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HomeMy WebLinkAbout0326 WEST MAIN STREET - HAZMAT r / � I I x Number Fee 47 THE COMMONWEALTH OF MASSACHUSETTS $o.00 Town of Barnstable Board of Health This is to Certify that Savon Gas 326 West Main Street, Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2014 . unless sooner suspended or revoked. --------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2013 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of larmta.ble or Regulatory Services °- Tnomas F. Ge33er,DirutDr } 3 3 Public Health Division MAC4 A hAO�a Thomas McKean, DindDr 200 Main Streit, Hyannis,MA 02601 OfEcs: 5084E 4644 F= 5OS-790-6304 A��li�a#ion F�a. �'1DD,D0 ASSESSORS-NLAP AND PARCEL NO. � �✓ DATE �1(� APPLICATION FOR PERNET TO STORE AND/QR UTI:= 1MGRE THAN III GALLqNS CE HAZARDOUS MATERIALS FDJ,L NAASE OF APPLICANT I ��J� /�iGYtT 'T_A3U OF ESTABI 3aEy T . ADDRESS OF EST �iU �� ��✓' TELEPHONE NUTYIBER SOLE O'W Ems: 4IS NO ® O IF APPLICANT IS A PARTN-KR=,FULL AND HONa ADDRESS OF AID PARTNERS: N y rn IF A.PPLICA--N-T IS A CORPORATION: ERAL IDENTH+'ICATION Na 4�� STATE OF INCORPORATION �'ITLZ NAME AND HO ADDRESS OF: PRESIDENT _ C-ILE= SIUi ATURE OF APPUCANT RESTRICTIONS: HOI ADDRESS L�r� H01f+ T=HONE# Thzdnc/wp/q i ,w SMF Town of Barnstable '"P"S`"BLS Regulatory.Services Public Health Division Thomas McKean,Director 200 Main Street,Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Certified Mail# 7015 1730 0001 4990 1338 August 30, 2017 V W M Associates LLC 22 Campion Road Yarmouth Port, MA 02675 RE : Sav-On Gas Station, 326 West Main Street,Hyannis NOTICE TO ABATE VIOLATIONS OF TOWN OF BARNSTABLE BOARD OF HEALTH REGULATIONS, HAZARDOUS MATERIALS STORAGE AND NUISANCE CONTROL The closed Sav-On gas station property located at 326 West Main St., Hyannis, MA was visited on August 30, 2017 by Timothy Lavelle, Hazardous Materials Specialist for the Town of Barnstable. This visit was conducted in response to a complaint filed with the Public Health Division. The following violations of the Town of Barnstable Board of Health Regulations, Chapter 108, Hazardous Materials, were observed: U08-5 (A) Storage Controls Two 55-gallon drums, of which one was 1/4 full of oily water, and a 5-gallon bucket full of unknown contents were observed outdoors on the west side of the building without protection from the elements, leakage, accidental'damage and vandalism, 'and without 110% secondary containment as required by Town of Barnstable Ordinance Chapter 108. You are directed to correct this violation within 24 hours of receipt of this order letter by removing the containers from the property and properly disposing or by moving the containers indoors onto an impermeable surface away from doorways and floor drains. In addition, the following violations of the Town of Barnstable Board of Health Regulations, Chapter 54 Building and Premises Maintenance were observed: 04-3 (A) Outdoor Storage and 454-5 (A) Storage and Removal of Rubbish Multiple items were observed outdoors on the east and north sides of the building and not screened from public view, as required by Town of Barnstable Ordinance Chapter 54. QAHazmat\2017-TL\20170830 SAV ON-326 w Main St.doc I Items observed included three indoor sofas and other broken furniture, a car engine block, an old Cumberland Farms gas pump, dozens of wooden pallets, and bags and broken bags of loose household rubbish. You are directed to correct these violations within fifteen (15) days of receipt of this order letter by disposing of all indoor furniture and rubbish and storing any potentially usable items screened from public view or in an enclosed structure. You may request.a hearing before the Board of Health if a written petition is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of$100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the above violations, please contact the Town Health Division and ask to, speak with the inspector who performed the inspection. PER ORDER OF THE BOARD OF HEALTH homas A. McKean, R.S. Director of Public Health Town of Barnstable Q:\Hazmat\2017-TL\20170830 SAV ON-326 W Main St.doc I WE Town of Barnstable MAS& ' Regulatory Services .,rA Building Division 200 Main Street,Hyannis,MA 02601 508-862-4679 fax 508-862-4725 Initial Site Plan Review Issues & Concerns Pre-application meeting with applicant 9/19/17 Applicant: Sav-On Gas SPR#: 043-17 Revised Property Address: 326 West Main Street,Hyannis Draft Plan revised 8-21-17 Map/Parcel: Map 269,Parcel 159 Zoning: HB,WP Overlay Proposal: Tear down of existing Sav-Qn gas station and removal of existing underground fuel tanks. Construction of new building with five service bays: three bays for oil changes and minor repairs,one bay for State inspections and one bay for alignments. Staff Brian Florence, Building Commissioner/SPR Chairman Elizabeth Jenkins, Director, Planning & Development Tom McKean, Director, Health Dept. Dean Melanson, Deputy Chief, Hyannis Fire Dept. Anna Brigham, Principle Planner, Planning& Development Elizabeth Hartsgrove- Supervisor, Consumer Affairs Ellen Swiniarski—Coordinator Applicant/Representatives Nazih Elkallassi & Jake - Owners/Applicants Attorney Benjamin J. Losordo Mike Pimental, Engineer, JC Engineering, Inc. Subsequent to the site plan review staff meeting held June 20, 2017, a pre-application meeting with the applicant was held on June 27, 2107 to review staff comments. Revised plans were reviewed with the applicant and representatives on September 19, 2017. The following information was discussed: Applicant/Representatives—Proposal • Demo/rebuild—convert from gas station to quick oil change facility • Changed plan—moved building and entrances. • Closing curb cut on West Main—proposing 2 curb cuts on Pontiac • Less intense use from gas station- 5,000 gallons less per day haz mat usage. • Traffic figures indicate 7 trips per hour average. • Customer turnaround time 10-12 minutes. • Services: o 3 oil change bays (any other fluids) and minor repairs= lights, belts etc. o 1 bay for alignments o 1 bay for State inspections • Existing tanks buried, proposed to be above ground • Sin Oil—for waste oil disposal. • Unable to meet existing non-conforming impervious surface of 70% - now at 77% - will use impervious pavers to bring back to existing 70% impervious 1 i^j Tf • 24 parking spaces are proposed. • 4 employees, possibly 5 —no cueing is anticipated based upon experience. • Will add Hyannis ladder truck turn template on final plan. • 45 ft landscape set back cannot be met. • Design = 12"thick reinforced walls with epoxy coating • Proposed to fill tanks by bringing hose into the basement • 9,000 total gallons of HazMats