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0160 ROSARY LANE - HAZMAT
,/Cv �O�n�ar C.../���ly�tn r �s . �- �'" , '�� �;' � � _ �� . .. .. `::F E -. � :� . �.. d _ � F - .. u� .[ .. �. i r , COMPLETE • • ON DELIVERY ■ complete items 1,2,and 3. A. Signature ■ Print your name and address on.the reverse X ❑ gent so that we can return the card to you. SL Addre ee ■ Attach this card to the back of the mailpiece, 13.Rece•ed by(iPi'nin edjNe) rve or on the front if space permits. u t/ ice- (,( 1�. _ D. Is delivery address different from item 1 ❑Y • If YES,enter delivery address below: ❑No CAPE COD MARBLE & GRANITE ATTN: HARLEY SILVA 38 ROSARY LANE HYANNIS, MA 02601 3, Service Type ❑Prio'rity Mail Express® II I IIIIII III III(III III I I I I(�II I I I I I 111 H ❑Adult istered MailTM CertifieSignatured Made Restricted Delivery ❑Re11 gistered Delieared Mail Restricted ry 9590 9402 3630 7305 4608 09 ❑Certified Mail Restricted Delivery fignature etum Receipt for ❑Collect on Delivery erchandise n__r_ n ry Confirmation2, Article Number(transfer from sen!ce.labPn -- ery Restricted Derive ,� w t s ` ❑Signature Confirmation 7 015 17 3 0 0 0' 4 9 9 0 5 7 3 2 S r I tricted Delivery Restricted Delivery er PS Form 811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt U§RkTR;.A Iizlc�. First-Class Mail Postage&Fees Paid C1SPS Permit No.G-10 I 9590 9402 3630 7305 4608 09 I United States •Sender:Please print your name,address,and ZIP+4®in this box* Postal Service Town of Barnstable I=j Health, Division oY 200 Main Street I Hyannis,MA 02601 I I� I _ -0 �. f`- CO OFFICIAL USE CO CO Postage $ fL Certified Fee ¢ C3 /FOf Retum.ReceiptFee / 0 (Endorsement Required) /M Restricted Delivery Fee ^tj40 (Endorsement Required) �O O Total Postage&Fees $ _ ! N Sent To eCe�fYla�b/e ,� k4-1 � ---------------------- --------------- Sneet apr.N.; 39 65a- 1 e �� or PO Box;No. City,State,ZIP+4 ' I Certified Mail Provides: ra A mailing receipt a A unique identifier for your mailpiece Y A record of delivery kept by the Postal Service for two years Important Reminders: a Certified Mail may ONLY be combined with First-Class Maile or Priority Maile. a Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the, fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. a For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking.-If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN.7530-02-000-9047 D © • q ru Ln o Er Certified Mail Fee -r Extra Services&Fees(check box,add fee as appropriate) �tits, ❑Return Receipt(hardoop» $ - Q ❑Return Receipt(electronic) $ Postmark j O ❑Certified Mail Restricted Delivery $ Herep ❑Adult Signature Required $ (� 1 +l U ❑Adult Signature Restricted Delivery$ O Postage Total Postage iCAPE COD MARBLEC&GRAN ThE ul $ ATTN: HARLEY S VA"�- � Sent To o sl:eelandapt:' 38 ROSARY LANE HYANNIS, MA 02601 City,State,ZIPi �• :•� .. • •. ••r r• t - Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the ■A record of delivery(including the recipient's retail associate. signature)that is retained by the Postal Service- Restricted delivery service,which provides for a specified period. delivery to the addressee specked by name,or to the addressee's authorized agent Important Reminders; Adult signature service,which requires the ■You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mail®;First-Class Package Service®, available at retail). or Priority Mail®service, Adult signature restricted delivery service,which ®Certified Mail service Is notavailable for requires the signee to be at least 21 years of age International mail. and provides delivery to the addressee specified 1 ■Insurance coverage Is notavailable for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the a To ensure that your Certified Mail receipt is Insurance coverage automatically included with accepted as legal proof of mailing,it should bear a- certain Priority Mail items: USPS postmark If you would like a postmark on e For an additional fee,and with a proper this Certified Mail receipt,please present your , endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for the following services- postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label,affix it to the mail piece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. j electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return - Receipt attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records. PS Form 3800,April 2015(Reverse)PSN 7530-02-000-9047 IKWE Town of Barnstable Office:508-862 4644 Public Health Division Fax:508-790-6304 BARMSfkq ` 200 Main Street• Hyannis, MA 02601 �ArFOMAy�`0� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: �� A" a UvAef Date: Alt t 10 Location/Mai ling Address: D 6L: avvi A' 16 tAA ti Contact Name/Phone: 10 22-- 1,$1 21 5 Inventory Total Amount. l SDS: 041wt-- License#: Tier II : o Labeling: O Spill Plan: � Oil/WaterSeparator: Floor Drains: o Emergency Numbers: " Storage Areas/Tanks: & ,b1 X b V,,.,,pA- o A. g,A, Emergency/Containment Equipment: Waste Generator ID: 0 Ilk 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 Z-%tat 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 V 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: �Q Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS