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HomeMy WebLinkAbout0325 STEVENS STREET - HAZMAT 3 S � �Vr ��/GL-YIYI is lJ . AN61 34-6�o -VII CA °FTHE l°k Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMAT,S- .9` 200 Main Street• Hyannis, MA 02601 ,6 M TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rE0 P'� ^^II Business Name: UU1 esnd f iar A Date: Lj l c) Location/Mailin Address: 3XC S S Contact Name/Phone: f- D - - 7461 Inventory Total Amount: <6�00 MSDS: U nq License#: 1200 Tier II : c! Labeling: Spill Plan: Oil/WaterSeparato AVA Floor Drains: NO Emergency Numbers: Storage Areas/Tanks: Emergency/Containment Equipment: Waste Generator ID: J,�-gy35.wI46 3 Waste Product: �! Date&Amount of Last Shi ment/Fre uenc • 9yo ' 04J Licensed Waste Hauler&Destination: 1 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: 0 ` 0, bi Nafi-- Inspector• • Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number Fee 1314 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Duchesney Painting ................................................................................................................................. 325 Stevens Street, Hyannis, 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 Fau/L Inspectional Services *L�� LErcngsPublic Health Division A2NBT40LE = 14 (A�Allm r Thomas McKean, Director, 1639 200 Main Street, Hyannis,MA 02601 ED Mld A + h,0 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 PER-MIT 111 —499 Gallons: $125.00 F1 CATEGORY 3 PERMIT 500 or more Gallons: $150.00 *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? ✓ YES NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: QV/ c btichesbeu 5. NAME OF ESTABLISHMENT: hre, 6. ADDRESS OF ESTABLISHMENT: plat S Ste S �r ,( 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: � l�YI 0l t.'TL'/ d fl-T GLl C/ DZIo�,s' 8. TELEPHONE NUMBER OF ESTABLISHMENT: 506 395-7-063 9. EMAIL ADDRESS: Gole-dUC41�Z711 J (R_ CAM CC4S�` 10. SOLEOWNER: V/YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE# F: CORPORATI NAME S/P� lf' 9 *k �L, PRESIDENT, 522d—.3,F S V6.2 TREASURER a CLERK 3,CUL1) ll(ff eSyr�Ptii 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE 6 ZD Q:Wpplication Forms\Haz Mat Appli Draft Jan20l9.docx Cg tHEI°yti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMST�BLE.g' 200 Main Street• Hyannis, MA 02601 =639• TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Date: Location/Mailing Address 217 V !2� Contact Name/Phone: 0 - � 7 — 2 —1214 Inventory Total Amount: >SOU SDS: e License#: Tier II : no Labelina: T5 Spill Plan: U Oil/WaterSeparator: IVO Floor Drains: Emergency Numbers: 1i ` '� Storage Areas/Tanks: v wre/ 0 S L� 0C TO C4 CA Or, VOL Emergency/Containment Eg6m t: t�U�]At\-JCQ56(WA Waste Generator ID: so$ %91 Waste Product: Date&Amount of Last Shipment/Frequency: D Licensed Waste Hauler&Destination: e ` U 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) zWindshield 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 aints, 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: ons Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS i Number Fee 1314 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Duchesney Painting 325 Stevens Street, 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 Town-of Barnstable a Inspectional Services BARNSTABLE THE Tf1.I wP1 CtiPNI �nU=-IM-=+°"r`. r • Public Health Division -, 2014 9 BARNSUBLE, Thomas McKean, Director059. ,. 200 Main Street, Hyannis,MA 02601 C> Office: 508-862-4644 Fax: 508-790-6304 X. APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE NO HAZARDOUS MATERIALS '1 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 L9 VST *A late charge of$10.00 will be assessed if payment is not received by July 1st. pA 416gT( "kq 1. ASSESSOR'S MAP AND PARCEL NO. 5tr5 ow 2. IS THIS A PERMIT RENEWAL? YES NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF • GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: IS GCChes NJi dun-6o ,� CzJlni�-d c �. 