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Home My WebLink About0379 IYANNOUGH ROAD - HAZMAT r r Number Fee 1127 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 5 ; S . Town of Barnstable Board of Health This is to Certify that SALONCENTRIC 379 IYANNOUGH ROAD, HYANNIS, MA Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 11/30/2016 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 10/20/2015 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health A I avl 042,vt+-Cl . s ROVt ITV eS �c)SLGy 1. 3 3 e Cry awl v�e- lam'- AL a4-6a/ 1 own oI uarnst able_ POtIKElay Regulatory Services Richard V. Seali,Director • iARNSfABL&7' M►S $ Public Health Division .• 9�A t639• �0. ems] Thomas McKean,Director 200 Main Street Hyannis, MA 02601 4a, Office: 508-8Q-4644 Fax: 508-790-63(W Application Fee:$100.00 � ASSESSORS"AND PARCELNO.. 02 J2-d�j( DATE APPLICATION FOR PERMIT TO STORE AND/OR UTII;IZE MORE THAN 1.1`1.GALLONS. OF RAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT LD�'j atwr7--IC ADDRESS OF ESTABLISIMENT A&©a�� TELEPHONE NUMBER �17 7a 7 SOLE, OWNER:. YES NO �WNT W.APPLICANT IS A PARTNERSHIP,FULL NAME AND,HOME ADDRESS:Or ALL: PARTNERS: I I IF.APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO.. .2f"oZO(O.)-O/,�/ STATE OF INCORPORATION / /�e /praA FULL NAME.AND HOME ADDRESS OF: PRESIDENT ( TREASURER S: . G ti CE7�`f7z I C CLERK N N72(L, RG A;TURE OF.APPLICANT RESTRICTIONS:. HOME-ADDRESS A4o y �,�yL�x►/A HOME TELEP.HONE.# (p t -a- S JAHAZAPP:DOC i ,a TOWN OF BARNSTABLE BAR-W 15'O 9 b Ordi.nan.ce or Regulation W1ARNTNG NOTICE: Name. of Offender./Manager faJ 1 1 �� h� -b5� Address of Offender MV/MB Reg.# Village/State/Zip Business Name �l+-�ow Cw�kr�L ( 'aa /pmj on. 11 20 1� Business Address 3- a ✓tam %'� g `I Si natur�aforcng Offa.cer �r 1, g La✓�l� village/State/Zip rl �/a rt✓I 15 ✓►� sae i Location: of Offense �'�-�o r� Ce►t��•L \r Enforcing Dept/Division Offense V �o Gc. �.ow y� loww.Coi �0$'�c Facts. 15}'or4-4 11 Se; ads' �' 11 1'.G 4`f o rC.S o 4'�"af- ayS c.�'2t',Q. S In1 1 -�� This will serve only as warning•. At this .time ;no legal action has been t en It is the goal of Town agencies to. achieve voluntary compliance of Town Ordinances, Rules and Regulations, Education efforts and warning notices are attempts to ;gain voluntary compliance, Subsequent violations will result in j appropriate legal action by the Town. `. .WHITE.-OFFENDER CANARY-ORDJAEG.=PROD; PINK-EN FORCING OFFICER GOLD-ENFORCINGDEPT, U*CampusShip: Shipment Label Page 1 of 1 UPS CampusShip:View/Print Label 1. Ensure there are no other shipping or tracking labels attached to your package. Select the Print button on the print dialog box that appears. Note: If your browser does not support this function select Print from the File menu to print the label. 2. Fold the printed label at the solid line below. Place the label in a UPS Shipping Pouch. If you do not have a pouch,affix the folded label using clear plastic shipping tape over the entire label. 3. GETTING YOUR SHIPMENT TO UPS Customers with a Daily Pickup Your driver will pickup your shipment(s)as usual. Customers without a Daily Pickup Take your package to any location of The UPS StoreA®, UPS Access Point(TM) location, UPS Drop Box, UPS Customer Center, UPS Alliances(Office DepotAO or StaplesA®)or Authorized Shipping Outlet near you. Items sent via UPS Return Services(SM) (including via Ground)are also accepted at Drop Boxes.To find the location nearest you, please visit the Resources area of CampusShip and select UPS Locations. Schedule a same day or future day Pickup to have a UPS driver pickup all your CampusShip packages. Hand the package to any UPS driver in your area. UPS Access PointTm UPS Access Poinfm UPS Access Point"^ ROUTE 130 DELI THE UPS STORE SPRINT 1835 2740 US HIGHWAY 130 2227 US HWY#1 1835 US HIGHWAY 130 NORTH BRUNSWICK,NJ 08902 NORTH BRUNSWICK,NJ 08902 NORTH BRUNSWICK,NJ 08902 FOLD HERE O V-, o I, 1 OD a O s 0 p z O M > N CK c � 0 O � Q 00 N�Q 2� 00 Co 0 N Z C7 a NW N � o o 000 rA ter ". .'• :".. ca *://www.carnpusship.ups.conVcship/create?ActionOriginPair It_PrintWindo... 10/15/2015 r Town of Barnstable Office: 508-862-4644 Fax: 508-790-6304 Regulatory Services Department Public Health Division MAS& Thomas A.McKean,CHO fl a`�� 200 Main Street, Hyannis, MA 02601 Payment Receipt ;Hazardous Materials Payment received: 110.00 (Check) on 10/20/2015—,-,--`- 'Check number: 0000252951 Check amount: $110.00 Name on check: Salon Centric Business: Salon Centric Inc. ;Address: 379Iyannough Road, Hyannis ;Note: $100 + $10 Late Fee e `°Ftroy� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMAS B';- o` 200 Main Street• Hyannis, MA 02601 t639 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT lED MP'� Business Name: `G Date: 03I20A0 Location/Mailing Address: Contact Name/Phone: 30g771 77 Inventory Total Amount: CS d d MSDS: C'6n��1�P. License#: Tier II : AD Labelina: tA Spill Plan: Oil/WaterSeparator: NJA Floor Drains: 416 Emergency Numbers: Storage AreaslTanks: Emergency/Containment Equipm nt: rb Waste Generator ID:MV50$77177)3 Waste Product: NSCkjQ(leOdS Qfpk)3 Date&Amount of Last Shipment/Frequency: 02116 1 9DI 7 Licensed Waste Hauler&Destination: SCr rti'C Other Waste Disposal Methods: 54YI))YuC,k 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 ZLye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes MiscellaneouA Flammables Fertilizers Floor&furniture strippers PCB's Vietal 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) V VIOLATIONS. ORDERS: -,y INFORMATION/RECO MENDATI NS: ei✓ ` ` mJL Inspector: , ._, '1 Facility Representative:—We�� WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS cos Send-- fo ' omz goy ,. i I { `oF�"Eroy� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 Sea MAC,' 200 Main Street• Hyannis, MA 02601 1639. �p�ED MP+p`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: on w o Date: g6 Location/Mailing Address: e N Contact Name/Phone: 3'051, e5 a. 7 Inventory Total Amount. 4r00 SDS: Ohl n License#: Y Tier II : hl d Labeling: (!�K Spill Plan: Oil/WaterSeparator: W 0 FloDrains: NO Emergency Numbers: eS Storage Areas/Tanks: ft+,W,4 JP A Emergency/Containment Equipment: 49AIOM �- Waste Generator ID: Waste Product: fh& ►edrJ � Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NO J0( J-100�C I NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws f 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 V 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: INFORMATI NS/REC fihe NDATIONS: , «J AI`in�t AO nZC4M Inspector Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS °p THE IoN� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BA NSTABLE.g 200 Main Street• Hyannis, MA 02601 039. MA a,0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rE0 'S Business Name: Date: 3 /o l 7 Location/Mailing Address: 3-7°I Hy,.h-1a S Contact Name/Phone: Nr- Al,ss� clack AstMti,,- Mer: sb6-'771- '7727 r I 112-T`7 Inventory Total Amount: �-l q4 SDS: 1D"', kM--#- aUZA S License#: +b 4f� Tier II : 00 Labeling: C elL,\k 0W5k .- Spill Plan: YC5 3 Oil/WaterSeparator: I�l'� Floor Drains: r n Emergency Numbers: yes Storage Areas/Tanks: qw1 c.�w�5 �..r �JtiS�� 6kct't•y- earUw�.,,r,sc ic,�K.1 p-tt c ti,.�.•l Emergency/Containment Equipment: 5 1\ \R-,k Waste Generator ID: MJ So 8-7-11-7-71.-1 Waste Product: ANN 5 C<,C 4aTw17 Date&Amount of Last Shipment/Frequency: 2J I b J t'I IV.(y l 01,116 Licensed Waste Hauler&Destination: Aft Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS ,V p dula�a,( t'V 0 S InI-2 �G 5 NOTE: Under the provisions of Ch. 111, Section 31, of the eneral Laws of MA, hazardous m terial use, ,��,,� storage and disposal of 111 gallons or more requires a license from the Public Health Division. ref-e, Corp IvIL.IV�S 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: e-4,8 b A ANO.", tibl.e- �o< vt �ov�3 INFORMATION/RECOMMENDATIONS: Je.\o,P-<S &\f\VJ -ee�c�,.., 0.�< eolo<,22:� � fA U,4_ 9~� "T!5OCea f ,/SAT l D°�,s k a CP v�no,htr! t�,� ,x f.G��'S A,4 6-m, r to5�+•N Inspector: I � La��--1�� Facility Representative: dCIAJ(JYO l� WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS • • •` s �3 Number Fee 1127 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that SALONCENTRIC 3 79 IYANNO UGH ROAD, HYANNIS, FL Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2017 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER, M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health i E Town of Barnstable • °F'IKE rwyy Regulatory Services °# Richard V. Seali,Director BARNSTABLE, BARNSTABLE MASS. Public Health Division 039 �0 a aysmei �r n.icaunm:rcesn p� rA xnra�s �'&tY.Uf•G'FSiaey6b5R E eo"1°' Thomas McKean, Director ^��4 `515 200 Main Street,Flyannis,IVIA 02601 ,U e Office: 508-862-4644 Fax: 508-790-6304 g O O 9 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS.GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS DULY 1 st-JUNE 3 Oth). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 O I CATEGORY 2 PERMIT .111 -499 Gallons: $125.00 E E CATEGORY 3 PERMIT 500 or more Gallons: $150.00 , V. S A late charge of$10.00 will be assessed if payment is not received by July 1st • Gtt)ezr)`i ASSESSORS MAP AND PARCEL NO.3Pq 1&7 I 33-E�0 DATE FULL NAME OF APPLICANT: NAME OF ESTABLISHMENT: L HMENT: Prl�©pt� C>✓P�T��-( ADDRESS OF ESTABLISHMENT: 7 ,yNA4J0t6&?q /eij, ; Y c MAILING ADDRESS (IF DIFFERENT): —5,q--Vt� a TELEPHONE NUMBER OF ESTABLISHMENT: EMAIL ADDRESS: V s y e'K)A 5�eo (q,-) SOLE OWNER: VYES_NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: I CORPORATION NAME N9Pl-L-O I COUM-4e, . 7X t l PRESIDENT OW h M66&0 0 /-cDS9N � 1JYj A1Y AC10 ,2/a - -s��9 TREASURER Mprg4 b- 1-ob /V CLERK IF PREPARED BY OUTSIDE PARTY: F N ATU F APPLtCANT Name: r Company Address : + k Y Telephone#: Email: QAApplication Fornis\HAZZAPP Revlb.doex Pagel oft x F IKE►ok Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 B'",„per`E 200 Main Street• Hyannis, MA 02601 F%639.. � TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: 6doo— 2r��• Date: 7 26�/�6 Location/Mailing Address: 37 T- a,�.,.