HomeMy WebLinkAbout0429 SOUTH STREET - HAZMAT f�7y �Sok�h ,5f �e t
TOW OF C3ARNSTAt3LE COMPLIANCE: CLASS: '1. hlarine,Gas Stations,Kepair
' Q satisfactory � 2. Printers ,
LTM. R D " OF .I-IFALTH 4 {auto Body Shops
Q unsatisfactory- . lanufacturers
COMPANYS 'n (see"Orders") S. Retail Stores
COMPANY SAXA00)
6. Fuel Suppliers
ADDRESS ' � o Class: 7. Miscellaneous
QUANTITIES AND STORAGE 0 . Indoors; OUT-outdoor:
MAJOR fU1TERIALS • Case -lots Drums ' AboveTanks Undetgro.i:nd Tanks
[� �tI N QUT 1ti ��11Qas_ Age Cs�S'
Fuels:
Gasoline, Jet Fuel (A)
Diesel, Kerosene, 12 (B) ,
Heavy Oils: -N
r'
'waste motor oil - (C)
new motor oil (C)
transmission/hydraulic
Synthetl.c Organics:
degreasers
•Niscella eons•
A
b
DISPOSAL/RECLAMATION REM US:'
1. Sanitary Sewage 2_ Water Supply
QTown Sewer 0 Public
Q on-site Q Private e
3. Indoor Floor Drains: YES NO
Q Holding tank: MDC _
O Catch basin/Dry well
QOn-site system
4. Outdoor Surface drains:YES NO
HoldinL tank: MDC ,
Catch basin/Dry well _.
QOn-site system .
S. Waste Transporter
Licensed?
Aim""aulDr.. - Destination Waste Product YES t_NQ_
V �U tt��Jj� le
u 23 01 arson s Int.erviewe pector at
TOW6 0.F BAR NSTABLE COMPLIANCH:" CLASS; 1. Marine,Gas Stations,Kepai.r
Q satisfactory 2. Printers
R D . 0F' HEALTH 3. {auto Body Shops
Qunsatlsfactory- 4. manufacturers
COMPANY �I7(�'� L +l/ti4' ) �� �J; ; f) (see"Orders") S. Retail Stores
6. Fuel SupFliers
ADDR@SS ` z%V,' 7;T0, ! Y�PPl J� Class: 7. Miscel Ianeous
1
QUANTITIES AND STORAGE (IN=indoors; OUT=outdoor.
MAJOR MATERIALS • Case - lots Drums AbclveTanks Undetgro.i►od Tanks
iii_ �f 1CL 4llZ _id_ ____5_gallons 9Y� Cs�S
Fuels:
• Gasoline, Jet Fuel (A)
Diesel, Kerosene, 02 (B)
Heavy Oils: ,-
waste motor oil - (C)
new motor oil (C)
transmission/hydraulic
`Synthetl.c Organics:
degreasers •
.Miscellaneous:, _
DISPOSAL/RECLAMATION MUMS:'
1. Sanitary Sewage 2. Water Supply y> 1 r r / ry
QTown Sewer Q Public T /C.t� J��(.,� / �. /,, !C� �A ) ' ! l � �,+ f•
O On-site Q Private. PV, )/ i 'rf iC�l ,f) /)[-'_ti� �1
3. Indoor Floor Drains: YES NO !-J � I iti ski/ii 1I Sell,J'i '�01/''��'
Q [folding tank: MDC 1, .r
Catch basin Dry well AN�J f> �� �,�7 _ ) (f.i''.�
1
On-site system
4. Outdoor Surface drains:YES NO
Q Nuldint tank: MDC .
O Catch basin/Drywall
0 On-site system
S. Waste Transporter Licensed? I
11s2m E iic3111�» Destination- .111aste Produ= -YES-1 NO
210.
1
f' T
u e► erson s ;Int.erviewe Inspector `'Date '
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
��u� /: ��� Mail To:
NAME OF BUSINESS: J 0 A � � o Board of Health
MAILING ADDRESS: Town of Barnstable
TELEPHONE NUMBER: 77,1 /�rl�ty P.O. Box 534
Hyannis, MA 02601
CONTACT PERSON: 3J4& y
Does your firm store any of the toxic or hazardous materials listed below, either for sale or for
your own use, in quantities totallin , 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
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 Refrigerants
Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides,
Other petroleum products: grease, lubricants rodenticides)
Degreasers for engines and metal V Photochemicals (fixers and developers)
Degreasers for driveways & garages Printing ink
Battery acid (electrolyte) Wood preservatives (creosote)
Rustproofers Swimming pool chlorine
Car wash detergents Lye or caustic soda
Car waxes and polishes Jewelry cleaners
Asphalt & roofing tar Leather dyes
Paints, varnishes, stains, dyes Fertilizers (if stored outdoors)
Paint & lacquer thinners PCB's
Paint & varnish removers, deglossers Other chlorinated hydrocarbons,
Paint brush cleaners (inc. carbon tetrachloride)
Floor & furniture strippers Any other products with "Poison" labels
Metal polishes (including chloroform, formaldehyde,
Laundry soil & stain removers hydrochloric acid, other acids)
(including bleach) Other products not listed which you feel may
Spot removers & cleaning fluids be toxic or hazardous (please list):
(dry cleaners) —
Other cleaning solvents � --- `
Bug and tar removers
Household cleansers, oven cleaners
White Copy- Health Department/ Canary Copy-Business
TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
nters
BOARD OF HEALTH satisfactory 3.2.Auto Body Shops
�7 unsatisfactory- 4.Manufacturers
e19Mf- ',h w U/�.e9S/!.1 (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS :.c V .fee �S`� CjBSS• 7.Miscellaneous
QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors)
MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks
IN OUT IN OUTI IN OUT #&gallons Age Test
els:
soline,Je el (A)
Diesel, Kerose , 2 .B)
i. waste umotpw"C)
ne motor oil (C)
transm' si ydraulic
Synthet' rganics:
degr sers
ellaneous:
DISPOSAURECLAMATION REMARKS:
V/1. Sanitary Sewage 2. Water Supply / 0UOd l
Town Sewer Public .�
O On-site OPrivate
V3. Indoor Floor Drains YES NO
O Holding tank:MDC `
O Catch basin/Dry well
O On-site system
L/4. Outdoor Surface drains:YES NO ORDERS:
O Holding tank: MDC
O Catch basin/Dry well
O On-site system
✓15.Waste Transporter
Name of Hauler Destination Waste Product
v 2.
Person (s) Interviewed Inspector D afto