6. ADDRESS OF ESTABLISHMENT: �2 � ��el/Pf2S �� 4,;7 ftiX 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: V5- X yt 8. TELEPHONE NUMBER OF E TABLISHMENT: 0� al/e uCG[eS�.e�l. ev CQ m"51 . ��f 9. EMAIL ADDRESS: GtL' 10. SOLEOWNER: L1 YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME AD RESS,AND TELEPHONE#O CORPORATIO NAME�f�'V& b U C��S/!/ x n-7 I7� C6 y7 Tko-t -G. PRESIDENT J)4V1 ,0 TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: Gj SIGNATURE OF APPLICANT DATE Q:\Application Forms\Haz Mat App Revised 09-10-18.docx JI� Number Fee 1314 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Duchesney Painting 325 Stevens Street, 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 { y r0-c,,hv,# 'kow of Unstable gi2atoervices �tKE Richard V. Scali,Director W. Public Health Division BARNSTABLE -� BARNEMABLE. Thomas McKean, Director rwy T4A89. � 1639-2014 ----200 Nlain Strddt,Hyannis_-MA 02601------ ---- - --- 377�- ---- --- - -- 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 3 Oth). APPLICATION FEES CATEGORY 1 PERMIT 26- 11 O Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 9 V,S . *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? ✓ YES_NO. IF YES, SHIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGEIUSE OF • GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: b ay-c- ba Ghe-s n e j 5. NAME OF ESTABLISHMENT: 3/ aUC, bQC: e-Sher/ ra#'n j,'n j Cor)4rgc�or e 6.' ADDRESS OF ESTABLISHMENT: 3a 3 64eyehs Nola h n,'s, 44 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: IS 1jes4 gral, Wes4ei h 8. TELEPHONE NUMBER OF ESTABLISHMENT: 5o[°- 3FS W6 3 9. EMAIL ADDRESS: da ue- uc h eS1'Lt`t Q� Coone.as� A r)e-4 10. SOLEOWNER: V YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME3)Qu2btdChl(.Si1f\/ PQ,'n-I ,n4 Ldrador lC PRESIDENT 2)av-e `Ot,l Yle TREASURER S ckh bU he.S h ems./ CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: • COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE Ile Q:Application FormsUiAZMAT APP 2017 REV&D.docx `aFT ►okti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMS LE.�` 200 Main Street• Hyannis, MA 02601 �"rFOMP+ TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Date: Location/Mailin Address: 15 Contact Name/Phone: e-14 e S SOS - 3 S S- 7gF,3 CK1\ 1 -1�1y- 21Z- 'I InventoryTot Amount: ti ,��oo SDS: ' 0 06�k\vt. License#: Tier II : o Labeling: ot-e- Spill Plan: 05 Oil/WaterSepgator: VNFloor Drains: o Emergency Numbers: " Storage Areas/Tanks:,f r s 5 &k Emergency/Containment Equipment: 4 .Pr ax-- 5 x0 Waste Generator I D:�-V W o H Waste Product: AI.+ Date&Amount of Last Shipmen•Frequency: cA� Licensed Waste Hauler&Destination: p k�y�( Other Waste Disposal Methods: �a 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 sco 1#t Swimming pool chlorine �— Paints, varnishes, stains, dyes Lye or caustic soda Lacquerthinners �."l�'WG��k�k�ouv�aa'�Z Miscellaneous Combustible Paint&varnish removers, deglossers aye 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: M. - 44A\vA- 1- nnA oks� 1 VL S �'i�l rX AA -1 e, 0,10 1-2—. nspector* Z �-o :ewt,,���y2�� . L a I�.l �I1 v�g t-r✓ co�.t�i�-�-�s 4 Facility Representative: f%e- s�'C C�� ©vl-1 V'S 1`S_ -t'�-� V�lv tx�, WHITE COPY- H LTH DEPARTMENT/CIANARY COPY- BUSINESSC �b�k©� 270 1 Number Fee 1314 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Duchesney Painting 325 Stevens Street, 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 S and expires 06/30/2017 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN -� PAUL J.CANNIFF, D.M.D. A� 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health r W 'as 0 Town of Barnstable' �IHE roy, Regulatory Services Richard V. Scali, Director �! MASS. ' Public Health Division BARNSTABLE . A 16 9. 