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HomeMy WebLinkAbout4418 FALMOUTH ROAD/RTE 28 - Health (3) ���� a 0 w�. TO N -OF BARNSTABLELot ANCE: CLASS: 1. Marine,Gas Stations,Repai.r factory 2. Printers BOARD F H E LT 3. Auto Body Shops isfactory- 4. Manufacturers' COMPANYr;^,.'„�Y __.a� (see"Orders") 5. Retail Stores 6. Fuel Suppliers ADDRESS Class: !_-_ 7. Miscellaneous QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums Above'ranks Underground Tanks fIN 19QUIT IIN IOUT ( INIOUT # & zallonse rest? Fuels: Gasoline, _Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: i �- waste motor oil (C) new motor oil �1 transmission/hydraulic 10 Synthetic Organics: i degreasers Miscellaneous: DISPOSAL RECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply O To Sewer �!�ub On-site Private 3. Indoor Floor Drains: YES NO' _ 4 Holding tank: MDC O Catch basin/Dry well �!V qOn-site system 4. Outdoor urface drains:YES NC \1 _ `c ,; Holding tank: OCatch basin/Dry well OOn-site system m _ `r ec" t;�= S. Waste Transporter Licensed? Name of Hauler. Destination .late Product 1. 1 ✓lr:�s+ate{:4a�r.;� I ..A?``PI'�r Fit?✓--+. ! - f:4r, C/ ,.. C?�J/ ��' i2 e� Person(s) Interviewed Inspector Date TOV � `RRSTABLl IL':"- - CI�iASS. 1': ilalllft:jva� :utoLivita, .arcaaa V . r L}\)�` k 2. Printers r " , actoBOARD OF HEALTH r'' ?`S. ,Auto Body Shops sfactory- 4: Manufacturers COMPANY --'�1- "�'L•. "� ee"Orders") S. Retail Stores 41 ' /' t 6. Fuel Suppliers ADDRESS ( C . � r Class: 7. Miscellaneous QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors MAJOR MATERIALS Case lots Drums AbOveTanks Underground Tanks IN 10DUT IN OUT IN UT N 6 zEllonse Test Fuels: Gasoline, Jet Fuel (A) Diesel, Kerosene, N2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) {� transmission/hydraulic Synthetic Organics: 1 degreasers ! U Miscellaneous: DISPOSAL RECLAMATION REWtRKS• . 1. Sanitary Sewage 2. Water Supply OTown Sewer ublic On-site Private --— 3. Indoor Floor Drains: YES NO XI ' _ V Holding tank: MDC — OCatch basin/Dry well ---_-M - --'-- _ On-site systemOR 4. Outdoor Surface drains:YES 11 O it Holding• tank: MDC �b il O Catch basin/Dry well _ - 0 On-site system �� ?� �. , ) .' f S. Waste Transporter P 1 Licensed? Name of Hauler A&sti_nafinn--- a to Prodh� YES NO' 1. - hr-? _ c e s' r i e ' u e•23 ei /) nspecto a TOWN ' OF BARNSTABLE O1+PLIANCe: CLASS 1. tlarine,Gas Stations,REpal. satisfactory 2. Printers KKR [� Or -ICALTI-1 3. (auto rod Shops m unsatisfactory- 4. lanufact rers COMPANY �S (see"Orders") S, Retal.l Stores 6. Fuel Suppliers ADDRESS � Class: _ 7. Miscellaneous U 1 QUANTITIES AND STORAGE (IN=indoors; OUTsoutdoor MAJOR IUITERIALS•• Case lots Drums AbUveTanks Undetgrofind Tanks N 6 Rt 1long- Affe. Cs.�! Fuels: • Gasoline, Jet Fuel (A) . Diesel, Kerosene, 02 -(D) ' heavy Oils: el_.. • 'waste motor oil - (C) new motor oil. (C) transmission/hydraulic -Synthetic Organics: degreasers Miscellaneous: I ISPOSAL REC , ti T O REMUS: 1. "Sanitary Sewage 2. Water Supply .0 Town Sewer O Public On.-:Site _. 0 Q Private 3. Indoor Floor Drains: YES NO Q holding tank: MDC • . O Catch basin/pry well 0 On-site system Fjj1_ nor -r �~ 4. Outdoor Surface drains:YES NO � I b O lluldin& tank: MDC J�/—�¢� Q Catch basin/Dry well C� OOn-site system S. Waste Transporter Licensed? al: M _Destination_ Haste Produc. No . . 