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0064 PLANT ROAD - HAZMAT
bq p�m� �qq_ 610 -cog, Number Fee 1090 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that T&JMOTORWORKS, INC. .-------------------------------------------------------------------------------------------------------------------------------- 64 PLANT ROAD, 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 n t� Town of Barnstable Inspectional Services BARNSTABLE Public Health Division .rns e•encnvn t•to urz•rranuts Qn ncasms H:us•o>�m7�•eFsl eawrsmas r 1639-2014 • ��� MMSrABM � Thomas McKean, Director F1639. 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 ,,• �y APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE ' HAZARDOUS MATERIALS ram' 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 El CATEGORY ��N� *A late charge of$10 00 will be assessed if payment is not received by July 1st. 2 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:. 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: �e yuow�°�s\►�e w4;-�_ Cam. � ffII 10. SOLEOWNER: YES-/NO IF NO,NAME OF PARTNER: 0-bah tt Stti 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME ,l,(d"hib lv<< PRESIDENT �o� TREASURER 1- CLERK k- 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: • SIGNATURE OF APPLICANT DATE Q.'\Application Forms\Haz Mat Appli Draft Jan20l9.docx Number Fee 1090 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that T&J MO TOR WORKS, INC. 64 PLANT 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 `6. .r. Town of Barnstable Inspectional Services BARNSTABLE W SwCv 4f3.CE�iE..�1.,uP.Pli13WeWA,x�tE o Public Health Division =401 BARNSTABLE, ` Thomas McKean, Director 1639. 0 iOrEn �A� 200 Main Street, Hyannis,MA 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 1st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 1,11 -499 Gallons: $125.00 -❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 gVS-1-p114 C�qv--A-- *A late charge of$10.00 will be assessed if payment is not received by July 1st. c� 1. ASSESSOR'S MAP AND PARCEL NO. a qq- 0:7-& 2. IS THIS A PERMIT RENEWAL? YES_NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS, INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF • GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: �./�o�v� �� 11n 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 150$._ C( 9. EMAIL ADDRESS: �f n �., ACprW"AC) \A L-. WSJ, Ak 1- C owe 10. SOLEOWNER: YES AO IF NO,NAME OF PARTNER: dC;"V\ �°� SAy�. 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATIO711tb�y-- AME � 6�t ^'.� PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE Q:\Application FonnS\Haz Mat App Revised 09-10-18.docx 4 Number Fee 1090 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of ,Barnstable Board of Health This is to Certify that T&JMOTORWORKS, INC. 64 PLANT 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 06/30/2019 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 lS0 c h i .- (q Vofow B nstable egulatory�emces Richard V. Scah,Director THE Public Health Division BARNSTABLE � B4F.NSTMLE•CfilfEiMLLE.UfiIIR•NYX.".YLS • RARNW'ABLE. = Thomas McKean,DirectorMAS& is o arhs axnsTnes F659- c e.`0� 200 Main Street, Hyannis,MA 02601 ��Ig 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 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 %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: a A L 5. NAME OF ESTABLISHMENT: /f� 0— `vac, 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: si-g— 9. EMAIL ADDRESS: rtk 10. SOLEOWNER: YES_V�O IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME y PRESIDENT TREASURER �r CLERK ' 12. IF PREPARED BY OUTSIDE.PARTY: • NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT ,�-- DATE Q:1Application FormsUTAZMAT APP 2017 REVISE6.doex Number Fee 1090 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that T&JMOTORWORKS, INC. 64 PLANT ROAD, HYANNIS, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. --------------- ---------------------------------------------------------------------------------------------------------- -------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2018 unless sooner suspended or revoked. --------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health ZZo10N.J LTOZ l-T p$� ' owr of Unstable V eg atory ervlces Richard V. Scali,Director