HomeMy WebLinkAbout0872 MAIN STREET (OST.) - HAZMAT �5 �' AAA
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Qy�ETHE TO�y TOWN OF BARNSTABLE
OFFICE OF
t seaasTsaz& BOARD OF HEALTH
s�0 639 \0�
0R k 367 MAIN STREET
HYANNIS, MASS. 02601
August 14, 1987
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AAA Sani-Services , Flint St.
872 Main Street
Osterville, MA 02655
Dear Mr. Grace:
You are reminded that State regulations require periodic
pumping and - or . cleaning of all MDC traps (Metropolitan
District Commission". gas and oil separator tanks) .
You are directed to contract with a licensed hazardous waste
transporter\contractor to perform the required pumping and or
cleaning of your MDC trap by September 11 , 1987 , or provide
proof of such maintenance performed within the past three
months .
You are further directed to have your MDC trap inspected and
cleaned if necessary, by a licensed hazardous waste
contractor every three months . Written proof from a licensed
contractor will be required.
Inspections will follow by the Health Department to verify
�. compliance.
You are reminded that failure to comply could result in a
fine of $200 . 00 daily under the Town of Barnstable Toxic and
Hazardous Waste By-law.
Very Truly Yours ,
ohn M. Kelly
Director
Barnstable Health Department
A o COMMONWEALTH OF MASSACHUSETTS
r DEPARTMENT OF ENVIRONMENTAL QUALITY ENGINEERING
- DIVISION OF SOLID AND HAZARDOUS WASTE
One Winter Street
��. . Boston, Massachusetts 02108
Please print or type.(Form designed for use on elite It 2-pitch)typewriter.)
UNIFORM HAZARDOUS 1.Generator US EPA ID No. Manifest 2.Page 1 Information in the shaded areas
:� f A,,D9CumantNoy
WASTE MANIFEST Ej ? r yea�_�� 1 "' t.* ; of A Is not required by Federal law.
3.Generator's Name and Mailing Address A State Manifest Document Number
�C4523 `6<,
` B State Gen ID
4.Generator's Phone(61:7 )42 y;F,•f — ------__._-- ------�_--- �
5.Transporter 1, Company Name 6. US EPA 1D Number C.Staie Trans:'ID
CYN OIL CORPORATION IMIA O 10 18 12131013171717
7.Transporter 2 ;'Company Name 8. US EPA ID Number D:'Transporter!s Phone,l •617 sl 344-0265
E.State Trans.ID
I
tV 9. Designated Facility Name and Site Address 10. US EPA ID Number
00 CYN OIL CORPORATION F Transporters Phone( ) r
OP 1771 WASHINGTON STREET G•,State Facility`s ID Not Required `
CN
STOUGHTON, MA 02072 — ! A D 0 8 'L 3 0 3H12.Cont.iners
H.":'Facility's Phone( 617 I 344 0265
It ---- __L_1_1_I
13. 14. 1O 11.US DOT Description(Including Proper Shipping Name,HazardClass,and ID,Vumber) Total Unit Waste No.
00 Type Quantity Wt/Vol
a.
N
a WASTE PETROLEUM OILS N.O.S. COMBUSTIBLE LIQUID NA 1270 0 0 1 T T G M 0 1
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J.Additional
�Dw escnptions+for Materialom s Listed Above,(include,physical state and hazard code.! K Handling Codes for,VUastes Listed'Above
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15.Special Handling Instructions and Additional Information
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a 16.GENERATOR'S CERTIFICATION:I hereby declare that the contents of this consignment are fully and accurately described above by -1
- proper shipping name and are classified,packed,marked,and labeled,and are in all respects in proper condition for transport by highway
O according to applicable international and national government regulations.
U If I am a large quantity generator:I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable
�C and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human health and the environ
ment:OR,if 1 am a small quantity generator,I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I
0) can afford.
E Date
Printed/Typed Name Signature, Month Day Year
w
R1.7..Trans orter` 1 Acknowledgement O
p g ment of Receipt of Materials Date'
to A Printed/Typed Name Si9matureC) N '
Month Day Year
0 16.Transporter 2 Acknowledgement of Receipt of Materials Date
R
E Printed/Typed Name Signature Month Day Year
19.Discrepancy Indication Space
F
A
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I
L 20.Facility Owner or Operator:Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19.
T Date
y Printed/TypedName Signature Month Day Year
GERALD E. MCCARTHY I I I
Form Approved OMB No.2050-0039,Expires 9-30-88
EPA Form 8700-22(Rev.9-86)Previous editions are obsolete.
COPY>8 : GENERATOR-RETAINED BY GENERATOR
r
4 CYN 01L. CORPS ,
.1771 WASHINGTON ST. STOUGHTON. MASS.02072:
(617) 344-02e3•a 1-800-242 881 E- o-
PICKUP171
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TERRITORY-A4y
DRIVER_ � caUi�/� //�r1�
TRUCK NO.—K= .TRAILER NO.'
