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Home My WebLink About0124 RIDGEWOOD AVENUE - HAZMAT r A I +r i ®0® SMEAD'i No. 10339 smead.com o Made In USA �iCpNBJ Atl ON ,& �0,jr�,(w6t,&&A0.U1 32�- 2(' `°F�Me rok1 Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARNSTABLE. MASS. g 200 Main Street• Hyannis, MA 02601 .639. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rF0 MP'� Business Name: Lw �i11 Lim Date: Location/Mailing Address: Contact Name/Phone: J(q-77% <$oo Inventory Total Amount: �® MSDS: License#: v0 Tier II : NO Labeling: Spill Plan: Oil/WaterSeparator: NIA Floor Drains: t� Emergency Numbers: Storage Areas/Tanks: MI&PIjaAe SMA C44 o Emer enc /Containment Equipment: 41 doub e,61 * L- 0�j 5f ijaw nl I� [Date& ste Generator ID: Waste Product: I\1 Amount of Last Shipment/Frequencensed Waste Hauler&Destination: er 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 fro the Public Health Division. Antifreeze 7/Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils V Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives (creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda acquer thinners V Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Flocr&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons VLaundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION COMMENDATIONS: - i 4 Sp, ,111 ,` Inspector: Facility Representative: WHITE COPY HEALTH DEPARTMENT/CANARY COPY-BUSINESS CHURCHILL C 'eL t f9J2,:. 124 Ridgewood Ave., Hyannis, MA 02601 Phone: 508-778-6929, Fax: 508-771-4470 Chemical Inventory Base Alkali Sodium Hydroxide BiSoft Perla Fabric Softener Borchlor 5(Bleach) Sodium Hypochlorite CC Sour Citric Acid Chlo-Rid Sodium Thiosulfate Pentahydrate Dual Brite Detergent Mulan Citro Detergent/De-Greaser Power Extract Complexing Agent Aries 3019 Boiler Water Treatment Aries 3091 Boiler Water Treatment s ' Number Fee 600 THE COMMONWEALTH OF MASSACHUSETTS $15o.00 Town of Barnstable Board of Health This is to Certify that Arann._.,nandry 1 Churchill Linen Service; Ina 124 Rag d Ave, Ilyannis, MA .....------------------------------------------------------------------------------------------------------------------------------------------------------------------- Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. ------------- ------------------------------------------------------------------------------------------------------------------------------------------------------ Restrictions: -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable Inspectional Services BARNSTABLE Public Health Division " ' 1639-2014 BAMUrABLL : Thomas McKean, Director 039. 200 Main Street,Hyannis,MA 02601 C0 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, -0J1 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 ❑ LT-111 —499 Gallons: - $125.00 _ ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 0vgr d Ch *A late charge of$10 00 will be assessed if payment is not received by July 1st. S 09(10a... 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: GNP a�•� Li n e+^ Se4-V i Ge- y\ C . 5. NAME OF ESTABLISHMENT: C UL,rGL4-', I I v r c e vt G. 6. ADDRESS OF ESTABLISHMENT: I L" R'%O {CJJ100d I�Ve• ��a�� S -11A 4 0260/ ll , 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: �S'G m e1 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: A @ G�t~�GUl ' L; /N � 10. SOLEOWNER: YES v O IF NO,NAME OF PARTNER: J r, (5CU,a ter co r� 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: r CORPORATION NAME CL t-. I%A ex Se V', Ge— PRESIDENT 1te%%v,,eiL, TREASURER a C kt-,rGL�Cd 1 CLERK ICpfny�e��+ e t��Gi s12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT y�� DATE D 6�0; /,, 0o A Q:\Application Forms\Haz Mat Appli Draft Jan20l9.docx Number Fee 600 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Acme Laundry 124 Ridgewood Ave, 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 i Town of Barnstable Inspectional Services BAMSTABLE FTHE fn. wv." LE-M Ml u v� Public Health Division =679_214 MASS.— Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 r k Office: 508-862-4644 Fax: 508-790-63.04.=4 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 XVSr *A late charge of$10.00 will be assessed if payment is not received by July 1st. f Cgot 1. ASSESSOR'S MAP AND PARCEL No. 3a g a y 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. G C 4. FULL NAME OF APPLICANT: G k k rC(n 1 1( L i-O e%A 5. NAME OF ESTABLISHMENT: C �u r c < U&,r u'1 Le / %^c . 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 50 g - -?7 8 - G q o� 9 9. EMAIL ADDRESS: 2 t4ct@ c L u rcat, �0 - l i r e C-D'V" 10. SOLEOWNER: YES VINO IF NO,NAME OF PARTNER: Su GC�4aier �fp, 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME C G%4 r cLAJ1 L1 vi L vN SQ.r v6 ce q^c . PRESIDENT t>e >o m i H.Gi TREASURER Ta e C-,,C c.UJ 1 CLERK VetA%4e-1L4 \7ebpviA K; c 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: • COMPANY ADDRESS EMAIL: J SIGNATURE OF APPLICANT �G DATE D Q:\Application Formsgiaz Mat App Revised 09-10-18.docx Oil Number Fee 600 THE COMMONWEALTH OF MASSACHUSETTS $1so.00 Town of Barnstable Board of Health This is to Certify that Acme Laundry 124 Ridgewood Ave, 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 05011 a- ' owrl�of Bagnstable TROegu atory 3emces Richard V. Scah,Director 3 i; Ft►,�T�`'�'o, Public Health Division BARNSTABLE'4 e wam!¢nuu m�anux•rcsrae 'ne i BAMsrAst r. Thomas McKean,Director Mass. � Arfo3,ts 200 Main Street,Hyannis,MA 02601 ,:, Office: 508-862-4644 Fax: 508-790-630dEa APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS FT.) 