�,� t n ,5 Contact Name/Phone: a -T`7 ► -772 &,e4 K,,4rit►a, . M , Inventory Total Amount: MSDS: �Va�la�o�2 License#: IY21 Tier II : N ►4 Labeling: moo _ Spill Plan: e.s Oil/WaterSeparator: !N8 Floor Drains: A�o - Emergency Numbers: 7125 Storage Areas/Tanks: E e w% Wa0{-f- v921 Emergency/Containment Equipment: ae, 004@ pQ CMA,. - Waste Generator ID: MV Sd I -7 fg,-7 Waste Product: r►1,-sc. (aKj. CorC� x Date&Amount of Last Shi ment/Fre uenc : .Z -7/1 r; — 3D l b /x/y< Licensed Waste Hauler&Destination: C ear C-fa—bars �/ t�� o A YZ Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALSSQ-- I KVeA+&4ys�rr►.+��1 Glect�on�ca� 2/ZS+�f3/i�l NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous mate ial use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils �- Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners �— Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: �I�6'b5 ►n®� a-Va %\ANo1e-4-o &Lr, ` �1ce-5 o< eivvc.A��/e�S d,1 Z ►AO+ o In to cc 5 ORDERS: a vCG C I kvlm 6,45 155 6,t.,� 4o IX cz SS INFORMATION/RE OMMENDATIONS: C vL e 40( pU all co okf q, tiJo 4< a Inspector: Facility Representative: �.�.✓L!/) , G%` WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS I � I 664A-6c Jeri ) ys I I w epo+1.5,Af— I `oF"'ETati Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMs�Le.� 200 Main Street• Hyannis, MA 02601 039. �pfEDrnn+°�0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Date: z Location/Mailing Address: 3'7 J- 4s4 o0 a K ynl►S r o�uva,1 lc_ Contact Name/Phone: -7- -7-7; aII IA - ecb k ors C J vC 2 S 7 I q 127—•e; Inventory Total Amount: t h�IISDS: License#: Q e.o Tier II : �o �" Labeling: 110a Spill Plan. S Oil/WaterSeparator: Floor Drains: Emergency Numbers: Ye s Storage Areas/Tanks: 1<qa o Emergency/Containment Eq ipment: �� Al Waste Generator ID: 99d-1 77 -7 Waste Product:M\5(A4\Ak, C&cl., ors` Date&Amount of Last Shipment/Frequency: ci 1-1 ly N. I Y. ! +%2 1 b Licensed Waste Hauler&Destination: Ue a<boc5 E a o Other Waste Disposal Methods: , \ LIST OF TOXIC AND HAZARDOUS MATERIALS IV0 �q 1D�( c.�c�� v� 1v�VQ �y Iv�(� I r►t fi NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of9(/IA, hazardous matefial use, 3/i?li 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, n hydrochloric acid, other acids) VIOLATIONS:rYCWA 9vv PvVee5 uvl-ww<e e� M-*6 aecest�, ORDERS: �c�e - 5 a lC- 2 a- evK o *44S qr� we.�&-+ v-e-- k<cg�55 to INFORMATION/RECOMM ND TIONS: Inspector: r, L CW4If— Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: 3/ I-7 / I� ' TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS RE44STRATtWFORM NAME OF BUSINESS: ?e'rVO& n BUSINESS LOCATION: J�� .l- yav�✓to��j� t� , �y�r.n i5 INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: �'D$-77/ - 7727 � 1l( y CONTACT PERSON: 1?0Lj1r-r%AV,- y- y'8xw� 13'&<Y— yw",L-f EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: .�joy& preAvets ryf,., I A1L�55 ok ,,,e1ns,-fie, INFORMATION / RECOMMENDATIONS: '�It T ja,_ 14 po5feV A A/et j "'Aire bl, J��oo pp (� Ire Dlstt�ict: A*A4009 1n9 e. 5 Yloiss 3� 1' ��li o S �C. d�N/1I5 �cd�(�aK.�- wel(�oc�avlrac•L�fo�c, 7� No re�owt•�c,�..�,orc.5 a�'�I-�,� �.e_ �i Waste Transportation: _�o p141ev,Og b-et Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: rhihz 04VA,COV-, f OXIC, Licensed? Yes No NOTE: Under the provisions of Ch. 111; Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS _ -, �Je,)eJ(bm,,z-A The Board of Health and the Public Health Division have determined that the followin products exhibit toxic or hazardous characteristics and must be registered regardless of volume. AMA/y-f 343/1�f Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) .Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene,#2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform,formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil & stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash rj WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials IT Aft �— OPERATIONS Product Clean-Up g Date Policy Page g 10/2013 905.00 1 of 6 Purpose: To protect Team Members when there is a need to clean-up products that have spilled and may have hazardous properties. To ensure the surface the products spilled on is cleaned thoroughly to avoid slippery surfaces after the material area has dried, or further surface damage. Responsible Person(s): All SalonCentric Team Members References: OSHA 29CFR 1910, NFPA, AIHA and ACGIH, Hazmat training Procedure: Team Members are responsible for notifying the Store Manager as soon as possible if a product is spilled. They are also responsible for cleaning up the products as quickly as possible to avoid a Team Member or customer from slipping. Protective Equipment: For most spilled products there are limited hazards. However, to ensure that all Team Members who clean-up spilled products are protected, no matter what the hazard of the product is, the following protective equipment will be worn whenever cleaning up any spilled products. • Gloves - Nitrile gloves with a thickness of 6 or 8 millimetres will be used to clean-up spilled products of all types. Nitrile gloves that are 4 millimetres (such as nitrile exam gloves) can be used if 2 gloves are worn on each hand. Examples of Nitrile gloves are in Appendix A. • Chemical Goggles - Goggles will be used to protect Team Members' eyes during any product spill clean-up. • Splash Apron - When cleaning up products that are corrosive or oxidizers, a splash apron should be worn. Aprons used in hair coloring and other chemical hair treatments are adequate. • Long sleeves - For any spill clean-up, especially of corrosives and oxidizers, long sleeve shirts must be worn. Having a smock or long sleeve apron on hand at each store is recommended. Clean-up Materials: • Paper towels, spill clean-up pads, synthetic sponges, speedy dry or clay type kitty litter • Plastic garbage bags • Assorted cleaning materials - Primarily a mild soap cleaning solution • Small flat plastic shovel or plastic dust pan and small broom Product Clean-up Procedure: • When a product breaks and spills on any surface, the area needs to blocked off to prevent customers and other Team Members from slipping or getting the material on them. Place cones or wet floor signs around area. Note: Where there is more than one Team Member available, one Team Member should stay near the spill to keep customers from walking in the area to prevent slips and falls. • Prior to attempting to clean-up any product spill, Team Members must identify the product and obtain the MSDS sheet to determine the hazard, if it is not known. Once the product hazards are known, the Team Member(s) need to put on the protective equipment as noted in this procedure. • For any spilled products that are liquids, Team Members should stop the immediate spread of the material by using paper towels or spill pads. Use paper towels or synthetic sponge to absorb all liquid products. While doing this, move the paper towels slowly to limit the possibility of splashing of the product. Be sure to use enough paper towels to absorb all liquid so that is not dripping when the paper towels are removed. Avoid contact with footwear to limit the chance of contact with skin. • Place paper towels and other cleaning materials in a plastic garbage bag. • Clean the surface of all products so there is no liquid remaining. Place all paper towels and other cleaning materials used for the product clean-up in the plastic garbage bags. • Use a cleaning solution (mild soap solution and warm water) to clean the surface where the product spilled. Repeat this process at least 2 times and rinse with clean warm water. i • Let the surface dry. Check to ensure the surface is not slippery after the clean-up. Repeat cleaning if necessary with mild detergent solution and warm water. Special Clean-Up Procedures Broken Glass Handling: • Where broken glass is present, Team Members should not attempt to use their hands to pick-up the glass. • A piece of cardboard or plastic dust pan should be used to remove the glass. Leather or other cut resistant gloves should be worn if the broken glass will be handled. Corrosive Products (Relaxers, Skin Peels, etc.): • Do not pour any products down drains or dispose free flowing liquids in the garbage. • See the disposal section of this procedure for more details. Solids: • Wipe up the material with damp paper towels or a sponge. • Rinse fabric towels if used for clean-up. • Place rinsed towels, sponges and other clean-up debris into a plastic garbage bag. • Wash the area completely with mild soap and water. • Completely rinse the area with water and check to be sure the area is dry. Place all clean-up materials in a plastic bag. Oxidizers (Developers Above 25 Vol, etc.): • Never use any metal equipment or containers for any oxidizer. Using metal equipment to clean-up these products can result in serious reactions, fires and injury. • Contact Regulatory Services immediately for disposal requirements (732- 499-2746). Do not pour any products down drains or dispose free flowing liquids in the garbage. You will be directed as to the proper disposal. Liquids: • Absorb liquid with inert material such as a synthetic sponge, paper towels or mops. • Scrub the area with mild detergent and rinse with water. • Rinse fabric towels, sponges, or mops thoroughly prior to disposal or storage. • Do not dispose of any liquids in the trash. • Absorb all loose liquids and rinse out. • Place all clean-up materials in a plastic bag. Paste Products: • Use a small plastic shovel/dust pan to scrape up the paste product and place into a compatible container or plastic bag. • Wipe the remaining product off the floor or other surface using a dry paper towel. • Clean the area with mild soap and water. • Dry the area and inspect to ensure the surface is not slippery. • Place all clean-up materials in a plastic bag. Powder Products: • Approach powder product spills with caution so as not to cause product to become airborne unnecessarily. • Use a