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HomeMy WebLinkAbout0181 SPRING STREET - HAZMAT 1�`� �� � � �, �n�s -� � � ��� � L / � P`°F� ►owti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMAT,'; E.$' 200 Main Street• Hyannis, MA 02601 , �A t639.6 �fOMP� TOXIC AND HAZARDOUSMATERIALS INSPECTION REPORT Business Name: CoG Date: Location/Mailing Address: 1 _ Contact Name/Phone: — -7� Inventory Total Amount:•_ SDS: License#: Tier II : Q Labeling: re4,11 Spill Plan: k — 61C Oil/WaterSeeparator: Floor Drains: �� Emergency Numbers: Storage Areas/Tanks: V Emergency/Containment Equip entent: op",nol c ` i Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: N I Licensed Waste Hauler&Destination: mP 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 PN Up Gasoline,jet fuel, aviation gas Cesspool cleaners c�lnc -a� 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/RE OMMENDATION : 004 :J)QM qXll Plax,.lot i haa op Inspect Facility Representative: ` WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS °p IME row ' Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-7s0-6304 •1EA ASSELE.MASS. ' 200 Main Street• Hyannis, MA 02601 \\� i6 q. 0 A 3 a\ 'EDMP� I AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: 144rathIcs Date: 141 Location/Mailing Address: TKI SPdhiA $ Contact Name/Phone: ��7 Inventory Total Amount: «5 SDS: UK— NIA License#: 13 Tier II : O Labeling: L Spill Plan: LAP s Oil/Water Separator: on Floor Drains: up Emergency Numbers: 'Jes Storage Areas/Tanks: V► A Emergency/Containment Equipme t: Waste Generator ID: 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 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 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: lJ W dVdi Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS °F IKE ro/%ti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 e" MARM`E�,' 200 Main Street• Hyannis, MA 02601 i639 M TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rFD P'� Business Name: 111COD©vl I L47 Date: 1 I 1 ! Location/Mailing Address: 1 Contact Name/Phone: W f O J ®1 J" InventoryTotal Amount. �� �� SDS: License A- Tier II : tli C Labeling: Spill Plan: Oil/WaterSeparator: Floor Drains: Emergency Numbers: Storage Areas/Tanks: Emergency/Containment Equipment: Waste Generator ID: Waste Product: Date&Amount of Last Shipment/FrequencX: 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: o v-1l t�wv►�L ,�,ino1 Caulk/Grout insecticides herbcidds 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 ,� Q Miscellaneous Flammables Fertilizers 0<J 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. v 00 Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS IB�oyti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 T BpBN SABLE.g' • 200 Main Street• Hyannis, MA 02601 �639 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rF0 MPS s r �1 Business Name: �..-•,.�'<-. � ��� i a aJ,,A 'i •'• Date: I �i Ik Location/Mailing Address: 10 I 54' —7•'VioN1wg m Contact Name/Phone: J J 11 11 , 11 ;v I ,IA. D, Jilt ,/� Inventory Total Amount: q C, SDS: License#: r 1 A Tier II : �i c Labeling: Spill Plan: Oil/WaterSeparator: Floor Drains: Emergency Numbers: Storage Areas/Tanks: Emergency/Containment Equipment: Waste Generator ID: 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 V Pesticides: t,�`j A 6,1 tom-A- 1-10`' 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 f� Miscellaneous Flammables ✓ Fertilizers D<J Floor&furniture strippers PCB's �� 5 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: r D J J i,-)I 1 AS�ACr I y V\- , t � Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS S C04 !f I ! 