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HomeMy WebLinkAbout0081 PLANT ROAD - HAZMAT R-oQ aq� - onto-cao2.- TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS/_7V1 �) :'S WII_5106 K'0'5 nl�.�r0 r7 Board of Health MAILING ADDRESS: �1 ��G � Town of Barnstable TELEPHONE NUMBER: P.O. Box 534 CONTACT PERSON: Hyannis, MA 02601 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: ` TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put a check beside each product that you store: Antifreeze (for gasoline or coolant systems) Drain cleaners _ ( Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners _ Hydraulic fluid (including brake fluid) Disinfectants _Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel XRefrigerants 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) ,k 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 VW TOWN 1V OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 0 satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers - (see"Orders") 5.Retail Stores COMP ANY r,�r9f,� ���. ���r . 6.Fuel Suppliers ADDRESS ��� /`" r4nf �l A� Class: � 7.Miscellaneous `AW v"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 Organic�s-:P �' ,''/ degreasersi Miscellaneous: s .DISPOSAIJRECLAMATION REMARKS: `t 1 Sanitary Sewage 2. Water Supply l:��7'f �L. " r ". ,ra`i 17 O=Town Sewer �OPublic Q'On-site O Private 3. Indoor Floor Drains YES NO O Holding tank: MDC O Catch basin/Dry well G On-site system 4. Outdoor Surface drains:YES NO ORDERS: Q Holding tank:MDC Q Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YtE, 1• �� 'lei CJ '�0'G/�1"r,�.�a1 r�.�,+'[,ft/� ,>a& ,.'J�- e�£ LGA�+.# � ��1^�.ri4' ! 6' 2. Person W Interviewed "" Inspector �,h` Date Number Fee 1232 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Johns Collision .-----•-•------------•-•----------------•-------.....------------------------------••-----------•-•••----------.......----------- 81 Plant Road, Hyannis, MA •-------•--•--------------------------•--------------•------------..........---------•------------------•---------•••----------....------------•••-•----------.......... Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. -------••----------------------------------------••-•--------.............-------•-------------------•-•--------...---------....----------•-••-------------...••---- Restrictions: --------------•------•-••-----------...-----------.....-----------.... This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ------------------------------------ JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF, D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health (fp r } Town of Barnstable Inspectional Services BARNSTABLE �• ^ LWR IMLE•R IE Nnq L .CMU—ANNIS TIS .•U:1S10!R N'tt5•OSEAVILL..4-S B.S�'l LE tT Public Health Division 1639-2014 �17g STAB Thomas McKean, Director 1659. s 200 Main Street, Hyannis,MA 02601 � f0 MAr Office: 508-862-4644 Fax: 508-790-6304 . T APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE r 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 I PERMIT 26— 110 Gallons: $ 50.00 �v�N p CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 I� 1 CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10 00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. owl 016a a®a 2. IS THIS A PERMIT RENEWAL? 9C 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)? C YES NO. 4. FULL NAME OF APPLICANT:. Zv1,, P. 6111,5 5. NAME OF ESTABLISHMENT: q b�% s C0 tit 5 i o v, 6. ADDRESS OF ESTABLISHMENT: 0a601 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: l y In r► 5 j P Cynncc,5t. net' 10. SOLEOWNER: Z,YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME-306v7s TvtC. D89-BYO"n s 014 ,n PRESIDENT<atio CIla's 94a dfj42. s1'• W -wA blc rnA 62"F TREASURER �u d ti �n'1 � 0.26 S CLERK&--li C11,.5 Soo 5 ud--T6L d . 