type Continuous Interstitial Space Monitoring Automatic • Leak Detection System Installation Date Tank Corrosion Prevention System Type Pipe and Fitting Corrosion Prevention System Type l E-NtPRi i i� An Environmental Services Company Job# I I — NON HAZARDOUS 1,Generator's US EPA ID No: LManifest 2.PageLLIL��i JJ il��Jl atN . of WASTE MANIFEST111IJ1 .10 r 0 .1. 7 2 1 3.Generators Name and Melling Address A.Non . klrUersrdous * r�� v 1D ROW 3Pf toNHZO��ir'a 1 rW., v,l 2120 IwAnotjah Road 6�3GI"(t38n°SltaAddtees)r{ "tr i thHi+fry; Q ri>fitirlS Ns1A 42804 r* enwre _;� a�x ® 4,l3aneretoes Pion ! I: u. A e�3 a,� r� 1 — 5.Transporter 1 Company Name s, US 9AX 10 Number 1 S T i,y Plate ® ENPRO 5ER ES.IIVC. .. ... .'. _...._. WIC 3 0'0.6 9 S 3 d 9_ ,Did ;, r � i 7,Transporter 2 Company Name &. US EPA ID Number E„1Sa1 .t¢rc h ) r ,s�— t I., 9.Designated Facility Name and Site Address 10, US EPA ID Number 13: t4 F�pdUty's ID.3�� 3""?E 1fi C`„ � yG�•�w,t ��'��a�i '§,tski§�`'�rw1F'�`li IPara, rvlt es,Inc. 4 +� ak,, -•• ter E t, 4S`dY`dsc ",nudf6�W irn 3,. tdt✓r6l.;tylrt Fo3A 0186EE MIA P 13 10.0. 0. 1 4 12:Containers 11.US DOT Description{Including Proper Shipping Name,lfazarilClass and 10Numbe 0 Total Untt I;ai>i; No, Type Wan �iNwd Waste.Na;t r 1 C-;aso�ne 3 Fill(GasolinOwater rr'Ixture for realae vdon•IgTn1'bN*- Ifrxfr E r�trYL�nE) () p 1 � b, stye ,{ ' J i :,:l J,AEifeEasel Deana far AAa ed , ei` ''� F"ri ra"M 1•��f T i r r{€�` a t.7r"`"'"��` .I�:,^"'^"",Y.�dtlB fOrNwa6tea t36t9d�Flf0Y8 r Y a'F-i rr x �, eta :.,, r ,r,y,i f 11;�•J�Gst k`g erg•,s'sk�S o Fu'K'� `511 I' ] w 't, tl o�I N.t p r z'3 �� €�;{;�,�s�'v} a '8� a k,z'ii' 'v'-:, tt iia,{!: ,I .� `'1•n Frb?a 1�+�'`"Z76,?1��3r.ar 1 Nik k�i' 'ti�'•c '1 iiJL,Am+G..l�( i, .sir;. ], t. •� b'a,P hYMI 14'..!.`.S`ri,41' Ng,*, +f' L'. •' "rs+'+rx"rrrt'7;4'k�,u ..,i„e..a n»A ri' t! - r '�i.C.�°, - 'esiw•itF, h'f.1t.p,i{�".>•�.'1 7 )Ii4o.k fir., .`l, F, �}4.tY<1t}i"S il FeyY r.i� iF I Iqi lu3 ,�, 2r�y".w,ti,-i���t� .il�t�f E1-gt s,i✓}�t�n�}'i3 �� l .s' 4i g��(idw. / 1 T " �I;.,��1. �.��.�€flnl�.>rP'.'.,.,, i^,r.,�l,.:rrni � -nt�.�i ���� .1. `' ��a ,"'Oa:.wi,A'...c>u�.;,��•i`�,..iZ��17 'M. ��nlrt''+t'�.'_ �a�..;SU 15.Special Hendlktg insUuctlons and Additional lniormaUon _ T0172 i Point of Departure: EWROJON 77311-d34)2b 16.GENERATOR'S CERTIFICATION:I hereby declare that the contents of this consignment are fully,and accurately described above by proper shipping name and are classitled,packed,marked,and labeled,and are In all respects In proper Condition for transport by highway according to applicable International and national governnx;n!regulations,,and all appticebla state tans and regulatlorw. Y" 1 Pdnted/ryRad Name C. Signature: , r month Day, Year T 17_Transporter 1 Acknowledgement of Receipt of Materials Data A � Printed/Typed,'ame 8lgnelure r Month Day Year N a P y o Transporter2 Ac nowte*=nl of Receipt of Materials ate T Printed/Typed Norm Signature Month Day Peer E R 19.Discrepancy Indication Space F 0 A C 20.Facility Owner or Operator.Certification of receipt of waste materials covered by this manifest except as Holed In Item 19. � Y D018 �. Poniod/ryped Name Signature !Monti). Day ar 3 GENERATOR'S COPY . 1 i Number Fee 1198 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Rapid Refill#129 y 230Iyannough Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 100 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 g r� _Its • Town of Barnstable Regulatory Services 0 Richard V. Scali,Director . '"R MASS.M� Public Health Division BA�NSTABLE i639 Thomas McKean,Director 1 1639-2014 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 ` Fax: 508-790-6304 t �O 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 1 PERMIT 26— 110 Gallons: $ 50.00 CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ • CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ A late charge of$10.00 will be assessed if pgMent is not received by July 1st. ASSESSORS MAP AND PARCEL NO. DATE FULL NAME OF APPLICANT: NAME OF ESTABLISHMENT: E ADDRESS OF ESTABLISHMENT: rjk1AJ6i / MAILING ADDRESS (IF DIFFERENT): L�— TELEPHONE NUMBER OF ESTABLISHMENT: 5b — EMAIL ADDRESS: SOLE OWNER: YES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATIO NAME PRESIDENT :TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: 'SIG T Name: Company Address Telephone#: Email: QApplication Forms\HAZZAPP Rev I6.docx Page 1 of 2 Number Fee 1198 THE COMMONWEALTH OF MASSACHUSETTS $5o.00 Town of Barnstable Board of Health This is to Certify that Rapid Refill#129 230 Iyannough Road,Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 100 gallons 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. 02/01/2016 JUNICHI SAWAYANAGI THOMAS A. MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable • Ft r�,ti Regulatory Services ft Richard V. Scah, Director -n�SrABLE. BARMASS. g' Public Health DivisiolBARYS'AU-CMM5'OVS Y.LL Thomas McKean, Director 0 200 Main Street, Hyannis,MA 0260 Office: 508-862-4644 0 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STOR AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st-JUNE 30th): APPLICATION FEES 1 CATEGORY I PERMIT 26- 110 Gallons: $ 50.00 CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ A late charge of$10.00 will be assessed if payment is not received by July 1st. ASSESSORS MAP AND PARCEL NO: 3O?S // DATE FULL NAME OF APPLICANT: / � Of ,��L),�1 NAME OF ESTABLISHMENT: P I , i ADDRESS OF ESTABLISHMENT: -// MAILING ADDRESS (IF DIFFERENT): �` ►� ol Plu i A � TELEPHONE NUMBER OF ESTABLISHMENT: �'� 7 7 S^ 2) EMAIL ADDRESS: LA, SOLE OWNER: YES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE# OF: CORPORATION NAM T-6 PRESIDENT - i s TREASURER! - `x([ i —'jq6r-1`111 CLERK IF PREPARED BY OUTSIDE PARTY: • SIG ji wit P CANT✓ Name: Company Address Telephone#: Email: Q:Application FormA-IAZZAPP Rev I6.docx Page 1 of 2 Town of Barnstable °F1ME TpN� Regulatory Services Richard V. Scali, Director MASS. ' Public Health Division BARN LE MASS. yAf.S'6i...•tH.TFftv:liE•i.T4'R•M1.