small plastic shovel or dust pan to pick-up the powder and place into a compatible container or plastic bucket or bag. • Inspect and wipe down shelves, products and surfaces. • Clean the remainder of the area with mild soap and water. • Dry the area and inspect to endure the surface is not slippery. • Place all clean-up materials in a plastic bag. Self-heating Hair Bleaches: • Absorb with inert material such as a synthetic sponge, paper towels or mops. • Rinse paper towels, sponges, or mops thoroughly prior to disposal. • During clean-up do not contaminate product with organic material (i.e. wood pallets.) • Do not dispose of any of these products in the normal garbage. Flammable Products: • Nail Polish o Absorb liquid with spill pillows, paper towels or other absorbing material. o Remove spill residues with a non-flammable solvent (example - non- acetone nail polish remover). Assure proper venting. o Wash area with a mild detergent. o Place all clean-up materials in a plastic bag. • Non-Aerosol Hair Sprays/Perfumes/Colognes/Fragrances and After Shaves: o Absorb liquid with spill pillows, paper towels or other absorbing material. o Wash area with a mild detergent. o Place all clean-up materials in a plastic bag. Disposal of Clean-up Material and Residual Product: • Some spilled product cannot be disposed of in normal garbage. These include corrosive, Oxidizer and Self-heating hair bleaches. Where there is still free liquid absorb material with paper towels and kitty litter, place in a double poly bag and dispose of in the regular trash. • Contact Regulatory Affairs at 732-499-2746 to determine appropriate disposal methods. • Absolutely no hazardous products or clean-up materials are permitted to be rinsed down any drains. Non-Hazard Products: • Non-hazardous products, such as shampoos and conditioners, should be cleaned-up thoroughly. These products while not possessing hazardous properties need to be cleaned up to prevent slips and falls. The area should be cleaned to ensure no residue is left behind. Clean the surface with a mild detergent and warm water. • Damaged products from the spill and the clean-up materials can be disposed of in the normal trash. Cleaning up Blood and other Body Fluids: Team Member should not attempt to clean up blood or other bodily fluid spills. Contact Service Channel and open up a ticket to have this completed immediately. Until the Service Channel vendor arrives for clean-up, block off area to avoid further contact or contamination. Emergency/Contact Phone Numbers: Barnstable Health Department (508) 375-6600 MA Department of Environmental Protection (DEP) Emergency Response (888)304-1113 Main number (413)784-1100 Service Center/Permits Assistance (413)755-2214 Clean Harbors Emergency Contact (800)645-7745 `Appendix A Examples of Gloves: o Ansell Powder Free Nitrile Gloves (5 Mil) - 100 per box o Best N-Dex Plus Nitrile Gloves (8 Mil) - 50 per box o Best N-Dex Nitrile Gloves (6 Mil) - 50 per box o Best N-Dex Nitrile gloves powder Free (4 Mil) - 100 per box o Vinyl gloves can be used, but they cannot be used for emersion into pure product or long duration clean-ups without changing them periodically. Examples of Goggles: (safety glasses are not acceptable to use when cleaning spilled product) o Pyramex chemical goggles with anti-fog lens and foam padding o Pyramex Fog Free chemical goggles o Sperian Anti fog direct vent goggles o AO Safety Clear indirect vent goggles Product Clean up materials: o Speedy Dry/Clay type kitty litter o Trisodium Phosphate (TSP) (soap) o Plastic garbage bags o Sponges o Scrub brushes o Bucket o Paper towels o Plastic shovel/Dust plan o Floor Wet Caution signs i? SENDER: COMPLETETHIS SECTION COMPLETETHIS SECTION ON DELIVERY., o Complete items 1,2,and 3.Also complete. ;.; A. Sign item 4 if Restricted Delivery is desired.. .- 3 ❑Agent ® Print your name`and address on the reverse.-,= '' X ❑Addressee so that we can return the card to you. B. Received by(Printed ame) C. f De ■ Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery addr different from ite 1? ❑Y j 1. Article Addressed to: If YES,enter delivery addres ow: ❑No I I j Salon Centric I 379 lyannough Road I Hyannis, MA 02601 I 3. Service Type j Mertifigd Mail® ❑Priority Mail Express' j I ❑Registered WRetum Receipt for Merchandise `— ❑Insured Mail ❑Collect on Delivery 4. Restricted Delivery?(Extra Fee) ❑Yes j 2. Article Number t `7015 0640 0005 8489 73976'" (transfer from service label PS Form 3811,July 2013 Domestic Return Receipt 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• Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 il''l�:�rF'.t�r�tstiir'�'11�''i1!"1'llil�i�'�f14Fjl�it,�l�l�i►�it . �• ,� ._ i .,x. Er 0 F F I C I AT U S E--� ICO Certified Mail Fee $ Extra Services&Fees(check bm add fee as appropriate) Ll ❑Return Receipt(hardcopy) $ H ❑Return Receipt(electronic) $ -�OStnlafk- 0 ❑Certified Mail Restricted Delivery $ .�Here ❑Adult Signature Required $ .v ❑Adult Signature Restricted Delivery$ ` d A Postage r 0 � .► Total Postage and Pees 5, C3 Salon Centric ------------------------ r- 379 lyannough Road ci ----------------------- Hyannis, MA 02601 Certified Mail service provides the following benefits: �— ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this, delivery. USPS®-postmarked Certified Mail receipt to the ■A record of delivery Qncluding the recipients retail associate. signature)that is retained by the Postal Service- Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent Important Reminders. Adult signature service,which requires the ■You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class WHO,First-Class Package Service®, available at retail). or Priority Maii®service. -Adult signature restricted delivery service,which ■Certified Mail service is notavailable for requires the signee to be at least 21 years of age international mail, and provides delivery to the addressee specified ■Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent, with Certified Mail service.However,the purchase (not available at retall). of Certified Mall service does not change the ■To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark If you would like a postmark on ■For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record ,Certified Mail receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply , You can request a hardcopy return receipt or an—appropriate postage,and deposit the mailpiece.: electronic version.For a hardcopy return receipt complete PS Form 3811,Domestic Return Receipt,attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records. PS Form 3800,April 2015(Reverse)PSN 7530.02.000.9047 - TOWN OF BARNSTABLE BAR—W '0 Q Ordinance or Regulation WARNING NOTICE Name of Offender/Manager ?-loil f Address of Offender MV/MB Reg.# Village/State/Zip / Business Name '��w �.e vt {.� 11 :V0 ia'm/pm, on 11i1 2-0 /5-- Business Address �"7 �1Y +�✓t �•� � } ,� `�_t? / Signature of,"Enf orcing- Officer Village/State/Zip \A In V1 t i Location of Offense �d lvvi ► � Enforcing Dept/Division Offense 14Ai o vl ��^ 1 r�w� .ole, 10�-(� Facts '4A0Ca/.)o �1�.�? n� > I 1 4&�10VC5 0� ��i�a(-Sr") V\e4e ',ej p 1.,3 Ao,)4 �G�'� This will serve only as 'al warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. TOWN OF BARNSTABLE BAR-W Ordinance or Regulation WARNING NOTICE �.,..- Name of Ofender/Manager Address of Offender MV/MB Reg.# Village/State/Zip Business Name r r am/pm, on 20 Business Address � (t ��rt � �,, ��.: �, �✓ Signature of.Enforcing Officer Village/State/Zip Location of Offense Enforcing Dept/Division Of fense Facts v '� • '� r= 1 l =- -I�S.• "✓�'4r�Yl ' i i !j4' . rtvk. } f �^ 3 .t f t' - { Y ti f •' 7��/ J . This will serve only as al warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. I (OSalonCentriG PROFESSIONFL BEAUTY PARTNERS I _ Paul Tinney-Herbst I MANAGER E: SCSTORE.3711Csaloncentric.com ' P: 508.771.7727 F: 508.775.3595 t t r • J: b �4 k _ V �. .. R Number Fee 194 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Stewart Painting .-------------------------------------------------------------------------------------------------------------------------------- 379 Iyannough Road, Unit#7, Hyannis, MA ...--------------------------------------------------------------------------------------------------------------------------------------------------------------------- Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. ------------- ------------------------------------------------------------------------------------------------------------------------------------------------------ Restrictions: .------------------------------------------------------------------------------------------------------------------------------------------------------------------. This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable � r Inspectional Services STABLE Public Health Division .,.,�E.�639-�.«m...�a,s M:,unxn xs�s•o�amxe•rresr saarvstne!e 1639-2014 �--i 1 BAMWABL& Thomas McKean,DirectorMAM Fp 9. a` NIT 200 Main Street, Hyannis,MA 02601 N) Office: 508-862-4644 Fax: 508-790-6304 ' �r �r APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ❑ - - CATEGORK'2 YERMIT J H -499 Gallons:.... _$125.00. ❑l CATEGORY 3 PERMIT 500 or more Gallons: $150.00 L� VCS *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?)O 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:. Lh&Iellm SkWa.,e'l 5. NAME OF ESTABLISHMENT: GIANT aj-pAt7/,? 6. ADDRESS OF ESTABLISHMENT: M 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: �/ 8. TELEPHONE NUMBER OF ESTABLISHMENT: 50�f 36 ,2-pbO oZ.3 9. EMAIL ADDRESS: --r, 10. SOLEOWNER:X-YES_NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADD SS,AND LEPHONE#OF: CORPORATIO NAME PRESIDENT TREASURE S CLERK 4-- 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE Q:\Application Forms\Haz Mat Appli Draft Jan2019.docx III �7 Number Fee 1127 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that SALONCENTRIC ..............................................................................................................................•-- 379IYANNOUGHROAD, HYANNIS, MA ...------------------------------------------------•..........................--.........-----...----....-----.........•-----....------..............................•-- Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. .................................................................................................................................................................... Restrictions: ..................................................................................................................................................•----............. This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health • Town of Barnstable Inspectional Services BARNSTABLE �FtNC� Public Health Division $ �� • r Thomas McKean,Director arEo ,, 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fast: 50&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 LPERMIT 26— 110 Gallons: $ 50:00 O CATEGORY 2 PERMIT 111 —499 Gallons: $12500 i] - CATEGORY 3 PERMIT 500 or more Gallons: $150.00 1 v'r *A late charge of$10.00 will be assessed if payment is not received by July Ist. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? V/ YES_NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS • ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: !Matty POlatseck 5. NAME OF ESTA 3LISFI LENT; ' 6. ADDRESS OF ESTABLISHMENT: �-t kv,!�& C1(11 )U.C.k) t� 4��tc�flt�iS ,i`�l� f�C�a (itD I 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE:( t'�( J iNy tG 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: re-ne 11,3 C.a J► 1 St '�S1+ CI12?rS .Cn 10. SOLEOWNER: YES*NO,IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT%Urf Pd4e4ed DATE 6/29/20 • Q:\Applicadon Foansliiaz Mat App Revised 09-14luoex Number Fee 194 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Stewart Painting 379Iyannough Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. - -------------------------- -------- ------------------------------------------------- -- ---------- ----------------------------------. This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2020 unless sooner suspended or revoked. --- --------- ------------------------ PAUL J.CANNIFF, D.M.D, CHAIRMAN DONALD A.GUADAGNOLI, M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A. MCKEAN, R.S.,CHO Director of Public Health Town of Barnstable Inspectional Services BARNSTABLE Public Health Division N:5 1.1�N I.":. 163"201' I S/;- BARNgrABLE, Thomas McKean, Director MASS. 1639. 200 Main Street, Hyannis, MA02601 M eC 1-- CD Office: 508-862-4644 Fax: 508-790-63040 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 I st-JUNE 3)Oth). APPLICATION FEES CATEGORY IPERMIT 26- 11OGallons: $ 50.00 El CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 0 CATEGORY 3 PERMIT 500 or more Gallons: $150.00 JR *A late charge of$10.00 will be assessed if payment is not received by July 1st. q 1. ASSESSOR'S MAP AND PARCEL NO. �jaS � .q30 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: —nbd&2 TL- �)Ee-wari 5. NAME OF ESTABLISHMENT: A UJ Ck(-i , 6. ADDRESS OF ESTABLISHMENT: '319 1 ck nn otj G VA 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: sb� 9. EMAIL ADDRESS: (T i(le-p 51p-.")ar4. CLM 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME, HOME ADMDSS"AND TALEPRONE # OF: CORPORATION NA'ME VCA( 0 f,4 6\ —1(-,r- '�5jq VC PRESIDENT_�hy.Irk(,nAa ?44rrif a I I I YI 6� "z V-cj cgnTm) TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE COMPANY ADDRESS EMAIL: *SIGNATURE OF APPLICANT TE Q:\Applicatioil Forms\llaz Mat App Revised 09-10-18.docx Number Fee 1127 THE COMMONWEALTH OF MASSACHUSETTS $150.00 ! Town of Barnstable Board of Health This is to Certify that SALONCENTRIC 3 79 IYANNOUGH ROAD, HYANNIS, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. --------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2020 unless sooner suspended or revoked. PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI, M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A. MCKEAN, R.S.,CHO Director of Public Health f Y: Town of Barnstable Inspectional Services r oF, F BARNSTABLE Public Health Division ltos.)ms �9 ,BAMWABLE Thomas McKean,Director �°rFo 1. 200 Main Street,Hyannis,Na 02601 r, 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 I st—JUNE 30th). APPLICATION FEES 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 receivedby July St. 1. ASSESSOR'S MAP AND PARCEL NO. to2g 2. IS THIS A PERMIT RENEWAL? V YES—NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF • GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4, FULL NAME OF APPLICANT: Cx Yi Gl(,.1 -not S. NAME OF ESTABLISHMENT: c: �cL o ckc 4JO�" 1 L 6. ADDRESS OF ESTABLISHMENT: 2) Y1L1C)UC.a t 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: i� r K L EMI yINy t d 8. TELEPHONE NUMBER OF ESTABLISHMENT: (n�g �� 1-127 9. EMAIL ADDRESS: r'�ni l i s► 1�x�.sr n CI+ C 4_'.S < C rn 10, SOLEOWNER: YES `J-NO IF NO,NAME OF PARTNER: bAQjJ!e,. K 1 VA 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME J(z...l n'V-Ace' r� C. _ PRESIDENT - TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT -&Jyk�� DATE 51201 I'l • Q:\Appiicadon FomtWiaz Mat App R"ised 09-1 -18,docx 1 Number Fee 1127 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that SALONCENTRIC 379 IYANNO UGH ROAD, HYANNIS, FL Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. ---------- -------------------------------------------------------------------- -------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2019 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF, D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2018 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health T�. B4rn loewg8ofat y emc ble � � f Richard V. Scali,Director Public Health Division BAMSTABLE Cz# o�( BMWMBLE. • Thomas McKean Director h�OhS✓I 5'639 Y11F4W�9NN5T4CE � 16 4 575 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 g V.S . *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL?Y 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 ka Ae-�� , 5. NAME OF ESTABLISHMENT: Pw 6. ADDRESS OF ESTABLISHMENT: Q V1 -jeLtj V 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: (SDO—Tl I `"1-7 7.- 9. EMAIL ADDRESS: (AkPCC\Uar,�"11 i �&jMC i C-, COLA 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS:Al TELE HONE#OF: CORPORATIO AME PRESIDENT `4 TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: • NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: Ld SIGNATURE OF APPLICAN — DATE 5 ye Q:\Application FormsV AZMAT APP 2017 REVI DAm Number Fee 194 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Stewart Painting 379Iyannough Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. -------------------------------------------------------------------------------- ------------------------------------------------------------------------------ This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/360/2019 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 'Vel of Ttowl ftnstablee Wf atoervices Pa Richard V. Scali,Director , �THE Public Health DivisionO�Ak. 'j-4 BAMMBLE. Thomas McKean DirectorMp$$, 1 1639. 10 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE X HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st—JUNE 3 Oth). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 x V-S . *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? d 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: 5. NAME OF ESTABLISHMENT: + PG,I n +` CA 6. ADDRESS OF ESTABLISHMENT: �T�o nou c 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 50S -3(e ca V1 a 3 9. EMAIL ADDRESS: ,1 af I -e (a—'S t U)p,( 4-n � CLM 10. SOLEOWNER:,/ _YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADD S,AND TE EPHO #OF: CORPORATION NAME C % t i PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT )�; TE Q:Wpplication FormsUiAZMAT APP 2017 REVISED.docx L • Number Fee 194 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Stewart Painting 379Iyannough Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2018 unless sooner suspended or revoked. 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 r �� his o0 o of Unstable egi%atoe"ces Richard V. Scali,Director 'ME r Public Health Division BABSTABLE • • Bn2Y9i:.6tE••IxrkRY1LLE•COTUrt.—I:IS BARNssBLE• r Thomas McKean, Director WSTYTMLS 5 639-20E•p51Nii4&E -2014 039. 3.s 200 Main Street, Hyannis,MA 02601 5755 Office: 508-862-4644 6q v/ I —'? l" 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 I PERMIT 26- 110 Gallons: $ 50.00 . ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 9 *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: h:G dD n 5. NAME OF ESTABLISHMENT: -� w.a� �a rr-�`i V b 6. ADDRESS OF ESTABLISHMENT: 37g rt4arrno oC•f,�d ��rannis. NA 0!2-<vot 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: S. TELEPHONE NUMBER OF ESTABLISHMENT: 3-0 j 3(o� 9. EMAIL ADDRESS: e /tyo n O e w a �A� ✓�t -D+'►'► 10. SOLEOWNER: ✓ YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME r�- ,� + v►a IJ C. PRESIDENT e. TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: � COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE /�7 Q:\Application FonnsViAZMAT APP 2017 REVISED c Number _ Fee 1127 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that SALONCENTRIC 3 79 IYANNOUGH ROAD, HYANNIS, FL Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------- ----------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2018 unless sooner suspended or revoked. ---------------------------------------- PAUL_J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health I$ . J• Number Fee 1200 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health s This is to Certify that Cape Cod Polymers, Inc. A "Line X Cape Cod" 379 Iyannough Road Unit#8, 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 Town of Barnstable �tHE A Regulatory Services Richard V. Scali,Director C B"x"x Public Health Division BAMSTABLE 165 n. 0� BRRNSAOLE•@IfERV[LLE•CDN!f•MYAY..