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT f"" DATE 1D Q:\Application Forms\Haz Mat Appli Draft Jan2019.docx Number Fee 1232 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Johns Collision 81 Plant Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2020 unless sooner suspended or revoked. --------------------- ------------- ---- t'* 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 t . Town of Barnstable Inspectional Services BARNSTABLE[NE fp � .: Public Health Division ��'a"`�•`39 214 • : BARNSTABLE, 9 $ Thomas McKean, Director Q7 •i639 ♦0 Ar fo 39 s 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 M 0 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE tk 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 �Gh� CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ F CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ 1-{� *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. P91-1 o116 o ®oA 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: ®1n h S C o L I t 6-1 o n 6. ADDRESS OF ESTABLISHMENT: 1 1 P)"Lh+ Rat , 144 AA,1s 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: ,56?- ?7,S- ?Sd V 9. EMAIL ADDRESS: n e 10. SOLEOWNER YES NO W NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATIONNAME<Sohh.s lnr. DZA- lnn.s (adl,blo' PRESIDENT V alng t11:s Sqj Leda t 54. IV. 5,,.,nsh.61t P)e3 6a6,(? TREASURE t l,— a Ce,e4,,L � W, r°'''9- &,k_? CLERK Ep_�t C-If L -:to 1 _-P3fcf4Cf ed. S, ely- Maim ✓h 4 tab y 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: 0 SIGNATURE OF APPLICANT DATE Q:\Application Forms\Haz Mat App Revised 09-1 8.docx °FMe roW� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 (' AMASS. $ 200 Main Street• Hyannis, MA 02601 �A i639 a,M 0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT CFO Ay 4 Business Name: D NVI� C-0 I l 13 n to K, PCeS t..I_ v'CGU-,0u,. Date:-WI-8 Location/Mailing Address: 1 q 4-$4 t Contact Name/Phone: �o cam?, �t SD0- -77S Inventory Total mount: A OD SDS: 00<k, gka�C�o�(,�Ow, Li se#: 2�jZ i Tier II : NQ Labelina: Spill Plan: Oil/WaterSeparator: Floor Drains: o Emergency Numbers: _ Storage AreaslTanks: CAXOIv,) V�, �, <�;& Emergency/Containment Equipment: 'S 1 1k o<�P^ Waste Generator ID: MA 1914� 1534Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: V� )MC) "- W� 1✓O 5 LIST OF TOXIC AND HAZARDOUS MATERIALS ,^., v� C. Iw , .� (vkL� Iet5 k, NOTE: Under the provisions of Ch. 111, Section 3 , o the er+eral Laws of , hazardous material u 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 VHydraulic fluid (including brake fluid) V 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 V Refrigerants Degreasers f99r engines&garages Pesticides: Caulk/Grout/a4 1 iI\i � insecticides, herbicides, rodenticides Battery acid``(electrolyte)/batteries Photochemicals (Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: Vi k la tK a Inspector: 42, Facility Representative: Z- WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS Number Fee 1232 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable 'Board of Health This is to Certify that Johns.Collision 81 Plant Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. ---------------------------- ------------------------- --------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/3012019 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2018 JUNIrHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health L Vowof B stable egiaatorySemces Richard V. Scah,Director �t►�rqy, o Public Health Division BARMTABLE w"ms our ni�mn�mr"�"'e�s.4e k� II • BARNSTABLE, • Thomas McKean,Director 1639-2014 � pT1659. M A M, e`0� 200 Main Street Hyannis,MA 02601 �77g fD MP'� Y // 0 0D 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 V.S . CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. a 9 N of t . Do a 2. IS THIS A