0� ennnn,e�•�.�vnu.mnm•Hruws 3 ♦ nur°xsrus•osmvn�•ware.ruisns� Thomas McKean,Director 139 2019 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 `�, Fag: 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 �(1� A late charge of$10.00 will be assessed if payment is not received by July 1st. • ASSESSORS MAP AND PARCEL NO. DATE / FULL NAME OF APPLICANT: A NAME OF ESTABLISHMENT: / a e-ZWCA �iJ c C-✓�. ADDRESS OF ESTABLISHMENT: e PJ.S' Ste— /Y ,J�✓>S MAILING ADDRESS(IF DIFFERENT): /�� o S ls/?e:�i 4" TELEPHONE NUM 3E OF EST LISHMENT: EMAIL ADDRESS: /. �� /� 27 SOLE OWNER: ZYES NO IF NO,NAME OF PARTNER: FULL NAME,HOME AD SS,AND TELEPHO OF: _ CORPORATION NAME JQVe, PRESIDENT TREASURER �u.r:�.� �)clG.lP f Al e?s CLERK IF PREPARED BY OUTSIDE PARTY: S GN rT APP CANT Name: Company Address : Telephone#: Email: Q:\Application FormsUiAZZAPP Revl6.docx Page 1 of 2 I.. LE CHEM BROKER NO, 17 SOUTH FIRST STREET PHONE,•908-355-5800 Class In ME 2 ELM BETH, NY 07206 Facility WWIN°CYCLECHEM,COM ESM APPRPOVAL A. GENERATOR INFORMATION GENERATOR USEPA ID NO MAC300103777 Gen. Name Dave Duchesney Painting Contractor Inc MA6136 Mai/in Address 215 W. Great Western Road Yarmouth Port MA'02675 Generator Contact Susan Duchesne Generator Phone 508-385-7463 Site Address; 325 Stevens Street, Hyannis MA 02691 Process Generating: out of date,consolidated paints Name of Waste: Paint Sludge BTU>5000 D.REGULA TOR YINFORMATION B. PHYSICAL CHARACTERISTICS OF WASTE Color/Physical`Description: varies USEPA HAZARDOUS WASTE: X YES NO STRONG INCIDENTAL ODOR PRESENT PHYSICAL STATE(W 70°F USEPA CODE(5): _ D001,DO35,AM F005 X YES _No _ SOLID SINGLE PHASE —LIQ BI-LAYERED APPLICABLESUBCATEGORIES: —POWDER _MULTI-LAYERED NOKWSTEW4 TER _ NOS ,S G, SEMISOLID X SLUDGE . STATE HAZARDOUS WASTE. X YES NO _ WA — — FLASHPOINT LIQUID15OLIDI p STATE CODE(S): _<70' SLUDGE _ <1.0 XXrF-104PF Sludge z1-so D,0. _ YES _ NO Suspended Sc/ids_ _101°F-141°F Sol/d/Debns— —9.1-1z.4 PROPER SHIPPING UN1263,WASTE PAINTRELATEDMATERIAL _147 14z°F-zoo F — >12s CLASS. 3 I,D.NO:_ P.G,. II R.Q.: D001-100 LBS - Free Liquids 50% — 1 Z NO FLASH — NA/A —FA4CT Ignitable(if-lid) Dampable? _Yes _No _Yes X N° Pumpable? Yes No Open cup —Qen osed c Pourable? X Yes _No E.SHIPPINGINFORMATION/SHIPMENT METHOD; _ —BULK LIQUID BULK VOLUME GAL/YDS C.CHEMICAL COMPOSITION —BULKSOLID IsMSDSAttached? Yes—No Analysis Attached?_Yes_No —DUMP TRAILER UNITS 1 ROLL-OFF MINIMUM MAXIMUM X DRUMS/PAILS PRICE METHANOL 0 40 _PALLETS METHYL ETHYL KETON 0 40 —CYLINDERS FREQUENCY ACETONE 0 20 F.SPECIAL HANDLING CONSIDERATIONS MINERAL SPIRITS 0 50 CERCLA FACILITIES INCINERATE ONLY PETROLEUM DISTILLATES 0 50 NO LANDFILL GCCSALESCODE WED . PIGMENTS,ORGANIC DISPERSABLE 50 80 PROJECT CODE OTHER G TRANSPORTATION CUSTOMER WILL DELIVER TO CVCC X CVCC TO PROVIDE TRANSPORTATION H.OTHER HAZARDOUS CHARACTERSTICS Is this waste characteristically Indicate If The Waste Is: Indicate If The Waste Contains Any of the Following hazardous for metals or organics(EPA Waste _RCRA RE407VE Codes D004-DO43)?_YES —NO .If _WATER REACTIVE None or Less Than or Actual yes,please list the constituents and _RADI0AC77VE concentrations in Section D. _SUB)ECr TO SUBPART FF PCB'7 _ <SOPPM PPM Does this waste contain under/yi In BENZENEREGULATIONS g _ETIOLOGICAL Cyanides <25OPPM PPM hazardous constituents as defined in 40 CFR _75r,4 REGULATED — — 268(2)(I)at concentrations exceeding the _0XID,7INGMATERIAL Phenolics _ _<50PPM If WS treatment standards?