3 7 Old Date: TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM,, NAME OF BUSINESS: CCarx(, cl Hv{;Q(�U�(!ij ��a BUSINESS LOCATION INVENTORY MAILING ADDRESS: i �l (Sp r Ji q L�l t4yCdJl 1j ij TOTAL AMOUNT:: TELEPHONE NUMBER: ) - CONTACT PERSON: (. � 1 ,ul1 EMERGENCY CONTACT TELEPHONE NUMBER: - 7 3`1 " c�sSS MSDS ON SITE? TYPE OF BUSINESS: �6ct k*I INFORMATION / RECOMMENDATIONS: Fire District: Waste Transportation: 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 re uires 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 pro cts not listed which you feel Floor&furniture strippers may be toxi r hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers&cleaning fluids" (dry cleaners) Other cleaning solvents Bug and tar removers -. Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature �Staff's Initials j Date: TOWN OF BARNSTABLE _. TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM - NAME OF BUSINESS: C %� y(" ►. +. /Gk Zvi -{/I 1 j BUSINESS LOCATION: INVENTORY MAILING ADDRESS: I di ;;,» /►l ,fit I'(�Ct�Il) �J TOTALAMOUNT. TELEPHONE NUMBER: )��- 7 - ��3 CONTACT PERSON: 1JI I GiY1 �7 Of�v �� EMERGENCY CONTACT TELEPHONE NUMBER: �DD`:5 7 �i > " � �' MSDS ON SITE? TYPE OF BUSINESS: f4'. G \ I INFORMATION / RECOMMENDATIONS: Fire District: Waste Transportation: 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) r .� 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) Any other products with "poison" labels ` ` r `❑ NEW ❑ USED (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 Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials i - Number Fee 1245 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Adams Small Engine Service, Inc. 181 Spring Street, Hyannis,MA Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. t� -------------------------------------- ------------------------------------------------------------------------------------------------------------------------- --- \. This license is granted in conformity with the Statutes and ordinances relating there to, and j m and expires . 06/30/2018 unless sooner suspended or revoked. ' ----------------------------------=----- 7i PAUL J.CANNIFF,D.M.D,CHAIRMAN i DONALD A.GUADAGNOLI,M.D. 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO i Director of Public Health I Number Fee 1349 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Cape Cod Hydroponics .-............................................................................................................................... 181 Spring Street, 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 :.r 1 ti Town of BarnstableMA Inspectional Services BABSTAB_LE Public Health Division „�t• .�" 3R)9.70t. � 1 Thomas McKean,Director • s639. � 200 Main Street, Hyannis,MA 02601 Office: 508-8624644 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 lst—JUKE 30th). APPLICATION FEES �,,,/ CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 i V po) 3 bo C'ir14► 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. 3 a V fu l 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 STORAGEIUSE OF GREATER THAN HOUSEHOLD QUANTITIES(25cGALLONS)? YES NO. • 4. FULL NAME OF APPLICANT: )� l�{ yy\ ,) �(&- tUCH S. NAME OF ESTABLISHMENT: Cape C(yj _.W_WI ,,�qM( C-S 6. ADDRESS OF ESTABLISHMENT: s I G SE :R t it' , MA C006I 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE:8. TELEPHONE NUMBER OF ESTABLISHMENT: 6 U - 'n l �)7 - w6"Y 9. EMAIL ADDRESS: Cry e CCa kqA(A v (OM 10. SOLEOWNER: AYES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL:79) //�� . SIGNATURE OF APPLICANT DATE vl 5 �� QAApplication FonnsWaz Mat App Revised 09-1 18.doc- Number Fee 1349 THE COMMONWEALTH OF MASSACHUSETTS $so.00 Town of Barnstable Board of Health This is to Certify that Cape Cod Hydroponics 181 Spring Street, 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. ---------------------- 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 Jb Town of Barnstable I MWE Inspectional Services BARNSTABLE Public Health Division BARNSrABLE, MASS. T• w + homas McKean Director 1639. 