PERMIT RENEWAL? -�< YES NO. IF YES, SHIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: V ff 5(o•^ 6. ADDRESS OF ESTABLISHMENT: $ P(4��- �T�ak �s f'7/1- 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: Sob - 122 57- Fd I 9. EMAIL ADDRESS: I A✓1 S co tl, St o- Go✓v►(-W , ne f" 10. SOLEOWNER: --'-YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME�a*,s 6le shy. t u, Tn c. -WA- Qa h o s PRESIDENT `iyhn ell .y SYa (sa&2 S/ Gy 06CCIF TREASURERIZ-c)"v ell: Stia (ectc:2 s� uv. aa46$ CLERK C� 3, Q gv,-k 1661a,;Q U. UvC�FAD � c`�tnrnw�h MA d� �y 12. W PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT �Gf 2 DATE �Application FormsUAZMAT APP 2017 REV Q: Number Fee 1232 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Johns Collision 81 Plant Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 110 gallons of Hazardous Materials. ------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2018 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 • • • �9 Number Fee 1232 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Johns Collision 81 Plant Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 100 gallons of Hazardous Materials. ------------------------------------------------------------------------------------------------------------------------------------------------------------------- - - This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2018 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 66.tjL1 d L10Z 61 Nnf F ' wl of hmstable g atoervices �T Richard V. Scah, Director o Public Health Division iflMUARTI HARNETABLE, Thomas McKean, Director �.S7antF 1639-014muir rrcan,s xw,s�u:s nuts•nsi.aviue•.rsr ea?n;raa i63A9 ATFp �a 200 Main Street, Hyanni's�,/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 Ist-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 V s CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. D q'-/ 01,9 . oo A 2. IS THIS A PERMIT RENEWAL? K YES_NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGEIUSE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: ?I Piao f 1ed. t�ti li.�.?�s lv1,g Oa ko l 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: s co iv. 1 p cvMc�S�. net 10. SOLEOWNER: 'YES_NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME j�h�s 2��2�J�c� lAt. D4A ;zs'o 41-n's C o 11,6 v r� PRESIDENT F-11.•, s ti a cca,,, sJ. w. m.+ oa 6 6 r TREASURER C-(1.'3 Ced,-- �3 LV. k")e 104- 0ab6T CLERK �2�1z �l,-, <>o R��� Slake ad Ljo�j 1-1lJ /n4 12. IF PREPARED BY OUTSIDE PARTY: NAME: k TELEPHONE#: . COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT %t/' DATE e-6- 1 Q\Application Forms\HAZMAT APP 2017 REVI D.docx I IKE Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARNSTABLE, MASS. �. 200 Main Street w Hyannis, MA 02601 1639. 0 �'0'FOMP+a, TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Je�N A S Ce I N 51 o vL Date: I Z 6 6 Location/Mailing Address: 81 PI 14 L V%wi a Contact Name/Phone: o Inventory Total mount: N 1��tI SDS: t✓ `'b License#: 2�2 Tier II : o La eling: 6 Spill Plan: Ye s Oil/Water Separator: NIA Floor Drains: tj o Emergency Numbers: `k 5 Storage Areas/Tanks: 5'5-_gcr,1 S4vV-\, VM,.We. avck%) VA,5+4, 15 o5" w�.st��� , . <�V-4— a�evvw.,1 Emergency/Containment Equipment: Vft Waste Generator ID: nM q 9A 06I's3 Waste Product: �9gkL- .a►wsk �ol� Date&Amount of Last Shipment/Frequency: 0 1 5 h, 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. I Antifreeze 10 Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) 1 Windshield wash 1 3 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 olb— Refrigerants Il)y Vk alb Degreasers for engines&garages Pesticides: 2 Caulk/Grout VtAs)00(1,Vcv..iVh%LAs, 2 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 p k to Swimming pool chlorine 610 Paints, varnishes, stains, dyes Lye or caustic soda J,b Lacquer thinners