_ YES _NO. _PYRCPHORIC If yes,please list constituents and _EXPL057VEISHOCSENS)TIVE Sulfides _ _<500PPM PPM NONE OF THEASOVE concentrations inSedion0. _ VDUs _ _<500 PPM PPM GENERATOR CERTYFIG477ON:I hereby certify that all information submitted/n this and all attached documents is complete,contains true and accurate descnptions and is representative of the waste material,and that all relevant information regarding known or suspected hazards in me possession of the generator has been disclosed.If GCC discovers,alter ha✓ing taken delivery of the waste,drat any waste does not conform to the identification and description on this MPS then GCC shall provide notice of such condition to the Generator and coordinate the return of the nonconforming waste to the point of orig/n as set forth on the manifest or to such other locations designated in writing by the Generator,Generator agrees to reimburse GCC for al/handling,packaging,clean-up and transportation costs or charges,damage to equipment and costs associated with lost time incurred by GCC during the receipt;handling,temporary storage and return of such nonconfomi/ng waste to point of ongln or to such other/oration designated by Generator I hereby authorize GCC to amend and/or correct any Information on the MPS with the full understanding that d any amendment or correction is performed,I will be contacted as suds to issue any approval. AUTHORIZED SIGNATURE. 771E: DATE `CIE CHEM BROKER NO, =-,217 SOUTH FIRST STREET PHONE;908-355-5800 Class In Facility ELMBETH, NJ 07206 ESMAPPRPOVAL WWW.CYCLECHEM.COM A. GENERATOR INFORMATION GENERATOR USEPA ID NO, MAC300103777 Gen.Name Dave Duchesney Painting Contractor Inc MA6136 Mai/in Address 215 W.Great Western Road Yarmouth Port MA 02675 Generator Contact Susan Duchesne Generator Phone 508-385-7463 Site Address: 325 Stevens Street, Hyannis MA 02691 r Process Generating. out of date,consolidated: aints Name of Waste: PAINT/THINNERS D.REGULA TOR YINFORMATION B. PHYSICAL CHARACTERISTICS OF WASTE Color/Physical Description: varies USEPA HAZARDOUS WASTE.' X YES NO STRONG INCIDENTAL ODOR PRESENT PHYSICAL STATE 070'F USEPA CODE(S): DOO1,DO35,F003,FOGS XYES _No _ SOLID SINGLEPHASE APPLIC4BLESUBC,4TEGORIES: —LIQ _BI-LAYERED —POWDER _MULTI-LAYERED _WASTEWATER S G. _SEMISOLID XSLUDGE STATEHAZARDOUSWASTE: X YES — NO _NONWSTEWATER STATE CODE(S): FLASHPOINT LIQUIDISOLID1 pH SLUDGE <zO D,O,T.HAZARDOUS WASTE YES NO _<70' Sludge ZI-5.0 — — X7MF-SOOT Suspended Solids_ X 5.0-9.0 101"F-141°F Solid/Debris_ —9.1-12.4 PROPER SHIPPING UN1263r WASTE PAINT RELATED MATERIAL _14ZF-10tPF Free Liquids 100% — >1 CLASS: 3 I.D.NO:_ P.G.: II R.Q.: D001-100 LBS _ 25 >200'F NA/A _NO FLASH — EXACT Ignitable afsolyd) Dumpable? _Yes _No ye sea P No Pumpable? Yes No _ —open�„p Pourable? X Yes _No E,SHIPPING INFORMATION/SHIPMENT METHOD; —BULKLIQUID BULK VOLUME GAL/YDS C.CHEMICAL COMPOSITION _BULK SOLID DUMP TRAILER UNITS 4 Is MSDSAttached? Yes—No Analysis Attached?—Yes_No — ROLL-OFF MINIMUM MAXIMUM X ,DRUMS/PAILS PRICE METHANOL 0 40 _PALLETS METHYL ETHYL KETON 0 40 —CYLINDERS FREQUENCY ACETONE 0 20 F.SPECIAL HANDLING CONSIDERATIONS MINERAL SPIRITS 0 50 CERCLA FACILITIES INCINERATE ONLY " PETROLEUM DISTILLATES 0 50 NO LANDFILL GCC SALES CODE WED . PIGMENTS,ORGANIC DISPERSABLE <10 PROJECT CODE OTHER G. TRANSPORTATION CUSTOMER WILL DELIVER TO CVCC X CVCC TO PROVIDE TRANSPORTATION H,OTHER HAZARDOUSCHARACTERSTICS Is this waste characteristically Indicate If The Waste Is: Indicate If The Waste Contains Any of the Following hazardous for metals or organics(EPA waste _RCRA REACrtVE Codes D004-DO43)?_YES _NO .If _WATER REACTNE None or Less man orAdual yes,please list the constituents and RADIOACTIVE concentrations in Section A _5UB7ECT TO SUBPART FF PCn _ —<50PPM _PPM Does this waste contain underlying BENZENE REGULATIONS hazardous constituents as defined in 40 CFR _ETIOLOGICAL Cyanides _ <15OPPM — PPM 268(2)(I)at concentrations exceeding the _TSCA RECULATED _OXIDIZING MATERIAL Phenolics _ _<50 PPM _PPM If yes, aeas l standards?