1501
RECEIVED evlGALS. E G 6 I
RECEIVED FROM'
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TOWN OF BARNSTABLE
UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS
NAME
_. ADDRESS �� /� .J� VILLAGE �vG %�� 'i/LC J�
LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE:
OR CHEMICAL
go r
(Give same information for any additional tanks on reverse side of card)
_ DATE OF PURCHASE OF EACH: 1. 2. — 3. 4.
DATE OF FIRE DEPARTMENT PERMIT:
TESTING CERTIFICATION SUBMITTED:
PASSED DID NOT PASS
ii
A �,r
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TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAME OF FIRM: /4" r �,�j�'�✓�G�J' ���
MAILING ADDRESS: 9�72_ mil/► ,-IV J —, OaoY, ;2d'7, 0 5`/
TELEPHONE NUMBER: -OC�2 � z)r Q f 6
CONTACT PERSON: /phi/ // .i /✓ 6 Yp C �
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 y 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: L10?—
TELEPHONE: IF ya wr o LLr_
LIST OF TOXIC AND HAZARDOUS .MATERIALS
The Board of Health has determined that the following products exhibit toxic
or hazardous characteristics and must be registered when stored in quantities
totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put
a check beside each product that you store:
✓ Antifreeze (for gasline or coolant systems) Refrigerants
Automatic transmission fluid w Pesticides (insecticides,
Engine and Radiator flushes herbicides,rodenticides)
_L,— Hydraulic fluid (including brake fluid) Photochemicals
9/ Motor oils/waste oils Printing Ink
Gasoline, Jet fuel Wood preservatives
�j 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 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
(including bleach) Other products not listed
which you feel may be
Spot removers & cleaning fluids toxic or hazardous (please
(dry cleaners) R E C E I V E ED list. ;
Other cleaning solvents HEALTH DEPT. _
Bug and tar removers TOWN OF BARNSTABLE
Household cleansers, oven cleaners
Drain cleaners
Toilet cleaners
Cesspool cleaners
Disinfectants JUN 1 -1981
Road Salt (Halite)
ens•:::..—__:--_... .�;. ._ _ � �
N OF BARNSTABUE COMPLIANCE: . CLASS:; . Marine,Gas Stations,Repai.r
satisfactory 2• Printers
B • �i R D OF HEALTH ' 3. Auto P.ody Shops
4� ®unsatisfactory- 4. Manufacturers
►MPANY _ .' 11 '�- (see"Orders") S. Retail Stores
°1 "� "� """� -``��`� 6. Fuel Suppliers
'DRESS ; ?;' .f.. f ;r 1,. Class: 7. Miscellaneous
QUANTITIES AND STORAGE (IN=indoors; OUT-outdoors)
JOR MATERIALS Case lots Drums ' Abovel'anks Underground Tanks
1N lff est
Fuels: _ �L -E N a e r ?
r- 7
Gasoline, Jet Fuel (A)
L)
Diesel, Kerosene, 12 (B) r .
Vf
Leavy Oils: ; ��-�' ✓ .���
waste motor oil .. (C) a
new motor".0il (C)
1� transmission/hydraulic _
synthetic;Organics: $ ' ;
degreasers
iscel anequs�: ;
po:AL fiEc IA'riori -RE -� , _
WIRKS. ' <<
. Sanitary Sewage. 2. Water Supply
C) Town Sewer a public
On-site O Private
. .Indoor Floor Drains: YES NO
O Holding tank: MUC
O Catch basin/Dry well
0 On-site system
outdoor Surface drains:YES NO
Holding tank: MUC
0 Catch basin/Dry well
QOn-site system
haste Transporter Licensed?
Name of Ha Iet _besttna ion �'Adur ,
--------------
.,/ Af
Er5 D($.)__ ht.ery ewe _
®1�'�[ ,OF-., , RSVSTARLE
COMPLIANCE: 1. F;arine,Gas St at ions,Repair
Q satisfactory 2. Printers
BOA R'D O != EA LT H 3. Auto Body Shops
Q unsatisfactory- 4. Manufacturers
(see"Orderst S. Retail Stores
COMPANY �,- �v , 6. Fuel Suppliers
ADDRESS Class: 7. Miscellaneous
QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) .
MAJOR MATERIALS Case lots " Drums AboveTanks Undetgrauad Tanks
IN IDUT, IIN IOUT I IN IOUT izallons Aee
Fuels:
Gasoline, Jet Fuel (A)
f
Diesel, Kerosene, #2 (B)
G-`
Heavy Oils:
waste -motor oil (C)
new motor oil (C)
transmission/hydraulic
Synthetic Organics: 7
degreasers
Miscellaneous:
DISPOSAL RECLAMATION REMkkKS:
1. Sanitary Sewage 2. Water Supply
OTo ewer ® Public
-site rivate
3. Indoc oar Drains: YES, NO
Holding tank:
® Catch basin/Dry wellORDE
On-site system ` c C�
4. Outdoor Surface drains:.YES NC
Holding tank: MDC
® Catch basin/Dry well
® On-site system _
S. Waste .Transporter Licensed?
Name of Hauler. Destina ion Waste Product YESi NO
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sz .r3 si - -. '-- ' ' 77. Inspector ate` .
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