200 Main Street, Hyannis,MA 02601 Icy 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 I st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26 - 11OGallons: $ 50.00 pr Ch 4-f 1 M CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 0 CATEGORY 3 PERMIT 500 or more Gallons: $150.00 11 *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. bo 30 7 2. IS THIS A PERMIT RENEWAL? V YES NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF • GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: 00-0e cod R�60M(65 6. ADDRESS OF ESTABLISHMENT: rng aaw(j) 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: S. TELEPHONE NUMBER OF ESTABLISHMENT: 50� 13 1—as5y 9. EMAIL ADDRESS: (Cri hUdumu 6W UA C 604 10. SOLEOWNER: 4 YES NO IF NO, NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS, AND TELEPHONE# OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE COMPANY ADDRESS EMAIL: *SIGNATURE OF APPLICANT1Z �W,S g DATE QAApplication Forms\Flaz Mat App Revised 09-10-18.docx `°F,He rokti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 RARMs�LE. • 200 Main Street• Hyannis, MA 02601 1639. `rFOMP TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: -A4 M:5 SWLa-1 �vtfl► � rJ��� Date: `7 t 7 Location/Mailing Address: tool S t4V4-v%-v t-s Contact Name/Phone: Ado—A l 1,dr+o v4-. Sob-77 5-[>231 Inventory Total Amount: SDS: License#: Tier II : Labelincr Spill Plan: Oil/Water Separator: ,o Floor Drains: Emergency Numbers: Storage AreaslTanks: Emergency/Containment Equipment: Waste Generator ID: 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/RECO MENDATIONS: , SIAM -n AA M ,YugA 1 I \5 ova Inspector: V� a-xG2S5 �a5k.� 0 1 1 k2!Sk \��^ ` • 1 l C,V,nc Q,�e.•�l���ot„>y.,�•.0 Facility Representative: 2 �Co . WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS a! Town of Barnstable '` Office:508-862-4644 Public Health Division Fax:508-790-6304 + BARNSTABLE. ` +.r MASS. 200 Main Street• Hyannis, MA 02601 �A�EDM N TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT l F� Business Name: �4 rv1.S 5 Wi,-I CA y u.c t P. Date: -7/;I `7 Location/Mailing Address: I r`� I S Do -,X, �,J�� F-e' V el.K v11 Contact Name/Phone: AQ,,,,. ?75-•e:)rLS I Inventory Total Amount: /. SDS: License#: Tier II : V��i �t�. Labeling: Spill Plan: Oil/WaterSeparator: k v 10 Floor Drains: Emergency Numbers: I Storage Areas/Tanks: Emergency/Containment Equipment: Waste Generator ID: 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: \N V)o_ 0S vl,(t 4�Vn,n A1�tI t4> -- iv` J1Q-v- 0<1J 1�►45 401 <CIA.v_-,n<II 1 6-6�AQe- 14 k �c,s�.�_ Ov\ `J��E.• yNa �<c�l, c�r dC���� �Cv s -� 0k5A � o i � ���� ` +�.�� Inspector: ;, , �-C�v�( E,-- --� C,AV- to-s f%A 0Q,?—A dt,,.