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 F9r, C�eC�-#05 01)a *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. `ASSESSOR'S MAP AND PARCEL NO. 3a gv� y 2. IS THIS A PERMIT RENEWAL? /YES NO. IF YES,SKIP QUESTION 3. 3. a�OR 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: k c C 111 L I N e A Se rti l ee REA _,4CML LauM dr 5. .NAME OF ESTABLISHMENT: c M C Z-G U''^ r 6. ADDRESS OF ESTABLISHMENT: U R ►dCew D Dce 4•Ve . S 0,94501 IF 7. 1VIAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. `TELEPHONE NUMBER OF ESTABLISHMENT: (6,0 9. ;EMAIL ADDRESS: P e e yQ e G C van e f► \A e w n e, e r. COm. 1e +�I I 10. SOLEOWNER: YES✓NO IF NO,NAME OF PARTNER: SU 9C 1 !� `In r r�pc�, 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: �. CORPORATION NAME u`C a � i v�Qvn Se r,/*,C-e- PRESIDENT Ve-v\an e- ;tVi V),o art„i %,,%i C t TREASURER Tct CLERK lcew.\ef .97�vwa wa0�• 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: .COMPANY ADDRESS EMAIL: AI ;f • SIGNATURE OF APPLICANT .; DATE C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\BMQD49H2\HA MAT APP 2017 REVISED.docx SME TO�yti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BA MASS.LE. ' 200 Main Street• Hyannis, MA 02601 MASS. �u .6M TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rFD MAy nn Business Name: A e-wk, v►�d�r Date: 0 9 18 Location/Mailing Address: 12''E oo v �H n�5 Contact Name/Phone: r 1 c�8- 2.R►S a1 Jv�G��v� Inventory Total Amount: ,AV"Aod 21ka1� SDS:�S - 9A-e-S License#: �� C431 Tier II Nee., �- PO-DR Labeling: q ov Spill Plan: L�Zfl Oil/WaterSeparator: 4.au4� Floor Drains: �S Emergency Numbers: " i3� k � k� torage Areas/Tanks: 1 k 130 q,,1 d1,,a� v � ► G�+�o<'a Emergency/Containment Equipment: VJ P~ S vk S t3�C, l Waste Generator ID: �o <AI9-Af,f Waste Product: Pw5 �, ,raj , o, Date&Amount of Last Shipment/Frequency: 5—20 C,Ci 'I Y, Y `� Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 1 1 1, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons cr 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, C. hydrochloric acid, other acids) VIOLATIONS: �o pkaVJ,. Qa5A�. ORDERS: 0 S KVA- off. -!i l `a,! W lid INFORMATION/R COMM N ATIONS: �O tS la-\ -6 v\oLw `I of I I ) b k Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS .7 vV l TIME Toq Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARNSTABLE. ` 1 MASS. g 200 Main Street• Hyannis, MA 02601 t679. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rF0 MA'S Business Name: C L Lavkt Date: Location/Mailing Address: I 2W Q e, a yl Contact Name/Phone: o23- - Z WL" - -s YF Inventory Total Amount: 300� MSDS: 0v*- License#: Tier II : �cAt,�- a,Dl� Labelino: 4 ev Spill Plan: �g Oil/WaterSeparator: -��-1 Floor Drains: f-5 Emergency Numbers: o Storage Areas[Tanks: 00 t✓\n s r rr,.p,l a,5 -4/ e V\o-V-e,5 Emer enc /Containme t Ea ui Dment: \ w �000w&y f d- c bl,.- 2' �( Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LL LIST OF TOXIC AND HAZARDOUS MATERIALS �o vvla- v C�Awr IV I vt\/ZytT�j/ fjHGZ�RSf"+vlaj� 'L o� .- 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 yLaundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" . (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: �a �c� 5 �,la, k �j �Qt.>•�S a 11�a \ hfietc�Q y.��D6Y5 ta��'�"o`�� ORDERS: M,,,u CJw&ti xvJoo-f-6 A5 AQ INFORMATION/RECOMMENDATIO S: M".ni 41r,JVK6 I ►1 D O —.�t11�-�'A,i ,.( o� a✓V../ ��'.��.Q, �'-�o�� t 5 S vim.�. Inspector: V!ce Le Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS fi ',s s Number Fee 600 THE COMMONWEALTH OF MASSACHUSETTS $150:00 Town of Barnstable Board of Health This is to Certify that Acme Laundry 124 Ridgewood Ave, 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 ILL . t jTown of Barnstable €� Regulatory Services a Richard V. Scali, Director IARNSfAHLE. r Public Health Division BA�NSTABLE 163q. 10 w�nsr�as�""n.�' Thomas McKean, Director �+ 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax:,508-790-6304 �.. APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE.WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN M ANNUAL PERMIT(RUNS JULY 1 st-NNE 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 0 A late charge of$10.00 will be assessed if payment is not received by July 1st. ASSESSORS MAP AND PARCEL NO. _ :3ZB 2.14 DATE /7 Ac:, FULL NAME OF APPLICANT: C, HLSRehlILL (-tTSEN SERYi CE 1b8A. ACIME KDFI\l NAME OF ESTABLISHMENT: L_Nu - (Nzy ADDRESS OF ESTABLISHMENT: ( 2�{- Rtt�' W�� f� ` 14yNMnslS MAILING ADDRESS (IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: 56$ - ?`a r(:�,9 2c� EMAIL ADDRESS: �d�rn� ctctne�i tt�n mG.S��r. Corn SOLE OWNER: YES XNO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME U Lj Y40S2 Sew V/l ,g FL), PRESIDENT g1(1,41 G l TREASURER G14VV&&#I L CLERK_�/(��y -f '�6--bb44 r A J 1 L 2+Y f� IF PREPARED BY OUTSIDE PARTY: S NAT OF APPLICANT Name. Company Address Telephone#: Email: Q:\Application Fo:ms\HAZ.ZAPP Revl6.docx Page 1 of 2 Number Fee 600 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Acme Laundry 124 Ridgewood Ave, 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 f � 5 Town of Barnstable �VE� Regulatory Services � Richard V. Scab,Director M SS ` Public Health Division En► Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 X Office: 508-862-4644 Fax: 508-790-6304 Application Fee:$100.00 ASSESSORS MAP AND PARCEL NO. �O� o > / DATE /`�( "�0 i APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT !' ADDRESS OF ESTABLISHMENT ( Lq f L I (8:�V 001) I S TELEPHONE NUMBER S08' J SOLE OWNER: YES )(NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL J !) N u (o N W APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 01�—ad /0 7?.9 STATE OF INCORPORATION FULL NAMEA29,HOME ADDRESS OF: PRESIDENT V&&-W A110 C4 TREASURER CLERK • VSIGNXAM OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# Mcache\Temporary lntemet Files\OI.KD30AZAPP Rev2015.D0C I °tT"EToriti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMASSBLE.g`J' 200 Main Street• Hyannis, MA 02601 1639. iDlED MAy% TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Ar- vt c Date: Location/Mailing Address: 124 R e po 6,v1 Contact Name/Phone: SD -77 - 2 av� J�/ Inventory Total Amount:�`"3 J Sel ';AVfSDS: leg —�9— License#: bco Tier II : V e- — oX+rah (�� Labeling:—�—p0D` Spill Plan: Ve,1i Oil rator: -o —' +l �r 74VJ4loor Drains: C1 — e- Emergency Numbers: _ Storage Areas/Tanks: ee- o Emergency/Containment Equipment: Waste Generator ID: fJ aste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination. Other Waste Disposal Methods: 19 c _ �� , �( Co` V-A-y � �40 VGk' \/lb LIST OF TOXIC AND HAZARDOUS MATERIALS as 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 2aQc °, �►��bc,�� Automatic transmission fluid �— Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers t`to A g�`�` V-'`er- Hydraulic fluid (including brake fluid) Windshield wash V10AC- Motor oils �— Miscellaneous Corrosives �g�` s Gasoline,jet fuel, aviation gas Cesspool cleaners Q►ku.1* sior Est Diesel fuel, kerosene, #2 heating oil —�— Disinfectants Miscellaneous petroleum products: Road salts l�� oh�l c,�►, vq, 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 1� �'�`� (including carbon tetrachloride) (including bleach) LES �.0Vk Any other products with "poison labels" Ptz; (including chloroform, formaldehyde, l F�� hydrochloric acid, other acids) VIOLATIONS: W k GoY 5ko<'A 9A�., o AkZVA6& y7Aou 6,2e,A!C)e e0A i K,r ewb ORDERS: S-+,r�S b JKo tv�5% INFORMATION/RECOMM DATIONS: '�OD 4. r1 L ��' � 1 N S dal l r Iw►+I�+� �-e.v�.�-� .C �S� �S 9,P,+5, Inspector: --i�i Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS °FIB fok� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARNMate�E.�, 200 Main Street• Hyannis, MA 02601 �prFOMP+�`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Acv,— yn-A c Date: S 13 I y Location/Mailing Address: 7- R% V-%00Ave- 4V%AI S Contact Name/Phone: e o Sob-�7 - 1� f,7C�-k�•`� o�.l.'I-d 1'i cc,�\ SDS ci58 5�' Inventory TotalAmount: — too 0-1 MSDS: License#: bOD Tier II : W o Labeling: 6K Spill Plan: Ye-5 ovtetFloor Drains: U5-7Ao St-Of-Emergency Numbers:Storage Areas/Tanks: •�.5 gvS <-4,0Z �g. c� Emergency/Containment E ui ment: �vcA45 -, 0az Waste Generator ID: N Waste Product: Date&Amount of Last Shi ent/Fre uenc : 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 1/ 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: ?e.<�►�l�k �5 �x.��dr�-• ORDERS: exu-LJ mac AJ*A AMN- Sk- 4k006 k o S A JL INFORMATION/RECOMMENDATIONS: O 'LC J l Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: /2/36 /13 TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: k o'. Gwyn BUSINESS LOCATION: I Aq Awa, , r}yanrl is INVENTORY MAILING ADDRESS: ,.Saw�c, TOTAL AMOUNT: TELEPHONE NUMBER: 5'0$ - 77 R — &fX.� 1/0 W5 CONTACT PERSON: (ilnarle,S �o,� . EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: C-emvv -<,-,aj 14vvv r �eS INFORMATION / RECOMMENDATIONS: 411 44et:t/s .tr<w'z�Q ,rceQo�rs , Fire District: ll k,+ oK. s,+e c/1 V14,4, os4e, a,2 eorc_-��a►,�� r,7�all �yan•�, s �i�G -C.X.'�',r`.QJ,81�-t5 SG�Jt �� C�/t �G.S � Skw�tow Del. �►'�C. . ✓I,D jA.r% 1e"e, J►Kce— /Oct ,►L�i�4CG�►oY�-///blot' cxcetO+as v�a��.bcl Waste Transportation: Il A Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) 1 0 Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid 110 Disinfectants�b i'ea�� G�rvs clLa,�er 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 4 Q Laundry soil &stain removers n 2(� (including bleach) IAZ<eA X Spot removers&cleaning fluids Z (dry cleaners) �vw�-�aw� 52e v��/ C2�PD f-�►vt9 T�2�/u►�ewt�� Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staffs Initials JUN 20 2017 PM12:14 Number Fee 600 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Acme Laundry 124 Ridgewood Ave, 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 . oWw11��,, of Unstable. P�egulatorva ces Richard V. Scali,Director - " f ° .o Public Health Division BARNS LE r r flnxnsrwat•itxrviue•m*urt•nrur.s Thomas McKean Director � 39-2`1°"'`_`"°"_"° ]ypsg, ) 1639.2014 �q 200 Main Street, Hyannis,MA 02601 575 � Ca �0l� ao/8 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 X US. *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 32g 2I'4- 2. IS THIS A PERMIT RENEWAL? y 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: CHURCH 11_l_ 't>13A. ACtAp LAU SDRy 5. NAME OF ESTABLISHMENT: ACME LAU f 3 6&( 6. ADDRESS OF ESTABLISHMENT: 12-4 R i bSE.LI'MD a.V E � Ilya lNi,� fLIP� 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE:S. TELEPHONE NUMBER OF ESTABLISHMENT: (eO$1 l 775 -- (oB Z9 9. EMAIL ADDRESS: ci--Cg.M c�eme�i �eY11Mc-�s �1; coM 10. SOLEOWNER: YES X NO IF NO,NAME OF PARTNER: S UOCkAP-rCR 5 COPP 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME C H ls(ZCN 1 LL LI ih1E),� SERV f CF- ►"C PRESIDENT T(NE TREASURER ,SAKE C H URr-H ILL CLERK KENJME714 t>t L-0AjINIC.1 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT ATE Q:\Application FormsViAZMAT APP 2017 REVISED.docx 'Number Fee 600 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Acme Laundry Company, 124 Ridgewood Avenue, Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2011 unless sooner suspended or revoked. WAYNE MILLER, M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. , - 6/30/2010 JUNICHI SAWAYANAGI THOMAS A..MCKEAN,.R.S.,CHO Director of Public Health l/ M r ' Town of Barnstable �pF1HE Toy, Regulatory Services Thomas F. Geiler, Director BARNSfABLE, * Public Health Division ➢ MASS. g 1639. �m ATFnMA�°i Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100:00 ASSESSORS MAP AND PARCEL NO. 3 d!R�"14 DATE 6 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT c m � ;')ne n Pu.a-g NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT _ ��-� �.��z, e wv, L ✓�_ fX�n ►�.�� TELEPHONE NUMBER SAL 770-- 69 Yq SOLE OWNER: YES—X-NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. Q Y' 3q0 U 16 e STATE OF INCORPORATIONa FULL NAME ANDJ HOME ADDRESS OF: PRESIDENT ?: ,E -e Wl ,e. 75 X /4, a,-VA 1/:LzY. TREASURER r'e d, QvJ JP 6 CLERK �C✓,l^ p �y G 4'r SIGNATURE OF APPLICANT J RESTRICTIONS: HOME ADDRESS y S- 61-(� HOME TELEPHONE # 75Z11 Haz.dochap/y U 77777777777777777 II .. 1 •III II . .: !:;' ,: IL.0 CKN ,I ..0,:. I CHECK I. , I,fi L. I , _ .. ., .,,.. ,, _. .,.. I . �._ ATE III UE . _, w_. I ., n, VI NDOR N . _ .. I I I I I I I � I I I 1 � I I I I, 11 I I _ I II I,I I I I I I I I , I L I I I I. I I . I . I I I II I I I I I I I I I I I I I I I I I ,I I I I I I I I I_ I I 1 I I I_ . II Il 4 I u I I I I .I I I I I II I I I� I I I „ � I II I I,zr I I I II I I I I I I II I L 1 , _ z I II II I I I .1 I I I I , I I I I I I I G I I I . I I I I I I I I I I I L I L I L L L i 1 I I_ _ I I � II I I I I . I III III I _ 7 L. I L I I l I . . III , I I I I ; IIIII ,, IIu.III I III � I , L, I, II II IIII ,IIIIIII �i L I .III III I IL I Lyl I. IIIL . � . III . IIIL . I � I , I ,L I _ I , II tI I L .II IIS ..._II II III_ su��lllailllll F I I I ,.. �.131 � Ill ,,:. ,I� illlluilll,�� ,111�:�Illluul�l�,� . .,IIlul <vl�ll IC IIIII, I IIG IlUplll� 124T2IDGE�VOOD�AV$� ' _ IYANNIS MA02601 CAPE COD FIVE_CENTSAVINGBANK= _ �. _ — 53 7107/2113 n. 4 I li' I t^I I I II I I II 1 rr ECK AAA T I I I I I 11 I I L. , III n n s.III...,. ._Il�lllollllll w �lllIIII 111�I I .I �I� I_� lll,lllllll 1 �:nlllll Ilia r NONEHUND:�, ED 'AND 'Ob/100 DQLLA S SWISS PAYJIM 111 — = - - TOWN OF BARISTABLE "g>` n TO THE ta ACME 1NNEEIVMASTEI2 INC III III P I . al 0. BO �.;,.mad ,&......_ t ......, , ..1^.,. ., .� , , G. .. � .. w. _., . . ., . . H . ,. li L_ I :„. ... �� . . ,.�.�,. . . ..r III I.rc�l ,. � ��YA N4 SI L,, 4; IL�MA. 10: (114.r. ,II __ ,� ,�. .<...' w • .s x,:�... .,�. ,. { _.w I II ^ IIIII, , i� ,•.IIIh I�Ii��illllh�.. IIII Illlill��. .IIIII � ..:,I,I �.� III � ,,. <,,, I 11�11 �mia I. Il��l�lllli�ll II II �pUTHORIZED SSGNA 113016413,18 1: 2LL37LO78e: 86 20L5302ur F: Number 600 THE COMMONWEALTH OF MASSACHUSETTS Fee --- $100.00 Town of Barnstable Board of Health This is to Certify that Acme Laundry Company 124 Ridgewood Avenue,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 6/30/2009 PAUL J.CANNIFF,D.M.D. JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health • Town of Barnstable Barnstable 'THE Regulatory Services .Department ®Amtxica i 1ARNSfiABLE Public Health Division 9 IZLQ 639•. 200 Main Street, Hyannis MA 02601 sh39 �� m APF,� A 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. p GV DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT ,�/yl e._ 4'1vt-en.►4-0-s 4� NAME OF ESTABLISHMENT z I v ,An A.+ ADDRESS OF ESTABLISHMENT • TELEPHONE NUMBER �Q 7 7 f 69 p9 SOLE OWNER: YES xN0 T� IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: " CO ,,- s y co w4 IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO."�J y' f(y STATE OF INCORPORATION 4 ae )e FULL NAME AND HOME ADDRESS OF: y PRESIDENT ). D u,,e J, e 7571f M TREASURER & e- 3 . �a Sd • 6 ins � S • Q r� CLERK SIGNATURE OF APPLICANT • RESTRICTIONS: HOME ADDRESS qO QW0nf 0-1"r X HOME TELEPHONE# Q:\Hazmat\Haz Mat Application2008.DOC • ACME LINENMASTER, INC. SPILL CONTINGENCY PLAN - JANUARY` 13 , 2005 •] . Evacuate the immediate area, if necessary. 2 . Shut off valves, pumps , and electrical equipment as appropriate. 3. Remove or restrict any potential ignition source from the area if the material is flammable. 4. Cover or dike all existing sumps, and storm drains if not already covered . 5. Contain the spill by use of absorbent socks/booms, then apply appropriate absorbent material or additional absorbent socks/booms. Contact spill response firms on PAGE 2, if necessary, to assist in these activities . 6. Remove .all absorbed material or contained liquid and package on DOT approved container. Used absorbent materials should be packaged seperately from liquids . 7. Label all containers with the type of waste and the start date of accumulation. 8 . Notify the appropriate agencies and Acme Linenmaster officers as prescribed in PAGE 2. �. Once the spill has been controlled and materials collected and secured, ihspect the area for cleanliness and decontaminate all equipment used in the cleanup. 10. Replace all used materials and ensure all response equipment is in good working condition. 11 . Manage and dispose of collected absorbents and liquid in accordance with Federal and State environmental regulations. 