proposed as follows: 0 1,000 gallons waste 0 6,000 gallons clean 0 2,000 other fluids in cans, etc. Brian Florence, Building Commissioner/SPR Chairman • The office and waiting area is requested to be depicted on the final floor plan. • An engineering study and code narrative will need to be submitted and approved for the design of the proposed tanks explaining how they comply with fire and building code, citing each related section of CMR. Hyannis Water Department will be seeking proof that the site is in full compliance due to the close proximity to Town's drinking water wells. Elizabeth Jenkins—Director, Planning &Development Dept. • Project abuts residential land uses—the Zoning Board of Appeals will be interested in hours of operation, noise, etc. • Site is non-conforming. HB District landscape bylaws should be followed and further enhanced with dense landscaping, hedges or fencing along the residential property lines. • Relief from the Zoning Board of Appeals will be required for landscape setback and reduction of parking. • A Conditional Use Special Permit for uses in the HB District will be required. • Trip generation numbers comparing prior use versus proposed use will be of interest to the Zoning Board of Appeals. • The type of proposed fencing is requested to be identified. Tom McKean—Director, Health Department • A written spill response plan is required to be submitted to the Health Department for approval. Notification to the Hyannis Fire Department is required to be included in that plan. Hyannis FD—Deputy Chief Melanson • Fire safety sprinkler system is required to be installed • Location and sizing of the water main and separate fire service line is required to be added to the plan. • Fire flow testing is required to ensure adequacy. • Filling hose may not be brought into the basement. An outside fitting must be utilized for tank filling. • The FD ladder truck turn template and location of the filling truck parking space is required to be added to the landscape plan. • If pervious pavers are proposed in order to not exceed existing lot coverage, they should be located away from any area designated for filling trucks. • Curb stops will be required in spaces utilizing pervious pavers. • Double walled tanks are a State requirement—(527 CMR)—the 12 in. reinforced cement, epoxy coated basement walls are considered to be tertiary containment. 2 i • CO2 detectors and a 2nd egress from the basement area are required. Consumer Affairs—Elizabeth Hartsgrove—Supervisor • Removal of existing underground tanks require permits and oversight by the Hyannis Fire Department. • Permit/Licensing procedure for the installation of new tanks will depend upon total gallons proposed in the final plans. At a minimum,the existing Town Manager License will require amending to reflect that the tanks are above ground as well as the capacity of the tanks. Staff identified the following comments previously provided to the applicant to still be relevant and outstanding: DPW—Amanda Ruagerio, Assistant Town Engineer • Utility plans will need to be provided • Design of sewer and water hookup will require consultation with DPW. • Drainage plan and calcs will need to be provided. • All storm water must be retained onsite. • A lighting plan is required to be provided. • An estimate of wastewater flows is requested. • Dimensions of the access ways are requested. • Request detail of sidewalk—HC ramps required at driveways. Hans Keiiser—Hyannis Water Dept. • Expressed that he is opposed to the project due to the close proximity of the Towns wells. • The Zoning Board of Appeals will need to decide if this use is appropriate. REVISED PLANS AND FORMAL SITE PLAN REVIEW WILL BE REQUIRED. 0 Ct--(L/- (�A a.v SECTIONSENDER: COMPLETE THIS ■ Complete items 1,2,and 3. A. ' nature 0 Print your name and address on therreverse x �4 Agent .so that we can return the card to you. 0 Addressee 0 Attach this card to the back of the maiipiece, B eceived by(Pont E' C. Date of Delivery or on the front if space permits. P�SCl tt -��j Q—5-�1 1.Article Addressed_to: _ D. Is delivery address different from item 1? ❑Yes V W M Associates LLC _I If YES,enter delivery address below: ❑No 22 Campion Road Yarmouth Port:, MA. 02675 I ice IIIIII III III I II I I I II I I II I I I I III I I II I I II I ❑Adult Sign tureeRestrtgted Delivery ❑Reggistered Mal Restricted Certified Mall® Peigr 9590 9402 1934 6123 1099 75 ❑Certified Mali Restricted Delivery g!Retum Recelpt for O Collect on Delivery Merchandise 2. Article Number(ffaltSfer ffOm SeNICe label) El Collect on Delivery Restricted Delivery 11 Signature Confirmation- ❑Insured Mail ❑Signature Confirmation 7 015 17 3 0 0 0 01 4 9 9 0 13 3 8 ❑Ihsu Mall Restricted Delivery Restricted Delivery (over$500) PS Form 3811,July 2015VPSN 7530-02-000-9053 Domestic Return Receipt USPS TRACKING# r r 11-1 r.F+t1tr it 1. t INI First-Gass Mail Postage&Fees Paid USPS Permit No.GAO 9590 9402 1934 6123 1099 75 United States •Sender:Please print your name,address,and ZIP+4®in this box* Postal Service _ Public Health Division Town of Barnstable 200 Main Street Hyannis, MA 02601 I �tj,���ii:91,r„ �j,,�rlli►J�ll1�� 411r„�J,lftl� i a xa CO a - o 0 F FI 0' Certifiedmail FeeEr $ Extr Services&Fees(check box,add fee es eppropdate) eturn Receipt(hardcopy) $ r ❑Return Receipt(electronic) $ l Postmark i r3 ❑CeNfled Mail Restricted Delivery $ Here O []Adult Signature Required $ d1 R ❑Adult Signature Restricted Delivery$17 O Postage .✓ m rqTotal Postage and Fees dd $ ✓ l t � se"rr° V W M Associates LLC r- Sfreeiani 22 Campion Road afy sfafE Yarmouth Port, MA 02675 ,ii Certified Mail service provides the following benefits: IN A receipt(this portion of the Certified Mail label). for an electroc return receipt,see a retail •A unique identifier for your mailpiece. associate for assistance.Tareceive a duplicate •Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the 4 •A record of delivery(including the recipient's retail associate. signature)that is retained by the Postal Service' Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent _ Important Reminders: Adult signature service,which requires the ■You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mail®,First-Class Package Service®, available at retail). t or Priority Mail®service. Adult signature restricted delivery service,which •Certified Mail service is notavailabie for requires the signee to be at least 21 years of age international mail. and provides delivery to the addressee specified ■Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark.If you would like a postmark on - •For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for c the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion, of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.