o Public Health Division BARNSTABLE • r a e.ensrnn�•�rvr�;uvux•coTurt•xrn�,ri; �azAg�• � Thomas McKean,Director ���e�i639 vZa gv+sreacn;roo;t 1639. ``� 200 Main Street,Hyannis,MA 02601 ��g Office: 508-862-4644 �20/�L- d Vls 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 Xv/ . *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: ! / �Yyl�S a ,✓� "w- 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: C `I I l0,V4 y i O y ym 13 AA 01,&0 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: L� - 10. SOLEOWNER: YES V<O IF NO,NAME OF PARTNER: - V"Ax- 5J)' +A 11. FULL NAME,HOME ADDPtySS,AND TELEPHONE#OF: CORPORATION NAME K PRESIDENT b IV TREASURER CLERK ' 'f 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE Q:\Application FormsWAZMAT APP 2017 REVIS A= Number Fee 1090 THE COMMONWEALTH OF MASSACHUSETTS 100.00 Town of Barnstable Board of Health This is to Certify that T&JMOTORWORKS, INC. 64 PLANT 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 r.. I Town of Barnstable Regulatory Services ti Richard V. Scaii,Director Public Health Division 1 3 q. Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.0.0 oo Z � ASSESSORS MAP AND PARCEL NO. / DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT XYvkk-5- V y J(Acc.�� NAME OF ESTABLISHMENT ` 1 S d' • ADDRESS OF ESTABLISHMENTa„ TELEPHONE NUMBER SOLE OWNER: YES V/NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: cJ e,/` IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. �ILE- �( STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK SI tE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# C:\cache\Temporary Intemet Fi1es\0LKD3\IiAZAPP Rev2015.DOC f Town of Barnstable Office: 508-862-4644 til• Fax: 508-790-6304 Regulatory Services Department snxtvrn€�t a Public Health Division �+xasa Thomas A.McKean,CHO i639- �`` 200 Main Street, Hyannis, MA 02601 Payment Receipt !Hazardous Materials Payment received: $100.00 (Check) on 6/17/2015 Check number: 3457 Check amount: $100.00 Name on check: T&7 Motorworks, INC. Business: T&7 Motorworks Inc. Owner: JUANTOM GARAGE LLC Address: 64 PLANT ROAD, Hyannis I � II' i � Number Fee 1090 THE COMMONWEALTH OF MASSACHUSETTS 100.00 Town of Barnstable Board of Health This is to Certify that T&JMOTORWORKS, INC. 64 PLANT 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 4� J , Town of Barnstable °PINE�° Regulatory Services Richard V. Scali, Director '' MASS. �'r Public Health Division i°rEc nay° 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. "i z'((5 6C�02--•DATE .T ,.s..,.e+.. ,.:. .. ,x..., ..>...�......r'..—.'_`_,....+......�' �......r..a+ 3tS:.'r_ ......�wWriw.v[�s.. .ew...�#!wm+�.wae a:t�.:d.+7t.v+ �.L' tt � &:^"ry'- - -,-- ..-.._..__---.....,.-,..._--,,.-v-,-,_e,n,.,-•, .. ... -'.C'.. -. APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT o Wl';S i' fVNP'Pp NAME OF ESTABLISHMENT `�(� /�wCOcw �S I vvcc ADDRESS OF ESTABLISHMENT wyl+ TELEPHONE NUMBER SOLE OWNER: YES A/NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. LI "()'8 5 l 3� STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT Xn2j�R q6 Sccox.s C,rLL,- a�tcA[c Akt,� oaco r TREASURER r CLERK GNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS Q6 %,,&% C,rJe- Ctr\6\t� ANA- GIG HOME TELEPHONE# Q\Application FormAHAZAPP.DOC SPILL CONTINGENCE' PLAN Emergency Coordinator, Name: Address: Daytime Phone: Evening Phone: Fire Department: �,a, D,,� ,,_, �p 5b51_ Barnstable Public Health Division: 508-862-4644 DEP 24 Hour Spill Hot Line: 888-304-1133 Waste Hauler: Name: rT&,V„r1>'1W1A,%\A Phone: Building diagram indicating hazardous material/waste storage area, location of absorbent scavenger materials, fire extinguishers, fire alarms (if present), and evacuation route (if applicable). OIL Actions to be taken to control a spill or release, and preventing it from reaching a catch basin, sewer system or the ground. 