12 . For any spill greater than the reportable quantity or 25 gallons, whichever is less , this plan shall be implemented and proper records of action shall be kept on-site . 13 . Spill clean up equipment is located in the Boiler Room 14. The folboilin'� is a list of the spill equipment on site: a . Spill response kit capable of containing a spill of at least 25 gallons . This kit includes absorbent-materials, socks, and/or booms . b. An adequate amount of chemical resistant gloves, safety goggles, rubber boots and other personal protective equipment. c. First aid kit d. Eye wash • e. Fire extinguishers OVER FOR PAGE 2 EMERGENCY SERVICES •, LOCAL FIRE DEPT. Telephone 911 or 508-775-2323' gll__ or 508-775-1212- LOCAL POLICE- DEPT-= L AMBULANCE SERVICE ? 911 or 508-775-2323 - , LOCA NATIONAL RESPONSE CENTER 1-800-424-8802 Local DEP Office 508-646-2850 Advanced Liquid Recycling 203 238-6771 Clean Harbors 517-93.5-9066 ' or.. 697-849-1800 "ACME' LINEN14ASTER OFFICERS: 5-G9 -3�6 _ *$ Kevin Eldredge 508--S-30�2--� .508'-255-7522 Charles Dow n t s �1 III G I I .. lll�ll 11 .1 I pal" III I.I X16 x .a �. II I.I ,. 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' _,� ��.��"��:>:�.�'WLV��iJ�Ltl r7"ll.�O.L-�it, — '� ;3� k4 'y r� a ✓r,t W, "b'.°�'�:r vN'" ,v +sY'��: .�r '-� b. F'""rrs'="^� "��L,f *,.• .. �y a�i.:��w'`"'�`�9.��y' _,.c �`"�:s=ter=.�.��---z ��,"-.'7,dt 4 9�t �° ,=!,ti�� '�s/ 'tr y y ��• zk.'^..�4�'� °�`��' ,..�&'ro.,, ,ti'' T .Y�`z � r t �:»Pf�i-� ��_�-----= P$��•� "BQ,�1 tl��`�'c'a3 r.= � -.��i,eta>S _s,, w:.a.g a k': ,y�, "�:a�' ` x:< : ..,a: .?a ,a.,.q h � :•` �. ,�� .";,,� �«��`� `� �� »� � �. ��. . �. '*� � ACME NENMASTEii,INC w ,�. �'=7 ..�'� .aS. �°'+m- e dv 3,. Mro 1 •u„•. ^x 3 &+ >.<v. /•"4as"3,+\:7,far k ..'`� �`^�..r^.h.',:s.: u � n, ,,.. .. ., 1:,. If,l .." �. I:.a. .,. ,. L. 1 ,,. U., v ,..^k._. a .-7•.�., ... .. ,.,.,. <W,a.E. �:: .PRm.-. re I .�. .. ..� I:.. R .e -y.. :.,. .•:. r .. y,�; ..., .+ w z"` r':4i I :� � x� », II.. III.; -., ,... `rn :. S ._'£`. e,4 3x>.'&M1'"."'$.. w.ti..-.&?n..Y:'"r, �>•,n,. ..�....a 4 'M;;`t I I I I L AT'A � �I .SIGNURE � Also m``,,w?.a;.f..v'f§�Y,�a„R_*v.,,ati��'�:a„'�z 11'OLS It,611' 1: 211370545ll: LOL034. L5.4 Lill It, � • Number Fee 600 THE COMMONWEALTH OF MASSACHUSETTS $100.00 v Town of Barnstable Board of Health This is to Certify that Acme Laundry Company 124 Ridgewood Avenue, Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ---------------------------------- ------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 30, 2009 unless sooner suspended or revoked. - ------------------=-------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 07/01/08 JUNICHI SAWAYANAGI i, THOMAS A. MCKEAN,R.S.,CHO Director of Public Health 1� i . Town of Barnstable Barnstable 'THE Regulatory Services Department !.� o, ;erisaC"i BARNSTABLE ; Public Health Division 9c� ,` 61 200 Main Street, Hyannis MA 02601 Ar f p MA'S 2007 Office: 508-8624644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. 3aI DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT 14m %At�K hvu S � l►�:� NAME OF ESTABLISHMENT &IMA-- �cn.✓ d� (� �'��Z ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER SO k— 77 6'q" SOLE OWNER: YES X, No GV Q2. (tea Se IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS O ALL w PARTNERS: o W IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION A5:S 4--a li+its FULL NAME AND HOME DRESS OF: PRESIDENT P-✓'11 Pt .F-Yi e TREASURER l" 77 d v e ev CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS - 0"'t S HOME TELEPHONE# Q:\Hazmat\Haz Mat Application2008.DOC ACME LINENMASTER,INC. VENDOR: 000000010061 06/23/2008 CHECK NO. 14149 6868 000000000006868 06/17/08 100.00 100.00 .00 100.00 Check Total 100.00 } 'I . ,�. I. ,. L.. I ..I. � _... a. � : HE a, I I.C CKNO. .u.-CH ! ill ECK D TE I a V : I ..,....i. i I.. NUORNO.. .1...,.� I � L � I. ii i I. I�. .�:. I I .......:.. u,II �I I. u Il,ll�I�l ,I I.II.,,,.: 01I;I 0-0...,...........6I 11I 11 I�1:„I I�lLill��:�I:iIl:,u:I l._;.,,..._...:II I I III I 1II..-,...�.:1:I�I Iu:�,.�1,LI��iL......,,!:VIII I II II�I,.y,I III.L�I�.�:LI�,..,!..I,:I I II 1,II I1I II�:,......,__,.,:.1i,I,�i III Il 1l,1 IIII t1...,..__.-.:.::,.I,�1LI�.I.L��1l 1I_,_....."lu1I.I lI�!��I�.L ILA_,.:.•1,:II��.�1I��,I��.,.,.I l lIl��IIlllL-.,._.I,h:lI..I Il.IJ I,I�:lLL..I..:._,...,..,"...-.-.,-_.�,.I1 I�.,II�IIII,C.,,,.I,i�HEI I�,K.,;�II,�NIIII,IO itI II.,I� AC!'I 06LINENMAS R,,IIIIN unI.' lt;il.l �I I�� k IIIIUII'I�� RIDGEWOOD AUE — IIYANNIS MA 02601 08anCcn6rth,WA — - — - _• 53-545l211 � a i''IL-', ! �PII�„ dlpl n ,i'.` , , ,nII Ilinelll III.• I , !. . IPII�i, I I, I' 1,II{ . CHECKzAMOUNI IN I100/I,110.OId�I,DOLL Z�S ,, „ ,,.II II• II,,I ... ,: I .:x I'lll I ,�i� I I•. { ,�., - IIL .I1�., ..I .. L. : �ILI L n In I _I II el,ll:,l I,I,ILIII II, a uI..I. i I 6:1 II .III ,1. h a l t I IIII 11 �.; ti. 1 _� •��I: ..: �, 1. I I :. �. 1 I..I :- I I.. :.. .<",� :t•: a I.. ill .: �i.ilb-... I ...!!�. , I._ I l 100..00 I, ��I- 1 I 011�llk, �1I II�' I,IIII' VII Itll Ill' hmll I 11I IIII=11'illl��ll sl l�l il! IilIII�iII I),Ill,•--yllli I,Illlillll PAY �0W-M, �'AAI�STABLTr F _ I _ f -P TO THE n AC INE TER,INC ^IIII y.:l p l4 11 I�`,�. 'II!:.. .Ili y:11115 I I., I 1,.. .,,IIIP,._ z; .,, .,.,+, .. iI:II I. „s..-, II. all al -.,I I: ,i,�,.. -., „.:III,,.. !I ,. a (..._ 1J.L: :Ii.dl ,I I !, ..IIII: .L; II II !I a I X I !RD.ER„OF ,11,!I J,III! 11, .!III d, II. II. ullnl.