in-A I-5°iI --J.'of k 4� Miscellaneous Combustible Paint&varnish removers, deglossers�� J.1 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/RECOMMENDATI NS: NJ v 1S5Vf-1 or Inspector: Q ,� Facility Representative: ` WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS Number Fee 1232 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Johns Collision 81 Plant Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 100 gallons of Hazardous Materials. ----------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------ This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2017 unless sooner suspended or revoked. ---------- -------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable SINE►� Regulatory Services ti � Richard V. Scali, Director Z MASS. ` Public Health Division BABSTABLE 1639. 10� wns"ra s° �n�iiECDv'snr a nnsi e ' r QED MPt a Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 CO 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 S 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 Ist. ASSESSORS MAP AND PARCEL NO. ,?9l Di gd ova DATE - /S- /4 FULL NAME OF APPLICANT: 'Tohv, P. C/4_5 NAME OF ESTABLISHMENT: ADDRESS OF ESTABLISHMENT: S"1 P/4'd Jerl. A;64,14 me Ua 6o/ MAILING ADDRESS(IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: 50 8- `I7 6-- �a r) e — EMAIL ADDRESS: 1©h A S Co i f f Si 00 1 @ Cornc.G S1 . /1cot SOLE OWNER: ✓YES_No IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME �lylnvt's 3,AC. 17Fc9 '1 a hiss /fi Div' PRESIDENT J-Ohn P. 671hs S la Cedc..c Sf U1. oaCC Fr TREASURER So-f r CLERK Sc.tee. • IF PREPARED BY OUTSIDE PARTY: SIGNATU , F P CANT Name: Company Address Telephone#: Email: Q:\Application Forms\HAZZAPP Revl6.docx Page 1 of 2 ' ti AM r Town of Barnstable office: 508-862-4644 .. Fax: 508-790-6304 Regulatory Services Department w Public Health Division Thomas A.McKean,CHO a` 200 Main Street, Hyannis, MA 02601 Payment Receipt eHazardous Materials Payment received: $50.00 (Check) on 6/17/2016 MPermit number: 1045 'Check number: 44043 Check amount: $50.00 Name on check: Johns Collision ,Business: John's Collision Restoration Owner: JOHN P&LAURIE J TRS ;Address: 81 PLANT ROAD, Hyannis a .._..... __... ......... _ ......... ......... 6a�nsrab/e qo to F atmo��h ad Pt 28 vatmouth At,2a O CAPE COD MALL Route 132 t, t0 K•MART PLAZA D OAPOA, o JOHN'S © � 0 m Plant Road a 1 t i Z • FCAR 0 n's CRO s ollis i o n Expert Autobody Repairing&Refinishing S�'�cg Shop Reg.#250 Ohn Ellis www.johnscapecod.com 508-7754281 johnscollision 1 @comcast.net Fax 508-778.2377 81 Plant Road,Hyannis,MA 02601 FINE►ok Town of Barnstable Office:508-862-4644 Public Health Division Fax:508as0-6304 i . RnRMASSBLE.g` 200 Main Street• Hyannis, MA 02601 039. 'DTFOMA+p,O TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Date:IZZ-��I, I b Location/Mailing Address: 1 TA a.k k A, Contact Name/Phone: InventoryTotal mount. 1 MSDS: OK License#: NT Tier II : A Labeling: b K Spill Plan: AJ Oil/WaterSeparator: Floor Drains: r4b Emergency Numbers: Storage Areas/Tanks: 5 tky t Fo r e.S t�ww' c Emergency/Containment Equipment: o AI)t L+ Waste Generator ID: W> W k,-A2-_ Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: o Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS °FTTok� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMASS. 200 Main Street• Hyannis, MA 02601 039.�prF0lAp�0. `0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: " k��5 �ol�'S��ri {or0. �avt, Date: Location/Mailing Address: 131 a Oiaools Contact Name/Phone: o 15 ,Sow --7'71!�- $2-S I, G� x 4n4610. / I Invento Total Amount: -- IDD I ki MSDS: License Tier II : Labelino: G'aog Spill Plan: e-5 Oil/WaterSeparator: QJA Floor Drains: r`o Emergency Numbers: Y�5 Storage Areasjanks: DALA. coo 4C1w4-k1 wati ,— Coovk. la �c \ers etc Emergency/Containme t Equipment: 7 { V a,\wlo � ow k Waste Generator ID: t Waste Product: p�tv�k Sol�r.