\'IS ♦ NSAStOHS Y,!tt5.OSfEiV.lii•W3T 6UNSTRBtF �ED1i"0�a Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 'Office: 508-862-4644 Fax: 508-790-6304 tfi 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 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. DATE FULL NAME OF APPLICANT:&6�Z�l �I LC l� k NAME OF ESTABLISHMENT: C PA Cob Pd;,,�Mj;'29. &) .. ['I c� L mi,-x L/A Cc t) ADDRESS OF ESTABLISHMENT:3 2 9 � �V��aU:s�d �� , tom, A�I�V+�ts, Vv �e 07,01 MAILING ADDRESS(IF DIFFERENT): ,Z // TELEPHONE NUMBER OF ESTABLISHMENT: i ' i `C EMAIL ADDRESS: S Q. y\ at -I- SOLE OWNER:_L/YES_NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME C 4 0,D PCtyA4U4UVC PRESIDENT F fcD) a 0 y TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: SIG,>JATU OF PLIC T Name: Company Address Telephone#: Email: QAApplication Forms\HAZZAPP Rev 16.docx Page 1 of 2 Town of Barnstable Office: 508-862-4644 Fax: 508-790-6304 Regulatory Services Department BAIRN rAsL& Public Health Division MASS& Thomas A.McKean,CHO 109` 6` 200 Main Street, Hyannis, MA 02601 Payment Receipt Hazardous Materials Payment received: $125.00 (Check) on 6/10/2016 Permit number: 1200 !Check number: 1049 Check amount: $125.00 Name on check: Cape Cod Polymers, Inc. f Business: Cape Cod Polymers, Inc. DBA"Line-X Cape Cod" Owner: WILFRED B&DOROTHY TRS ,Address: 371 IYANNOUGH ROAD/RTE 28, Hyannis i i • _P7 Number Fee 1200 THE COMMONWEALTH OF MASSACHUSETTS $5o.00 Town of Barnstable Board of Health —i= This is to Certify that Cape Cod Polymers, Inc. DBA "Line X Cape Cod" 379 Iyannough Road Unit#8, 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. 02/03/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health • Town of Barnstable °FIB►op, Regulatory Services ti - °� Richard V. Scali, Director wSTABLE. MILRN M Y BARNSTABIE ASS. $ Public Health Division �[n IIANN$'AFLC•C[NIl'XYILLECOTVIT•iA'L:AIS 1639' \e N 5TONS Y.ILS•9SERVi1E•k'Si 2AnNSTABt ArfDN1°�A Thomas McKean, Director 1 575 200 Main Street, Hyannis,MA 02601 0 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 Jules • ASSESSORS MAP AND PARCEL NO. 39 cF30 DATE FULL NAME OF APPLICANT: G'km (I i CHAI-1- 5NRAME-k NAME OF ESTABLISHMENT: CAFf er� ►�ota��4Q.5, !:P(,- aA- [..1,D)5-r X CAPL C&T) ADDRESS OF ESTABLISHMENT:--�29L AkA) 6jj�k-Y 0Qj1f�HyA►4AzJ- MA C26C31 MAILING ADDRESS (IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: Sc)7-1776- 07iG . 77Y- 7?t 19-46 EMAIL ADDRESS: 4 5 kr'a Mek irP kA co--qAcasr• 11 6`13- SOLE OWNER: YES NO - IF NO,NAME OF PARTNER: FALL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME C AjPf- CO b ky M4-r-S, •: N ram: PRESIDENT GA : Q fZA M6 TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: SIG URE APP ICANT Name: ' Company Address Telephone#: a Email: Q\Application Forms\HAZZAPP Rev I6.docx Page 1 of 2 Town of Barnstable Office: 508-862-4644 Fax: 508-790-6304 Regulatory Services Department w: &UtNSTABM Public Health Division XAS& Thomas A.McKean,CHO 1b39x �`` 200 Main Street, Hyannis, MA 02601 Fn Payment Receipt lHazardous Materials Payment received: $50.00 (Check) on 2/3/2016 I ;Check number: 1019 Check amount: $50.00 Name on check: Cape Cod Polymers, Inc. ;Business: Cape Cod Polymers, Inc. Owner: Gary Michael Shramek Address: 379 Iyannough Road/Rte 28, Hyannis i Note: Category I —-- ------- -......... i TRow of B4nstable 4P eiK� Dea�a�ya3& eg atoty Services Richard V. Scali, Director Public Health Division BARN TABLE 6nunsr.:u ..sxruwu.e.eoiurt•grerrs l� BARNEMABLE. ' Thomas McKean Director r,p ) 1639-2014 " 200 Main Street,Hyannis, MA 02601 �Dg Office: 508-862-4644 Fax: 508-790-6304 p APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 ❑, CATEGORY 3 PERMIT 500 or more Gallons: $150.00 f�l VS *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. fVAap / lolorV,/IQ+ 3ai /G'i i /Code 3aAo 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: - --- - - - -- -�---- ---. - Salon Centric ' 5. NAME OF ESTABLISHMENT: ! 379 Iyannough Road Hyannis, MA 2601 6. ADDRESS OF ESTABLISHMENT: y E 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE:{o►►o► r; r+ - —r -` r54 SfZ $� ' .AasbL`q F�- loo 8. TELEPHONE NUMBER OF ESTABLISHMENT: `j o rd -- i i—-17a 1 9. EMAIL ADDRESS: C r�s5 e I 1[�S0.to Y1 CPn1 C .C O rrl 10. SOLEOWNER: ✓YES NO IF NO,NAME.OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME Sa(6 nC fnfV C- ) 101o1 Di,. Mc-K. J r. S�.W St-e 160 '771-3tvq-3151 PRESIDENT 'Ber+ron oalp yie- TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICA DATE f Q /20 I`7 Q:\Application Forms\HAZMAT APP 2017 REVISED.docx °rIKE owe Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • RaRMAWRRLE,g 200 Main Street• Hyannis, MA 02601 2639. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Da 2 3 1 Location/Mailing Address: 3? S Q vt,lev rl-t 7 k"yl S M1 iD 19 tb `7 Contact Name/Phone: S 1 s-1,e �. v8-362 O-1-3 IIe-- Inventory Total Amount: ^' Apo 0 °i SDS: iA, S License#: 19 q C4+3 Tier II : Labeling: Spill Plan: Off. Oil/WaterSeparator: 1J Floor Drains: Emergency Numbers: ©q<- � 5 ems. Storage Areas/Tanks: ti �� all.r.4 6 uw Emergency/Containment Equipment: S o2� < .,�}� I-'f s� I �� .-�,.101 Z Waste Generator ID: AAV 23 Waste Product: 41t& 4-li Date&Amount of Last Shipment/Frequency: b 7 N 4X Licensed Waste Hauler&Destination: Clem. /4;Lc-loos Bra i F iMA Other Waste Disposal Methods: 0 AAL-c M 5 c. OVA-V. ,Ak-, 'J ck' -< LIST OF TOXIC AND HAZARDOUS MATERIALS t�o ��M�-�o � q ��y�J,e,naca S Ian Ge, t tiy-t I V15� NOTE: Under the provisions of Ch. 111, Section 31, of the Ge eral Laws o MA, hazardous mat ial use, tiD storage and disposal of 111 gallons or more requires a license from the Public Health Division. C[A(otk+.1- 4K, 5 J-e-- Antifreeze Dry cleaning fluids t 0. k)I nke-r 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: QAAaAL 1 4,11 u00-42 2. Xry �1 k"7-,q Z a I F RMATI N/RECOMMENDATIONS: 0ct, k• r c ov 4 c�� D o aA--- os ,n vt 1 e I-, oJL MOJ�-� 4w�VkR (�- PfO�vL�"S 1 rl.{'a UKv544spector: , L4-4-- k-4- Q CL& Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS /� °p\NE rokti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • RaRMASSRLE.e` 200 Main Street• Hyannis, MA 02601 "rFO39. P+ TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: 14-0&c atw*% Date: 2 z 46 L �� .ti o ocation/Maibng Address: 3�1 �- � � aw I o 106'I Cew+ct v,f le_ Contact Name/Phone: a,r o - 60 Z.3 Inventory Total Amount: 00'(,L?o A&l MSDS:A �,v w,1- �g �yFL1 q'1�License#: I9 y cxti 3 Tier II : N // Labelina: Spill Plan: S Oil/WaterSeparator: Floor Drains: fl Emergency Numbers: e-5 Storage Area c,>wly \Ak rp4 ,+ &5A2 aSt KV,.,c y- +e_ vVt co Emer enc /Containment E ui ment: 5 g ®►a-s it— . Waste Generator ID: M 0 2 2 Waste Product: &U--k ivLyu-n Date&Amount of Last Shi ment/Fre uenc : 2 23 ti Licensed Waste Hauler&Destination: f�K. Ar/ od <41�4< A Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Podk-} Asphalt&roofing tar 100 Swimming pool chlorine ;Q'i X44 q7- ,4' Paints, varnishes, stains, dyes i Lye or caustic soda 1A I�° Lacquer thinners wooke,��`' 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 RE OM ENDATIONS: 0.4 IA-Leew u Wae7�� 1 '5 v.� q 106, KJJ i tA — / � e In sup r: ^�-- 2�-� �AU<Ir Vu9 MN afvA. Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS Number Fee 194 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Stewart Painting 379 Iyannough Road, Hyannis, MA Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2016 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2015 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health C� Town of Barnstable oFTHE 1pk� Regulatory Services • Richard V. Scali, Director * HAaxsenaLE, y MASS. Public Health Division i639• ArFCMA'�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. 32 -a3 0 DATE i APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT ��Q.t� m Pai. A • ADDRESS OF ESTABLISHMENT 1 ,J-(�G{,V no Ut rL& uvv TELEPHONE NUMBER JU 3 b'z 0 D Z` SOLE OWNER: �YES ONO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT Sh,&(day #. ef2U) 100 86Y 241o� C.e.o-fery,(Ce, M TREASURER W9 CLERK Ott • SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS 02/l b� Ce uc6Lei 'U'� 6u0 a HOME TELEPHONE# 526 Y- 36?- $023 Q:\Application FormMAZAPP.DOC r° Town of Barnstable Office: 508-862-4644 �. Regulatory Services Department Fax: 508-790-6304 • Public Health Division MASS. $ Thomas A. McKean, CHO 1659. �4r a . h 200 Main Street, Hyannis, MA 02601 Payment Receipt ,Hazardous Materials Payment received: $100.00 (Check) on 6/17/2015 � 'Check number: 11122 Check amount: $100.00 Name on check: Stewart Painting, INC. Business: Stewart Painting Address: 379 Iyannough Road , Hyannis (Note: Unit 7 i • Please print or type.(Form designed for use on elite(12-pitch)typewriter.)' Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFEST I r6 V` I I I FLE 5.,Generator's Name and Mailing Address Generators Site Address(if different than mailing address) -4�- ��; -f �I - -, ", 4'! Generator's Phone: 6.Transporter 1 Company Name U.S.EPA ID Number 7.Transporter 2 Company Name U.S.EPA ID Number 8.Designated Facility Name and Site Address U.S.EPA ID Number Facility's Phone: y-f -yr-, 9a. 9b.U.S.DOT Description(including Proper SKpping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit HM and Packing Group(if any)) N( Quantity Wt.Nol. 13.Waste Codes t 1"i Ff 'A'Y E,6 MI.F R t M. 2. 3. 4. 14.Special Handling Instructions and Additional Information -Z 15. GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged, marked and labelediplacarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations.If export shipment and I am the Primary Exporter,I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of C6 nsent. I certify that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(if I am a small quantity generator)is true. Generator's/Offeror-s Printed/Typed Name signature Month -Day---7e-ar- -j 16.1riternational Shipments El import to U.S. ❑Export from U.S. Port of ant.ry/exit: Transporter signature for exports only): Date leaving U.S.: LLI 17.Transporter Acknowledgment of Receipt of Materials Transporter 1 Printed/Typed Name Signature Month Day Year ZU) Transporter 2 Printed[Typed Name Signature Month Day I Year I18.Discrepancy 1 8a.Discrepancy Indication Space 11 Quantity ElType ❑Residue ❑Partial Rejection El Full Rejection Manifest Reference Number. 