5"0�) k( 4, rylAt(-k per'4) 0A 5%ze a'v Use C\,/V\ t vvv,.141; 4-b L Number Fee 1090 THE COMMONWEALTH OF MASSACHUSETTS $100.0o Town of Barnstable Board of Health This is to Certify that T&J MOTOR WORKS, INC. 64 PLANT 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 Town of Barnstable af1HE Regulatory Services -� Thomas F. Geiier,Direc#or } a aeztxcrearr, 3 'gyp MARE Public Health Division Thomas McKean,Director 200 Main Streit, Eyannis, MA 02601 Office: 508-S62-4644 Fax: 508-790-6304 Applicaticn Fee: $100.00 n rr II Coo a ASSESSORS MAP AND PARCEL NO, 0(9`1'O�1G DATE APPLICAU01N FOR. PERMIT.TO STORE AND/OR TTIU= MORE THAN 1I1 GALLONS OF HAZARDOUS 4RDOUS MATERIALS FULL NANR OF APPLICANT WNnL V!fVW NAME OF ESTABLISIi1V= -, cc} AkAo-(w-oACS I'Vic ADDRESS OF ESTABLISIBUNT TELEPHONE NIIBER o�' �- 6 �o�l SOLE OWNER: YES V- No IF APPLICANT IS A PARTNERS=,FULL NAME AND HONI ADDRESS OF ALL PARTNERS: Ofri I�YI�.Di� t�o Jcclv`, IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. '- G-Ot��w 3 G STATE OF INCORPORATION M k FULL NAME AND ONIE_ADDRESS OF: PRESIDENT bmam - PRESIDENT —� CLERK K A.TURE OF APPLICANT • i RESTRICUONS: HOME ADDRESS EoAff TEIXPHON.E# Haz dodwp/q i I l! SPILL CONTINGENCY PLAN Emergency Coordinator, Name: 400 „ Address: C*vkay k *Jk oaorz Daytime Phone: 274-367, ci co i Evening Phone: Fire Department: Barnstable Public Health Division: 508-862-4644 DEP 24 Hour Spill Hot Line:. 888-304-1133 Waste Hauler: Name: Phone: 12t ?S41 -5A01 Building diagram indicating hazardous material/waste storage area, location of absorbent scavenger materials, fire extinguishers, fire alarms (if present), and evacuation route (if applicable). r ' A ©i L Actions to be taken to control a spill or release, and preventing it from reaching a catch basin, sewer system or the ground. 4o 4, to oA- ylJ � t � `ptINETO Town of Barnstable Office:508-862-4644 ° ° Public Health Division Fax:508-790-6304 BARNnABLE..,' MASS. g. 200 Main Street• Hyannis, MA 02601 �ArEO MA�0. ' TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: (-t' J or tJe>rAe-S Date: 2 28 / Location/Mailing Address: (-Lf 41"-+ a v►Al S Contact Name/Phone: >v--- 50 -7 -OS� Cell 77 -3b!8-o`P3 Inventory Total Amount: I�VO 70 SDS: 0h.�%MA- acC155 License#: l0cfO 3 Tier II : o Labeling: 0,K Spill Plan: q,ss Oil/WaterSeparator: Floor Drains: o Emergency Numbers: `1e,S Storage Areas/Tanks:�3 0 _ -7y , � ����s o i,,1G��t�o. 1 30o al A`iq" Emergency/Containment Equipment: s, Waste Generator ID: PA\J 50$'1 I!bo toy Was a Product: WaS+e otl, ekk ., e 3-tS7c l Date&Amount of Last Shipment/Frequency: 5-6 kWT �►- 2�12< o�Lw•I eA,-, Licensed Waste Hauler&Destination: W C,',04 - ekMrl *<-,It Other Waste Disposal Methods: J,)1k4A{_ of U<-AC OVA. 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. 140 Antifreeze 35'k 5y 100 Wa 'kw- Dry cleaning fluids tiu Automatic transmission fluid U Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers S Hydraulic fluid (including brake fluid)S Windshield wash �S lytoo Motor oils 3ook tj)o +1000) Miscellaneous Corrosives Gasoline,jet fuel, avia ion gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil K Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries%b 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 5 (�a�Kk�T�"` 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: RIDERS: W,Ul,\J rA P 1001 a<o%)w Q G o< < kA 5 . kC rLt kow-4+0 CV'}.p a� INFORMATION/RECOMMENDATIONS: wln �.SvYtc, n R S C'Ovv�. CA -k-2-C 2K t i v Inspector: / , L VIIJ Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS i °F IINE ro Town of Barnstable Office:508-862-4644 _E. Public Health Division Fax:508-790-6304 BARN STABLE.� $ 200 Main Street• Hyannis, MA 02601 039.s "fFOMn+ TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name:`—r-t �J Date: Location/Mailing Address: kff PeLA+ q Contact Name/Phone: Sd8- 77S-oS6`-I e e/1 "1-74-368-0`j3I Inventory Total Amount: A' 14510 10 SDS: ow 1JNN-A-- License#: Tier II : �)o Labelino: O Spill Plan: ¢ S Oil/WaterSeparator: 1J 10, Floor Drains: o Emergency Numbers: Storage Areas/Tanks: 310 �a l , �x�.-(� as 1 cis W,e. 1 A S-C6 , I AeK,�,,.� Emer enc /Containment E ui ment: S dQ b� S 1- ,ek, e" Waste Generator ID: 5't7 1a Waste Product: D d =7 -�- Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: S r^�2�-1 2•a�y� V�-S wp .W �-c, �� �te� �5`�0&2C>(6 LIST OF TOXIC AND HAZARDOUS MATERIALS o W1 ti ul t)&A %V, %Vk\1 S IV"C� NOTE: Under the provisions of Ch. 111, Section 31, of the Gineral LawMA, hazardous material use, U storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze -}' wu+N-1- 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 -�. woa'S*-,L, 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 T 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 y/ 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/ ECO MENDATIO S: Ql{- 0 � S 0, a so d o av�2 -��c e.r� w�a ce\�e,+ 5\)kc tVy ems, 1Lw w `I-o Inspector: : cLLG2SS �j' �s 3�9 AMA 4.