�G. �d pc�,ae Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: e�- i 5.,\,9J P1GU1,k,,D kZe%,(aVv S octS t4- cec y'(�,e. 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: V Caulk/Grout ltllQ{S 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 4,4- -JX Swimming pool chlorine Paints, varnishes, stains, dyes %0 Lye or caustic soda Lacquer thinners 1_4S c\eA 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: INFO MATION/RECOMMENDATIONS: VVIA 474,4 00S K,AK-5 vL o ° S 5 VZ — e-k,L110l vt W L bt o Inspector: �a \� Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS f Number Fee 1045 THE COMMONWEALTH OF MASSACHUSETTS 100.00 Town of Barnstable Board of Health This is to Certify that John's Collision Restoration 81 Plant Rd., Hyannis, MA Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ----------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------ ----------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2016 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2015 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health ' Town of Barnstable Regulatory Services • Richard V. Sca14 Director MASS Public Health Division " Thomas McKean,Director k-w* 200 Main Street, Hyannis,MA 02601 JI Office: 508-862-4644 Fax: 508-790-6304 k� Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. aq.41014. Ooa DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT P. El 1, S NAME OF ESTABLISHMENT dhvi;S ��ll�. SlU n • ADDRESS OF ESTABLISHMENT '1 TELEPHONE NU OER SOLE OWNER: yYES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION N0. Cq-d g-,2 jj,0';) STATE OF INCORPORATION /YI FULL NAME AND HOME ADDRESS OF: PRESIDENT Sll ohn A C—IL5 52%) (edg•c.S1. GU. In f o---WV TREASURER CLERK rv, SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS /d S1. fit/ 6G.anS�cSlr A1/f dd�6 HOME TELEPHONE# C:=he\Temporary Intemet Files\0LKD3EAZAPP Rev2015DOC r. Town of Barnstable Office: 508-862-4644 Fax: 508-790-6304 o� Regulatory Services Department snttvsa81 Public Health Division Mom. Thomas A. McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt Hazardous Materials Payment received: $100.00 (Check) on 6/8/2015 Permit number: 1045 'Check number: 42362 Check amount: $100.00 Name on check: John's Restoration, Inc. 'Business: John's Collision Restoration Owner: JOHN P & LAURIE J TRS ,Address: 81 PLANT ROAD, Hyannis J • °pIMF r Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 \ BARMASS. 200 Main Street• Hyannis, MA 02601 1639. �OrfOran+"�� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: d o 11161-V%- �e5�o<�,o,ti Date: Location/Mailing Address: I _I?14v"k QX H y-.�V%.15 Contact Name/Phone: ,el, v,- C 1 l t$ �06-775--8 28 1 Inventory Total Amount: >k1( 4 MSDS: License#: IL Tier II : lQ o Labeling: 41 Ia4k1 �41mjA,-4c24, Spill Plan: Q-`5 Oil/WaterSeparator: Floor Drains: 00 Emergency Numbers: �5 Storage Areas/Tanks: 4-ro -c -qi&j wa ie. cleR01 vm CaftL,- d la -C bI kJ4 Foy Emergency/Containmen Equipment: S i ov` Q- Waste Generator ID: MAD 910GIn4 Waste Product: a,� �►^ -✓ Date&Amount of Last Shipment/Frequency: AO N c%,w 5 IV, j e,7 eQ rS I,L i w,.5 2 z o 9 Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot 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/ctWlk�s `BLS/C.IT,-4- insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine ✓ Paints, varnishes, stains, dyes Lye or caustic soda �— Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil&stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: NO W44 o! ,( S Wa�,AA, sa.r R r. Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number Fee 1045 THE COMMONWEALTH OF MASSACHUSETTS 100.00 Town of Barnstable Board of Health This is to Certify that John's Collision Restoration 81 Plant Rd., Hyannis, MA Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------------------------------------------------------------------------------------------------------------------------------------------------------ --------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2015 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health I Town of Barnstable F1HE, � Regulatory Services Richard V. Scali,Director H"R`MASS. Public Health Division 1639. ♦� i°lFn ' 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.CyotL,, CO DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT �l©�►� P. t Is NAME OF ESTABLISHMENT -101�✓�5 Co[I,W a� ADDRESS OF ESTABLISHMENT ?! Pl4w� ��• VG�5 y . /Y1✓� Oo�(aG1 TELEPHONE NUMBER 5 -773- bra8 SOLE OWNER: AYES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. Gy-a83110a STATE OF INCORPORATION Mh FULL NAME AND HOME ADDRESS OF: PRESIDENT ohn P. 611,1 54a Ced4lt 61. W. 6r.C-1�61e, /V* TREASURER —game CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS 5Hd f K S , U/.B�,�►sh M� rib 6� HOME TELEPHONE# Q\Application FormS1HAZAPP.D0C SPILL CONTINGENCY PLAN E Emergency Coordinator, Name: Address: ,5ya C",2 Sf. w.&,z,,s/4bk. mit ed./c.F Daytime Phone: Evening Phone: S'a 91c - (.q 8d Fire Department: #y41.4 01-5 502- 9,75-- 130O Barnstable Public Health Division: 508-862-4644 DEP 24 Hour Spill Hot Line: 888-304-1133 Waste Hauler: Name: o/✓y x Phone: Soo- a 7 - 13 3.3 Building diagram indicating hazardous material/waste storage area, location of absorbent scavenger materials, fire extinguishers, fire alarms (if present), and evacuation route (if applicable). 64A .1 - ---- -� a. D Alf � • s I �k i '` c���"e i`' ,r�'. �.+L.-��� �rlfl.l. �,—~�a:d•�aJe,��:'�;:;�. `^, �.1 c�f �,r..s .,,.y a�i"3 r', ���:� ✓ �6"A7'�7 •�y lG,,,^." �"�c i.✓ k l Actions to be taken to control a spill or release, and preventing it from reaching a catch basin, sewer system or the ground. tl �s 'o be I Q ,L y 5u-eVUvVidI-ij tie �p// dum5 cmd 4 soahe-7/ J/I the '5 1-1/ /CT/ /064j-r'C v ndzoL of O ,Lf G�G�D�o nd ty ►o\,)n @ 11-5 �7 G'►2 i Number Fee 1045 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that John's Collision Restoration 81 Plant Rd., Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------ ------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2014 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2013 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health �r Town of Barnstable Reguiatory Services Thomas F. Gefler,Dinctnr Public Health DI i ion a e�SlaAYR � ThoT.as 1M/ - ean,Director 2D0 Main Stect, Hyannis,MA 02601 F� 5os-790-6304 d-�^Eicu: 5o&- 62-4-644 Application Fee: $100-no AS�'SSORS jNj�_p AND FARCE,No,or��I 6(.�.OOD DATE 13 APPLICATIO�d FOR PERMIT TO STORE ANVOR 7-fT ,T „ MORE THAW 113 GAT j.n NS OF 14-A�AR-DOUS AIATERIALS NA-Na of APFLIC kNT OFESTABLT� Ur2 A11 S �"`<< 5ron ADDRESS OF ESTABLISII+iSENT Pl4 f 21 � s /17.1 oa(.o TE HONE NVM3ER sod- 17 SOLE 0 wNER: AYES No IF APPLICANT IS A FARTN ,FULL NAya AND HOT ADDRESS OF ALL PARTNERS: a a IF APPLICANT IS A, CCRPORA,=N: FED +RAT IDENIUICATION NO. 0" d 83 11C d �. STATE OF INCORPORATIOrT M6 I7zL NA2yfE AND Hones ADDRESS o �s �. �2gsF46/� m A PRESIDENT JoV+n p Fil/.5 ya CILYRK Lam' 2NATURE OF,01UCA-'U P.'STRICTIONS: HORSE ADDRESS 5`1d w '�"�al�c t,Y1A Od{,ol HOB TELEPHONE # ua7-dcdwp/q I Date: 91 2 / 13 TOWN OF 13ARNSTAI3LE :,:,-,, t,,,,-,.- TOXIC AND HAZARDOUS MATERIALS FORM NAME OF BUSINESS: J4oIvy\P6 Cp10151 oyL. 25-�ycc ova_ BUSINESS LOCATION: g I 0 AY4- 14 y4 n rA , s INVENTORY MAILING ADDRESS: JoLyxt, T TOTAL AMOUNT- TELEPHONE NUMBER: ,S-OS --7-7,5'-- 525 1 -7 4a I CONTACT PERSON: --3—, „` (✓ l I % -S EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: A\-) ' -o Uok F< a A,<- Ye-s INFORMATION / RECOMMENDATI NS: Fire District: Co,tip' ej 1,A vn- z L vt v key e-- �yg✓►n► 5 &A-°� � Waste T ` �' � Mvq b'?8/D61-6 3 9 Last shipment of hazardous waste: a IT 0 Name of Hauler: 6olj-,o„sDestination: ✓to Waste Product: Licensed eo /iyV,X6 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) 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 ! I _L +6 I�t,�ei 70 04��-b,2 K45 Laundry soil &stain removers ����� (including bleach) �DW �OXiL�-k/- c3h H 17, low- VOL r►yw-s-r Spot removers &cleaning fluids (dry cleaners) l.