> electronic version.For a hardcopy return receipt, f, complete PS Form 3811,Domestic Return Receipt,•attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records. Ps Form 3800,Apol 2015(Reverse)PSN 7530.02-000.9047 Citizen Web Request Page 1 of 1 ' y 0 �Ltis dddttt Citizen Request Management p� I.di`Z„ i4S0 n Ar4 Request ID: 59050 Created: 8/30/2017 9:43:44 AM Status: Assigned To Staff Assigned To: Lavelle,Timothy Health Office Chapter 108 Anonymous: No Category: Hazardous Materials Chapter 54-5 : Rubbish and Garbage E.C. Date: 9/13/2017 Created By: Soto, Kathryn Citations: j Health Office Time Worked: 0 Response Time: 0 Request Location: Neighbor sent in letter reporting garbage,furniture and car engine parts in abandoned lot. See copy of letter in your inbox. Request Work History: pet 05'16 eveC ev t,9f-eeR? (�jl3o�i7 tLOf"p3 xv&'+I&vt g - 2. s �c�vt�g t,J2gk 5,A- ' ev-tPTy) i 'l root p'l'y (NG'12r� ,A&Ve- t1/�OOfS IVVI1^2e�i4."��/�� C0 5 o a`�—�a1 bJGI s JwV�NGk — 1 0 V-T-91 sk--q%e4 �IC'k J?-�C-jCAX , j U ve.71 S�C C4 a,Vi-+'re,' e� --• �c�.5� `���X N�s� Si�. � 3 lu��{ So��g� � I I�dGoo.r. �.�nat,{' OL VL vim_ 1 oc.LC.� a,ti. D E, wm3a—r6 vi.,cQ t—o��wtr5�4 4 100 ,1�-� �o-�t,s a� woad�-- Pw►le.-f s� bc� 5 f .�fo S � too(�-.. http://issgl2/InternalWRS/VVRequestPrintPub.aspx?ID=59050 8/30/2017 6 C. _ e. _ /la _ 4 -Iles o - - c is CZkd -- i Qeu - CQA as L CtA-aiCzAJUA-ed . 1 - - r -_ c --_ .Ke reset orc,4 L.e emu. L . Cod- O LAXlC c. ca.v� ---/.oa v . _ may. cam, . A-Aec� rv--- Gv idc( _._ �- f Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMA.Bq • 200 Main Street• Hyannis, MA 02601 16 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Jav ow &,-L 5 Date: -7 Location/Mailing Address: 3 Z(o I Contact Name/Phone: S -y AA-Pk -S-ba- :Z Inventory Total Amount: MSDS: License#: Tier II : Labeling: Spill Plan: Oil/WaterSeparator: Floor Drains: Emergency Numbers: Storage Areaslranks: 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: Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS °p IKEr Town of Barnstable " Office:508-862-4644 Public Health Division Fax:508-790-6304 B`",„�'E�,' 200 Main Street• Hyannis, MA 02601 0r3u9+'�0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name. ,'Sc v p H- t�'U 5, Date: /f% /? Location/Mailing Address: ZS+ Contact Name/Phone: S"a�3-` 1. Inventory Total Amount: MSDS: License#: Tier[I : Labelina: 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. t 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 irk Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar + m Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda ` t 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: t£ Ln5 �,1 �DOAk yo 4 rX k:'S (41'1 0 0A) rt\,V_ ��•ti W�n¢,n G���5 J�C�` A u lvk, � Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS IMF Town of Barnstable Office:508-862-4644 • °� Public Health Division Fax:508-790-6304 • RnRMASS. .� 200 Main Street• Hyannis, MA 02601 *b M p,0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rE0 MPS Business Name: SaV ©►1, &a Date: Location/Mailing Address: 3 7.6 OZS4- a►vL avtel1S Contact Name/Phone: a ` wit -"72 -ot o0 Cc,>Z. A I InventoryTotal Amount: < 2 A"o MSDS: �wlt - License#: A Tier II : Q o Labeling: &A iA Spill Plan: Oil/WaterSeparator: MIA Floor Drains: No Emergency Numbers: —, Storage Areas/Tanks: S 1 - '; t'oLft p vti t wk- , 11�✓ts-1 1. +4 Ito-] Emergency/Containment Equipment: �, Waste Generator ID: uA)X.\A.VV0\&, 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: I`� 0015 C pt 46 Ovu 5%A-9- ORDERS: Qcc" l v 5 INFORMATION/RECO MENDATI N 0. 0.7 A. o •2� a � v�.S ,2 C..C..� •I-. o-� o - r Inspector:I o — CaJ� �� �Ldocs - ° e 1�/�dZoat S �w� t ear. W S Pa cility Representative: r 1 0 WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS `°p THE A "'f• Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • enaM�LE, 200 Main Street•Hyannis, MA 02601 �1°tEDMrta`0� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: A\j 1f) S Date: �3 y Location/Mailing Address: Oess�- I S Contact Name/Phone: T yAagk Sow-7�6-�-►00 Inventory Total Amount: < MSDS: QyAiy F..-CA-c-c.e-55 License#: eX lr�`w�- Tier II : P10 Labeling: i9K Spill Plan: MIA _ Oil/Water Separator: NV Floor Drains: Emergency Numbers: e-5 Storage Areas/Tanks: 1 r� Emer enc /Containment Equipment: N Aa-- Waste Generator ID: rJJA 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 VHydraulic fluid (including brake fluid) V 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, '1 hydrochloric acid, other acids) VIOLATIONS: I o ORDERS: )10-I'4,yn 5DJ1 � a Sb �tS o� G CGS d',��I ls �a� awr,05, INFORMATION/RECOMMENDATIONS: ?1,7Q4b oo falw J-1\_ v Inspector: 1 . Facility Representative* WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS Fl At- 8/21/2012 Town of Barnstable Page 2 of Fuel Tanks 10, 13, 15, 17, 19, 20+ Years Old which Require Testing Tank Owner Tank Age in Map Parcel Property Location Owner Address No Tag No Years Install Date Test Date 249105 830 WEST MAIN STREET GOODWIN, ROBERT H TR 5 01308 15 11/1/1996 8/21/1997 Hyannis 830 W MAIN ST HYANNIS, MA 02601 254016 1800 IYANNOUGH ROAD/RTE132 BARNSTABLE,TOWN OF(LB) 1 14 4/5/1998 Barnstable 367 MAIN ST HYANNIS,MA 02601 269159 326 WEST MAIN STREET V W M ASSOCIATES LLC 4 01107 19 5/1/1993 9/27/1996 Hyannis 22 CAMPION RD YARMOUTH PORT, MA 02675 292005 317 FALMOUTH ROAD/RTE 28 HESS CORPORATION 1 01374 14 9/29/1997 2/10/1998 Hyannis PO BOX 696419 SAN ANTONIO, TX 78269-6419 292005 317 FALMOUTH ROAD/RTE 28 HESS CORPORATION 2 01375 14 9/29/1997 2/10/1998 Hyannis PO BOX 696419 SAN ANTONIO,TX 78269-6419 292005 317 FALMOUTH ROAD/RTE 28 HESS CORPORATION 4 01373 14 9/29/1997 2/10/1997 Hyannis PO BOX 696419 SAN ANTONIO,TX 78269-6419 299026 3171 MAIN ST./RTE 6A(BARN.) BARNSTABLE COMEDY CLUB INC 1 00193 29 3/9/1983 11/23/1993 Barnstable BOX 361 BARNSTABLE,MA 02630 300008 3206 MAIN ST./RTE 6A(BARN.) FIELD,JOHN A&BEARSE, M 1 00000 14 1/1/1998 Barnstable KRISTEN 570 GRAND STREET,APT H1305 NEW YORK,NY 10002 308039 228 NORTH STREET THORNTON,DAVID S&LESLIE L TRS 8 01020 22 1/1/1990 5/18/1998 Hyannis 242 JOE THOMPSON ROAD WEST BARNSTABLE, MA 02668 308039 228 NORTH STREET THORNTON,DAVID S&LESLIE L TRS 9 01021 22 1/1/1990 5/18/1998 Hyannis 242 JOE THOMPSON ROAD WEST BARNSTABLE, MA 02668 8/21/2012 Town of Barnstable Page 3 of Fuel Tanks 10, 13, 15, 17, 19, 20+ Years Old which Require Testing Tank Owner Tank Age in Map Parcel Property Location Owner Address No Tag No Years Install Date Test Date 308039 228 NORTH STREET THORNTON,DAVID S&LESLIE L TRS 10 01022 22 1/1/1990 5/18/1998 Hyannis 242 JOE THOMPSON ROAD WEST