>vj-< Facility Representative: vA-3 `���7��1c -1Co Ce-}o<�-V�,\A©\)�` Ao WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS I °aI Tom Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMASS ,. ` 200 Main Street• Hyannis, MA 02601 %639 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT RFD MPS s Business Name: T 1AA4IS 5 MA,I I ( w"iyL,c, t5e-eV.CA— Date: Location/Mailing Address: I ( _ K,n, Contact Name/Phone: �} a w�- F7311 tti Ni --77:5-- 07-3 I Inventory Total Amount: ~ �1D 0 t rt5ly MSDS: eS on I �-a cc eg s License Tier II : 0 Labeling:Avo Spill Plan: o s Oil/WaterSeparator: Floor Drains: a Emergency Numbers: Storage Areas/Tanks: � '5 y6tft 0%1 -4e Ak'f !gm- 150 ac.1 AS< Emergency/Containment Equipment: S 64d-, Ac V� s%fie Waste Generator ID: J %1,6 Dy t IWaste Product: & e- 50 5 cJ.e4o4(' Date&Amount of Last Shipment/Frequency: VLA17 a 1 ZX Licensed Waste Hauler&Destination: N\ Z'o Other Waste Disposal Methods: Wk'g� 01 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 'L Hydraulic fluid (including brake fluid)ti'r�o Windshield wash Motor oils IyXsk$�3b��-2 p �s� Miscellaneous Corrosives 150 Gasoline,let fuel, aviation gas3 Cesspool cleaners Me --uel, kerosene, #2 heating oil Disinfectants I Miscellaneous petroleum products: Road salts grease, lubricants, gear oil 1 Refrigerants Degreasers for engines,&garages<�,�y Pesticides: Caulk/Grout Q° �t insecticides, herbicides, rodenticides Q� Battery acid (electrolyte)/batter'es Photochemicals(Fixers) Rustproofers 1611,=0 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" 400 (including chloroform, formaldehyde, �vil lb�� t X N� hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: vJ o Iaw�c. abtvtc o oo�(S \A-% AA I Inspector: Facility Representative: C WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Z Date: TOWN OF BARNSTABLE v<g ,alc, TOXIC AND HAZARDOUS MATERIALS REGMUMPION FORM NAME OF BUSINESS: AaQar�tib auml�,v��IwC-�G���c e� BUSINESS LOCATION: Of Sp<<nq 6 - 5 INVENTORY MAILING ADDRESS: ,54v�u, TOTAL AMOUNT: TELEPHONE NUMBER: D'OO i allows CONTACT PERSON: ArAwr. J:�V de rko,ti EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: awo\,- lOL _ INFORMATION / RECOMMENDATIONS: "'�� '�' °`"�`'��f F!'Fe Distric uw o & e— of I ceaeds& At AAK► 5 h CeCUr, a5v�I o I + W45{a ,M0,-A4"k6 Waste Trans�ortation: Last - a shipment of hazardous waste: Name of Hauler: JlcLk a\, iav-, Destination: Waste Product: u%A AarC-4 eIzAxt< Jolve Kt Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 1, 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 M or Oils ��- ���: '��� X Pesticides M-30NEW�� USED �� �,��'�� . C+ (insecticides, herbicides, rodenticides) �� sc� 00, V Photochemlcals(Fixers) I D Gasoline, Jet fuel,Aviation gas L to 5 Diesel Fuel, kerosene, #2 heating oil a ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals(Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal ` Printing ink a Degreasers for driveways&garages ` S l Wood preservatives (creosote) Caulk/Grout 5w�� I Ne'w' V" 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-L-atib b Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) ^ v-edC Spot removers&cleaning fluids (dry cleaners) 6Vt. 5 VAA S b p, eecq:! wf p`f Other cleaning solvents (' Bug and tar removers -9 70{ pQ�gpof"1 Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staffs Initials I Adam's Small Engine Service Chainsdws,Mowers,Trimmers,Snow Blowers,Scooters,&More s Adam Fullerton,Owner 181 Spring Street Hyannis,MA 02601 Phone:(508)775-0231 /1Vt/C1Vr0A\1 C/- 5r- o y TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair satisfactory 2. Printers BOARD OF HEALTH 3.Auto Body Shops 0 unsatisfactory- 4.Manufacturers COMPANY��75 Si�QiGC (see"Orders") 5. Retail Stores 6. Fuel Suppliers ADDRESS Class' I 094aa—ii—t— 7. Miscellaneous s UANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MAT RMLS Drums Above Tanks Underground t,>b yp IN OU IN OUT IN OUT #&gallons Age Test Fuels: S Gasoline,Jet Fuel (A) ;4* 2 oc S IW.5a otoi�' ) ,7! envy Oils: 9q waste motor oil (C) 10.2 l7 f new motor oil(C) r3>. transmission/hydraulic I/0>. /, z PA V7 degreasers Pc4,+ .5 e I rvet^e a4-,�e,4A •PI 12- 45. Luc-�-u ca�vt- 5 jS Miscellaneous: ps 71 , SPOSAU/RECLAMAT ON REMARKS: 1. Sanitary a 2.Water Supply / �3 Town Sewer \VPublic _ O On-site OPrivate Ul-Eaz w 3. Indoor Floor Drains YES NO L/ O Holding tank:MDC O Catch basin/Dry well O On-site system / _ 4. Outdoor Surface drains:YES NO c/ ORDERS: O Holding tank:MDC s �" �'Lcrt u O Catch basin/Dry well O On-site system a.