�, M.e,Facility Representative: G.V e., i° y WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS �1 Number Fee 1090 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that T&J MOTOR WORKS, INC. 64 PLANT 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 I Town of Barnstable • °�� 'O'',ti Regulatory Services Richard V. Scah,Director " BARNS 6 9. ` Public Health Division 1639. 10� n�`eas"•.o'xsr�r"en ue�es°reu+n�fe QED MAC A Thomas McKean,Director 1657 14 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 e Fax: 508-79CIO4 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTE&-1.08, 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 Y's • A late charge of$10.00 will be assessed if payment is not received by July 1st. ASSESSORS MAP AND PARCEL NO. ���, 6`�Ce C?�2. DATE FULL NAME OF APPLICANT: Zh--O�V" - 6kapo NAME OF ESTABLISHMENT: /I ? t,-I, \h, or VJt C7 4.�R ADDRESS OF ESTABLISHMENT: MAILING ADDRESS(IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: Sy "���` OJT L� EMAIL ADDRESS: (Ova SOLE OWNER: YES V NO 1F NO,NAME OF PARTNER: 0ya,\ CoS wee FULL NAME,HOME ADDWS,AND TELEPHONE#OF: CORPORATIO NAME e PRESIDENT --'( ��, W- lcw-oa TREASURER�_ ` , CLERK • IF PREPARED BY OUTSIDE PARTY: SIGNATURE OF APPLICANT Name: Company Address Telephone#: Email: Q\Application FormsUiAZZAPP Revl6.docx Page 1 of 2 IKE►oh� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 RARMASS. 200 Main Street• Hyannis, MA 02601 039. �iDrEO MA�a`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name:—�T'M o�o�Wo��2. Date: 1 (b Location/Mailing Address: 0 PIA V+ RXk n Contact Name/Phone: ::g AAo So --7 -b e% c-2/ -7, -36$-al31 Inventory Total mount: I`- I T-1 MSDS: License#: 100 3 Tier II : o Labeling: 0K Spill Plan: e� Oil/Water Separator: Floor Drains: 1`,�o Emergency Numbers: e5 Storage Areas/Tanks: N 6 -W8 k?"01 33D �j<aL1 �OJ�e�.J o�1(oxl��.IJek1vJ-\Dv Emer enc /Containment Equipment: 5 �— 100 4ci Waste Generator ID: Waste Product: Dt > VIr qv\ i tee�e Date&Amount of Last Shipment/Frequency: Gt� a c.��. C., \ \ - i%/v e' �o"�A e6-k6 't�f4l - Licensed Waste Hauler&Destination: � Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. 1 OD Antifreeze 100 wwskf-4^�� Dry cleaning fluids V0 Automatic transmission fluid tb Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash 1300 Motoroils ��5�� 33p-} �.'I��a'1� Miscellaneous Corrosives Gasoline,jet fuel, aviation gas +%ooN)" Cesspool cleaners � Diesel fuel, kerosene, #2 heating oil %`N Disinfectants l5 Miscellaneous petroleum products: �� Road salts grease, lubricants, gear oil iS 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 o Miscellaneous Flammables S t 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: f INFORMATION/R COMMENDATIONS: a \ adt o A 5 ac'e— a -C)A-\4Qe-VXt15 OQ a M—- I vL e Cpvt �u.c c-5 PFacility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS °FINE to Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMASS- 200 Main Street• Hyannis, MA 02601 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name:-J-;--�- � Gs mac. , Date: b 'q Location/Mailing Address: b arc •4AA15 Contact Name/Phone:--o vk v flA Sw -Tlfl- oSlsy . Ge 1 y -3�S-D93 I Inventory Total Amount: A'I MSDS: ye-S License#: Old Tier II : N)o Labeling:•�t e. �-lb� `P ..•e. ok Spill Plan: s Oil/WaterSeparator: o Floor Drains: o Emergency Numbers: Ye�'5 Storage Areas/Tanks: 3 e k S kcat u oo t,So&C•s5 �z d Emergency/Containment Equip Waste Generator ID: ly\�J y o1'1$0�(o� Waste Product: &v k,Qsea4�:e, Date&Amount of Last Shipment/Frequency: I t h 3 13 I o 0k�.a �« 2 l Licensed Waste Hauler&Destination: 0 7-7 Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS wla 10( �InaMc�S �•n ��ll¢ dt NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardoul material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Jt 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) V Windshield wash V 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 5�o►t-�I I o„} g 41 o a e� A kso Qr1G, �,I D! a9. 0-1 54oca aVtc� s� e "" a� e,' c ` , ORDE : CILa4 f 1, $a 2a1e-, a s . Po 1� c ke, &J koq� Vt I � K I FORMATION/RECOM ENDATIONS: v r,� C. 5 m L ti\ G�v� a ✓wC t A c.