BARNSTABLE, MA 02668 308039 228 NORTH STREET THORNTON,DAVID S&LESLIE L TRS 11 01023 22 1/1/1990 5/18/1998 Hyannis 242 JOE THOMPSON ROAD WEST BARNSTABLE, MA 02668 308039 228 NORTH STREET THORNTON,DAVID S&LESLIE L TRS 12 01024 22 1/1/1990 5/18/1998 Hyannis 242 JOE THOMPSON ROAD WEST BARNSTABLE,MA 02668 308039 228 NORTH STREET THORNTON,DAVID S &LESLIE L TRS 13 01025 22 1/1/1990 5/18/1998 Hyannis 242 JOE THOMPSON ROAD WEST BARNSTABLE,MA 02668 309230 95 HIGH SCHOOL ROAD EXT HYANNIS FIRE DISTRICT 2 00000 25 8/1/1987 3/18/1997 Hyannis 95 HIGH SCHOOL ROAD HYANNIS,MA 02601 310119 375 BARNSTABLE ROAD CUMBERLAND FARMS, INC 4 00000 16 3/27/1996 12/9/1997 Hyannis 100 CROSSING BLVD,V0742 FRAMINGHAM, MA 01702 310119 375 BARNSTABLE ROAD CUMBERLAND FARMS, INC 5 00000 16 3/27/1996 12/9/1997 Hyannis 100 CROSSING BLVD,V0742 FRAMINGHAM,MA 01702 310119 375 BARNSTABLE ROAD CUMBERLAND FARMS, INC 6 00000 16 3/27/1996 12/9/1997 Hyannis 100 CROSSING BLVD,V0742 FRAMINGHAM,MA 01702 311079 199 FALMOUTH ROAD/RTE 28 LEEMILT'S PETROLEUM, INC 7 00000 17 4/24/1995 5/18/1995 Hyannis 125 JERICHO TURNPIKE, STE 103 JERICHO,NY 11753 311079 199 FALMOUTH ROAD/RTE 28 LEEMILT'S PETROLEUM,INC 8 00000 17 4/24/1995 5/18/1995 Hyannis 125 JERICHO TURNPIKE, STE 103 JERICHO,NY 11753 326025 49 OCEAN STREET NEW ENGLAND TEL&TEL CO 3 00000 20 11/27/1991 12/27/1994 Hyannis P O BOX 152206 IRVING,TX 75015-2206 as•• 8/21/2012 Town of Barnstable Page 4 of 4 Fuel Tanks 10, 13, 15, 17, 19, 20+ Years Old which Require Testing Tank Owner Tank Age in Map Parcel Property Location Owner Address No Tag No Years Install Date Test Date 327055 112 BARNSTABLE ROAD POWER TEST RLTY CO LTD 9 00000 17 1/24/1995 Hyannis 1500 HEMPSTEAD TURNPIKE EAST MEADOW,NY 11554 327055 112 BARNSTABLE ROAD POWER TEST RLTY CO LTD 10 00000 17 1/24/1995 Hyannis 1500 HEMPSTEAD TURNPIKE EAST MEADOW,NY 11554 327069 17 ELM AVENUE PLYMOUTH&BROCKTON STREET 3 01307 15 6/25/1997 Hyannis RAILWAY CO 8 INDUSTRIAL PARK RD PLYMOUTH, MA 02360 327264 50 OCEAN STREET CHRISTYS REALTY LP 6 01131 19 5/1/1993 3/3/1998 Hyannis PROPERTY TAX DEPT ONE HESS PLAZA WOODBRIDGE,NJ 07095 327264 50 OCEAN STREET CHRISTYS REALTY LP 8 01133 19 5/1/1993 3/3/1998 Hyannis PROPERTY TAX DEPT ONE HESS PLAZA WOODBRIDGE,NJ 07095 3/20/2015 Town of Barnstable Pagel of 5 Fuel Tanks 20 Years Old and In Zone of Contribution + 5p),4 Zov--�L- Tank Owner Tank Age in Town State Map Parcel Property Location Owner Address No Tag No Install Date Years ZOc ZOc 021008 140 OLD OYSTER ROAD BARNSTABLE, TOWN OF (SCH) 2 00652 7/25/1988 26 SPLIT SPLIT �oob G Cotuit + ' P.O. BOX 955 Ao°o Y41 Cor`UIC1til tx}4ry 5C1�v o HYANNIS, MA 02601 ,10'1k y 024021 4418 FALMOUTH ROAD/RTE 28 JASON, REGAN C& TASHA, M J TRS 1 00870 9/15/1987 27 WP IN Cotuit P O BOX 692 80ryal �— SAGAMORE,MA 02561 4 S scivtt"" 024021 4418 FALMOUTH ROAD/RTE 28 JASON, REGAN C& TASHA,M J TRS 2 00871 9/15/1987 27 WP IN 0/1-IL Cotuit P O BOX 692 gQO�ia� SAGAMORE,MA 02561 024021 4418 FALMOUTH ROAD/RTE 28 JASON, REGAN C &TASHA, M J TRS 3 00872 9/15/1987 27 WP IN2�t . Cotuit P O BOX 692 t000141 SAGAMORE, MA 02561 jklli- s'►t�' ' 024021 4418 FALMOUTH ROAD/RTE 28 JASON, REGAN C &TASHA, M J TRS 4 00873 9/15/1987 27 WP IN Cotuit T=OX 692 '{000 Ral SAGAMORE, MA 02561 d'e"5'0 104002T00 1000 RACE LANE / BARNSTABLE, TOWN OF(LB) 2 00931 7/6/1989 25 GP OUT _ r (, Marstons Mills ✓ 367 MAIN STREET 10'11001&1 � w HYANNIS, MA 02601 >�v 104001TOY 1460 ROUTE 149 BARNSTABLE, TOWN OF(MUN) 1 01052 1/1/1990 25 SPLIT OUT �� 4 Marstons Mills 367 MAIN STREET loop HYANNIS, MA 02601 104003T00 1460 ROUTE 149 BARNSTABLE, TOWN OF(MUN) 2 01053 1/1/1990 25 SPLIT OUT C4- Marstons Mills 367 MAIN STREET yoeo ya HYANNIS,MA 02601 �a5 g� 117026 981 MAIN STREET(OST.) CALLAHAN, RICHARD P TR 7 00205 11/9/1992 22 WP IN Osterville C/O HOSTETTER, DANIEL J� ,q �I� p� 770 A MAIN ST .,pi %� \ OSTERVILLE, MA 02655 9p0 G� y 117026 981 MAIN STREET(OST.) CALLAHAN, RICHARD P TR 8 00206 9/1/1986 28 WP IN Osterville C/O HOSTETTER, DANIEL 770 A MAIN ST �o ,\` 001 OSTERVILLE,MA 02655 b0 I 3/20/2015 Town of Barnstable Page 2 of 5 Fuel Tanks 20 Years Old and In Zone of Contribution Tank Owner Tank Age in Town State Map Parcel Property Location Owner Address No a No Install Date rs ZOC ZOC 117026 981 MAIN STREET(OST.) CALLAHAN, RICHARD P TR 9 00205 11/18/1992 22 WP IN Osterville C/O HOSTETTER, DANIEL 770 A MAIN ST OSTERVILLE, MA 02655 124005 540 OLD FALMOUTH ROAD SHAFFER, SEMA L f�, �{, 1 00478 1/1/1968 47 ( SPLIT IN SN�� g Marstons Mills oK I 24 CORCORAN STREET ceI V—� 33o 1A, 5�kG- g,�+wP L�1/ RANDOLPH, MA 02368 fk'e4 215027002 2155 IYANNOUGH ROAD/RTE132 MASSACHUSETTS, 9 01027 1/5/1990 25 SPLIT SPLIT West Ba stable n 7 COMMONWEALTH OF (HIGHWAY) 15 Jolt w}t NQ2.,�5 �Oat-�� O�jl e( 9 2155 IYANNOUGH RD/RT 132 b-r 1 '0 ppp aw aj . WEST BARNSTABLE, MA 02668 215027002 2155 IYANNOUGH ROAD/pTE132 ' MASSACHUSETTS, 10 01028 1/5/1990 25 SPLIT SPLIT West Barnstable p,00 41g �1a COMMONWEALTH OF(HIGHWAY) 4', � \ 2155 IYANNOUGH RD/RT-132 WEST BARNSTABLE, MA 02668 254015 10 ATTUCKS LANE MACGREGOR, J BRUCE TR 1 00966 1/4/1986 29 WP IN Barnstable DRAWER W Loo If,,1 G HYANNIS, MA 02601 � .5tS ' 254015 10 ATTUCKS LANE MACGREGOR,J BRUCE TR 6V "-A'? 2 009651 1/4/1986 29 WP IN $ L� Barnstable DRAWER W c D� a HYANNIS, MA 02601 aQi4� 269002 549 WEST MAIN STREET y BARNSTABLE, TOWN OF(SCH) 3 � '1 01114 7/1/1989 25 SPLIT SPLIT Hyannis P.O. BOX 955 101on o91 I , HYANNIS, MA 02601 S��' I�UYJ�� 269002 549 WEST MAIN STREET BARNSTABLE, TOWN OF(SCH) 4 1 01113 7/1/1989 25- SPLIT SPLIT Hyannis P.O. BOX 955 0'p Q e,\ HYANNIS, MA 02601 R M 269159 326 WEST MAIN STREET V W M ASSOCIATES LLC 4 01107 5/1/1993 21 WP IN Hyannis 22 CAMPION RD 104., n 1 C YARMOUTH PORT,MA 02675 f n 3/20/2015 Town of Barnstable Page 3 of 5 Fuel Tanks 20 Years Old and In Zone of Contribution Tank Owner Tank Age in Town State Map Parcel Property Location Owner Address No Tag No Install Date Years ZOc ZOc 274020 1449 IYANNOUGH ROAD/RTE132 GLOBAL COMPANIES LLC 6 00000 9/1/1989 25 WP IN Hyannis ATTN: TAX DEPARTMENT 0°0 36 E INDUSTRIAL ROAD BRANFORD, CT 06405 274020 1449 IYANNOUGH ROAD/RTE132 GLOBAL COMPANIES LLC 7 00000 9/1/1989 25 WP IN Hyannis ATTN: TAX DEPARTMENT 000 �— 36 E INDUSTRIAL ROAD �a6 �hd, BRANFORD, CT 06405 274020 1449 IYANNOUGH ROAD/RTE132 GLOBAL COMPANIES LLC 8 00000 9/1/1989 25 WP IN Hyannis ATTN: TAX DEPARTMENT > 0°0 G 36 E INDUSTRIAL ROAD BRANFORD, CT 06405 ��,�,�� 274020 1449 IYANNOUGH ROAD/RTE132 GLOBAL COMPANIES LLC 9 00000 9/1/1989 25 WP IN doJ Hyannis ATTN: TAX DEPARTMENT �000 36 E INDUSTRIAL ROAD �oa>° BRANFORD, CT 06405 274020 1449 IYANNOUGH ROAD/RTE132 GLOBAL COMPANIES LLC 10 00000 9/1/1989 25 WP IN Hyannis ATTN: TAX DEPARTMENT jo°o VA 36 E INDUSTRIAL ROAD v;Okk BRANFORD, CT 