1 UZ o O 0 _. IN, u �� ersj interviewed nspector, e _ __. TOWN'' OF BARNSTABLE OMPLIANCH: CLASS 1. tlarine,Gas StationsoRFpai.r satisfactory 2. PP/rintersyy MR D OF= HEALTI-I q: Flanufecti�reIrsps • �,�, n ® Qunsatlsfactory- COMPANY lam/ 3 (see"Orders, so Retail Stores 6, Fuel Suppliers ADD1RBS5 ,.F • ® Class: 7. tit s ce I I aneous U® QUANTITIES AND STORAGB (114=1ndoors; OUTwoutdoor 1 Case- lots Drums AboveTanks Undetgro[:od Tanks MAJOR tIATBRIALS-• I QUT N B gallons rAM Vol Fuels: • Gasoline, Jet Fuel (A) Diesel, Kerosene, 12 (B) ' Heavy Oils: TO waste motor oil (C) new motor oil- (C) transmission/hydraulic '-synthetic Organics: degreasers _:._ • Miscellaneous: ISPOSAL RCC , M T ON REtf�.RKSi 1. 'Sanitary Sewage 2. Water Supply OTown Sewer O Public ®, - Q On--:site 0 Private 3. Indoor Floor Drains: YES N0_�- ��,,____�_,r _ Q lfolding tank: MDC Catch basin/Dry well On-site system -� 4. Outdoor Surface drains:YES NO �•- 'ANT A N�V{) Q UuldinL tank: MDC �j '/ 7 r� �� QCatch basin/Dry well QOn-site system S. Waste Transporter Licensed? auLar- cL. VC _HQ_ l © ® f --- u �� ers n Int.ery ewe Inspector. D e TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1. Marine,Gas Stations,RFpai.r Q s�sfactory 2. Printers BOARD OF HEALTH 3. Auto Body Shops Ou.nsatisfactory- 4. Manufacturers - see"Orders" 5, Retail Stores COMPANY 1 _�-�� C `� " , _ . \ ( ) 6. Fuel Suppliers ADDRESS - [- ` Class: � 7. Miscellaneous QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) . MAJOR MATERIALS Case lots Drums AboveTanks Underground Tanks IN UT IN IOUT IN OUT gallons Agerest? Fuels: Gasoline, Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: ; waste motor oil (C) + new motor oil transmission/hydraulic��E Synthetic Organics: degreasers i t ! Miscellaneous: DISPOSAL RECLAYA- TION REW RKS: 1. Sanitary Sewage 2. Water Supply 0To Sewer 0 Public - 0 On-site rivate 3. Indoor Floor Drains: YES N0 _ O Holding tank: MDC OCatch basin/Dry well _._____.__._...__......__.-_..__. _...._.._.� ._.._ ._._._ 0 On-site system f � 4. Outdoor Surface drains-YES NO Holding tank: MDC 10 ---- v Catch basin/Dry well c I OOn-site system S. Waste 'Transporter f . Licensed? Name of Hauler. C Destination I � Ylaste\Product YES NO 12 23 81 Person(s) Interviewed Inspector Date C_ I�WN 01. BARNJ�+/�1�L�T . 2. Printers Q satisfactory. , 3. �uto Body Shops BOARD OF HEALTH satisfactory- 4. Manufacturers � tt Retall Stores CU6fPA ^^ � - - Y-- -- ^' (see"Orders") S. Fuel Suppliers 1 �-� 7. Miscellaneous ADDRESS a) ,i� !j Class. r` UANT TIES AND S70RAGH (IN=indoors; OUT=outdooi r �1`•T" Q MAJOR FIATERIALS Case lots Drums AbOveTanks Undetgroued Tanks 1N U r OUC II 6 gellons 9g_e_ Fuels: ' Gasoline, Jet Fuel (A) ' fuel, Kerosene, 12 (D) � "flea LY Oils: traste motor oil (C) f` new motor oil (C) transmission/hydraulic Synthetic Organics: ; ti degreasers — Miscellaneous: i UISPUSAL REC�N' 'f UN REWXKS: 1. Sanitary Sewage 2. Water Supply O Town Sewer ublic p i --� On-site 0 Private � 't •3. I door Floor Drains: YES __ no _ Q Holding tank: MUC - OCatch basin/Dry well IWE _-.��_..._. __._._ _.... ... - On-site system 4. Outdoor Surface drains:YE5 NO, ' . Holding- tank: MUC VW O Catch basin/Dry well - On-site system .r. • • .