18b.Alternate Facility(or Generator) U.S.EPA 10 Number Facility's Phone: Lo 18c.Signature of Alternate Facility(or Generator) U Month Day Year Z v5CD 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) LLJ 1 2. 3. 4. 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Printed/Typed Name Signature Month Day Year EPA Form 8700-22(Rev.3-05) Previous editions.are obsolete. .1 E .. I :- I - ell". -,;, 7' % 4, � f.t!'. i - 1-1. GENERATOR'S INITIAL COPY I-eanollar@jr Land Disposal Restriction Page : 1 of 1 Notification Form Printed Date :Dec 17, 2015 _ENVIRONMENTAL SERVICES® --------------------------------------- -------------------------------------r-------------------------------------------------------------- Generator Stewart Painting Inc ; Manifest Tracking Info. Address: 379 lyannough Road i 009029768fle Hyannis,MA 02601 ; EPA ID#: M V 5 0 8 3�6 2 8 0 2 3 Sales Order No: 1503967485 ------------------------------------------------------------------------------=------------------------------------------------------------- LINE ITEM INFORMATION Line Item: i Page No: ;Profile No: ;Treatability Group: ; LDR Disposal Category -----------------T------------------r-------------------r-------------------------------- ---------------------------------------------- 1. ;1 ;CH609472 ;NON-WASTEWATER ;2 (This is subject to LDR.) ; ___________1 -------------------L-------------------L;-------------------------------J------------------------------------------------- EPA Waste Code ; EPA Waste SubCategory D001 ;High TOC Ignitable Liquids F003 'Carbon Disulfide,Cyclohexanone,and/or methanol 'mixtures only F005 'Carbon Disulfide,Cyclohexanone,and/or methanol mixtures --- only---------------------------------------------- ------------------------------------------------------------------------------ -------- LDR Chemical Data Underlying Constituents Contaminants Hazardous of Subject to Chemical Constituents Concern Treatment ----------------------------------------------------------------------------------------------------------------------------- ------------ ACETONE Y Y N METHANOL Y Y N TOLUENE Y Y N XYLENES (MIXED ISOMERS) Y Y N Certification Applies to Manifest Line Items Pursuant to 40 CFR 268.7(a), I hereby notify that this shipment contains waste restricted under 40 CFR Ill Part 268. ------------ ------------------------------- Waste analysis data, whe ilabZe�Jittaed. Signature -__ Print Name ---I_v_c i_e___ �`__-______ Title : - Date : ____ 17_2,7— l,- I - � !~�.'')',,`w4#y 1 d.�r4.^ Ck.- tf•:t�t :�!�tj'�-�_'�y..p�y Please print or type.(Form designed for use on elite(12-pitch)typewriter.)' Form Approved.OMB No.2050-0039 UNIFOR.M'HAZARDOUS 1 Generator,lD Number 2.Page 1 of F3 Emergency Response Phone 14,Manifest Tracking Number WASTE MANIFEST. _ t` H `` y', r G 2.> 4fFLE 5.Generators Name and Mailing Address ; Generator's Site Address(if different than mailing address)Ir . SA NIT, Generator's Phone: 6.Transporter 1 Company Name' U.S.EPA ID Number S 22 5 o' 7.Transporter 2 Company Name U.S.EPA ID Number 8.Designated Facility Name and Site Address U.S.EPA ID Number -:��p�}sL'fjigf•��r��;irct��s��.�c� c€�.. NIS 0 _ Facility's Phone: tom ._n ' e:12. ga, 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total- 12.Unit j3:Waste Codes HM and Packing Group(if any)) No. Type Quantity Wt.Nol. - _ YEYa .1..0 � l P ..65 f '£.S".,. -B•Ek. A _ f'-r.k 0, 00'13! 0 6 12 Z . 2. W 3: 4 :14.Special Handling Instructions and Additional Information 3 _".2`,`,' 0,5,s's'.'S,~ `i�'' - E.LYf_i -�t 15. GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classed,packaged, marked and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations.If,export shipment and I am the Primary . Exporter,I certify that the contents of this consignment conform to the terns of the attached EPAAcknowledgment of Consent. I certify that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(if I am a small quantity generator)is true. GeneratoeslOfferoors,Pdnted/Typed Name signature --w on ay ear .r fit t �:�E.- `'-, t` _�,�.- � -„_.,-`. �` ? J 16'1nternational Shipments H Import to U.S. ❑Export from U.S. Port of entry/exit: Z Transporter signature for exports only): Date leaving U.S.: Elf 17.TransporterAcknowledgment of Receipt of Materials Trans +ear 1 Printeedrryped Name) Signature Wo— �Uay Year N .! t h f Z° _f'�e'/'i6 � I ( :+ >»/°r ""^� r 7'.�-sa 11 .I Z Tra6sp3 er 2 PdntedTlype"ame Signature Month Day Ye'at. � I t- 18.Discrepancy 18a.Discrepancy Indication SpaceEl Quantity.; ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number. 18b.Alternate Facility(or Generator) U.S.EPA ID Number U LL Facility's Phone: w 18c.Signature of Alternate Facility(or Generator). Month Day Year Q Z N19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and.recycling systems) o t. 2. 3 4. srg 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a PnntedlTyped Name Signature Month Day Year EPA Form,8700 22(Rev.3-05) Previous editions are obsolete: n� DESIGNATED FACILITY TO GENERATOR . 2,T'.c„x."`j. `;.,k(fa G.rs F$s. 'I't�r ii FsC,�„U¢e esi:4? u st f6i & Fs.€33`t�# eyr;;.:[":• gf4.,l E;G€iE«x. cs`so io '�`Wi' �F4 r -..��epg =. rq Drum Order Packing List Date: 12/17/2015 Job Owner Jeanne M Engel : r v 1503967485 k Created B Darnel Paradise'. Attention Drivers:Call 1-877-333-4244 with Additions or Questions Regarding this Order Generator Code: ST4985 Customer Code: ST4985 Manifest Mailing Address: Site Address: Customer Address: Stewart Painting Inc Stewart Painting Inc Stewart Painting Inc 379 lyannough Road 379 lyannough Road 379 lyannough Road Hyannis, MA 02601 Hyannis, MA 02601 Hyannis, MA 02601 EPA ID#: MV5083628023 State EPA ID#: Purchase Order No: NO PO NEEDED Actual Unit Extended Oty Oty UOM Price Price Item# Item Description 3 EA 45.00 1,35.00 DM55CSTL 55 G/205 L Closed Steel Drum,Recon WN1.4/100(17-E) I Signature: C �, Date: f2- Z3 •- � � i f Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 B"M R& � 200 Main Street• Hyannis, MA 02601 "rEDMPr TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: iki Date: IZ J Location/Mailing Address: 37q awE 7 ,nn"L D o IDb e -er� ll� Contact Name/Phone:Q'S1�s��ow , e�,,)asr�lf ,stag-3L2- 6023 Inventory Total Amount: ^� �D� al MSDS: ,G�t 4vt,�1.JG�`� License#: Tier II : c Labeling: Spill Plan: Oil/WaterSeparator: N A Floor Drains: 1-Jo Emergency Numbers: Storage Areas/Tanks: \av� t 5 aw 1 IQie- t Emergency/Containment Equipment: t 2. 5 ti'v. + ° . �v 5 Waste Generator ID: fl2 Waste Product: pad Date&Amount of Last Shipment/Frequency: 110 l Licensed Waste Hauler&Destination: Other Waste Disposal Methods: V 1k\J 4 LIST OF TOXIC AND HAZARDOUS MATERIALS �p J�°�1DC C�A IV�- k�J2vv Cj I�Ce �Q�i`kNOTE: Under Under the provisions of Ch. 111, Section 31, of the(general La s of MA, hazardo 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 Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants t2-7a� 6�-Miscellaneous t-e-- 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 ��Y Swimming pool chlorine Paints, varnishes, stains, dyesI vA Lye or caustic soda Lacquer thinners/W IQcL14,5l-6X 5-5; , Miscellaneous Combustible Paint&varnish removers, deglossers d'Or1 Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: TdO l Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS TOWN OF BARN TABLE Date: 1 / 17 / I`-� S TOXIC AND HAZARDOUS MATERIALS FORM NAME OF BUSINESS: S`j"-�w�•�-��a�w�', BUSINESS LOCATION: 3'11 J yan�o.�q Vvtl+—t INVENTORY MAILING ADDRESS: PO1BOX I fl b'l, oA63 2 TOTAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON: EMERGENCY CONTACTn TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: INFORMATION / RECOMMENDA ONS: I6s ege.4.yc.c .,. jn-yeylo/ ire District: s >1c�move, cvrc �v6ar �w -t also -- ",j�S o Ia�ex G,rt-�' �iok ,sa""- m�} Z /Uo arc A lwotL d,s�osa,l 814c4 move- -ho �ZVD 106a-f,orc, 3�sA�11 ,#S abso�b�nts, c,�� ,llon �r�� Waste T M�5'083J-216023 Last shipment of hazardous waste: > r5 Name of Hauler: works o,•t. A'KdQ, r-eQ Destination: Waste Product: 0A"-rteR— Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Photochemicals (Fixers) Gasoline, Jet fuel,Aviation gas Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt&roofing tar PCB's l4t-cx- 24'y /D D Paints, varnishes, stains, dyes,,, 1 _ to o Other chlorinated hydrocarbons, Lac uer thinners 1 (including carbon tetrachloride) (, ZNEW C�USED 3 X� i+'^s 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 `l�qu-l�o�tsa '�o 60^01..Pwt—IV%Ipe .- Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) L�> 5i.J�„,..�,,,y Other cleaning solvents Bug and tar removers C-PC R-A e.l;L 20&+o, Ala, Windshield wash WHITE COPY-HEALTH DEPARTMENT I CANARY COPY-BUSINESS Applicant's Signature Staff's Initials Number Fee 194 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Stewart Painting 379Iyannough Road, Hyannis, MA Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2015 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health f = Town of Barnstable °FSHE tom, Regulatory Services ti Richard V. Scali, Director r &UUiSTA MASS. " Public Health Division 1639. '°rFc Mai° 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 c I�L,411 J NAME OF ESTABLISHMENT7��L✓�4 ADDRESS OF ESTABLISHMENT C3 `i � TELEPHONE NUMBER SOLE OWNERA_�YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 0 STATE OF INCORPORATION FULL NAME AND HOMEfal DRESS OF: PRESIDENT S G� -, TREASURER -� CLERK SIGNATURE OF APP RESTRICTIONS: HOME ADDRESS,/-,0Z Sod/- y� HOME TELEPHONE# Q:�App l ication.FormsIHAZAPP.DOC 3, MAIL-IN REQUESTS Please mail the completed application form to the address below. Also include a copy of your contingency plan (to handle hazardous waste spills, etc). In addition, please include the required fee of$100. Make check payable to: Town of Barnstable. Allow five to seven (7) working days for in- house processing. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601. FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax us a copy of your contingency plan (to handle hazardous waste spills, etc). In addition, please mail the required fee amount of$100.00. Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow up to four days for in-house processing. For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page i Q:Wpplication Forms\HAZAPP.DOC r SPILL CONTINGENCY PLAN 1) Restrict or remove any potential ignition source from the area if the material is flammable. 2) Contain the spill by use of absorbent socks/booms, then apply appropriate absorbent material or additional absorbent socks/booms. Contact spill response firms (See List), if necessary to assist in these activities. 3) Label all containers with the type of waste and the start date of accumulation. 4) Notify the appropriate agencies. 5) Manage and dispose of collected absorbents and liquid in accordance with Federal and State environmental regulations. 6) Spill kits hanging from the shelves to quick and easy access. 7) The following is a list of the spill equipment on site: a. Spill response kit. b. An adequate amount of nitrile gloves, nitrile or rubber boots and other personal protective equipment. c. First Aid Kit. d. Fire extinguishers. e. MSDS—Hanging near shelves of product. SPILL CONTINGENCY PLAN NON- EMERGENCY SERVICES PHONE NUMBERS FIRE DEPARTMENT 508-775-2323 POLICE DEPARTMENT 508-775-1212 AMBULANCE SERVICE 508-775-2323 ENVIRONMENTAL PHONE NUMBERS HEALTH DEPARTMENT 508-862-4644 LOCAL DEP OFFICE 508-771-6003/508-946-2827 CYN OIL 781-311-5108 OTHER CONTACTS SHELDON STEWART 508-367-8023 TODD PH0;ICK 508-367-8356 Number Fee 1127 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that SALONCENTRIC 3 79 IYANNOUGH ROAD, HYANNIS,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------------------------------------------------------------------------------------------------------------------------------------------------------ This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2014 unless sooner suspended or revoked. --------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 3/12/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable Barnstable W. Regulatory Services Department SAMNIMCKY s' Public Health Division 1 �+ternsM MAM200 Main Street, Hyannis MA 02601 163 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 March 12,2014 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT: Jennifer Alberta-District Manager SalonCentric NAME OF ESTABLISHMENT : SalonCentric ADDRESS OF ESTABLISHMENT: 379 Iannough Road Hyannis,MA 02601 TELEPHONE NUMBER: 508.771.7727 SOLE OWNER: YES X NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: N/A IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. #91-2062018 STATE OF INCORPORATION: Nevada corporation FULL NAME AND HOME ADDRESS OF: PRESIDENT: Bertrand Fontaine President,SalonCentric 50 Connell Drive,Berkeley Heights,NJ 07922 TREASURER: Alexandre Pagliano Senior Vice President, Chief Financial Officer, Treasurer 50 Connell Drive,Berkeley Heights,NJ 07922 C:\Users\scs3711.02\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.IE5\JTFX4E 15\Haz%20Mat%20Application2008[1].doc CLERK: Chris Corbett Clerk 50 Connell Drive,Berkeley Heights,NJ 07922 An Ali A I.;am— �-- A1AX'TVk]ffbrF APPLIfCANT RESTRICTIONS:HOME ADDRESS: 3791 Road Hyannis,MA 02601 HOME TELEPHONE# 508.771.7727 MAIL-IN REQUESTS Please mail the completed application form to the address below. Also include a copy of your contingency plan(to handle hazardous waste spills, etc.) In addition, please include the required fee of$100. Make check payable to: Town of Barnstable. Allow time 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 of$100. Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow time for in- house processing. For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page C:\Users\scs3711.02\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.IE5\JTFX4E 15\Haz%20Mat%20Application2008[1].doc Number Fee 194 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Stewart Painting 379Iyannough Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. --------------------------"------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2017 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health is f Town of Barnstable ?�S�i6 �S°. T °F'IHKE ti Regulatory Services �t Richard V. Scali, Director .S . B�grABLE. BARNSTABLE MASS. r Public Health Division 16•e 9• DARNSTABLE•CENT RVIIAE•CC1Ui 1•'i IYANti15 J a\ .MAn5T0A5 MILS-WERViu W.TV.5TABU AlEO A°� Thomas McKean, Director 1 639-20 A 575 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-634 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(RU1,1S DULY Ist-DUNE 3Oth). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 V; . • A late charge of$10.00 will be assessed if payment is not received by July 1st. ASSESSORS MAP AND PARCEL NO. 32gDATE �J FULL NAME OF APPLICANT: G I C16 n � )�ew B r- NAME OF ESTABLISHMENT: e r T J i ✓1 l• r) C ADDRESS OF ESTABLISH M Y1 p n f MAILING ADDRESS (IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: EMAIL ADDRESS: C S Gc v a r T r`✓ti�� O ''� SOLE OWNER: ZYES_NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHQ]�E# OF: CORPORATION NAME c -�' � J , i PRESIDENT ASA - ' 6 f t o x l �a a e1.r/��I`f/; TREASURER 1519 M e z�3a CLERK 5 /4 M C _— IF PREPARED BY OUTSIDE PARTY: ATURE OF A ANT Name: Company Address : Telephone #: Email: Q:\Application Forms\FIAZZAPP Revl6.docx Page I oft Number Fee 194 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Stewart Painting 379 Iyannough Road, Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2014 unless sooner suspended or revoked. ---------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 6/30/2013 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health al Town of Barmtable of1ME Regulatory ,services °- T10m2s F. Gamer,Director Public Health Division x+�a T2=a9 Mr—Kean, Director 200 Main Stn—z, Hen tiS, MA 02601 Offica: 508462-464 Fay: 508-790-63 04 Applioa#ion Feat $100,0o ASSESSORS ASAP AND PARCEL NO, DATE Cv / /� APPLICATION FOR PERNET TO STORE AND/OR.U'TTI= MORE THAN III GALLONS OF HAZARDOUS MATERIALS FTT7,T,NA2�a OF APPLICANT Nam. + OF ESTABLL T ADDRESS OF ESTA=9Hiy= 5tlg VU 7 / 'I'EI.,EPHONE N[T1YDER .Sod-�� 2093 SOLE 07YNER:' )C YES NO IF APPLICANT IS A PARTNIiR=,.FU-L.L NAA9, AND HOMI ADDRESS OF ALL PARTNERS: I -T APPLICANNT IS A CORPORATION: FEDFPAL DDET=CATION NO, ' STATE OF INCORPORATION J=NAINIE ANP H01AIE ADDRESS OF: IRFSIDEI tT CJ = SIU'�ii ATIIIE OF AP UCANT _ I RESTRIC EONS: H0AE ADDRESS H0?YU T EONS# Fo ' I --dadwp/q i f June 19,2013 SPILL CONTINGENCY PLAN 1) Restrict or remove .any potential ignition source from the area if the material is flammable. 2) Contain the spill by use of absorbent socks/booms, then apply appropriate absorbent material or additional absorbent socks/booms. Contact spill response firms (See List), if necessary to assist in these activities. 3) Label all containers with the type of waste and the start date of accumulation. 4) Notify the appropriate agencies. 5) Manage and dispose of collected absorbents and liquid in accordance with Federal and State environmental regulations. 6) Spill kits hanging from the shelves to quick and easy access. 7) The following is a list of the spill equipment on site: a. Spill response kit. b. An adequate amount of nitrile gloves, nitrile or rubber boots and other personal protective equipment. c. First Aid Kit. d. Fire extinguishers. e. MSDS—Hanging near shelves of product. SPILL CONTINGENCY PLAN NON - EMERGENCY SERVICES PHONE NUMBERS FIRE DEPARTMENT 508-775-2323 POLICE DEPARTMENT 508-775-1212 AMBULANCE SERVICE 508-775-2323 ENVIRONMENTAL PHONE NUMBERS HEALTH DEPARTMENT 508-862-4644 LOCAL DEP OFFICE 508-771-6003/508-946-2827 CYN OIL 781-311-5108 OTHER CONTACTS SHELDON STEWART 508-367-8023 TODD PIKNICK 508-367-8356 Number Fee 194 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Stewart Painting _ Hyannis MAIL: Centerville,MA 02632 y �7Is 1-14eeby Gr ted a License l� 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 6/30/2012 unless sooner suspended or revoked. ------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2011 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health a3 Town of Barnstable Q Low ' Regulatory Services 1 GK -100 ( Thomas F. Geiler, Director 9'" `�•�' Public Health Division 1639. Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-8624644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. 3Z6 Z DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER 5�15 — Z. Z o SOLE OWNER: YES NO i= rJ IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL d PARTNERS: v� co IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 6L13191A11 STATE OF INCORPORATION M A . FULL NAME AND O ADD OF: PRESIDENT L TREASURER CLERK Z &GNATURE OF P ICA f RESTRICTIONS: HOME ADDRESS bZ Shf461(lt HOME TELEPHONE# Haz.doc/wp/q June 27, 2007 SPILL CONTINGENCY ]PLAN 1) Restrict or remove any potential ignition source from the area if the material is flammable. 2) Contain the spill by use of absorbent socks/boonis; then apply appropriate absorbent material or additional absorbent socks/booms. Contact spill response firms (See List), if necessary to assist in these activities. 3) Label all containers with the type of waste and the start date of accumulation. 4) Notify the appropriate agencies. 5) Manage and dispose of collected absorbents and liquid in accordance with Federal and State environmental regulations. 6) Spill kits hanging from the shelves to quick and easy access. 