HomeMy WebLinkAbout1031 MAIN STREET (OST.) - HAZMAT 2
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAME .OF FIRM: Cazeault Roofing, Inc.
MAILING ADDRESS: 1031 Main Street, Box 239 a \��,
TELEPHONE NUMBER: 428 6812
CONTACT PERSON: Richard P. Cazeault, President
Does your firm store any of the toxic or- hazardous materials- liste&b`eibw,
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 X NO
This form must be returned to the Board of Health regardless of a YES or NO f
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 i
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:
i
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
XGasoline, Jet fuel Wood preservatives li
-�-'�-- , 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
Car wash detergents outdoors)
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
list.,;:
Other cleaning solvents HEALTH D'
Bug and tar removers TOWN OF BARNSIABLE
Household cleansers, oven cleaners
Drain cleaners i
Toilet cleaners
Cesspool cleaners
Disinfectants MAY .1 4 1981
Road Salt (Halite)
T
TOWN OF BARNSTABLE
BOARD OF HEALTH
CONTA L,19F TOt IC AND HAZARDOUS MATERIALS - INSPECTION SHEET
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FIRM ,F
ADDRESS
Major types of materials: 1) 2) 3)
a s) 6)
I. Description of material(s) use: a.@
II. Storage (denote product by number listed above)
A. Containers
me 1 la plastic
cans,bottles,jars
drums,barrels
aboveground tanks 0 1
underground tanks ,.-
bags,boxes
open,loose,uncovered
inadequate labelling
B. Storage Facility ✓or # Remarks/Recommen ions
1. Indoor
a) separatb, contained room -
b) stored in general work area
i) inadequate ventilation
ii) floor drains 0 dtr ! Gut
iii) inadequate fire protection �
1p
2. Outdoor ,
a) uncovered, exposed to weather
b) pervious surface/catch basins U " °
III. .Disposal .
A. Reclamation/Recycling unit
B. On-site disposal M�
1. Town sewer
d� 'Q
2. Regular septic system
3. Separate holding tank
C. Off-site disposal `'
1, hauled by own firmto
2, hired hauler
a) name of hauler
b) address or disposal site
r - ` r
Pers s Interviewed / �"`f off( ) ,rviewed — — — — — — — Inspector
Date
rU\ N__0F� K(�RNSTA1E— Isee"Orders")
t.a,.a
Y Y 1�1V1V/11 1 \ Q satisctory 2• Printers
BOARD OF HEALTH 3. Auto Body Shops
tQnsatfactory- 4. Manufacturers
`/ { --dt< �'t ( S. Retail Stores
COMPANY x� - 6. Fuel Suppliers
ADDRESS Class: 7. Miscellaneous
QUANT TIES AND STORAGE (IN=indoors; OUT=outdoor:
MAJOR MATERIALS' Case lots Drums AboveTanks Underground Tanks
IN OUT IN IOUT IN IOUT al n e est
Fuels: -
Gasoline, Jet Fuel (A) t f;
•Diesel, Kerosene, #2 (B) /
Heavy Oils:
waste motor oil (C)
. new motor oil (C) �5
'a
transmission/hydrauli�,c
Synthetic Organics. !
degreasers
�
Miscellaneous:
DISPOSAL RECLAMATION REW, S:
1. Sanitary Sewage 2. Water Supply. _...
OTown Sewer Public
On-site
Private
3. ndoor Floor Drains: Y NO
O Holding tank: MDC
O Catch basin/Dry well _
On-site system
rr-
4. Outdoor Surface drains:YES N .
- ,
Q Holding tank: MDC
r.
O Catch basin/Dry well
OOn-site system
S W"te Transportericensed
Name of Hauler_ Dd�st i nat i or �/t�lt.C.. ��"a e prodlirt .
' L
12 23ei �•I c Eor Date