� Inspector: — ' LoLv'tAk Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS I` Date: b l Y / /3 TOWN OF BARNSTABLE to,� TOXIC AND HAZARDOUS MATERIALS N FORM NAME OF BUSINESS: 777 M4orwo�k s � � BUSINESS LOCATION: ego fjY&rtrt t5 INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: 775 - 056 y -/ oo 200 CONTACT PERSON: EMERGENCY CONTACT TELEPHO NUMBER: CG// 77Sf- 36 8,rq93/ MSDS ON SITE? TYPE OF BUSINESS: gvl& INFORMATION / RECOMMENDA IONS: _riovW''T L��-,Zoiz lnsfe4t?6.`. Fire District: -KVZ K. 4►'I I Waste Transportation: Last shipment of hazardous waste: Name of Hauler: C, yL Destination: 4� w �9, Waste Product: 004-e awf,Age- Licensed es No (Jae � Q� g L(24ru.� 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 C 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 CO/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 Iit�QcS�'� ol � r,5 6�ofersQ aPt 64e, & Laundry soil &stain removers (including bleach) V r-Aa I K- spa-e-e, Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials I TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM .t Mail To: NAME OF BUSINESS: ti Board of Health MAILING ADDRESS:` Town of Barnstable TELEPHONE NUMBER: ��.��° ��/� P.O. Box 534 Hyannis, MA 02601 ' CONTACT PERSON: iO Does your firm store any of the toxic or hazardous materials listed below, either for sale,,br for your own use, in quantities totallliin�g,, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES V NOI This form must be returned to the Board of Health regardless of a yes or no answer. Use the r enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your i mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS, t The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put a check beside each product that you store: V Antifreeze (for gasoline or coolant systems) `° Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners i ✓/ Hydraulic fluid (including brake fluid) T Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel 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 9 Y Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners es 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 - h- ,� ,..+q.. �.,..fi+v-t`-'?.+�... '.t'».!.n:++.+rtin. ...,+lz•�.. -_ 'p....yy,;. �cp. TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 2 Printers BOARD OF HEALTH O'satisfactory 3.Auto Body Shops t O unsatisfactory- 4.Manufacturers j (see"Orders 5.Retail Stores COMPANY ,�-A�` ,f.:7,�..t Arm - f� r ,,y ,, y 6.Fuel Suppliers ADDRESS r� s `r+ s C lass .-�* `/ �� �� 7.Miscellaneous t>-W `rIQUANTITIES 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) new motor oil (C) �j transmissioon/hvdrraul is Synthetic Organics: degreasers ,+gip r �If"'• �,., , Miscellaneous: 1V-T n 5- - A& r r. u ;?404firms DISPOSAL/RECLAMATION Y REMARKS: , 1. Sanitary Sewage 2.Water Supply O Town Sewer OPublic ' � � ,. <0 On-site QPrivate •�- 3. Indoor Floor Drains YES NO f !•y O Holding tank:MDC Q Catch basin/Dry well O On-site system +.4:butdoor Surface drains:YES NO—L ORDERS: K 0 Holding tank: MDC r Y O Catch basin/Dry well O On-site system 5. Waste Transporter Name of Hauler Destination Waste Product YES NO 2. Person (s) Interviewed In • t!, Date 4. TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM � � Mail To: NAME OF BUSINESS: � � ��°1!/�-e..+� Board of Health MAILING ADDRESS: '� Town of Barnstable TELEPHONE NUMBER: "7:71 y� ''� P.O. Box 534 CONTACT PERSON: Hyannis, MA 02601 :� c.3�a Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quan ' ies totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES P 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 Please put a check beside each product that you store: t/ Antifreeze (for gasoline or coolant systems) V Drain cleaners L_ Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants V Motor oils/waste oils Road Salt (Halite) x Gasoline, Jet fuel V Refrigerants J' Diesel fuel, kerosene, #2 heating oil V Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda _ - Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes V Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) V Paint & lacquer thinners PCB's 1� 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 f Bug and tar removers �J Household cleansers, oven cleaners I White Copy- Health Department/ Canary Copy-Business ` r