*-u e-e . 5.Waste Transporter Yes — I-�5eof O!l Narne of Hauler Destination Waste Product LicensedT YES 101 2. AL0.62n FLICIMP�L±3MO ,A-t� Wa Aa-u_ `Y ai a o Le � Person(s) Interviewed Insp ct r Date Number Fee 1245 THE COMMONWEALTH OF MASSACHUSETTS $5o.00 Town of Barnstable Board of Health This is to Certify that Adams Small Engine Service, Inc. 181 Spring Street, 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 sooner suspended or revoked. p unless soo s sp \ PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADA_GNOLI,M.D. 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health C!� 1; open 1712S- fVi 066 L, Tow of Unstable Regaatoervices Richard V. Scali,Director THE '�'"o„ Public Health Division BARNSTABLE • PaN'tlSfAPlk..lyiPF lLLi.CONR•MYa.(.li =* YFRiW516i5•Mi.4ti1LLE•Yf:il PabiitP'2 h BAMEMnai.E. .' Thomas McKean, Director 639-2014 �Fo039. s`� 200 Main Street, Hyannis,MA 02601 575 -,a Office: 508-862-4644 40/ '0�ba9 Fax: 508-790-6304;S APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE tl 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 Lx7 ✓S CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed iif,payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. �f/ / 067 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: t�Y 5. NAME OF ESTABLISHMENT: r 6. ADDRESS OF ESTABLISHMENT: GjI�i�IVlOO ��, GIYIVJI�7 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT:. at— 0 2� 9. EMAIL ADDRESS: OoMod 10. SOLEOWNER: • YES ✓NO IF NO,NAME OF PARTNER: Adam rV I L�hYI 11. FULL NAME,HOME ADD SS,AND TELEPHONE#OF: CORPORATION NAME IW7 {, 1 L PRESIDENT e. -+Dr1 TREASURER CLERK i UMO1. r Fib l er th 12. IF PREPARED'BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICAN DATE Q:\Application Forms\fAZMAT APP 2017 REVIS cx Number Fee 1245 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Adams Small Engine Service, Inc. 181 Spring Street, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 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 rM � • • Town of Barnstable �t Regulatory Services Richard V. Scali, Director , ) $APMAS&L Public Health Division BABSTABLE 1639. 0� wansxeic•mmnhue•mnm•n nrcrcs 3 ♦ .unsroiaKws. .�'e.rxsrrs Thomas McKean, Director 1619-2014 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 ANNUAL PERMIT(RUNS DULY 1st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ I A'late charge of$10.00 will be assessed if payment is not received by July 1st. Ld ASSESSORS MAP AND PARCEL NO. "O� DATE FULL NAME OF APPLICANT: NAME OF ESTABLISHMENT: Adft'S 5w I l Emil, 6m�f', ADDRESS OF ESTABLISHMENT: I I 9 a n 1 MAILING ADDRESS (IF DIFFERENT): 1 TELEPHONE NUMBER OF ESTABLISHMENT: �— 775-U2:6 J EMAIL ADDRESS: adoys enal 1yamal, . 