06405 289140 88 GREENWOOD AVENUE WHITCOMB, LINDA MARIE CARA 1 0 1/1/1968 47 ( SPLIT OUT Hyannis J DONNA 1 ��0,1 - y zxk� x 88 GREENWOOD AVENUE �teL` HYANNIS, MA 02601 � l� 293001 382 FALMOUTH ROAD/RTE 28 BARNSTABLE, TOWN OF (MUN) 7 00754 9/26/1988 26 SPLIT SPLIT Hyannis 367 MAIN STREET poo �a HYANNIS,MA 02601 �xl 293001 382 FALMOUTH ROAD/RTE 28 BARNSTABLE, TOWN OF(MUN) 8 00755 9/26/1988 26 SPLIT SPLIT ,I, Hyannis 367 MAIN STREET °' lT qr HYANNIS,MA 02601 bo�,J" 1 / 293001 382 FALMOUTH ROAD/RTE 28 BARNSTABLE, TOWN OF(MUN) 9 1 00756 9/26/1988 26 SPLIT SPLIT Hyannis 367 MAIN STREET b p00 q4 HYANNIS, MA 02601 12, 3/20/2015 Town of Barnstable Page 4 of 5 Fuel Tanks 20 Years Old and In Zone of Contribution Tank Owner Tank Age in Town State Map Parcel Property Location Owner Address No Tag No Install Date Years ZOc ZOc �(o� 295004001 0 WILKENS LANE CAPE COD HOSPITAL 2 00040 10/1/1985 29 WP IN Barnstable GLEASON HOUSE h �� G 14� bnn,5 St4�rSfM�I 27 PARK ST � �� `��ti �-� � ►�^' HYANNIS, MA 02601 311017 590 IYANNOUGH ROAD/RTE132 JAY IMAD ENTR IYANNOUGH RD 1 00890,/ 1/1/1987 28 GP IN Hyannis - LLC 326 WEST MAIN ST I�-►�o(7 HYANNIS, MA 02601 qah 311017 590 IYANNOUGH ROAD/RTE132 JAY IMAD ENTR IYANNOUGH RD b2 \ 00891 4 1/1/1987 28 GP IN 9 ©� Hyannis LLC 1Z,000 326 WEST MAIN ST q07 HYANNIS, MA 02601 311017 590 IYANNOUGH ROAD/RTE132 JAY IMAD ENTR IYANNOUGH RD 3 00892 5/1/1987 27 GP IN Hyannis LLC -4 0p0-1a,\ ! '►}�� 326 WEST MAIN ST ' 4wg HYANNIS, MA 02601 311017 590 IYANNOUGH ROAD/RTE132 JAY IMAD ENTR IYANNOUGH RD 6 0000 1/1/1986 29 GP IN Hyannis LLC ov ti� .g 326 WEST MAIN ST HYANNIS, MA 02601 y10 �pD �311022003 513 BARNST BLE ROAD BARNSTABLE, TOWN OF(ARP) 2 00000 8/1/1981 33 GP IN �L� x Hyannis J`54 , 6 SYLVAN WAY • it) has !3c pr. � J PARSIPPANY,NJ 07054 5�' 5k� �,1 O 311060 -39 OTIS ROAD? Al t, JEAN,ANDREW M 1 01050 11/5/1990 24 GP IN Hyannis p f 39 OTIS ROAD \vc \o,\ a' X HYANNIS, MA 02601 S� gk�� kS� 327055 112 BARNSTABLE ROAD SAVON HATEM LLC 9 00000 1/24/1995 20 SPLIT OUT Hyannis 607 EAST MAIN STREET 1 poo e �' `� Andih FALMOUTH,MA 02540 327055 112 BARNSTABLE ROAD SAVON HATEM LLC 10 00000 1/24/1995 20 SPLIT OUT �aS Hyannis 607 EAST MAIN STREET 00 FALMOUTH,MA 02540 bo`if� -{-acg �oble, ,a1�� ber 9 �•[Sg 3/20/2015 Town of Barnstable Page 5 of 5 Fuel Tanks 20 Years Old and In Zone of Contribution Tank Owner Tank Age in Town State Map Parcel Property Location Owner Address No Tag No Install Date Years ZOc ZOc 329003 480 BARNSTABLE ROAD BARNSTABLE, TOWN OF (ARP) 6 01266 12/19/1985 29 SPLIT IN Hyannis 480 BARNTABLE HYANN SSMA 02601�2ND FL �p� iw n b 9\44y Q(o� 329003 480 BARNSTABLE ROAD BARNSTABLE, TOWN OF (ARP) 15 01118 1/1/1990 25 SPLIT IN Hyannis 480 BARNSTABLE RD 2ND FL Ss ��1\ C a1gcf�x , HYANNIS, MA 02601 Q, 1 �S� ll }GGY` s 1-he Commonwealth of Massachusetts Department ,of Public Safety Division of Fire Prevention and Regulation PERMIT Date TO MAINTAIN AN EXISTING/NEW UNDERGROUND STORAGE FACILITY i.' In accordance with the provisions of 527 r:MR 9.26 this permit to maintain an existing/new undergroa a facility Y is granted to: Location of property: 300 West Main Street ..i Owner of property: Street address p P Y� Drake Petroleum Company, Inc. Full Restrictions: name of person. firm or corporation 1(one) 18,000 gallon multi product u/g storage tank including diesel Fee Paid:$ Lp (M.G.L.A. Chapt. 148 Sec. This permit will expire tz bi FORM F.P. 290 Date Sig atu►e f Head of re Dept. or a (rev. 10/90) P ppolnte designee (Owner's copy to be posted a+i the storage facility) j! t' Kv , .. Not MMMMMI v:r v "'.';•. '\':Sn.ti?{ 'i�\1,N «�2e�•2ba w+f'F'\a-�is:+'k}"{$�M.,',�t])S: 05�3. <�`' `i%Sifx•:,v � ^f :�:U'�\�r' f� fii4:,� �5:�: 'r,� ` �j .`+> if.i,a'.• {+ t A?s:iisiifs..i:;::i'Xis:ffAii::i.">j s>`,':i� 'iS ; Yt S .� k� '� � '��'•,.,';q."'r^4+.'',Z;<+},e�;.;}%� .S"��K•, ' �.�y�; +x � ,f:fi�y.�s�1:J.�2,ifi: wv�.Wr•h\.,"`�`F`::. .w.J.�:'S:,,Kv..kv�.' .:. , : .. .^.;.f'".: ai' :• : S'1 2' • K :tt{{ "'�;: .�y�.`E`+" Kr K�}�4'k::,G�cK;>?; .. t� +nK,', 'MM ?,' -. :fin "� •'s:3. .,n. �x •.{„x � , .... .. - SSca. ... ... ... v r: . , 1 / �c ��- �� �� � � � ��� TOWN OF BARNSTAB E IA� UNDERGROUND FUEL AND CHEMICAL ST KGMSTTE S �D � y NAME "t c vn C. ����'�-�L� t J► l� I . ADDRESS s 3QC �eJ� ���n cS� • VILLAGE LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE: (,'q/leks OR CHEMICAL Uyj en Yeo on o Ado /n e / 7 .Steel o (Give same information for any additional tanks on reverse side f car ) T DATE OF PURCHASE OF EACH: jq((. 1. a�a 2. a J 3. -3 0 0 0 4 300 0 DATE OF FIRE DEPARTMENT PERMIT: TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS •- . - a e'er . K c e= . ,f, - •_ fir.;_ �• �_ y - •.f ... � • �� "_ t -. t:..•� - p �• Manager' ♦ r ,_ '" :. Triple 3 c/o .Old. Colony .Petroleum .Co. R " "Quincy, Ma: 02169 k i West Main 'Street.-.Hyannis Rte 28"1 Hyannis s `• j. r .f �„�'• _ • .;st � � � ., a r:- •G:� • v • v • � a r .. 4 ��d b �� u<F r .,. a� • - •4� - s.K ._ Y #`6 .... � t., .. ... q y. 3; AW .. I * �;t ..' a '+ P _ • � � r 9'` # .4j � � c,#. ! • >'.-fin r. wE +.� .+ •'•.� .a 4u !~ ' t ..''y. .sa 'S _ r .. fr• �•- Y c�,:+ .*.p y .. �.rtie ♦ .ar � / •� ' ' °'i sC. c �'� '` rt-, '. ' .•.r �, • s t' "w r .`•+ ff • • _ �. • to i .. P1�„ Q �., � `o C4nnnw�- }� ���, Tuu �a�' � � � � R � � � Wvh� o i � � I ��7 �37 � - �fa33 I �• leak lokafor> GATE OF TEST � 1 t GREAT.VALLEY A4AKW`A+Y7,.,SUITE V f6 , -''TEST;..; , .• '' d� • c�� r I E PA 19355 } /• w _ CONTRACT NUM?ER t. i_296-7380 800-523.4370 :1' •RESUL�',S1 • ,!'' ISTOMER. }• ,.�',!' ^~'.1r.i• :,'''• ', i' i ;'' •it4i i.''• lei )CATION—IDENTIFI ATION NUMBER y of,. ,, ; '.. 'iti�'iXl c:r• 'NAi;;E "' r ''!"1''`'F a� .v..., I'.it 'Lii` 1•id , )DRESS CIT a .�. STATE. •1 V f.. TEST RESULTS SUMMARY L.aAKLOM USE I ONLY LEA LOKATOR RESULTS' CONCL.10009 SYSTEM TANK SIZE' WATER " K PRODUCT GALLONS DIA/MATL INCHES LCVy[L' ( ,:GnN CONCLUSION RECOMMENDATIONS T9ST TANK SYS Oct .1 j c 1 a I c lei G ; �1 r r• 1 v l3ST/ 'r O I IC' •:.( rryye .r•. THER INFORMATION I / -1 , PRODUCT..L I N E S— HYDROSTATIC PRESSURE TEST RESULTS SYSTEM TYPE OF PUMP PRODUCT ' PRODUCT . MINUTES LOSS LOSS : CONCLUSION/ 1O, PRODUCT REMOTE SUCTION; APPLIED',:., ', ,.APPLIED CC'S •. GPH' '.::. RESULT ..A � n � •. .,� Y,l,y;t i rl,• I 1, .. I,•. ri . ;,. NOTE: On suction systems,NEVER put more than 16'psl on any pumP.System, THER CONTRACTORS,OFFICIALS CUSTOMER REPRESENTATIVES,PFESENT'; ' +1� . ' ' �' '•�'. .. I ... i. ,�,.:.f.111ii�1iV'••%:)i'S" �! 'i ' .. f�,r iL: .. ,• '.� '� u DETAIL-OF,TEST RESULTS I'r' �; : : •,:!. f`a t►_,�i��. MATURE y. LL t T '• a , •. �. 1 •�M►LNSATION' LCAK 11AT1 '!'''••• •''•. J CHFCK T. SYSTE EST TEST TIME �' ,LEAK RATE' �o u 000 NO. LEVEL CLocK ou�ATION .