>titi 9Q 039• �� arsmxsMn.is.asTezvu.e.t-+:srxa;szeee DArFD MAC 1639-2oi: Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 L Office: 508-862-4644 IPd 61l e Fax: 508-790-630 1'Y 293 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS, ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1st-.TUNE 30th). APPLICATION FEES / CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 Icy CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ A late charge of$10.00 will be assessed if payment is not received by July 1st. • ASSESSORS MAP AND PARCEL NO. 3a8//o2 DATE FULL NAME OF APPLICANT: , co Y )r n >�1 NAME OF ESTABLISHMENT: _ I ADDRESS OF ESTABLISHMENT: CAV)A-IC-An &�J- MAILING ADDRESS(IF DIFFERENT): JP1 (�rV'ajk)Aj4a `id) r TELEPHONE NUMBER OF ESTABLISHMENT: �b� '�j EMAIL ADDRESS: SOLE OWNER: YES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND T EP ONE# OF• CORPORATIO"AAIE PRESIDENT TREASURER C IF PREPARED BY OUTSIDE PARTY: • LICANT Name: Company Address Telephone#: C:\Users\KSmith.VOLTA.000\AppData\Loca1\Microsoft\Windows\Temporary Intemet Files\Contentoutlook\XIRKZWUG\HAZZAPP Revl6.docx Page 1 of 2 ' Office: 508-862-4644 Town of Barnstable Fax: 508-790-6304 Regulatory Services Department BntivrAt�t Public Health Division Mass. Thomas A.McKean,CHO �y16 Sys 200 Main Street, Hyannis,MA 02601 Payment Receipt ,Hazardous Materials Payment received: $50.00 (Check) on 2/2/2016 `Check number: 142935 Check amount: $50.00 Name on check: M.P.G. Corporation Business: Rapid Refill #129 Owner: B &A FOURNIER REALTY INC ;Address: 230 IYANNOUGH ROAD/RTE 28, Hyannis Note: Category I i A t Number Fee 1067 THE COMMONWEALTH OF MASSACHUSETTS $100.0o Town of Barnstable Board of Health This is to Certify that Christy's of Cape Cod 230Iyannough Road, MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 30, 2007 unless sooner suspended or revoked. WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. June 19, 2006 PAUL J. CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health CHRISTY'S OF CAPE COD,LLC/105 PLEASANT ST.HYANNIS,MA 02601 31281 VENDORID NAME PAYMENT NUMBER CHECK DATE *; DOCUMENT NUMBER, DATE AMOUNT AMOUNT PAID SCOUNT NET 230 IYANNOUGH RD 6/4/2006 $100.00 $100.00 $0.00 $100.00 COMMENT _ Town of Barnstable A p j P, 'THE Regulatory ti Re ulator Y Servic es es b Gu,P Thomas F. Geiler, Director � � BA S MASS.S. + Public Health Division � MA db i639. AIEo �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._ - l l a- DATE /z APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 1II GALLONS OF HAZARDOUS NL4,TERIALS FULL NAME OF APPLICANT �Q�ajS 2fr ��C U ► r NAME OF ESTABLISHMENT �, ADDRESS OF ESTABLISHMENT 2 3o N wn r►ire TELEPHONE NUMBER �(��_ �h - /�9O �• SOLE OWNER: YES ,ENO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: Ck att x Mho i IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. D(j-361 10-36 STATE OF INCORPORATION_ FULL NAME AND HOME ADDRESS OF: PRESIDENT --,UR i iru TREASURER j CLERK I I GNATURE OF APPLICANT RESTRICTIONS: ` HOME ADDRESS 63 HOME TELEPHONE# Q:\Application FOnns1HAZAPP.D0C I t MAIL-IN REQUESTS [fee ease mail the completed application form to the address below. Also include a copy of your ntingency plan (to handle hazardous waste spills, etc). In addition, please include the required of$100. Make check payable to: Town of Barnstable. Allow five to seven (7) working days for in-house processing. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application,form. Also, please fax us a copy of your contingency plan(to handle hazardous waste spills, etc). In addition, please mail the required fee amount of$100.00. Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow up to four days for in-house processing. For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Pale Q:\Application Forms\HAZAPP.DOC 3 Number Fee 1067 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Christy's of Cape Cod 230Iyannough Road, MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 31, 2008 unless sooner suspended or revoked. ` --------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. 5/31/2007 PAUL J. CANNIFF,D.M.D. THOMAS A. MCKEAN,R.S.,CHO Director of Public Health r Town of Barnstable Regulatory Services 'Dy Q Thomas F. Geiler,Director BARNSfABLE. + MAn Public Health Division 943 i639 10� '°�faMu•+" Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Approved! Application Fee: $100.00 Kenneth Camille,Jr ASSESSORS MAP AND PARCEL NO. 3W—1J27 DATE _ S Zy d-7 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN I II GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT G A03 6 S 01" NAME OF ESTABLISHMENT Cb ADDRESS OF ESTABLISHMENT Z30 (-1AA+a��`+ ��• �`7�n��S TELEPHONE NUMBER S6�� 77,?• /79P SOLE OWNER: YES 'e NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION:. FEDERAL IDENTIFICATION NO. Oy- 3 y1523 STATE OF INCORPORATION Mass. FULL NAME AND HOME ADDRESS OF: PRESIDENT chriS 6h M I Ads TREASURER CLERK SIGNATURE OF APPLICCAN�T RESTRICTIONS: HOME ADDRESS 63 5m,V4 ' a)~f HOME TELEPHONE# r6j-77 ) -01J0 06/25/2007 11: 17 115087789403 HUBBARD OIL CO INC PAGE 03/03 a ,i Town of Barnstable zrti Regulatory Services Thornas.F:Geiler,Director -.. w AA$N'SCAALR. � _ RAM $ - Public Health Division. °lcon�rt" Thomas McKean,Director 200 Main Street, l lyamis,NIA 0260 i. OlFcc: 508-862-4694 Fax: 508-790-6304 Appitcation Fee: $100.00 ASSESSORS MAP AND PARCEL NO. _- _ DATE_ APPLIC,A,TION rOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111. GALLONS OF HAZARDOUS MATERIALS FULL NA MF, OF APPLICANT �n/�S �S D C CG� � � LL C. NAME OF ESTABLISHMENT If w—f 4?,)4-yC4n C ADDRESS O]FESTABLISHMENT —730 annoy G>nnrS l� UZI,b TELEPHONE NUMBER J 0- SOLE OWNER: YES O D 0 D IF APPLICANT IS A P�R7[1VlERSfIII', FULL NAME AND HOME ADDRESS Ole'ALL PARTNERS: IF APPLICANT IS .A, CORPORATION: FEDERAL IDENTIFICATION NO. 13 STATE OF INCORIPORATION M A FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURED CLERK SIGNATURE OF rkPPJLICANT RESTRICT.I.ONS: HOME ADDRESS HOME TELEPT-TONE# TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS 1Y 0;4 &0 NAME ADDRESS ��� &/V&" � VILLAGE �/ y�N/°J 9 LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE: OR CHEM CAL �Z d �ivy eel ®®� sd 'A (Give same information for any additional tanks on reverse ide of card) DATE OF PURCHASE OF EACH: 1. 