10M Lj SOLE OWNER: YES_J�NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE# OF: CORPORATION NAME M&h(y60411 60AIrt ewee I n e PRESIDENT I I 1 1 Pr T ©� TREASURER tO n j'For ja j-j j &j )0 k /f CLERK r• IF PREPARED BY OUTSIDE PARTY: • S GNA OF T Name: Company Address Telephone#: Email: Q\Application Forms\HAZZAPP Rev I6.docx Page 1 of 2 �jo o ID p d �]®. .o. r�•p� C �'T ❑ ':o 'Ni 5E5T THIfVG5 IN LIFEE AXZE-WT -pµINGS-%V Q o � O-f ❑ o ol .0 WC JOAqW 20 ❑ .o GCS" I�Si � o: ❑ ❑ -° `( ❑ ®DCI❑ o ® ❑❑ wwe.5u nbhadeh.cbm' TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM - Mail To: NAME OF BUSINESS: 6 ec Board of Health MAILING ADDRESS: Aw 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 qu Ities totalling, at anytime, 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 a slow as 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 V Hydraulic fluid (including brake fluid) Disinfectants ✓ Motor oils/waste oils Road Salt (Halite) T✓/ Gasoline, Je+ftref' Refrigerants Y Dfeesei4uel, kerosene, #24* f- Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) ✓ Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink ✓ Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may `✓ Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners I White Copy-Health Department/ Canary Copy-Business j TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 2. nters BOARD OF HEALTH 0 satisfactory 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS s _ C18SS: � 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERTALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: J�V A"" G oline,4et-FrreltAY - Q Piesal, Kerosener#2-031"' Heavy Oils: waste motor oil (C) v 1 ydraulic P01 Synthetic Organics: degreasers Gvwt avT i�raS�Z ��a3 � !/ Miscellaneous: JAot 6 zv,4� DISPOSAIMECLAMATION /REMARKS: 1. anitary Sewage 2. Water Supply l/" S &4� Town Sewer OrPublic O On-site OPrivate 3. Indoor Floor Drains YES NO y O Holding tank:MDC O Catch basin/Dry well O On-site system / 4. Outdoor Surface drains:YES NO ` ORDERS: Q Holding tank:MDC O Catch basin/Dry well �> O On-site system 5.Waste Transporter ----Name of Hauler Destination Waste Product xAle YES NO 2. s n (s) Interviewed Inspector Date TOWN OF BARNSTABLE ­. COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD-6F HEALTH . (D satisfactory 2.Printers 3.Auto Body Shops 0 unsatisfactory- 4.Manufacturers COMPANY ne>Co f)lero (see'Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS 11 -77,o,413 A ft. Class: 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 —Ve— Test Fuels: Gasoline,Jet Fuel(A) Diesel, Kerosene, #2(B) Heavy Oils: waste motor oil (C) 0 1'Cie new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: v- DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply 0 Town Sewer OPublic On-site OPrivate 3. Indoor Floor Drains YESNO)L 0 Holding tank: MiDC_ 0 Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES NO111<,_ �ORDERS 0 Holding tank:MDC 0 Catch basin/DryWell 0 On-site system 5.Waste Transporter Name of Hauler Destination Waste Product Licensed? YES NO 1 Q JG, 775 2. �_� Pers'Ori-(s) Interviewed Inspector Date f j TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF FIRM: ,f, ,C a 10p,�cI74 L ;/✓ci MAILING ADDRESS: /�1 S/ 11,;16 TELEPHONE NUMBER: CONTACT PERSON: Does your firm store any of-the toxic or_ hazardous materials li..sted 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 J NO This form must be returned to the Board of Health regardless of a YES or NO answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at A site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put a check beside each product that.you store: Antifreeze (for gasline or coolant systems) Refrigerants Automatic transmission fluid Pesticides (insecticides, Engine and Radiator flushes herbicides,rodenticides) Hydraulic fluid (including brake fluid) Photochemicals Motor oils/waste oils _ so 6iC, Printing Ink Gasoline, Jet fuel Wood preservatives Diesel fuel Kerosene #2 heating oil (creosote) i Other petroleum products: grease, Swimming Pool chlorine lubricants