• • il'•. ~ (INCHES) ILOCKTAAT URATIN. CC/pIV CC/MIN A f CC/MIN'• CC/MIN 'OPH 1 •• /I 4.. .'.I` 1& fir. . Z �\ l �zms IV ,. A. LEVEL— INCHES FROM TANK BOTTOM TO TEST LEVEL ALR—'ABSOLUTE LEAK RATE (MEASURED LEAK RATE—TEMPERATNRE COMPENSATIONI'IN GALLONS PER HOUR ' r CONCLUSION— NFPA 329 CRITERION OF S 0.05 GPH IS USED TO CERTIFY'TI.OHTNESS •' ERTIFICATION This Is to certify the%the above deicrlbed lu k iystems livers tested,'6sIng the KUNTE,n ENVIRONMENTAL' . SERVICES, INC. LEAK LOKATOO•liccordlnp to III stenderd operetl�p'procedures,Those Indicated at tight at;full system most the criterlon'istebltshed t?jr'o Niildhal Fire P.rotection•Assoclatltin Pamphlet 329 for Preclslon TolgV9, TESTS CONDUCTED BY CERTIFIED BY TINO SP ALIST I1r CI 31ONATURjE TEST VAN NO, TANK TE :•,.:�' , DAT4i1 . •• '' �'I� vi;�r �1 i •1.r /• ;•' :'I' I ��.l.,� .I..� r, ' •'Y%�� • r �.� �1 � .� � / tea~ 'l •C.. ( t \.�.'L.J�•' 1 • TANK TESTING SPECIALIST * _ NAME TITLE �� i w� ' -� NANE I_OCA IOnt c/o Old Colony Petroleum Co. u m Triple 3 (T-i P.O. Box 835 S� - west Main St: ' 123 Furnace }3rook Parkway dya ini s, Mass. Quincy, Mass. 0216;� BOOK & PAGE--DATE GRAN',''ED A-yiJUITT STORED 37/294 8/1/51 15,500 gallons add'1\ 77/254 1 1/Cb/.,>, 1-3,606 gal lore tanks 250 gallon tanks DATE PAID 1973--March 22 "eir�tt '• i ?r 7W44 Ar,ril 10 a f MA 171975 MAR 101976 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA I -�­ . , X,k��:Ijr4jf�,.:,tt-1-1, - 11 A�, , '.1, , ,,': y, —,e ik'�I��11�1�1 I"� � ,,, ; I m;fl, � � - , � -.I , I, ,.. i.—I., ,,,�5;­�' ��.. "1-1 .- ,N#�� ��.,�,�Z- .�J,I.;,- , . N v , , - , I .��f4 . i­",e­­; I '!,�-- �1�2 C,t. �, e 1�, v,�A, -, , ,,�F', �­ ,f, , --p . . , ­ , . I�.`. �, ,, I­­Z . I . . � . - � . I - . 0�1 ,1�,� ,V�­n,­,, I I . i..", -I , ,41.,� i� 6FtM.77-ri6l:I6 't_Nt. I-i I �� � I I, 1,�,, - ... ,i- I,, I , "' , � e.1 I-t1j; ' il k '' - I 11 , Chad for Tank Sy stems Tig4tfi: , i '"best-, ,­ � 4.11 03-3641:;,, �1141(i7l,17,I.44X�w""I'l�I �. ,Ik­ ­, , 'y i. . -.: n _"v , . , .211 ,� , �,�i� : . . � ,4 � 'ri -,, _., 7,1 , i, 11 ,� _ I 1c, .i I� + . ,�. Y,W, 1 . . 2 -PIP S '.A�_ "" . 'I'll, ,��'�T,�',,- ,," , ­­­­". - I I., . .. i : . � 1 , . , , - 'I'lW�Y�T"�;-0--;.4 . I � . �. ."' .3 *1Q1j' W� '� IN KENT.MOORE CORPORATION TANK TIGHTNESSTESTER 'W , -, * ri � ,", I � I -;:fourolq_�e � � , ," . A --", �' ". I, � . , �, MODEL . ,ii�_,%i,-�-, ;,�� ,� It C,t;3 ,�ki,�,�eil-��,��,,��t�,J,',��",:"I I , ') i I I . - f i". � � 1: ,,,,,,,1�t,-I I a 1111111,I,' , , . � � , ­1 n, . I.. 1 4 1 1 " �, . "Copyright 0 Kent-Moore Corporation 1977 -r ' J, ; ,�ir,�, ,, ", "', � , �,� OTIAU Charts 1 -e ­_� i',: 0- I.. . . � 11 ,Z, "I- .1 .. , , . -1 "�­tii,, -"if— ir I , � . '. , �!,' ,'.,,-r,.,­,'.. . I AVO.. ",� %.�� � i � . �`­' , ,� - . ,. 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I . -. . 1. I . 1 9 .. .I 7 I I - ,, ,;,I I I.1',�,�,i�,,*L. -�,".,� . !eta,t �5­,,`­'93. Uti 11FICAT-JUN-­,!-4`,,'v, ,'; the.-ationak Fire Protection Asociation Pamphlet 329.. 1 � ,q L" I � '*, � ,IJL�­ - :. , q,�� 'i , � - ii., k ; .4 jl;,,Jj�7,I .Ir' E" .� 4'A Protection, , .��L� I . "'s .t - ... _�"'' ,.r.: 'L.:' 1,11 10 ,It,�,,�,� ",I,�-A.l, �111.1, � j,�,r j ;'"' r 113�.,. . I v 1�t,1 `?`��` ' � " ' i��'i'r"�"N: .�..,.i ),�, ,�� -�,�,"::L ­1 .,��j"- - - "�, " , ,t,I I I e.I--I,tw� _j .- 1 ...i,,I! � I�, r. (// .,�o 1' I � ,j, .." . It ,4 1� .;V� ,. i ;, j �L , .. I ,�, " t .,�', ,�A, 11 L , ,!,�, ��' . , . - �� 1� I i A, r, i, .� _� . . "� . .,�";-..,:-, ,I ,.,.1, '. . -I ? ­1�_� -_%1,0� I .It�t LL , . , .",�.f,4:;:,i�t�, ,.­ , 1;1�,�.� ,, �I I� ,.4 _t. ,� ; , ,. - I 11. , . ..;jU, il. �'o , 11 , - ., 9 . I �Dat" ,1"­ ,I . ! , , 1, , . I 4 Y' L yJ, 1. , , . I, , , _ L '�­�"�.�ii, J9_­ .�I � �9 q.��t��',z � ?-.1:,,i, ,-� 9 !, I testing Contra 0 or pony. 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Tme G �i 1st_. ,-9 o aP =:� t C h st :� Ij.0 r : ..:., s s: - Hrt5:SUDD ed<IIV - o. , 1 TT;�< ~fi f r;Mm N lAt'.CITY" # a : t Y �T� ,M �t .,�a.<Y .. §.-i .t- „_- , :F r - - 8 s-!-. - ::A. .._.. �,lY�.t. .e-.: :. �.. {,n-r .zC a.-S: q i.:`h' _^.iS i-.ti 4..."' ._Z. -5 ../.Y(>!ft - S,_ra i Rr1d - 2 _ +�4fl b;. �fl 7 Otfier A ,- x 7 -.,. 3 _ w. . - : ,-:w : y p� sK- .�� ._ xk _. t CkRea n s s, -: _.::.,, x s _. _ _ ..:.. , -n $t1 dig TOtet Galforro. -11 .,.H t TEST :._. ;_ r _< _. ..,, - ;t'- to/eJn. ;:Gallons Ba:Eiee4ir' - C t Y =: L. • , , 5.a':..--..-. .y: .._.,w _ ..,a..- :.ts,-.... 3 .-r-: i, ,,.T�' e, .L,_R ,C tiF- �'4., ,1-.. ��K_,,` ")Y'-'w et�"u'Y -"y rIMWYB.MYBt�r.:VNlIVIH ts.:. -`i 'P,r'_ +i "$-{i= _T+h.,r2"e.__i g '5E- "}'� efi , e"3h:1: -'..•f .,. , 1,.. ti..,a :J ..t..;--+`'` .,.: _ if'"' >> b` .} •C ,,SD. si- .Y' , a- - 0., :,:= � ., Ft1 z. -: __-> s 'invertto _�,: 6eto�e;. �uP fi.; - _. y ;..-� .' ,^ ..-,' -,, .,? - .,:may:_ <,.r r -:: 6i11'u STICK.BEFORE,AN.O",AFTER:"EACH,,;t:OMPARTM.ENT DROP..:nR EACH_:METEREC�.DEL VERY.,QUAN TY _^w ,,. ,,,; , I','ti r. 11 ®-,: A = m f 1 k t 'fill i -:Tank Diameter (uP-- P Pe) A . .,�:z : 'mil X:,= ,- _ Product ul tan o a F - - _ .a M - y "s A -'CONDITI NS'+AN PROCEDURES TO,,TEST%THIS TANK �_. - `VAPOR RECOVERY =' ,;�, 18` SPECI L 0 p ,e., m `r "e See': anuaksee4rons i Plrca --. MWWRYm -and�cord<.prgcedure-rn-log:(26},, - _„, s sa a p a '� g s - „o" r _r: a _r- bi v _Lin 5<h in .t ted wifh LVLLT:- Sta ii. - ; m ---: :: ::Water in;tank Hrgh meter teble an tank exca anon Q es stage Q Q ;_- - -. ec ) g �. t ,�w'Z.mT y, an n ' r � _ - -,q -::, ;4, x - 21 x:T€MPERATURE/VOLUME'FACTOR a ''T0'.TEST THIS:TANK '.: A' r.:.. ...Pc) - :_ , - ]9: TANK MEASUREMENTS_fOR rt. . . I ) ' .,,-' --. - ,.`:i,.,,, ,y-.War,, 0 D" Colder?❑—°-F Product in Tank F Fill-up Product on Truck'-- F Expected Change('+ or ) �`� TSTT.ASSEMBLY D t - - O m - �'n _ _ _ tz ,, , , ., . , �, „_ ,-Bottom of tank to Grade P ' _, m 2Z Thermal-Sensor reading after'circulation - °F ^ i ' -. ® � a Y9 I m< ` Add 30-for 4 f _ dtgns' _ 1. Nearest x - -,. 1- _ r. ;r _ r ,a ro,-m =Add.24"for a -or;arr leaf _ is z3 Di it r°F'in range of expected change _ = 9I�Pe M� ! �,- .a; s<,,-..2n- ., .: -,,r f,:,r .-.<.< s'-.,x s2., .. -- _ - - dtgAs_ _ - .a x.w_ :Total tubrn _to assembte'<A - �__` C -,9 pPTOXttrW�B. _ f::. rs s?.: r �Ij " -^ :.,_ - 06, " r -4 24 x T gallons s 1 0 20 a EXT!N.SI�N;Ii():SE $ETTiNG ,:. 4h- tank o _ ,;,, :` total quantity m _'coefficient of expansion for`: volume change in _ - �..o, r;,,. 3' u Tank•top to_grade >: .. w_ r< full: o1.r.17 involved ucY' `F i -- .,,.:a� r. .1,. w. x' tank: 16 ) Prod PC►. +.�.--,,, ate..:_� :::::ERf ah-9e'.'Vft, n-: b8,$!`. -.o r8 �t .-.., a.s,. �:. R ,:�^^r. - ? -Lx s z., enA 0 , .., trr. ^br�rtw __ 4.. . y �.:a , - 2 :F ,. 2. < -- 3 r .F.__:Tq± ,.-, '�...:;-:.