>:II I, n, LII I .,�. l iil 1<•�iI! I . I'.: ,II I Ili i II „! I,,IIII JI„h r-. I , I, .q I iI.,,II�.. :.III,,.III .,Ill.. II. I�. lilld,, V lIl I L.III.I I�IM�1.02,601 I L. �.../� I ( I I11II.. 1 all• I, I �-I ,it :.1� I ,.L1 r1 I:, ,; I. I I I .I,, 1 ".;ILI._ ! .I 1 ., I a . � ...., { ,>,.-,. � ,.:, IlII L,,... 1 ,. III,1 _11 .,,��..II L. ,I��III i ,,1y�,� I� ..I.II n i�,JL.. III ..,I ,il�,l,I,,I Illi Il I I �.,;�:�..` ^., :. - :,.,,., a. .•:a, 111, .'-�ll l .,lv�,.':�I�I.,IIiI�I t�I USA',u':�I L.- L. Irn,,Il, III II.,II III;-�., IIII�I'l'.. �I IIIII-'li�,l-. -Ilp,I I�.I:III'IIIIIII °•,.: I:'�., t. .'a^-. „�:, dl II',IIIII!III'�,. ,,Idlll l lllu}!Igl�.!. a,Il�,l'� !li,;h,ll dl `1!'�I!��IIIIIIII1�1In I II`;i;; '111,,III,II �I IIIVi':IIJI!VL�l�ll :s �``Y AUTHORIZED SIGNATURE ��'014 L4911' 1: 2113705451: 101034 154 1�i' Number Fee 600 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Acme.Laundfy Company 124 Ridgewood Avenue, MA. 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 30, 2008 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. 7/1/2007 PAUL J. CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health all "'.- -1, 4 010DATE 3K ° t NO 4964 y �� 53 RECEIVED FROMAl I g ADDRESS = t, ic1 aD cc DOLLARS'$ ❑FOR RENT; ❑FOR 3 - - �� AMT.OF L E ACCOUNT CASH ., IIr AMT.PAID CHECK ti = BALANCE DUE Town of Barnstable Regulatory Services Thomas F. Geiler,Director >>NAS& ' Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508?790-6304 Application Fee: $100.00 L.-- -:r N Cf) C-n . CQ --j ASSESSORS MAP AND PARCEL NO. ��lc� DATE a-/ 4 1 :V. %> tv r w rz APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT 4c-iw+ e L- '&i e-v\rn a S Vim' I 44-c' NAME OF ESTABLISHMENT /C W+< /�tw*� r ti (� v-x n _ ADDRESS OF ESTABLISHMENT �d �y e-.vita d TELEPHONE NUMBER 5-6 79 6 f)-J SOLE OWNER: YES _,XNO Ae-. IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENL,T�I,FICATION NO. STATE OF INCORPORATION FULL NAME ANP,HOME ADDRESS OF: PRESIDENT *e-✓ice (1,16 f w 4 TREASURER CLERK �^ 'SIIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS `7S� �� 0 6-�e�" S HOME TELEPHONE# iL ° ACME LINENMASTER, INC. SPILL CONTINGENCY PLAN - JANUARY' 13 , 2005 1 . Evacuate the immediate area, if necessary. 2. Shut off valves, pumps, and electrical equipment as appropriate. 3. Remove or restrict any potential ignition source from the area if the material is flammable. 4. Cover or dike all existing sumps, and storm drains if not already covered . 5. Contain the spill by use of absorbent socks/booms, then apply appropriate absorbent material or additional absorbent socks/booms. Contact spill response firms on PAGE 2, if necessary, to assist in these activities. 6. Remove .all absorbed material or contained liquid and package on DOT approved container. Used absorbent materials should be packaged seperately from liquids . 7. Label all containers with the type of waste and the start date of accumulation. 8. Notify the appropriate agencies and Acme Linenmaster officers as prescribed in PAGE '2. 9. Once the spill has been controlled and materials collected and secured, imspect the area for cleanliness and decontaminate all equipment used in the cleanup. 10. Replace all used materials and ensure all response equipment is in good working condition. 11 . Manage and dispose of collected absorbents and liquid in accordance with Federal and State environmental regulations. 12 . For any spill greater than the reportable quantity or 25 gallons, whichever is less, this plan shall be implemented and proper records of action shall be kept on-site . 13 . Spill clean up equipment is located in the Boiler Room 14. The folboVin6 is a list of the spill equipment on site: a. Spill response kit capable of containing a spill of at least 25 gallons . This kit includes absorbent-materials, socks, and/or booms. b. An adequate amount of chemical resistant gloves, safety goggles, rubber boots and other personal protective equipment. c. First aid kit d. Eye wash e. Fire extinguishers OVER FOR PAGE 2 • EMERGENCY SERVICES LOCAL FIRE DEPT. Telephone # 911 or 508-775-2323 LOCAL POLICE DEPT. if 911 or 508-775-1212 LOCAL AMBULANCE SERVICE q 911 or 508-775-2323 NATIONAL RESPONSE CENTER " 1-800-424-8802 Local DEP Office 508-946-2850 Advanced Liquid Recycling 203-238-6771 Clean Harbors 617-935-9066 or 697-849-1800 ACME LINENMASTER OFFICERS: Kevin Eldredge 508-430-1237 Charles Dow 508-255-7522 Town of Barnstable '"E rati Regulatory Services Thomas F. Geiler,Director * RUWSMLE, •MAI% ic Health Division 1639. 10 'OrFnMo�e Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Wayne Miller,M.D. Fax: 508-790-6304 Sumner Kaufman,M.S.P.H. Paul J.Canniff,D.M.D. NOTICE TO ALL BUSINESS OPERATORS WITH HAZARDOUS MATERIALS IN BARNSTABLE The Town of Barnstable Town Council adopted, Chapter 108: Hazardous Materials, a requirement-for each business operator.