3 �7 f 2. 3. r� 4.3 r 7/� DATE OF FIRE DEPARTMENT PERMIT: `�//�Z7-7 TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS Cc—� S' , O� s�j®CJ �@ �� /Ctz ��6�S �de✓ GI�� SmFDQtd -r"g If .5 cam: . A \ 7 • \ * • r '° ..s } !rf• • r ; .; ; "! �,. - ,tea<t��. .,�•. a .. io- � _ _ ".1 - ,�"�•� of - _ .!_' i �• .•°-,. .` ruary' 22 !:1982 Y 4 {°A •3 r 1{�. .` ;.' , .t- F)- \ fb' A y '* - � f r � l.' l., ret: yG�4 � Y,r � F , ' r�e r,` i,4.. ��; § �,4 .w �';'_ • 1. 44 r re'. Hubbard''•Oil •COTttan t`. r r . P .i • �!Al L F.a .. ,r ''-Box 607 P Deax' Mr. ,F6uinier. ew of our, records indicates that we 'have ,never re- ` 1 :ce'ived"a card'-from;you.li�stifig; the -undeergaround ,fuel tanks ` on your property y3ocated at` 2 3i? t lyariough r Rond ,Hyannis'; {nearest cross .•street �• Mary lJunn Road) . n •i. a,a 't ,P .ease[ f91' ,out the enclose ,d card nd return it to yt t'a . a. tour earliest„cony mience: •#r- ,.=a � `rs. "t ..f.,.£" — �1 ! ,iC L It~••r , '.tC.�k F J, � ♦Y: I... L , Rte}." V�:. � i'f 4 t � . Very truly yours " t t ,D ,Ir •z ^act i. .��'�•�+ e i.i i{} +:'��'. ' w'i `/ 4Y,! ..' _` r � r,, wr„t i• y`, jy,-v Vahn•• M.• l\e'. .4yt ""' Y-<, ,•„ .'. h;.'. .. y ;d_ !. t :;yam , �. , . .. . zA birector'.of t Publiciealth ' 4i!??,.•.uh�{ ti `•�, MK/m -A y- ` .j}, �y i�^i s '.. .'t5 §. 7 #.4 n a. °^ -•x t -4 r r , encl JN 41 x �� , •., < h 4 �for� '!,�'s i � 4. .�, q ',�J / '.�,. ,,p, y,'� , _ �C ;M , \ ..wi ..F{,. �^ T _t- p�.Y � F 3 ,�Y M Q. iY cs/• i 5` ., � , Son ',. t �,.Lr• 'f Y [� � C r '"��. ! 'y• \ ��- -.. � ', •, ° *{ ' Ks...4. a r. r.` �`,. � - ? •� { .. , `�r'•rr , a>.H '�.- :^.' a itij - ; � .. i + ta' � �•,4. 'µ4 a : � HURIJARD OIL COMPANY INC. GASOLINE- MOTOR- OILS FUEL OIL - BROOKS RD., P. O. BOX 607, HYAN MASSACHUSETTS ® 617-775-3711 I I November 20, 1980 To: Barnstable Conservation Commission Barnstable Health .Department Hyannis Fire Department Barnstable Board of Selectmen . RE: Gasoline Storage Tank Installation Please know by this letter of our intention to install four (4) gasoline storage tanks, 'with a capacity of ten thousand (10,000) gallons each, at the Airport Amoco Station, located at the intersection of Iyanough Road and Mary Dunn Road in Hyannis. } 1 These tanks are known as 11Sti-P311 storage tanks, and are warranteed for twenty (20) years, with a use expectancy of fifty (50) years. Very, truly yours, I Kevin E. M inness-Rossi HUBBARD OIL COMPANY, INC. . KMR:tq I i i I .- 1PPR OYED-t � Barnstable Conservation Ccmmiss =fHealth /,/ /��� //�� ion Vda�d c yac �� �4�,PQ Town of Barnstable j Signed Pate P.O. Box 534 Hyannis, Massachusetts 02601 1 r •r-� 1 ai� ""irA' '' ` � y� i r.a k. i F; e'� y�•�w t� •F� w t ` Lt"'C Y 1 'cp , a.i't- �'� � � d.•.m if; ♦ti: tM ,� r 1 The site' is within the Barnstable Water ' °, .' F• r0'W fit• a.f„ �' , �� . Company well-field area. �•• <� t ,�� F ��� / �a���� �.- ' Where do we go from here? /17 Ath of fiassu*1afts DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION 1010 CQMMONwtALTH AVKNUE. BOSTON A �AT71ATah i H nPr-Pm Pr 19, 19 /-I 7 mw.r To") (Dots) r9a L S PARIS ICNWH FW II ' In accordance with the provisions of Chapter 148 of the General Laws, a license is hereby granted to use the land { lierein described for the lawful use of the building.••• or other structure.... which is/an or i /are to be situated thereon, and as described on the plot plan filed with the application for this lieenss. 30 Iyanq.pgji..RQaa ............................Nearest eras street .. ... Fad r...HY.e?�?'is.......... Location of landz.......... (strf.t a Number) ....Address ..S1GOok8 Bd.....H�anlila....Ma►............................ Owner of landHUBBARD...OI L...COMPJWy............................ , Number of buildings or other strnelnres to which this license aPpf'iee one ._.................I. ................................... Occupancy or Use of such buildings .........ga.sol.ine..zervica..*:a�n....... ..:. ._:...:...................................... 4 sA99.... 30R000..additional Total capacity of tanks in �aUans:--Aboveground.... ............................... ......... ..� .; . "gallons in 3 tanks c�a►soliane and diesel, fuel ,:1. d of fluid to be stored in tanks ......... ... .. ... .„.. . ......................„ .._..........._........... Restrictions—If any: .....................................................:......r:..........:`................... ..:::.. 1 airman, Boazd�of Selectmen uawi:s �a6od4)........Town of Barnstable THIS CEhISE OR A PH 4 rATic Apt c jB1 tLKR QOry THERZQE mula SE [_ANRrIQUQUs)LX' POSTED IN A PitOTXCTED PLACE QN THE LAND FOR ' ICH IT 1• GRANTXD I S I T E S A N D L O C A T I O N S I N T H E T 0 W N O F ' *** BARN STABLE *** April 15, 1989 ------------------------------------------------[ C O N F I R M E D S I T E S ------------------------------------------------ First First New Site Listed Listed to Est^ Number Name Address Current Status L.T.B.I. Confirmed List • ---------------- ------ ---------------------------- --------------- -------- --------------- -------- ----- ---- CONFIRMED 4-0190 BARNSTABLE FIRE TRAINING MARY DUNN RD. PHASE 2 / / 01/15/87 ** Petroleum Release Site ** Response action by: RP ONLY ** PRIORITY Site ** Petroleum, organics and chlorinated solvents released at a municipal site resulting in a release to the soil and a groundwater release. CONFIRMED 4-0392 BP STATION 230 IYANOUGH RD. PHASE 1 07/15/87 10/15/87 ** Petroleum Release Site ** Response action by: RP ONLY ** PRIORITY Site ** Gasoline released at a gas station from a leaking underground storage tank resulting in a release to the soil and a groundwater release. CONFIRMED 4-0214 HYANNIS MOBILE SERV. STA. RTE 132 PHASE 2 / / 01/15/87 ** Petroleum