• � Licensed? S. Waste Transporter Prods ' dame of Hauler_ ties ination _ Wncte �t *� u � 01 sci 1 fifer eNe Inspector Date N OF BA R N STA B L E' COMPLIANCE: CLASS 1. Marine,Gas Stations,RFpai.r .O satisfactory 2. Printers BOA R D OF HEALTH 3. Auto Body Shops , Q unsatisfactory- 4. Manufacturers CQMPANY :, z (see"Orders") .5. Retail Stores 6. Fuel Suppliers. ADDRESS Class: 7. Miscellaneous QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums AbdveTanks Undetground Tanks IN IDUT IN IOUT f IN IOUT gallonsAverest? Fuels: -- Gasoline, Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (�) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: DISPOSAL RECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply C) Town Sewer OOn-site. Q Private 3. Indoor Floor Drains: YES NO 4 Holding tank: MDC O Catch basin/Dry wellOR On-site systemEi "- !` 4. Outdoor Surface drains:YES NO Q Holding tank: MDC Q Catch basin/Dry well OOn-site system ---- S. Waste Transporter ' Licensed? Name of Hauler. Desti na inn ,, a to ProdUct YES NO 1{ - 12 2j el Persons Interviewe ` . Inspector Date �O} � BA.RNSTABLE COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repai.r .. .......... 2. Printers .isfactery --__.. BOARD OF HEALTH 3. Auto Body Shops unsatisfactory- 4. Manufacturers _ COMPANY JGO (see"Orders") S. Retail Stores 6. Fuel S�upFliers `.DDRESS��jaZ „ Class: 7. Miscellaneous QUANTITIES AND STORAGE (IN=indoors; OUT=autdcorsl MAJOR MA7ERLALS HCaseots Drums AboveTanks Undeigrouad Tanks N QLrr IN IOUT IN tOUT # 2 I lons A eTest? Fuels: ( t� i•�0 \ 6 Gasoline, Jet Fuel (A) � 00-0 Diesel, Kerosene, #2 (B) i I Heavy Oils: waste motor oil (C) I f new motor oil (C) transmission/hydraulic <_'� Synthetic Organics: _ degreasers I !4i Miscellaneous: I DISPOSAL RECL.A°%AT 1. Sanitary wage 2. Water S y �� O c p wee Town Sewer Public ® On-site ® Private — 1. Indoor Floor Drains: YES ill,,'0 0 Holding tank: MDC 2— S.k& Q-Catch 'basin/Dry well On-site system ° 4. Qutdocr Surface drains:YES NC 0 Holding tank: MC Catch basin/Dry well +►" Ct rnu _jAv.- w4' nuxs , On-site system jir,��► �. r �5 u1GS + � _ �—�-_--- S. -Waste Transporter ° " con �ar4- to t �� �" s ' 1,aust vx s- ¢ �(-o,n"� i .,` Licen�ed': Name of Hauler -Waste Product_ y- 1. t _ L' 23 81 Perso Int.e &wed Inspector Date .; z, COMfPLIANCE: CLASS , ,,1, M ' ine,Gas-Stations,Repai.r FOWN OF BARNST�+ � LE 2. Printers satisfactory 3. Auto Body Shops BOARD OF .HEALTH unsatisfactory- 4. Manufacturers (see"Orders") S. Retail Stores COMPANY 4 6. Fuel Suppliers ADDRESSJ. .Class:_______ 7. Miscellaneous QUANTITIES AND STORAGE (IN=indocrs; OUT=outdoors) Case lots Drums ' AboveTanks Undetgtound Tanks MAJOR MATERIALS 1N UT IN O I # 21 erest? Fuels: i� Gasoline, Jet Fuel (A) ►� uZD Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) 3))L V__A� new motor oil (C) . transmission/hydraulic Synthetic Organics: degreasers r Miscel 'ariep s:. DiS,POEAL RECLAMATION REW,RKS:, I.;. Sanitary Sewage 2. Water upply JaTown Sewer blic Rv*t on-site Private 3. ,IJ door Floor Drains: YES NO - Holding tank: MD I ` Catch basin/Dry, well ------ .._. ..----- _._--- . - ---- — -site s !I On stem y 4. Outdoor Surface drains:YES NC 0 'HoldinL• tank: MDC . 0. cat*6 basin/Dry well .�. ---------- C ...On-site asystem -_ —. - - -------- ------ }, Y; i censed? L S. Waste Transporter YES , - -""'ii nect i nati nn Waste- rodur.L erson(s) Int.erviewe ector Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM .�,� Mail To: NAME OF BUSINESS: * Board of Health MAILING ADDRESS: / 1 '`� Town of Barnstable TELEPHONE NUMBER: 1C - 1 - P.O. Box 534 CONTACT PERSON: -��� w " � 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 quaptities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES ??// NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored i Please put a check beside each product that you store: i JJ 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) 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 Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH O satisfactory 2.3nters .Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY A� (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS a � Class: � 7.Miscellaneous RW 46ANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT ro llons Age Test Fuels: � Gasoline,Jet-F } Diesel:_Yrar e ,#2 (B) /0 Heavy Oils: waste motor oil (C) /,d new motor oil (C) s�G'g L transmission/hydraulic.. Synthetic Organics: 4 de easers Miscellaneous: DISPOSAIJRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply awv 0 Town Sewer tPublic frOn-site OPrivate 3. Indoor Floor Drains YES NO ��y 0 Holding tank: MDC O Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES d ` NO OI RS: O Holding tank:MDC cJ Catch basin/Dry wellyL—lJ 0 On-site system �/ ?�l .Q 5. Waste Transporter Name of Hauler Destination Waste Product YES NO S-A�. - Iva a, 2. � f � Person (s) Interviewed Inspec or Date 4 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: _ % if oard of Health MAILING ADDRESS: /2YzS Town of Barnstable TELEPHONE NUMBER: 7 L l �' � P.O. Box 534 t Hyannis, MA 02601 CONTACT PERSON: -, � 52�,f��1 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put a check beside each product that you store: Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid i/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, ke esgne, # -haaating of— 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 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 ,�� � Bug and tar removers _ Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business a�- T TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair O satisfactory 2.Printers -BOARD OF F&LTH 3.Auto Body Shops (, unsatisfactory- 4.Manufacturers COMPANY C (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Class: 7.Miscellaneous UANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: -fit✓� f ihVVb Gasoline, �) L���F-� Diesel, Ken #2 ) 11-/ Heavy Oils: 10V wa to motor oil (C) new motor oil (C) ao transmissiflAydraulic err Synthetic Organics: degreasers Af Miscellaneous: 1 � � �9� S Tali'% ys� DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply 4& L, O Town Sewer Public Yon-site OPrivate 3. Indoor Floor Drains YES_�/NO O Holding tank:MDC �J Catch basin/Dry-well O On-site system 4. Outdoor.Surface drains:YES f1 NO O E S: Q Holding tank:MDC Catch basin/Dry well On-site system 5. Waste Transporter ' Name of Hauler 1 'roduct Lice sed? 2. Person (s) Interviewed Inspector Date r TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 0 satisfactory 2.Printers - BOARD ALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY_" A I (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Class: Z 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Drums Above Tanks Underground IN OUT IN I OUTI IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) .6•14 nevO motor oil (C)4 transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: /Zes 6 cil DISPOSALlRECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply O Town Sewer &Public O On-site OPrivaate 3. Indoor Floor Drains YES Y 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 �Catch basin/Dry well On-site system 5. Waste Transporter Name of Hauler Destination Waste Product YES I NO 2. Person (s) Interviewed Ins ector Date