>, ''s`., ..n_> -,r , 'd 31?, .: r-:'la .tea- :,r'- - ,,> a .s :::* ",.r!, -.,, . .. :o ., ,,below.,tan ,Io ,. - ,.-: ,�-�"...'^`s. ,'.A' ,. '4{ ." - VJ P, K . • �� -' ftFe 3s __... „_.. — � x µ -1 � �•4 g a N ,,, ,: _, .,. er-F D its r"F-a _te Vofgme::cha a er.drgrt ... r�srQ�ume change P (24) '`; 19 pe ng-, strK x:_ .r. _:,, r_ a r fi x a ` n P, le ",- r.;:_:If-rR r: ezt dstabove f4rtl _: �..m v r•:: i t F ri 4. i/nal IaCE3 a t _. -..._ P PB, 8rE gwde,yse- -o n ._. ., r t , Ra ge r 23); Co nptite>to. deC p facia►j ) .. .yam �.. - - - � < ,,. i - : r "L -Vim;_ : ,-, _,-: -,_:,.-" ...,.. <;- ,-. r :.�-'.:.. . , s. - r:. r�`F ;: w r.,: . _ j < 4" T O .- NET, O,LUME a'.: _ s «:� �,: L. x - 1IdEAS .i TEpPERIfsURE`COYI'f]fSs610N fi ACCUMULATC<I. :, .. 1*-,.,_.a r a... 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FILL-UP-FOR"TEST' s_ Stick Readings - .Total Ga loos �. :; ._,•_ `� # ct� /e in "Gallons -- • mg • � � .. - ,. to ^ea Reading -Stick Water Bottom _ ,~ a zxs ra, a .:before Fill-up 4 - Inventory, r : to Ye 1n.s - Gallons j 0 Fill up.STICK BEFORE AND AFTER EACH-COMPARTMENT DROP OR EACH METERED DELIVERY QUANTITY3oi A. _ 0 -Tank Diameter s� a aI �z e1 `D Product in full tank(up to fill pipe) - d L� 18. SPECIAL CONDITIONS`AND.PROCEDURES TO:TEST THIS-TANK VAPOR RECOVERY SYSTEM I -M u �. See:manual sections-applicable.Check below and record procedure in log(26) Stage ! : °•m P Water in tank."- El High_water-table in tank excavation F -Line(sy:tieing tested with LVLLT Stage 11 - - - W. w j 71 - 21 •.TEMPERATURE/VOLUME FACTOR (a) TO TEST THIS TANK _ 19. TANK MEASUREMENTS FOR - ' Is Today Warmer?O Colder?D—°F Product in Tank_°F Fill-up Product on Truck °F Expected Change ( + or - ) I TSTT ASSEMBLY 11. O Bottom of tank to Grade* a .J M 22.. Thermal-Sensor reading after circulation Q °F x i►t Add 30"for 4"L ....... digits Nearest ro m Add 24 for 3"L or air seal 23- " Digits per°F In range of expected change 3.7 3 " n Total.tubin to assemble A a ` digits. 9 proximal" .. r 20. EXTENSION'HOSE SETTING 24 V� x �l ('� - t2 Q1 -'w�f e g -total quantity.m coefficient of expansion for volume change in this tank rn_ Tank top to grade` ... -............................. tank(16 or 17) involved product per F '. full g - _. allons ' -Extend hose on suction tube 6 or more -,' '- - ...below tank top ....:.` ....., _ '- - 3.1 'a .Q(/ % - r is °F Volume-change per dr t test is volume change per°F(24). Digits per in testgi �1 If Fill pipe extends above grade,use top of fill ange(23) - Compute to 4 decimal places: factor(a) i 26" HYDROSTATIC 31 34. 38.NET VOLUME 39. f R t YOLUIIE MEASUREMENTS(h TEMPERATURE COMPENSATION 4 ACCUMULATED _ LOG OF TEST PROCEDURES x ,. `PRESSURE RECORD TO.001 GAL., USE FACTDR(a)^ CHANGES' CHANGE ..CONTROL, EACH READING .- 2'7. ` 28. 29 Sliaridpipe Level 35. 36. 37. Temperature At Hi tonal record e, •, .Produetm - Product + r DATE RecDrd details Df Setting up - � in Inches . Change Computation - Adjustmant Total End Deflection ' j 32� Graduate Replaced( Thermal,. Hi her and.running test.(Use-full De= r9. g ICY- (a) volume Minus length Of line if Deeded.). 8egximnp a Level to Lower;-. Expansion+ :5 ,:Expansion(+)or• 'At Lor larehcttmpute _ i , ^r of =which - Before ' After. Product - .:fleadin9�' (c)'- traction- ntraction -`.ChaZge pa;Nour f '> Readin f. 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'�r' - i 'b'£-z- ^c' L.r- ..;4b=:, =*a:'_` - .25�+,�.' d. .�.. ;"�•• '{�_ �'� - :.=s -9•� :'�`."" �� �r�R:-r' �� .`�'# - ` -: -' +- `' �.r..rr y y c" ;,`JS .�n`"k'�Sy�+�.:L :+Y`F'�,'::s� '`.4• <N - `�` {"N :�4.- �;:.,,• .,�4r<- __ ..�`'k?. -;;� �r Asa �'�- - i� .L:.r..'. >wiL':'ebY_. kk�;M �n1' �'x'R,Y�s 1 9Wes.ty M ntsy=:.; 6 {ft6 P �E F1E P { 1 i r i i I TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM r NAME OF FIRM: :5� � MAILING ADDRESS: ?jd�i L�L,�,-_e '�` ��` 1#7 TELEPHONE NUMBER: -7 7 CONTACT PERSON: �4.4 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: 100 4),;5t S'*f TELEPHONE: y � ' 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)w Refrigerants Automatic transmission fluid Pesticides (insecticides, Engine and .Radiator. flu,shes herbicides,rodenticides) Hydraulic fluid (including brake fluid) Photochemicals i/ Motor oils/waste oils Printing. Ink Gasoline, Jet fuel Wood preservatives Diesel fuel, Kerosene, #2 heating oil (creosote) Other petroleum products: grease,lubricants Swimming Pool chlorine 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 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 III Paint brush cleaners chloroform, formaldehyde, i Floor & Furniture strippers _ hydrochloric acid, other Metal polishes acids) Laundry soil & stain removers(including bleach) Other products not listed Spot removers & cleaning fluids which you feel may betoxic or hazardous (please (dry cleaners) Other cleaning solvents list) :, Bug and tar removers � � � � I � E ® ,�- ►tee ram` � HEALTH DEPT. 1 Household cleansers, oven cleaner��sj OF QARNSTASLE �,tc�v.,S ' & � % Drain cleaners Toilet cleaners Cesspool cleaners � f-;- Disinfectants Road Salt (Halite) ��.� V AY V4 ��` 10 TOWN OF BARNSTABLE BOARD OF HEALTH CONTROL OF TOXIC AND HAZARDOUS MATERIALS - INSPECTION SHEET FIRM Aw, Al U o r ADDRES-&':.. Major types of materials:, 1) /,� 2) 3) a) ,/� s) 6) I. Description of materials) 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 V/or•# Remarks/Recommendations 1. Indoor - a) separate, contained room , b) stored-in.general work area -i) inadequate ventilation ,. — _. ii)-.floor drains Hi)- inadequate fire protection 2. Outdoor " )a uncovered, exposed to weather ti) ,pervious_surface/cat;chX15asihs 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 f IV b) address or disposal site Person(s) Interviewe _ nspectox/ �' ��' Dates/ �� _�f/ — — — — — TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: 0�a6 ��'� Board of Health MAILING ADDRESS: y ,� '°;f -i2 Town of Barnstable TELEPHONE NUMBER: 7 ,9 P.O. Box 534 CONTACT PERSON: ��e 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 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 Please put a check beside each product that you store: ?< Antifreeze (for gasoline or coolant systems) Drain cleaners 22 Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) e, Disinfectants ;L Motor oils/waste oils _ Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil , Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine L 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, Laundy 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 c Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 2. nters BOARD OF HEALTH O satisfactory 3.Auto Body Shops O unsatisfactory- 4.Manufacturers C0MPANYZ ,g� .10/, (see"Orders") 5.Retail Stores J ^ 6.Fuel Suppliers ADDRESS % �12YAta•.