Release Site ** Response action by: RP ONLY ** PRIORITY Site ** Gasoline released at a gas station from a leaking underground storage tank resulting in a release to the soil and a groundwater release. CONFIRMED 4-0026 OLD COLONY STATION 258 IYANOUGH RD. PHASE 2 / / 01/15/87 ** Petroleum Release Site ** Response action by: RP ONLY - ** PRIORITY Site ** Gasoline released at a gas station from a leaking underground storage tank resulting in a release to the soil and a groundwater release. CONFIRMED 4-0585 PROPERTY 57 LAKE ST. PHASE 1 10/15/88 10/15/88 ** Hazardous Material Release Site ** Response action by: RP ONLY ** NON-PRIORITY Site ** Hazardous materials released at a site. CONFIRMED 4-0609 RESIDENCE 355 EEL RIVER RD. PHASE 1 01/15/89 01/15/89 ** Petroleum Release Site ** Response action by: RP ONLY ** Unclassified Site ** Virgin oil released at a residence from a leaking underground storage tank resulting in a release to the soil and a groundwater release. CONFIRMED 4-0027 WARREN BUICK 100 BARNSTABLE RD. HYANNIS PHASE 4 / / 01/15/87 ** Petroleum Release Site ** Response action by: RP ONLY - ** NON-PRIORITY Site ** Short Term Measures Taken ** Gasoline and virgin oil released at a commercial site from a leaking underground storage tank resulting in a release to the soil and a groundwater release. I D E L.E T E D S I T E S First First New Site Reason for Listed Listed to List Number Name Address Deletion L.T.B.I. Deleted List ---------------- ------ ---------------------------- --------------------------- --------------- -------- -------- ---- DELETED 4-0323 CAPE REGENCY NURSING HOME 120 S. MAIN ST. (CENTERVL) NOT A SITE 04/15/87 10/15/87 DELETED 4-0331 PROPERTY 749 MAIN ST. NOT A SITE 04/15/87 07/15/87 DELETED 4-0310 PROPERTY 619 MAIN ST. N.F.A. 01/15/88 04/15/89 Yes DELETED. 4-0316 PROPERTY (DUPLICATE) RTE 28 ERROR/DUPL 04/15/87 01/15/88 L O CA T I O N S T O B E I N V E S T I G A T E D First New Site Listed to List Number Name Address Current Status Source L.T.B.I. List ---------------- ------ ---------------------------- --------------------------- --------------- -------- -------- ---- L.T.B.I. 4-0706 BARNSTABLE GETTY STATION BARNSTABLE RD. PHASE 1 DEOE 04/15/89 Yes L.T.B.I. 4-0025 BARNSTABLE LANDFILL SW FLINT ST.OLD BARNSTABLE P.A. EPA 01/15/87 L.T.B.I. 4-0477 BRADLEY'S DRY CLEANER 242 MAIN ST. PHASE 1 DEOE 01/15/88 L.T.B.I. 4-0222 CHEVRON GULF FACILITY 725 MAIN ST. PHASE 1 DEGE 04/15/87 L.T.B.I. 4-0545 CRANE DUPLICATING RTE. 6A 8 PLUM ST. PHASE 1 DEQE 10/15/88 L.T.B.I. 4-0368 CYRUS REALTY TRUST 157 AIRPORT RD. PHASE 1 DEOE 07/15/87 L.T.B.I. 4-0624 LEWIS BAY MOTEL 53 SOUTH ST. PHASE 1 DEOE 01/15/89 L.T.B.I. 4-0383 PROPERTY 5 CHARLES ST. PHASE 1 DEOE 07/15/87 L.T.B.I. 4-0435 PROPERTY 24 PLANT RD. PHASE 1 DEQE 01/15/88 L.T.B.I. 4-0461 PROPERTY 599 IYANOUGH RD. P.A. DEOE O1/15/88 L.T.B.I. 4-0582 PROPERTY 485—c..504 SOUTH ST.._ PHASE 1 DEOE 10/15/88 L.T.B.I. 4-0279 THE STRAIGHT WAY STRAIGHT WAY PHASE 1 DEOE 01/15/87 R E M E D I A L S I T E S First First New Site Resp. Response Listed Listed to List Number Name Address Codes Action By L.T.B.I. Remedial List ---------------- ------ ---------------------------- --------------------------- ----- -- ------ ----- -------- ---- REMEDIAL 4-0233 CUMMAOUID GOLF COURSE MARSTON LANE A RP ONLY / / 04/15/87 REMEDIAL 4-0251 PURITAN. PONTIAC 460 YARMOUTH RD. A RP ONLY 01/15/87 10/15/87 ---------------------------------------------------------------------------------------------------------------------------------=-- ------------------------------------------------------------------------------------------------------------------------------------ TOTAL SITES.: 25 CONFIRMED SITES.: 7 DELETED SITES.: 4 L.T.B.I. SITES.: 12 REMEDIAL SITES.: 2 Daniel S. Greenbaum Commissioner (D �iz�CG'uzles� JGeet �oalcuz, ��. 0.2�08 April 18, 1989 Dear Interested Party: In accordance with the provisions of MGL c. 21E, Section 3A(b) and the Massachusetts Contingency Plan (310 CMR 40.00), the Department is publishing the following lists: ° MASTER INDEX OF SITES AND LOCATIONS: AN INDEX OF ALL LOCATIONS AND DISPOSAL SITES. (3141 locations and sites from all lists, of which 400 were added this quarter) ° REMEDIAL : SITES AT WHICH A REMEDIAL ACTION HAS BEEN COMPLETED AND FOR WHICH NO FURTHER ACTIONS ARE PLANNED (271 sites, of which 0 have been added in the last quarter) CONFIRMED: SITES WHERE RELEASES OF OIL AND HAZARDOUS MATERIALS HAVE BEEN CONFIRMED AND WHICH REQUIRE FURTHER ACTION (1061 sites, of which 106 have been added in this quarter) • DELETED: LOCATIONS WHERE INFORMATION EXISTS WHICH INDICATES NO FURTHER INVESTIGATION IS WARRANTED (144 locations, of which 35 were added in this quarter) ° LOCATIONS TO BE INVESTIGATED: (1665 locations, of which 350 are listed for the first time) This information updates lists that were published on January 17, 1989. For information about individual locations on these lists, please write to "Site List", DEQE/Waste Site Cleanup Program, .One Winter Street, 5th Floor, Boston, Massachusetts 02108. Today' s list reports the status of assessment and cleanup efforts. Among the deadlines established by c. 21E is a requirement for performing preliminary assessments of all locations on the "To Be Investigated" List within one year of their initial listing. Of the 79 locations listed for the first time in April , 1988, 71 have been the subject of some action: ° 44 have become confirmed sites, ° 5 were confirmed and remedial actions were taken, 5 were determined either not to be disposal sites or not to need further investigation,and 17 have had Preliminary Assessments completed, but require additional investigation to determine whether the locations are disposal sites. -2- We have also continued to assess and clean up sites where releases have been confirmed. In .accordance with c. 21E, we have classified 644 sites: 280 are priority disposal sites and 364 are non-priority disposal sites. Other sites on the Confirmed List are reported as unclassified while