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Home My WebLink About0405 WEST MAIN STREET - HAZMAT fps U1e�/ra in -- 1 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Kawasaki — Yamaha & Marine of Cape Cod Mail To: NAME OF BUSINESS: Board of Health MAILING ADDRESS: 405 West Main Street Town of Barnstable TELEPHONE NUMBER: 508 - 771-5900 P.O. Box 534 CONTACT PERSON: Wayne Zervis 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 quantities totallipol, 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: I� 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 - Please put a check beside each product that you store: Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners ✓ Hydraulic fluid (including brake fluid) Disinfectants ✓ Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) _v-" 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 spt,AY wAsN — Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business l � TOWN OF BARNSTABLE C MPLI WCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY �l� bl /�fj (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS I ffeeze Class: ' 7•Miscellaneous �TITIES AND STORAGE (IN=indoors;OUT=outdoors) �OR MATERIALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Sjrzlw ¢a . /IV rr e,4 2 (B Heavy Oils: - ............ waste motor oil (C) new motor oil(C) /.� tr draulic /'Jr, f/ Synthetic Organics: degreasers /Z � Mi cel aneou 6" Ark /r <,g3�� ice,✓ DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O Town Sewer OPublic O On-site OPrivate 3. Indoor Floor Drains YES NO O Holding tank: MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 1. 2. Perso n rviewed Inspector Date TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD O M RD OF HEALTH satisfactory 3.Auto Body Shops unsatisfactory- 4. anufacturers COMPANY k4lvA4/� A%Rr' (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESSy� —lass: t 7.Miscellaneous QU TITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: gasoline, rep A&@ A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C1 new motor oil(C) y � d raulic . ° Synthetic Organics: degreasers at ri�" Miscellaneous: i i v (idle DISPOSALIRECLAMA ION REMARKS: 1. Sanitary Sewage 2.Water Supply s 4)Town Sewer *Public O On-site OPrivate 101, 3. Indoor Floor Drains YES NO O Holding tank:MDC 0 Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: 0 Holding tank:MDC O Catch basin/Dry well O On-site system 5. Waste Transporter Name of Hauler Destination Waste Product 10 YES NO 1240,7 _PA V, 1. d 2• ems- :`,� a' Person (s) e ed Inspector Dfite f _ 4 s - TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF F I P,M: Kawasaki-Yamahl of C.C. 405 W. Main Street MAILING ADDRESS: Hyannis, MA 02601 (617)77"204 TELEPHONE NUMBER: CONTACT PERSON: Al Ah —73—MV15 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 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: i 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 I 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 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 E Battery acid (electrolyte) Fertilizers (if stored Rustproofers � ' Car wash detergents outdoors)PCBs 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 (dry cleaners) R E C E I V' E ® toxic or hazardous (please Other cleaningsolvents list.; HEALTH DEPT. Bug and tar removers TOWN OF BARNSTABLE Household cleansers, oven cleaners Drain cleaners Toilet cleaners Cesspool cleaners Disinfectants MAY 1 8 1981 Road Salt (Halite) TOWN OF BARNSTABLE BOAR ® OF HEALTH CONTROL OF TOXIC AND HAZARDOUS MATERIALS - INSPECTION SHEET FIRM A Gi✓ A ADDRESS Major types of materials: 1) , 3} 4) 6) I. Description of material(s) use II. Storage (denote product by number listed above) 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 ✓or # Remarks/Recommenu :Jons 1. Indoor a) separate, contained room b) stored in general work aready 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 o 6r- 3. Separate holding tank C. Off-site disposal 1. hauled by own firm �! sTo ��flT@ e�✓ n�s� 2. hired hauler °• a) name of hauler b) address or disposal site PerscLn(s) Intervie d — _ — — — — Inspector ` Date I 6 30 81 - - - - - - - - - - J COMOLIANCt� ' CLAS 1. Marine,Gas Stations,Repai.r TOWN . OF- BARNSTA`�B: I! % . Printers BOARD OF HEALTH �tisfactory 3. Auto Body Shops a unsatisfactory- 4. Manufacturers 1 1 (see"Orders") s. Retail Stores COMPANY "'`� ;�'` » �-i %i� ,^ I 6. Fuel Suppliers ADDRESS ,1 C�;:�>� '_ Class: 7. Miscellaneous t ) � QUANTITIES AND STORAGE (IN=indocrs; OUT=outdoors) / Case lots Drums AbnveTanks Underground Tanks MAJOR MATERIALS IN 100 UT IN [OUT IN VUT # gellons Ape rest? Fuels: Gasoline, Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil. . (C) 0 - transmission/hydraulic Synthetic Organics: ! degreasers Miscellaneous: p ( � r DISPOSAL RECLAMATION REW.RKS: 1. Sanitary Sewage 2. Water Supply Town Sewer Public _— Off On-site Private 3. .lndoor Floor Drains: YES N0 r O Holding tank: MDC — O Catch basin/Dry well On-site system ' 4.= Outdoor Surface drains:YES NC 3 O Holding tank: MDC O Catch basin/Dry well OOn-site system ____ �_---- -- —•--S. Waste Transporter Licensed? Name of�Hauleg_ Destination 11a5te Product YES NO TO 1. LA4 T�Pdf\ ` \ Uaii 1,6A r ,` j u' i ,I'erso ) I/,t.ervi-e ��" Inspector Date