-to obtain an annual permit and,.,,-; -, to,remit a fee`of$T00 00 f one`hundred and eleven (111) gallotls or more'of 4 liaza'rdous materials are stored transported; utilized,;and/or disposed of"at a particular site. Please complete the attached application form and submit it along with the required fee of$100.00 to this office on or before June 30, 2007. A late charge of$10.00 will be assessed if payment is not received by July 1, 2007. Checks should be made payable to the: Town of Barnstable. Upon receipt of the fee and a completed application form, an inspection will be performed by the Hazardous Materials Specialist to complete the Hazardous Materials On-Site Inventory. A permit will be issued once the inspection is completed and has passed. Please feel free to view the above Code, Chapter 108: Hazardous Materials on the Town Website, w«ul.town.bamstable.ma.us , which is located under the E-Code section if you should have any questions or concerns. Q:1Hazmat\Haz Mat Permit Letter.DOC �a Number Fee 600 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Acme Laundry Company 124 Ridgewood Avenue, Hyannis,MA 02601 _ Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ---------------------------------------------------------- ------------------------------------------------------------------------- -------------------------- �N -------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 6/30/2012 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2011 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health j iG� 1d0 Ob (o)2Zl�0I i Town of BarnstableG . �1HE Regulatory Services ti Thomas F. Geiler,Director BA MASS.LE, ' Public Health Division 9� 11K6A3.S9S. �EDPM'�A Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. 328214 DATE o 6/2 o12 n i l APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT Acme L i n e n m a s t e r , T n r . NAME OF ESTABLISHMENT Acme Laundry Company ADDRESS OF ESTABLISHMENT 12 4 Ridgewood Ave . Hyannis TELEPHONE NUMBER 5 0 8-7 7 8-6 9 29 SOLE OWNER: YES__X_NO we lease the property. !�w ARPLICAN IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL *ART-NERS: s0 c� as � ttF APPLICAA'TIS A CORPORATION: FEDERAL IDENTIFICATION NO. 0 4-3 4 0 0 16 8 STATE OF INCORPORATION Massachusetts FULL NAME AND HOME ADDRESS OF: PRESIDENT Kevin P . Eldredge 79R Main street- _ Chatham TREASURER Charles B. Dow 450 south orlpanG Rd - Rn - nrleans CLERK Kevin P. Eldredge SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS 4 5 0 So , Orleans Rd . s o . . O r l e a n s HOME TELEPHONE# 5 0 8-2 5 5-7 5 2 2 Haz.doc/wp/q f J Town of Barnstable 1ME t ,,oFti Regulatory Services Thomas F. Geiler, Director • BARNSTABLE, 9Q MASS. �Q Public Health Division v 1639. ArFo `�A Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Wayne Miller,M.D. Fax: 508-790-6304 Paul J. Canniff,D.M.D. Junichi Sawayanagi NOTICE TO ALL BUSINESS OPERATORS WITH HAZARDOUS MATERIALS IN BARNSTABLE The Town of Barnstable Town Council adopted, Chapter 108: Hazardous Materials, a requirement for each business operator to obtain an annual permit and to remit a fee of$100.00 if one-hundred and eleven (111) gallons or more of hazardous materials are stored, transported, utilized, and/or disposed of at a particular site. STEPS 1 — 2 - 3: 1. Please complete the attached application form 2. Include a copy of your contingency plan (to handle hazardous waste spills, etc.) 3. Submit the fee of$100.00 payable to the: Town of Barnstable. MAIL all of the above to this office-on or before June 30, 2010. A late charge of$10.00 will be assessed if payment is not received by July 1, 2010. Upon receipt of the fee and a completed application form, an inspection will be performed by the Hazardous Materials Specialist to complete the Hazardous Materials On-Site Inventory. A permit will be issued once the inspection is completed and has passed. Please feel free to view the above Code, Chapter 108: Hazardous Materials on the Town Website, www.town.barnstable.ma.us , which is located under the E-Code section if you should have any questions or concerns. QAHazmat\I-laz Mat Permit Letter.DOC ACME LINENMASTER, INC. SPILL CONTINGENCY PLAN - JA.NUARY 13 , 2005 1 . Evacuate the immediate area , if necessary. 2 . Shut off valves, pumps , and electrical equipment as appropriate. 3 . Remove or restrict any potential ignition source from the area if the material is flammable. 4. Cover or dike all existing sumps , and storm drains if not already covered . 5 . Contain the spill by use of absorbent socks/booms, then apply appropriate absorbent material or additional absorbent socks/booms- Contact spill response firms on PAGE 2 , if necessary, to assist in these activities . 6. Remove all absorbed material or contained liquid and package on DOT approved container. Used absorbent materials should be packaged seperately from liquids . 7. Label all containers with the type of waste and the start date of accumulation. 8. Notify the appropriate agencies and Acme Linenmaster officers as prescribed in PAGE 2 . 9. Once the spill has been controlled and materials collected and secured, inspect the area for cleanliness and decontaminate all equipment used in the cleanup. 10. Replace all used materials and ensure all response equipment is in good working condition. 11 . Manage and dispose of collected absorbents and liquid in accordance with Federal and State environmental regulations . 12 . For any spill greater than the reportable quantity or 25 gallons, whichever is less , this plan shall be implemented and proper records Of action shall be kept on-site . 13 . Spill clean up equipment is located in the Boiler Room 14 . The foljovjn'� is 8L list of the spill equipment on site: a. Spill response kit capable of containing a spill of at least 25 gallons . This kit includes absorbent°`materials , socks, and/or booms . b. An adequate amount of chemical resistant gloves , safety goggles, rubber boots and other personal protective equipment. C. First aid kit d . Eye wash e. Fire extinguishers OVER FOR PAGE 2 LOCAL FIRE DEPT. Telephone # 911 or 508-775-2323 911. or 508-775-1212 LOCAL POLICE DEPT. - 911 or. 508-775-2323 LOCAL AMBULANCE SERVICE ° 1-800-424-8802 NATIONAL 'RESPON SE CENTER ER Local DEP Office 508-946-2850 Advanced Liquid Recycling 203-238-6771 617-935-9066 Clean Harbors or 697-849-1800 . ACME LINENMASTER OFFIC ERS: �G9 aa Kevin Eldredge 508-^ 7 Charles Dow 508-255-7522 tt^ Number Fee 600 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Acme Laundry Company 124 Ridgewood Avenue, 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 J Town of Barnstable �p1HE Regulatory Services Thomas F. Geiler,Director MANSCS. Public Health Division °TFa iwa� Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-63 04 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. 