documentation is being completed. Today' s Confirmed List provides site classification infor- mation and a brief description of each site. In addition, it identifies: ° 22 sites which have been classified as "Public Involvement Plan" or PIP sites, where activities to involve .the public in planning and implementing response actions will be conducted, and ° 21 non-priority sites for which waivers of Department approvals of response actions have been granted. Thank you for your interest in the Waste Site Cleanup Program. y truly yours, Qwv�4/J Jam s C. Colman Ass stant Commissioner for aste Site Cleanup W JCC S / ' / JP e j' MAS-1 DESCRIPTION OF THE MASTER INDEX This list is a master index for all locations and sites being published this quarter. It is arranged alphabetically by town and site name, and contains a compilation of all listings for the four lists described in section 310 CMR 40.520 of the Massachusetts Contingency Plan. The four lists are: REMEDIAL: Sites at which remedial response actions have been completed and for which further remedial response actions are unnecessary. CONFIRMED: Locations confirmed by the Department to be disposal sites, and for which remedial response actions have not i been completed: DELETED: Locations which are not disposal sites or disposal sites. which do not currently require remedial response actions. L.T.B.I . : Locations To Be Investigated, which are locations the Department considers reasonably likely to be disposal sites but are as yet unconfirmed. To locate information about a site or location on this list, look up the city or town name in the Master Index and then the site or location name. The Master Index also contains the site number for each listing and the address on record for the site or location. For more detailed information .about a particular site or location, the Master Index identifies the current list and page where the location or site is described. To find specific listing information, look up the site or location on the page number of the individual list. For example, if a site is currently listed as "confirmed" on page CON-4, look on page four of the Confirmed Site List to identify more detailed information about the site. The last column of the Master Index indicates whether a location or a site is "New to Book". If a "Yes" appears in this column, the listing is shown for the first time on any list in this quarter' s report. REM-1 DESCRIPTION OF THE REMEDIAL LIST This list identifies disposal sites where uncontrolled oil or hazardous materials (as defined by the Massachusetts Contingency Plan, 310 CMR 40.020) has been released—and an appropriate remedial action has been completed as of March 15; 1989. These actions were determined to adequately protect public health, safety and the environment at the time they were taken. Changes in cleanup technology or in our ability to identify and assess the nature and extent of contamination may require an examination of these sites in the future. At this time, no further action is planned for the sites on this list. This list is arranged alphabetically by community and within each' community by the 'name of the site. For each site at which a remedial action has been completed, this list provides the following information: * TOWN - The municipality in which the site is located. * SITE NUMBER - A unique number assigned to each site. * NAME The name commonly used by DEQE staff. The name does not necessarily reflect the .identity of any responsible parties. * ADDRESS - The address that most accurately describes the location of the site. * RESPONSE CODES - Type of response action taken. Code Action Taken A Removal of- the contamination source (su.ch as drums, tanks or contaminated soil ) to a licensed facility. B Capping and/or fencing of contaminated area. C Groundwater and/or soil treatment, including soil venting, groundwater recirculation, filtration, or aeration. D Monitoring (i .e., via groundwater wells). E Other (e.g., replacement of a water line, disconnecting improper sewer connections, drainage improvements, and flood protection). * RESPONSE ACTION BY - Identifies the source(s) of funds used for remedial action planning and implementation. "RP" indicates that the Responsible Party is paying for all or part of the investigation and assessment costs. "DEQE" refers to funds drawn from the State Superfund. "EPA" refers to funds drawn from the Federal Superfund. REM-2 * FIRST LISTED L .T.B.I . - The date on which a disposal site first appeared on L .T.B.I . , the Locations To Be Investigated List. If no date is listed, the site was known to DEQE prior to January 15, 1987. * FIRST LISTED REMEDIAL - The date on which a disposal site first appeared on the Remedial List. * NEW TO LIST - Indicates if this disposal site is new to the Remedial List this quarter. 4 CON-1 DESCRIPTION OF THE CONFIRMED LIST This list identifies confirmed disposal sites where oil or hazardous materials (as defined by the Massachusetts Contingency Plan, 310 CMR 40.020) have been released and for which remedial response actions have not been completed as of March 15, 1989. This list is arranged alphabetically by com- munity, and within each community by site name. For each site listed, the following information is provided: * TOWN - The municipality in which the site is located. * SITE NUMBER - A unique number assigned to each site. * NAME - The name commonly used by DEQE staff. The site name does not necessarily reflect the identity of any responsible parties. * ADDRESS - The address that most accurately describes the location of d sit * CURRENT STATUS OF REMEDIAL ACTIVITIES PHASE ACTIVITIES I Limited Site Investigation, including site classification II Comprehensive Site Assessment III Development of Remedial Response Alternatives and the Final Remedial Response Plan IV Implementation of the Approved Remedial Response Alternatives V Operation and Maintenance Activities * FIRST LISTED L .T.B.I . - The date on which a disposal site