i 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 ;rzF tf 'G (see"Orders") 5.Retail Stores ADDRESS �- _ --4c$ 3,2n'�L��85f 6.Fuel Suppliers 5: 7.Miscellaneous ANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIAL Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Je ) Diesel, Keros ne, #2 (B) Heavy Oils: waste motor oil (C) `�� new motor oil (C) �i"✓� transmission/hydraulic 114) Synthetic Organics: degreasers a i l�s Miscellaneous: ti DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply O Town Sewer (`Public ,O(On-site OPrivate 3. Indoor Floor Drains YES NO 1W � d> m O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO P rso (s) Interviewed Inspector Date TOWN OF 13/b1RN`JTAl-�TI }.1 2. Printers satisfactofy: 1 3. Auto P•od Shops BOARD OF HEALTH . 4.' Manufacturers unsatisfattory- (see"Orders") S. Retail �5tores_ COMPANY AE ©-FF _ 6. Fuel Suppliers ADDRESS 1 - j Class: • 7. Miscellaneous QUANTITIES AND STORAGE (IN=IN indoors; OUT=outdoor MAJOR MATERIALS Case lots Drums AboveTanks Undetground Tanks 1N UT 0 G gellons a fesi Fuels: Gasoline, Jet Fuel (A) Diesel, Kerosene, Al (0) - Heavy Oils: waste motor oil (C) > S new motor oil (C) , transmission/hydraulic I' QA Synthetic Organics: . , ti degreasers L — ,Miscellaneous: DISPOS LA AL KECM�AFION REWJZKS: 1. Sanitary Sewage 2. Water Supply 0 Town Sewer ublic _ /— site �Oprivate .3. Indoor Floor Drains: YES NO O Holding tank: MDC OCatch basin/Dry well �_,.:_. ._._._...._._.... _..__. 0 On-site system 4. Outdoor Surface drains:YES NO r 0 Holding tank: MUC x O Catch basin/Dry well QOn-site system S. Waste Transporter Licensed? am Pf Ha ler- beatinatinn _ li'.t. ' le et erson(s) .1 t.erviewe Inspector. Date u as _ 0X I C i L; t,1_ :,.=li.)i: i2I AL �.��1 STr ft'i IO C, J tti� NAME OF FIRM: 4 MAILING ADDRESS: c) iu UE i'sLt toll /Jos' �� .// TELEPHONE NUMBER: l�4NT Rd AFC I I 18•s- CONTACT PERSON: -7 ?f_- 9 �� Does your firm store any of the toxic or hazardous materials listed below., either for sale or for your own use, in,rquantities totalling, at any time, more than 50 gallons liquid volume or 2S 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`'converiience If you answered YES above, please indicate if the materials are stored at a site other than your mailing address : ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities totalling more than SO gallons liquid volume or 25 pounds dry-weight. - Please put a check beside each product that you store: Antifreeze (for gasline or coolant .sys-tems ) Refrigerants Automatic transmission fluid ~ Pesticides (insecticides, Engine and Radiator flushes herbicides,rodenticides ) I ---•�� Hydraulic fluid (including brake fluid) Photochemicals tO Motor oils/waste oils Printing Ink Gasoline, Jet fuel Wood preservatives � Diesel fuel, Kerosene, #2 heating 'oil (creosote) �- Other petroleum products :' grease,lubricants Swimming Pool chlorine � Lye or caustic soda Degreasers. for engines and metal Jewelry cleaners Degreasers for driveways & garages Leather dyes I Battery acid (electrolyte) Fertilizers (if stored Rustproofers outdoors) - V - Car wash detergents PCB' s -Car waxes and polishes Other chlorinated -hydro- Asphalt & roofing tar carbons, (inc.carbon -Paints, varnishes, stains, dyes tetrachloride) Paint and lacquer thinners Any other products with �- Paint & Varnish removers, deglossers "Poison" labels (including Paint brush cleaners chloroform, formaldehyde, Floor & Furniture strippers hydrochloric acid, other Metal polishes acids) ` -- Laundry soil & stain removers (including bleach) . Other products not listed which you feel may be Spot removers & -cleaning fluids t (dry cleaners ) toxic or hazardous (please Other cleaning solvents list) : Bug and tar removers Household cleansers, oven cleaners Drain cleaners Toilet cleaners Cesspool cleaners Disinfectants Road Salt (Halite) it THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I A , m / �C(�'J IL DATA F BARNSTABLE COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repai.r Osatisfactory 2. Printers sa D OF HEALTH 3. Auto Body Shops 0unsatisfactory- 4. Manufacturers COMPANY -S�� - (see"Orders") 5. Retail Stores b. Fuel Suppliers ADDRESS - yr V�r Class: 7. Miscellaneous 1,V3" !