—?_ YES NO. _PYROPHORIC If yes,please list constituents and _IXPLOSNE/SHOC 5ENSILTVE Sulfides — —<500 PPM _PPM concentrations in Section D. _NONE OF THEABOVE VOC's _ —<500 PPM _PPM GENERATOR CER77FIG477ON.'I hereby certify that all Information submitted in this and all attached documents/s complete,contains true and accurate descriptions and/s representative of the waste material,and that all relevant information regarding known or suspected hazards in the possession of the generator has been disclosed.If GCC discovers after having taken delivery of the waste,that any waste does not conform to the identification and description on this MPS then GCC shall provide notice of such condition to the Generator and coordinate the return of the nonconforming waste to the point of origin as set forth on the manifest or ro such other locations designated in writing by the Generator.Generator agrees to reimburse GCC for al/handling,packaging,clean-up and transportation costs or charges,damage to equipment and costs associated with lost tme incurred by GCC during the receipt;handling,temporary storage and return of such nonconforming waste to point of origin or to such other location designated by Generator I hereby authorize GCC to amend and/or correct any information on the MP5 with the full understanding that if any amendment or correction is performed,I will be contacted as such to issue any approval. AUTHORIZED SIGNATURE. MILE.' DATE CYCLE CHEM BROKER NO. 217SOOM FIRST STREET PHONE:908-355-5800 Class In EL MWETH,AU 07206 Facility WWW.CYCLECHEN.COM ESMAPPRPOVAL A. GENERATOR INFORMA770N GENERATOR USEPA ID NO.MAC300103777 Gen,Name Dave Duchesnqy Painting Contractor Inc Bi/tin Address Global Remediation Services Inc. Mailin Address 215 W.'Great Western Road 700 Richmond Street Yarmouth Port MA 02675 East Taunton MA 02719 Generator Contact Susan Duchesney Contact Tim Burbank Paul Mastrodomenico Generator Phone SOB-385-7463 Phone 508 828-1005 Fax 508 824-2486 Site Address: 325 Stevens Street Hyannis MA 02691 Proeew 0weratin . out of date,consolidated rots Name of Waste PAINT/THINNERS D.REGULATORY rwok ATim B.PHYSICAL CHARACTERISTICS OFWASTE Color/Physical D2SG17plion: varies USEPA HAZARDOUS HAVE x YES _ NO USEPA CODE(S): 2VA DV FOQ3.FOD3 5MONGIN0MENTAIODORPRESENT P1lYSILitLBTA7F®77TF RYES _No - baLiD MNGLEPHASiE_LTC DI LAYERED APPLICABLESUBCATEGGRIES _WASTEWATER POWDER -MULTI-LAYERED _NONW57FWAM 5 G, _5EWS04rD XSMME STA17R47ARDOUS WASTE.' X YES _ NO STATE CODE(S): SIUDGu4uzD/souD/ H FLASH rNT E D,O.T.HAZARDOUS WASTE _ YES NO X7rF-MVF S1As na�tiSoAds� _101°F-14rF -�1- PROPERSHIPPING UN1263,WASTEPAINTRELAIEDMATM41 _14ZF-2MF Fr-Liquids, 1M _ a 125 CLASS: 3 -M NO. P. II R. _>200"F _ MACr (X. DO01-lob Las _NO FL4&V _ IWA _ExACr fpnitabk(M—W) Dimpabte7 —Yes No —Yes )L No `aosed a+D Pa y X Yes =NoN� E.SHIPPINGINFORMATIDN/SHIPMENT METHOD:—vase am BUtKLIQUID BULKVOLUME GAL/YD-S C CHEMICAL L7RMPOSIT3ON _SULKSOLID ISMSDSAttaahed? Yes-No Ana&SSAttached?_Yes_No —DUMP TRAILER UNITS 4 _ROLL-OFF MINIMUM MAVNIUMM K_ DRUMS/PAILS PRICE METHANOL 0 40 _PALLETS METHYL ETHYL IETON 0 40 CYLINDERS FREQUENCY ACETONE 0 20 F.SPEM4 HANDLINGCONSIDERATIONS MINERAL SPIRITS 0 50 CERCLA FACILITIES INCINERATEONLY PETROLEUM DISTILLATES 0 50 NO LANDFILL GCCSALESCODE WED . PIGMENTS ORGANIC DISPERSABLE <10 PRQ7ECTCODE OTHER G. TRANSPORTATION alSTOMER WILL DELIVER TO CVC1C X CVCC TO PROVIDE TRANSPORTATION H.,07NER HAZARDOUS CHARACTERSTICS is dris waste charadeistically Indicate If The Waste Is: Indicate If The Waste Contains Any of the Following hazardous for met&ororganics(EPA Waste —RQU RFACIIYf Codes D004-D043)7_YES _NO .If —wA75 MCrM Nacre or Less Than orActua! RADIOACTIVE yes,please list the tanstituents and cWtEntrationsin Section A _SUMT 70 SUBPARTPF PCs''s _ —<MARM _PAN Dogs thtS waste contain and 88MENEREMAIMN5 e*Ay _MOLOGMU Cy.217kk-, <250PPM _ PPM hazardous cons�Tuer&as detlned In 40 CFR -7SC4 REM A7FD - 268(2)(I)at concentrations exceeding ffie -MOLMNGMAMMI Phenaft _ -<50 APM _PPM UTS treatmentstandams?