3 DATE 13.h APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAAn OF APPLICANT C4v%e NAMM OF ESTAB7,ISMgH',NT `►,e 1/ k^ti Lo w, n wyl ADDRESS OF ESTABLISIINffNT I P"4 eLrAfevdl. Ave . /��/A+i+KS� TELEPHONE NUMBER �U� '-7-7 —( I):9 SOLE OWNER: YES K NO t/e- �-a se- 'f�e. 7' rv�� IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT 1? 6 lc[.,--d S /?a Sv.. TREASURER G �a,�-4 �3 c w �f� SaW 4, Sv, CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDREss D�-1�4 M 5_pc(, S� 6✓ !e 4%S HOME TELEPHONE# s'a if- a sue'-W I Haz.doc/wp/q MAIL-IN REQUESTS Please mail the completed application form to the address . PP below. In addition, please include the required fee amount. Make check payable to: Town of Barnstable. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. In addition, you must mail the required fee amount (see fees at bottom of this page). Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. For further assistance on any item above, call (508) 862-4644 a I I I I i i I I I i i I I Number Fee 600 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Acme Laundry 124 Ridgewood Ave, 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 va Town of Barnstable (y Ft►+e�o,,ti Regulatory Services Richard V. Scali, Director i ♦ i 9 S&LE, Public Health Division 16309. 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. 3 2 91DATE 10 20 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT k4nno, a UCLii, I I L in-� (V ca. (11,, C•�.�,A, NAME OF ESTABLISHMENT Ln e- ka(A 1,4, ADDRESS OF ESTABLISHMENT _ TELEPHONE NUMBER �j 7 7-9 -6 29 Ua SOLE OWNER: YES xN0 ln/e- ( 52 r- -�- I�aAPPEICANT FS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL $�i�RT1 A RS: C-) + IF APPLICANT IS A CORPORATION FEDERAL IDENTIFICATION NO. g9` STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK e SIGNATURE OF APPLICANT 1 RESTRICTIONS: HOME ADDRESS-5 Fie c ce S t 6-s j HOME TELEPHONE# 50$-S 9 6-h u w Q:1Application FormsUiAZAPP.DOC r i • MAIL-IN REQUESTS Please mail the completed application form to the address below. Also include a copy of your contingency plan (to handle hazardous waste spills, etc). In addition, please include the required fee of$100. Make check payable to: Town of Barnstable. Allow five to seven (7) working days for in- house processing. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax us a copy of your contingency plan (to handle hazardous waste spills, etc). In addition, please mail the required fee amount of$100.00. Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow up to four days for in-house processing. For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page i I Q:\Application Forms\HAZAPP.DOC Number Fee 600 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Acme Laundry Company 124 Ridgewood Avenue, MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 30, 2007 unless sooner suspended or revoked. --- --------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. June 12, 2006 PAUL J. CANNIFF,D.M.D. THOMAS A. MCKEAN,R.S.,CHO Director of Public Health ACME LINENMASTER,INC. VENDOR:" 000000010061 06/06/2006 CHECK NO. 12056 • • RommFi7mmou .i pfflsmi/ • • • • DISCOUNTTAKEN • 3926 000000000003926 06/06/06 100.00 100.00 .00 100.00 Check Total 100.00 f h Town of Barnstable rQ - Regulatory Services 4 °° Thomas F. Geiler,Director Public Health Division } y 4 p z @/�///��1 1p Thomas McKean,Director .. ....... + °rt.:.<"� 200 Main Street, Hyannis,MA 02601 Office:`508-8624644 Fax:.508-790-6304 . Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. ��/ DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT G- f4A VK_1- t U r NAME OF ESTABLISHMENT PA Q ADDRESS OF ESTABLISHMENT =� ��r .eWea 11-_"C' TELEPHONE NUMBER �z t- '7 -SOLE OWNER: YES NO ---� IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL i PARTNERS: r I a IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO.. � STATE OF INCORPORATION_�/7 Q S�-i C_ �'51e FULL NAME AND HOME ADDRESS OF: 1 PRESIDENT Kt IA e Zd �rV A-wit V,2 / TREASURER e q Sa o - LICAv� CLERK w. F_(4-•czc�,o SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS 6, HOME TELEPHONE-# Sa &- S, Hszdow'wplq, MAHAN REQUESTS Please mail the completed application form to the address below. Also include copies of your employees food sanitation training certificates. In addition, please include the required fee amount (see fees at bottom of this page). Make check payable to: Town of Barnstable. Allow five to seven (7)working days for in-house processing. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax copies of your employees food sanitation training certificates. In addition, you must mail the required fee amount (see fees at bottom of this page). Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow up to four days for in- house processing. For further assistance on any item above, call(508) 862-4644 Back to Main Public Health Division Page