first appeared on the Locations To Be Investiaated List. If no date appears, the site was known to DEQE prior to January 15, 1987. * FIRST LISTED CONFIRMED - The date on which a disposal site first appeared on the Confirmed Disposal Site List. * NEW TO LIST - Indicates if this disposal site is new to the Confirmed List .this quarter. Where appropriate, the following information is also included for each disposal site listed: * FEDERAL SUPERFUND SITES - Disposal sites placed on the National Priority List by the U.S. Environmental Protection Agency. CON-2 * PETROLEUM RELEASE SITES - Disposal sites where a petroleum product not contaminated by hazardous materials has been released, including gasoline, fuel oil , and industrial oils,. * HAZARDOUS MATERIALS RELEASE SITES - These include sites of releases of any hazardous material . * PETROLEUM AND HAZARDOUS MATERIALS RELEASE SITES - Disposal sites where both oil and hazardous materials have been released, including oil that has been contaminated by a hazardous material . * RESPON.SE ACTION BY -Identifies the source(s) of funds used for remedial action planning and implementation. "RP" 'indicates that those liable are paying for all or part of the investigation, assessment and cleanup costs . "DEQE" refers to funds drawn from the State Superfund. "EPA" refers to funds drawn from the Federal S,uperfund. * PRIORITY, NON-PRIORITY or UNCLASSIFIED SITE - A disposal site is classified based on information provided on the Preliminary Assessment Form, in the Phase I Report and other information which may be available to the Department. PRIORITY SITE - A disposal site that meets any one of the criteria listed in the Massachusetts -Contingency Plan (310 CMR 40.544) . Such a site poses a substantial hazard to health, safety, public welfare, or the environment. NON-PRIORITY SITE - If, .after review, none of the priority criteria are met, the disposal site is classified .as a non-priority site. UNCLASSIFIED SITE - Additional information is necessary to classify the disposal site. * PUBLIC INVOLVEMENT PLAN SITE (PIP SITE) - Any disposal site for which additional public involvement activities will be conducted beyond those required for all disposal sites, and which has been designated as a PIP site pursuant to 310 CMR 40.203. A PIP site is designated when the Department receives a petition requesting this action from ten or more residents or when DEQE determines that such designation is appropriate. * SHORT-TERM MEASURE TAKEN - A measure or combination of measures that are taken pursuant to 310 CMR 40.542 to prevent or stop an imminent threat to public health or the environment. They can include removal of "hot spots" of contamination, capping, fencing, or the installation of tem- porary water supplies . CON-3 *WAIVER SITE - A non-priority disposal site for which the Department has granted a waiver of its approvals of five documents that must be submitted to DEQE as part of a response action, in accordance with the Massachusetts Contingency Plan (310 CMR 40.537) . *SITE DESCRIPTION - The last few lines of the site listing provides information about the su stance(s ) released, the site' s use, the type of container or source of the release, and the environmental media (air, water, or soil ) affected by the release. s DEL-1 DESCRIPTION OF THE DELETED LIST Deleted locations are those for which Preliminary Assessments, Phase I - Limited Site Investigations, or Phase II - Comprehensive Site Assessments have been completed with a finding that no further investigations or remedial response actions are required by the Massachusetts Superfund Program to protect health, safety, public welfare or the environment. These locations have been identified based on information available as of March 15, 1989. For some locations on this list, the Preliminary Assessments or the Phase I - Limited Site Investigations have found that the locations are not disposal sites. - In other cases the locations are disposal sites for which no further remedial response actions are necessary. Other locations are included in this list because their original listing contained errors (e.g. , the wrong community name). Where errors were found, the erroneous listings are included in the "Deleted List", and correct listings have been included in the appropriate lists in this report. For each location on this Deleted List, the following information is provided: * TOWN - The name of the community that was originally published on the ist of "Locations To Be Investigated". * SITE NUMBER - A unique number assigned to each location. * NAME - The name that was originally published on the list of "Locations To Be Investigated". * ADDRESS - The address that was originally published on the list of "Locations To Be Investigated". * REASON FOR DELETION - Identified here is the reason for including a location on the Deleted List. Categories for deleting a site from the list are: NFA: Stands for "No Further Action". These are disposal sites where no further remedial response action is necessary. NOT A SITE: These locations are not disposal sites. ERROR/DUPLICATE: The initial listings were in error or were duplicate listings. * FIRST LISTED AS L.T.B.I . - The date on which a location was first included in the "Locations To Be Investigated" list. If the date is not listed, then this location was known to the Department prior to January 15, 1987. * DATE FIRST LISTED AS DELETED - The date on which a location was first included in the "Deleted" list. * NEW TO LIST - "Yes" denotes locations which were added to the Deleted List this quarter.. 