Lye or caustic soda i Degreasers for engines and metal Jewelry cleaners Degreasers for driveways & garages Leather dyes i Battery acid (electrolyte) Fertilizers (if stored Rustproofers outdoors) Car wash detergents PCB' s Car waxes and polishes Other chlorinated hydro- j Asphalt & roofing tar carbons (inc.carbon Paints, varnishes, stains, dyes tetrachloride) Paint and lacquer thinners Any other products with Paint & Varnish removers, deglossers "Poison" labels (including Paint brush cleaners chloroform, formaldehyde, Floor & Furniture strippers hydrochloric acid, other Metal polishes acids) Laundry soil & stain removers Other products not listed (including bleach) which you feel may be Spot removers & cleaning fluids E C E I V E D toxic or hazardous(please (dry cleaners) HEALTH DEPT. list) :-I--- Other cleaning solvents TOWN OF BARNSTABLE Bug and tar removers Household cleansers, oven cleaners Drain cleaners Toilet cleaners Cesspool cleaners SUN 4 1981 Disinfectants Road Salt (Halite) 3 TOWN OF BARNSTABLE BOARD OF HEALTH CONTROL OF TOXIC AND HAZARDOUS MATERIALS - INSPECTION SHEET FIRMf �„ ADDRESSr, Major types of materials: 1) 2) 3} 4) 5) 6) I. Description of material(s) use: 0 'e- II. Storage (denote product by number listed above) A. Containers metal lass t/ paper plastic cans,bottl.es,jars i_- drums,barrels , aboveground tanks underground tanks bags,boxes open,loose,uncovered inadequate labelling B. Storage Facility ✓or # Remarks/Recommenc::Jons l. ' Indoor a) separate, contained room b) stored in general work area i) inadequate ventilation ii) floor drains iii) inadequate fire protection �+ 2. Outdoor a) uncovered, exposed to weather b) pervious surface/catch basins m' III. Disposal A. Reclamation/Recycling unit B. On-site disposal 1. Town sewer 2. Regular septic system ` fi 3. Separate holding tankw �w C. Off-site disposal 1. hauled by own firm 2. hired hauler a) name of hauler b) address or disposal site Perso.n(s) Interviewei — — — � _ Inspector 24� — — — — — — - - .. V"7 _/� � — — — — — — — — — Date � - — - - — — — — — 6 30 81 r TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM / 4 NAME OF FIRM. ABC® TOOLc, DIE, INIC. r MAILING ADDRESS: TELEPHONE NUMBER: HYAN'," S, 1vIASS. 04 01 CONTACT PERSON: G�. Does your T rm store any of the toxic #hCAzZ,` ,,s materials listed:below_,_ either for sale or for your own use, in quantities totalling, at anytime re 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 SO gallons liquid volume or 25 pounds dry weight. Please put a check beside each product that,you store: Antifreeze (for gasline or coolant systems) Refrigerants Automatic transmission fluid Pesticides (insecticides, Engine and Radiator flushes herbicides,rodenticides) Hydraulic fluid (including brake fluid) Photochemicals Motor oils/waste oils Printing Ink Gasoline, Jet fuel Wood preservatives Diesel fuel, Kerosene, #2 heating oil (creosote) Other petroleum products: grease, Swimming Pool chlorine lubricants Lye or caustic soda i Degreasers for , engines and metal Jewelry cleaners j Degreasers for driveways & garages Leather dyes Battery acid (electrolyte) Fertilizers (if stored Rustproofers outdoors) Car wash detergents PCB' s Car waxes and polishes Other chlorinated hydro- Asphalt & roofing tar carbons, (inc.carbon Paints, varnishes, stains, dyes tetrachloride) Paint and lacquer thinners Any other products with Paint & Varnish removers, deglossers "Poison" labels (including Paint brush cleaners chloroform, formaldehyde, Floor & Furniture strippers hydrochloric acid, other Metal polishes acids) Laundry soil & stain removers Other products