� Class: 7.Miscellaneous a� QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) IAL MAJOR MATE S Case lots Drums Above Tanks Underground Tanks IN OUT IN OUTI IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel(A) Diesel Kerosene #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) .s.rr transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: I ; •Q � :� DISPOSAIJRECLAMATIO REMARKS: 1. Sanitary Sewage 2.Water Supply 4 e Town Sewer ,Public ' O On-site OPrivate 3. Indoor Floor Drains YES / NO tJ O Holding tank: MDC ( O Catch basin/Dry well ` O On-site system 4. Outdoor Surface drains:YES_NO O DERS: O Holding tank:MDC. O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO Person (s) Interviewed I spect r Da e Date: l TOWN OF BARNSTABLE Re �'t TOXIC AND HAZARDOUS MATERIALS ON-SITE 1118 NAME OF BUSINESS: OhIV `5 ,qY0 ,5 e-Xvr°e11 BUSINESS LOCATION: �� �(/' ,�c�r I' �,��v�r� INVENTORY MAILING ADDRESS: , , r' TOTAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON: TO h Al02f1/-1 EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: q_h%C "rti S DP.�l 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) 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 products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) ,e r` loet , 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 Initia s ,M,a,c-Okv, 05 '7210 2,1 ov TOWN OF BARNSTABLE Date: J�/►� /r3 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: BUSINESS LOCATION: 3a(o Wesf JVIalyt 6-- nvt INVENTORY MAILING ADDRESS: /Vo+ -lo-Ar of v�-- ? �o a�t� � ,ll�i�mt�e� - l Q�'-�' n TOTAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON: ----mra EMERGENCY CONTACT ELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: 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) 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 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 TOWN OF BARNSTABLE Date: 1 P-7 /13 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: -75,5�y 5 8- ,A ,., Se<-,I,ce— BUSINESS LOCATION: INVENTORY MAILING ADDRESS: Mon� ,�,V`. ? M TOTAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON: /PAb, �- -- EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: INFORMATION / RECOMMENDATIONS: Fire District: f Waste Transportation: Last shipment of hazardous waste: j 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) 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 Photo:�hemicals (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 Printirg ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Misceilaneous Combustible Car wash detergents Leather dyes All Car waxes and polishes Fertilizers Asphalt&roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, _ Lacquer thinners (includi6g carbon-tetrachloride)_ t ❑ NEW ❑ USED Any ocher products with "poison" labels (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 • r YOU WISH TO OPEN A BUSINESS? For Your, Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st FI., 367 Main St_, Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: ( Fill in please: [f istq,iti �r APPLICANT'S YOUR NAME/S: ©Z BUSINESS YOUR HOME ADDRESS: p 1 40 j 'Orr ° y1 TELEPHONE # Home Telephone Number Xu NAME OF CORPORATION ss NAME OF NEW BUSINESS . f? .e,� TYPE OFBUSINESS r.f/ E� ;, /✓ IS THIS A HOME OCCUPATIO � YES NO- .� ADDRESS OF 13lJSINESS G MAP/PARCEL NUMBER [Assessing)' When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 M in St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate y uP business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 2. BOARD OF HEALTH This individual ha beernp or e of the permit requirements that pertain to this type of business. MUST w�©MPLY WITH ALL j J.f T Authorized Signature** '4,7ARDUUS MATERIAL S REGLiLAT!r I COMMENTS: - 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has beer infor t e licensing requirements that pertain to this type of business. COMMENTS: �oAuthori tii Date: �/ �/ 13 TOWN OF 13ARNSTAI3LE-,,, ,,-�.,OJ,— TOXIC AND HAZARDOUS MATERIALS RE 31STRA-TtON FORM NAME OF BUSINESS: Sgvcv- BUSINESS LOCATION: r326 oes{' INVENTORY MAILING ADDRESS: ,54,E TOTAL AMOUNT: TELEPHONE NUMBER: .-o$ 7-76 Y12-y a CONTACT PERSON: et EMERGENCY CONTACT TEL16PHONE NUMBER: 72(. 2.700 MSDS ON SITE? TYPE OF BUSINESS: (�%-a-S S�-a ion INFORMATION / RECOMMENDATIONS: /{4;9-,4A, r01A)KJs {o Fire District: c'e ail 6aIe- aptly. /Udf-,i. u5z bv s-ta_qC oYc- safe . cal, SLY ono by S lI ezH y7— ,P /a n s 4o -re.-o�e►.L Waste Transportation: o OAS�e - 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) 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 Ly"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 products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes f(0 ayLe- �/S ��S o rsa.lo-P— f� Laundry soil &stain removers Q (including bleach) a�-��Q V• 6- - r2 ,Mafs�1, Spot removers&cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers J2 Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials Number Fee 47 THE COMMONWEALTH OF MASSACHUSETTS $o.00 Town of Barnstable Board of Health This is to Certify that Savon Gas 326 West Main Street, Hyannis,MA 02601 Is Hereby Granted a License 61 FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. (�l -------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 6/30/2013 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2012 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health I ' Town of Barnstable oFVE Regulatory Services tia Thomas F. Geiier, Director RAAN '. i Public Health DivisionDivisiony$ iMnSS.63s95. � Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-46a4 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERlYI r TO STORE AND/OR UTILIZE MORE TE AN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABL7SE = 111 r ta(1 (�v and n WDA,� ADDRESS OF ESTABLISB31ENT I-310 W �' a f TELEPHONE NUMBER SOLE OWNER: YES NO IF APRLICA 7T IS A Pr TNERSHIP,FULL NAME AND HOIYIE ADDRESS OF ALL PARTNERS: IF APP-EICAN;T IS A Co.RPORATION: FEDERAL IDENTIFICATION NO-.a�6 � STATE OF LNCORPORATION; FULL NAME AND HOME ADDRESS OF: PRESIDENT QUA h) LS O & . TREASDRER CLERK SIGNATURE OF APPLICANT RESTRICTI ONS: HOME ADDRESS I HOME TELEPHONE# Haz.doc/wp/q n MAIL-IN REQUESTS Please mail the completed application form to the address below. In addition, please include the required fee amount. Make check payable to: Town of Barnstable. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. In addition, you must mail the required fee amount (see fees at bottom of this page). Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. For further assistance on any item above, call (508) 862-4644 i i i I i I