7) The following is a list of the spill equipment on site: a. Spill response kit. b. An adequate amount of nitrile gloves, nitrile or rubber boots and other personal protective equipment. c. First Aid Kit. d. Fire extinguishers. e. MSDS —Hanging near shelves of product. j 1 i I I SPILL CONTINGENCY PLAN NON - EMERGENCY SERVICES PRONE NU1V[BERS FIRE DEPARTMENT 505-775-2323 POLICE DEPARTMENT 50&775-1212 AM 3ULANCE SERVICE 50&775-2323 ENVIRONMENTAL PHONE NUMBERS HEALTH DEPARTMENT 508-862-4644 LOCAL DEP OFFICE 508-771-6003/508-946-2827 CYN OIL 781•-311-5108 OTHER CONTACTS i I SF[ELDON STEWART 508-367-5023 TODD PIKNICK 509-367-8356 i i I t�- 1/ ` i f i Number Fee 194 THE COMMONWEALTH OF MASSACHUSETTS $100.0o Town of Barnstable Board of Health This is to Certify that Stewart Painting 379 Iyannough Road, Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ---------------------------------------------------------------------------------------------------------------------------------------- ------------------------- - - --- --- ---------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2013 unless sooner suspended or revoked. WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2012 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health i f d ., R 'own of Barnstable p�-0F1HE TO Regulatory Services Thomas F. Geller Director 9� ,fig Public Health Division i63�. 'O�Fa 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. 3a DATE APPLICATION FOR PERMIT TO SWORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT Jh,6r`C1d q NAME OF ESTABLISHMENT 15; f 2 Azab�n;-11C3 ADI?2ESS.,QF ESTABLISHMENT / W17/71(S, 11440 TEI2EPH©NE NUMBER &V —'RO2 3 i'-) w_ SOa OWNER: V J YES NO �) c�: IF PLICANT IS A�PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: e7 e.e IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. O11J''/I11-W STATE OF INCORPORATION 111,4 FULL NAME AND HOME ADDRESS OF: PRESIDENT �Sh,J�Bean : lkoul 6 `� ��,%. A-7 ' i Jam, e 0- TREASURER CLERK SIG TURF OF APPLICANT RESTRICTIONS: HOME ADDRESSd,2a2 aaj4F HOME TELEPHONE Haz.doc/wp/q L rw NLkM-IN REQUESTS Please mail the completed application form to the address below. In addition, please include the required fee amount. Make check payable to: Town of Barnstable. 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. 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. For further assistance on any item above, call (508) 862-4644 i i +... IL SPILL CONTINGENCY PLAN 1) Restrict or remove any potential ignition source from the area if the material is flammable. 2) Contain the spill-:)y use of absorbent socks/booms, then apply appropriate absorbent material or additional absorbent socks/booms. Contact spill response firms (See List), if necessary to assist in these activities. 3) Label all containers with the type of waste and the start date of accumulation. 4) Notify the appropriate agencies. 5) Manage and dispose of collected absorbents and liquid in accordance with Federal , and State environmental regulations. 6) Spill kits hanging from the shelves to quick and easy access. 7) The following is a list of the spill equipment on site: a. Spill response kit. b. An adequate amount of nitrile gloves, nitrile or rubber boots and other personal protective equipment. c. First Aid Kit. d. Fire extinguishers. e. MSDS-Hanging near shelves of product. SPILL CONTINGENCY PLAN NON -.EMERGENCY SERVICES PHONE NUMBERS FIRE DEPARTMENT 508-775-2323 POLICE DEPARTMENT 508-775-1212 AMBULANCE SERVICE 508-775-2323 ENVIRONMENTAL PHONE NUMBERS HEALTH DEPARTMENT 508-862-4644 LOCAL DEP OFFICE 508-771-6003/508-946-2827 CYN OIL 781-311-5108 OTHER CONTACTS SHELDON STEWART 508-367-8023 TODD PIKNICK 508-367-8356 ' S TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: 41VV-A z!µ d Board of Health MAILING ADDRESS: Town of Barnstable TELEPHONE NUMBER: t -- l'c P.O. Box 534 CONTACT PERSON: �-., Hyannis, MA 02601 _ �,1 �� .�� Does your firm store any f the toxic or hazardous materials listed below, either for sale or for your own use, in quantities tota ing, 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: .—P 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 i lease put a check beside each product that you store: Antifreeze (for gasolene 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-s4 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 C•ti.1 t`# TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair Bnters OARD OF HEALTH satisfactory 3.2.Auto Body Shops j�] O unsatisfactory- 4.Manufacturers COMPANY G�-e A,01Cff A,f (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS kA,$d Class: 1 7.Miscellaneous V QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATER S Case lots Drurns 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) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: i' DISPOSAL/RECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply —3-&,e2e% O Town Sewer ublic ' On-site OPrivate 3. Indoor Floor Drains YES_L_NO O Holding tank:MDC AV O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORD RS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5. Waste Transporter Name of Hauler Destination Waste Product YES NO 1. 2. ` t Person (s) Interviewed nspector Date l ro TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM ` Mail To: NAME OF BUSINESS: L a �, Board of Health MAILING ADDRESS: ° Z0 k,1Aee _ � s$KfX�G� Town of Barnstable TELEPHONE NUMBER: 11 j g'7 P.O. Box 534 ��d'7^' Hyannis, MA 02601 CONTACT PERSON: Does your firm store any of the toxic or hazardous materials Fisted below, either for sale or for your own use, in qua (ties totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES V 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 t,"**'Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, 'f 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, `l 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 i Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory 2.Printers 0 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRES �--4jV . -Class: 7.Miscellaneous QIJANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR TERIALSUndergroundove Tanks IN OUT IN I OUTI IN OUT #&gallons Age 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 M scellaneous: J%� DISPOSAURECI.AMATION REMARKS: 1. Sanitary Sewage 2. Water Supply O Town Sewer OPublic O On-site OPrivate 3. Indoor Floor Drains YES NO O Holding tank:MDC 0 Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES NO ORDERS: 0 Holding tank:MDC O Catch basin/Dry well " 0 On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES INO 1. 2. 00 Person(s) Interviewed Inspector Date TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair nters BOARD OF HEALTH satisfactory 3.2.Auto Body Shops 0 unsatisfactory- 4.Manufacturers COMPANY r�� A�i� (see"Orders") 5.Retail Stores , 1 `�L —� 6.Fuel Suppliers ADDRESS Class: 7.Miscellaneous UANTITIES 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) 0 new motor oil(C) transmission/h draulic 2/ �Sy thetic Organics: degreasers — 1 if --- rs Miscellaneous: .4 ,1 DISPOSAUR.ECLAMATION REMARKS: f 1. Sanitary Sewage 2.Water Supply Zz 0 GNU O Town Sewer /*Public 0 On-site 0Private 3. Indoor Floor Drains YES NO O Holding tank: MDC d f O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO O RS: t 0 Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product _ YES NO 1. 2. 47 Person(s) Interviewed Inspector Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: Board of Health MAILING ADDRESS: P - � � Town of Barnstable TELEPHONE NUMBER: YL .mow Aug 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 quaptities 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 i ease 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) 9L/"Gasoline, Jgt-#tmt-�i Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, V 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, *arrts es, 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 11� 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 O satisfactory 3.Printers ito Body Shops y O unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS f4t Class: 7.Miscellaneous 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: Gasoline,qat _u_e !D Diesel, Kerosene, #2 (B) Heavy Oils: ` waste motor oil (C) 1 new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers L� Miscell neous: 6� -z- A DISPOSAL/R11CLAMATION REMARKS: 'n 1. Sanitary Sewage 2. Water Supply O Town Sewer f 'ublic 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—NO—Z OR ERS: r 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 Inspector Date i t TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY V -1 (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS AW7 Case lots Drurnsl Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age 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 Z4L -47 Miscellaneous: • �GE� f/ ��sT�� v v D POSAURECLAMA O REMARKS: f 1. Sanitary Sewage 2.F_ nU ter Spply O Town Sewer Public x O On-site Priv 3. Indoor Floor Drains YES NO O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES iV NO ORDERS: O Holding tank:MDC �� G Catch basin/Dry well O On-site system , 5.Waste Transporter Name of Hauler Destination Waste Product 1. YES NO 2. rz Person (s) Aterviewed Inspector Date TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair nters BOARD OF HEALTH satisfactory 3.2.Auto Body Shops 0 unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT-outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age 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: l _V DISPOSALfRECI.AMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O Town Sewer OPublic 0 On-site OPrivate 3. Indoor Floor Drains YES NO 0 Holding tank:MDC 0 Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES NO ORDERS: 0 Holding tank:MDC O Catch basin/Dry well 0 On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES I NO 1. 2. Person (s) Inte ewed Inspector Date C TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM ca_re:� . �JMail To: NAME OF BUSINESS: !�allee,31 Board of Health MAILING ADDRESS: -1 ol/ 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 totalli g, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: 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 registere 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 _4z +Is/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, othe 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