not listed (including bleach) which you feel may be Spot removers & cleaning fluids toxic or hazardous (please (dry cleaners) RECEIVED list)*,:- r Other cleaning solvents HEALTH DEPT. Bug and tar removers TOWN OF BARNSTABLE — Household cleansers, oven cleaners Drain cleaners Toilet cleaners Cesspool cleaners g 1981 Disinfectants MAY Road Salt (Halite) + TOW%Ab F BARNSTABLE B'� OF HEALTH CONTROL OF TOXIC AND HAZARDOUS MATERIALS - INSPECTION SHEET FIRM A kc-oTroal4- ,' .ADDRESS r tVQ_ ValMajor types of materials: 1) J 2} 3) �� ecT1� 4) f_ 1 l U � 6) (t1Se coo t�+� I. Description of material(s) use: �r`'"'� �Vt`Y II. Storage (denote product by number listed above) yeC445 ' A. Containers metal glass paper plastic cans,bottles,jars drums,barrels aboveground tanks underground tanks bags,boxes open,loose,uncovered inadequate labelling B. Storage Facility v/or # ,J Remarks/Recommenti: .i_ons 1. Indoor a) separate, contained room 5 b) stored in general work area i) inadequate ventilation ii) floor drains iii) inadequate fire protection 2. Outdoor a) uncovered; exposed to weather b) pervious surface/catch basins III. Disposal A. Reclamation/Recycling unit B. On-site disposal 1. Town sewer 2. Regular septic system 3. Separate holding tank C. Off-site disposal 1, hauled by own firm 2, hired hauler a) name of hauler b) address or disposal site at AJ l Perso�n(s) Interviewed •— — s— — _ — — — Inspector Date _ _ _ '' !! - - _ - - 6 30 81 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) m A- -1 DATA s3 E ¢ OWN` �`� ��t� �-r tt ��� CUMPLIANCE: CLASS: 1. Marine,Gas Stations,Rc�� !�V BARN STABLE t1 (Os atisfactory 2• Printers BOARD ® FJ EALTH 3. Auto Body Shops 0 unsatisfactory- 4. Manufacturers COMPANY • 4see"Orders" 5. Retail Stores �?�- -� ) L 6. Fuel Suppliers ADDRESS Class: 7. Miscellaneous c F)n q J —= f,/ QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS % Case lots Drums AbOveTanks Undetgrouad Tanks " IN 13Lrr IN IOUT IIN IOUT gallons Aee s ? Fuels: -Gasoline, Jet Fuel `(A) Diesel, Kerosene 4 #2 (B) Heavy 0 ls: #` - 1 waste nID86r`roA (C) fir, new motor oil (C) transmission/hydraulic Synthetic Organics: ; :degreasers Miscellaneous: DISPOSAL RECLAMATION REMARKS: 1. Sanitary Sewage. 2. Water Supply OTown Sewer C)Publi"c ® _ite ® Private 3. Indoor Floor Drains: YES NO V Holding tank: MDC ® Cat ch basin/Dry well - C) On-site system 4. Outdoor Surface drains-YES NC Q Holding tank: MDC O Catch basin/Dry well On-site system 5. Waste Transporter Licensed? Name of Hauler- Destination Waste Produ t YES NO 12 .2 rso ).-Yn rvi;ewed` . •' Inspector-.---.___ Date . .-1 ` . 9 . •1 %..1 .:��-.��.,rrvv �`rv���� satisfactory 2. Printers__ R OA R D OR H EAL-1-IA •' 3. AU-to.aody Shops Qunsati9factory- 4. Manufacturers COMPANY __rk-1, r. �- � ] c, (see"Orders") S. Reta).1 Stores � —' 6. Fuel Suppliers AUURESS E.• Class:_ 7. tifisc llaneous QUANTITIES AND STORAGE (IN--indoors; OUT=outdoo Case lots '. Drums AbOveTanks Undet roved Tanks MAJOR MATERIALS $ IN .)UT, I oirrI N 6 ge l lons j 1' Fue)s: — Gasoline, Jet Fuel (A) �^ Diesel, Kerosene, 12 (8) Heavy Oils., waste motor oil (C) new motor oil (C) transmission/hydraulic 4 w' •3 Synthetic Organics: t= degreasers 0 I' eel . Miscellaneous: 1 t ISp0S.AL REECIAP 1'1'ION 1. Sanitary Sewage 2. Water_ Supply Town Sewer public Tian ' .x On-site _ rivate x t; 3. 1 ool Floor Drains: YES NO O Holding tanks , MUC O Catch basin/Dry well On-site system / 4. Outdoor Surface drains:YES NO l _ _ Q HoldinL- tank: MUC . Q Catch basin/Dry well r..�,.;k, Qon-site system T — S. Waste Transporter Licensed? n ti nat Ian 1 r ewe> • + nsper.tor Date