� S AVI Other cleaning solvents Bug and tar removers j { Jvt. ckayhmff 104tws Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials Number Fee 1045 THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that John's Collision Restoration 81 Plant Rd., Hyannis,MA 02601 q. . Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -- ------- -- ----- --. -- ------ -- _ -- - ---- -- -- ---- --• --- ._ -- --- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2011 unless sooner suspended or revoked. WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D._ 6/30/2010 JUNICHI SAWAYANAGI ^ -- — .. _..._.._. ._...._.w... THOMAS A..MC..KEAN,.R.S.,CHO Director of Public Health r, e , Town of Barnstable °F1HE r° Regulatory Services Thomas F. Geiler, Director • BARNSTABLE, 9 MASS. 4Q Public Health Division 1639. �°rFnrna+ Thomas Ntcl(ean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO.-)q�j O16. oba DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS r FULL NAME OF APPLICANT rj��►� P• �l�0 NAME OF ESTABLISHMENT J�%► 5 (.��L�S�v i1 ADDRESS OF ESTABLISHMENT cal 1'tc.,..h • .s TELEPHONE NUMBER (5'017- ?7 S 7XV SOLE OWNER: AYES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. O q' ;X83`10 q STATE OF INCORPORATION M FULL NAME AND HOME ADDRESS OF: PRESIDENT loin A f ll,S SK a (-e-k.t -*74 ' 1DeC TREASURER 5c,rv)e CLERK S4rvt c SIGNATURE OF APPLICANT ` RESTRICTIONS: HOME ADDRESS SYd 6a4,e ef� W. &-v,*444 44/�od6eF HOME TELEPHONE # ,4'08-,3ja- flo5' Haz.doc"�%P/q , ',yR•^ T ,iT' �'.�f+��h 4 '" 'T � r- � -i7- '� aV 49ck r•; 5- n '� ..[1�.s '; _r - y= ,�1• � � 3 s" � .�`-`� �.r"y �1;r�,x` � 3 r. .t 3.:�F 4"S r �b `L ."F y,� kS�" �' .-.xr � �. _:. t 3. .. �, �.k t .�•�x`�"^ ?. ke s zt � t ".� �, n` �v c �a` � ,}�r _+_..s t* d' 4�h F y,, p A..• ra r F.•i JO �IrSON HNS 5,02 �R. "" - •wi�*4 .G s� +,yi 3"' h• a c `'i�a h - e s i `� n Zk TRD F 8�1 P�LAI�I _> HYryANNIS;MA 02601 F. N=� 508 775�8281 , CONTINGENCY PL.�'�1 TO HAyA13�E - °HAZARDOUS WASTE'SPILLS . .�. To prevent spills: No container larger than 5 gallons allowed Most hazardous materials in gallon and quart containers (paint) All containers in second�*y conta,nCm__ent akic s All containers checked daily for spills All paint liquids recycled on site If spill occurs: Use spill containment emergency kit Package all contaminated items in 55 gallon drum Contact disposal and clean-up Company • ONYX ENVIROMENTAL SERVICES LLC 398 Cedar Hill St. Marlboro, MA 01752 Phone #: 800-354-2382 • Town of Barnstable �0*VE rok2 Regulatory Services ° Thomas F. Geiler, Director • ' BA MASS. LE• • )Public Health Division 9 MASS. q . �p t639. , ATFDMA�A Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6 304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE `J APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT ), NAME OF ESTABLISHMENT i ADDRESS OF ESTABLISHMENT6 I TELEPHONE NUMBER �'°f I K00' . SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF:ALL PARTNERS: ys„r I IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. -�a STATE OF INCORPORATION AA FULL NAME AND HOME ADDRESS OF: PRESIDENT ( 1 , , TREASURER CLERK • ATURE F PPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE # u- Flaz.doc.wP;;q Number Fee loan THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that John's Collision Restoration 81 Plant