_ YES _NO. PYROPHORW If yes.Please At constituents and _1APt0STVESH0CSEAM77VF surrldes _. —<5D0PPM _PPM COntentratiDrr5in Section D. -NONE DF7HEA80W Vocs _ _<SW PPM _PPM GENERATOR aR77FM477ON.'thereby certify drat amfwwdon submRwin this and affattaMed docmnentsis complete,mnta/ns buy andecarrate dew ands reprea niadve ofdre wastemateW rVanfmgk~cr5uspectedAaaardshiOepuzagswofdwgenewbrhas been dls ff6C'dkop&4aAy1?avinytakendetiveiyofthewaslGffiar any waste does not%r,+� kL-nfflkff On and desntpobn on Ws MPSbrw Gxshallmwde notice ofsudr mwi#m 6 die awwatarand manfnate byre return of the naubnforndng mwe to the po/ntofak}tn as set l�� on the 1@ t orto Suds otherlaabh-&m0vted in wnbv by the Generatar.C&a Mragmw to remburse GX foraittok ix�parbWv,dean-up and banwwwbon tusk or charges,damage to n assodated NO lastdme/named by 6W during the race handling,tenrporarys7Orage and mAm cfs;Y6 nwrvnfnmV waste topahtOfOff ar m such D&W/radar designated b tor. hembyau GLC to amend aWOrcwmf a h7&madan on the MPSss M the 8rll understaaft drat lfanyamendmentOrror ectron is paformat I xfbe aanAxtedassuch to&n a an 17 � AU7HDRMFDSTGNA7URf.! 'vim TI77F THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) M ^ L DATA Please%printor,type,(Form;designed.for use on elite(12 pitch)-typewriter.) Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1 Generator ID Number 2 Page 1 of 3..Emergency Response Phone 4.:ManifestTracking Number � �( WASTE.MANIFEST.. ' b e d ae� JJ I� 5.Generator's Name`and Mailing Address al c ,;.'i' P. Generator's Site Address(ff different than mailing address) ';r. .i,i. t y.+.i_? -- fi'. Generator's Phone f 6.Transporter-1 CdripanyName U.S.EPA ID Number 7.Transporter 2 Company Name U.S.EPA ID Number 8.Designated Faahtypame and Site Address U.S.EPA ID Number Facilitys Phone: ga. 9b U.S:DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers- 11.Total 12.Unit 13.Waste Codes HM, 'and Packing Group(•f any)) No. Type Quantity W V01. d' t S 3. 4::-:_. 14.SpeciatHandling Instructions and Additional Information 15: GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully,and accurately described above by the proper shipping.name,and:are dassfied;;packaged, marked and labeled/placarded,and are in all respects in proper condition for transport according to applicable intemational and national governmental.regulations.If expoort shipment and I am the Primary "Exporter I certify that the contents of:this consignment conform to the terns of the attached EPAAcknowledgment of Consent. I cir*that the vasfe mihim¢ationstatement identified in40 CFR`262.27(a)(dt am a large quantity generator)or(b).(•d l am a small quantity generator)is true. �efierat6eslOfferor's PrintW[TypedMame Signature =' Month 'Day 1 Year 4 - 16.1ntemational Shipments,: ' F- ❑import to U.S./ ❑Export from US. Port of entiylezit Z Transporter signature(for.exports only): :`'Date leaving U.S.: W 17.Transporter Acknowledgment of Receipt of Materials g Transporter 1 Pdfited/Typed Name Signature `E' Month Day .Year Z ,Transporter 2 Pfintedfryped Name Sfdnafurd' Month '. Day Year Q 16:Discrepancy 18a.Discrepancy Indication Space ,Quantity PartalRelecti on YPe Rid Full Rejection Manifest Reference Number. 