� (_J. UANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums AboveTanks Uridetgiouad Tanks 11N 110UT IIN IOUT IN OUT # z2llons Aeerest? Fuels: Gasoline, Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: i waste motor oil (C) 1�il'Jr new motor oil. (C) transmission/hydraulic 1 Synthetic Organics: degreasers Miscell/Lneous: J ►-ham > DISPOSAL/R.ECLAMATION REWORKS: 1. Sanitary Sewage 2. Water Supply O Town Sewer - O Public OOn-site O Priv a ..�..._._..._._ .._.._ 3. Indoor Floor Drains: YES NO 4 Holding tank: MDC O Catch basin/Dry well ' . ...._d___. On-site system V _`' ^`I i�__..._�....__'..'.._+�_..._.._.__ (YY_S7- 1 U 4. Outdoor Surface drains:YES NO� O Holding tank: MDC _ — --- y OCatch basin/Dry well ,`�(J�__.__\ OOn-site system S. Waste Transporter �� i . t (� 1kjI1 Licensed? Name of Hau.ler. Des in ti= Xaste Product � � .j YPJ Jei Person(s) InterViewed Inspector Date ` z Ir TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM +� r NAME OF FIRM: �� PaA:2 , MAILING ADDRESS: yr �J�(�j�— ) J� TELEPHONE NUMBER: CONTACT PERSON: Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES 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 when stored in quantities totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put a check beside each product that you store: Antifreeze (for gasline or coolant systems)w Refrigerants Automatic transmission fluid Pesticides (insecticides, Engine and Radiator flushes herbicides,rodenticides) Hydraulic fluid (including brake fluid) Photochemicals Motor is/waste Printing Ink aaoline, Jet fuel Wood preservatives Diesel fuel , Kerosene, #2 heating oil (creosote) Other petroleum products: grease, Swimming Pool chlorine �Xlubricants Lye or caustic soda egreasers for engines and metal Jewelry cleaners Degreasers for driveways & garages Leather dyes Battery acid (electrolyte) Fertilizers (if stored Rustproofers outdoors) Car wash detergents PCB' s Car waxes and polishes Other chlorinated hydro— Asphalt & roofing tar carbons, (inc.carbon Paints, varnishes, stains, dyes tetrachloride) Paint and lacquer thinners Any other products with Paint & Varnish removers, deglossers "Poison" labels (including Paint brush cleaners chloroform, formaldehyde, Floor & Furniture strippers hydrochloric acid, other _ Metal polishes acids) Laundry soil & stain removers Other products not listed (including bleach) which you feel may be Spot removers & cleaning fluids toxic or hazardous (please (dry cleaners ) list) : Other cleaning solvents Bug and tar removers _ Household cleansers , oven cleaners Drain cleaners Toilet cleaners Cesspool cleaners Disinfectants Road Salt (Halite) TOWN OF BARNSTABLE BOARD OF HEALTH CONTROL OF TOXIC AND HAZARDOUS MATERIALS - INSPECTION SHEET FIRM ADDRESS J(J), ( I-L)w, Major types of materials: 1) 2) 3} prot'l 4) 5) 6) I. Description of materials) use: (, II. Storage (denote product by number listed abo e) A. Containers metal paper lass a g p p plastic cans,bottles,jars drums,barrels aboveground tanks underground tanks bags,boxes open,loose,uncovered inadequate labelling B. Storage Facility ✓or # Remarks/Recommenu"-Lions 1. Indoor a) separate, contained room b) stored in general work area We i) inadequate ventilation ii) floor drains :19- R iii) inadequate fire protection 2. Outdoor a) uncovered, exposed to weather b) pervious surface/catch basins III. Disposal A. Reclamation/Recycling unit B. On-site disposal 1. Town sewer 2. Regular septic system 3. Separate holding tank C. Off-site disposal 1. hauled by own firm 2, hired hauler a) name of hauler b) address or disposal site Perso.n(s) Interviewed r _ _ _ Inspector 'Date 6 30 81 BLE . WN OF -BARNS` ' ., ` satisfacto ' 2. Printers RPA R D OF H EkL H 3. Auto aBodyctu shops unsatisfactory- or 4.' Manufacturers r e Ord rs S. Retail Stores COMPANY " ``N ' i ' (se ) 6. Fuel Suppliers ADDRESS class: Class: 7. Miscellaneous ` //1 ., QUANTITIES AND STORAGE (I indoors; OUT=outdovi "V Case lots Drums AbdveTanks Undetgtound Tanks MAJOR MATERIALS IN U'T N 6 gellons &y e Fuels: Gasoline, Jet Fuel (A) Diesel. Kerosene, 12 (0) Heavy Oils: waste motor oil tns'ao new motor oil (C) transmission/hydraulic 1 Synthetic Organics: . degreasers Miscellaneous: DISPOSAL MCf.AMJlFLUN REWAKS: 1. Sanitary Sewage 2. Water Supply 0 Town Sewer Public _ 0 On-site Q Private ' •3. Indoor Floor Drains: YES- NO `Q [folding tank: MDC O Catch basin/Dry well . RDEM: 0 On-site system �_�_ • 4. Outdoor Surface drains:YES NO Q Holding- tank: 'MDC 0 Catch basin/Dry well - s 0 On-site system S. Waste Transporter Licensed? lame of Hauler_ ,-cleat i nati nn }rite_Product ' •e'rson s) Int-erVMea Inspector Date TOWN N O F BA R N STA B L L COMPLIANCE: CLASS:. 