7 - 1 N DEL-2 tip The Deleted List has provided the public with information both about loca- tions that have- been investigated and found not to be disposal sites, and about errors in previous lists (see page DEL-1, ERROR/DUPLICATE ). In the future, the Deleted List will not contain listings made solely to report an error.. Starting in July 1989, the List will include an errata sheet showing errors in the previous quarters List. This change should prevent confusion between sites deleted because an investigation showed that they are not disposal sites, and sites deleted because their original listing was an error. v LTB-1 DESCRIPTION OF THE �OCATIONS TO BE INVESTIGATED LIST This list contains those locations which the Departmentdeterminedhas are reasonably likely to be disposal sites where oil or hazardous 'materials may have been released to the environment. Reasons for listing include past or present uses of the property, the conditions reported and any other information available to the Department. Inclusion of a location on this list does 'not imply that a release of oil or hazardous materials has been confirmed. It does mean that DEQE has received sufficient information to warrant an initial investigation. MGL c. 21E and the Massachusetts Contingency Plan C310 CMR 40.00) require that a preliminary assessment must be performed for each location on this list within one year of the list's publication. This assessment will attempt to determine if the location i s . a disposal site, ;and :whether_.f uri:her . investigation is needed. Future updates of the lists 'will descri'be2the outcome of investigations of locations listed here. Locations are listed here based on information available to the Department as of March 15, 1989. The publication of a list of "Locations To Be Investigated," is required by MGL c. 21E. Complete information concerning the correct and current owner, other potentially responsible parties, the address, and the nature of problems (if any) may not be known at the time of listing. Any errors which therefore result will be corrected during the investigation. Some locations will be found not to be oil or hazardous materials disposal sites . This list is organized alphabetically by community and, within each com- munity, by location name. For each location to be investigated, this list provides the following information: * TOWN - The municipality where a location has been identified. * SITE NUMBER - The unique number assigned to each location. * NAME - The name commonly used by DEQE staff to refer to the location. It has been included in this list solely to assist the {public in identifying locations to be investigated as specifically as possible. Frequently, the name is that of the location owner"or occupant at the time DEQE became aware of a possible release. Where the location is vacant, or the property owner/occupant is unknown, the term "Property" has been used. Where the location is in a residential area, the term "Residence" is used. * ADDRESS - The most accurate description of the location available. Where known, the address includes the specific street number or cross street. Since some of these locations have yet to be investigated by DEQE, the address provides no indication of the extent of a release of oil or hazardous materials, if any. * CURRENT STATUS - PA - An initial evaluation called a Preliminary Assessment is required to determine whether or not a location is a disposal site, and whether further remedial response action is necessary. r LTB-2 . PHASE I - A Limited Site Investigation. These locations have undergone a Preliminary Assessment, but it is still unclear whether , the location is a disposal site, and further remedial response action is necessary. * SOURCE - The source of the information for listing is described by the following codes: EPA - Locations from the Comprehensive Environmental Response Compensation and Liability Inventory System (CERCLIS), a data base assembled by the U.S. Environmental Protection Agency (EPA). These locations have not been fully investigated by either EPA or DEQE. This data base includes some locations reported to EPA in compliance with the Federal Superfund Law, which requires that .anyone with knowledge of improper disposal of hazardous substances report these to EPA. It does not include releases of petroleum only. DEQE - Information that has been submitted to DEQE, including reports summarizing site assessments undertaken as part of real estate trans- fers, citizens ' complaints received by DEQE, and notifications of releases of oil and hazardous materials required under MGL c. 21E and the Massachusetts Contingency Plan. * First Listed L.T.B.I . - The date on which a location first appeared on the "Locations To Be Investigated List". * New to List - A "yes" in this column indicates this location appears on this list for the first time this quarter. _ L OF IHE E�� TOWN OF BARNSTABLE i HEALTH DEPT. BAR\STABLE, 9 MASS. P �679• `00 �PlED MPS 0, EDWARD F. BARRY HEALTH INSPECTOR OFFICE HOURS: -76 V 0.4f7s7^ 8:30 - 9:30 A.M. 12:30 - 2:00 P.M. 7 'I TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM hb�PO Mail To: R NAME OF BUSINESS: Tiko Board of Health MAILING ADDRESS: L�fnucl = Town of Barnstable TELEPHONE NUMBER: '-Z7 ��`7�n . P.O. Box 534 CONTACT PERSON: ,L. 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 qua,plities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES L 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: v 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) 4� Gasoline, 4et+dis4- Refrigerants Diesel fuel, e 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 .1�.. ,. . .. t...zt-•ti,.rf.J x..,^,..�, � .�...-..,,. •,-. -..+.r'_".''-�`'v ter.._. v �.. • ^' _,.y ... 1,:._ R- ..r v - ._.. ? ,. a. _ Ile . TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To,- NAME OF BUSINESS: Board of Health MAILING ADDRESS: c-23/D L.-717 00Q Town of Barnstable TELEPHONE NUMBER: -77 - / 7 n . 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 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 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: f Y Antifreeze (for gasoline or coolant systems) , Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners 's Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils :.-Road-SaGt(Halite) - - - Gasoline, Jet-fuel- Refrigerants Diesel fuel,FkeFasene.;,#2 f eati-ng�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 r Jewelry cleaners Asphalt & roofing tar Leather dyes Paints,,varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners` - m 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) x Other cleaning solvents Bug and tar removers 1 Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business i` p TOWN OF BARNSTABLE COMPLIAN E: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH O satisfactory 2.Printers O 3.Auto Body Shops unsatisfactory- 4. an COMPANY1`� [ (see"Orders") 5.Retail Stores D u ./� 6.Fuel Suppliers ADDRESS C18SS: 7.Miscellaneous . QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATER S Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Gasoline,Fuels: ,�� l/ate � a Diesel, Tzero -,-, uZB) � g Heavy Oils: waste motor oil (C) ` AP n r new motor oil (C) 7,ks� #`� -1901- S 3 transmission/ anhs- Synthetic Organics: degreasers Miscellaneous: DISPOSAL/RECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O Town Sewer Public O On-site OPrivate 3. Indoor Floor Drains YES NO ' O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES-NOZ ORDE S: O Holding tank:MDC 4Z O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product Licensed'. YES NO 1. 2. rersYn (s) Tnterview_ed Inspector D to u w. ...•' r4n „ .. ..... i�� an .. �. .... .r ti"t'-I ... 'r. - .. • '• 1 .. _ �. � ��1.'j��.�..��Yu �� .. TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH O satisfactory 2. nters 3.Auto Body Shops COMPANY ( �, satisfactory- 4.Manufacturers - see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Class: 7•Miscellaneous 7 ,*' r 'QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: r Gasoline,Jet-FueX-A) ` t Diesel, Kerosene,#2 (B) 11AX r" HeavyrOils: . waste motor oil (C) "6"new motor oil (C) 145 transmission/hydraulic. Synthetic Organics: degreasers } Miscellaneous: DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply O Town Sewer OPublic Q On-site QPrivate 3. Indoor Floor Drains YES NO 1" O Holding tank:MDC Q Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: Q Holding tank:MDC xl ' Q Catch basin/Dry well -r1 O On-site system 5.Waste Transporter F y Name of Hauler Destination Waste Product 1. YES INO 2. fi Eerson (s) fnterviewed' Inspector f,� Date i TOXIC AND HAZARDOUS HAZARDOUS MATERIALS REGISTRATION FORM NAME OF FIRM: �`�/�v�+� �T��®C ro d A 4 C/ ® I°L MAILING ADDRESS: Z3 d .may',4N®0?``//7 41�10-4 Q TELEPHONE NUMBER: b f7 7 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 totalling, at. ,anytime, 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 addres§: 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 gasline or coolant systems) Refrigerants Automatic transmission fluid w Pesticides (insecticides, Engine and Radiator flushes herbicides,rodenticides) t/ Hydraulic fluid (including brake fluid) Photochemicals — 7 Motor oils/waste oils Printing Ink ✓ Gasoline, Jet fuel Wood preservatives V Diesel fuel, Kerosene, #2 heating oil (creosote) Other petroleum products: grease,lubricants Swimming Pool chlorine Degreasers for engines and metal Lye or caustic soda Jewelry cleaners Degreasers for driveways & garages Leather dyes Battery acid (electrolyte)Rustproofers Fertilizers (if stored outdoors) Car wash detergents PCB' s Car waxes and polishes Other chlorinated hydro— Asphalt & roofing tar carbons, (inc.carbon Paints, varnishes, stains, dyes tetrachloride) Paint and lacquer thinners Any other products with Paint & Varnish removers, deglossers "Poison" labels (including Paint brush cleaners chloroform, formaldehyde, Floor & Furniture strippers hydrochloric acid, other Metal polishes acids) Laundry soil & stain removers Other products not listed (including bleach) which you feel may be Spot removers & cleaning fluids R E C E I V E ® toxic or hazardous (please (dry cleaners ) HEALTH DEPT. Other cleaning solvents list) : Bug and tar removers TOWN OF BARNSTABLE . Household cleansers, oven cleaners Drain cleaners Toilet cleaners Cesspool cleaners MAY 1 4 1981 Disinfectants Road Salt HlaliLe ) Z TOWN] OF BMNSTABLE BOARD OF HEALTH CONTROL OF TOXIC AND HAZARDOUS MATERIALS - INSPECTION SHEET FIRM w, ADDRESS i Major types of materials: 1) 2) 3 ) 4) 5) 6) I. Description of material(s) use: II. Storage (denote product by number listed above) A. Containers ; metal glass paper plastic° } f� cans,bottles,jars drums,barrels ti3 aboveground tanks f underground tanks bags,boxes open,loose,uncovered inadequate labelling B. Storage Facility or.# I Remarks/Recommendations 1. Indoor r a) separate, contained room b) stored in general work area i) inadequate ventilation 5 -1 ii) floor drains 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 r.�. C. Off-site disposal 1, hauled by own firm Q. 2, hired hauler a) name of hauler b) address or disposal site Persons) Interviewed , - — — — — Inspect r '" s Date —/— — - - - - - - - - TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: Board of Health MAILING ADDRESS: R Town of Barnstable TELEPHONE NUMBER: P.O. Box 534 CONTACT PERSON: "'D rs r 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 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)/ G soline, 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 4' L TOWN OF BARNS TABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 0 satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores 6.Fuel.Suppliers ADDRESS.Z - / - Class: 7.Miscellaneous ANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATER Underground IN OUT IN OUT IN OUT #&gallons Age Test D/ Fuels: Gasoline,Jet Fuel (A) p. Diesel Kerosene, #2 (B) Heavy Oils: waste motor oil (C) ngA motor oil (C) transmis i-o'�ydraulic Synthetic Organics: degreasers Miscellaneous: .P ten- �_il, DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply O Town Sewer fflPublic POn-site OPrivate 3. Indoor Floor Drains YES NO d� O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank: MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 2. Person (s) Interviewed Spector Date