18b.Alternate Facility(or Generator) U.S.EPA ID Number LL Facil vs Phone: w 18c.Signature of Alternate Facility(ot Generator)' Month Day Year ILD 19-Hazardous.Waste:Report Management Method Codes(i.e.,codes forhazardous wasteareatment,disposal,and recycling systems) LAJ 1. 2. 3. 4. 20,.Designated Facility Owner or Operator.Certification of receipt of hazardous materials covered by the manifest except as noted in Item 186 Printedrryped Name Signature - Month Day Year EPA Farm 8700-22(Rev.3-05) Previous editions are obsolete. GENERATOR'S INITIAL COPY r Please print or type.(Farm designed for use on elite(I 2-pitch)typewriter.) Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1 Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFEST .� J J K 5.Generators Name and Mailing Address Generators Site Address(d different than mailing address) Generators Phone: 6.Transporter 1 Company Name U.S.EPA1D Number 7.Transporter 2 Company Name U.S.EPA ID Number 8.Designated Facility Name and Site Address U.S.EPA ID Number 4, Facility's Phone. ga. 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit HM and Packing Group(it any)) 13.Waste Codes No. Type Quantity Wt.Nol. 1 fY w ' 3 ,.. , 4. 14.'Special Handling Instructions and Additional Information r - 15. GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged, marked and labeled/placarded,and are in ail respects in proper condition for transport according to applicable intemational and national governmental regulations.If export shipment and I am the Primary Exporter,I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent. I certify that the waste minimization statement identified.in 40 CFR 262.27(a)(if I am a large quantity generator)or (if I am a small quantity generator)is true. :: GoneratorslOfferors Printedrryped;Name Signature Month Day Year —j 16.International Shipments H ❑Import to U.S. ❑Export from U.S. Port of entry/exit. z Transporter signature(for exports only): Date leaving U.S.: w 17.TransporterAdmowledgment of Receipt of Materials S Transportefl Pnnted(fyped Name ) Signature P Month Day Year z0 Transporter 2 PnntedlTyped Name Signature Mbnth r Day Year H 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity El Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number. 18b.Alternate Facility(or Generator) U.S.EPA ID Number J C.0 LL Facility's Phone: w 18c.Signature of Alternate Facility(or Generator) Month Day Year Q z H19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) p 1• 2. 3. 4. 20.Designated Facility Owner or Operator.Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Printed/Typed Name Signature Month Day Year EPA Form 8700.22(Rev.3-05) Previous editions are obsolete. GENERATOR'S INITIAL COPY Cycle Chem, Inc 201 South First Street Elizabeth,NJ 07206 PHONE: 908-355-5800, FAX: 908-355-0562 Land Disposal Restriction Notification and Certification Form Generator: DAVE DUCHESNEY PAINTING Manifest Tracking Number: 45545 EPAID: MAC300103777 Manifest Document Number: 016819468JJK Work Order: 79148 The EPA hazardous wastes identified below must be treated to the applicable treatment standards set forth In 40 CF'R 268.40. EPA Waste Code Information Manifest Line Waste- EPACodes water? Page 1 Line I No D001 (High TOC ignitable liquids subcategory),D035,F003,F005 Page 1 Line 2 No DOO1 (High TOC i nitable liquids subcategory),D035,F003,F005 Spent Solvent Constituents Manifest Line Solvents Page 1 Line 1 F003:acetone,methanol F005:methyl ethyl ketone Page 1 Line 2 F003:acetone,methanol F005:methyl ethyl ketone Underlying Hazardous Constituents (None present unless identified below.) anifest Line Constituents I certify that all information submitted On this Land Disposal Restriction and Certification Form is accurate and complete, to the best of my knowledge and information. Signature: Name: Title: Date: JUN 202017Pm12:13 Number