1. Marine,Gas Stations,Repai.r F �-s-�tisfactory 2• Printers 3 Auto Body Shops BOA R D OF HEALTH O unsatisfactory- 4. Manufacturers COMPANY„ L{ �, �� (see'Orders' ) S. Retail Stores _ 6. Fuel Suppliers ADDRESS(r N Q\ z,»v Class: * lass: 7. Miscellaneous QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS _ Case lots Drums AboveTanks Undetgrouad Tanks IN QUIT IIN IOUT IN IOUT ga1 Ions kie s ? Fuels: Gasoline, Jet Fuel (A} 1 Diesel, Kerosene, #2 (B) Heavy Oils: r�- 1 waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers . f Miscell neous: i DISPOSAL RECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply r O Town Sewer Public QOn-site Q Private 3. Indoor Floor Drains: YES N0�_ Q Holding tank: MDC OCatch basin/Dry well On-site system 4. Outdoor Surface drains:YES NO --1 0 Holding tank: MDC O Catch basin/Dry well OOn-site system S. Waste Transporter Licensed? Name of Hauler_ Desr;na ;on Waste Product _YFS1 NO 1. _ \ (?.J '� U 23 ei Person" s) Interviewed Inspector Date t 1 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS:, � Board of Health MAILING ADDRESS: A ��. jown of Barnstable TELEPHONE NUMBER: P.O. Box 534 /, Hyannis, MA 02601 CONTACT PERSON: Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quant' 'es totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry g wei ht? 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 land must be registered when stored in quantities totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put a check beside each product that you store: Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners t/' 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, 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 5�*r Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business � .:n.y, ... F ,,sY—a.�,.;s:,.^'.--,et :—xT':...,.,�-. . - r. .,,<:.•..-•,e.,.... .. .".. _ .i._- - _ S.,_. _ ('ti.r. ..i-y _`4 1 -=TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair ' BOARD`OF HEALTH2.satisfactory 3.Auto Body Shops �-y/ O unsatisfactory- 4.Manufacturers COMPANY . s� �1 „� (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS r � Class: 7•Miscellaneous f , . 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: V 'i Zp_ t• DISPOSAURECI.AMATION REMARKS: . 1. Sanitary Sewage 2.Water Supply 1`.,.�,114 J4 O Town Sewer O" ublic �® On-site OPrivate x 3. Indoor Floor Drains YES NO O Holding tank `MDC O Catch basin/Dry well O:.On-site system. 4. Outdoor Surface drains:YES Z.NO ORDERS: O Holding tank:MDC fr 1 Catch basin/Dry�wOP , O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product •d �• 3.;--• YES F'o }�-• j(j/(n ^y � /.y�'/ ��, - '�`�.F-f,, tJ.t 1. /' N``"f ,�,`�• ` /`/ ..•':'�'.h. 'r s.. �l.r-^ �" ,: G=..�", .,G._.:._-7.:�'..,�i�=���..r+.•Y" /.-�,N.A`' C x�''F.✓'�.t�'�� Persoh'(s) Interviewed "T ispector Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: Board of Health MAILING ADDRESS: Town of Barnstable TELEPHONE NUMBER: �2,�.. �- 0 P.O. Box 534 CONTACT PERSON: Hyannis, MA 02601 /Y.�-� E - �` Does our firm store an of the toxic or hazardous materials listed below, either for sale or for Y Y , your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when store Please put a check beside each product that you store: _ V Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) _ Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink _�Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business TOWN OF BARNSTABLE , coMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS — lass: 7.Miscellaneous TITIES 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) new motor oil(C) l transmission/hydraulic Synthetic Organics: degreasers OAVItiv� A— 2�.5 Misce laneous: DISPOSAL/REC;LAMATION 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 O Catch basin/Dry well O On-site system I / 4. Outdoor Surface drains:YES�l✓ NO ORDERS: f l O Holding tank:MDC �V O Catch basin/Dry well O On-site system 5. Waste Transporter Name of Hauler Destination Waste Product � YES NO 2. 4 did, rli^ C erson (s) Interviewbd Inspector Date