Rd., Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111'GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------------------------------------- -------- -------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------- --------------- -------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2010 unless sooner suspended or revoked. -------------------------- WAYNE MILLER, M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 6/30/2009 JUNICHI SAWAYANAGI THOMAS A. MCKEAN, R.S.,CHO Director of Public Health 1� Town of Barnstable Barnstable QYt to o Regulatory Services Department L1RNS74BLE. Public Health Division 200 Main Street,Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. Ol 6 .00a DATE _/� -a; APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN I II GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT �l �'►� �� NAME OF ESTABLISHMENT �o 6 n's Co fr i, S a 0 r'1 ADDRESS OF ESTABLISHMENT g! PIC,44 ed. �1y�M�s , M (5k0/ • TELEPHONE NUMBER SO - - SOLE OWNER: YES NO 14 IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL � C PARTNERS: Co ,- t�3 IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. O/- �23 t! o STATE OF INCORPORATION . IAA FULL NAME AND HOME ADDRESS OF: PRESIDENT —Xo E 11,S S`1d (ee&,a 6f �e Uv rchs�i<Vle <n4 a3 G 6Sr TREASURER SA,m b CLERK S n� S NATURE OF APPLICANT • RESTRICTIONS: HOME ADDRESS'5Yd HOME TELEPHONE# Q:\HazmatVHaz flat Application2008.DOC JOHNS COLLISON • 81 PLANT RD HYANNIS, MA 02601 508-775-8281 CONTINGENCY PLAN TO HANDLE HAZARDOUS WASTE SPILLS To prevent spills: No container larger than 5 gallons allowed Most hazardous materials in gallon and quart containers (paint) All containers in secondary containment areas All containers checked daily for spills All paint liquids recycled on site If spill occurs: Use spill containment emergency kit Package all contaminated items in 55 gallon drum Contact disposal and clean-up Company • ONYX ENVIROMENTAL SERVICES LLC 398 Cedar Hill St. Marlboro, MA 01752 Phone #: 800-354-2382 Number Fee 1045 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that John's Collision Restoration ___.... 81 Plant Rd., Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. (� ------------------------------------------------------------------------------------------ ---------------------------------------------- ------------------------------------------------------------------------------------ ----------------------------- This license is ranted in conformity with the Statutes and ordinances relating there to, and g Y g and expires June 30, 2009 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/08 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I A , �-, m / LI DATA TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 0 satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS (Mass: 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: 7 l � DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply O Town Sewer OPublic O On-site 0Private 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 ORDERS: O Holding tank: MDC 'Catch basin/Dry well'DoG)d C �1>✓n On-site system 5. Waste Transporter Name of Hauler Destination Waste ProductLicensed? YES NO 1. 2. \J"o wy PLUS Person (s) Interviewed Inspector Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM ' �� ....�C Mail To: � NAME OF BUSINESS:—_a �, s .� Board of Health MAILING ADDRESS: l PIC."* ed. /V,1"n 14f14 Town of Barnstable TELEPHONE NUMBER: 11713= ?d-F/ P.O. Box 534 CONTACT PERSON: Cok V, Hyannis, MA 02601 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in qua ities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES tZ NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put a check beside each product that you store: Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners d t& 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 QQ 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