Fee 1314 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Duchesney Painting 325 Stevens Street,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 ldd r a "�o of B nstable Kegi%atory Services Richard V. Scali,Director I VKWE Ta`"� Public Health Division :*: : BLE z _ urt•xra:�asBARNST 639. isren9r.ee;eMARS • Thomas McKean, Director 200 Main Street,Hyannis, MA 02601 Office: 508-862-4644 a19/ 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 El CATEGORY 3 PERMIT 500 or more Gallons: $150.00 M LDS. *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 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 (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: �C{{� UI butkesli-eu 5. NAME OF ESTABLISHMENT: — ve- atheS -e f h 6. ADDRESS OF ESTABLISHMENT: 3 Z-S- 9, ,eyeg -tyu—1 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: . S 8. 'TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: atle C om �S 10. SOLEOWNER: V YES_NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS AND wTELEPHON ./�'e E#OF. WIAE5�ivE)( M �171'h�("IT "- T CORP ORAT NAME 2/ Yam'W.!pr P8 Pok/ D Z(e 7 S� PRESIDENT TREASURER X, bur-AII CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE Q:Wpphcation FormS\HAZMAT APP 2017 REVIS am, I pis PEC"E-0 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM 6 2- W NAME OF FIRM: 6-UE4TiN 4,617W,/ 5A-5, IWC, MAILING ADDRESS: �0 ✓?Z3 STEYE,�/S ST: �Y/�ti�''cS1 /1'O. ez C�GI TELEPHONE NUMBER: T7� _zoo CONTACT PERSON: Does your firm store any of the toxic or hazardous materials listed below.; either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES ✓ NO This form must be returned to the Board of Health regardless of a YES or NO answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address : ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics' and must be registered when stored in quantities totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put a check beside each product. that you store: kntifreeze (for gaslirie or coolant systems) Refrigerants Automatic transmission fluid w Pesticides (insecticides, Engine and Radiator flushes herbicides,r..odentici.des) 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 Degreasers for engines and metal �/ Jewelry cleaners 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 Paint & Varnish removers, deglossers ✓ Any other products with Paint brush cleaners Poison labels (including Floor & Furniture strippers chloroform, formaldehyde, Metal polishes hydrochloric acid, other �Laundry soil & stain removers acids) (including bleach) Other products not listed which .you feel may be Spot removers & cleaning fluids(dry cleaners ) toxic or hazardous (please list) : Other cleaning solvents RECEIVE ® /f//C -I Bug and tar removers , HEALTH DEPT, I� Household cleansers, oven cljaa`"nPFsBARNSTABLE Drain cleaners Toilet cleaners Cesspool cleaners Disinfectants Road Salt (Halite) MAY 1 5 1981 TOWN OF BARNSTABLE BOARD OF HEALTH CONTROL OF TOXIC AND HAZARDOUS MATERIALS - INSPECTION SHEET FIRM Gu_ _ I •yt '�, ti ADDRESS aj or types of materials: 1) ;�� ' 2) —1V j make) 541 Wk 3) Alt&-d __6,0y� SOdty CY4r1 4) ( [ • ,.b e ®�� 5) . \ ��� �' 6) C 7` or G ac I I. Description of material(s) use: `QV�� i�C���l G liel Cleg-Al Ac II. Storage ' (denote product by number listed above) A. Containers metal glass paper plastic cans,bottles,j ars drums,barrels aboveground tanks underground- tanks ; bags,boxes 3 open,loose,uncovered inadequate labelling B. Storage Facility V/or.# Remarks/Recommendations 1. 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 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 5 a) name of hauler o �. b) address or disposal site U ro _ ..-. 0. Perso�(s) InterviewedV�_ — _ _g4j� — Inspector _ _ Xe�A�— • Date